Exosomes are extracellular vesicles with plasma membrane. They are produced intracellularly and then secreted out of the cells. Almost all types of cells in human bodies can produce and excrete exosomes. Exosomes carry a variety of signal proteins, mRNA, miRNA, lncRNA and their degradation fragments. Due to the protection of lipid membrane, these components have biological activity and get involved in the process of cell migration, apoptosis and proliferation, and can modulate the function of the recipient cells. As an important cell-cell signal carrier, exosomes are involved in the development of many kidney diseases. This article reviewed the biological characteristics of exosomes and their roles in acute kidney injury.

OBJECTIVES: To study the effects of infantile positional plagiocephaly on the growth and neural development. METHODS: A retrospective study was conducted on the medical data of 467 children who underwent craniographic examination and were followed up to 3 years of age in Peking University Third Hospital from June 2018 to May 2022. They were divided into four groups: mild positional plagiocephaly (n=108), moderate positional plagiocephaly (n=49), severe positional plagiocephaly (n=12), and normal cranial shape (n=298). The general information of the four groups and the weight, length, head circumference, visual acuity screening results, hearing test results, and the scores of Pediatric Neuropsychological Developmental Scales/Gesell Developmental Schedules of the four groups from 6 to 36 months old were compared. RESULTS: The rates of adverse perinatal factors, congenital muscular torticollis, and supine fixed sleeping posture in the mild, moderate, and severe positional plagiocephaly groups were higher than the normal cranial group (P<0.05). There was no significant difference in weight, length, and head circumference among the four groups at 6, 12, 24 and 36 months of age (P>0.05). The incidence rate of abnormal vision in the severe positional plagiocephaly group was higher than that in the mild positional plagiocephaly, moderate positional plagiocephaly and normal cranial shape groups at 24 and 36 months of age (P<0.05). The scores of the Pediatric Neuropsychological Developmental Scales at 12 and 24 months of age and the scores of the Gesell Developmental Schedules at 36 months of age in the severe positional plagiocephaly group were lower than those in the mild positional plagiocephaly, moderate positional plagiocephaly and normal cranial shape groups, but the difference was not statistically significant (P>0.05). CONCLUSIONS Adverse perinatal factors, congenital muscular torticollis, and supine fixed sleeping position may be associated with infantile positional plagiocephaly. Mild or moderate positional plagiocephaly has no significant impact on the growth and neural development of children. Severe positional plagiocephaly have adverse effects on the visual acuity. However, it is not considered that severe positional plagiocephaly can affect the neurological development.
Child ; Humans ; Infant ; Child, Preschool ; Plagiocephaly, Nonsynostotic/therapy* ; Follow-Up Studies ; Prognosis ; Retrospective Studies

OBJECTIVETo evaluate (18)F-fluorodeoxyglucose-position-emission tomography-computer tomography imaging ((18)F-FDG-PET-CT) on head and neck squamous cell carcinoma(HNSCCA) and lymph node metastasis.

METHODS(18)F-FDG-PET-CT imaging of 20 patients with HNSCCA was evaluated retrospectively.

RESULTSAll the primary tumors were correctly diagnosed by (18)F-PET-CT imaging and SUV(avg) of the primary tumors was (6.22 +/- 2.20). All the sensitivity, specificity, positive predictive value and the negative predictive value were 100%. In detecting lymph node metastasis, the sensitivity was 51%, specificity 97.7%, false positive rate 2.3%, false negative rate 49%, positive predictive value 82%, and negative predictive value 91.2%.

CONCLUSIONS(18)F-FDG-PET-CT imaging was valuable in detecting HNSCCA and lymph node metastasis. SUV was helpful for differential diagnosis between benign or malignant tumors but it needs further study to determine the cutoff SUV for differentiating lymph node metastasis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Female ; Fluorodeoxyglucose F18 ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Positron-Emission Tomography ; methods ; Tomography, X-Ray Computed

Objective Adopting serology assay-fluorescent antibody to membrane antigen (FAMA) as "gold standard" , sero-prevalence status of varicella-zoster virus (VZV) infection was investigated, in Guangzhou. Methods FAMA test was established with VZV infected human embryo fibroblasts as antigens and fluorescein isothiocyanate(FITC) labeled goat anti-human IgG as the secondary antibody. Sensitivity and specificity of the assay were evaluated. The sero-prevalence of anti-VZV IgG in 592 serum specimens randomly collected from a clinical laboratory, was analyzed with FAMA. Results Data from FAMA test showed no cross-reaction with other Herpesviruses when it was used to detect VZV antibodies. The overall prevalence of VZV antibody was 76.52%. Age-specific prevalence rates of VZV antibody in different age groups as: 1-3, 4-6, 7-13, 14-19, 20-29, 30-39, 40-49, ≥50, were found to be 14.67%, 51.56%, 73.91%, 91.26%, 92.78%, 95.65%, 98.11% and 100%, respectively.The sero-prevalence of 1-3 age group appeared the lowest but rose sharply with the increase of age but showing no association with gender. Conclusion Our data indicated that VZV infection occurred in early childhood, in Guangzhou, suggesting that the primary recipients of VZV vaccine should be under the 1-3 age group. Additional subjects for vaccination would be children above 3 years old with no history of VZV infection, and serology test negative for VZV. The assay was validated by its excellent specificity and could be used as the first choice in the detection of protective antibodies against VZV infection.

OBJECTIVETo study the diagnostic value of determinations of serum acute phase reaction protein, such as complement 3 (C3), complement 4 (C4), prealbumin (PA) and C-reactive protein (CRP), etc., in patients with severe acute respiratory syndrome (SARS).

METHODSSerum levels of C3, C4, PA and CRP were determined by turbidimetry in 54 cases of SARS, 20 of other pneumonia and 30 normal persons.

RESULTSSerum concentrations of C3, C4, CRP and PA were (1.18 +/- 0.42) g/L, (1.15 +/- 0.56) g/L, (10.52 +/- 8.77) mg/L and (107 +/- 54) mg/L in SARS patients, (1.30 +/- 0.46) g/L, (0.57 +/- 0.31) g/L, (0.88 +/- 0.43) mg/L and (291 +/- 76) mg/L in patients with other pneumonia, and (1.11 +/- 0.56) g/L, (0.38 +/- 0.26) g/L, (0.42 +/- 0.26) mg/L and (376 +/- 74) mg/L in normal persons, respectively. Serum level of PA was significantly lower and levels of C4 and CRP significantly in patients with SARS higher than those in patients with other pneumonia and normal persons (P < 0.01). There was no significant difference in serum level of C3 between the three groups (P > 0.05).

CONCLUSIONDetermination of serum level of C4, CRP and PA in suspected patients is beneficial to early differential diagnosis for SARS.

Acute-Phase Proteins ; analysis ; Acute-Phase Reaction ; blood ; Adult ; Aged ; C-Reactive Protein ; analysis ; Complement C3 ; analysis ; Complement C4 ; analysis ; Female ; Humans ; Male ; Middle Aged ; Prealbumin ; analysis ; Severe Acute Respiratory Syndrome ; blood

OBJECTIVETo investigate genetic etiology of fetal urinary abnormalities with array-based comparative genomic hycridization(array-CGH).

METHODSThirty-two fetuses with variable urinary abnormalities but normal karyotyping by conventional cytogenetic technique were selected. DNA from the fetuses and their parents samples were prepared and hybridization with Affymetrix cytogenetic 2.7M arrays by follwing the manufacture's standard protocol. The data were analyzed by special CHAS software packages.

RESULTSBy using array-CGH detection, genomic imbalanced copy number variations (CNVs) were identified in night fetuses(28%), four out of night CNVs were inherited from parental samples; two were indicated to be benign variants(6%) in the database; and the other three CNVs (9%) were all de novo adjacent microdeletions and microduplication mapping on to common chromosome 1q21.1 region, within which was genitourinaty system function associated gene PDZK1.

CONCLUSIONThe incidence of genomic unbalanced variations in fetuses with congenital urinary malformations is approximately 28%, including about 9% pathogenic variations. Copy number variations (CNVs) of chromosome 1q21.1 region are associated with congenital urinary malformations which may be due to haploinsufficiency or overexpression of PDZK1 gene.

Chromosome Deletion ; Chromosomes, Human, Pair 1 ; Comparative Genomic Hybridization ; DNA Copy Number Variations ; Female ; Humans ; Kidney ; abnormalities ; Pregnancy ; Prenatal Diagnosis

OBJECTIVETo investigate the correlations of serum interleukin-18 (IL-18) level and IL-18 gene promoter polymorphisms to the development of sepsis in children.

METHODUsing enzyme-linked immunosorbent assay (ELISA), the authors tested the serum IL-18 level in 90 patients with sepsis and 123 normal controls, and their single nucleotide polymorphisms of the promoter region of IL-18 gene at position -607C/A and -137G/C were detected using polymerase chain reaction with sequence specific primers method and sequencing technique.

RESULT(1) The serum IL-18 level in sepsis groups was (196.56 +/- 157.32) pg/ml that was significantly higher than (66.16 +/- 41.63) pg/ml in normal controls (P < 0.01), the more severe the degree of sepsis was, the more significantly higher the serum IL-18 level was. The serum IL-18 level in non serious sepsis group was (152.87 +/- 114.96) pg/ml that was significantly higher than (66.16 +/- 41.63) pg/ml in normal controls, the serum IL-18 level in serious sepsis group was (191.98 +/- 169.72) pg/ml that was significantly higher than that in non serious sepsis group, and the serum IL-18 level in extremely serious sepsis patients was (323.89 +/- 159.35) pg/ml, the difference was highly significant (P = 0.000). The difference was significant among the groups with different severity of sepsis (P < 0.01). There was a negative correlation between PCIS (pediatric critical illness score) of sepsis and the serum IL-18 level (P < 0.01). (2) There were polymorphisms in IL-18 gene promoter of matched healthy children and sepsis in children. The GG genotype frequency (61.8%) of IL-18-137G/C in healthy children was the highest, followed by GC genotype (35.8%) and CC genotype (2.4%) in sequence. The G allele frequency (79.7%) was higher in IL-18-137G/C of healthy children than C allele (20.3%). The GG genotype frequency (71.1%) of IL-18-137G/C in septic children was the highest, the next were GC genotype (26.7%) and CC genotype (2.2%). The G allele frequency (84.4%) was higher in IL-18-137G/C of septic children than C allele (15.6%). The CA genotype frequency (61.0%) of IL-18-607C/A in healthy children was the highest, followed by CC genotype (26.8%) and AA genotype (12.2%). The C allele frequency (57.3%) was higher in IL-18-607C/A of healthy children than A allele (42.7%). The CA genotype frequency (76.7%) of IL-18-607C/A in septic children was the highest, followed by CC genotype (21.1%) and AA genotype (2.2%) in sequence. The C allele frequency (59.4%) was higher in IL-18-607C/A of septic children than A allele (40.6%). (3) The genotype frequency of IL-18-607 CA was 76.7% in sepsis groups that was significantly higher than 61.0% in normal controls, and the genotype frequency of -607 AA was 2.2% in sepsis groups that was significantly lower than 12.2% in normal controls, the difference was significant (P < 0.05). (4) In the order of -137CC, -137GC, -137GG, the serum IL-18 level in normal controls were as follows: (45.67 +/- 28.36) pg/ml, (53.27 +/- 37.91) pg/ml, (76.91 +/- 42.44) pg/ml, and with (140.50 +/- 60.10) pg/ml, (184.42 +/- 157.33) pg/ml, (237.02 +/- 161.76) pg/ml respectively in sepsis groups. In the order of -607AA, -607CA, -607CC, the serum IL-18 level in normal controls were: (48.80 +/- 32.11) pg/ml, (68.41 +/- 42.53) pg/ml, (70.17 +/- 43.87) pg/ml; and with (141.50 +/- 64.35) pg/ml, (151.21 +/- 121.19) pg/ml, (211.16 +/- 163.64) pg/ml respectively in sepsis groups. The difference was not significant among different groups (P > 0.05).

CONCLUSIONThe serum IL-18 level in sepsis groups was significantly higher than that in normal controls, which was related to the severity of sepsis. It was possible that the genotype of -607CA carriers was susceptible to sepsis, which mean that the genotype of -607CA might be susceptible genotype of sepsis. However, the genotype of -607AA might play an oppose role in the risk of sepsis.

Adolescent ; Child ; Child, Preschool ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Infant ; Interleukin-18 ; blood ; genetics ; Male ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Sepsis ; blood ; genetics

OBJECTIVE: To evaluate the clinical effect and prognostic factors of nasopharyngeal carcinoma in 44 children and adolescents. METHODS: From June 1987 to December 2003,44 children and adolescents with nasopharyngeal carcinoma were treated by radiotherapy, and some patients also received chemotherapy. Kaplan-Meier method was used for the survival rate and univariate analysis, and Cox proportional hazard model was used in multivariate analysis. RESULTS: The 3.5 year survival rate was 84.2% and 62.3%.In the univariate analysis, clinical stage, lymph node (N) stage, radiotherapy dose and chemotherapy were significant prognostic factors of survival.In the multivariate analysis, N stage and chemotherapy were the prognostic factors in the survival rate. CONCLUSION Most nasopharyngeal carcinomas belong to the advanced degree. These patients are sensitive to radiotherapy and chemotherapy. Combined modality therapy can improve the clinical effect of nasopharyngeal carcinoma in children and adolescents.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; Child ; Combined Modality Therapy ; Female ; Humans ; Male ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Prognosis ; Survival Analysis

BACKGROUNDThe benefit of neoadjuvant chemotherapy in the management of head and neck squamous cell carcinomas (HNSCC) still remains controversial. The aim of this meta-analysis is to evaluate the role of the neoadjuvant chemotherapy with the cisplatin and fluororacil (PF) regimen in enhancing the overall survival of and decreasing locoregional relapse and distant metastasis in HNSCC patients.

METHODSMedline and manual searches were performed to identify all published randomized controlled trials (RCTs) investigating the efficacy of the neoadjuvant chemotherapy with the PF regimen. Outcomes assessed by meta-analysis included locoregional relapse, distant metastasis, and overall survival. The odds ratio was the principle measurement of effect, which was calculated as the treatment group (chemotherapy plus locoregional treatment) versus the control group (locoregional treatment alone) and was presented as a point estimate with 95% confidence intervals (CI).

RESULTSEight RCTs were adopted for analysis. The meta-analysis showed that the odds ratio for the locoregional relapse was 0.92 (0.70 - 1.22, 95% CI), which was not statistically significant. The odds ratios for distant metastasis and overall survival were 0.47 (0.33 - 0.68, 95% CI) and 1.28 (1.01 - 1.62, 95% CI) respectively, which were both statistically significant.

CONCLUSIONSNeoadjuvant chemotherapy with the PF regimen in HNSCC patients has no effect on locoregional relapse. However, it shows a small but significant benefit in reducing distant metastasis and improving the overall survival.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; mortality ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Fluorouracil ; administration & dosage ; Head and Neck Neoplasms ; drug therapy ; mortality ; Humans ; Neoadjuvant Therapy ; Randomized Controlled Trials as Topic

Objective To evaluate the effect of an integrated control strategy and to quantify the spatial-temporal variation of infected snails in the bottomland areas after the strategy was implemented.Methods Based on the geographic database of infected snail distribution at the village level during 2004-2010 in Anxiang county,Hunan province,spatial autocorrelation analysis and spatial scan statistics were applied to analyze the spatial-temporal characteristics on the distribution of infected snails.Results The number of embankments with infected snails in Anxiang county decreased from 23 in 2004 to 10 in 2010,while the rate of frame with infected snail in embankments decreased from 4.32‰ in 2004 to 0.12‰ in 2010.The spatial distribution of infected snails was nonrandom,only in 2004 and 2005 with Moran's I=0.21 (P＜0.10) and Moran's I=0.13 (P＜0.10) respectively.Data from the local spatial auto-correlation analysis showed that the number of villages with H-H types of auto-correlation model had been gradually decreasing.The results of SaTScan statistics appeared the same as from the local spatial auto-correlation analysis,showing that the number of areas with increased risk was decreasing.Conclusion The comprehensive measures with emphasis on infectious source control seemed effective for schistosomiasis control program.The current distribution characteristics provided us with evidence that the resource assignment could be more reasonably implemented so as to control schistosomiasis in a more effective way.