Objective To explore the clinical characteristics,pathogens,inflammatory biomarkers,therapeutic methods and prognosis of necrotizing pneumonia (NP) in children.Methods The clinical data of children with NP who were admitted to the Department of Pediatrics of Shengjing Hospital of China Medical University from October 2010 to October 2015 were collected.The data included demographic data,laboratory test results,intrapulmonary complications,therapeutic methods and so on were analyzed,retrospectively.Results Forty-nine pediatric patients with NP were enrolled,31 cases were boys,18 cases were girls;the average age of the patients were 2.5 years (4 months-13 years).The average febrile time were (15.08 ± 5.92) d,and the hospital stay was (21.19 ± 10.83) d,respectively.The median value of peripheral blood leukocyte count was 17.7 × 109/L,the average of neutrophils ratio was (67.62 ± 18.52)％,and the median value of C-reactive protein (CRP) and procalcitonin (PCT) was 97.9 mg/L and 0.54 μg/L,respectively.Nineteen cases had Mycoplasma pneumoniae (MP) infection,16 cases with pneumonia chlamydia infection,9 cases complicated with MP and chlamydia pneumoniae infection,and 8 cases with positive bacterial culture,and 10 cases suffered from the intrapulmonary complications.Forty-seven cases got better prognosis with the treatment of antibiotics,glucocorticoids,intravenous immunoglobulin and other comprehensive therapeutic methods such as bronchoalveolar lavage with fiber bronchoscope and closed thoracic drainage.Conclusions NP is a severe complication of community-acquired pneumonia in children,and the occurrence of NP should be alerted in the children who have persistent high fever,higher inflammatory index and pleural effusion,but the great majority of patients do recover fully after comprehensive treatment.

AIM: To investigate the expression and significance of hypoxia-inducible factor -1α (HIF-1α)and Cyclooxygenase-2(COX-2) in the retinal neovascularization.METHODS: Mouse model of hyperoxia-induced ischemic retinopathy were established. A novel flucorescein-dextran perfusion method has been developed to assess the vascular pattern. histological methods were used to count blood vessel profiles in the inner retina with HE staining.HIF-1α and COX-2 expression in the retina was determined by immunohistochemical method.RESULTS: Lots of neovascularization were seen in hyperoxia group. The number of nuclei of proliferative retinal vessels increased significantly as compared with normal control group (P＜0.001). The expression of HIF -1α was noted in the ganglion cells and retinal blood vessels. The expression of COX-2 was noted in the inner nuclear layer and ganglion cells and retinal blood vessels.CONCLUSION: There are the expression of HIF-1α and COX-2 in the retinal neovascularization and they have correlation.

Objective The purpose of the study was to compare the P63 expression in non-small cell lung cancer (NSCLC) between Xuanwei and other regions, and to investigate the relationship of P63 expression and biological behavior. Methods Immunohistochemical method was used. Results The results indicated that the expression of P63 in lung squamous cell carcinoma was extraordinarily high. P63 was related to the TNM staging system,tissue differentiation degree and lymph node metastasis,but not related to gender. In NSCLC,there was no significant difference of the P63 positive expression rate in the same pathological types, staging, tissue differentiation degree, lymph node metastasis and gender between Xuanwei and other regions. It indicated that the expression of P63 was not the reason why it was high incidence of lung cancer in Xuanwei region.

Objective To investigate the effect of adenosine A2A receptor on pituitary-adrenal axis response in acute phase of moderate craniocerebral trauma.Methods Eighteen adenosine A2A receptor knock-out mice in a C57BL/6 background and another eighteen their wild-type littermates were divided into normal control group and craniocerebral trauma for 4 hours group,and craniocerebral trauma for 24 hours group according to random number table,with siμ mice per group.Plasma levels of adrenocorticotropic-hormone (ACTH) and corticosterone at hours 4 and 24 postinjury were determined using ELISA method.Results At 4 and 24 hours,brain water content in wild-type mice [(80.950 ± 0.184) ％,(82.178 ± 0.255)％ respectively] was higher than that in gene knock-out mice [(80.006 ± 0.199)％,(81.091 ± 0.295)％ respectively,P ＜ 0.01].Besides,brain water content in both wild-type and gene knock-out mice increased after injury (P ＜ 0.01).Plasma levels of ACTH and corticosterone were higher in geneknock-out sham mice than in wild-type sham mice [(120.214 ± 2.472) ng/L vs (91.767 ±7.395) ng/L,(27.814 ±0.888) μg/L vs (11.430 ±0.644) μg/L respectively,P ＜0.0l].At 4 and 24 hours,plasma levels of ACTH [(174.776-± 5.040) ng/L,(189.613 ± 4.802) ng/L respectively] in geneknock-out mice showed a higher increase than those in wild-type mice [(119.594 ± 6.945) ng/L,(124.93-± 11.001 7) ng/L respectively,P ＜ 0.05].Moreover,plasma levels of corticosterone [(40.138 ±-0.805) μg/L] at 4 hours and [(37.440-0.485)μg/L] at 24 hours in gene knock-out mice showed a same result as compared with that in wild-type mice [(19.702 ± 0.804) μg/L,(17.602 ± 0.743) μg/L respectively,P ＜ 0.05].Conclusions Knock-out of adenosine A2A receptor increases the release of ACTH and corticosterone in acute stage of moderate craniocerebral trauma and promotes pituitary-adrenal stress response.This may provide a novel explanation for the neuroprotective effect of A2A receptor deficiency.

AIM: To investigate the effect of berberine (Ber) on Helicobacter pylori (Hp)-induced human gastric epithelial cells (GES-1) injury and the underlying mechanism .METHODS: Berberine (5, 10 and 20 μmol/L) and PD98059 (20 μmol/L), a selective inhibitor of extracellular regulated protein kinases (ERK)1/2 signaling pathway, were added to Hp-infected GES-1 cells.The cell activity and apoptosis, the levels of interleukin (IL)-1βand IL-8, lactic dehydrogenase ( LDH) activity and the protein levels of Bax , Bcl-2 and p-ERK1/2 in the GES-1 cells were determined by MTT assay, flow cytometry, ELISA, colorimetry and Western blot, respectively.RESULTS: Compared with control group, Hp significantly inhibited the cell activity , increased the apoptotic rate , LDH activity, IL-1βand IL-8 levels, the Bax and p-ERK1/2 protein levels but decreased the Bcl-2 protein level in GES-1 cells (P<0.05).However, these effects of Hp were reversed by berberine at medium-dose and high-dose, as compared with the Hp-infected GES-1 cells ( P<0.05).Moreover, the protective effects of berberine were significantly enhanced by the co-incubation of berberine with PD98059, as compared with the berberine at higher dose (P<0.05).CONCLUSION:Berberine may attenuate Hp-in-duced human gastric epithelial GES-1 cells injury by anti-inflammation, promoting cell growth and anti-apoptosis via the in-hibition of ERK1/2 signaling pathway .

Objective To establish small-for-size (SFS) graft injury models in miniature pigs with high standardization, reproducibility and similarity to clinical situation. Methods Ba-Ma miniature pigs were introduced in this study and orthotopic liver transplantations (OLTs) were performed in 12 pigs with 30% liver volume allogeneil grafts (small portion of right paramedian lobe, right lateral lobe and caudate lobe) without veno-venous bypass. The profiles of intra-operational hemodynamics and metabolism were investigated. Animals were observed for 7 days with daily serum biochemistry and coagulation function exam. The survival rate related to operation itself and the SFS grafts were respectively calculated as well as the graft regenerative ratio at post-operational day (POD) 7. Results Graft weight as a percentage of the recipient's native liver weight (GW/RLW) and the total body weight (GW/BW) were (28. 63±4. 42)% and (0. 73±0.06)%. The mean operation time, anhepatic phase, and the time of blockage of infra-hepatic IVC were (191. 7±14. 2) min, (28. 3±3. 6) min, and (45. 0±5. 8) min. The survival rate related to the operation itself and the SFS graft were 83. 33% (10/12) and 40% (4/10), and the graft regenerative ratio at POD7 was (278. 06±42. 95) %. Contrast to the remarkable increase of heart rate and serum potassium during anhepatic phase, the mean arterial pressure, central venous pressure, rectal temperature, PH value and buffer excess had a significant decrease (P<0.01) with a gradual recovery after reperfusioa Serum ALT, AST, PT, Cr, and TB were significantly increased with a peak level at POD1 for the former 4 and POD2 for TB, and then began to decrease and favorably recovered at POD7, but TB, PT, and AST levels were still high when compared to those of prereperfusion (P<0. 05). Conclusion This model of OLT performed with 30% liver volume graft without veno-venous bypass was an ideal large animal model for series studies related to SFS graft injury.

ObjectiveTo investigate the mechanism of dexamethasone (Dex) in inhibiting monocyte adhesion and phagocytose function.Methods Under the stimulation of phorbo1-12-myristate-13-acetate (PMA),U937 monocytes cultured in vitro were treated with Dex and Fasudil respectively.The adhesion rate of U937 monocles to human umbilical vein endothelial cells (HUVECs) and their phagocytic ability of India ink were studied.The protein content and activity of rho-associated coiled-coil protein kinase 1 ( ROCK1 ) as well as the effects of mifepristone and cycloheximide on Dex were determined.ResultsBoth DEX and Fasudil could significantly inhibit the adhesion tate and phagocytosis of U937 cells stimulated by PMA and suppressed the activity of ROCK1.While mifepristone and cycloheximide could not alter these effects of DEX.ConclusionDEX interferes with the adhesion and phagocytosis function of U937 cells by inhibiting ROCKI activity.

ABSTRACT:Objective To evaluate the curative effect of tension-free vaginal tape-obturator (TVT-O)and modified TVT-O in treating female stress urinary incontinence (SUI).Methods We selected 1 1 3 female patients diagnosed with SUI from January to December 2013 in our department and divided them into standard TVT-O group (group A,5 6 cases)and modified TVT-O group (group B,5 7 cases).We evaluated prospectively the safety,short-term efficacy and complications of operation in the two groups.Results The length from bilateral obturator membrane to the puncture point in the skin was greater in group A than in group B.The average intraoperative blood loss was more in group A than in group B.The median NRS score of postoperatie thigh pain in group A was higher than in group B (P<0 .0 5 ).The two groups did not differ significantly in operation duration,postoperative catheterization,mean hospital stay duration,the length and position from bilateral obturator membrane to the puncture point,or surgical efficacy (P>0.05).Conclusion Both TVT-O and modified TVT-O techniques are effective in treating female SUI.Modified TVT-O has a short path to get through the adductor muscles and less intraoperative blood loss;therefore,it can significantly reduce the complications such as postoperative pain to enhance the quality of life after operation. 

Objective Previous studies indicated that activation of Toll-like receptor4 (TLR4) was involved in the progression and instability of atherosclerotic plaque.Anti-inflammatory effects were shown in statins. However,the mechanisms underlying these effects have not been well explored.We test the hypothesis that a por- tion of these anti-inflammatory effects are mediated by regulation of TLR4 expression.Methods One hundred twenty-one subjects (22 normal persons,17 patients with stable angina and 82 patients with ACS) were recruited. 41 patients with ACS were randomized to atorvastatin 10 mg/d or atorvastatin 40 mg/d on top of routine anti-anginal treatment.Serum level of hsCRP,blood lipids,TLR4 expression on CD_(14)~+ monocytes were measuered before and after one month treatment.TLR4 expression on CD_(14)~+ monocytes were quantified via flow-cytometry.Results hsCRP and TLR4 expression on CD_(14)~+ monocytes in patients with ACS were higher than patients with stable angina and normal persons(hsCRP,ACS:11.1?14.3 vs stable angina:2.5?2.7 mg/L vs normal:2.3?4.2 mg/L,P

Nucleos(t)ide analogues (NAs) are commonly used as the antiviral treatment in patients with chronic hepatitis B (CHB). The majority of patients need long term medication. Renal injury has been observed in some patients treated with NAs in clinical practice. Therefore, this article reviews the issues regarding renal safety in CHB patients treated with NAs from the following aspects: the possible mechanisms of renal injury, the incidence of renal injury in patients treated with various NAs in recent clinical studies, and the management of renal injury in CHB patients, in order to select the most appropriate drugs for patients.