OBJECTIVES: To investigate the risk factors for acute kidney injury (AKI) in children with cardiac arrest (CA) and the influencing factors for prognosis. METHODS: A retrospective analysis was performed on the medical records of the children who developed CA in the pediatric intensive care unit (PICU) of Hunan Children's Hospital from June 2016 to June 2021. According to the presence or absence of AKI within 48 hours after return of spontaneous circulation (ROSC) for CA, the children were divided into two groups: AKI (n=50) and non-AKI (n=113). According to their prognosis on day 7 after ROSC, the AKI group was further divided into a survival group (n=21) and a death group (n=29). The multivariate logistic regression analysis was used to investigate the risk factors for early AKI in the children with CA and the influencing factors for prognosis. RESULTS: The incidence rate of AKI after CA was 30.7% (50/163). The AKI group had a 7-day mortality rate of 58.0% (29/50) and a 28-day mortality rate of 78.0% (39/50), and the non-AKI group had a 7-day mortality rate of 31.9% (36/113) and a 28-day mortality rate of 58.4% (66/113). The multivariate logistic regression analysis showed that long duration of cardiopulmonary resuscitation (OR=1.164, 95%CI: 1.088-1.246, P<0.001), low baseline albumin (OR=0.879, 95%CI: 0.806-0.958, P=0.003), and adrenaline administration before CA (OR=2.791, 95%CI: 1.119-6.961, P=0.028) were closely associated with the development of AKI after CA, and that low baseline pediatric critical illness score (OR=0.761, 95%CI: 0.612-0.945, P=0.014), adrenaline administration before CA (OR=7.018, 95%CI: 1.196-41.188, P=0.031), and mechanical ventilation before CA (OR=7.875, 95%CI: 1.358-45.672, P=0.021) were closely associated with the death of the children with AKI after CA. CONCLUSIONS Albumin should be closely monitored for children with ROSC after CA, especially for those with long duration of cardiopulmonary resuscitation, low baseline pediatric critical illness score, adrenaline administration before CA, and mechanical ventilation before CA, and such children should be identified and intervened as early as possible to reduce the incidence of AKI and the mortality rate.
Child ; Humans ; Prognosis ; Retrospective Studies ; Critical Illness ; Heart Arrest/complications* ; Acute Kidney Injury/epidemiology* ; Intensive Care Units, Pediatric ; Risk Factors ; Epinephrine ; Albumins

Animals ; Insulin ; Insulin Resistance ; Liver ; Male ; Non-alcoholic Fatty Liver Disease ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled

Two new lignan glucosides, tinsinlignans A and B (1 and 2), two new oxyneolignans, tinsinlignans C and D (3 and 4), along with one known analogue (5), were isolated from the stems of Tinospora sinensis. The structures of the new compounds were elucidated based on analysis of spectroscopic data, and the absolute configuration of 1 was determined through electronic circular dichroism (ECD) calculation based on the time-dependent density functional theory (TD-DFT). Compounds 1-4 were evaluated for their inhibitory effects on nitric oxide (NO) production induced by lipopolysaccharide (LPS) in murine RAW264.7 macrophage cells and compounds 1 and 2 exhibited moderate inhibitory activities with IC
Animals ; Glucosides/pharmacology* ; Lignans/pharmacology* ; Lipopolysaccharides ; Mice ; Molecular Structure ; Nitric Oxide ; Phytochemicals/pharmacology* ; RAW 264.7 Cells ; Tinospora/chemistry*

Humans ; Pruritus ; Somatosensory Cortex ; Spinal Cord

Objective:To observe the clinical efficacy and influence of modified Chaihu Shugansan combined with ursodeoxycholic acid tablets on inflammatory factors in treatment of chronic cholecystitis cholelithiasis （stagnation of liver and gallbladder Qi）. Method:One hundred and ten patients were randomly divided into control group （60 cases） and observation group （60 cases）. Both groups received lifestyle intervention， and oral ursodeoxycholic acid tablets， 50 mg/time， taken in the morning and evening meals. Patients in control group additionally took Yidanshu capsules orally， 4 capsules/time， 3 times/day. Patients in observation group additionally took modified Chaihu Shugansan orally， 1 dose/day. The treatment courses continued 3 months in both groups. Before and after treatment， traditional Chinese medicine （TCM） symptom scores were graded， the ultrasound status of chronic gallbladder inflammation， gallbladder contraction function and stones was graded， the levels of interleukin-6 （IL-6）， IL-8， tumor necrosis factor-α （TNF-α） and nuclear transcription factor-κB（NF-κB）Were detected， and safety was evaluated. The efficacy for TCM syndromes， imaging efficacy and the efficacy for eliminating gallbladder stones were compared between the two groups. Result:The efficacy for TCM syndrome， efficacy on color ultrasound for chronic cholecystitis and the efficacy on imaging for cholelithiasis in the observation group were all better than those in the control group（Z=2.104，Z=2.076，Z=2.101，P<0.05）. The thickness of gallbladder wall and volume of the gallbladder of the observation group were smaller than those of the control group （P<0.01）， and gallbladder contraction function was higher than that in control group （P<0.01）. Levels of IL-6， IL-8， TNF-α and NF-κB in observation group were lower than those in control group （P<0.01）. Conclusion:modified Chaihu Shugansan combined with ursodeoxycholic acid in the treatment of chronic cholecystitis and cholelithiasis （liver and gall Qi stagnation） is better than Yidanshu capsule combined with ursodeoxycholic acid sour scheme in terms of clinical efficacy， imaging efficacy， and elimination of gallbladder stones. It can reduce inflammation， and enhance gallbladder contraction， with high safety in clinical use.

OBJECTIVE: To study the association of Nod-like receptor protein 3 (NLRP3) inflammasome with inflammatory response in the acute stage and coronary artery lesion (CAL) in children with Kawasaki disease (KD). METHODS: A total of 42 children with KD who were hospitalized from January to October 2017 were enrolled as the KD group, among whom 9 had CAL (CAL group) and 33 had no CAL (NCAL group). Fifteen age- and gender-matched children with pneumonia and pyrexia were enrolled as the pneumonia-pyrexia group. Fifteen healthy children were enrolled as the healthy control group. Real-time PCR was used to measure the mRNA expression of NLRP3 inflammasome (NLRP3, ASC and caspase-1) in peripheral blood mononuclear cells. The Spearman rank correlation test was used to investigate the correlation of NLRP3 mRNA expression with serum levels of C-reactive protein, erythrocyte sedimentation rate, interleukin-6, interleukin-1β, procalcitonin, albumin and prealbumin. RESULTS: The KD group had significantly higher mRNA expression of NLRP3, ASC and caspase-1 in the acute stage than the pneumonia-pyrexia and healthy control groups (P<0.05). The CAL group had significantly higher mRNA expression of NLRP3 than the NCAL group (P<0.05). NLRP3 mRNA expression was correlated with C-reactive protein, interleukin-6, interleukin-1β, and prealbumin levels in children with KD in the acute stage (r=0.449, 0.376, 0.427, and -0.416 respectively; P<0.05). CONCLUSIONS NLRP3 inflammasome may participate in inflammatory response in the acute stage and the development of CAL in children with KD.
Child ; Humans ; Inflammasomes ; Interleukin-1beta ; Leukocytes, Mononuclear ; Mucocutaneous Lymph Node Syndrome ; NLR Family, Pyrin Domain-Containing 3 Protein ; metabolism

Objective To investigate the clinical efficacy of electroacupuncture and (or) massotherapy plus behavior therapy for cervical spondylosis.Methods Three hundred patients with cervical spondylosis were randomly allocated to three groups (A, B and C) by random number generated from calculator, 100 cases each. In addition to cupping and behavior therapy, group A received electroacupuncture; group B, massotherapy; group C, electroacupuncture and massotherapy. The clinical symptom and sign score was recorded in the three groups before and after treatment. The clinical therapeutic effects were compared.Results There were no statistically significant differences in the clinical control rate, marked control rate and total efficacy rate among the three groups after four and eight weeks of treatment and at the 4-month and 6-month follow-ups after treatment (P>0.05). In the three groups, there was a statistically significant difference in the clinical symptom and sign score between before treatment and after four and eight weeks of treatment or at the 4-month and 6-month follow-ups after treatment (P<0.01) and between after four weeks of treatment and after eight weeks of treatment or at the 4-month and 6-month follow-ups after treatment (P<0.01). There was no statistically significant differences in the clinical symptom and sign score among the three groups after four and eight weeks of treatment and at the 4-month and 6-month follow-ups after treatment (P>0.05). Conclusions Electroacupuncture and (or) massotherapy plus behavior therapy is an effective protocol for preventing and treating cervical spondylosis. It is characterized by simplicity, convenience, easiness and cheapness and can be provide for clinical application.

Objective To understand the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis(SENEAS),and to verify the conclusion of previous studies,so as to provide the evidence for schistosomiasis monitoring in such areas in Nantong City,Jiangsu Province. Methods The controlled field tests were carried out to observe the O. hupensis snails artificially infected by schistosome miracidia in SENEAS. The influence of the soil from SENEAS and the en-demic areas on O. hupensis snails artificially infected by miracidia were observed. Results All the experimental snails could be infected by schistosome miracidia except the smooth-shell snails from Tangyuan Village in the controlled field test environment of SENEAS or the endemic areas. The infection rates of the smooth-shell snails were lower than those of the ribbed-shell snails , but there were no statistically significant differences. The mortality rates of the smooth-shell snails were higher than those of the ribbed-shell snails,which were statistically significant (χ2Xindian = 135.118,χ2Shuangdian = 122.836,χ2Baipu =154.436,χ2Dingyan =138.288,χ2Control=151.923,all P<0.01). There were no significant differences in the infection rates of snails between each test group of the soil from SENEAS and the endemic areas(χ2Rugao=0.071,χ2Rudong=0.216,both P>0.05). Also there was no signifi-cant difference between each test group and the control group without soil(χ2=7.148,P>0.05). Conclusion It is likely to form the spread of schistosomiasis in SENEAS in Nantong City with sufficient amount of infection source of schistosomiasis im-ported. It is still necessary to implement the surveillance of schistosomiasis and O. hupensis snails in Nantong City.

BACKGROUNDUrine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KDIGO) definition and classification system for acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria (KDIGOUO) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGOSCr).

METHODSWe conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1, 2009 to August 31, 2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOUOand KDIGOSCr. Hospital mortality of patients with more severe AKI classification based on KDIGOUOwas compared with other patients by univariate and multivariate regression analyses.

RESULTSThe prevalence of AKI increased from 52.4% based on KDIGOSCrto 55.4% based on KDIGOSCrcombined with KDIGOUO. KDIGOUOalso resulted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AKI classification based on KDIGOUO. Compared with non-AKI patients or those with maximum AKI classification by KDIGOSCr, those with maximum AKI classification by KDIGOUOhad a significantly higher hospital mortality of 58.4% (odds ratio [OR]: 7.580, 95% confidence interval [CI]: 4.141-13.873, P< 0.001). In a multivariate logistic regression analysis, AKI based on KDIGOUO (OR: 2.891, 95% CI: 1.964-4.254, P< 0.001), but not based on KDIGOSCr (OR: 1.322, 95% CI: 0.902-1.939, P = 0.152), was an independent risk factor for hospital mortality.

CONCLUSIONUO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.

Acute Disease ; mortality ; Aged ; Creatinine ; blood ; Critical Illness ; mortality ; Female ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Kidney Diseases ; blood ; mortality ; pathology ; urine ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Risk Factors

ABSTRACT:OBJECTIVE To explore the cardiac protective effects of Shensong Yangxin Capsule on patients with chest tumor radiotherapy.METHODS 120 patients with thoracic tumors(including lung cancer,breast cancer,mediastinal tumor and e-sophageal cancer) requiring radiotherapy were randomly divided into radiotherapy combined with Shensong Yangxin Capsule group (group A),radiotherapy with Rhodiola rosea group(group B),radiotherapy plus Shensong Yangxin Capsule and Rhodi-ola rosea group(group C) and radiotherapy alone group (group D),with 30 patients in each group.Levels of serum transfor-ming growth factor(TGF-β1),tumor necrosis factor(TNF-α),endothelin(ET) contents,occurrence rate of radioactive heart damage of each group were compared within three months after radiotherapy and changes of myocardial integrated back scatter (IBS) in the third month were observed.RESULTS After radiotherapy the contents of TGF-β1 ,TNF-α and ET contents of group A B and C were lower than those of the group D(P <0.01).The incidence rates of acute cardiac injury of the first three groups were also lower than those of the group D within one to three months after radiotherapy(P <0.05).IBS levels of ante-rior wall and anterior inter-ventricular septum in the third month after radiotherapy were increased significantly in the group D while no changes were detected in the other three groups.CONCULSION Shensong Yangxin Capsule combined with Rhodiola rosea is able to reduce the production of inflammatory cytokines in tissues and inhibit the increase of IBS during radiotherapy so as to protect heart from radiation injury.