To explore the clinical significance of serum cardiac troponin I (cTnI) for the detection of myocardial injury in children with Kawasaki disease (KD) in acute stage, the levels of serum cTn I, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactic dehydrogenase (LDH) and glutamic oxalacetic transaminase (GOT) were determined in 40 children with KD and 23 controlled children without heart disease, respectively. The results showed that the levels of serum cTn I and CK-MB in the KD group were significantly higher than those in the controlled group (P＜0.001),while no obviously differences of CK, LDH and GOT were noticed between two groups (P＞0.05). cTn I was more sensitive comparing to CK-MB for the detection of myocardial injury (P＜0.05). It is concluded that the determination of cTn I and CK-MB will be available for the diagnosis of myocardial injury in children with KD in acute stage, and the determination of cTn I is more sensitivity and specificity comparing to CK-MB.

Objective To explore the clinical features and treatment of children with acute severe viral myocarditis.Methods The clinical data of presentation,diagnosis,therapy and prognosis of children who were admitted in our hospital from Jan 2005 to Jan 2012 with acute severe viral myocarditis(severe myocarditis group) were analyzed retrospectively.Twenty-three cases of normal healthy children in the same period were selected as control group.The levels of serum cardiac troponin(CTn)-Ⅰ and N-terminal pro-brain natriuretic peptide(NT-proBNP) were detected by ELISA method,the changes of left ventricular ejection fraction and left ventricular fraction shortening were understood by color doppler echocardiography.Results The level of CTn-Ⅰin severe myocarditis group was significantly higher than that of control group,the difference was statistically significant [(18.67 ± 12.31) ng/ml vs (0.02 ±0.01) ng/ml,P ＜0.05].Compared with the acute phase,the level of CTn-Ⅰshowed a trend of gradual decline in 7 d [(0.55 ±0.24) ng/ml],basic close to normal in 14 d [(0.06 ±0.03) ng/ml] (P ＜0.05).The level of NT-proBNP increased significantly in severe myocarditis group compared with control group [(3 067.26 ± 902.79) pg/ml vs (80.04 ± 17.79) pg/ml,P ＜0.05].Compared with acute phase,the levels of NT-proBNP were closed to normal in 7 d [(648.63 ±342.37) pg/ml] and 14 d [(213.58 ± 129.51) pg/ml] (P ＜ 0.05).The left ventricular ejection fraction [(52.63 ± 6.98) ％ vs (71.39 ± 2.41) ％] and left ventricular fraction shortening [(32.1 ± 2.97) ％ vs (40.04 ± 2.31) ％] in severe myocarditis group were significantly lower than those in control group (P ＜ 0.05).Conclusion Acute severe viral myocarditis of children was characterized by rapid onset,severe illness and high mortality.Early use of adrenal cortical hormone and gamma globulin under the comprehensive treatment and application temporary pacemaker can help patients to recover from the disease.

Adult ; Atrioventricular Block ; complications ; Cardiomyopathies ; complications ; diagnosis ; Humans ; Male ; Sarcoidosis ; complications ; diagnosis

As human beings ascend to high altitude, a number of reactions may occur against hypoxic injuries. These hypoxic responses are related to intake, transportation and utility of the oxygen. As a crucial subcellular organelle of oxygen utility, mitochondrion is a central link of high altitude acclimatization, adaptation and mountain sicknesses. In this review, we discussed the recent advances in researches on hypoxic mitochondrial responses at high altitude.
Adaptation, Physiological ; Altitude ; Altitude Sickness ; Animals ; Humans ; Hypoxia ; Mitochondria ; pathology ; Oxygen ; physiology

AIM:To establish a rat hyperlipidemia model for studying the aortic expression of heat shock protein 22 (HSP22), tumor necrosis factor alpha (TNF-α) and endothelial nitric oxide synthase (eNOS) and the effect of atorvasta-tin intervention.METHODS:Hyperlipidemia model was established in SD rats.Afterwards, the rats were divided into nor-mal control group, high fat group and high fat+atorvastatin intervention group.The expression of HSP22 and TNF-αin the rat aortas was detected by immunohistochemical assay and the expression of eNOS was assessed by Western blotting.RE-SULTS:No detectable expression of HSP22 and TNF-αin the normal control group was observed.However, the expression of HSP22 and TNF-αwas positive in the high fat group and the atorvastatin intervention group.The mean densities of HSP22 and TNF-αpositive particles were significant lower in the atorvastatin intervention group as compared with high fat group ( both P<0.05) .The expression of eNOS protein in the high fat group and atorvastatin intervention group was significantly lower than that in normal control group (P<0.01).However, no marked difference of eNOS protein expression between high fat group and atorvastatins intervention group was observed.CONCLUSION:The expression of HSP22 and TNF-αin the rat aortas is increased in the hyperlipidemia rat model.This effect can be restored by atorvastatin treatment.The expression of eNOS in the rat aortas is decreased in the hyperlipidemia rat model, but this tendency could not be attenuated by atorvastatin.

Objective To discuss the efficacy of retroperitoneal laparoscopic dismembered pyeloplasty for pediatric ureteropelvic junction obstruction(UPJO). Methods Retroperitoneal laparoscopic dismembered pyeloplasty was performed on 24 patients with UPJO.The age of the patients ranged from 3 to 14 years(mean,7 years).The diagnosis was set up by ultrasonography,IVU,CT or magnetic resonance urography.All the patients had hydronephrosis,with 4 cases mild,10 cases moderate and 10 severe ones. Results All operations were completed laparoscopieally,without conversions to open surgery during operation.The mean operative time was 180 min(range 150 to 200).The mean blood loss was 60 ml(range 40 to 100)and the mean postoperative hospital stay was 7 d (range 5 to 9).All 24 patients were followed-up for 6 to 24 months(mean,1 4 months).There was no stricture at UPJ.Eighteen patients had complete resolution of hydronephrosis and 6 patients showed obvious alleviation in hydronephrosis. Conclusion Retroperitoneal laparoseopie dismembered pyeloplasty could be a mini-invasive,safe,and effective procedure for the treatment of UPJO in pediatric patients.

Objective To investigate the change of leptin,nitric oxide (NO) and interleukin-6 (IL- 6) levels in serum of children with Kawasaki disease (KD) and the possible relationship between leptin,NO and IL-6 levels,explore the role of leptin,NO and IL-6 in the pathogenesis of KD.Methods Fourty-five children with KD were studied.Twelve of them had coronary artery lesions and 33 had non-coronary artery lesions;thirty healthy children and 18 children with juvenile idiopathic arthritis or Henoch-Scholeion purpuru were enrolled as control subjects.Serum was collected from each patients during acute stage of KD and remission.Leptin,NO and IL-6 contents were detected by radioimmuno-assay and spectrophotometry and enzyme-linked immunoserbent assay.Meanwhile,C-reactive protein (CRP) were examined.Results ① The concentrations of serum leptin,NO,IL-6 and CRP in children with KD were significantly higher in the acute stage of KD than those at clinical remission and those of the normal control group (q=26.24,25.23; 21.38,31.30;35.37,33.68;16.32,15.66;P＜0.01,respectively).No significant differences in serum leptin, IL-6 and CRP were found between the clinical remission group and the normal control group (q=1.02,1.04, 0.61,P＞0.05,respectively);The concentrations of serum NO were significantly higher at clinical remission group than those of the normal control group (q=11.31,P＜0.01).② There was no significant difference in the concentrations of serum leptin,IL-6 and CRP at the acute stage of KD than those in patients with and without coronary artery lesions (q=1.17,1.92,1.60,P＞0.05).The concentrations of serum NO were significantly higher at the acute stage of KD with coronary artery lesions than those of KD without coronary artery lesions (q=6.91,P＜0.01).③ The concentrations of serum leptin in children with juvenile idiopathic arthritis or Henoch-Scholeion purpura were signifietantly higher than those of the normal control group (t=13.26,P＜ 0.01).No significant differences in serum leptin were found between children with juvenile idiopathic arthritis or Henoch-Seholeion purpura and children with KD (t=1.28,P＞0.05).④ Correlation was found between serum leptin values and levels of the following parameters (P＜0.01);NO (r=0.69),IL-6 (r=0.55),CRP (r=0.42).However,there were no associations between leptin and leukocytes (r=0.21,P＞0.05) or serum albumin level (r=-0.24,P＞0.05).Association was found between serum NO and IL-6 (r=0.45,P＜0.01)or CRP(r=0.49,P＜0.01).Conclusion These results suggest that leptin,NO and IL-6 may have a role in the immunoinflammatory process of KD,especially in the acute phase.Further in vivo and in vitro studies are needed to establish the roles of leptin,NO and IL-6 in the pathogenesis of KD.

BACKGROUND: Although some studies have been done on the functional change of cochlea in chickens during prolonged administration of kanamycin,few studies on ultrastructural changes in chicken cochlea have been reported.OBJECTIVE: To observe ultrastructural changes of the chicken basilar papilla following poisoning with prolonged administration of kanamycin.DESIGN: A completely randomized design and controlled observation.SETTING: Affiliated Xinhua Hospital, Shanghai Second Medical University.MATERIALS:The experiment was conducted in Xinhua Hospital Affiliated to Medical College, Shanghai Jiao Tong University from June 2001 to August 2003. Newly born Roman chickens (n=78), of either sex, provided by Shanghai Guixing Breeding Chick Farm, were used as subjects.METHODS: 200 mg/kg kanamycin was injected into muscles daily at day 3 after birth for 10 days. Then they were divided into 3 groups randomly:①typical application group: The chickens were applied with drugs no longer, and then killed at days 1, 3,7, 10 and 15, 6 chickens in each time phase. ②prolonged application group: 200 mg/kg kanamycin per day were injected into muscles continuously, and then killed at days 13, 17, 20, 25and 30, 6 chickens in each time phase. ③control group: The chickens were not treated with any drug. They were assigned into 3, 13 and 33 days groups with 6 chickens in each time phase. When the chickens were killed they were at the same age with the experime ntal animals at days 0, 10 and 30 of kanamycin treatment. All the experimental animals were studied with auditory brain-stem response (ABR) and scanning electron microscopy in chicken basilar papilla to observe ultrastructural change of cochlea, threshold, latency and amplitude of ABR wave I.MAIN OUTCOME MEASURES: ①Ultrastructural change of the chicken basilar papilla, and ② ABR result of chicken.RESULTS: A total of 78 Roman chickens were involved in the result analysis, without dropout. ①Outcome of ABR: Loss and recovery of chicken ABR threshold value was similar between within continuous administration for 20 days and administration for 10 days plus 10 days of recovery (drug withdrawal group). Twenty days after administration, ABR threshold significantly increased again. ②Outcome of scanning electron microscopy: At the end of 10-day kanamycin administration, hair cells in 40％ proximal chicken basilar papilla were destroyedand disappeared completely. Although continuous administration was performed, the hair cells began to regenerate and repair after damage. Within the 20-day continuous administration, the regenerated hair cells of basilar papilla developed maturity, which was mostly coincident with the administration for 10 days group. At day 25, regenerated hair cells of proximal basilar papilla were injured once again. At day 30, most of the regenerated hair cells were destroyed and disappeared.CONCLUSION: Prolonged administration of kanamycin obviously prevents the full repair of chicken basilar papilla damaged by kanamycin poisoning.

This study is to observe anti-lipotoxic effect of sesamin on renovascular hypertensive rats fed with a high-fat, high-sucrose diet. Thirty-four complex model rats were induced by two-kidney, one-clip method and on high-fat and refined-carbohydrate diet for thirteen weeks. From the fifth week, intragastric administration of sesamin (120, 60 and 30 mg x kg(-1) x d(-1)) lasted for eight weeks. Blood pressure (BP), blood fat (BF), blood glucose (BG), free fatty acids (FFA), insulin (Ins), tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 were determined. Pathological changes of pancreas, perirenal fat and liver were semiquantitatively analyzed. In sesamin (120 and 60 mg x kg(-1) x d(-1)) group, it was found that there were decrease of levels of BP, BF, BG, TNF-alpha, IL-6 and FFA, improvement of insulin resistance and glucose tolerance, alleviation of body weight, humid weight of fat, liver and pancreas and their organ index, and reduction of islet cell hyperplasia and amount of lipid droplet vacuoles in lipocyte and hepatocyte. It is implied that sesamin had anti-lipotoxic effect and its mechanism may be closely associated with the amelioration of insulin resistance via reducing lipidoses in hepatocyte and inflammatory adipokines such as TNF-alpha and IL-6.
Adipocytes ; drug effects ; Animals ; Anticholesteremic Agents ; administration & dosage ; pharmacology ; Antihypertensive Agents ; administration & dosage ; pharmacology ; Blood Glucose ; metabolism ; Blood Pressure ; drug effects ; Body Weight ; drug effects ; Cholesterol ; blood ; Diet, High-Fat ; Dioxoles ; administration & dosage ; pharmacology ; Dose-Response Relationship, Drug ; Fatty Acids, Nonesterified ; blood ; Glucose Tolerance Test ; Hypertension, Renovascular ; blood ; pathology ; Insulin ; blood ; Insulin Resistance ; Interleukin-6 ; blood ; Islets of Langerhans ; pathology ; Lignans ; administration & dosage ; pharmacology ; Liver ; pathology ; Male ; Pancreas ; pathology ; Rats ; Rats, Sprague-Dawley ; Sucrose ; Triglycerides ; blood ; Tumor Necrosis Factor-alpha ; blood

Objective To investigate the influence of factors related to metabolic syndrome(MS)on the outcome in subjects without diabetes mellitus in a community.Methods A two-year follow-up study was conducted in 885 subjects who were enrolled in the epidemiologic survey carried out in Pingliang Community, Shanghai in 2002.Oral glucose tolerance test,lipid prefde,blood pressure(BP),body mass index(BMI),waist and hip circumferences were measured.Results (1)The baseline of BMI,fasting plasma glucose(FPG),2h plasma glucose after glucose loading(2hPG),BP,triglyceride(TG)in the subjects with impaired glucose regulation(IGR)increased significantly as compared to those with normal glucose regulation(NGR)(all P