Objective To investigate the change of extracellular histone level as well as the mecha-nism of the cytotoxicity of extracellular histones on vascular endothelial cell in sepsis. Methods Septic chil-dren admitted to PICU in Shanghai Children′s Medical Center between January 2010 and December 2014 were included in the present study. According to the diagnostic criteria of sepsis,the patients were divided into the sepsis group(51 cases) and the severe sepsis group(79 cases),with healthy children as the control group (108 cases). Patients in the severe sepsis group were further divided into the survival group(45 cases) and the non-survival group ( 34 cases ) based on 28-day mortality. The plasma concentration of extracellular histones in these children was determined and its correlation with the severity of sepsis was analyzed. Human umbilical vein endothelial cells(HUVECs) were incubated with calf thymus histone(CTH) at various con-centrations(0,50,100,200 and 300μg/ml) or different time periods(200μg/ml,0,5,15,30,45 and 60 mi-nutes) . The treated cells were subject to flow cytometer to measure the cell survival rate and scanning/trans-mission electron microscopy to observe their morphological changes. Western blot was used to detect the ex-pression of IκB and phosphor-p38/p38 in nuclear factor ( NF )-κB and mitogen-activated protein kinase ( MAPK) signaling pathways,while ELISA was used to determine the levels of tumor necrosis factor-α and interleukin-6. Results The levels of circulating histones in the septic children(2. 29 ± 1. 00) and severe sep-tic children ( 19. 17 ± 10. 20 ) were significantly higher than that of healthy controls ( 0. 23 ± 0. 26 ) ( P <0. 001),and the histone levels in the severe septic children were even higher(P<0. 001). Among the chil-dren diagnosed as severe sepsis,the level of circulating histones in the non-survivors was significantly higher than that in the survivors(29. 47 ± 5. 99 vs. 10. 94 ± 2. 68,P<0. 001). The survival rate of HUVEC gradually decreased along with the increase of CTH concentration or the treatment period in vitro. Data from electron microscopy showed that CTH treatment could directly disrupt the plasma membrane of HUVEC. Histones could also activate NF-κB and MAPK pathways,leading to the release of large amount of tumor necrosis fac-tor-α and interleukin-6. Conclusion The levels of extracellular histones in the septic children are correlated with the severity of sepsis. CTH can induce HUVEC death in a dose-and time-dependent manner. Extracellu-lar histone-induced endothelial dysfunction may mediate the progression of sepsis and such cytotoxicity might be due to the destruction of endothelial cell membranes and activation of the NF-κB and MAPK signaling pathways.

Objective To explore the association of galactose-deifcient IgA1 levels with clinical features, and further to provide guidance for individualized treatment of HSP. Methods According to the clinical symptoms and curative effect, 57 children with HSP were divided into four groups:non-HSPN group (n=26), HSPN group (n=7), refractory HSP group (n=7) and remission group (n=17). In non-HSPN group, 12 cases received glucorticoid therapy and 14 cases did not. Serum galactose-de-ifcient IgA1 (Gd-IgA1) concentrations were detected using a Helix aspersa-lectin-based enzyme-linked immunosorbent assay (ELISA), and the total IgA1 levels were measured by ELISA. Results The serum Gd-IgA1 level was signiifcantly higher in 40 HSP children who were not cured than that in remission group and control group (P<0.05). However, there was no difference in Gd-IgA1 level between remission group and control group (P>0.05). Compared with the control group, the serum Gd-IgA1 level was signiifcantly higher in HSPN group, non-HSPN group and refractory HSP, and children with refractory HSP had signiifcantly higher Gd-IgA1 level than children in non-HSPN group (P<0.05). No signiifcant difference in Gd-IgA1 level was found either between HSPN group and refractory HSP group or between HSPN group and non-HSPN group (P>0.05). Furthermore, in non-HSPN group, the serum Gd-IgA1 level in HSP children who were not treated with glucorticoid was signiifcantly higher than that in HSP children treated with glucorticoid (P<0.05). Conclusions The serum Gd-IgA1 level is associated with the disease activ-ity and curative effect of HSP, especially in children with refractory HSP, and it is thus likely to be a new non-invasive disease activity marker for guiding the proper usage of glucocorticoid and immunosuppressants in HSP children.

Cochlear Implantation ; Cochlear Implants ; Guidelines as Topic

Objective To evaluate the cardiac function in patients with chronic obstructive pulmonary disease ( COPD) by using echocardiography.Methods Three hundred and twenty eight COPD patients and 60 age and gender-matched healthy subjects ( control group ) were enrolled in the study. According to Global Initiative for Chronic Obstructive Lung Disease ( GOLD ) criteria, patients were as classified as mild (n=102), moderate (n=85), severe (n=80) and very severe (61).All participants underwent conventional echocardiography and two dimensional-speckle tracking echocardiography (2D-STE) to assess cardiac function.Results The LVEF was reduced significantly, while the PASP was increased in severe and very severe COPD patients [(60.9 ±2.0)% and (59.4 ±2.8)%, t value:3.358, 4.859 to normal controls, 5.247, 6.641 to mild, 3.280, 4.863 to moderate, respectively, all P<0.001].The LA size was dilated in very severe COPD patients [(3.9 ±0.5) cm, t value: -2.407, -2.625, -2.071,-2.186, P<0.05 ] , and the RVEF was significantly less than those of the other patients [ ( 42.8 ± 7.3)%,t value: 6.357, 6.832, 5.581, 4.639, P<0.05 ] .The right ventricular FAC of moderate or severe COPD patients and the segmental and global LS of left and right ventricular in COPD patients were significantly lower than those in the normal controls, and which were gradually decreased as GOLD classification rising [ RVFAC, moderate: ( 37.7 ±2.0 )%, severe: ( 35.5 ±3.2 ) %, very severe:(34.0 ±3.1) %, t value: -4.616, -5.982, -7.195, respectively; LSLVg, moderate: ( -18.62 ± 1.76) %, severe: ( -17.15 ±0.73 ) %, very severe: ( -16.51 ±0.89 ) %, t value: -9.389,-15.494, -16.873, respectively;LSRVg, moderate:(-20.52 ±2.27) %, severe:(-18.84 ±1.38)%, very severe:(-16.82 ±1.10) %, t value:-8.555, -13.595, -18.499, respectively, all P<0.001].Besides, the FAC of COPD patients was positively correlated with the RVEF (r =0.676,P <0.05), while the RVLSg was negatively correlated with the FAC and RVEF (r=-0.677, -0.591,all P<0.05) .Conclusions There were left and right ventricular dysfunction in COPD patients, which decreased as GOLD classification upgraded. The FAC and 2D-STE can effectively detect the subtle abnormalities of regional and global ventricular function.

Objective To test the effect of an APP in the adherence of inhalation medicines for children with asthma,improve the rate of inhalation medicines compliance,self management ability and the quality of life of children with asthma.Methods The research use self-control study.We use Medication Adherence Report Scale for Asthma (MARS-A) to test the adherence of inhalation medicines for children with asthma in outpatient department.After 2 months using the APP,the children with asthma may be re-tested by the MARS-A to compare the differences in medication adherence,asthma knowledge,use method and pulmonary function,etc.Finally,data analysis using paired t test.Results After using the APP,the inhalation medicines adherence rate is increased from 25.78 ％ to 68.75 ％,the awareness rate of patients and their caregivers are increased from 25 ％ to 65 ％,and the APP usage rate is 42.18％,there was significant difference (P＜0.01).Conclusion The APP can effectively improve the adherence of inhalation drugs,standardized medication management,guarantee treatment effect and improve the quality of life of children with asthma.It could also reducing medical costs and improving work efficiency and service quality,thus deserves promotion.

OBJECTIVETo investigate the relationship between the type 1 diabetic rats residual islet function and postoperative glycemia of gastric bypass procedure (GBP).

METHODSIntraperitoneal injection of STZ was used to produce type 1 diabetic rat model. According to the level of serum glucose, rats were divided into two groups: group 1 (fasting glucose 16.7-22.0 mmol/L, n=42) and group 2 (fasting glucose>22.0 mmol/L, n=54). Half rats of group 1 and group 2 received GBP, which were OP1 group (n=21) and OP2 group (n=27). The normal control group included 20 Wistar rats. The fasting glycemia and fasting C-peptide (C-P) were tested at postoperative weeks 1, 2, 3, and pancreas pathological slices were examined 3 weeks after surgery under microscope.

RESULTSAfter GBP, the C-P was elevated and the glycemia was well controlled in OP1 group compared with group 1 (P<0.05). But the C-P was not significantly increased and the glycemia control was poor compared with group 2 (P>0.05). Pathological examination revealed that there were partial islets residual in pancrease of group 1, the islets were shown obvious hyperplasia in OP1 group after GBP. There were almost no islets residual in pancrease of group 2, and the islets were shown no obvious hyperplasia in OP2 group after GBP.

CONCLUSIONSResidual islet function determines the glycemia changes of type 1 diabetic rats after gastric bypass.

Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; physiopathology ; surgery ; Female ; Gastric Bypass ; Male ; Pancreas ; physiopathology ; Postoperative Period ; Rats ; Rats, Wistar

Objective To study the neuroprotective effect of erythropoietin(EPO) on neonatal rats model with hypoxia-ischemia encephalopathy(HIE).Methods HIE was induced in rats on 7th day of postnatal age by ligation of right common carotid artery,followed by 2 h of hypoxia(80 mL/L O2).The subjects were divided into sham-operated group,control group and EPO group.EPO 4 000 U/(kg?day) was injected daily from day 2 pre-surgery for 9 to 16 days and PBS was injected in the control group.The neuroprotective effect of EPO on HIE model was detected by brain weight,the difference in weights between the ipsilateral(right) and contralateral(left) brain and the function test.In vitro study,the neural progenitor cell line C17.2 under gone apoptosis following an ischemia-like metabolic inhibition.The effect of EPO on the cell line ischemia modle 17.2 was evaluated by detecting Annexin V with flow cytometry.Results The signi-ficant and sustained brain injury in the hypoxia-ischemia and vehicle-treated group was observed and measured by reduction in relative weights of ipsilateral to contralateral and compromised sensorimotor functions in response to postural reflex test,compared with those of sham-operated animals(Pa

This study was designed to explore the RNA interference technique in inhibition of the expression of the mouse fibrinogen like protein 2 (mfgl2), which has been reported to be involved in the development a variety of diseases including fulminant viral hepatitis. A plasmid named p-mfgl2shRNA,complementary to the sequence of mfgl2 was constructed, while another short hairpin RNA (shRNA)which was a mutated form of the mfgl2shRNA sequences was used as a control. A plasmid named pEGFP-mfgl2 expressing the mfgl2-EGFP fusion protein was also constructed for the screening of the effect of p-mfgl2shRNA on mfgl2 expression. By cotransfection of p-mfgl2shRNA and pEGFP-mfgl2 or pcDNA3.1-mfgl2 expression construct into CHO cells or HeLa cells, the inhibition of mfgl2 expression by mfgl2shRNA was analyzed by direct observation through fluorescent microscopy, FACS, RT-PCR and immunohistochemistry staining. The experiments showed the significant inhibitory effect of p-mfgl2shRNA on mfgl2 expression at 48h post-transfection in both CHO and Hela cell lines with the inhibitory efficiency as high as 80.1%. The study demonstrated that the construct of p-mfgl2shRNA successfully interfered with the mfgl2 expression in vitro.

OBJECTIVETo investigate the distribution of serum mannose binding lectin (MBL) levels in Han ethnic group children.

METHODSThe concentrations of MBL in serum were measured by ELISA in 268 umbilical cord blood specimens from Chongqing, Wuhan and Urumqi as well as in serum of 470 normal children aged from 0 to 6 years and 87 adults in Chongqing.

RESULTSThe distribution of serum MBL levels in children (28 days to 6 years) was abnormal but there was no significant difference in MBL serum levels in subjects of different ages and genders. The median concentration of MBL in serum was significantly lower in newborns (median: 1597 microg/L, range: 884 - 1825 microg/L), cord blood group (median: 1462 microg/L, range: 0 - 4604 microg/L) than in other groups (children group median: 2536 microg/L, range 0 - 7860 microg/L; adult group median: 2920 microg/L, range 98 - 6495 microg/L). While among the other sub-groups aged from 28 days-6 years (28 day group median 2299 microg/L, range 214 - 4195 microg/L; 6 months-group median 2622 microg/L, range 5 - 4637 microg/L; 2 years-6 years group 2585 microg/L, range 198 - 7860 microg/L), there was no statistically significant difference. The median serum MBL level in normal children aged from 28 days to 6 years was 2563 microg/L and the P(2.5)-P(97.5) was 171 - 5079 microg/L.

CONCLUSIONSThe distribution of serum MBL levels in children (28 days to 6 years) was abnormal type but there was no statistically significant difference among different age and sex groups. The reference value of P(2.5)-P(97.5) in children (28 days-6 years) was 171 - 5079 microg/L.

Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mannose-Binding Lectin ; blood ; Reference Values ; Serologic Tests ; statistics & numerical data ; Young Adult

OBJECTIVETo investigate the early diagnosis and treatment of acute mesenteric ischemia.

METHODSForty-two patients with acute mesenteric ischemia from June 2007 to November 2011 were reviewed retrospectively. All patients were diagnosed with DSA and (or) CT and (or) surgery. In this group, there were 32 cases of acute occlusion of meseteric ischemia (AOMI), 9 cases of superior mesenteric venous thrombosis (SMVT) and 1 case of non-occlusive mesenteric ischemia. The patients were treated using comprehensive treatment including early intervention treatment and application of the principle of damage control. The survival of all patients was followed up for 6 months or more in outpatient.

RESULTS(1) Of the 32 AOMI cases, 4 cases healing by systemic anticoagulation; The 19 cases received interventional treatment, including 10 cases received simply interventional treatment, surgery after the failure of intervention in 5 cases, 3 patients died without surgery and postoperative interventional treatment one cases were cured; Eight cases received surgery treatment; One case gave up. (2) Of the 9 SMVT cases, 2 cases healing by systemic anticoagulation; The 6 cases received interventional treatment, including 1 cases received simply interventional treatment, surgery after the failure of intervention in 1 cases, 4 cases to consider intestinal necrosis received interventional treatment again after surgery; One patient died without treatment. (3) Eight cases received delay abdomen close treatment with the principle of damage control surgery. The overall mortality rate of 23.8% (10/42). Interventional treatment of 26 cases, 4 deaths, a mortality rate of 15.3%; The abdomen delayed close of 8 cases, 1 death.

CONCLUSIONSThe results show that early diagnosis and treatment is critical to reduce AMI mortality. Comprehensive treatment of early intervention treatment and application of the principle of damage control can significantly reduce the mortality of AMI.

Adult ; Aged ; Aged, 80 and over ; Early Diagnosis ; Female ; Humans ; Ischemia ; diagnosis ; therapy ; Male ; Mesenteric Ischemia ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Vascular Diseases ; diagnosis ; therapy ; Young Adult