Our previous studies have suggested that angiopoietin-related protein 2 (Arp2) may improve rat cardiac function after acute myocardial infarction (AMI) by accelerating angiogenesis.We want to study the efficacy of the adenoviral vector-mediated gene transfer of Arp2 (Ad.Arp2) in inducing angiogenesis and in improving the myocardial perfusion and function in a porcine acute myocardial ischemic model.Methods The minipigs underwent ligation of the proximal circumflex coronary artery (LCx) and were randomly assigned to treatment with Ad.Arp2,adenoviral vectors with no transgene (Ad.Null) or PBS.Four weeks later,the animals were evaluated using echocardiography,cardiac perfusion imaging and pathologic observation.Results Four weeks after treatment,the Arp2 protein was revealed in the myocardium of Ad.Arp2 animals,but was not found in the Ad.Null or PBS animals.Also,a significant revival of myocardial perfusion was found in the ischemic area in Ad.Arp2-treated animals,whose global and regional myocardial function was greatly improved.The quantitation of new capillaries was much greater in the Ad.Arp2 group than in the Ad.Null or PBS groups.Conclusion Treatment with Ad.ARP2 offers the obvious advantage of greatly improving the blood supply and the heart function.(J Geriatr Cardiol 2008;5:230-234)

Objective To investigate the advantages of glucocorticoid combined with traditional meth-ods and to explore glucocorticoid use in appropriate time in the whole course of the disease and the appropriate dose.Methods With reference to Kawasaki disease(KD)diagnostic criteria,363 cases of patients with KD were enrolled,and divided into conventional treatment group and combined hormone group randomly. Combined hormone group according to clinical manifestations can be divided into sub groups as typical KD and atypical KD group. We analyzed respectively before and after 1 week treatment in two groups of children with the onset of age,gender,heating duration after treatment, IVIG treatment time, hospitalization days and total hospitalization expenses,tips and course of acute stage,recovery period the relevant indexes to the test,and coronary artery le-sion( CAL) in one month. Results Thermal process after treatment,hospitalization duration and hospitalization expenses decreased significantly in combined hormone group compared with conventional treatment group. The difference between the two,in the clinical laboratory indexes and CAL have no obvious difference. In different types of KD, the thermal process after treatment, hospitalization days and hospitalization expenses, have de-creased significantly in typical KD sub group when treating with combined hormone therapy comparing with hor-mone therapy atypical sub group. Other clinical laboratory indexes and CAL have no obvious differences in com-pared between the sub groups. Conclusion Combined hormone therapy for KD patients,plays an important role in shortening the thermal process after treatment and reducing the hospitalization expense.

Objective:To develop a recombinant protein vaccine based on KPC-2, a drug resistance target in Klebsiella pneumoniae, and evaluate its immunogenicity, protective efficacy and mechanism in a mouse model of pneumonia. Methods:KPC-2 was expressed in Escherichia coli and purified using GST affinity chromatography. A recombinant protein vaccine was prepared with KPC-2 and used to immunize New Zealand rabbits through subcutaneous injection. Serum samples were isolated from cardiac blood and Protein G chromatography was used to purify polyclonal antibodies against KPC-2. Opsonophagocytic killing assay was used to assess the bactericidal activity of the polyclonal antibodies in vitro. Female BALB/c mice were immunized three times with the recombinant protein vaccine, and the titers of specific IgG antibodies in serum were measured by indirect ELISA. One week after the last vaccination, the mice were infected with Klebsiella pneumoniae strain SRT through tracheal intubation, and received a single intravenous dose of meropenem (0.1 mg) 1 h later. The protective efficacy of the KPC-2 recombinant protein vaccine was evaluated by comparing the survival rates, bacterial colonization and histopathological changes between vaccine group and adjuvant group as well as the survival rates between meropenem group and normal saline group. Moreover, the protective efficacy of polyclonal antibodies against KPC-2 was evaluated through passive immunization. Results:The level of specific IgG antibodies in serum was significantly higher in the vaccine group than in the adjuvant group ( t=4.325, P<0.05). The survival rate in the vaccine group was also higher than that of the adjuvant group [70% (7/10) vs 10% (1/10), P<0.05]. Furthermore, lung inflammation was less severe and bacterial burden was reduced in the vaccine group as compared with those of the control group ( t=3.127, P<0.05). Both active and passive vaccination strategies demonstrated strong protective efficacy against Klebsiella pneumoniae infection, and had a synergistic effect when used in combination with antibiotic therapy. The polyclonal antibodies against KPC-2 had bactericidal activity in vitro ( t=5.427, P<0.05). Conclusions:The prepared KPC-2 vaccine has better immunogenicity and protective efficacy. It can induce strong humoral immune responses. This study suggest that drug resistance target may be used as a candidate antigen for future vaccine development.

OBJECTIVETo explore the value of electronic data capture (EDC) system in large-sample size studies on Kawasaki disease (KD).

METHODThe clinical data of 602 KD cases from 2007 to 2012 admitted to Shanghai Children's Hospital with EDC system connected with hospital information system (HIS) were retrospectively analyzed. Age, gender, acute symptoms, laboratory results, echocardiography, therapy were collected. The differences in parameters were compared between KD with and without coronary artery lesion (CAL). Furthermore, the difference between intravenous immunoglobulin (IVIG) resistant group and sensitive group were compared. Multi-factor logistic regression analyses were used to analyze the risk factors. The sensitivity and specificity of IVIG resistance parameters were detected with receiver operating characteristic curve (ROC) analysis.

RESULTThe male to female ratio of KD cases was 1.85: 1. The median age of KD cases was 2.0 years (one month to 11.7 years old); 20.1% cases (121/602) exhibited CAL. Compared with KD without CAL (n = 481), the incidence of bright red cracked lips (71.1% vs. 88.6%, P = 0.001), peeling of the skin of the toes (28.1% vs. 41.6%, P = 0.021) and perianal skin peeling (29.8% vs. 38.9%, P = 0.031) were statistically lower in KD with CAL (n = 121). The incidence of CAL in KD IVIG resistant group was significantly higher than KD IVIG sensitive group (34.6% (9/26) vs.21.3% (112/525), P = 0.05 ). Male ratio (80.8% vs. 63.4%, P = 0.05), time of IVIG ( (6 ± 2) vs. (8 ± 5) d, P = 0.009), erythrocyte sedimentation rate(ESR) ( (81 ± 2) vs. (66 ± 30) mm/1 h, P = 0.014), C-reactive protein ((107 ± 51) vs. (87 ± 52) mg/L, P = 0.017), blood platelet ( (599 ± 178) vs. (489 ± 182) ×10(9)/L, P = 0.003), hemoglobin ( (96 ± 13) vs. (102 ± 19) g/L, P = 0.032) and albumin ((34 ± 6) vs. (37 ± 6) g/L, P = 0.020) were significantly different between IVIG resistant group and sensitive group. Logistic regression analysis showed that alanine aminotransferase (ALT) ≥ 80 U/L was the independent risk factor of IVIG resistance (P = 0.012). C-reactive protein = 104 mg/L (sensitivity 61.5%, specificity 62.7%), ESR = 106 mm/1 h (sensitivity 26.9%, specificity 93.6%) and blood platelet = 187×10(9)/L (sensitivity 76.9%, specificity 53.1%) of KD in acute phase were predictive for IVIG resistance with receiver operate characteristic curve analysis.

CONCLUSIONEDC system can acquire KD clinical data quickly and accurately. It is helpful for multicenter retrospective analysis of KD.

Blood Platelets ; Blood Sedimentation ; C-Reactive Protein ; Child ; Child, Preschool ; China ; Coronary Artery Disease ; Echocardiography ; Electronic Health Records ; Female ; Hemoglobins ; Humans ; Immunoglobulins, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome ; Retrospective Studies ; Risk Factors