Journal of Clinical Pediatrics

Current status of extracorporeal membrane oxygenation in pediatric critical care medicine in China

HONG Xiaoyang, FENG Zhichun

. 2015, 33(1): 1. doi:10.3969 j.issn.1000-3606.2015.01.001

Abstract ( 335 )

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　Extracorporeal membrane oxygenation is an extracorporeal life support technology that can provide cardiopulmonary support for a long time. In this article, the application of extracorporeal membrane oxygenation in pediatric critical care medicine in domestically and abroad is introduced, and the factors of restricting domestic extracorporeal membrane oxygenation technology development are also analyzed. It is expected that the article can improve extracorporeal membrane oxygenation technology in pediatrics and promote the building and development of medical technology system in pediatric critical care medicine in China.

Application of extracorporeal membrane oxygenation in pediatric cardiopulmonary failure

　HONG Xiaoyang, ZHOU Gengxu, LIU Yuhang, LIU Yingyue, WANG Hui, GAO Haitao, FENG Zhichun

. 2015, 33(1): 5. doi:10.3969 j.issn.1000-3606.2015.01.002

Abstract ( 359 )

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Objective　To introduce the application of extracorporeal membrane oxygenation (ECMO) in treatment of pediatric cardiopulmonary failure. Methods The clinical data of pediatric patients with cardiopulmonary failure who received ECMO support from June 2012 to October 2014 were retrospectively analyzed. Results A total of 24 children with cardiopulmonary failure received ECMO support including 18 male and 6 female aged from 1 day to 7 years old with weight between 3-20 kg. There were 15 cases who successfully weaned from ECMO (62.5%) and 10 cases survived and discharged (42.7%). 14 patients died. Among them, 9 patients died of unsuccessful weaning from ECMO, 3 patients died of complications and 2 patients died of giving up treatment after weaning from ECMO. Complications were found in 11 cases (45.8%) during ECMO support. Conclusions ECMO can provide effective support for pediatric patients with refractory cardiopulmonary failure.

Investigation of peripherally inserted central catheter-associated infection in very low birth weight infants

SHUAI Chun,FENG Zhichun, WANG Hao, YE Xiuzhen, ZHANG Yong

. 2015, 33(1): 9. doi:10.3969 j.issn.1000-3606.2015.01.003

Abstract ( 462 )

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　Objective　To investigate the incidence of catheter-related bloodstream infection (CRBSI) among the very low birth weight infant with peripheral inserted central venous catheter (PICC) and the factors related to the occurrence of CRBSI. Methods The clinical data of very low birth weight infants admitted to our NICU and receiving PICC between January 2012 and December 2013 were retrospectively analyzed. Results The incidence of PICC catheter-related blood stream infection was 32/5028 (6.36/1000). The results of pathogens detection indicated that coagulase-negative staphylococcus was predominant, accounting for 46.9% (15/32), and gram-negative bacteria and candida parapsilosis were also relatively common. Drug-resistance was found in all bacteria, but not in fungi. The premature infants with a gestational age less than 28 weeks (27.9%) had a significantly higher incidence of CRBSI than that in premature infants with gestational ages between 28 and 32 weeks (9.9%) and more than 32 weeks (2.4%) (P<0.05). Compared with premature infants with birth weight of 1000 g or more, the incidence of CRBSI were significantly higher in premature infants with birth weight less than 1000 g (19.2% vs. 8.6%, P<0.05). The incidence of CRBSI was significantly lower in infants with PICC indwelling time less than 20 days (2%) than that in infants with PICC indwelling time of 20-30 days (20.9%) and more than 30 days (15.3%) (P<0.05). Conclusions In very low birth weight infants with PICC, CRBSI is often caused by the conditioned pathogens, in which drug-resistant bacteria were common. The risk factors related to CRBSI were gestational age, birth weight and the indwelling time of PICC.

Clinical analysis of purulent meningitis caused by different pathogens in neonates

HU Yueyuan, GAO Xirong, ZHAN Caixia, LI Guinan, PENG Xiaoming, HUANG Ruiwen

. 2015, 33(1): 13. doi:10.3969 j.issn.1000-3606.2015.01.004

Abstract ( 430 )

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Objective　To explore the clinical characteristics of purulent meningitis caused by different pathogens in neonates. Methods Clinical data of 172 cases of neonatal purulent meningitis from January 1, 2011 to December 31, 2012 were retrospectively analyzed. Results Cerebrospinal fluid (CSF) appeared turbid and purulent in 54 cases (31.4%). The CSF cultures showed positive in 70 cases (40.7%), and Escherichia coli (E. coli) and staphylococcus were common. Thirty-one patients had complications (18.0%), among whom, 14 patients (8.1%) were complicated by hydrocephalus. Among E. coli meningitis group, other pathogens group and unknown pathogens group, there were significant differences in the rate of abnormal CSF appearance, CSF white blood cell counts, the rate of CSF white blood cell counts greater than 500×106/L, the levels of sugar and protein in CSF, duration of fever, the time of CSF return to normal, length of hospital stay and cost, complication and case-fatality rate (all P<0.05). Conclusions When CSF appears turbid and purulent, especially when CSF white blood cell counts are greater than 500×106/L, E. coli infection should be considered. The purulent meningitis caused by E. coli has high occurrence rates of complication and case-fatality and poor prognosis.

Clinical features and resistance analysis of bacteremia due to Achromobacter xylosoxidans in neonates

WANG Weibao, WANG Jianfang, XIE Fei, NIU Shuli, WANG Zhixia

. 2015, 33(1): 17. doi:10.3969 j.issn.1000-3606.2015.01.005

Abstract ( 476 )

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Objective　To investigate outbreak of Achromobacter xylosoxidans in neonatesand present clinical and laboratory data of the patients. Methods　All the neonates with bacteremia due to Achromobacter xylosoxidans from Mar 2012 to Dec 2013 were retrospectively analyzed. Results　Eighteen episodes of bacteremia occurred in 13 neonates. All neonates were preterm newborns and 61.5% (8/13) had birth weight<1000 g. Prematurity, total parenteral nutrition, previous broad spectrum antibiotic therapy and umbilical venous catheter use were predisposing factors. Prematurity and respiratory distress syndrome were the most common diagnosis at admission. The frequent features were thrombocytopenia, abdominal distention, neutropenia and apnea. Three (23.1%) episodes were breakthrough infections. All isolates were susceptible to Trimethoprim-sulfametoxazole and Meropenem, but showed varied susceptibility to other antibiotics. Conclusions　Achromobacter xylosoxidans has potential risk of serious infections in neonate, inviting close attention to early diagnosis. Timely and accurate susceptibility testing and consideration for predisposing factors could help to control neonatal bacteremia.

The change of coagulation indicators and procalcitonin in children with severe pneumonia

HUANG Caizhi, MO Liya, LI Aiguo, YANG Juan, DENG Yongchao

. 2015, 33(1): 20. doi:10.3969 j.issn.1000-3606.2015.01.006

Abstract ( 416 )

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Objective　To explore the changes in the levels of coagulation indicators and procalcitonin (PCT) in children with severe pneumonia. Methods A total of 76 children with severe pneumonia were selected and were divided into two groups according to the level of PCT, PCT<2.00 ng/ml group and PCT ≥ 2.00 ng/ml group. Thirty healthy children were selected as normal controls. The levels of PCT, platelet counts (PLT), antithrombin- Ⅲ (AT- Ⅲ ) activity and D-dimer (DD) were measured and compared among groups. Results Compared with control group, PCT, PLT and DD levels were significantly higher and AT- Ⅲ activity was significantly lower in severe pneumonia group (P<0.05). AT- Ⅲ activity and PLT were significantly lower and DD level was significantly higher in PCT≥2.00 ng/ml group than those in PCT<2.00 ng/ml group (P<0.05). The incidence of disseminated intravascular coagulation (DIC) in PCT≥2.00ng/ml group was significantly higher than that in PCT<2.00ng/ml group (33.33% vs. 9.09%, corrected χ2=5.02, P=0.025). Conclusions There is dysfunction of coagulation in children with severe pneumonia. The higher level of PCT is, more obvious coagulation dysfunction is. The severe pneumonia children with high level of PCT are more likely to be complicated with disseminated inravascular coagulation.

The value of procalcitonin in conjunction with heart-related markers in assessment of the severity of sepsis

PENG Hongyan, ZHU Yimin, ZHANG Xinping

. 2015, 33(1): 23. doi:10.3969 j.issn.1000-3606.2015.01.007

Abstract ( 406 )

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Objectives　To explore the clinical value of procalcitonin (PCT) in conjunction with heart-related markers in assessment of the severity of sepsis. Methods The clinical data of 147 children with sepsis (88 cases of sepsis and 59 cases of severe sepsis) admitted to pediatric intensive care unit (PICU) from September 2013 to April 2014 were retrospectively analyzed. The levels of procalcitonin and heart-related markers at different stages of sepsis were compared. Results The levels of PCT, CK-MB, NT-proBNP, and cTnT-hs in severe sepsis group were significantly higher than those in sepsis group (P<0.01). However, there was no significant difference in WBC and CRP between the two groups (P>0.05). Compared with surviving patients, the levels of PCT, CK-MB, cTnT-hs, and NT-proBNP were significantly higher in dead patients (P<0.05). The area under the curve (AUC) of PCT, CK-MB, NT-proBNP, and cTnT-hs in assessment of the severity of sepsis was 0.838, 0.811, 0.854 and 0.713, respectively. The AUC of PCT, CK-MB, NT-proBNP, and cTnT-hs in predicting survival situation was 0.766, 0.715, 0.778 and 0.609, respectively. A binary logistic regression equation was established based on the results of procalcitonin and heart-related indicators: logt(P) = 2.668×NT-proBNP+1.083×PCT+ 1.620×CK-MB+0.864×cTnT-hs–11.461. The AUC of logt (P) in assessment of the severity of sepsis and in predicting survival situation was 0.928 and 0.807. Conclusions Individual indicator of PCT, CK-MB, NT-proBNP, and cTnT-hs can be independently used to evaluate the severity of sepsis in children, and in comparison with single index, the assessment value is higher when four indicators are combined. The severity of sepsis in children is closely related to myocardial injury and cardiac dysfunction.

Analysis of 12 cases of severe sepsis caused by methicillin-resistant Staphylococcus aureus infections in children　

CHEN Yuqing, JIN Danqun, LU Songjian

. 2015, 33(1): 28. doi:10.3969 j.issn.1000-3606.2015.01.008

Abstract ( 462 )

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Objective　To analyze the clinical features and bacterial drug resistance of severe sepsis caused by methicillin-resistant Staphylococcus aureus (MRSA) infections in children. Methods　The clinical data and results of antibiotic susceptibility test in 12 children with severe sepsis caused by MRSA infections from January 2010 to December 2013 were analyzed retrospectively. Results　Among 12 children, there were 5 boys and 7 girls. Their age ranged from 8 days to 11 years, with a median age of 1 year and there were 9 infants. All cases presented with acute onset which included 5 cases of acute osteomyelitis or purulent arthritis, 5 cases of necrotizing pneumonia with pyothorax, one case of necrotizing fasciitis and one case of bloodstream infection. 8 cases were complicated by skin and soft tissue infection, 7 cases by septic shock and 1 case by disseminated intravascular coagulation. The levels of C-reactive protein were increased in all children and white blood cell counts were decreased in 4 children. The susceptibility testing showed MRSA was sensitive to vancomycin and linezolid, and resistant to erythromycin, clindamycin and compound sulfamethoxazole. After treatment with surgical debridement and closed-chest drainage, 8 cases survived and 4 cases died. Conclusions　The severe sepsis caused by MRSA infections was common in infants with sudden onset and rapid progress, so active treatments are needed.

The nutritional status of the hospitalized premature infants with very low birth weight in China：a retrospective multicenter study

The National Cooperation Group on Nutrition, The Chinese Neonatologist Association, China

. 2015, 33(1): 32. doi:10.3969 j.issn.1000-3606.2015.01.009

Abstract ( 314 )

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Objective　The aim of this study was to investigate the nutritional status of the hospitalized premature infants with birth weight lower than 1 500 g in the different areas in China, and to analyze the related influence factors of extrauterine growth restriction (EUGR). Methods The retrospective survey method was used to collect clinical data of the premature infants with birth weight lower than 1 500 g and hospital stay of more than 2 weeks in 15 hospitals between January 1, 2012 and December 31, 2012. A descriptive analysis was performed for intestinal and parenteral nutrition and weight gain, and the related influence factors of EUGR were analyzed. Results A total of 572 premature infants were selected. The mean gestational age was 30.6±2.0 weeks, and the mean birth weight was 1255.7±164.8 g. The mean enteral feeding starting time after birth was 68.2±85.4 hours, and the mean age to reach oral calorie of 100 kcal/(kg·d) was 29.9±14.1 days. During hospitalization, the mean weight growth velocity after return to birth weight was 11.8±5.5 g/(kg·d). The duration of hospitalization was 42.2±20.8 days and the corrected gestational age was 36.6±2.7 weeks at the time of discharge. At birth, the percentage of birth weight below P10 was 52.6%, and below P3 was 29.0%. At the time of discharge, the percentage of weight below P10 was 80.9%, and below P3 was 63.6%. There were differences between two time points (P<0.01). The indices of nutrition, weight gain and other indices at discharge were significantly different among 15 hospitals (P<0.05). Small gestational age, low birth weight, birth weight below P10, taking a long time to reach oral calorie limit and slow weight gain were independent risk factors of EUGR in premature infants with very low birth weight (VLBW) at the time of discharge (P<0.05). Conclusions Now in our country, the nutritional status of hospitalized premature infants with VLBW was not optimistic, and there was significant difference in different areas. To improve the nutritional status of hospitalized preterm infants, active implementation of standardized nutritional support strategies were important.

Value of general movements combined with evoked potentials in predicting motor development of high-risk neonates

ZHANG Haiyan, ZHOU Jun, WANG Zhenzhen, TU Yanping, LIU Jing, LIU Changqing, YANG Enhua

. 2015, 33(1): 38. doi:10.3969 j.issn.1000-3606.2015.01.010

Abstract ( 312 )

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　Objective　To explore the clinical value of early application of general movements (GMs) combined with evoked potentials (EPs) in predicting motor development of high-risk neonates. Methods A total of 112 high-risk neonates in follow-up clinic of pediatric neurological rehabilitation were selected. GMs evaluation and EPs detection were measured in writhing movements period and fidgety movements period respectively. The motor developmental outcomes were determined at the corrected age of 12 months after continuous follow-up according to the diagnostic criteria (2006) of cerebral palsy (CP) and Peabody motor development scale. The predictive validity of GMs, EPs and the combination of GMs and EPs was calculated. Results The motor developmental outcomes of 112 cases showed that there were 26 cases (23.2%) of CP, 14 cases (12.5%) of motor retardation and 72 normal cases (64.3%). In writhing movements period, the predictive validity of GMs in conjunction with median nerve somatosensory evoked potentials (MNSEP) for abnormal motor development was as follows: sensitivity 80%, specificity 98.6%, positive predictive value 97%, and negative predictive value 89.9%. In fidgety movements period, the predictive validity of GMs for CP was as follows: sensitivity 96.1%, specificity 97.7%, positive predictive value 92.6% and negative predictive value 98.8%. However, the predictive validity of the combination of GMs and MNSEP for CP had no significant increase. The predictive validity of MNSEP in both writhing movements period and fidgety movements period for abnormal motor development was as follows: sensitivity 82.5%, specificity 91.7%, positive predictive value 84.6% and negative predictive value 90.4%. Conclusions　In writhing movements period, combination with GMs and MNSEPs can improve the predictive validity for abnormal motor development in high-risk neonates.

Diagnostic value of urine S-100B protein levels in brain injury in premature infants

JIN Yue, LU Jihong, BAO Xingxing, WANG Fen, JIN Quan, ZHANG Min, HE Zhen, TANG Hanhong, XIAO Mei

. 2015, 33(1): 44. doi:10.3969 j.issn.1000-3606.2015.01.011

Abstract ( 357 )

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　Objective　To investigate the diagnostic value of urine S-100B protein levels in brain injury in premature infants. Methods A total of 76 premature infants with gestational age less than 35 weeks were selected from January to December 2012. Urine samples were obtained at 24 h, 72 h and 120 h after birth, and S-100B protein levels in urine were detected by chemiluminescence. According to the results of cranial ultrasound and MRI, all infants were divided into periventricular leukomalacia (PVL) group (n=16), periventricular-intraventricular haemorrhage (PVH-IVH) group (n=20) and no brain injury group (control group) (n=40). Urine S-100B protein levels were compared among groups. Results There was significant difference in Urine S-100B protein levels among PVL, PVH-IVH and control groups at 24 h, 72 h and 120 h after birth (P<0.01). At each time point, the urine S-100B protein levels were highest in PVL group and lowest in control group, and the differences were significant (P<0.01). The urine S-100B protein levels were significantly different among different time points in PVL and PVH-IVH groups (P<0.01), reaching a peak at 72 h and starting to decrease at 120 h. Conclusions Urine S-100B protein can be used as a sensitive indicator of brain injury in judging disease severity and assessing prognosis.

The analysis of risk factors associated with perioperative respiratory adverse events in children undergoing tracheobronchial foreign body removal

　WANG Liang, LIU Pingyuan, CUI Jie, CHEN Beibei, LIU Lifei, TANG Wen

. 2015, 33(1): 48. doi:10.3969 j.issn.1000-3606.2015.01.012

Abstract ( 368 )

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Objective　To identify the risk factors associated with perioperative respiratory adverse events in children undergoing tracheobronchial foreign body removal. Methods A total of 263 children undergoing tracheobronchial foreign body removal by rigid bronchoscopy were selected and divided into two groups, complication group and non-complication group, according to whether the intraoperative and postoperative (within 24 h) respiratory serious complications occurred. Furthermore, comparisons were performed between two groups in past medical history, rate of preoperative respiratory infection, duration of foreign body retention, types of foreign body, operation time and anesthetic effects. The independent risk factors associated with the occurrence of perioperative respiratory adverse events were analyzed by multivariate logistic regression analysis. Results Of the 263 patients included, 31(11.8%) developed respiratory adverse events. Compared with non-complication group, children in complication group had higher rate of preoperative respiratory infection, longer duration of foreign body retention, longer time of operation and higher rate of poor anesthetic effects, and the differences were significant (P<0.05). The results of multivariate logistic regression analysis indicated that the independent risk factors associated with perioperative respiratory adverse events were poor anesthesia effects (OR=11.07, 95%CI: 3.16~38.75), preoperative respiratory infection (OR=2.99, 95%CI: 1.04~8.59) and longer time of operation (OR=1.07, 95%CI: 1.00~1.14). Conclusions If children who underwent tracheobronchial foreign body removal had poor anesthesia effects, preoperative respiratory infection and long operation time, the occurrence of perioperative respiratory adverse events was likely to be increased, so appropriate preventive measures should be adopted.

Effect of graded exercise test on hemodynamics in overweight teenagers

DONG Congmin

. 2015, 33(1): 52. doi:10.3969 j.issn.1000-3606.2015.01.013

Abstract ( 332 )

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Objective　To explore hemodynamics response to the graded exercise test in overweight and normal weight teenagers. Methods A total of 87 overweight teenagers were enrolled and divided into girl overweight group (GO, n=20), girl normal weight group (GN, n=21), boy overweigh group (BO, n=25) and boy normal weight group (BN, n=21). The following variables were measured: anthropometrics (weight, height and BMI), hemodynamic variables at rest and during graded exercise test such as rest systolic blood pressure (SBP), diastolic blood pressure (DBP), mean aterial pressure (MAP) and heart rate (HR) as well as maximal SBP, DBP, MAP and HR. Results The rest SBP in BO group was higher than that in BN group (P<0.01). During graded exercise test, compared with GN group, maximal SBP were significantly higher while maximal oxygen uptake (VO2max) were significantly lower in GO group (P<0.05). Furthermore, compared with BN group, maximal SBP were significantly higher while VO2max were significantly lower in BO group (P<0.01). When height, weight, BMI, and VO2max were adjusted as confounding factors, the difference in SBP was not significant between GO and GN groups (P=0.105) while the differences in rest SBP and maximal SBP were still significant between BO and BN groups (P=0.021, P=0.016). Conclusions Arterial blood pressure was higher in overweight teenagers than that in normal weight teenagers both at rest and during graded exercise test. Influence of overweight on hemodynamic parameters was more obvious in male teenagers in comparison with female teenagers.

Association of SNP polymorphisms in ARID5B gene with childhood acute lymphoblastic leukemia in China

Zhao Shanshan, Xu Jinping, Wu Jinzhun, Guo Biyun, WEN Hong, Bai Haitao

. 2015, 33(1): 56. doi:10.3969 j.issn.1000-3606.2015.01.014

Abstract ( 509 )

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　Objective　To study the relationship between ARID5B polymorphisms and the susceptibility of the childhood acute lymphoblastic leukemia (ALL) in Minnan Chinese Han population. Methods　The association analysis between ALL and polymorphisms of ARID5B were performed in a Minnan Han population case-control series using fluorescence resonance energy transfer probes analysis. Results　We analyzed the genotypes of the rs7073837 and rs10821936 in ARID5B in 108 patients with acute lymphoblastic leukemia and 116 ethnically matched controls. The genotype distribution of rs7073837 and rs10821936 in ALL and control groups followed Hardy-Weinberg equilibrium. No significant differences in genotypic and allelic distributions between ALL patients and controls were observed for rs7073837. We found significant differences in genotypic distribution of rs10821936 variant between ALL patients and control subjects (P<0.001), and variant allele C in ALL group was significantly more frequent than that in the controls (P<0.001, Odds ratio=2.203, 95% confidence interval, CI: 1.507-3.220). Conclusions　 Our data suggested that rs10821936 variant in ARID5B plays a potential role in childhood ALL in Minnan Han population, and variant allele C carriers may be at an increased risk of developing ALL. Moreover, no association between rs7073837 and childhood ALL was observed.

Expression of suppressor of cytokine signaling 1, 3 mRNA in peripheral blood mononuclear cells in children with Henoch-Schöenlein purpura

WANG Fengying, LU Man

. 2015, 33(1): 60. doi:10.3969 j.issn.1000-3606.2015.01.015

Abstract ( 397 )

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　Objective　To explore the expression and role of suppressor of cytokine signaling 1 (SOCS1) and SOCS3 mRNA in the development of Henoch-Schöenlein purpura (HSP) in children. Methods Real-Time reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression levels of SOCS1 and SOCS3 mRNA in peripheral blood mononuclear cells (PBMCs) in children with HSP (HSP group, n=20) and healthy children (control group, n=15), respectively. Results The expression levels of SOCS1 and SOCS3 mRNA in HSP group were (1.37±0.38) and (1.87±0.53), and in control group were (0.85±0.12) and (0.77±0.13). Compared with control group, the expressions of SOCS1 and SOCS3 mRNA, especially the latter, were significantly up-regulated in HSP group (P<0.001). Conclusions The up-regulated expression of SOCS3 may be invol ed in the pathogenesis of HSP in children.

In vitro inhibition of the human cytomegalovirus gene replication by RNA interference

GU Shaoqing, ZHAO Yuan, MA Xiaomeng

. 2015, 33(1): 64. doi:10.3969 j.issn.1000-3606.2015.01.016

Abstract ( 354 )

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Objective　To investigate the effect on in vitro inhibition of the human cytomegalovirus (HCMV) gene replication by RNA interference using different orders of small interfering RNA (siRNA) transfection and HCMV infection. Methods The siRNAs were designed and synthesized according to the sequence of the immediate early (IE) genes of HCMV. The siRNAs were transfected into human embryonic lung fibroblastic (HELF) cells by cationic liposome through different orders including before or after or at the same time as HCMV infection. Simultaneously, the control groups were set including normal control group, negative control group, positive control group and transfection reagent group. The inhibitory effects of siRNAs on HCMV-IE and a positive control gene of GAPDH were examined by fluorescent quantitative PCR and agarose gel electrophoresis. Results The expression level of GAPDH mRNA in positive control group was significantly lower than that in negative control group and transfection reagent group (P<0.05), and the inhibition rate of siRNA was 70.4%. Among different experimental groups of siRNAs transfection before, after or at the same time as HCMV infection and three control groups of negative control group, positive control group and transfection reagent group, the expression level of IE mRNA was significantly different (F=146.93, P=0.000). In the groups of siRNAs transfection before HCMV infection or at the same time as HCMV infection, the expression levels of IE mRNA were significantly lower than those in the group of siRNAs transfection after HCMV infection (P<0.05). Conclusions In vitro, siRNAs can effectively inhibit the expression of target gene and it is better to do siRNA transfection first then followed by HCMV infection. It is suggested that siRNA might have a role in prevention from HCMV infection.

The influence of bone marrow mesenchymal stem cells on the injured cardiomyocytes and its relationship with Wnt/β-catenin signaling pathway

RUAN Tao, HE Xuehua, LIU Liping, YUAN Yonghua, PAN Li, LUO Jianhong, HU Shaya

. 2015, 33(1): 69. doi:10.3969 j.issn.1000-3606.2015.01.017

Abstract ( 386 )

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Objective　To investigate the molecular mechanism of bone marrow mesenchymal stem cells (MSCs) in the treatment of injured cardiomyocytes and to explore the role of Wnt/β-catenin signaling pathway in this process. Methods After isolation, identification and culture for 72 hours, cardiomyocytes were divided into 3 groups: normal cardiomyocytes group (Group A), injured cardiomyocytes group (induced by 1 mg/L doxorubicin for 4 hours, Group B) and co-culture group (doxorubicininjured cardiomyocytes co-cultured with MSCs, Group C). After 72 hours of culture, apoptosis of cardiomyocytes was detected by flow cytometer, and the expression of β-catenin, c-Myc and p53 protein were tested by western blot. Results The apoptosis rates of cardiomyocytes in Group A, B and C were 0.74±0.65, 26.58±3.89 and 7.72±0.90, respectively, and the difference was significant (F=98.13, P<0.001). Through pairwise comparison, it was found that the apoptosis rate of cardiomyocytes in Group B was significantly higher than that in Group A and C (P<0.05). The results of western blot showed that the protein expression levels of β-catenin, c-Myc and p53 in Group B were significantly higher than those in Group C (P<0.01). However, in Group A, the protein expression of β-catenin, c-Myc and p53 could not be measured by western blot. Conclusions MSCs have significant anti-apoptotic effect on doxorubicin-induced cardiomyocyte injury and the molecular mechanism may related to the inhibition of Wnt/β-catenin signaling pathway.

The effect of ceftriaxone on apoptosis genes in human renal tubular epithelial cells in vitro

HE Yanfang, LIU Xinrong, ZHANG Aiqing, SHI Huimin, GAN Weihua

. 2015, 33(1): 74. doi:10.3969 j.issn.1000-3606.2015.01.018

Abstract ( 378 )

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Objective　To explore the effect of ceftriaxone on apoptosis genes in human renal tubular epithelial cells in vitro. Methods The human renal tubular epithelial cells were cultivated in vitro and their morphology was observed under inverted microscope after stimulation with different concentrations of ceftriaxone. The expression levels of three apoptosis-related genes, p53, bcl-2 and c-Myc, were detected in human renal tubular epithelial cells stimulated with different concentrations of ceftriaxone. Results The morphology of human renal tubular epithelial cells had no obvious changes under microscope when they were stimulated with different concentrations of ceftriaxone (0, 20, 40, and 80 mg/L). There were significant differences in expression levels of p53, bcl-2 and c-Myc genes among different concentrations of ceftriaxone (P<0.01). Compared with other three groups, in 80 mg/L group, the expression levels of p53 and c-Myc genes were significantly increased and levels of bcl-2 genes were significantly decreased (P<0.01). However, there was no difference in the expression levels of three apoptosis-related genes among 0, 20, and 40 mg/L groups (P>0.05). Conclusions High blood drug concentrations of ceftriaxone lead to increased expression of pro-apoptotic genes and decreased expression of anti-apoptotic genes, which may be one of the mechanisms causing kidney damage.

Co-word analysis of research trends on neonatal necrotizing enterocolitis

ZHANG Aimei

. 2015, 33(1): 78. doi:10.3969 j.issn.1000-3606.2015.01.020

Abstract ( 435 )

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Objective　To explore the research trends of neonatal necrotizing enterocolitis (NEC) using a co-word analysis. Methods Original articles about NEC were searched throughout the PubMed Database using a co-word analysis. The included articles were analyzed by Bibliographic Items Co-occurrence Matrix Builder (BICOMB) to retrieve MeSH words with high frequency. Then SPSS software was used to perform co-word cluster analysis and results of cluster analysis were compared between before 2008 and after 2008. Results　In total, 1479 articles were included into the co-word analysis with 776 dated before 2008 and 703 dated from 2009 to 2014. By comparison of MeSH words with high frequency between before 2008 and 2009-2014 and after co-word cluster analysis, it was found that most research hotspots were same in two periods. However, after 2008, some research hotspots disappeared and a few new hotspots were emerged. Conclusions Co-word analysis is helpful to master the research trends of NEC.

Research progress on hypotension in extremely low gestational age newborns

Zhu Xingwang

. 2015, 33(1): 83. doi:10.3969 j.issn.1000-3606.2015.01.021

Abstract ( 489 )

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　Systemic hypotension is a relatively common complication of extremely low gestational age newborns, which may increase mortality and neuro-developmental morbidity. Because of the lack of agreed standards on the diagnosis, management and outcomes of hypotension in the extremely low gestational age newborns, treatment of hypotension among neonatal intensive care units varies widely. Unified clinical guidelines for hypotension in extremely low gestational age newborns should be made through multi-center and large sample perspective study.

Advances in the treatment of Eisenmenger syndrome

LI Honghong

. 2015, 33(1): 87. doi:10.3969 j.issn.1000-3606.2015.01.022

Abstract ( 402 )

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Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

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