H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective:To analyze hepatic hemodynamic parameters detected by Doppler ultrasound (DU) of uncomplicated children who underwent left lateral segment(LLS) LDLT (LLS-LDLT), explore their change trends over time and determine the normal reference intervals.Methods:This retrospective study involved the data from 261 pediatric LLS-LDLT cases in Tianjin First Central Hospital from June 2014 to January 2018. Hemodynamic parameters included peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI), and pulsation index (PI) of hepatic artery (HA), and portal vein velocity (PVV) during intra-operative and on the 1st, 3rd, 5th and 7th days after operation were collected. Among whom, 232 cases with uncomplicated and normal recovery were finally involved in our study, with 200 cases who were collected from June 2014 to August 2017 as test group. Those collected from September 2017 to January 2018, totally 32 cases were set as validation group. The change trends and normal ranges of hemodynamic parameters over time were analyzed in test group, and the results were further tested in the validation group.Results:In the test group, PSV HA, EDV HA showed a similar change trend at one week after surgery, with an overall decrease-rise trend; RI HA, PI HA also changed similarly with an overall rise-decrease trend. PVV at surgery was lower than at all time points after surgery. In addition, this study provided the normal reference intervals of hemodynamic parameters for LDLT patients at early postoperative period, which at intra-operation they were PSV HA 18.4-98.3 cm/s, EDV HA 0-43.3 cm/s, RI HA 0.41-1.0, PI HA 0.51-2.0, PVV 19.0-83.7 cm/s. Within 1 week after surgery: PSV HA 21.0-97.7 cm/s, EDV HA 0-32.7 cm/s, RI HA 0.47-1.0, PI HA 0.62-2.0, PVV 23.0-92.0 cm/s. By using those results, the coincidence rate of Doppler parameter change trend was 84.3%(27/32), 84.3%(27/32), 78.1%(25/32), 78.1%(25/32), 87.5%(28/32) for PSV HA, EDV HA, RI HA, PI HA, PVV in the validation group, respectively. As for the normal reference intervals of blood flow parameters, RI HA and PI HA in one case in the validation group were lower than the lower limits of the normal reference intervals, accounting for 3.1% of the total. PSV HA in two cases was lower than the lower limit of normal reference interval, accounting for 6.2% of the total. Conclusions:The hepatic hemodynamic in post-transplanted children detected by DU has specific changing trends and normal ranges, which provides valuable reference values for ultrasonologists and pediatric transplant clinicians.

OBJECTIVE: To investigate the effects of blocking the activation of ERK pathway on the expression of matrix metalloproteinase-9 (MMP-9) and the formation of cerebral edema in SD rats after brain injury. METHODS: Ninety SD rats were randomly divided into 3 equal groups, including a sham-operated group, modified Feeney's traumatic brain injury model group, and ERK inhibition group where the ERK inhibitor SCH772984 (500 μg/kg) was injected via the femoral vein 15 min before brain trauma. At 2 h and 2 days after brain trauma, the permeability of blood-brain barrier was assessed by Evans blue method, the water content of the brain tissue was determined, and the phosphorylation level of ERK and the expression level of MMP-9 mRNA and protein were measured by RT-PCR and Western blotting. RESULTS: Compared with the sham-operated group, the rats with brain trauma exhibited significantly increased level of ERK phosphorylation at 2 h and significantly increased expression of MMP-9 mRNA and protein 2 days after the injury ( < 0.01). Treatment with the ERK inhibitor significantly decreased the phosphorylation level of ERK after the injury ( < 0.01), suppressed over-expression of MMP-9 mRNA and protein 2 days after the injury ( < 0.01). The permeability of blood-brain barrier increased significantly 2 h after brain trauma ( < 0.05) and increased further at 2 days ( < 0.01); the water content of the brain did not change significantly at 2 h ( > 0.05) but increased significantly 2 d after the injury ( < 0.01). Treatment with the ERK inhibitor significantly lowered the permeability of blood-brain barrier and brain water content after brain trauma ( < 0.01). CONCLUSIONS Blocking the activation of ERK pathway significantly reduced the over-expression of MMP-9 and alleviates the damage of blood-brain barrier and traumatic brain edema, suggesting that ERK signaling pathway plays an important role in traumatic brain edema by regulating the expression of MMP-9.
Animals ; Brain Edema ; drug therapy ; etiology ; Brain Injuries, Traumatic ; complications ; drug therapy ; Gene Expression Regulation, Enzymologic ; drug effects ; Indazoles ; pharmacology ; therapeutic use ; MAP Kinase Signaling System ; drug effects ; Matrix Metalloproteinase 9 ; genetics ; Piperazines ; pharmacology ; therapeutic use ; Protein Kinase Inhibitors ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To investigate the effects of blocking the activation of ERK pathway on the expression of matrix metalloproteinase-9 (MMP-9) and the formation of cerebral edema in SD rats after brain injury. METHODS: Ninety SD rats were randomly divided into 3 equal groups, including a sham-operated group, modified Feeney's traumatic brain injury model group, and ERK inhibition group where the ERK inhibitor SCH772984 (500 μg/kg) was injected via the femoral vein 15 min before brain trauma. At 2 h and 2 days after brain trauma, the permeability of blood-brain barrier was assessed by Evans blue method, the water content of the brain tissue was determined, and the phosphorylation level of ERK and the expression level of MMP-9 mRNA and protein were measured by RT-PCR and Western blotting. RESULTS: Compared with the sham-operated group, the rats with brain trauma exhibited significantly increased level of ERK phosphorylation at 2 h and significantly increased expression of MMP-9 mRNA and protein 2 days after the injury ( < 0.01). Treatment with the ERK inhibitor significantly decreased the phosphorylation level of ERK after the injury ( < 0.01), suppressed over-expression of MMP-9 mRNA and protein 2 days after the injury ( < 0.01). The permeability of blood-brain barrier increased significantly 2 h after brain trauma ( < 0.05) and increased further at 2 days ( < 0.01); the water content of the brain did not change significantly at 2 h ( > 0.05) but increased significantly 2 d after the injury ( < 0.01). Treatment with the ERK inhibitor significantly lowered the permeability of blood-brain barrier and brain water content after brain trauma ( < 0.01). CONCLUSIONS Blocking the activation of ERK pathway significantly reduced the over-expression of MMP-9 and alleviates the damage of blood-brain barrier and traumatic brain edema, suggesting that ERK signaling pathway plays an important role in traumatic brain edema by regulating the expression of MMP-9.
Animals ; Blood-Brain Barrier ; Brain Edema ; Brain Injuries, Traumatic ; MAP Kinase Signaling System ; Matrix Metalloproteinase 9 ; Rats ; Rats, Sprague-Dawley

Objective: To explore the impact of immediate breast reconstruction on the onset of adjuvant chemotherapy and on the postoperative complications. Methods: We retrospectively analyzed the clinical data from female breast cancer patients treated by either modified radical mastectomy with immediate breast reconstruction(IBR) ( n=108) or modified radical mastectomy alone(n=115), followed by adjuvant chemotherapy at our department between January 2011 and December 2012. Results: There was no significant difference in the overall complication rates between the IBR group and modified radical mastectomy group (49.1% vs. 52.2%, P=0.87). However, more secondary surgery was applied in the IBR group than the modified radical mastectomy group (13.0% vs. 1.7%, P=0.001). However, the incidence of hematoma in the modified radical mastectomy group was significantly higher than the IBR group (17.4% vs. 4.6%, P=0.003). There was a significant difference in the onset of adjuvant chemotherapy between the IBR group and modified radical mastectomy group (21 days vs. 11days, P<0.001). Conclusions Immediate breast reconstruction has no significant impact on the overall complication rate, but increases the incidence of secondary surgery, especially after the initiation of chemotherapy. In addition, it slightly delays adjuvant chemotherapy in the patients.

Objective To evaluate the value of electrospun polymethyl methacrylate (PMMA) nanofibers with different topological structures as scaffolds for growth of Schwann cells (SCs).Methods Electrospun PMMA nanofibers with random or aligned topological structures were fabricated and measured with biocompatibility.Lentivirus-transfected green fluorescent protein was used as the reporting gene to monitor form and growth manner of SCs on different substrates and dependency of cell body and process with fiber structure,with PMMA thin films served as the control.Results Electrospun PMMA nanofibers revealed good biocompatibility and could exert contact guidance to the growth of SCs.Topological structures of the electrospun nanofibers influenced cell morphology.SCs were aligned with the orientation of substrate fibers and form longer cell process when growing on aligned nanofibers (P ＜0.01).Primary SCs preferred to follow the cue of aligned nanofibers compared to random fibers.Conclusion Aligned electrospun PMMA nanofibers have the potentiality as transplantable scaffolds for loading SCs after neural injury.

OBJECTIVETo evaluate the impact of the topographic features of electrospun polymethylmethacrylate (PMMA) nanofibers on growth pattern of primary rat astrocytes.

METHODSRat astrocytes were cultured on fabricated random and aligned electrospun nanofibers. Using PMMA film as the control, the cells were transfected with a lentivirus harboring GFP gene to reveal the cell growth pattern on different substrates.

RESULTSoth random and aligned electrospun PMMA nanofibers could support the growth of rat astrocytes, but the topographic features of the fibers significantly affected their growth pattern. On aligned nanofibers, astrocytes extended long cell processes along the direction of the substrate fibers, and on random fibers the astrocytes formed shorter processes. On merged images of GFP expressions and substrate fibers, the cell processes of the astrocytes were shown to adhere to and elongate along the fibers both on random and aligned nanofibers.

CONCLUSIONThe topographic features of PMMA nanofibers can significantly influence the growth pattern of primary rat astrocytes. Aligned electrospun nanofibers has the potential to serve as scaffold material for reducing glia scar formation after spinal cord injury.

Objective To investigate the effect and underlying mechanism of apolipoprotein E (APOE) genetic polymorphism in treating blood brain barrier (BBB) breakdown after traumatic brain injury (TBI).Methods Human APOE knock-in mice (ε3,ε4),APOE knockout mice,and APOE wild-type mice with each numbering 80 were respectively divided into TBI group (n =50),sham-operation group (n =15) and normal control group (n =15) according to the random number table.TBI group was subdivided at 1 day (n=15),3 days (n=15),and7 days (n=20).TBI was induced with a pneumatically operated injury device.BBB permeability to large or small molecules was evaluated by measuring Evans blue (EB) and fluorescein sodium (NaFI) extravasation into the damage area at 1,3,and 7 days postinjury.Brain water content was determined using the dry-wet method.Western blotting and qRT-PCR for tight junction-associated proteins Occludin and Claudin-5 were performed at 7 days postinjury.Results With respect to normal control group,BBB permeability to EB and NaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice.There appeared significant increase in BBB permeability to EB and NaFI in TBI group,with insignificant differences among rats of each genotype at 1 and 3 days postinjury (P ＞ 0.05).Whereas at 7 days postinjury,BBB permeability to EB in APOE wild-type and e3 mice returned to the normal level (P ＞ 0.05),but it re mained at a high level in APOE knockout and ε4 mice (P ＜ 0.01).Meanwhile,BBB permeability toNaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice (P ＜ 0.01).Brain water content was equivalent among rats of each genotype at 1,3 and 7 days postinjury (P ＞0.05).Western blotting and qRT-PCR demonstrated Occludin and Claudin-5 in ε4 and APOE knockout mice were significantly lower than those in ε3 and APOE wide-type mice (P ＜ 0.05).Conclusion APOE plays an important role in restoration of BBB function after TBI,but ε4 may impede the recovery of BBB breakdown after TBI through its effect on tight junction.

The knowledge absence of neurosurgical regional anatomy is the major shortcoming which makes seven-year program medical students feel difficult in studying neurosurgical special course.The reasons for this phenomenon include the limited teaching time for basic medical course and the continuous progress in the field of neurological anatomy.The teacher should make good use of clinical resources to carry on the additional teaching of neurosurgical regional anatony.The detailed plans include small-class teaching and individual case analysis using the data of neuroimaging and angiography of the brain and spinal cord.All these measures are intend to let the students grasp of the basic knowledge clinical neurosurgery during the internship and make the smooth transition from interns to doctors,providing references for other department.

This study was aimed to establish the ultra high performance liquid chromatography (UHPLC) fingerprints of Psoralea corylifolia L. The separation was achieved on a Shim-pack XR-ODS Ⅲ column (50 mm í 2.0 mm, 1.6μm) by gradient elution with acetonitrile-0.2% glacial acetic acid solution as the mobile phase. The flow rate was 0.1 mL·min-1 and the measurement wavelength was 246 nm. The temperature of the column was 45oC. The results showed that the UHPLC fingerprint of P. corylifolia L. was established and 10 characteristic common peaks were found, among which 6 peaks were recognized by comparing with reference substances. It was concluded that the method was rapid, reliable and reproducible. The established fingerprint can provide references for the study of sub-stance basis and quality control of P. c orylifolia L.