Anticoagulants ; therapeutic use ; Blood Coagulation Tests ; Blood Component Transfusion ; methods ; Disseminated Intravascular Coagulation ; blood ; diagnosis ; etiology ; therapy ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Fibrinolysis ; Fibrinolytic Agents ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Platelet Count ; Predictive Value of Tests ; Sepsis ; complications

Objective To investigate the anti-apoptotic function of clusterin in LNCaP cell line and the role of clusterin antisense oligodcoxynucleotide(AS-ODN)in TNF-?-induced death of LNCaP cell. Methods The wild type LNCaP(group L),LNCaP transfected with the control vector(group M),LNCaP transfected with full-length clusterin expression vector(group A,ie,study group)were cultured.For the de- tection of cytotoxic effect of TNF-?,MTT and ELISA methods were used to determine the cell proliferation and apoptosis of the 3 clones,and the changes of proliferation and apoptosis in A cell after transfection of clusterin AS-ODN were also assessed.Results MTT method showed that the cell proliferation activity(A value)of groups L,M,and A were 0.84?0.03,0.85?0.04,0.95?0.03,respectively;the difference be- tween groups L and M was not significant(P＞0.05);but compared with group A the cell proliferation activ- ity was significantly lower in groups L and M(P＜0.01 for both).ELISA resuhs showed that the A values of groups L,M,and A were 0.59?0.04,0.62?0.03,0.33?0.04,respectively;the difference between groups L and M was not significant(P＞0.05);but compared with group A,the apoptosis rates were significantly higher in groups L and M(P＜0.01 for both).In group A,A values of cell proliferation activity in subgroups control,AS-ODN,TNF-?,TNF-?+AS-ODN were 1.30?0.03,1.25?0.03,0.99?0.03,0.80?0.03, respectively;the differences between each group were significant(P＜0.05 for all).And the A values of cell apoptosis in the above 4 groups were 0.02?0.00,0.21?0.02,0.63?0.07,1.16?0.04,respectively,the differences between each group were significant(P＜0.01 for all).Conclusions Stable transfection and subsequent expression of clusterin result in resistance to the cytotoxic effect of TNF-?.Transfection with clus- terin AS-ODN enhances cytotoxic effect of TNF-?in A cells.These results suggest that clusterin plays an im- portant role in anti-apoptotic function in LNCaP cell line.

OBJECTIVETo investigate the expression of zinc ribbon domain-containing1 (ZNRD1) in human renal cell carcinoma and normal kidney tissues.

METHODSThe expression of ZNRD1 protein was examined by immunohistochemical staining in 71 renal cell carcinomas and 24 samples of normal kidney tissue. The correlation between the expressions of ZNRD1 protein and clinicopathologic features was analyzed. The expression of ZNRD1 mRNA and ZNRD1 protein was detected by quantitative reverse transcriptase-polymerase chain reaction (PT-PCR) and Western blot in 20 renal cell carcinomas and corresponding adjacent non-cancerous tissues.

RESULTSZNRD1 protein was detected mostly in the cell nuclei by immunohistochemistry. The positive expression rate of ZNRD1 protein was 91.7% (22/24) in renal cell carcinomas and 20.8% (5/24) in the normal kidney tissues, with a statistically significant difference between cancer and normal kidney tissue (P < 0.01). However, no significant correlation was observed between ZNRD1 protein expression level and clinicopathologic features (P > 0.05). ZNRD1 mRNA expression level was significantly higher in renal cell carcinomas (0.6186) than that in the normal kidney tissues (0.4273) assessed by RT-PCR (P < 0.01). The expression level of ZNRD1 protein by Western blot was 0.5623 in renal cell carcinomas, significantly higher than that in normal kidney tissues (0.3885, P < 0.01).

CONCLUSIONZNRD1 gene and ZNRD1 protein may play an important role in the carcinogenesis of renal cell carcinoma. Further investigation is still needed.

Adult ; Aged ; Aged, 80 and over ; Blotting, Western ; Carcinoma, Renal Cell ; metabolism ; pathology ; DNA-Binding Proteins ; biosynthesis ; genetics ; Female ; Humans ; Immunohistochemistry ; Kidney ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

Bilirubin ; blood ; Brain Diseases ; etiology ; prevention & control ; Electroencephalography ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Hyperbilirubinemia, Neonatal ; complications ; physiopathology ; Infant, Newborn ; Male ; Serum Albumin ; analysis

OBJECTIVETo investigate the clinical value of humidified high-flow nasal cannula (HHFNC) as a respiratory support after extubation by comparing it with nasal continuous positive airway pressure (NCPAP) in neonates with meconium aspiration syndrome (MAS) and persistent pulmonary hypertension of the newborn (PPHN).

METHODSA total of 78 neonates with MAS and PPHN were randomly administered with HHFNC or NCPAP immediately after extubation. The following indices were compared between the two groups: blood gas parameters, duration of noninvasive ventilation, rate of extubation failure, and incidence of complications, such as nasal damage, abdominal distension, and intraventricular hemorrhage.

RESULTSThere were no significant differences in the rate of extubation failure, PaO, PCO, and PaO/FiOratio at one hour after NCPAP or HHFNC, duration of noninvasive ventilation, time to full enteral feeding, length of hospital stay, and incidence of intraventricular hemorrhage between the two groups (P>0.05). The HHFNC group had significantly lower incidence of nasal damage (5.0% vs 31.6%; P<0.05) and incidence of abdominal distension (7.5% vs 34.2%; P<0.05) than the NCPAP group.

CONCLUSIONSBoth NCPAP and HHFNC can be used as the sequential therapy for neonates with MSA and PPHN after extubation, and they both have a definite effect. As a new strategy of respiratory support, HHFNC is better tolerated, and has fewer side effects than NCPAP.

Airway Extubation ; adverse effects ; Continuous Positive Airway Pressure ; instrumentation ; methods ; Female ; Humans ; Hypertension, Pulmonary ; therapy ; Infant, Newborn ; Male ; Meconium Aspiration Syndrome ; therapy ; Noninvasive Ventilation ; instrumentation ; methods

OBJECTIVETo study the validity of criteria currently used in China for the classification of symmetric small for gestational age infants (SGA) as compared with its definition.

METHODSThis study included 417 inpatients diagnosed as SGA in authors' hospital from January 1998 to June 2002. Symmetric SGA was diagnosed by the following three criteria: (1) the Ponderal Index (PI), (2) the crown-heel length-to-head circumference ratio (BL/HC) issued in Chin J Pediatr (1988;26:164 - 165), as well as (3) the SGA definition. The definition criterion was considered as the "gold standard". The sensitivity, specificity, false positive and negative values, positive and negative predictive values, exact agreement ratio, diagnosis index, and Cohen's Kappa value were used to evaluate the validity and agreement of the methods of PI and BL/HC. Receiver Operating Characteristic (ROC) analysis was used to evaluate the validity of the diagnosis.

RESULTSOf 417 SGA infants, 376 (90.17%), 376 (90.17%) and 187 (44.84%) subjects were diagnosed as symmetric type with PI, BL/HC and the definition criteria, respectively. (2) The agreement rate and Kappa value between PI and BL/HC was 80.82% and -0.093 (SEM 0.026), respectively. And the agreement rates between PI or BL/HC and the definition criterion were 49.88% and 50.84%, respectively. As compared with the definition criterion, the PI and BL/HC methods had sensitivities of 91.8% - 96.4%, specificities of 9.3% - 25.9%, positive predictive values of 45.8% - 51.1%, negative predictive values of 72.7% - 82.8%, diagnosis indices of 4.9% - 17.7% and Kappa values of 0.070 - 0.167. (3) The areas under the ROC curves in full-term and preterm infants by PI method were 0.635 (95% CI, 0.573 - 0.697) and 0.698 (95% CI, 0.622 - 0.725), respectively. PI cutoffs at 2.47 in full-term SGA, at 2.43 in preterm SGA, and BL/HC cutoff at 1.43 produced the maximum diagnosis indices that were 24.7%, 39.6% and 33.7%, respectively. When the PI at 2.50 (full-term), PI at 2.31 (preterm) and BL/HC values at 1.46, the sensitivity closed mostly to the specificity. The sensitivities and specificities in full-term and preterm infants were 59.4% and 59.3%, 65.3% and 65.5%, and 66.3% and 65.5%, respectively.

CONCLUSIONIn the classification of SGA, the results showed a poor agreement between PI or BL/HC and the definition criterion. The results suggested that the current cutoffs of PI and BL/HC might not be appropriate for the diagnosis of symmetric SGA. Low AUC suggested that PI and BL/HC could not give a valid diagnosis at any cutoffs.

Anthropometry ; methods ; Birth Weight ; Body Height ; China ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Reproducibility of Results ; Sex Factors

Evoked Potentials, Auditory, Brain Stem ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Reflex, Acoustic ; Syphilis, Congenital ; physiopathology

OBJECTIVETo investigate the catch-up growth of preterm infants within a corrected age of 6 months and the risk factors for extrauterine growth retardation (EUGR).

METHODSA total of 321 preterm infants who were discharged after treatment in the neonatal intensive care unit and had regular follow-up documents with complete follow-up records were enrolled. According to the Prenatal Health Care Norms in 2015, these infants were divided into low-risk group with 69 infants and high-risk group with 252 infants. The Z-score method was used to evaluate body weight, body length, and head circumference, and the catch-up growth of the preterm infants within a corrected age of 6 months was analyzed. A multivariate logistic regression analysis was performed to identify the risk factors for EUGR at the corrected age of 6 months.

RESULTSThe percentage of preterm infants with Z scores of body weight, body length, and head circumference of < -2 (not reach the standard for catch-up growth) in both groups decreased gradually with increasing corrected age. At the corrected age of 6 months, the percentages of preterm infants whose body weight, body length, and head circumference did not reach the standard for catch-up growth in the low-risk group were reduced to 1.4% (1/69), 2.9% (2/69), and 1.4% (1/69) respectively, while in the high-risk group, these percentages were reduced to 1.2% (3/252), 1.6% (4/252), and 3.6% (9/252) respectively. The high-risk group had a significantly higher incidence rate of EUGR at the corrected age of 6 months than the low-risk group (28.2% vs 15.9%, P=0.039). The multivariate logistic regression analysis showed that multiple birth (OR=2.68, P=0.010), low birth weight (<1 000 g: OR=14.84, P<0.001; 1 000-1 499 g: OR=2.85, P=0.005), and intrauterine growth retardation (IUGR) (OR=11.41, P<0.001) were risk factors for EUGR at the corrected age of 6 months, while nutritional enhancement after birth (OR=0.25, P<0.001) reduced the risk of EUGR.

CONCLUSIONSMost preterm infants can achieve catch-up growth at the corrected age of 6 months. High-risk preterm infants have a high incidence rate of EUGR at the corrected age of 6 months. Multiple birth, low birth weight, and IUGR are risk factors for EUGR, while rational nutritional enhancement after birth can reduce the incidence rate of EUGR in preterm infants.

Adult ; Body Height ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; physiopathology ; Infant, Premature ; growth & development ; Intensive Care Units, Neonatal ; Male ; Patient Discharge ; Pregnancy ; Risk Factors

OBJECTIVETo investigate the safety and efficacy of low-concentration inhaled nitric oxide (NO) in the treatment of hypoxic respiratory failure (HRF) among premature infants.

METHODSSixty premature infants (gestational age ≤ 34 weeks) with HRF were randomized into NO and control groups between 2012 and 2013, with 30 cases in each group. Both groups received nasal continuous positive airway pressure (nCPAP) or mechanical ventilation. NO inhalation was continued for at least 7 days or until weaning in the NO group. The general conditions, blood gas results, complications, and clinical outcomes of the two groups were analyzed.

RESULTSThe NO group showed significantly more improvement in blood gas results than the control group after 12 hours of treatment (P<0.05). After that, the change in oxygenation status over time showed no significant difference between the two groups (P>0.05). There were no significant differences in total time of assisted ventilation and duration of oxygen therapy between the two groups (P>0.05). The incidence of bronchopulmonary dysplasia (BPD), patent ductus arteriosus, necrotizing enterocolitis, retinopathy of prematurity, and pneumothorax in infants showed no significant differences between the NO and control groups (P>0.05), but the incidence of IVH and mortality were significantly lower in the NO group than in the control group (7% vs 17%, P<0.05; 3% vs 13%, P<0.05).

CONCLUSIONSNO inhalation may improve oxygenation status and reduce the mortality in premature infants with HRF, but it cannot reduce the incidence of BPD and the total time of mechanical ventilation or nCPAP and duration of oxygen therapy. NO therapy may have a brain-protective effect for premature infants with HRF and does not increase clinical complications.

Administration, Inhalation ; Blood Gas Analysis ; Bronchopulmonary Dysplasia ; epidemiology ; Humans ; Hypoxia ; complications ; Incidence ; Infant, Newborn ; Infant, Premature ; Nitric Oxide ; administration & dosage ; Respiratory Insufficiency ; blood ; complications ; drug therapy

OBJECTIVETo define changes in clusterin expression following short-term neoadjuvant hormone therapy (NHT) and its biological significance in prostate cancer tissues.

METHODSTwenty-six archival radical prostatectomy (RP) specimens without receiving NHT, 19 needle biopsies and corresponding 19 RP specimens following 3-month NHT, were subjected to immunohistochemical clusterin staining.

RESULTSStaining for clusterin was mainly found in cytoplasm and part of extracellular matrix. Clusterin expression was significantly greater in RP specimens with preoperative NHT (t = 2.91, P < 0.01); Needle biopsies obtained before NHT consistently demonstrated lower staining intensity (1.42 +/- 0.51) than corresponding RP specimens (2.16 +/- 0.60) following 3-month NHT (t = 7.10, P < 0.01).

CONCLUSIONSUpregulation of clusterin in part accounts for malignant progression of prostate cancer through its anti-apoptotic action following androgen withdrawal. These findings support that adjuvant therapy targeting clusterin may enhance androgen ablation therapy in advanced prostate cancer.

Aged ; Clusterin ; genetics ; metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoadjuvant Therapy ; methods ; Oligonucleotides, Antisense ; therapeutic use ; Prostatic Neoplasms ; metabolism ; pathology ; therapy