Purpose To characterize the middle cerebral artery atherosclerotic plaque and investigate its relationship with infarction patterns by using 3.0T high resolution magnetic resonance imaging (HRMRI).Materials and Methods Forty-nine patients with intracranial atherosclerosis underwent HRMRI.The characteristics of the plaques of middle cerebral artery were investigated,including morphology,distribution and enhancement.Patients were categorized as two groups (strong/mild and none) according to the strength of plaque enhancement,then clinical data were compared between the two groups and the risk factors were investigated.Acute infarction was classified as three subtypes (single/multiple perforating artery occlusion/arterial embolism) basedon diffusion weighted imaging,and the plaque characteristics of each subtype were investigated.Results Sixty-five plaques were identified in middle cerebral artery of 49 patients,62 plaques (95.4％) were eccentric,31 plaques (50.0％) were located at the ventral wall.Patients with low levels of high-density lipoprotein were significantly more prevalent in strong enhancement group (56.7％ vs.26.3％,P＜0.05).The percentage of strong enhancement plaque in arterial embolism group (88.9％) was significantly higher than non-arterial embolism group (36.4％) (P＜0.05).Conclusion Middle cerebral artery plaque distribution is correlated with ischemic stroke,strong enhancement plaque is associated with its vulnerability.HRMRI can provide information to predict the ischemic event and infarction pattern.

Objective To investigate the influence of early diet on recovery of physical and gastrointestinal function in patients after spinal operation.Methods 120 patients were randomly divided two groups:experimental group(n=60)and control group(n=60).The experimental group began to eat 4 hoursafter the tracheal cannula being extracted post operation,while the control group did it after 24 hours.The time for eating,normal diet recovery,passage of gas by allus,and incidence of constipation in two groups after the operation were compared.Results Compared with the control group,the time for eating,normal diet recovery and passage of gas by anus were remarkably advanced and incidence of constipation was obviously decreased in the experimental group.There was significant difference between the two groups in terms of the time for eating,normal diet recovery and passage of gas by anus and incidence of constipation(P<0.05).Conclusions Early diet after spinal operation could promote recovery of gastrointestinal function,relieve abdominal distention,increase appetite and resistance,and prevent occurrence of constipation.

OBJECTIVETo determine the effect of butylphthalide on the expressions of protein disulfide isomerase (PDI) and P53 in the brain tissue of rats with Alzheimer's disease (AD).

METHODSSixty male adult rats were randomly divided into AD model group, butylphthalide group and control group (n = 20). AD models were established by injecting beta-amyloid protein 1-42 into the hippocampus of rats. Sixty days later, the learning and memory abilities of the rats were evaluated using Y-maze test, and the expressions of PDI and P53 in the brain tissue of the rats were measured by immunohistochemistry.

RESULTSCompared with the control group, the rats in AD model group exhibited significantly reduced learning and memory abilities, lowered expressions of PDI in the hippocampus and increased expression of P53 in the cortex (P > 0.01). In comparison with the model group, the rats in the butylphthalide group showed significantly increased PDI-positive cells in the hippocampus and decreased expression of P53 in the cortex (P < 0.01).

CONCLUSIONButylphthalide improves the learning and memory abilities of rats with experimental AD, the mechanism of which may involve inhibition of P53 expression and enhancement of PDI expression in the brain tissues.

Alzheimer Disease ; physiopathology ; Animals ; Apoptosis ; drug effects ; Benzofurans ; pharmacology ; Brain ; enzymology ; metabolism ; Disease Models, Animal ; Learning ; drug effects ; Male ; Memory ; drug effects ; Protein Disulfide-Isomerases ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo study the clinical effect and safety of early postnatal application of glucocorticoids in the prevention of bronchopulmonary dysplasia (BPD) in preterm infants.

METHODSThe databases including PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, and VIP were comprehensively searched for articles on early postnatal application of glucocorticoids in the prevention of BPD in preterm infants published up to June 2016. Review Manager 5.3 was used for the Meta analysis of 16 randomized controlled trials (RCTs) that met the inclusion criteria.

RESULTSA total of 2 962 participants were enrolled in the 16 RCTs, with 1 486 patients in the trial group and 1 476 in the control group. The Meta analysis showed that early postnatal application of glucocorticoids reduced the incidence rate of BPD at a corrected gestational age of 36 weeks (OR=0.73, 95%CI: 0.61-0.87, P=0.0004), but there was an increase in the risk of hyperglycemia (OR=1.61, 95%CI: 1.24-2.09, P=0.0003), hypertension (OR=1.63, 95%CI: 1.11-2.38, P=0.01), and intestinal perforation (OR=1.51, 95%CI: 1.12-2.04, P=0.007).

CONCLUSIONSAt present, it is not recommended to use glucocorticoids to prevent BPD in preterm infants. Its advantages and disadvantages need further studies, with special focuses on the adverse effects of hyperglycemia, hypertension, and intestinal perforation.

Bronchopulmonary Dysplasia ; prevention & control ; Glucocorticoids ; adverse effects ; therapeutic use ; Humans ; Hyperglycemia ; chemically induced ; Hypertension ; chemically induced ; Infant, Newborn ; Infant, Premature ; Intestinal Perforation ; chemically induced

OBJECTIVETo obtain specific small interfering RNAs (siRNA) for hepatitis B virus (HBV) and evaluate their interfering effect.

METHODSThree siRNAs were transfected into HepG2.2.15 cells, and the amount of HBV mRNA in the cell culture medium was quantified with real-time fluorescence quantitative RT-PCR. HBsAg in the culture media was assayed with Western blotting at different time points after transfection.

RESULTSThe cells transfected with specific siRNAs showed decreased levels of HBV mRNA and HBsAg (P<0.05), but those with nonspecific siRNA transfection as the negative control did not show such changes (P>0.05).

CONCLUSIONSpecific siRNA can significantly inhibit protein expression and mRNA synthesis of HBV in HepG2.2.15 cells in vitro.

Cell Line, Tumor ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B virus ; drug effects ; physiology ; Humans ; RNA, Messenger ; analysis ; RNA, Small Interfering ; pharmacology ; RNA, Viral ; analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection ; Virus Replication ; drug effects

OBJECTIVETo apply single nucleotide polymorphism array (SNP-array) for the diagnosis of Williams-Beuren syndrome (WBS) in a patient.

METHODSChromosome G-banding and SNP-array were used to analyze a girl featuring mental retardation.

RESULTSThe karyotypes of the child and her parents were all normal, but SNP-array showed a 1.9 Mb deletion at 7q11.23 in the patient. The same deletion was not found in her parents.

CONCLUSIONThe mental retardation and special facies of the girl were probably due to the 7q11.23 microdeletion. SNP-array has an important value for the diagnosis of mental retardation.

Child ; Chromosome Deletion ; Chromosomes, Human, Pair 7 ; Female ; Humans ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Williams Syndrome ; genetics

Objective To confirm the mediation effect of trait coping styles between childhood a-buse and psychosomatic symptoms among college students. Methods 262 medical students were investiga-ted by Psychosomatic Health Questionnaire( PHQ) ,Personal Report of Childhood Abuse( PRCA) ,Trait Cop-ing Styles Questionnaire(TCSQ),Self-rating Anxiety Scale(SAS),Suicide Ideation Scale(SIS) and Beck Depression Inventory(BDI).Structural equation models were established by Amos 7.0. Results The positive coping scores of medical students were (34.70±4.50),and (27.48±5.68) for negative coping,(7.79±5.58) for depression,(29.40±6.22) for self rating anxiety,(1.33±1.75) for suicidal ideation,(1.26±0.51) for mental symptoms,(1.27±0.52) for somatic symptoms and (3.17±4.26) for behavioral problems.Abuse total score was positively correlated with negative coping style, depression, self rating anxiety, suicidal ideation, mental symptoms and behavioral problems ( r=0.148-0.417,P<0.05) ,and negatively correlated with positive coping style(r=-0.148,P<0.05).Negative coping style was positively correlated with Beck depression,self rating anxiety,suicidal ideation,mental symptoms and somatic symptoms( r=0.252-0.350,P<0.01) ,and neg-atively correlated with positive coping style(r=-0.309,P<0.01).Positive coping style was negatively correla-ted with Beck depression,self rating anxiety,suicidal ideation,mental symptoms and somatic symptoms ( r=-0.208--0.271,P<0.01).Structural equation modeling showed that childhood abuse had an direct effect on psychosomatic symptoms( B=0.290,P<0.01) ,positive coping styles( B=-0.129,P<0.05) and negative cop-ing styles(B=0.243,P<0.01) among medical students.Positive coping styles and negative coping styles had direct effect on psychosomatic symptoms(B=-0.194,P<0.01;B=0.263,P<0.01).The model fit indexes were χ2/df=1.576,PGFI=0.585,PCFI=0.689,PNFI=0.645,RMSEA=0.047,GFI=0.951,AGFI=0.920, NFI=0.900,RFI=0.858,IFI=0.960,TLI=0.943,CFI=0.959. Conclusion The results indicate that trait coping styles as a mediator mediating the relationship between childhood abuse and psychosomatic symptoms in medical students.

Objective: To understand the characteristics of bacterial meningitis after pediatric neurosurgical procedures. Methods: This was a retrospective observational study. From January 2016 to December 2022, 64 children diagnosed with post-neurosurgical bacterial meningitis based on positive cerebrospinal fluid (CSF) culture in Department of Neurosurgery of Shanghai Children's Medical Center were selected as the study population. The clinical characteristics, onset time, routine biochemical indexes of cerebrospinal fluid before anti infection treatment, bacteriology characteristics and sensitivity to antibiotics of bacteria cultured from cerebrospinal fluid were analyzed. Based on the CSF culture results, the patients were divided into the Gram-positive bacteria infection group and the Gram-negative bacteria infection group. The clinical characteristics of the two groups were compared using t-tests or Wilcoxon rank-sum tests, and chi-square tests. Results: There were 64 children,42 boys and 22 girls, with onset age of 0.83 (0.50, 1.75) years. Seventy cases of post-neurosurgical bacterial meningitis occurred in the 64 children, of which 15 cases (21%) in spring, 23 cases (33%) in summer, 19 cases (27%) in autumn, and 13 cases (19%) in winter. The time of onset was 3.5 (1.0, 10.0) months after surgery; 15 cases (21%) occurred within the first month after the surgery, and 55 cases (79%) occurred after the first month. There were 38 cases (59%) showing obvious abnormal clinical manifestations, fever 36 cases (56%), vomiting 11 cases (17%). Forty-eight cases (69%) were caused by Gram-positive bacteria, with Staphylococcus epidermidis 24 cases; 22 cases (31%) were caused by Gram-negative bacteria, with Acinetobacter baumannii the prominent pathogen 7 cases. The Gram-positive bacterial infection was more common in summer than the Gram-negative bacterial infection (20 cases (42%) vs. 3 cases (14%), χ²=5.37, P=0.020), while the Gram-negative bacterial infection was more in autumn and within the first month after surgery than the Gram-positive bacterial infection (11 cases (50%) vs. 8 cases (17%), 15 cases (67%) vs. 5 cases (33%), χ²=8.48, 9.02; P=0.004, 0.003). Gram-positive bacteria resistant to vancomycin and Acinetobacter baumannii resistant to polymyxin were not found. However, Acinetobacter baumannii showed only 45% (10/22) susceptibility to carbapenem antibiotics. Conclusions: The clinical presentation of post-neurosurgical bacterial meningitis in children is atypical. Gram-positive bacteria are the main pathogens causing post-neurosurgical bacterial meningitis; Gram-negative bacterial meningitis are more likely to occur in autumn and within the first month after surgery. Acinetobacter baumannii has a high resistance rate to carbapenem antibiotics, which should be taken seriously.
Male ; Female ; Humans ; Child ; China/epidemiology* ; Anti-Bacterial Agents/pharmacology* ; Meningitis, Bacterial/diagnosis* ; Gram-Negative Bacterial Infections/drug therapy* ; Gram-Positive Bacteria ; Gram-Positive Bacterial Infections/drug therapy* ; Carbapenems ; Retrospective Studies ; Microbial Sensitivity Tests ; Drug Resistance, Bacterial

BACKGROUNDInfantile hemangioma (IH) is the most common benign tumor in children with prevalence in the face and neck. Various treatment options including oral propranolol have been described for IH, but the mechanism of drugs remains enigmatic. The aim of this study was to investigate the pathogenesis and establish a reliable in vivo model of IH which can provide platform for drug exploration.

METHODSStem cells from the proliferating hemangiomas (HemSCs) were isolated by CD133-tagged immunomagnetic beads. Their phenotype and angiogenic property were investigated by flow cytometry, culturing on Matrigel, real-time polymerase chain reaction (PCR), immunofluorescent staining and injection into BALB/c-nu mice.

RESULTSHemSCs had robust ability of proliferating and cloning. The time of cells doubling in proliferative phase was 16 hours. Flow cytometry showed that HemSCs expressed mesenchymal markers CD29, CD44, but not endothelial/hematopoietic marker of CD34 and hematopoietic marker CD45. The expression of CD105 was much lower than that of the reported hemangioma derived or normal mesenchymal stem cell (MSC). Real-time PCR showed that the mRNA levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and matrix metalloproteinase-1 (MMP-1) of HemSCs were higher than that of neonatal human dermal fibroblasts (NHDFs) and human umbilical vein endothelial cells (HUVECs). After HemSCs were cultured on Matrigel in vitro, they formed tube-like structure in a short time (16 hours) and differentiated into endothelial cells in 7 days. After 1 - 2 weeks of implantation into immunodeficient mice, HemSCs generated glucose transporter 1 positive blood vessels. When co-injected with HUVECs, the vascularization of HemSCs was greatly enhanced. However, the single implantation of HUVECs hardly formed blood vessels in BALB/c-nu mice (P < 0.05).

CONCLUSIONSHemSCs may be some kinds of primitive mesoderm derived stem cells with powerful angiogenic ability, which can recapitulate human hemangioma by co-injecting into immunodeficient mice with HUVECs.

AC133 Antigen ; Animals ; Antigens, CD ; analysis ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Collagen ; Disease Models, Animal ; Drug Combinations ; Glycoproteins ; analysis ; Hemangioma ; pathology ; Humans ; Laminin ; Male ; Mice ; Mice, Inbred BALB C ; Neoplastic Stem Cells ; chemistry ; pathology ; Peptides ; analysis ; Proteoglycans ; Vascular Endothelial Growth Factor A ; physiology

OBJECTIVETo investigate the anti-fibrogenesis property of intraportal vein injection of small interfering RNA targeting connective tissue growth factor (CTGF) in a rat model of liver fibrosis and its effect on the accumulation of extracellular matrix (ECM).

METHODSThirty male rats were randomly divided into five groups. Some rats received CCl4 subcutaneously every three days for 6 consecutive weeks, and in the meantime they also received either siRNA targeting CTGF (preventive group), saline (model group) or siRNA (siRNA control group) by intraportal vein injections. Other rats received CCl4 by subcutaneous injection for 2 weeks, followed by CCl4 and CTGF siRNA intraportal vein injection for 4 more weeks (as treatment group). The expressions of CTGF and type I and III collagen genes were detected by means of reverse transcription-polymerase chain reaction (RT-PCR) and/or Western blot respectively. Hepatic histology was evaluated by HE and Sirius red stained sections. The collagen staining areas were measured quantitatively using a computer-aided manipulator with slight modifications. Serum procollagen type III and hyaluronic acid were determined by radioimmunoassay.

RESULTSSix weeks after CCl4 injection, prominent upregulation of gene expressions of CTGF, type I and III collagen, and laminin in saline or siRNA-treated rat livers were observed. The expressions of CTGF at mRNA and protein level and type I and III collagen at mRNA level were markedly reduced in rats with CTGF siRNA treated for four or six weeks. Expressions of CTGF at mRNA and protein levels decreased by 76%+/-8%, 80%+/-3% (F = 68.630) and 95%+/-2%, 93%+/-3% (F = 21.234, P < 0.01); type I and III collagen and laminin at mRNA levels decreased by 74%+/-8%, 78%+/-8%, 31%+/-7% and 57%+/-6%, 59%+/-10%, 43%+/-9% (F = 24.219, 16.315, 9.716, P < 0.01) compared with rats in the model group at 72 h. The CTGF siRNA treatment markedly reduced serum levels of procollagen type III and hyaluronic acid and the degrees of liver fibrosis.

CONCLUSIONIntraportal vein siRNA injection targeting CTGF could significantly inhibit CTGF gene expression in rats, thereby attenuating liver fibrosis by reducing ECM accumulation.

Animals ; Carbon Tetrachloride ; Connective Tissue Growth Factor ; metabolism ; Extracellular Matrix ; metabolism ; Gene Silencing ; Liver ; metabolism ; pathology ; Liver Cirrhosis, Experimental ; chemically induced ; metabolism ; pathology ; Male ; RNA, Small Interfering ; Rats ; Rats, Sprague-Dawley