Table of Content

15 August 2016 Volume 34 Issue 8

  

Expression and clinical significance of sB 7 -H 3 and cytokines in the bronchoalveolar lavage fluid in children with refractory Mycoplasma pneumoniae pneumonia

ZHANG Xinxing, CHEN Zhengrong, GU Wenjing, YAN Yongdong, WANG Yuqing, ZHU Canhong, HUANG Li, WANG Meijuan, SHAO Xuejun, JI Wei

. 2016, 34(8):  561.  doi:10.3969/j.issn.1000-3606.2016.08.001

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Objective To explore the level of expression, clinical significance of sB 7 -H 3 in the bronchoalveolar lavage fluid (BALF) of refractory Mycoplasma pneumoniae (MP) pneumonia (RMPP) in children and the relationship between sB 7 -H 3 and various cytokines. Methods The BALF of forty-three hospitalized children with RMPP (RMPP group) were collected for the diagnosis and treatment. Thirteen cases were lavaged only once and the other thirty cases had collected the BALF twice. The BALF of fifteen hospitalized children with bronchial foreign body were collected as control group. The expression levels of sB 7 -H 3 , IL- 1 β, IL- 2 and IL- 36 in the BALF were detected by enzyme-linked immunosorbent assay. The expression levels of sB 7 -H 3 , IL- 1 β, IL- 2 and IL- 36 in the BALF at the acute phase were compared with control group and the group after treatment. Analyzed the correlation between the level of sB 7 -H 3 and IL- 1 β, IL- 2 , IL- 36 in the BALF of RMPP children at acute stage. Results The levels of sB 7 -H 3 , IL- 1 β and IL- 36 in the BALF of the first lavage group were higher than those of single lavage group and control group (all P< 0 . 05 ). The levels of sB 7 -H 3 , IL- 1 β, IL- 2 and IL- 36 in the BALF of single lavage group were higher than those of control group (all P<0.05). The levels of sB7-H3, IL-1β, IL-2 and IL-36 in the BALF of the second lavage group were lower than those of the first lavage group (all P< 0 . 05 ).The levels of sB 7 -H 3 , IL- 2 in the BALF of the second lavage group were higher than those in the control group (both P< 0 . 05 ), but the levels of IL- 1 β, IL- 36 in the BALF showed no difference between the second lavage group and the control group (both P> 0 . 05 ). The levels of sB 7 -H 3 had positive correlation with the levels of IL- 1 β, IL- 2 and IL- 36 (all P< 0 . 001 ). Conclusions sB 7 -H 3 may control the secretion of IL- 1 β, IL- 2 and IL- 36 , and participate in immune response and lung injury after MP infection, which may lead to occurrence and development of RMPP.

Diagnostic significance of fibrin related markers for pre-disseminated intravascular coagulation state in children with severe pneumonia

HUANG Caizhi, MO Liya, ZHANG Cong, LI Aiguo, DENG Yongchao

. 2016, 34(8):  566.  doi:10.3969/j.issn.1000-3606.2016.08.002

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Objectives To study the significance of fibrin related markers such as fibrin monome (FM), D-dimer (D-D), fibrinogen and fibrin degradation products (FDP) in diagnosis of pre-disseminated intravascular coagulation (pre-DIC) state in children with severe pneumonia. Methods A total of 213 children with severe pneumonia in pediatric intensive care unit were divided into pre-DIC group and case control group according to the occurrence of pre-DIC. And 40 healthy children were included as normal control group. FM、D-D、FDP、prothrombin time (PT)、activated partial thromboplastin time (APTT)、fibrinogen (FIB)、platelet count (PLT)、thrombomodulin (TM) levels were analyzed. Receiver operating characteristic curve was used to evaluate the above indexes. Results All the markers but FIB showed significant difference among the three groups (P< 0 . 05 ). The differences of FM、D-D、FDP、APTT in paired comparison among the three groups were also significant (P< 0 . 01 ), Pre-DIC group had the highest level and case control group was the second. Pre-DIC group had higher PT than that of the other two groups (P< 0 . 05 ), but PT levels in normal control group and the control group are of no significant difference (P> 0 . 05 ). Compared with those in normal control group, TM and PLT levels were significantly higher in the other two groups (P< 0 . 01 ), but the differences of TM and PLT in pre-DIC group were not significant in comparison to those in case control group (P> 0 . 05 ). FM、D-D、FDP had larger area under curves (AUC) for pre-DIC than other indexes ( 0 . 84、0.76、0 . 64 , respectively). The AUC for the joint detection of the three indexes was 0 . 85 . Conclusions Fibrin related markers such as FM、D-D and FDP are valuable indexes in diagnosis of pre-DIC state in children with severe pneumonia, the joint detection of the three indexes would help to improve diagnostic accuracy.

Serum vancomycin concentration distribution and its clinical therapeutic effect on children with severe Gram-positive cocci pneumonia

ZOU Xin, ZHANG Guangli, ZHOU Gan, CHEN Ming, MENG Qingqing, TIAN Xiaoyin, WANG Wei, JIA Yuntao, LUO Zhengxiu

. 2016, 34(8):  570.  doi:10.3969/j.issn.1000-3606.2016.08.003

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Objective To analyze the characteristics of serum vancomycin concentrations and its clinical therapeutic effects. Methods Serum vancomycin concentrations of 59 children diagnosed with severe Gram positive cocci pneumonia and treated with vancomycin were retrospectively analyzed. Vancomycin concentrations, biochemical values and disease status of patients were analyzed. Results The serum vancomycin concentrations of severe Gram positive cocci pneumonia children accompanied by acyanotic congenital heart disease was significantly higher than those without congenital heart disease, ( 12 . 12 mg/L vs 7 . 76 mg/L, P= 0 . 008 ). The therapeutic effect of 40 - 60 mg/(kg·d) dosage group was significantly higher than that of < 40 mg/(kg·d) group ( 89 . 47 % vs 46 . 15 %, P= 0 . 004 ), while the therapeutic effect was similar between 40 - 60 mg/(kg·d) and > 60 mg/(kg·d) dosage group. Acute liver function damage and moderate/severe anemia may be risk factors for poor therapeutic effects to severe Gram positive cocci pneumonia children (P < 0 . 05 ). Conclusions Severe Gram positive cocci pneumonia children accompanied by acyanotic congenital heart disease may lead to a high serum vancomycin concentration. The 40 - 60 mg/(kg·d) dosage group may reach a satisfactory therapeutic effect. For children with acute liver function damage and moderate/severe anemia, a close monitoring to the state of illness is recommended to prevent poor prognosis.

Clinical features and treatment of protracted bacterial bronchitis in children

CHEN Jiehua, LI Zhichuan, MA Hongling, WANG Wenjian, XU Jianqiang, ZHENG Yuejie

. 2016, 34(8):  575.  doi:10.3969/j.issn.1000-3606.2016.08.004

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Objective To study the diagnosis and treatment of protracted bacterial bronchitis (PBB) in children. Methods Children with PBB confirmed by bronchoscopy were recruited from May 2013 to April 2015 . The clinical data were retrospectively analyzed. Results All 31 cases include 18 boys and 13 girls were recruited. 28 / 31 were younger than 6 years old. They all complained of wet cough, some of them were reported with wheeze ( 17 / 31 ) and with ruttle in the lungs ( 16 / 31 ). White blood cell were in normal range ( 18 / 31 ) or slightly elevated ( 13 / 31 ). The C-reactin protein was in normal range ( 28 / 31 ). Chest X-ray test of 16 cases were normal. Twenty-four cases taken chest computerized tomograph scan, 5 had a sign of tracheobronchial stenosis. The purulent bronchitis without tracheobronchial stenosis were confirmed by bronchoscopy. Four cases had tracheomalacia. The medians of proportion of neutrophil were 80 % in bronchoalveolar lavage fluid (BALF). The pathogens were identified in BALF in 17 cases, 6 with Streptococcus pneumoniae, 6 with Haemophilus parainfluenzae, 3 with Moraxella catarrhalis, 2 with Staphylococcus aureus and 1 with Haemophilus influenzae. The symptoms were improved in all cases and co-amoxiclav was prescribed to most cases when discharged. The course of antibiotics therapy was 2 - 4 weeks in 23 cases, and more than 4 weeks in 8 cases. Twenty-three ( 23 ) cases were cured but 8 of them relapsed. Another 8 cases were improved but not completely remitted, 7 / 8 were cured by further treatment for concomitant diseases such as nasosinusitis and allergic rhinitis. Conclusions Children with PBB are typically younger than six years old, and presented with prolonged wet cough and parent-reported wheeze, normal or with ruttle in the lungs. A confirmed diagnosis was reached by bronchoscopy. The antibiotics therapy were effective, the course should be more than 2-4 weeks, however, relapse were common. When antibiotics therapy does not lead to complete remission, concomitant diseases should be considered.

Association between ADAM10 polymorphism and clinical characteristics in children with asthma

LIU Yan, LIU Sheng, WU Honghui, ZHANG Xiang

. 2016, 34(8):  580.  doi:10.3969/j.issn.1000-3606.2016.08.005

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Objective To investigate the association between single nucleotide polymorphisms (SNP) rs 653765 and rs 514049 in ADAM10 gene and clinical characteristics in asthma in Han Chinese children. Methods A case-control study was performed in that research, and 221 children with asthma were recruited and an other 236 normal children were recruited as controls. The genotypes of two SNPs in ADAM10 gene were detected using PCR-RFLP. And all data were analyzed by SPSS19 . 0 . Results In case-controlled study, we found the frequency of TT genotype in case group was higher than that of controlgroup (P = 0 . 028 ), and the frequency of T allele was higher than that of control group (P = 0 . 008 ). The genotypes and alleles of rs 514049 was not associated with asthma (P = 0 . 604 , 0 . 356 ).There were no difference in serum ADAM 10 levels between asthma and control group (P = 0 . 238 ), but in asthma group we found patients with TT genotype may have a higher level ADAM 10 than the one with CC genotype (P = 0 . 034 ). The polymorphism of rs 653765 was not associated with the level of C-reaction protein, the number of LYM, IgE and EOS% (P > 0 . 05 ). Conclusions The genotype of rs 653765 in ADAM10 gene was associated with asthma in the central of China, and T allele was a risk factor. The polymorphism of rs 653765 might be associated with the levels of ADAM 10 .

Genetic diagnosis of spondyloenchondrodysplasia with immune dysregulation: a case report and literature review

DONG Chen, SUN Bijun, YANG Lin, WU Bingbing, ZHOU Wenhao, WANG Huijun

. 2016, 34(8):  584.  doi:10.3969/j.issn.1000-3606.2016.08.006

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Objective To investigate the clinical and laboratory diagnosis in a rare case with dwarfism and multisystem abnormalities. Methods Whole-exome sequencing was performed and data was processed using high-throughput data analysis pipeline. Genetic test result is verified by Sanger sequencing. Results This is a 14 -year-old boy with short stature (the height is 132 cm) and autoimmune hemolytic anemia. He was treated with long-term oral prednisone. Head CT from other hospital found multiple calcifications on both sides of the basal ganglia, two sides of the frontal lobe, and the left side of parietal lobe. Lateral spinal X-ray photography showed flat in thoracolumbar vertebral body. Valgus was surgically corrected. He also has facial pigmentation spot and onychomycosis. Whole-exome sequencing combined with Sanger sequencing identified a known homozygous pathogenic mutation in ACP5 genes (c. 643 G>A, p.G 215 R). Identification of such a mutation results in the diagnosis of spondylo enchondrody splasia with immune dysregulation (SPENCDI). Conclusions Wholeexome sequencing is one of the effective methods for detection of rare disease, the SPENCDI case reported here is a good example of it.

蛋白聚糖型脊柱骨骺干骺端发育不良； 矮小； 基因突变

YANG Xi, LIU Yujie, MA Huijuan

. 2016, 34(8):  589.  doi:10.3969/j.issn.1000-3606.2016.08.007

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Objectives To analyze a rare autosomal recessive disease, aggrecan type spondylometaphyseal dysplasia (SEMD), which was caused by ACAN gene mutations. Methods A 7 years old girl was diagnosed with short stature after excluding growth hormone deficiency, idiopathic short stature, and hypothyroidism. Combining family history and clinical features, SEMD were suspected and genetic tests were performed. Results The patient was found with homozygous mutations of c.512C > T in ACAN gene, and was diagnosed with aggrecan type SEMD. Her parents were found to be heterozygous mutation carrier. Conclusions In patients with high suspection of a special type of short stature, early genetic tests should be carried out for a clear diagnosis.

LMNA- associated congenital muscular dystrophy: a case report and literature review

WAN Chunhui, ZHAO Peiwei, YUE Xin, HE Xuelian

. 2016, 34(8):  592.  doi:10.3969/j.issn.1000-3606.2016.08.008

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Objectives To explore the clinical features and diagnosis of LMNA-associated congenital muscular dystrophy. Methods The clinical data from a case of muscular dystrophy caused by LMNA gene mutation were retrospectively analyzed. The related literatures were reviewed. Results A 8 -month-old female infant suffered from weakness of raising head, eyelid droop, and motor development retardtion. LMNA gene was sequenced for the infant, her parents and the older sister. Heterozygous mutation of c. 94 _ 96 del AAG (p. K 32 del) was found in the infant leading to the diagnosis of LMNA- associated congenital muscular dystrophy. No mutation was found in the infant’s parents and her older sister. The literature review showed that all of LMNA- associated congenital muscular dystrophy patients had LMNA gene mutation, more than 80 % patients mainly presented with weakness of raising head and may accompany with weakness of proximal limb, motor development retardation, and weakness of axial muscle. Conclusions Mutation analysis of LMNA gene is conducive to the diagnosis of congenital muscular dystrophy.

Mutation spectrum of the PAH gene in phenylketonuria children in Ningxia

ZHANG Xuehong, YANG Li,LU Biao,GUI Yufang

. 2016, 34(8):  596.  doi:10.3969/j.issn.1000-3606.2016.08.009

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Objective  To determine the mutation spectrum of the PAH gene in PKU children in Ningxia, six exons of PAH gene were sequenced in each of the 30 phenylketonuria (PKU) children. Methods 30 children diagnosed as PKU by the neonatal  sereening and/or GC/MS analysis in Ningxia were enrolled in this study. Meanwhile, 30 normal children were served as controls.  The exons 3、 5、 6、 7、11 and 12 of the PAH gene were amplified by polymerase chain reaction. The amplicons were analyzed by  single strand conformation polymorphism and sequencing. Results Mutations were identified for 51 of 60 alleles in this study,  representing a mutation detection rate of 85%. A total of 16 different causative mutations were detected, including 8 missense  mutations (R241C、R243Q、R252Q、G257V、R359K、R408Q、R413P、Q419R), 3 splicing mutations (IVS4-1G?>? A、 Y204C、IVS7+2T?>?A), 3 nonsense mutations (R111X、Q160X、Y356X), 1 synonymous mutation (V399V) and 1 deletion  (N183del). R243Q (18.3%) had the highest frequency of PAH mutations, and then Y204C (11.7%)、IVS4-1G?>? A (10.0%)、 R111X (6.7%) and IVS7+2T?>? A (6.7%). For the first time in China, two novel mutations, deletion mutation N183del  （C.547549delGAA）  in exon 6 and missense mutation R359K (C.1078G?>?A) in exon11, were identified in PKU children. Two silent  mutations, V245V (C.735G?>?A) and Q232Q (C.696A?>?G), were observed in PKU children and the controls, but there were no  significant difference between them (P?>?0.05). Conclusions The most common mutations were missense and R243Q had the  highest frequency of mutation. The identification of 2 novel mutations expands the spectrum of Chinese PAH mutations.

Analysis of screening and therapeutic effect of congenital hypothyroidism

WANG Xiuli, PENG Lei, YANG Danyan, WU Jiao

. 2016, 34(8):  602.  doi:10.3969/j.issn.1000-3606.2016.08.010

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Objective  To explore neonatal screening and therapeutic effects of congenital hypothyroidism (CH)  in Xuzhou. Methods Data of  neonatal heel blood thyroid stimulating hormone (TSH) tested with time-resolved  fluoroimmunoassay from July 2003 to July 2015 were retrospectively analyzed; The cases with positive screening tests were  called back for further examination of the serum thyroid function (TSH，FT3，FT4) by chemiluminescence immunoassay method.  The CH patients were given levothyroxine replacement. A total of 686 patients with CH treated routinely for 1 years later (CH  group) and 650 matched healthy children (control group) were included in the study. The physical development was monitored  regularly. The neurodevelopment was tested at 1 and 3 years old. Results In Xuzhou 1228289 neonates were screened during  12 years，of them 950 cases were diagnosed with CH and the incidence was 1/1293. Among 635 CH patients who received  treatment and follow-up regularly for 2 years,?488 cases (76.85%) were evaluated to have permanent hypothyroidism and 147  cases (23.15%) have transient hypothyroidism. There were no significant differences in developmental quotient between the CH  group and the control group at 1 and 3 years old (P?>?0.05). Conclusions Neonatal disease screening is an effective measure  for early diagnosis of CH; the physical and mental development are normal in CH patients after early replacement therapy.

Congenital nephrogenic diabetes insipidus: 2 cases report of brothers and review

LIU Ziqin, CHEN Xiaobo, SONG Fuying, QIU Mingfang, LIU Ying, YE Xue, QIAN Ye

. 2016, 34(8):  606.  doi:10.3969/j.issn.1000-3606.2016.08.011

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Objective  Congenital nephrogenic diabetes insipidus (CNDI) is a rare disease, the aim of this article is to help  better understanding of this disease. Methods The clinical features, genetic analysis and treatments of two siblings with CNDI  were retrospectively analyzed, and related literatures were reviewed. Results Both brothers had polydispia, polyuria and low  concentrate urine continuously, and they both had a mutation in AQP2 confirmmed with Sanger sequencing. This novel frame  shift mutation caused arginine of 254 to histidine, and prolonged AQP2 protein. Conclusions Gene analysis can help diagnosis  of CNDI. Amiloride is useful option for treatment.

Infant with both alpha 1 antitrypsin deficiency and biliary atresia: a case report and literature review

YANG Ying, LIU Yan, HUANG Zhihua

. 2016, 34(8):  610.  doi:10.3969/j.issn.1000-3606.2016.08.012

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Objectives  To study the clinical characteristics and early diagnosis of infant with both alpha 1 antitrypin  deficiency (α1-ATD) and biliary atresia (BA). Methods The clinical characteristics, serum biochemical parameters, gene  mutations and treatment of one infant with both α1-ATD and BA was reported. Related literatures about liver disease caused by  α1-ATD were reviewed and analyzed. Results The infant was characterised with neonatal cholestasis, hepatomegaly, elevated  serum ALT, AST, total bilirubin (TB), direct bilirubin (DB) and γ-glutamyltransferase (γ-GT) and absence of bile secretion  from the duodenal drainage tube. BA was confirmed by laparotomy and pathological examination and Kasai′s operation was  performed. Further, the infant was confirmed by SERPINA1 gene mutation analysis, which leads to the diagnosis of α1-ATD. The  case of infant with both alpha 1 ATD and BA has not yet been reported at home and abroad. According to the literatures, children  with α1-ATD were characterized with cholestasis, hepatomegaly, hypoproteinemia, high serum ALT and AST, coagulation  disorders caused by vitamin K1 deficiency and hepatic dysfunction. Prognosis was poor without early diagnosis and treatment.  Conclusions For infant cholestasis, a lot of auxiliary examinations should be performed to identify the etiology of cholestasis.  Gene analysis could help differential diagnosis. Prompt diagnosis and early treatment are the key to improve the survival rate and  prognosis.

Chronic granulomatous disease and Mcleod syndrome caused by continuous X chromosome deletion: a report of two cases and literature review

HE Jianxin, GUO Yajie, FENG Xueli, WANG Lei, XU Baoping, LIU Xiuyun, SHEN Kunling, JIANG Zaifang

. 2016, 34(8):  614.  doi:10.3969/j.issn.1000-3606.2016.08.013

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Objective  To explore the clinical features of chronic granulomatous diseases and Mcleod syndrome caused  by continuous X chromosome deletion. Methods The clinical data of two children diagnosed as chronic granulomatous  disease and Mcleod syndrome by gene detection were retrospectively analyzed. Results Two males, 4 year 1 month and 1  year 9 month old, were both hospitalized due to persistent pulmonary infections. Both of them had a history of repeated severe  infections and BCG vaccine associated lymphadenitis, and were diagnosed as X-linked chronic granulomatous disease for  respiratory burst defects and deletion of all CYBB exons. Both of them had retarded motor development, and were diagnosed  as DMD for detection of DMD gene exons and muscle specific promoter region and exon 1-2 deletion by MLPA. One case  was found with obvious echinocytes, the other case showed whole exons deletion of XK gene. Both of them were diagnosed as  Mcleod syndrome. Conclusion Continuous X chromosome deletion could lead to combination of Mcleod syndrome, DMD,  and X-CGD, which may complicate the condition. Due to the lack of Kx antigen, repeated common blood transfusion can  produce relative antibody, which lead to severe hemolytic crisis.

Genotype-phenotype analysis in Apert syndrome

LU Mei, FU Meijiao, XIE Hui

. 2016, 34(8):  618.  doi:10.3969/j.issn.1000-3606.2016.08.014

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Objectives  To analyze the clinical features and gene types of Apert syndrome (AS). Methods The clinical data of one boy with AS were retrospectively revisited and FGFR2 of the boy and his father were analyzed with PCR  amplification and gene sequencing. The relevant literatures were reviewed. Results The boy was one year and one month  old, with brachycephaly, exophthalmos, hypertelorism, low set ears, micrognathia, high-vaulted arch, without cleft palate, and  with syndactyly of both fingersⅠ-Ⅴ and toesⅠ-Ⅴ. A heterozygous mutation (c.758C?>?G,p.P253R) in exon 7 of FGFR2 was  detected in the boy, supporting the diagnosis of AS. The relevant gene mutation was not detected in his father. Among the 24 cases  of AS retrieved from literature, 22 cases were with obvious craniofacial malformations, one with mild craniofacial malformations  and one without craniofacial malformations. All cases were with syndactyly of both fingers and toes. Thirteen cases of FGFR2 were with S252W mutation, 3 cases with P253R , 3 cases with Alu insertion, one with 1.93-kb deletion, removing exon IIIc and  substantial portions of the flanking introns, one case with a heterozygous 1372 bp deletion between FGFR2 exons IIIb and IIIc,  2 cases with (c.756_758delGCCinsCTT) in the IgIIe-IgIIIa linker region and one case with sequence variant T78.501A in intron 8.  Conclusions Apert syndrome present with craniofacial malformations and syndactyly of hands and feet, S252W and P253R  are main mutations of AS.

Analysis on correlation between dietary fatty acid intake of pregnant women and neonateal anthropometry at birth

CHEN Dandan, DAI Nan, DAI Shan, PENG Xiaoju, SHAO Yingying, YIN Lu, WANG Zhixu

. 2016, 34(8):  623.  doi:10.3969/j.issn.1000-3606.2016.08.015

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Objectives  To investigate the correlation between dietary fatty acids intake of pregnant women and neonatal  anthropometry at birth. Methods Women in early pregnancy were recruited with appropriate value of weight gain in pregnancy.  Instant photography was used to assess the dietary situation in both the second trimester and the third trimester to calculate the  intakes of food, energy, macronutrients, and fatty acids. The body weight, height and BMI at birth were evaluated with Z scores. The  correlation between dietary fatty acids of pregnant women and neonatal anthropometry at birth were analyzed. Results There were  516 pregnant women recruited in this study. The average intakes of polyunsaturated fatty acids (PUFA) and the proportion of total fatty  acids in the two trimesters were 15.09 g/d, 23.93% and 17.18 g/d, 24.86%. In the second trimester the intakes of n-6 and n-3 PUFA  were 14.23g/d and 3.45g/d, and in the third trimester, n-6 and n-3 PUFA were 16.08g/d and 3.81g/d, the average intakes in the  third trimester were significantly higher than those in the second trimester (P?＜?0.05).n-6/n-3PUFA ratio was 4.11 and 4.28?in the second trimester and the third trimester, respectively, without  significantdifference between the two trimesters (P?>?0.05). The intake  of DHA (64.43mg/d) in the second trimester was lower than that in the third trimester 75.12 mg/d, (P?＜?0.05). The percentage of  linoleic acid (LA) and α-linolenic acid (ALA) contribution to energy were 5.95%, 1.42% and 6.20%, 1.45% in the second and  the third trimesters, respectively. There was no significant difference between the two trimesters (P?>?0.05).The dietary intakes of  n-3 PUFA, n-6 PUFA and n-6/n-3 ratio in the second trimester were positively correlated with neonatal BMI r =0.142~0.189,  P?＜?0.05). But in the third trimester, only n-3PUFA and DHA were positively correlated with birth weight ( r =0.206, 0.193, P?＜?0.05); there was no correlation between n-6/n-3 ratio and neonatal BMI ( r =-0.018, P?>?0.05). Conclusions The dietary ratio of n-6/n-3 PUFA in  the second trimester was positively correlated with neonatal BMI, suggesting that moderately increasing the intake  of n-3 PUFA may play a positive role in reducing childhood obesity.

The effect of different dosages of low molecular weight heparin on acute pulmonary embolism and inhibition of pulmonary intimal hyperplasiain immature rats

SUN Fuqiang, DUAN Yang, QUE Shengshun, LI Yueqin, YANG Suyan

. 2016, 34(8):  628.  doi:10.3969/j.issn.1000-3606.2016.08.016

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Objectives  To investigate the effect of different dosages of low molecular weight heparin on acute pulmonary  embolism and inhibition of pulmonary intimal hyperplasia in immature rats. Methods 90 male immature SD rats were randomly  divided into five groups: sham group, pulmonary embolism group, low-low molecular heparin group (L-LMH), medium-low  molecular heparin group (M-LMH) and high-low molecular heparin group (H-LMH). The model of acute pulmonary embolism  was established through jugular vein injection with gel-foam solution. The rates in the L-LMH, M-LMH, H-LMH groups were  treated with low molecular weight heparin by subcutaneous injection after surgery with a dosage of 0.005ml/kg, 0.01ml/kg,  0.02ml/kg, twice a day. Animals in the control group were given saline injection. Arterial blood gas, pulmonary artery pressure  (mPAP), right ventricular pressure (RVP), wall area/tube area, wall thickness/tube diameter, and the expression of PDGF-B  and MCP-1 at gene and protein levels in lung tissue were detected on the 7th (7d), 14th (14d) and 28th (28d) after opration.  Results There were significant differences of PaO2 among 5 groups on 7d, 14d and 28d. PaO2 in group M-LMH (105.1±4.6  mm Hg) were significantly higher than that of embolization group, L-LMH, but not H-LMH group at 28d. mPAP of M-LMH  group was lower than that in the other three intervention groups, but showed no significant difference compared with sham group  (P?>0.05). There were significant differences of RVP on 7d and 14d. PDGF-B, MCP-1 of M-LMH group were significantly  lower compared with the other three intervention groups (P?＜?0.05), but showed no significant difference compared with sham  group (P?>0.05). Wall area/tube area, wall thickness/tube diameter scores of M-LMH group had no significance differences  compared with sham group on 28d (P?>?0.05). Conclusion  Medium dose of low molecular weight heparin could ameliorate the  acute pulmonary embolism and inhibit the proliferation of pulmonary arteries in rats.


The progress of the mechanism on brain protection of remote ischemic preconditioning

LU Fangfang, WANG Wei

. 2016, 34(8):  634.  doi:10.3969/j.issn.1000-3606.2016.08.017

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In recent years, remote ischemic preconditioning is found as a novel way to protect the brain, which may be achieved  through nerve pathways, humoral factors or nerve-humoral interaction. The molecular mechanisms for the protection might be related  to mitochondria ATP-sensitive potassium channel, mitogen-activated protection kinase, mammalian target of rapamycin, including  nitric oxide synthase and cannabinoid receptors. The aim of this review is to explain the mechanism of action of remote ischemic  preconditioning on brain protection, as well as the possible direction of clinical application.