OBJECTIVE:To observe the effect of acyclovir on neurological function and cytokines of children with viral menin-gitis. METHODS:Totally 70 children with viral meningitis were randomly divided into control group and observation group. All children were given routine treatment,including defervescence,reducing intracranial pressure and regulating water and electrolyte balance,etc. Based on it,the control group was treated by Ribavirin glucose injection 15 mg/kg,iv,bid;observation group was treated by Acyclovir glucose injection 5 mg/kg,iv,tid. The course for both was 7 d. The clinical data was compared,including the vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9) in cerebrospinal fluid (CSF) and serum,insu-lin-like growth factor-Ⅱ(IGF-Ⅱ) and insulin like growth factor binding protein-3(IGFBP-3) in CSF before and after treatment and the incidence of adverse reactions. There were no obvious adverse reactions during the treatment. RESULTS:After treatment, the VEGF and MMP-9 in serum and the VEGF,MMP-9,IGF-Ⅱ and IGFBP-3 in CSF in 2 groups were significantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). There was no adverse reactions in 2 groups during the treatment. CONCLUSIONS:Compared with ribavirin,acyclovir can more obviously improve the neurological function and cytokines of children with viral meningitis,with similar safety.

Objective To investigate serum procalcitonin(PCT)and C-reactive protein(CRP)and clinical significance of changes in children with pneumonia.Methods 123 cases of childhood pneumonia included 48 cases of bacterial infection,mycoplasma infection in 36 cases,39 cases with viral infections,40 cases of physical healthy children were selected as the control group.They were measured in serum PCT and CRP content of the correlation between test results and analysis of clinical final diagnosis.Results The level of PCT in Bacterial pneumonia group, Mycoplasma pneumonia group and viral pneumonia group were (5.80 ±1.92)μg/L,(0.45 ±0.15 )μg/L and (0.32 ±0.17)μg/L,respectively,significantly higher than control group(0.19 ±0.10)μg/L(t =5.37,3.41,1.23, all P <0.05);the level of CRP in Bacterial pneumonia group,mycoplasma pneumonia group and viral pneumonia group were(45.34 ±13.35 )mg/L,(28.63 ±11.37)mg/L and (8.19 ±2.07)mg/L,respectively,significantly higher than control group(3.85 ±1.31)mg/L(t =5.37,3.41,1.23,all P <0.05);serum PCT sensitivity to detect pneumonia children,specificity and the positive predictive were 93.56%,82.35% and 69.25%,respectively,higher than serum CRP diagnosis of pneumonia sensitivity,specificity and positive predictive(χ2 =4.41,5.83 and 7.62, respectively,all P <0.05).Conclusion Serum PCT and CRP measurement can be used as an auxiliary to identify indicators of childhood pneumonia,the diagnosis of pneumonia in children has important clinical significance.

Objective To establish a method for calculating deferral periods of blood donors having taken traditional Chinese medicines based on the drug's pharmacokinetics.Methods The pharmacokinetic method was used.For drugs that are not known to cause anaphylaxis or teratogenesis,the interval between last dose of drug and safe blood donation equals to t max plus 7t 1/2 .For drugs with known teratogenic and anaphylactic risks,a deferral period of 20 plasma elimination half lives and t maxis necessary.There are some rules independent of the drug's half life.Results 22 intervals of traditional Chinese medicine are determined.Conclusion Our recommendations for deferral periods of blood donors after traditional Chinese medicine treatment,based on pharmacokinetics can increase the safety of donated blood.

Epithelial-to-mesenchymal transition (EMT) plays a critical role in cancer metastasis,and is relevant to the inflammatory microenvironment.Lipopolysaccharide (LPS),a cell wall constituent of gram-negative bacteria,has been reported to induce EMT of cancer cells through TLR4 signal.We previously reported that LPS promoted metastasis of mesenchymallike breast cancer cells with high expression of cyclin D 1 b.However,the role of cyclin D1b in LPS-induced EMT has not been fully elucidated.In the present study,we described that cyclin D1b augmented EMT induced by LPS in MCF-7 breast cancer cells.Cyclin D1b markedly amplified integrin αvβ3 expression,which was further up-regulated under LPS stimulation.Our results showed ectopic expression of cyclin D1b promoted invasiveness of epithelial-like MCF-7 cells under LPS stimulation.Additionally,LPS-induced metastasis and EMT in MCF-7-D1b cells might depend on αvβ3 expression.Further exploration indicated that cyclin D1b cooperated with HoxD3,a transcription factor promoting αvβ3 expression,to promote LPS-induced EMT.Knockout of HoxD3 repressed LPS-induced EMT and αvβ3 over-expression in MCF-7 cells with high expression of cyclin D1b.Specifically,all these effects were in a cyclin D1a independent manner.Taken all together,LPS up-regulated integrin αvβ3 expression in MCF-7 cells with high expression of cyclin D 1b and induced EMT in breast cancer cells,which highlights that cyclin D1b may act as an endogenous pathway participating in exogenous signal inducing EMT in breast cancer cells.

Calpain ; genetics ; Diabetes, Gestational ; genetics ; Female ; Genotype ; Haploidy ; Humans ; Polymorphism, Single Nucleotide ; Pregnancy

Objective To explore the circadian rhythm of neurally mediated syncope (NMS)in children. Methods There were 21 6 children with NMS included in the study,including 91 male and 1 25 female,aged from 4 to 1 7 years old with a mean age of (1 1 .34 ±2.65)years,who came from the Specialist Syncope Outpatient Department or Inpatient Department of the Second Xiangya Hospital of Central South University from December 201 3 to October 201 5. The patients were divided into vasovagal syncope (VVS)group and postural tachycardia syndrome (POTS)group ac-cording to head -up tilt test (HUTT)results,including 1 78 VVS patients and 38 POTS patients.Ninety -four patients with NMS were in the <1 2 years old group[(8.88 ±1 .88)years old]and 1 22 subjects with NMS were in the ≥1 2 years old group[(1 3.24 ±1 .1 8)years old].All patients or guardians were carefully asked about the number of synco-pal attacks and the periods in which episodes occurred in before HUTT [24 hours of a day were divided into 4 periods:morning (0600 AM-1 200 AM),afternoon (1 200 AM-1 800 PM),evening (1 800 PM-2400 PM), night (0000 AM-0600 AM)].Results (1 )General data:the total syncopal episodes of 21 6 children with NMS were 61 4 episodes,including 1 78 VVS patients with 471 syncopal episodes in total and 1 43 attacks of 38 children with POTS.There were 273 episodes of 94 patients in the <1 2 years old group and 341 episodes of 1 22 subjects in the ≥1 2 years old group.There were no significant differences in the diurnal variation of syncopal episodes between the VVS group and POTS group regarding age and gender (P >0.05).(2)The number of syncopal episodes in patients with VVS which occurred in the morning hours was strikingly higher than that of afternoon,evening or nighttime (P <0.05).But there was no significant difference in the frequency of episodes in different periods through the day in the POTS group (P >0.05).Patients with VVS had a higher proportion of episodes in the morning but a lower proportion in the evening when compared with the POTS group (P <0.05).(3)The male children with NMS tended to have a higher proportion of episodes in the morning than the female patients(χ2 =1 1 .001 ,P =0.01 2).(4)There seemed to be no difference in the frequency of syncopal episodes through the day between the <1 2 years old group and the ≥1 2 years old group(χ2 =1 .995,P =0.573).Conclusions The frequency of syncopal episodes in children with VVS displayed a clear circadian rhythm,with a peak in the morning,but the POTS patients did not show a circadian variation.The male children with NMS tended to have a higher proportion of episodes in the morning than the female patients.

Objective To explore the changes in serum and urine electrolytes of children with neurally media-ted syncope (NMS)after oral rehydration salts (ORS)[Ⅰ]treatment.Methods The study group included 135 patients [60 male and 75 female,aged 4 -16 years,average of (10.20 ±2.68)years old]with unexplained syncope and prodro-mal symptoms of syncope in our hospital between May 2014 and April 2015.The patients underwent head -up tilt test (HUTT),and completed serum electrolytes and 24 -hour urine electrolytes,and the serum electrolytes and 24 -hour u-rine electrolytes in different hemodynamic type of HUTT were compared.Positive HUTT patients were treated with health education and ORS[Ⅰ],while negative HUTT patients were received health education.Then 21 -154(42.63 ±27.71) days later,the patients returned to hospital,for the inquiry of symptom improvement,and review of HUTT,24 -hour urine and serum electrolytes.Results (1)The total effective rate of ORS[Ⅰ]treatment was 62.96% (17 /27 cases),while negative conversion rate of HUTT was 48.15% (13 /27 cases).(2)There was no significant difference in serum electro-lytes,24 -hour urine electrolytes or 24 -hour urine volume between HUTT positive group and negative group during the first visit (all P >0.05).(3)In return visit,serum calcium [(2.30 ±0.10)mmol/L vs (2.20 ±0.09)mmol/L,t =2.72,P <0.05]and serum phosphorus [(1.73 ±0.22)mmol/L vs (1.51 ±0.23)mmol/L,t =2.671,P <0.05]in HUTT positive group were significantly higher than those in negative group.The serum sodium,potassium,chloride,mag-nesium and 24 -hour urine electrolytes,24 -hour urine volume had no statistical difference(all P >0.05).(4)24 -hour urine sodium [(159.06 ±72.76)mmol/24 h vs (118.97 ±52.75)mmol/24 h,t =2.712,P <0.05],24 -hour urine chloride [(139.08 ±66.53)mmol/24 h vs (111.34 ±47.33)mmol/24 h,t =2.116,P <0.05]and 24 -hour urine volume [(1 564.21 ±829.39)mL vs (1 058.95 ±509.92)mL,t =3.371,P <0.01]after ORS[Ⅰ]treatment were sig-nificantly higher than those before ORS[Ⅰ]treatment.The serum electrolytes and 24 -hour urine potassium,calcium, phosphorus,magnesium had no statistical difference (all P >0.05).(5)There was no significant difference in serum elec-trolytes,24 -hour urine electrolytes or 24 -hour urine volume between vasovagal syncope group and postural orthostatic tachycardia syndrome group during the first visit(all P >0.05).Conclusions ORS[Ⅰ]treatment can obviously increase the 24 -hour urine sodium,24 -hour urine chloride in children with NMS.ORS[Ⅰ]is an effective therapy for NMS.

Objective To observe the protective effects of nuclear factor (NF) κB inhibitor pyrrolidine dithiocarbamate (PDTC) on chronic mixed reflux esophagitis in rats and its influence on NF-κB/interleukin (IL)-6 signaling pathway.Method A total of 40 healthy male Sprague-Dawley (SD) rats were divided into healthy control group,sham operation group,model control group,omeprazole group and PDTC group with eight rats in each group.Except rats in healthy control group and sham operation group,mixed reflux esophagitis model were established in all the other groups.The rats of healthy control group,sham operation group and model control group were all intraperitoneally injected with 2 mL 0.9％ NaCl,rats of omeprazole group were intraperitoneally injected with omeprazole 20 mg/kg,and rats of PDTC group were intraperitoneally injected with PDTC 100 mg/kg every day.After six weeks,the rats were sacrificed,the morphological changes of esophageal tissues were observed and scored by visual inspection and under light microscope.The serum levels of NF-κB p65 and IL-6 in rats of each group were assessed by enzyme linked immunoassay (ELISA).t test was performed for mean comparison among groups.Results The scores of esophageal mucosa judged by visual inspection of healthy control group,sham operation group,model control group,omeprazole group and PDTC group were 0.000 20.000,0.000±0.000,2.250± 0.707,1.125 ± 0.835 and 1.429± 0.535,respectively.The pathological scores were 0.00020.000,0.000±0.000,2.625±0.518,1.500±0.535,1.429±0.535,respectively.Compared with those of model control group,the scores judged by visual inspection and the pathological scores of healthy control group,sham operation group,omeprazole group and PDTC group were lower,and the differences were statistically significant (t=7.603,7.603,2.909,2.506; t=9.674,9.674,4.277,4.399,all P＜0.05).The serum levels of NF-κB p65 protein of healthy control group,sham operation group,omeprazole group and PDTC group were (68.618±18.450) pg/mL,(77.824±22.228) pg/mL,(106.693±45.312) pg/mL and (103.781± 42.502)pg/mL,respectively; compared with that of model group ((184.882±49.165) pg/mL),which were significantly lower and the differences were statistically significant (t=6.262,5.612,3.308 and 3.427,all P＜0.05).The serum levels of IL-6 protein were (24.826±4.008) pg/mL,(23.599±4.351) pg/mL,(32.370± 11.657) pg/mL and (33.694±10.394) pg/mL,respectively,which significantly decreased when compared with that of model group ((51.378±9.697) pg/mL,t=7.157,7.393,3.546 and 3.392,all P＜0.05).There was no significant difference between PDTC group and omeprazole group in the score judged by visual inspection,pathological scores,the serum levels of NF-κB p65 and IL-6 protein (all P＞0.05).Conclusion NF-κB inhibitor PDTC could reduce the injury severity of esophageal mucosal in reflux esophagitis rat,which mechanism might be related with the down-regulation of NF-κB/1L-6 signaling pathway.

Objective To observe the protective effects of quercetin on esophageal mucosa in chronic mixed reflux esophagitis (RE) rats and the effect of quercetin on nuclear factor (NF)-κB/interleukin (IL)-6 signaling pathway.Methods Mixed RE model was successfully induced by cardia ligation and esophagoduodenostomy.48 healthy male Sprague-Dawley rats were equally divided into the following 6 groups using random number table method:normal control group,sham-operation group,model control group,omeprazole group,low-dose quercetin group,and high-dose quercetin group.The 6 groups were treated with peritoneal injection of 2 ml normal saline (normal control,sham-operation,model control groups),20 mg/kg omeprazole,100 mg/kg quercetin (low-dose) and 200 mg/kg quercetin (high-dose) once daily,respectively.The rats were sacrificed after 6 weeks of intervention.The microscopic pathological changes of esophageal mucosa were scored.NF-κB p65 and IL-6 protein levels in esophageal mucosa and serum were assessed using immunohistochemistry and enzyme-linked immunosorbent assay,respectively.Results In normal control group,shamoperation group,model control group,omeprazole group,low-dose quercetin group and high-dose quercetin group,the pathological scores of esophageal mucosa were 0.250 ± 0.463,0.250 ± 0.463,2.625 ± 0.518,1.500 ±0.535,1.250 ±0.463,and 1.375 ±0.518; the NF-κB p65 protein scores in esophageal mucosa were 0.500±0.535,0.625 ±0.518,3.500 ±0.535,1.875 ±0.649,1.750 ±0.707,and 2.000 ±0.535; the IL-6 protein scores in esophageal mucosa were 1.125 ± 0.641,1.125 ± 0.835,5.375 ± 0.518,2.375 ± 0.518,2.000 ±0.535,and 2.250 ±0.463; the serum NF-κB p65 protein levels were (68.618 ± 18.500),(77.824 ± 22.228),(184.882 ± 49.165),(106.693 ± 45.312),(76.215 ± 16.588),and (108.207 ± 42.107) pg/ml; the serum IL-6 protein levels were (24.826 ±4.008),(23.599 ±4.351),(51.378 ± 9.697),(32.370 ± 11.657),(23.085 ± 4.660),and (26.243 ± 4.955) pg/ml.In terms of the 5 indicators,there were no statistically significant differences between the normal control group and the sham-operation group (P =1.000,P =0.642,P =1.000,P =0.518,P =0.673) ; the results in the normal control,shamoperation,omeprazole,low-dose quercetin,and high-dose quercetin groups were significantly different from those in the model control group (P < 0.001,P < 0.001,P < 0.001,P =0.002,P =0.001 ; P < 0.001,P < 0.001,P<0.001,P=0.004,P=0.002; P=0.001,P<0.001,P<0.001,P=0.025,P=0.023; all P <0.001 ; P <0.001,P <0.001,P <0.001,P =0.023,P <0.001) ; there were no statistically significant differences between low-dose quercetin group and omeprazole group,nor between high-dose quercetin group and omeprazole group (P=0.334,P=0.717,P=0.176,P=0.121,P =0.074; P =0.642,P=0.678,P=0.619,P =0.949,P =0.225); there were no statistically significant differences between low-dose quercetin group and high-dose quercetin group (P =0.619,P =0.438,P =0.334,P =0.086,P =0.243).The microscopic pathological score of esophageal mucosa was positively correlated with NF-κB p65 and IL-6 protein scores in esophageal mucosa (r =0.803,P < 0.001 ; r =0.758,P < 0.001),also positively correlated with serum NF-κB p65 and IL-6 protein levels (r=0.486,P=0.004; r=0.544,P=0.001).Conclusions The expression levels of NF-κB p65 and IL-6 protein in esophageal mucosa and serum increase with the severity of esophageal mucosal injury.Quercetin can reduce the severity of esophageal mucosal injury in RE,possibly through down-regulating NF-κB and IL-6 expression and mitigatng esophageal inflammatory status.

Objective To evaluate the outcome of combination of intensive preconditioning regimen allo-HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia (ALL). Methods Between 2009 and 2010, 8 patients diagnosed as Ph+ ALL received allo-HSCT from HLA identical sibling during complete remission. Imatinib was added into the therapies of 5 patients.Seven patients received the intensive preconditioning regimen based on BuCy2, one patient received the regimen of TBI-Cy. A median of 6. 02 × 108/kg mononuclear cells and 3. 14 × 106/kg CD34+ cells were transfused. GVHD prophylaxis included cyclosporine A and methotrexate. Results All patients were well tolerant to the regimen without serious regimen-related toxicity. The median time of ANC≥0. 5 × 109/L was 15. 5 days, and that of PLT≥20 × 109/L was 19 days. Thirty days after allo-HSCT, all patients got donor engraftment successfully. Among 8 cases, 4 cases presented acute GVHD, 2 developed degree Ⅰ , one developed degree Ⅱ , and one developed degree Ⅳ. Seven patients were alive 100 days after allo-HSCT, 3 of whom presented chronic GVHD. At the end of following-up period, 6 patients were alive, among them, 3 patients were alive without relapse; 3 patients relapsed; Two patients died, one from acute GVHD, and one from leukemia relapse. Conclusion Combined intensive preconditioning regimen allo-HSCT with Imatinib was an effective treatment for Ph+ ALL, but the effect of anti-chronic GVHD of imatinib should arouse certain attention.