Objective To investigate the role of signal transduction of toll-like receptors(TLRs)in immunological pathogenesis in children with acute idiopathic thrombocytopenic purpura(ITP).Methods Thirty children with actue ITP and 30 age-matched healthy children were studied.Real-time fluorescent quantitative PCR was used to evaluate the levels of TLR 1-10 and signal transducing molecules,and cytokines associated with TLRs,such as IL-1?,granulocyte-macrophage colony-stimulating factor(GM-CSF),macrophage colony-stimulating factor(M-CSF)and IFN-?/? mRNA.Expressions of co-stimulatory molecules such as CD40,CD80 and CD86 in mo-nocyte/macrophage(MC)was analyzed by flow cytometry.Results Compared with healthy control group,the mRNA levels of TLR3,7,8 and 9 in ITP group were significantly up-regulated(Pa0.05).Transcription le-vels of MyD88-dependent and-independent pathway molecules such as MD-2,MyD88,IRAK-4,TRAF6,TAK1,TRIF,TRAM,TBK-1 and IFN-? were significantly up-regulated in acute ITP(Pa0.05).Conclusion Aberrant activation of toll-like receptors signaling may be one of the initiating factors of immune dysfunction in children with acute ITP.

Objective To study the expression of vascular endothelial growth factor(VEGF)-C, VEGF-D and their receptor-3(VEGFR-3)in patients with colorectal cancer and their clinicopathological value.Methods Eighty specimens of the colorectal cancer and thirty normal adjacent bowels were stud- ied.The expression of VEGF-C,VEGF-D and VEGFR-3 proteins and mRNAs in specimens of colorectal cancers and normal colorectal tissues was studied by Strept-avidin-biotin complex method and RT-PCR. Clinicopathological data and survival of each patient were recorded and analyzed.Results①The staining of brown or filemot in cytoplast were observed as the positive expression of VEGF-C,VEGF-D and VEGFR-3 proteins.The positive rate(48.8%,56.3%,38.8%)and mean value(1.09?1.20,1.13?1.09,0.90?1.19)of VEGF-C,VEGF-D,VEGFR-3 expressions in specimens of colorectal cancer were significantly higher than those of the normal bowel tissues(P＜0.05).The expression of VEGF- C,VEGF-D and VEGFR-3 mRNAs by RT-PCR was correlated with that of VEGF-C,VEGF-D and VEGFR-3 proteins in colorectal carcinomas and normal bowel tissues.②Significant correlation between VEGF-C(P=0.0069),VEGF-D(P=0.0024)and VEGFR-3 expression was observed in colorectal cancers;moreover,no correlation between VEGF-C and VEGF-D.③The expression of VEGF-C, VEGF-D and VEGFR-3 in colorectal cancers was not correlated with age,gender,site and dimension of lesion,types of gross and histological,degree of differentiation and liver and pulmonary metastasis,but correlated significantly with Dukes' stage(P=0.0234,P=0.0003,P=0.0429)and lymph node me tastasis(P=0.0059,P＜0.01,P=0.0068).The increased death rate(P=0.0374,P=0.0127) and poor survival(P＜0.01,P＜0.01)were observed in the colorectal cancer patients with positive ex- pression of VEGF-C and VEGFR-3 when comparing with the patients of the negative expressions,but the expression of VEGF-D in colorectal cancers was not correlated with prognosis of the patients.Con- clusions Colorectal cancer cells may secrete lymphangiogenetic growth factors VEGF-C,VEGF-D and their receptor VEGFR-3,which induce the growth of lymphatic vessel endothelium and lymphangiogene- sis by VEGF-C,VEGF-D/VEGFR-3 signaling pathway,further accelerate lymphatic metastasis of colo- rectal cancers.VEGF-C,VEGF-D and VEGFR-3 might be acted as molecular phenotypes of lym- phangiogenesis in coiorectal cancers and important markers for evaluating lymphatic metastasis and prog- nosis in patients with coloreetaI carcinoma.

Objective To investigate the expression of pattern recognition receptor (PRR)of immune cells from the patients with enterovirus 71 ( EV 71 ) infection and the changes of cytokines. Methods Seventy-one patients and 20 age-matched healthy children were enrolled in the study. The patients were divided into three groups according to the critical degree: 20 mild patients, 25 severe patients and 26 critical patients. Real-time PCR were used to evaluate the levels of retinoic acidinducible gene Ⅰ ( RIG- Ⅰ ), melanoma differentitation-associated gene 5 ( MDA5 ) and cytokines IL-12, IFN-α mRNA expression in peripheral blood mononuclear cells (PBMC). The proportions of Toll like receptors(TLRs) on monocytes/macrophages (MC) , myloiddentritic cells (mDC) and plasmacytoiddentritic cells (pDC) were analyzed by flow cytometry. The concentrations of plasma cytokines( IL-12, IFN-α) were measured by ELISA. Results ( 1 ) The proportion of TLR7 is the unique TLR which is increased in mild patients and it was significantly elevated in MC, mDC and pDC in severe group (P＜0.05), TLR2, TLR3 and TLR4 also had an enhanced expression in MC and mDC. The enhanced expression of TLRs mentioned above had a decreased trend in critical patients. (2)Transcription levels of RIG- Ⅰ and MDA5 was significantly elevated in EV71 infected children.(3)The expression levels of DC-associated cytokines gene( IL-12 and IFN-α) have an increased trend in mild cases and these cytokines were remarkably increased in severe patients (P＜0.05), whereas decreased in critical cases (P＜0.05). ConclusionTLR7 might be the main PRR recognizing EV71 in immune cells and RIG-Ⅰ/MDA5 might also take part in the recognition of EV71. The exogenous or endogenous ligands released from bacterial infection and cell destruction could result in the activation of TLR2 or TLR4, inducing the inflammatory response.

Objective To investigate the features of chronic prostatitis during puberty(CPP)and the effects of pelvic floor biofeedback therapy.Methods Totally,25 CPP children (mean age,16 years) and 15 children (mean age,16 years) with normal lower urinary tract as controls were included.In CPP group,NIH-CPSI scores were evaluated,expressed prostatic secretions (EPS) were examined,and bacterial culture was done;and CPP patients were categorized based on the definitions of NIH types.In both groups, urodynamic examination was performed,including evaluation of uroflow curve,maximum flow rate (Q_(max)), post-voiding residual urine (PVR),detrusor-sphincter dyssynergia (DSD),maximum detrusor pressure (P_(det,max))and maximum urethral closure pressure (MUCP).CPP patients underwent biofeedback therapy, and 10 weeks later the effects were assessed.Results In CPP group,NIH typing showedⅡ,ⅢA andⅢB in 1,3 and 21 cases,respectively.Before treatment in CPP and control groups,the incidence of staccato voiding (20 cases vs 1 case),DSD (22 cases vs 1 case),Q_(max)(10.7?3.7 vs 15.0?4.3ml/s),PVR (7.7?4.1vs 3.2?2.6ml),P_(det,max)(115.1?33.6vs 76.8?16.6cm H_2O)and MUCP(176.5?45.7 vs 86.2?28.5cm H_2O)all showed significant differences between the 2 groups(P＜0.05).In CPP group,the differences in pain(4.6?2.2 vs 2.1?1.6),urination (7.9?2.0vs 2.2?1.7),life impact (9.4?2.2vs 2.6?2.1)and total scores(22.0?5.2vs 7.0?4.2) of NIH-CPSI and Q_(max)(10.7?3.7 vs 14.9?5.6) between pre-and post-biofeedback were significant (P＜0.05).Conclusions The main type of CPP is categoryⅢB.The primary symptom is voiding disorder,which leads to greater psychological stress in patients.Children with CPP have pelvic floor dysfunctions and multiple abnormal urodynamic param- eters.The short-term effect of biofeedback strategies for CPP is satisfactory.

High glucose stimulated angiotensinⅡ(ATⅡ) production in mesangial cells of rat.Both high glucose and ATⅡdecreased expressions of matrix metalloprotein-9 (MMP-9) mRNA and MMP-9/tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA ratio and increased TIMP-1 mRNA expression in mesangial cells of rat,which could be reversed by an ATⅡreceptor blocker,Saralasin.

Objective To screen for the causative genes involved in the occurrence and development of minimal changes nephritic syndrome(MCNS) and to furtherly assist the genetic diagnosis and treatment of MCNS.Methods Human genome U133 Array Set from Affymetrix Inc was used to evaluate gene expression patterns in peripheral blood mononuclear cells(PBMC) isolated from 7 children with primary MCNS and 7 age-matched health volunteers.Reverse transcription-polymerase chain reaction(RT-PCR) and real-time PCR were performed to identify the findings of gene chip.Results Of 33 000 genes detected,969 genes showed significant difference between children with(MCNS) and healthy volunteers;552 genes were up-regulated,while 417 genes down-regulated significantly.Findings from RT-PCR and real-time PCR were consistent with those of gene chip.Conclusions Gene chip of expression patterns is a powerful method to detect expression difference of genes correlated with MCNS.Occurrence and development of MCNS can be a complicated process that many correlative genes may participate in.

Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications. Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors. All donor nephrectomy was successful. There were no donor deaths and no conversion to open surgery. Mean operation time was 112 min (range, 70-200 min). Intraoperative blood loss was 10-150 mL with an average of 30 mL. Warm ischemia time was 1.3 to 6 min with an average of 3.1 min. Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications. Donors were discharged from the hospital 5 to 10 days postoperation. Average postoperative hospital stay was 6.4 days. One graft was removed due to acute rejection. Delayed graft function occurred in two recipients but renal function returned to normal within four weeks. The other recipients had normal renal function in two weeks except three recipients in four weeks. We believe that retroperitoneal laparoscopic live donor nephrectomy is safe, reliable, and less invasive.

Objective To investigate the role of negative-regulatory factors of toll-like receptors (TLRs)signal pathways in immunological pathogenesis of Kawasaki disease(KD).Methods Thirty-two chil- dren with Kawasaki disease and 16 age-matched healthy children were studied.Reverse-transcription PCR (RT-PCR)and real-time PCR were used to evaluate the mRNA expression levels of toll-like receptor 4(TLR4), MD-2,MyD88,IRAK-4,TRAF6,T1/ST2,IRAK-M,Triad 3A,and proinflammatory factors such as IL-1?, IL-6,IL-8 and TNF-?,in peripheral blood monocytes/macrophages(MC).The expression of TLR4 protein in MC was analyzed by flow cytometry.Results①Compared with the control group,the mRNA levels of TLR4, MD-2,MyD88,IRAK-4 and TRAF6 in KD group were up-regulated significantly(P＜0.01),and the expression level of TLR4 protein was also found to be up-regulated in KD group during acute phase.It was detected that expression levels of TLR4 protein in KD with coronary artery lesion(KD-CAL~+)was significantly higher than that of KD without coronary artery lesion(KD-CAL-)[flow cytometry:(6.5?1.7)% vs(11.9_+2.4)%,P＜0.01].②The expression level of negative-regulatory factors such as IRAK-M and Triad3A were significantly up-regulat- ed in acute phase of Kawasaki disease,while the mRNA levels of IRAK-M and Triad3A in KD-CAL~+ group was found to be significantly lower than those of KD-CAL~- group(P＜0.01).No difference of T1/ST2 mRNA expres sion level was detected among all groups(P＞0.05).③The expressions of proinflammatory eytokines such as IL-1?, IL-6,IL-8 and TNF-?in monoeytes/macrophages during acute phase of Kawasaki disease were higher than those of the control group(P＜0.01),and expression of proinflammatory cytokines in KD-CAL~+ group was significantly higher than that of KD-CAL~- group.Conclusion Relative insufficient expression of negative-regulatory factors, such as IRAK-M and Triad3A,maybe correlate with immunological pathogenesis of Kawasaki disease.

Objective To study the effect of trachea intubation and mechanical ventilation on the prognosis and discharge rate of patients with successful cardiac-pulmonary resuscitation.Method The clinical data of 389 patients,who were admitted from January 2005 to February 2007,were retrospectively analyzed.The relation between trachea intubation time and discharge rate was studied.According to the time from cardiac arrest to finishing trachea intubation,patients were divided into group A (within 3 minutes,n=209) and group B (over 3 minutes,n=143);according to the time from reaching emergency medicine department to finishing trachea intubation,the rest patients were divided into group C (within 5 minutes,n=9) and group D (over 5 minutes, n=38) minutes.The discharge rate was calculated between groups.The software of SPSS 11.0 was used for statistical analysis.Results The successful rate was 9.75% (389/3988),and 59 patients were discharged, with discharge rate 1.48% (59/3988).The discharge rate of group A was 19.62% (41/209),and was significantly higher than that of group B 6.99 % (10/143) (P

OBJECTIVE:To observe clinical efficacy and safety of citalopram in the treatment of depression patients after lung cancer operation. METHODS:114 depression patients after lung cancer operation were selected and randomly divided into observa-tion group and control group (n=57). Control group was given routine treatment as nutrition support and electrolyte balance,but had no anti-depression drugs;observation group was given Citalopram tablet 20 mg orally,qd. Two groups were treated for 6 weeks. Clinical efficacy,HAMD and HAMA scores,each score and total score of SF-36 were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 87.72%,which was significant-ly higher than that that of control group(71.93%),with statistical significance(P<0.05);there was no statistical significance in HAMA score,HAMD score,each score and total score of SF-36 between 2 groups before treatment(P>0.05);HAMA score and HAMD score of 2 groups decreased significantly after treatment,the observation group was lower than the control group;each score and total score of SF-36 increased significantly,the observation group was higher than the control group,with statistical sig-nificance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Citalopram is effective and safe for depression af-ter lung cancer operation,can improve mental state and quality of life.