There is a trackphenomenon in the development of hypertension and pediatric hypertension has an important predictive value for adult hypertension. However pediatric hypertension is not typical and normal blood pressure is associated with age,sex and height. The blood pressure level,clinical presentation and complication rates of secondary pediatric hypertension are higher than primary pediatric hypertension. So secondary pediatric hypertension could get timely treatment compared to primary pediatric hypertension. This paper focus on the clinical presentation and diagnosis criterion of pediatric hypertension and provide a reference for the pediatrician.

Objective To observe the clinical efficacy of docetaxel and nedaplatin (NDP)in treatment of patients with epithelial ovarian cancer. Methods 50 cases with epithelial ovarian cancer collected in Shifang People’s Hospital from 2009 January to 2010 January were randomly divided into treatment group and control group,each had 25 cases.Treatment group were given docetaxel and nedaplatin,while control group were given carboplatin. The efficacy and adverse reactions in two groups were observed and compared.Results The recent efficacy in two groups were 76.00% and 52.00%, respectively,and the difference was significant (P <0.05 ).Compared with control group, the incidence of leucopenia was 36.00% and thrombocytopenia was 24.00% in treatment group,there was no significant difference between them.The incidences of nausea,vomiting and alopecia in treatment group were 12.00%,8.00% and 44.00%,which lower than that in control group (40%,28% and 64%),the differences between two groups were all significant(P<0.05 ).The two years survival rates in treatment group was 37.5%,and 28% in control group,there was no significant difference between two groups.Conclusion Docetaxel and nedaplatin has good clinical efficacy in treatment of epithelial ovarian cancer.

It is recognized that the increasing prevalence of diastolic heart failure in adults has signifi-cantly worsen the quality of life and shorten lifespan.However,the assessment and diagnostic criterion of dias-tolic heart failure in children is controversial.The diagnosis and treatment of DHF are mainly based on small samples of clinical research and clinical experience.There is no effective treatment plan of diastolic heart failure from evidence-based medicine.In this article,we review the progress of diastolic heart failure in children in as-pects of its pathological mechanism,clinical manifestations,function evaluation,diagnosis and treatment.

[ ABSTRACT] AIM: To investigate the regulatory mechanism of histone acetylation on cardiac hypertrophy in -duced by phenylephrine , and to provide a new idea for preventing and curing hypertrophic cardiomyopathy .METHODS:Phenylephrine was given by continuous subcutaneous injection for modeling cardiac hypertrophy in C 57BL/6 mice.The le-vel of histone H3 lysine 27 acetylation (H3K27ac) in the promoter of cardiac nuclear transcription factor GATA4 and the mRNA expression of GATA4 were identified by chromatin immunoprecipitation (ChIP) and real-time PCR, respectively. Meanwhile, the protein expression of histone H3K27ac, atrial natriuretic peptide (ANP) and α-myosin heavy chain (α-MHC) was determined by Western blot .Cardiac hypertrophy in the mice was observed by HE staining and echocardio-graphy.RESULTS:The results of Western blot showed that the level of histone H 3K27ac in phenylephrine group was sig-nificantly increased compared with normal saline group (P<0.05), and ChIP-qPCR data showed that the level of histone H3K27ac in the promoter of GATA4 was increased significantly in the same samples (P<0.05).The expression levels of GATA4 mRNA and ANP protein in phenylephrine group were apparently increased compared with normal saline group ( P<0.05).However, histone acetylase inhibitor anacardic acid attenuated histone H 3K27 hyperacetylation induced by pheny-lephrine, and downregulated the over-expression of GATA4 and ANP in the heart of the mice (P<0.05).HE staining and echocardiography data showed that phenylephrine apparently increased left ventricular posterior wall thickness and de -creased left ventricular end-systolic diameter and left ventricular end-diastolic diameter , while anacardic acid also reversed these indexes that mentioned above and attenuated cardiac hypertrophy induced by phenylephrine in the mice .CONCLU-SION:Histone acetylation modification imbalance is involved in cardiac hypertrophy induced by phenylephrine , and the histone acetylase inhibitor anacardic acid decreases histone hyperacetylation induced by phenylephrine and attenuates car -diac hypertrophy in the mice .

Objective To investigate the relationship and mechanism between the serum level of high mobility group box protein-1(HMGB1)and the mortality rate in patients with sepsis.Methods The serum levels of HMGB1,superoxide dismutase(SOD)and malondialdehyde(MDA)in 48 patients with sepsis were determined.The clinical outcomes in those patients were recorded and anlyzed.Results After the onset of sepsis,the serum HMGB1 levels of both death group and survival group were increased gradually and peaked at 72h after the onset of the disease.The semm HMGB1 levels of death group were much higher than those of survival group except at 24h(t=6.07,6.20,24.43,all P＜0.05).The activity of serum SOD of death group was markedly lower than that of survival group at 12h,24h,48h and 72h(t=10.24,20.61,11.67,33.33,all P＜0.05),and the level of serum MDA of death group was significantly higher than those of survival group at all time points(t=26.06,22.17,23.86,9.49,5.95,all P＜0.05).There was a significantly positive correlation between the serum HMGB1 and MDA level.Conlusioa The increase in serum HMGB1 level may be the important reasoll for the increased mortality rate in patients with sepsis;Oxidant/antioxidant imbalance may be olle reason for the increase in serum HMGB1 level.

Objective To investigate that ox-LDL inhibits endothelial differentiation of bone marrow mesenchymal stem cells (MSCs) in rats and its underlying mechanism .Methods Cultured MSCs were divided into four groups:blank groups , ox-LDL groups ( 5 μg/mL ox-LDL ) , ox-LDL +NAC groups ( 5 μg/mL ox-LDL and pre-treated NAC), and negative LDL groups (5 μg/mL nLDL).Cell morphology, endothelial marker and differentiation effi-ciency as well as signal of oxidative and pathway protein were detected after induction by Western blot , real-time PCR.Results MSCs can differentiate into endothelial cells with the expression of endothelial marker vWF , Flk-1 and CD31 at the mRNA and protein level , vascular morphology , ox-LDL obvious inhibited endothelial differentia-tion of MSCs ( P<0.05 ) , but NAC can reverse the inhibition , the amount of ROS in ox-LDL groups was higher than that in ox-LDL+NAC groups ( P <0.05 ) , The expression of phosphorylated Akt decreased distinctly after treatment with ox-LDL( P<0.05 ) , NAC can stimulated its expression close to normal .Conclusions ox-LDL can inhibit endothelial differentiation of MSCs via ROS , NAC in this procese shows inhibition to effect of ox-LDL and Akt signaling also played a critical role .

Objective To construct the p300 specific siRNA vector in mice and observe its effect on cardiac transcription factor,GATA4,for further study of the effect of p300-mediated histone acetylation on heart growth. Methods Three recombinant plasmid vectors ( p300 RNAi1,p300 RNAi2,and p300 RNAi3s) ,designed and constructed according to the conservative sequence of mice p300,were respectively tansfected into in vitro cultured cardiac muscle cells of suckling mice. Expression of p300 and GATA4 at mRNA and protein levels was detected by RT-PCR and immunofluorescence,respectively. Results The expression level of p300 mRNA was not significantly decreased in pSOS-HUS and p300 RNAi2 groups,but significantly decreased in p300 RNAi1 and p300 RNAi3 groups ( 0. 220 8 ? 0. 020 0 and 0. 170 8 ? 0. 040 0 vs 0. 509 5 ? 0. 030 0,P

BACKGROUND: Hip arthroplasty and internal fixation with intramedullary cannulated screws are mainly used for senile femoral neck fractures. However, osteoporosis can usually lead to failure in internal fixation.OBJECTIVE: To analyze the joint function after fixed with intramedullary cannulated screws in elderly patients with femoral neck fractures, and to explore the factors related to functional recovery.METHODS: Clinical data of 89 patients with femoral neck fractures undergoing internal fixation with intramedullary cannulated screws after 2-year follow-up were analyzed retrospectively. The sex, age, Garden type, bone mineral density, body mass index, screw distribution, reduction index, operation time, bearing time and Harris hip scores were analyzed. Rank related analysis and accumulative Logistic regression analysis were performed on SPSS18.0 software. RESULTS AND CONCLUSION: (1) Normal Q-Q plot and normality test results indicated that the Horris scores in all patients after 2-year follow-up presented with skewed distribution (P=0.000). (2) Rank related analysis showed that age,Garden type, bone mineral density, and reduction index were related with Harris score (P < 0.05 or P < 0.01). (3) Accumulative Logistic regression analysis showed that the independent variables including age, Garden type, bone mineral density, and reduction index made significant effect on Harris hip scores. (4) To conclude, age, Garden type,bone mineral density, and reduction index are important factors for functional recovery of the hip after fixed with intramedullary cannulated screws.

Objective To detect the effect of ox‐LDL on self‐renewal and Oct‐4 express of MSCs in vitro .Methods MSCs cul‐tured in vitro were divided into 4 groups :blank control(no reagents in culture system ) ,ox‐LDL (1 ,5 ,10 ,20 μg/mL ox‐LDL were added into culture system) ,ox‐LDL+NAC(corresponding ox‐LDL were added into culture system after NAC treatment ) ,negative control(corresponding nLDL were added into culture system ) .Growth curve were drawn at different time ,Oct‐4 ,a stem cell special marker ,were detected by real‐time PCR ,the production of ROS (reactive oxygen species ,ROS) in culture system were measured with electron paramagnetic resonance spectroscopy .Results proliferation of MSCs was inhibited by ox‐LDL ,when concentration of ox‐LDL was more than 5μg/mL ;apoptosis of MSCs appeared as well as attenuated expression of Bcl‐2 ,ox‐LDL generated a signifi‐cant amount of ROS in the culture system ,which was completely prevented by NAC .Conclusion The proliferation and Oct‐4 ex‐pression of MSCs were inhibited by ox‐LDL ,which may be related to increase of ROS in culture system .

Objective To evaluate the clinical efficacy of early diagnosis by contrast-enhanced ultrasound (CEUS) combined with mesenchymal stem cell (MSC) therapy in the treatment of biliary ischemia after liver transplantation. Methods Clinical data of 9 recipients presenting with biliary ischemia detected by CEUS within 4 weeks after liver transplantation and diagnosed with non-anastomotic biliary stricture (NAS) within postoperative 1 year were retrospectively analyzed. In the conventional treatment group, 4 recipients were treated with conventional treatment including liver protection, cholagogic therapy and interventional therapy. In MSC treatment group, 5 recipients received intravenous infusion of MSC at 1, 2, 4, 8, 12 and 16 weeks after biliary ischemia detected by CEUS on the basis of conventional therapy. The interventional treatment and clinical prognosis within 1 year after liver transplantation were analyzed between two groups. Results Two recipients in the MSC treatment group required interventional therapy, which was initially given at 7-9 months after liver transplantation for 1-2 times. All recipients in the conventional treatment group required interventional therapy, which was initially delivered at postoperative 1-3 months for 2-6 times, earlier than that in the MSC treatment group. Within 1 year following liver transplantation, diffuse bile duct injury occurred in 2 recipients in MSC treatment group, and no graft dysfunction was observed. In the conventional treatment group, all recipients developed diffuse bile duct injury, and 2 recipients presented with graft dysfunction. Conclusions Early diagnosis of biliary ischemia after liver transplantation by CEUS combined with MSC therapy may delay and reduce the requirement of interventional therapy for NAS, and also improve clinical prognosis of the recipients.