Objective To investigate the predictive value of fluid overload for mortality in children with severe sepsis.Methods In this retrospective study,the children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU),Children's Hospital of Soochow University between January 2011 and March 2015.Fluid accumulation was calculated in the first 72 hours after admission.Pediatric index of mortality Ⅱ (PIM2) score was calculated during the first 1 hour after admission.Multivariate Logistic regression analysis assessed the relationship between fluid overload and mortality after adjustment for confounding factors.The predictive value of fluid overload for mortality was assessed by the receiver operating characteristic curve and au area under the receiver-operating-characteristic curve (AUC).Results Of the 199 children admitted,62 cases (31.2％) died during PICU stay.Among the children,133 cases (66.8％) had fluid overload of＜5％,55 cases (27.6％)had fluid overload of≥5％-10％,and 11 cases (5.6％) had fluid overload of≥ 10％.Multivariate regression analysis showed that a high fluid overload percent (OR =1.263,95 ％ CI:1.113-1.434,P ＜ 0.001),a high PIM2 score (OR =1.028,95 ％ CI:1.012-1.043,P ＜ 0.001) and multiple organ dysfunction syndrome(OR =4.160,95％ CI:1.728-10.012,P =0.001) were independent risk factors for mortality in children with severe sepsis.The fluid overload was significantly associated with mortality (OR =1.309,95％ CI:1.158-1.480,P ＜0.001),even after adjustment for age and illness severity assessed by PIM2 scores.Fluid overload achieved AUC of 0.741 (95％ CI:0.661-0.820,P ＜ 0.001) for predicting mortality in children with severe sepsis.Conclusion Fluid overload developed during the first 72 hours after admission is independently associated with and predictive of PICU mortality in children with severe sepsis.

Objective To investigate the clinical application of serum interleukin-6 (IL-6)and interleukin-22 (IL-22) levels in predicting the recurrence of hepatitis B virus (HBV)-related early hepatocellular carcinoma (HCC) after receiving microwave ablation (MWA).Methods Preoperative peripheral blood samples were collected in 49 patients with early-stage HBV-related HCC,and serum concentrations of IL-6 and IL-22 were measured by using ELISA.Thirty healthy volunteers were recruited and used as the control group.The xtile software was used to define the best cut-off value,and the IL-6 and IL-22 levels were divided into highlevel group and low-level group.The tumor-free survivals of high-level and low-level groups were analyzed with Kaplan-Meier analysis,log rank test was adopted to determine the difference,and Cox regression model was employed to screen the risk factors affecting HBV-related HCC recurrence.Results The serum IL-6 and IL-22 levels of HCC group were 13.20 pg/ml (11.87-15.79 pg/ml) and 42.18 pg/ml (34.39-57.44 pg/ml) respectively,which were significantly higher than 10.47 pg/ml (9.50-13.82 pg/ml) and 25.45 pg/ml (22.31-30.12 pg/ml) of the control group (P=0.001 and P＜0.001 respectively).Kaplan-Meier analysis revealed that preoperative lower IL-6,higher total bilirubin and lower albumin levels indicated a shorter disease-free survival (DFS),and IL-22 levels had no statistically significant effect on the recurrence of HCC.Cox regression multivariate analysis showed that lower serum IL-6 level (≤ 13.2 pg/ml;hazard ratio=3.721;95％ CI=1.674-8.272;P=0.001) and lower serum albumin level (≤41.0 g/L;hazard mtio=2.085;95％CI=1.101-3.950;P=0.024) were independent risk factors affecting HBV-related HCC recurrence Conclusion Preoperative serum IL-6 level and serum albumin level can be used as the predictors of HCC recurrence in patients with HBV-related early HCC who are receiving MWA treatment.(J Intervent Radiol,2017,26:232-236)

Objective To observe the effect of tumor necrosis factor-α( TNF-α) on islet cell apoptosis and TXNIP expression.Methods INS-1 cells were cultured in vitro, treating with TNF-α(0, 1, 5, 10 and 20 mg/L).We tested the effect of TNF-αon cell viability by CCK-8.INS-1 cells were treated with TNF-α( 5 mg/L, 24 h) for the proper concentration and incubation time; mRNA expression of TXNIP and ChREBP were measured by real-time PCR;in addition, protein levels of TXNIP , ChREBP and FOXO1 were analyzed by Western blot .Results TNF-αdecreased the survival rate of INS-1 cells in a dose-dependent manner ( P<0.05 ) , and induced apoptosis;protein and mRNA expression of TXNIP and ChREBP were significantly higher than that in control group ( P<0.05 );while the expression of protein level of FOXO 1 was down-regulated .Conclusions TNF-αinduces apoptosis in INS-1 cells and aggravates the cells damage .

The aim of this study was to observe the change in angiotensin II receptor subtype 1 (AT(1)) autoantibody during the development of renovascular hypertension (RVH). The Goldblatt renovascular hypertension model was established by the two-kidney one-clip method, and a synthetic peptide corresponding to amino acid sequence 165-191 of the second extracellular loop of the AT(1)-receptor was used as the antigen. Sera AT(1)-receptor autoantibody was detected by SA-ELISA. It was shown that two weeks after operation both the frequency of occurrence and the titre of autoantibodies to AT(1)-receptor were significantly increased as compared with the pre-treatment control. The increase in autoantibodies lasted several weeks and then decreased gradually to the pre-clipping level at 12 weeks. It is suggested that autoimmune mechanisms are involved in the pathogenesis of renovascular hypertension and the AT(1) autoantibodies may be one of the mechanisms leading to cardiac hypertrophy.
Animals ; Autoantibodies ; blood ; Disease Models, Animal ; Hypertension, Renovascular ; blood ; immunology ; Kidney ; physiopathology ; Rats ; Receptor, Angiotensin, Type 1 ; immunology ; metabolism

AIM AND METHODSThe effects of losartan (after operation 2 week to 10 week, 5 mg/kg d ig) on generation of AT1R-AA in sera were observed during development of hypertension in rats. The renovascular hypertension (RVH) model was established by two-kidney one-clip method, a synthetic peptide corresponding to amino acid sequence 165-191 of the second extracellular loop of the angiotensin II-1 receptor (AT1R) was used as antigen, SA-ELISA were used to examine sera AT1R autoantibody (AT1R-AA).

RESULTSThe frequencies and titres of AT1R-AA after operation one week rats were significantly increased (P < 0.05). The treatment with losartan not only inhibited structural and functional changes, but also the frequencies and titres of AT1R-AA was significantly lower (P < 0.05) than RVH group.

CONCLUSIONIt is suggested that the losartan significantly inhibits generation of the AT1R-AA.

Animals ; Autoantibodies ; biosynthesis ; blood ; Hypertension, Renovascular ; blood ; immunology ; Losartan ; pharmacology ; Male ; Rats ; Rats, Wistar ; Receptors, Angiotensin ; immunology

BACKGROUNDFood composition and style is changing dramatically now, which causes inappropriate secretion of hormones from brain, gastrointestinal and endo-pancreas, may be related to unbalance of glucose in blood. The aim of this study was to explore the fast response of C-peptide, glucagon-like peptide-1 (GLP-1), ghrelin and endomorphin-1 (EM-1) to the eastern and western style meals in patients with type 2 diabetes mellitus.

METHODSThe study enrolled 57 patients with type 2 diabetes (20 men and 37 women, mean age (67.05 ± 8.26) years). Eastern style meal (meal A) and western style meal (meal B) were designed to produce the fullness effect. C-peptide, GLP-1, ghrelin and EM-1 were assessed before (0 hour) and after (2 hours) each diet.

RESULTSThe delta (2h - 0h) of C- peptide in meal A was significantly lower than that in meal B (P = 0.0004). C-peptide, GLP-1, ghrelin and EM-1 were obviously higher before meal B than those before meal A (P < 0.0001, < 0.0001, = 0.001, = 0.0004 respectively). Blood glucose 2 hours and 3 hours after meal B were higher than those after meal A (P = 0.0005, 0.0079 respectively). Correlations between GLP-1 and ghrelin were strongly positive before both meals and 2 hours after both meals and also in relation to the delta of meal A and meal B (r(A0h) = 0.7836, r(B0h) = 0.9368, r(A2h) = 0.7615, r(B2h) = 0.9409, r(A(2h-0h)) = 0.7531, r((2h-0h))B = 0.9980, respectively, P < 0.0001).

CONCLUSIONWestern style meal (high fat and protein food) could make more response of C-peptide than eastern style meal, and could stimulate more gut hormones (GLP-1, ghrelin) and brain peptide (EM-1) at the first phase of digestion.

Aged ; C-Peptide ; blood ; Diabetes Mellitus, Type 2 ; blood ; Diet ; Fasting ; blood ; Female ; Ghrelin ; blood ; Glucagon-Like Peptide 1 ; blood ; Humans ; Male ; Middle Aged ; Oligopeptides ; blood ; Postprandial Period

Using two-kidney one-clip renal hypertensive (2K1C group), stress-induced hypertensive (neural group), DOCA-salt treated hypertensive (DOCA group) and spontaneously hypertensive rats (SHR group), to investigate the change in AT(1A)-receptor autoantibodies (AT(1A)-AAs) during the development of the four types of hypertension. The biological activities of AT(1A)-AAs were examined. It was shown that the frequency of occurrence and titres of AT(1A)-AAs increased significantly during the development of hypertension. In the four hypertensive groups studied, the occurrence of AT(1A)-AAs was most prominent in SHR, 2K1C and neural groups. The biological effects of AT(1A)-AAs were shown to increase the beating frequency of cultured neonatal myocardial and vascular contractile tension. It is suggested that autoimmune mechanisms are involved the pathogenesis of different types of hypertension and the AT(1A)-AAs may be one of the mechanisms leading to cardiac hypertrophy.
Animals ; Autoantibodies ; blood ; Desoxycorticosterone ; administration & dosage ; Hypertension ; classification ; etiology ; immunology ; physiopathology ; Hypertension, Renovascular ; immunology ; physiopathology ; Male ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Rats, Wistar ; Receptor, Angiotensin, Type 1 ; immunology ; Stress, Physiological ; physiology

In this report, we present two cases of bronchial foreign body granulomas caused by the suture ties used in bronchial surgery for esophageal cancer. Both of them was hospitalized as "tumor transfer or an invasion", but pathological examination of the neoplasms indicated an inflammatory granuloma showing reaction to the foreign body. These two cases give us an attention that the neoplasms in tracheal or bronchial was not only the invasion or transfer of the primary tumor, but also the possibility of granuloma development due to the surgical sutures.
Bronchial Neoplasms ; etiology ; Esophageal Neoplasms ; surgery ; Granuloma, Foreign-Body ; etiology ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Sutures ; adverse effects

The purpose of this study was to compare the vasodilating effects of angiotensin-(1-7) [Ang-(1-7)] on the different vessels and to clarify its mechanisms by using relaxing responses of preconstricted vascular rings. The results showed: (1) Ang-(1-7) dose-dependently induced vasorelaxation in all the vessels studied. However, there is apparent heterogeneity in the responsiveness of vessels from different origin. (2) The Ang-(1-7)-induced vasorelaxation was endothelium dependent and largely mediated by NO system. (3) The vasodilator action of Ang-(1-7) was not mediated by AT1 or AT2 receptor subtypes. It is suggested that the Ang-(1-7)-induced vasorelaxation is endothelium dependent by some other unclarified angiotensin receptor subtypes and is largely mediated by NO system.
Angiotensin I ; pharmacology ; physiology ; Animals ; Endothelium, Vascular ; drug effects ; metabolism ; Female ; Male ; Nitric Oxide ; biosynthesis ; Peptide Fragments ; pharmacology ; Rabbits ; Receptor, Angiotensin, Type 1 ; physiology ; Vasodilator Agents ; pharmacology

AIM:To explore whether the angiotensin II type 1 receptor autoantibodies(AT1-AA)induces islet β-cell apoptosis and whether autophagy is involved in the process.METHODS:The INS-1 cells treated with AT1-AA at 10-6mol/L for 24 h,and then the apoptosis was analyzed by flow cytometry,Western blot and Hoechst 33258 staining.In addition,the expression of autophagy-related proteins such as LC3 and beclin 1 were determined by Western blot.The effects of AT1-AA on the apoptosis,autophagy and viability of INS-1 cells with or without 3-methyladenine(3-MA;a com-mon autophagy inhibitor)or telmisartan(an angiotensin Ⅱ type 1 receptor blocker)pretreatment, were detected by flow cytometry,Western blot and CCK-8 assay.RESULTS: Treatment with AT1-AA at 10 -6mol/L for 24 h significantly re-duced the cell viability(P<0.05).Compared with the negative IgG control group,the apoptotic cells increased after incu-bation with AT1-AA for 12 h,24 h and 36 h,respectively(P<0.05).Moreover,the protein levels of LC3 and beclin 1 also increased gradually with the prolongation of treatment time,and the elevation of apoptosis and autophagy were blocked by telmisartan.After pretreatment with 3-MA, the apoptotic rate of the cells was obviously decreased compared with the cells treated with AT1-AA alone.CONCLUSION: AT1-AA induces the apoptosis of INS-1 islet βcells by upregulating autophagy via the angiotensin Ⅱtype 1 receptor pathway.