Objective To analyze the differentially expressed microRNA(miRNA)and their target genes in the serum of pediatric patients with fulminant myocarditis(FM)through bioinformatics methods,and to explore the pathogenesis.Methods GSE221090 dataset from the high-throughput Gene Expression Omnibus(GEO)were selected,and bioinformatics analysis was performed by using the GEO2R online tool to screen for differentially expressed miRNA.The online miRDB database was used to predict the target genes of the differentially expressed miRNA.The DAVID tool was employed for gene ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis of the screened target genes.Additionally,protein-protein interaction networks(PPI)associated with the differentially expressed genes was constructed by using STRING database and Cytoscape software,and core genes were screened.Results A total of 148 differentially expressed miRNA were identified in the serum of pediatric FM group compared to normal children group,including 109 up-regulated and 39 down-regulated miRNA.The top ten up-regulated and down-regulated miRNA based on their scores were selected,and target gene prediction for a forementioned miRNA was conducted by using the online miRDB database,identifying 291 target genes regulated by up-regulted miRNA and 290 target genes regulated by down-regulated miRNA.Subsequent GO and KEGG analyses demonstrated that the target genes of up-regulated miRNA were primarily enriched in signaling pathways including phosphatidylinositol 3-kinase/protein kinase B signaling pathway(PI3K/Akt)and forhead box O,whereas the target genes of down-regulated miRNA predominantly participated in the transforming growth factor-β(TGF-β)signaling pathway and related pathways.The top ten differentially expressed genes with the highest relevance scores using PPI and Cytoscape software were identified,including sirtuin 1(SIRT1),signal transducer and activator of transcription 3,estrogen receptor 1,H3.3 histone B,nuclear receptor corepressor 1,interferon regulatory factor 4,interleukin-1 Beta,dicer 1 ribonuclease Ⅲ,histone deacetylase 1(HDAC1),and DEAD-box helicase.Conclusion miR-22-3p,miR-4284,and others are crucial in the pathogenesis of pediatric FM,possibly related to the expression levels of SIRT1 and HDAC1 regulated,with mechanisms that may exert biological effects via the PI3K/Akt,TGF-β,and other signaling pathways.

Objective To analyze the differentially expressed microRNA(miRNA)and their target genes in the serum of pediatric patients with fulminant myocarditis(FM)through bioinformatics methods,and to explore the pathogenesis.Methods GSE221090 dataset from the high-throughput Gene Expression Omnibus(GEO)were selected,and bioinformatics analysis was performed by using the GEO2R online tool to screen for differentially expressed miRNA.The online miRDB database was used to predict the target genes of the differentially expressed miRNA.The DAVID tool was employed for gene ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis of the screened target genes.Additionally,protein-protein interaction networks(PPI)associated with the differentially expressed genes was constructed by using STRING database and Cytoscape software,and core genes were screened.Results A total of 148 differentially expressed miRNA were identified in the serum of pediatric FM group compared to normal children group,including 109 up-regulated and 39 down-regulated miRNA.The top ten up-regulated and down-regulated miRNA based on their scores were selected,and target gene prediction for a forementioned miRNA was conducted by using the online miRDB database,identifying 291 target genes regulated by up-regulted miRNA and 290 target genes regulated by down-regulated miRNA.Subsequent GO and KEGG analyses demonstrated that the target genes of up-regulated miRNA were primarily enriched in signaling pathways including phosphatidylinositol 3-kinase/protein kinase B signaling pathway(PI3K/Akt)and forhead box O,whereas the target genes of down-regulated miRNA predominantly participated in the transforming growth factor-β(TGF-β)signaling pathway and related pathways.The top ten differentially expressed genes with the highest relevance scores using PPI and Cytoscape software were identified,including sirtuin 1(SIRT1),signal transducer and activator of transcription 3,estrogen receptor 1,H3.3 histone B,nuclear receptor corepressor 1,interferon regulatory factor 4,interleukin-1 Beta,dicer 1 ribonuclease Ⅲ,histone deacetylase 1(HDAC1),and DEAD-box helicase.Conclusion miR-22-3p,miR-4284,and others are crucial in the pathogenesis of pediatric FM,possibly related to the expression levels of SIRT1 and HDAC1 regulated,with mechanisms that may exert biological effects via the PI3K/Akt,TGF-β,and other signaling pathways.

Objective:To examine the correlation factors of acute appendicitis associated with appendiceal neoplasms.Methods:Consecutive 712 patients with acute appendicitis who treated at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2002 to December 2016 were analyzed retrospectively. There were 314 females and 398 males, aging (42.5±16.2) years (range: 14 to 94 years). Among the 712 cases, 36 patients were diagnosed with acute appendicitis associated with appendiceal neoplasms, the other 676 patients had no appendiceal neoplasm. The patients ′ clinical baseline characteristics and clinical parameters were compared between the two groups. The correlation factors of acute appendicitis associated with appendiceal neoplasms were evaluated by using the univariate (χ 2 test or t test) and multivariate Logistic regression analysis. The area under curve of receiver operating characteristic curves was utilized to evaluate the discriminatory power of the predictive models. Results:According to the univariate analysis, gender, age, body mass index, the duration of chronic right low abdominal pains≥3 months, the frequency of recurrently acute right lower abdominal pain≥2, the frequency of acute right lower abdominal pain, past history of diabetes, hypertension or coronary heart disease, the level of neutrophils and leukocytes preoperatively, stercolith and periappendiceal effusion, and modified Alvarado score were positively correlated with appendiceal neoplasms (all P<0.05). Then four variables were incorporated into the model eventually by multivariate Logistic regression analysis, which were as follows: age (increased per decade) ( OR=2.23, 95% CI: 1.68 to 2.95, P<0.01), gender (female) ( OR=4.21, 95% CI: 1.74 to 10.19, P=0.001), the duration of chronic right low abdominal pains (more than 3 months) ( OR=2.53, 95% CI: 1.01 to 3.37, P=0.048), and modified Alvarado score (decreased per 1 score) ( OR=2.54, 95% CI: 1.87 to 3.34, P<0.01). The area of curve was 0.93 (95% CI: 0.88 to 0.97), which indicated that the model exhibits an excellent ability to discriminate between appendiceal neoplasms and acute appendicitis. Conclusions:The older age, female, the duration of chronic right low abdominal pains, and lower modified Alvarado score are independent correlation factors for acute appendicitis associated with appendiceal neoplasms. Clinicians should be alert for the above clinical characteristics and choose optimal treatment for acute appendicitis associated with appendiceal neoplasms.

Objective:To examine the correlation factors of acute appendicitis associated with appendiceal neoplasms.Methods:Consecutive 712 patients with acute appendicitis who treated at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2002 to December 2016 were analyzed retrospectively. There were 314 females and 398 males, aging (42.5±16.2) years (range: 14 to 94 years). Among the 712 cases, 36 patients were diagnosed with acute appendicitis associated with appendiceal neoplasms, the other 676 patients had no appendiceal neoplasm. The patients ′ clinical baseline characteristics and clinical parameters were compared between the two groups. The correlation factors of acute appendicitis associated with appendiceal neoplasms were evaluated by using the univariate (χ 2 test or t test) and multivariate Logistic regression analysis. The area under curve of receiver operating characteristic curves was utilized to evaluate the discriminatory power of the predictive models. Results:According to the univariate analysis, gender, age, body mass index, the duration of chronic right low abdominal pains≥3 months, the frequency of recurrently acute right lower abdominal pain≥2, the frequency of acute right lower abdominal pain, past history of diabetes, hypertension or coronary heart disease, the level of neutrophils and leukocytes preoperatively, stercolith and periappendiceal effusion, and modified Alvarado score were positively correlated with appendiceal neoplasms (all P<0.05). Then four variables were incorporated into the model eventually by multivariate Logistic regression analysis, which were as follows: age (increased per decade) ( OR=2.23, 95% CI: 1.68 to 2.95, P<0.01), gender (female) ( OR=4.21, 95% CI: 1.74 to 10.19, P=0.001), the duration of chronic right low abdominal pains (more than 3 months) ( OR=2.53, 95% CI: 1.01 to 3.37, P=0.048), and modified Alvarado score (decreased per 1 score) ( OR=2.54, 95% CI: 1.87 to 3.34, P<0.01). The area of curve was 0.93 (95% CI: 0.88 to 0.97), which indicated that the model exhibits an excellent ability to discriminate between appendiceal neoplasms and acute appendicitis. Conclusions:The older age, female, the duration of chronic right low abdominal pains, and lower modified Alvarado score are independent correlation factors for acute appendicitis associated with appendiceal neoplasms. Clinicians should be alert for the above clinical characteristics and choose optimal treatment for acute appendicitis associated with appendiceal neoplasms.