Objective:To provide clinical data for early identification and diagnosis of vascular embolism in children.Methods:We collected and analyzed the clinical data of children with vascular embolism diagnosed at the Children Medical Center of the First Affiliated Hospital of Hunan Normal University from January 2017 to January 2020.Results:A total of 29 children with vascular embolism were included.The male to female ratio was 2.2∶1(20/9); the age range was 1 month to 13 years, and the median age(IQR) was 16 (6-41)months.Among them, 22 cases were diagnosed with venous thrombosis, including 13 children with lower limb venous thrombosis(13/29, 44.8%), and six children with intracranial venous thrombosis(6/29, 20.7%). Arterial embolism was found in six cases, and left atrial appendage thrombosis was found in one case.Severe pneumonia was the most common primary disease(19/29, 65.5%), followed by cardiopulmonary resuscitation(3/29, 10.3%), and Kawasaki disease(3/29, 10.3%). Analysis on the risk factors of vascular embolization diseases, including catheter-related, long-term bed rest, elevated D-dimer, mechanical ventilation, and intravenous hormone administration, showed that 89.2%(25/29)had ≥3 risk factors at the same time, and 82.8%(24/29)had ≥5 risk factors at the same time.Conclusion:In children with vascular thrombotic diseases, deep venous thrombosis, especially lower extremity venous thrombosis, are common.The severe pneumonia is more common in primary disease.Children with multiple risk factors have a higher risk of developing vascular embolism.In clinic, coagulation function should be monitored and local symptoms should be observed for early identification.

Objective:To explore the prognostic value of CysC and NT‐proBNP in patients with non‐ST elevation a‐cute coronary syndrome (NSTE‐ACS) .Methods :A total of 166 NSTE‐ACS patients hospitalized in our hospital from Jan 2012 to Dec 2012 were selected .They were followed up for 12 months ,then general data ,levels of CysC , NT‐proBNP ,hsCRP and cTnI etc .and incidence rate of MACE were recorded and measured .According to MACE occurrence during follow‐up or not ,156 cases were divided into non‐MACE group (n=137) and MACE group (n=19) ,risk factors for MACE in NSTE‐ACS patients were analyzed ,receiver operator characteristic curve (ROC) was performed ,and the optimal cutoffs of related indexes predicting MACE occurrence in these patients were analyzed . Results :Compared with non‐MACE group ,there were significant rise in age [ (60.26 ± 10.45) years vs .(64.16 ± 11.21) years] ,levels of CysC [ (1.02 ± 0.11) mg/L vs .(1.15 ± 0.12) mg/L] ,NT‐proBNP [ (251.97 ± 89.65) pg/ml vs .(347.93 ± 107.29) pg/ml] ,hsCRP [ (14.69 ± 3.53) mg/L vs .(17.13 ± 3.68) mg/L] and cTnI [ (0.36 ± 0.46) ng/ml vs .(0.90 ± 0.88) ng/ml] in MACE group ,P<0.05 or <0.01. Multi‐factor regression analysis indica‐ted that CysC ,NT‐proBNP and cTnI levels were independent predictors for MACE in NSTE‐ACS patients ( P<0.05 or <0.01) .ROC curves of CysC ,NT‐proBNP ,cTnI and hsCRP judging prognosis were drawn , only AUC of CysC and NT‐proBNP curves were >0.7 [CysC:0.784 ,95% CI:0.687~0.881 ;NT‐proBNP:0.753 ,95% CI :0.639~0.867] , and it′s analysis indicated that CysC=1.07 mg/L and NT‐proBNP=279.60 pg/ml were their optimal cutoff predicting MACE .Kaplan‐Meier survival curves with above two cutoffs as risk stratification cutoff indicated that survival time of high risk group was significantly shorter than that of low risk group (P<0.05) .Conclusion:Serum CysC and NT‐proBNP levels are independent predictors assessing prognosis in NSTE‐ACS patients .

Objective To analyze MRI appearance after augmentation mammoplasty,and to assess the clinical value.Methods Sixty-three cases with augmentation mammoplasty were imaged by MR scanner.MR imaging features of silicone implant and injected implant were analyzed respectively.Results(80 breasts) in 40 patients were with polyacrylamide hydrogel injection.In 50 breasts,the implants were shown as irregular gel in mammary gland,pectoralis muscle,and subcutaneous tissue.Auto-fat injection in both side of breast was performed in 7 cases.Among them,fibrofatty mass was detected in 12 breasts,fat-fluid interface was seen in 6 breasts,and fat in pectoralis major was revealed in 6 breasts.Silicone implant in both side of breast was performed in 16 cases.2 breasts in 2 case were detected as saline-filled implants with intracapsular rupture.14 cases were with silicone gel-filled implants,among them,4 breasts were found to have extracapsular rupture and 10 breasts intracapsular rupture.Conclusion MRI is a perfect method in accessing the patients with augmentation mammoplasty.

Objective To investigate the protective effects and underlying molecular mechanisms of hydrogen (H2) on high glucose-induced poly (ADP-ribose) polymerase-1 (PARP-1) dependent cell death (PARthanatos) in primary rat Schwann cells. Methods Cultured primary rat Schwann cells were randomly divided into five groups: blank control group (C group), H2 control group (H2 group), high osmotic control group (M group), high glucose treatment group (HG group), and H2 treatment group (HG+H2 group). The cells in H2 group and HG+H2 group were cultured with saturated hydrogen-rich medium containing 0.6 mmol/L of H2, and those in three control groups were cultured with low sugar DMEM medium containing 5.6 mmol/L of sugar, and the cells in HG and HG+H2 groups were given 44.4 mmol/L of glucose in addition (the medium containing 50 mmol/L of glucose), the cells in C group and H2 group were given the same volume of normal saline, and the cells in M group were given the same volume of mannitol. Cytotoxicity was evaluated using lactate dehydrogenase (LDH) release rate assays after treatment for 48 hours in each group. The contents of peroxynitrite (ONOO-) and 8-hydroxy-2-deoxyguanosine (8-OHdG) reflecting oxidative stress injury and DNA damage were detected by enzyme linked immunosorbent assay (ELISA). Poly (ADP-ribose) (PAR) protein expression was analyzed by Western Blot, and immunofluorescence staining was used to determine the nuclear translocation of the apoptosis-inducing factor (AIF). Results The cytotoxicity in HG and HG+H2 groups was significantly increased as compared with that of C group [LDH release rate: (61.40±2.89)%, (42.80±2.32)% vs. (9.92±0.38)%, both P < 0.01], the levels of ONOO- and 8-OHdG were markedly elevated [ONOO- (ng/L): 853.58±51.00, 553.11±38.66 vs. 113.56±14.22; 8-OHdG (ng/L): 1 177.37±60.97, 732.06±54.29 vs. 419.67±28.77, all P < 0.01], and the PAR protein expression was up-regulated (A value: 0.603±0.028, 0.441±0.010 vs. 0.324±0.021, both P < 0.01). The cytotoxicity, the levels of ONOO- and 8-OHdG, and PAR expression in HG+H2 group were significantly lower than those of the HG group (all P < 0.01). There were no significant differences in above parameters between H2 group as well as M group and C group. It was shown by immunofluorescence that AIF was expressed in the cytoplasm in C group, H2 group and M group, AIF was expressed in the whole cell in HG group, and the expression in the nucleus was particularly increased. A small amount of AIF expression was found in the nucleus of HG+H2 group, which indicated that high glucose could promote the AIF nuclear translocation, and that hydrogen-rich medium could prevent the process of translocation. Conclusions High glucose levels could enhance DNA damage that enhance PARthanatos in primary rat Schwann cells. However, H2 can not only reduce DNA damage of injured cells, but also inhibit the special death process, reduce the cell toxicity, all of which have protective effects.

Objective To investigate the effects of hydrogen-rich medium on lipopolysaccharide (LPS)-induced intestinal epithelial barrier dysfunction of human intestinal epithelial (Caco2) cells. Methods Caco2 cells (passages 28-35) were purchased from the Cell Bank of the Shanghai Institute of Cell Biology, Chinese Academy of Sciences in Shanghai, China, and they were cultured in Dulbecco minimum essential medium (DMEM) containing 20% fetal bovine serum. These cells were randomly divided into four groups: control group (group A), hydrogen-rich medium group (group B), LPS group (group C) and LPS + hydrogen-rich medium group (group D). Cells were cultured with normal medium in group A and group C or with hydrogen-rich medium in group B and group D. Meanwhile, 1 g/L LPS was simultaneously added into group C and group D, while an equivalent volume of normal saline was added into group A and group B instead. In vitro intestinal epithelial models were reproduced with monolayer filter-grown Caco2 and intestinal epithelium. The trans-epithelial electrical resistance (TEER) in models of each group was measured at different incubation times (0, 3, 6, 12, 24 and 48 hours). Cell viability and cytotoxicity were assessed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and lactate dehydrogenase (LDH) release assay, respectively, after incubation for 24 hours. The expression levels of claudin-1 and occludin were respectively determined at 6, 12 and 24 hours of incubation by Western Blot assay. The morphological structure of claudin-1 and occludin was respectively observed after incubation for 24 hours with immunofluorescence staining. Results There was no statistical significance in variables between group A and group B. Compared with group A, it was shown that TEER was time-dependently decreased in groups C and D after 6 hours. Compared with group C, TEER in group D was increased after 6 hours. Compared with group A, the cell viability was significantly reduced in group C [(67.2±7.9)% vs. (100.0±0.0)%, P < 0.05] and cell injury was obvious [LDH release rate: (38.5±2.1)% vs. (1.2±0.3)%, P < 0.05]; the expression levels of claudin-1 and occludin at 6, 12, 24 hours were significantly down-regulated [claudin-1 (gray value): 0.351±0.079, 0.272±0.075, 0.190±0.049 vs. 0.518±0.030; occludin (gray value): 0.416±0.044, 0.290±0.062, 0.226±0.019 vs. 0.602±0.038, all P < 0.05], and the structure of claudin-1 and occludin were profoundly disrupted. Compared with group C, it was shown that the cell viability was significantly increased in group D [(88.8±7.4)% vs. (67.2±7.9)%, P < 0.05] and cell injury was significantly abated [LDH release rate: (16.4±4.3)% vs. (38.5±2.1)%, P < 0.05]; the expression levels of claudin-1 and occludin were significantly up-regulated at 24 hours [claudin-1 (gray value): 0.428±0.046 vs. 0.190±0.049, occludin (gray value): 0.466±0.071 vs. 0.226±0.019, both P < 0.05]; the disrupted structures of claudin-1 and occludin were partially recovered. Conclusion Hydrogen-rich medium can effectively attenuate LPS-induced dysfunction of intestinal epithelial barrier in human Caco2 cells by ameliorating cell viability as well as regulating claudin-1 and occludin expression and structure.

Objective To measure the present situation of medical students' learning adaptability and find the influencing factors in order to revise Learning Adaptability Scale for medical students.Methods A stratified sampling method was used to collect 1 180 medical students from Harbin Medical University.Using the internal consistency reliability test,the reliability of the revised student learning adaptability scale was verified.Five common factors were extracted by the exploratory factor analysis of the principal analysis method,and Logistic regression was used to analyze the influencing factors of medical student learning adaptability.Results The revised Student Learning Adaptability Scale (Cronbach's Alpha=0.914) consists of 27 measurement items.It includes five dimensions,namely self-directed learning,information utilization,environment choice,stresses response and goal orientation.The results showed that the adaptability of medical students was moderate (3.28 ± 0.52),and the influencing factors included job position (OR =1.496,95％ CI=1.114-2.009),academic achievement (OR =1.638,95 ％ CI=1.386-1.936),satisfaction with learning (OR=2.160,95％CI=1.745-2.673),professional satisfaction (OR=1.369,95％CI=1.092-1.718),professional interest (OR =1.426,95％ CI=1.186-1.715) and employment prospects (OR =1.526,95％ CI=1.251-1.862).Conclusion The reliability and validity of the Student Learning Adaptability Scale is appropriate.Medical students' learning adaptability is influenced by many factors.

OBJECTIVE: To investigate the relationship between platelet activating factor (PAF) and occurrence of hepatorenal syndrome (HRS). METHODS: A total of 57 cases of patients with liver cirrhosis or hepatitis gravis were enrolled. The serum concentrations of PAF, lipopolysaccharide (LPS) and prothrombin activity (PTA), total bilirubin, and serum creatinine were detected in patients combined with HRS and in patients without HRS in hospital at the term. The correlations among the PAF, LPS, and the function of liver and kidney were analyzed. RESULTS: The concentrations of PAF and LPS in the patients combined with HRS were significantly higher than those patients without HRS. There were linear correlations between the PAF and LPS level, the total bilirubin level and PAF level, the PAF level and serum creatinine level. CONCLUSION The PAF associates with the occurrence of HRS. The PAF may mediate the occurrence of HRS induced by LPS. The PAF level may forecast whether patients with liver failure will take place HRS.
Biomarkers ; metabolism ; Female ; Hepatorenal Syndrome ; metabolism ; Humans ; Male ; Platelet Activating Factor ; metabolism

Melatonin has been reported to inhibit hepatic fibrosis and the mechanism may be correlated to its anti-oxidant effect.Nevertheless,the mechanism is not completely identified.This study was conducted to investigate the effects of melatonin on TGF-β1/Smad signaling pathway in liver fibrosis in rats.The liver fibrosis model was made by the subcutaneous injection of CCl4.The liver pathology changes were detected using hematoxylin and eosin (H&E) staining and Van Gieson (VG) staining.Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were measured with an autoanalyzer.Glutathione peroxidase (GPx) activities and levels of malondialdehyde (MDA) and hydroxyproline (Hyp) in liver were evaluated by spectrophotometry.Expression levels of TGF-β1,Smad2/3,phosphorylated Smad2/3 (p-Smad2/3) and Smad7 in liver were detected by immunohistochemistry and Western blot analysis.Results showed that melatonin suppressed CC14-induced liver fibrosis,along with an improvement in histological changes,significant decreases in pathologic grading sores and obvious decreases in Hyp levels in liver.Melatonin improved liver function indicated by decreased serum ALT and AST activities.In addition,melatonin exerted its anti-oxidant effects,as supported by decreased MDA levels and increased GPx activities in liver.Furthermore,melatonin inhibited TGF-β1/Smad pathway,as evidenced by decreased TGF-β1,Smad2/3 and p-Smad2/3 expression and increased Smad7 expression in liver.In conclusion,melatonin may suppress CCl4-induced hepatic fibrosis in rats via inhibiting TGF-β1/Smad pathway.It is possible for melatonin to be a potential reagent to treat and cure liver fibrosis.

Objective To study the anti-fatigue effect of Cynomorium songaricum flavone(CSF)on old rats.Methods50 old male Wistar rats were randomly divided into the control group(no swimming,no drugs),single swimming group(swimming,given saline by gavage),and three swimming plus CSF groups(swimming,given CSF 20 g/kg weight,10 g/kg weight and 5 g/kg weight respectively),total five groups with 10 animals in each group.Animals swam with free swimming in endless cycles water 30 minutes once every day for 10 days.The level of monoamine oxidase(MAO) and glutathione peroxidase(GSH-px) in blood of animals were examined by MAO kit,GSH-px kit and ultraviolet spectrophotometer at 11th day.ResultsCompared with single swimming group,the body weights of swimming plus CSF groups increased significantly by 12.9%,80.6% and 200% respectively(P<0.01);swimming times before sinking increased by 19.4%,29% and 48.4%;sinking times of each rat(time/10 min) decreased by 17.8%,43.2% and 72.9%;total swimming times increased by 2.8%,7% and 29.6% respectively(P<0.01);MAO decreased by 60%,69.8% and 80.5%,GSH-px increased by 465.3%,563.8% and 635% respectively(P<0.01).ConclusionCSF shows anti-oxidative and anti-fatigue properties and can be given as prophylactic/therapeutic supplements for increasing antioxidant enzyme activities and preventing lipid peroxidation during strenuous exercise.

ObjectiveTo investigate the effect of whole-period psychiatric rehabilitation on outpatients with schizophrenia.Methods90 outpatients with schizophrenia were randomly divided into the study group and control group with 45 cases in each group. All cases in two groups received pharmacotherapy, but cases of study group were added with whole-period psychiatric rehabilitation. Assessments were performed before and after study. All subjects were evaluated with the Brief Psychiatric Rating Scale (BPRS) and Social Disability Screening Schedule (SDSS).ResultsThe outcome of the study group was significantly superior to the control group on overall improvement according to the reductions of BPRS score, Anergia factor score, thought disturbance factor score, suspiciousness factor score and SDSS score(P<0.05-0.01).ConclusionThe whole-period psychiatric rehabilitation may play an important role in controlling symptoms and improving social function to outpatients with schizophrenia.