Child ; Chromobacterium ; Female ; Humans ; Sepsis ; drug therapy ; etiology ; microbiology ; mortality

Objective To compare the effects of oral Sildenafil(SIL)and intravenous prostaglandin E_1(Alprostadil,PGE_1)in treatment of postoperative pulmonary hypertension(PH)associated with congenital heart defects(CHD).Methods Data were collected from 24 children with postoperative mPAP≥35 mmHg in our hospital between August 2004 and March 2005.These children were randomly divided into three groups:8 children(group A)initially received SIL(0.35 mg/kg,orally by nasal gastric tube),followed by the addition of intravenous PGE_1(20 ng/kg per min)at 40 min.The second group of 8 children(group C)initially received intravenous PGE_1 followed by the addition of SIL at 20 min(dose as above).And remains(group B)were placebo-controlled.The changes of hemodynamic variables,arterial blood gas,lung static compliance(C)and work of breathing(W)were measured after drugs were given.Results Compared with group B,the mPAP and mPAP/mSAP was significantly reduced(P

Female ; Forced Expiratory Volume ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Positive-Pressure Respiration ; methods ; Pulmonary Ventilation ; Respiratory Insufficiency ; physiopathology ; therapy ; Treatment Outcome

Objective To explore the clinical characteristics, treatment and prognostic factors of cardiogenic shock in children. Methods A retrospective analysis was done on clinical features,management strategies and outcome in 36 children with cardiogenic shock in Intensive Care Unit of our hospital from February 1994 to December 2005. Results The clinical presentations of 36 patients varied with the different ages and different primary diseases. And the duration between the presentation and the onset of shock varied with the different primary diseases: the duration for paroxysmal supraventricular tachycardia (PST) was (62.2?12.9) hours, cardiomyopathy (CMP) was (42.0?23.0) hours, endocardial fibroelastosis (ECF) was (20.3?11.1) hours, and fulminant myocarditis (FMC) was (15.0?7.8) hours. At the early stage of shock, all patients showed soft heart sounds.Gallop rhythm was found in 15 cases (41.6%)and cardiopulmonary resuscitation was needed in 17 cases (47.2%).All cases had decreased ejection fraction(EF) and fractional shortening(FS) [(0.32?0.11), (0.14?0.05),respectively] on echocardiography.Cardiothoracic ratio increased in 35 cases (97.2%) and arrhythmia developed in 34 cases (94.4%). The duration from initial treatment to shock correction of was related to the prognosis (P=0.002, Wald=9.91).Fluid resuscitation in cardiogenic shock needed close monitor, and the amount of fluid was 5.25 ml?kg -1?h -1,4.48 ml?kg -1?h -1,4.75 ml?kg -1?h -1 in ECF,FMC and CMP,respectively. Conclusion The clinical presentations high in cardiogenic shock in children were various. Early bedside echocardiogram, chest X-ray and electrocardiogram would be helpful in diagnosis. The duration from initial treatment to shock correction was a strong prognostic factor for cardiogenic shock. Compared with other kinds of shock, fluid resuscitation had its features.

ObjectiveTo evaluate the usefulness of an ultrasonography-based method to examine quadriceps femoris contracting. MethodsThe thickness of bilateral rectus femoris (RF) and vastus intermedius (VI) and the cross-sectional area (CSA) of RF was measured in 10 healthy subjects （n=20） in a relaxed position and 3 isometric contraction states using ultrasonography by two examiners. The date was compared with paired t test. Half of these subjects （n=10） were also measured with MRI at rest. The date was also compared with paired t test. ResultsThere was no significant difference between MRI and static compound ultrasonography, nor between two examiners. There was a significant difference (P<0.05) in thickness of RF and VI between relaxed and isometric contraction conditions. There was no significant difference among isometric contraction conditions. There was no significant difference among measurements of RF-CSA. Conclusionultrasonography shows good validity and reliability in measuring quadriceps shape.

Dietary Proteins ; administration & dosage ; Energy Intake ; Female ; Hospitalization ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; Logistic Models ; Male ; Parenteral Nutrition ; Weight Gain

Objective To observe the expression of tumor necrosis factor-α(TNF-α)in acute lung injury caused by paraquat(PQ)in rats,and investigate the mechanism of the rhubarb in respect of pmteetive effects.Method PQ intragastrically poisoning at the dose of 50 mg/kg made a model of the acute lung injury in Sprague-Dawley(SD)rats.Totally 144 adult healthy SD rats(72 female,72male)were randomly divided into control group (group A,n=24),poisoned group(group B,n=48),rhubarb treated group(group C,n=48)and the shaln poisoning group(group D,n=24).Rats of group B and group C were poisoned intmgastrically with PQ(50 mg/kg).and rats of group C and group D were intervened intragastrieally with 300 mg/(kg·d)of rhubarb in 15 min-utes.The white blood cells and total cells in bronchoalveolar lavage fluid(BALF)were counted by using a blood cell counting plate and the protein content of BALF was measured by using the way of Lowry in order to calculate the neutmphiks pereentage and lung permeability index.A small portion of left lung was stained with HE to observe the pathological changes and the expression oftumor necrosis factor-α in the rest of the left lung was observed with immunohistochemistry.The data were handled by the analysis of variance and NK method using SPSS 14.0.Re-suits Compared with group A,the lungs of rats mainly showed congestion,edema and leukocytes infiltration in group B,and fibrosis was found onlyt in a few rats.And the rate neutrophils percentage,protein content and lung permeability index in BALF increased(P＜0.01).The expression of TNF-α were obviously inereased at 12 hours after PQ poisoning,and immtmohistochemistry score (IHS)was higher,and peaked at 24 hours later(P＜0.05),then remained on a high level for a while and sluggishly declined.Compared with group B,the changes of above mentioned were alleviated obviously,and the expression of TNF-α delayed with the less magnitude of increasing an an obvious tendency of less expression.Compared with group B,delayed,lower increasing extent,obviously re-ducing tendency in group C with statistical difference in IHS(P＜0.05).Conclusions Rhubarb ameliorates a-cute lung injury caused by PQ poisoning in rats by means of inhibiting the expression of TNF-α in turn to alleviate inflammatory reaction.

Objective To study the injury and protective action of drugs on neurons, the model of glutamate excitotoxicity on primary cultured hippocampual neurons from new born rats were( set up. Methods)By use of trypan blue dye staning and testing the lactate dehydrogenase leakage from cultured neurons, to investigate the neuron survival rate. Results We found the injury of neurons was related with the concentration of glutamate. NMDAR non-competitive antagonist —MK-801 could protect the glutamate excitotoxic damage on neurons. Conclusion The glutamate results in neuron injury through NMDAR; the model of neuron culture was sufficient for glutamate-induced excitotoxicity.

As an agonist of peroxisome proliferator-activated receptor γ (PPARγ), pioglitazone may be involved in the regulation of glycolipid metabolism, oxidative stress and immune inflammatory response, thereby improving depression. Studies find that pioglitazone is effective in treating depression, especially in patients with resistance and comorbid metabolic syndrome, and is expected to be a new treatment for depression. This article reviews the research progress of pioglitazone in clinical application and related mechanisms of depression, in order to provide theoretical basis and support for subsequent research.

Background Lead exposure induces microglial cell death, of which the mechanism is unclear. Ferroptosis is a new death form and its role in microglia death has not been reported. Objective To investigate the role of ferroptosis in microglia following lead exposure in order to provide a theoretical basis for the mechanism of lead neurotoxicity. Methods Microglial cell line BV-2 cells were co-cultured with 0, 10, 20 and 40 μmol·L⁻¹ lead acetate for 24 h. The 40 μmol·L⁻¹ lead acetate group with iron chelator (DFO) was named the 40+DFO group. Changes in BV-2 cell morphology after lead exposure were observed under an inverted microscope; tissue iron kit and glutathione kit were used to detect intracellular iron and glutathione (GSH) respectively; flow cytometry was applied to detect lipid reactive oxygen species (lipid ROS) immunofluorescence intensity. Western blotting and qPCR were adopted to detect the expressions of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), transferrin receptor 1 (TFR-1), divalent metal transporter 1 (DMT1), ferroportin 1 (FPN1) protein and mRNA. Results Compared with the control group, the number of BV-2 cells decreased with increasing doses of lead and the cells showed a large, round amoeboid shape. The intracellular levels of iron of BV-2 cells were (1.08±0.04), (1.29±0.03), and (1.72±0.10) mg·g⁻¹ (calculated by protein, thereafter) in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups, respectively, significantly higher than that in the control group (P<0.05), and the intracellular level of iron in the 40+DFO group, (1.34±0.10) mg·g⁻¹, was lower than that in the 40 μmol·L⁻¹ lead acetate group, (1.72±0.03) mg·g⁻¹ (P<0.05). Compared with the control group, the TFR-1 and DMT1 protein and mRNA expressions were increased in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups (P<0.05), especially in the 40 μmol·L⁻¹ lead acetate group; the FPN1 protein expression did not change significantly, but the FPN1 mRNA expressions in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups were significantly decreased (P<0.05). Compared with the control group, the intracellular GSH level decreased and the lipid ROS content increased in all three lead acetate groups; compared with the 40 μmol·L⁻¹ lead acetate group, the GSH level increased by 12.30% and the lipid ROS content decreased by 13.00% in the 40+DFO group (P<0.05). The expressions of GPX4 protein were reduced to 50.00%, 35.00%, and 17.00% of that of the control group in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups respectively, while the expressions of GPX4 mRNA were also significantly reduced; the expressions of SLC7A11 protein and mRNA in the 20 and 40 μmol·L⁻¹ lead acetate groups were lower than that in the control group, with the most significant decrease in the 40 μmol·L⁻¹ lead acetate group (P<0.05). Conclusion Lead exposure could induce ferroptosis in BV-2 cells, in which iron transport imbalance and oxidative damage might be involved.