Journal of Clinical Pediatrics

Treatment of childhood and adolescent mature B-cell lymphoma

GAO Yijin

. 2014, 32(5): 401-404.

Abstract ( 290 )

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Mature B-cell non-Hodgkin lymphoma (B-NHL) represents about 55%-60% of all NHL cases in children and adolescents. Burkitt lymphoma and diffuse large B-cell lymphoma are the most common subtypes. Current combination chemotherapy regimen succeeds in overall survival rates of more than 80%. Risk factors for the prognosis of childhood and adolescent B-NHL include, bone marrow and central nervous system involvement, serum lactate dehydrogenase level and kinetics of response to therapy. Future strategies should include further understanding of the genetic alternation of B-NHL and utilization of novel target therapies to decrease treatment-related toxicity. We performed a retrospective analysis on the treatment of child and adolescent mature B-cell lymphoma.

Different induction therapies in the treatment of childhood acute promyelocytic leukemia　

WANG Jing,JIA Yueping,LIU Guilan,LU Aidong,ZHANG Leping,ZUO Yingxi,WANG Bin

. 2014, 32(5): 405-409.

Abstract ( 447 )

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　Objectives　To compare the efficacy and adverse effects of combining all-trans retinoic acid and arsenic trioxide with or without anthracyclines on the treatment of childhood acute promyelocytic leukemia (APL) patients. Methods The retrospective study included 46 children as newly diagnosed APL from January 1st, 2001 to December 31st , 2012. Efficacy and adverse effects for different induction therapies and in high and low white blood cell (WBC) count subgroups were studied. Results In the non antharcycline containing group, 2 patients died during remission induction, and in the antharcycline containing group none of the patients died. No statistical difference was observed between the antharcycline containing group and the non antharcycline containing group in complete remission, the length of time to achieve molecular complete remission and minimal residual disease quantitative analysis at the end of the induction.The mean duration of high WBC count subgroup in the antharcycline containing group was shortened than that of the non antharcycline containing group (P＜0.05). In the low WBC subgroups, the WBC count peak in the antharcycline containing group was lower than that of the non antharcycline containing group (P＜0.05); The recovery time of the abnormal coagulation was found similar between these two groups. Conclusions The use of antharcycline in induction therapy could shorten the duration of high WBC count and reduced the WBC count peak , thus reduces the risk of early death.

Long-term follow-up of stage 1-2 neuroblastoma

Pan Ci,Zhang Anan,Ye Qidong,Zhou Min,Hue Huiliang,Chen Jing,Luo Changyin,Shen Shuhong,Wang Jiangmin,Tang Yanjing,Tang Jingyan

. 2014, 32(5): 410-412.

Abstract ( 384 )

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Objective To evaluate the clinical features, treatment scheme and long-term outcomes of stage 1-2 childhood Neuroblastoma (NB). Methods The retrospective study included 49 newly diagnosed NB stage 1-2 patients from June 1998 to December 2010. Clinical data and long-term outcomes were analyzed. Results Twenty-four patients with stage 1 NB and twenty-five patients with stage 2 NB were found among all 237 patients with NB enrolled in this study. The median age at diagnosis was 25 months（２ week to９ year old），29 males and 20 females. 31 patients (63.6%) without symptoms were discovered with tumor by physical or imaging examination. Thorax and abdomen were the most common sites of primary tumor (21 and 22 cases, accounting for 42.9% and 44.9% of all patients, respectively) .40 (81.6%) NB patients had favorable pathology classification. One patient was of MYCN amplification status. Urine vanilla mandelic acid was normal in 32 (91.4%) patients, and serum lactate dehydrogenase was less than five times of the normal value in all patients. Ten NB patients were treated according to the low-risk protocol who received surgery alone.Thirty-nine patients were treated according to intermediate-risk protocol who received both surgery and chemotherapy. All the patients achieved very good partial remission (VGPR) (100%).The median follow-up period was 60 months （22 months to148months）。Nine patients were lost after a follow up of 3 months in median. The 2-、3-、5-year event free survival (EFS) and overall survial (OS) of all 49 patients was 100%. Conclusions The prognosis for neuroblastoma of stage 1-2 in this study was with 100% survival, which provides opportunity for further reduction of dosage and/or duration of episodes in chemotherapy.

Outcome of children with low- or intermediate-risk neuroblastoma: a report of 70 cases

　Tang Yanjing,Pan Ci,Xue Huiliang,Chen Jing,Dong Lu,Zhou Min,Ye Qidong,Shen Shuhong,Wang Yao-ping,Gu Longjun,Tang Jingyan

. 2014, 32(5): 413-416.

Abstract ( 429 )

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　Objectives　To evaluate the long-term outcomes of childhood low or intermediate risk neuroblastoma (NB) and their relevant prognostic factors. Methods　Total 70 new cases of low or intermediate risk NB diagnosed and treated by NB-99 protocol between 1999 and 2008 were analyzed retrospectively. Results　Of these 70 NB patients, fourteen patients were in low risk group and 56 were in intermediate risk group. 67 patients reached complete remission (CR) or very good partial remission (VGPR) and 3 (5%) achieved partial remission (PR). Ten patients relapsed. One patient occured second malignant neoplasm. No patients died of chemotherapy-related adverse events or infections the 5 year overall survival rate was 85.9%, event-free survival rate was 81.0%. Bone marrow infiltration, age at diagnosis, stage, lactate dehydrogenase level had a significant effect on prognosis. Conclusion　Develop cytogenetic and molecular biology tests and pretreatment risk stratification are important for further improve treatment protocol.

Clinical analysis of childhood hepatoblastoma

HOU Weina,ZOU Xiang,GUO Jia,WANG Lu,SHENG Guangyao,SUN Suke

. 2014, 32(5): 417-420.

Abstract ( 329 )

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　Objective　To investigate the rational treatment strategy of hepatoblastoma (HB) in children. Methods Clinical data and follow-up of 25 children with HB admitted from February 2009 to March 2013 were retrospectively analyzed. Results Twenty-five children with newly diagnosed HB (14 males and 11 females) were enrolled. The median age on diagnosis was 25 months (3-92 months); In 18 of 25 cases with complete resection of the primary tumor, 17 cases survived. Only 1 of 7 cases with incomplete resection survived. The survival rate in children with complete resection of primary tumor is significantly higher than those without complete resection (P<0.05). The survival rate in children of stage I or II is significantly higher than the children of stage III or IV (P<0.05). Conclusions Complete tumor resection is the cornerstone of therapy for long-term disease-free survival in HB patients. Treatment strategy remains to be further improved for children with recurrent and metastatic HB.

Magnetic Resonance Imaging evaluation in the diagnosis of pediatric neck masses

WANG Xiaoxia,ZHONG Yumin Zhou Ying,Xue Lianyan,Shi Meihua,Tang Jingyan

. 2014, 32(5): 421-424.

Abstract ( 344 )

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　Objective　To evaluate pediatric neck masses with magnetic resonance imaging (MRI). Methods In this retrospective study, 140 children with neck masses underwent MRI were collected from May 2006 to December 2013.Of them 34 cases went through pathological examinations. The results of MRI diagnosis and pathology were compared in 34 cases. Results In 140 children with neck masses diagnosed by MRI, 103 (73.6%) cases were benign lesions, including 62 vascular malformations, 30 hemangiomas, then cysts, hamartoma, infectious lumps etc., 29 (20.7%) were malignant tumors, including 22 lymphomas, 3 rhabdomyosarcomas, 3 Langerhans cell histiocytosis, 1 neuroblastoma, and 8 (5.7%) cases were undetermined masses. Four in 103 cases with benign lesions were performed by pathological examination and all had been confirmed. Tewenty-five in 29 cases with malignant tumors were performed by pathological examination and 22 cases had been confirmed. Conclusion MRI can help to diagnose the pediatric neck masses and to guide the treatment and follow-up.

Clinical Features and Prognosis of 28 Children with Hemophagocytic Syndrome

　XU Dongqing,YUAN Xiaojun,AN Xia,TANG Mengjie,WANG Chen

. 2014, 32(5): 425-429.

Abstract ( 321 )

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　Objective　To investigate the clinical profile and prognosis of hemophagocytic syndrome (HPS). Methods A retrospective study was carried out to analyze the clinical features and laboratory findings in 28 children with HPS. Fisher's exact probability method and Logistic multivariate regression were used to explore the prognostic risk factors.. Results HPS was clinically characterized by prolonged fever (100%), hepatomegaly (64.29%)，and other minor features including respiratory symptoms (53.57%), splenomegaly (50%), hydrops of multiple serous cavity (42.86%), lymphadenectasis (32.14%), jaundice (17.85%), skin rash (14.29%), central nervous system involvement (14.29%), and alimentary tracthemorrhage (10.71%). Laboratory data showed that 1iver dysfunction, pancytopenia, coagulation abnormalities, disseminated intravascular coagulation, hypertriglyceridemia, decreased number of natural killer cells and hyponatremia were prominent. The etiological analysis indicated that infection associated hemophagocytic syndrome was most common (60.71%), in which EB virus associated HPS was predominant, accounting for 64.71%. Significant difference was observed in the difference of albumin，blood urea nitrogen and activated partial thromboplastin time between death and survival cases (P＜0.05). The Logistic regression multivariate analysis showed that hypoalbuminemia was an independent prognostic factor. Conclusion There are various underlying diseases and clinical manifestations for HPS. The lower level of serum albumin is an independent prognostic factor. A prompt diagnosis and treatment is very important for HPS prognosis due to the rapid progression and high mortality.

Congenital factor Ⅶ deficiency: A report of two cases and literature review

ZHAI Qian,CAO Yun,ZHAI Xiaowen,ZHANG Rong

. 2014, 32(5): 430-433.

Abstract ( 321 )

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　Objective　To study the pathogenesis, clinical characteristics, laboratory tests, treatments and prognosis of congenital factor Ⅶ deficiency. Methods The clinical data of two cases of congenital factor Ⅶ deficiency diagnosed at the Children’s Hospital of Fudan University and 9 cases reported in the past 10 years retrieved from Pubmed, Web of Knowledge and CNKI, Wangfang database by using the factor Ⅶ deficiency , congenital, newborn and case report as keyword were reviewed and analyzed. Results All cases were full term birth with low birth weight (<2 500 g), including 7 females and 7 males. Parental consanguinity was found in 3 cases, and a family history was found in 3 cases. The laboratory tests were characterized by significantly prolonged prothrombin time, normal partial thromboplastin time, and decreased coagulation factor Ⅶ activity. The coagulation factor Ⅶ activity of 10 cases were less than 5%. Five cases (45.5%) were treated with human recombinant activated factor Ⅶ. Four cases(36.4%) treated with plasma or human recombinant activated factor Ⅶ are currently in normal growth and development. Four cases (36.4%) died during the hospitalization. Conclusions A diagnosis of congenital factor Ⅶ deficiency should be considered in the neonates with severe bleeding, prolonged prothrombin time, normal partial thromboplastin time, and being intractable to vitamin K treatment. Human recombinant activated factor Ⅶ is the first choice of the treatment of congenital factor Ⅶ deficiency. The further study of gene mutation type will be of great significance for disease screening, diagnosis, treatment and prognosis prediction.

Clinical significance of Combining second-trimester serum and ultrasound screening for Down’s syndrome　

ZHANG Ping,MENG Yongqin,WANG Jimei

. 2014, 32(5): 434-437.

Abstract ( 298 )

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　objectives　To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening performed in normal singleton pregnancies at 14⁺¹ to 19⁺⁶ weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1~23+6weeks from 2010 to 2013. Results In 24,368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14% (35/24,368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnancies with an expected date of delivery higher than 35 years old.In 1215 pregnancies, second-trimester serum screening showed high risk (cutoff >1:380), 14 were confirmed as Down syndromes ( sensitivity 40%; specificity 95.06%) .In 1142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down’s syndrome (sensitivity 60%; specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syndrome (sensitivity 11.43%; specificity 99.56).. Conclusion The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

Analysis of factors affecting the neonatal birth weight　

Yi Lilan,Zhang Baolin,Han Qi,Liu Jiaqi,Chen Lan,Liu Xueqin

. 2014, 32(5): 438-441.

Abstract ( 336 )

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　Objective　To investigate factors affecting neonate birth weight. Methods Random cluster sampling method was adopted to investigate the physical development of 5539 single live newborns in Beijing, Harbin, Changsha, and Guangzhou. Single factor analysis and logistic regression analysis were used to find the factors influencing neonate birth weight. Results Single factor analysis showed that neonatal sex, gestational age, maternal age, maternal pre-pregnancy BMI, gestational weight gain, mother's education and occupation have effects on neonatal birth weight. Risk factors for macrosomia, including male fetus, maternal age ≥ 25 years before pregnancy, maternal pre-pregnancy BMI ≥ 24 kg/m2, gestational weight gain greater than 12.5 kg, and preterm delivery and maternal pre-pregnant BMI < 18.5kg/m2 are the risk factors of low birth weight. Conclusions Premature, excessive weight gain during pregnancy, high or low maternal pre-pregnancy BMI are main factors that caused abnormal body mass in neonates.

The comparison of wasting, stunting, low weight, and overweight rate in infants by using the World Health Organization Child Growth Standards and China Growth Standards

KANG Yu,LIANG Xiaohua,LI Tingyu,LIU Youxue

. 2014, 32(5): 442-445.

Abstract ( 595 )

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　Objective　To compare the 2006 World Health Organization (WHO) growth standards and the 2005 China national growth standards for identification of the wasting, stunting, low weight and overweight in infants. Methods Data were drawn from “Infants’ feeding and growth” project. Weight-for-length, weight-for-age and length-for-age were derived in z-scores using the two growth references. Stunting was defined as having a length-for-age Z-score less than -2. Low weight was defined as having a weight-for-age Z-score less than -2. Wasting was defined as having a weight-for-length Z-score less than -2. Over weight was defined as having a weight-for-length Z-score more than +2. Results Data of a total of 3909 records from 959 health children aged from 2 to 12 months from June 2008 to May 2009 were analyzed. Of them, 53.88%（2106/3909）were from male and 46.12% (1803/3909）were from female. There was no difference in wasting rate and stunting rate between using two growth references. Fewer infants were identified as low weight by using WHO growth standard than using China growth standard. The results were 0.57% at 0-3 months (0.85% vs.1.42), P>0.05, 0.72% at 4-6 months (0.39% vs. 1.11%) and 0.97% at 7-9 months (0.79% vs.1.76%), P<0.05. They were equivalent at 10-12 months (1.3% vs.1.3%), P=1.00. Oppositely, more infants were identified as overweight by using WHO growth standard than using China growth standard in our study. The results were 2.9 times at 0-3 months (6.54% vs. 3.13%), 2.12 times at 4-6 months (9.02% vs.4.25%) and 1.62 times at 7-9 months (7.11% vs. 4.39%) , P<0.05. It was 1.37 times at 10-12 months（4.84% vs. 3.54%）without statistically significant difference (P>0.05). Conclusion Some differences were found in low weight and overweight rate by using two growth standards. Infant low weight rate was lower and overweight rate was higher by using WHO growth standard than that using China growth standard.

Application of next generation sequencing technology for genetic diagnosis of a neonate and the family with hereditary dystrophic epidermolysis bullosa　

WANG Yan,LIANG Jing,ZHAO Baoli,WU Honglin,LIU Xin,FENG Zhichun

. 2014, 32(5): 446-448.

Abstract ( 343 )

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　Objective　To detect genetic causes of dystrophic epidermolysis bullosa (DEB). Methods　Next-generation sequencing was used to detect a neonate with dystrophic epidermolysis bullosa. Sanger sequencing was used to confirm the results and detect his parents and grandmother from the family. Results　The neonate was found to have heterozygous mutation c.6781C>T of exon 86 in COL7A1 gene．This mutation results in R2261X nonsense mutation in type Ⅶ collagen. His mother and grandmother have the same mutation. Conclusion Next-generation sequencing technology is a useful tool for the detection of mutations of COL7A1 gene, which is valuable for clinical application.

Intravenous immunoglobulin in the treatment of severe adenovirus pneumonia in children：A clinical observation of 210 cases　

PU Kaibin,HUANG Ying,SHU Chang,YAN Li,HAN Huanli.

. 2014, 32(5): 449-452.

Abstract ( 598 )

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　Objective　To observe the clinical effect and complications of intravenous immunoglobulin（IVIG）in the treatment of severe adenovirus pneumonia（SAP） in children. Methods Clinical data of 210 hospitalized children with SAP from June 2009 to June 2011were retrospectively analyzed.Patientswere divided into IVIG group (109 cases) and control group (101 cases) tocompare the therapeutic effects, duration of fever,length of stay in hospital,duration of mechanical ventilation, and complications between the two groups. Results There was no difference in the severity of illness on admission and underlying diseases between the two groups. Both groups were givenantiviral,antibacterialandcomprehensivesupportingtherapy, andin theIVIG groupIVIG(250-400mg/(kg.d)were administeredfor 3-5d. The mean hospital stay and fever time of the IVIG group were significantly shortened comparing to that of the control group, and the time of mechanical ventilation on the IVIG groupis less than that of the Non-IVIG group.Incidence rate of pleural effusion ,atelectasis,myocarditis and toxic encephalopathy in the IVIG group is lower than the control group,and the cure rateand effective therapy of the IVIG groupis higher than control group,all of the difference was statistically significant(P<0.05). No adverse drug reaction was observed. Conclusions IVIG is safe and effective in the treatment of SAP in children.

A study on the efficacy of β-lactam antibiotics combined with macrolides in treatment of severe community-acquired pneumonia in children

LI Jiafeng,Wang Shibiao,Liu Guanghua,Ruan Guanyu,Zeng Fanxiang

. 2014, 32(5): 453-455.

Abstract ( 331 )

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　Objective To investigate the clinical efficacy of β-lactam combined with macrolides antibiotics in treatment of severe community-acquired pneumonia (CAP) in children. Methods Children with severe CAP on admission between 2012 February and 2012 April were divided into treatment group and control group. With the same symptom specific supportive treatment, the patients in the treatment group were treated with both cefmetazole and azithromycin, while the patients in the control group were treated with cefmetazole alone. The total effective rate, number of days of symptoms and signs disappeared and number of days of hospitalization were observed. Results The total effective rate was 87.8% in the trearment group and 61.3% in the control group with significant difference (P<0.05). Compared with control group, the recovery time of temperature, time of pulmonary rale disappearing and cough retraction were reduced (P<0.05). As well as the number of days of hospitalization was decreased (P<0.05). Conclusions The treatment of severe CAP in children with combination of azithromycin and cefmetazole results in better curative effect. A combined medication of β-lactam and macrolides antibiotics may be rational and effective.

Clinical significance of high sensitive C-reactive Protein and immune function in children with Mycoplasma Pneumoniae Pneumonia

Chu Wenying,Xu Hui,Gao Shuqing,Jiang Cairong

. 2014, 32(5): 456-458.

Abstract ( 394 )

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　Objective　To detect the clinical significance of high sensitive C-reactive Protein (Hs- CRP) and immune function in children with mycoplasma pneumoniae pneumonia (MPP). Methods 103 children with MPP, 47 cases of systemic inflammatory resPonse syndrome (SIRS group), 56 cases of non- systemic inflammatory resPonse syndrome (non-SIRS group) were recruited. 26 healthy children served as the control grouP. ELISA was used to detect the level of serum Hs- CRP, immune indexes, IgG, IgA, and IgM, Cellular immune CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺. Results The level of serum Hs- CRP、IgG、IgM and CD8⁺ in control grouP were significantly lower than those in non-SIRS group and SIRS group (P<0.05). The level of IgA、CD3⁺,CD4⁺, CD4⁺/CD8⁺in control grouP were significantly higher than those in non-SIRS grouP and SIRS group (P<0.05). The level of serum Hs- CRP、IgG in SIRS group were significantly higher than those in non-SIRS group (P<0.05). The level of IgA、CD3⁺、CD4⁺、CD4⁺/CD8⁺ in SIRS grouP were significantly lower than those in non-SIRS group. There was no significant difference in non-SIRS group and SIRS group of IgM and CD8+（P>0.05）. The level change of serum hs-CRP were positively related with IgG (r=0.66， P=0.001) and were negatively related with IgA、CD4⁺、CD4⁺/CD8⁺ (r= 0.79, 0.67, 0.82, P all were< 0.05) in children with MPP. Conclusion Children with MPP have Immunity function（ including humoral immunity and cellular immunity ）disorder which is related to the disease status. The level of Hs - CRP could be an anpation index for the severity and immune function of the children with MPP.

The clinical experience of childhood cardiomyopathy caused by inborn errors of metabolism in 11 cases　

RAO Jiao,LI Yufen,WANG Shushui,ZHANG Zhiwei,ZHANG Cheng ,ZENG Guohong,

. 2014, 32(5): 459-461.

Abstract ( 412 )

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　Objective　To summarize the diagnosis and treatment of cardiomyopathy caused by inborn errors of metabolism (IEM). Methods The retrospective study included 11 cases diagnosed as metabolic cardiomyopathy through tandem mass spectrometry, activity of serum enzyme, detection of urine mucopolysaccharide and gene analysis from 2012 to 2013. Six cases were diagnosed as primary carnitine deficiency (PCD). Four cases were diagnosed as glycogen storage disease (GSD) and only 1 case was diagnosed as mucopolysaccharidosis (MPS). 6 PCD cases received carnitine supplementation and anti-heart failure therapy and received follow-up for 2 -10 months .Other 5 cases received supportive treatment and follow-up. Results Patients with PCD recovered soon after treatment but other 5 cases have died within 5 months. Conclusion IEM is an important cause of children cardiomyopathy which varied in clinical manifestation, diagnosis, treatment and prognosis of different kinds of metabolic cardiomyopathy. Early diagnosis and treatment could be lifesaving for cardiomyopathy caused by IEM..

Preparation of HL-60 cell vaccine expressing BCG-HSP70 and its anti-leukemia effect

　LI Xiaoling,LIU Chunlei,SUN Lirong

. 2014, 32(5): 462-466.

Abstract ( 257 )

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　Objective　To prepare the HL-60 cell vaccine expressing heat shock protein 70 (Hsp70) of Bacille calmette-Guérin (BCG), so as to study its anti-tumor effect and mechanism. Methods The whole BCG HSP70 gene was amplified from BCG genome by polymerase chain reaction (PCR) and sub-cloned into the polyclone endonuclease sites in pDisplay. The recombinant vector of pDisplay-HSP70 was verified by sequencing .Then the HL-60 cell vaccine expressing the protein onto the cell surface was prepared by lipofectamine transfection. To detect the immunogenicity of HL-60 cells expressing HSP70 , the test groups were divided into three subgroups, HL60-wt, HL60-pDisplay, and HL60-HSP70 respectively. Each group was cultured with peripheral blood T cells for 72h, then the proliferation indices of T cells were assayed by CFSE-staining method, and IFN-γ were tested by enzyme-linked immunosorbent assay (ELISA). The HL-60 cells of different groups were cultured with peripheral blood T cells for 6d. The wild-type HL-60 cells were added and co-cultured for another 12h. Cytotoxicity assay was measured by LDH release. Results (1) The fragment of BCG HSP70 was consistent with the theoretical value. DNA sequencing showed that the recombinant vector of pDisplay-HSP70 was correctly constructed. (2) BCG HSP70 expressed onto the HL-60 cells surface. (3) Detection of the immunogenicity: ① The most significant T cell proliferation was observed in the group of HSP70-transfected HL-60 cells (P<0.05). There was no difference between the HL60-wt group and HL60-pDisplay group (P＞0.05). ② The contents of IFN-γ of the HSP70-HL60 group was the highest. ③ The inhibiting activity of CTLs on HL-60 cells in the group of HSP70-transfected HL-60 cells was more significant than that of wide-type and pDisplay--transfected HL-60 cells. And with the increase of the E:T ratio, the inhibiting activity of CTLs in the HSP70-HL60 group was rising. Conclusions The recombinant eukaryotic expression vector (pDisplay-HSP70) of BCG HSP70 was successfully constructed. And the HL-60 cell vaccine expressing BCG HSP70 onto its surface was successfully prepared. The results showed that gene transfection of BCG Hsp70 could significantly enhance the immunogenicity of HL-60 cells.

The effect of matrine on CXCR4 expression in SK-NEP-1 cells

MAO Ling,XUE TianYang,XU Wei

. 2014, 32(5): 467-470.

Abstract ( 353 )

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　Objective　To investigate the effects of matrine on the proliferation and apoptosis of SK-NEP-1 cells in vitro,and its possible mechanism. Methods Trials were divided into following groups: control group, 0.5, 1.0 and 1.5mg/ml of matrine intervention groups. The inhibition rate of SK-NEP-1 cells treated with different concentration of Matrine was detected by MTT colorimetric assay. Apoptosis rate was detected by flow cytometry (FCM). RT-PCR analysis was employed to measure the PDCD4 mRNA expression. Results Matrine (final concentrations=0.5, 1.0 and 1.5mg/ml) could induce apoptosis and inhibit the growth of SK-NEP-1 cells. Compared with the controls without matrine treatment (8.81±3.71) %, the inhibition rates of SK-NEP-1 cells were (20.79±6.20)%, (31.25±5.07)%, and (51.15±12.70)%, respectively; the apoptotic rates of SK-NEP-1 cells treated with different concentration of matrine were (13.67±0.78)%,(17.43±1.65)% and (20.80±1.54)%, respectively. Significant difference in the inhibition and apoptotic rates of SK-NEP-1 cells between each drug group and control group was observed(P<0.05), and the inhibition and apoptotic rates of SK-NEP-1 cells increased gradually with increased matrine concentration, thus exhibiting a dose-dependent effect （P<0.05）. To the expression of CXCR4 mRNA，the grey levels of SK-NEP-1 cells treated with matrine intervention group (final concentrations=0.5, 1.0 and 1.5 mg/ml) were (0.720±0.058), (0.540±0.095) and (0.307±0.050), respectively. The mRNA expression of CXCR4 was seen in SK-NEP-1 cells. Compared with control group, the expression of CXCR4 mRNA was decreased significantly in matrine intervention group (P<0.01).There were significant difference in CXCR4 mRNA level among the SK-NEP-1 cells treated with 0.5,1.0,1.5mg/mL of matrine (P<0.01). Conclusion Matrine could induce apoptosis and inhibit the growth of SK-NEP-1 cells in a dose-dependent way which may be associated with the down-regulated CXCR4 expression in SK-NEP-1 cells.

Protective effect of vitamin D on high glucose-induced podocyte insulin resistance

ZOU Minshu,YU Jian,NIE Guoming,LUO Liman,XU Hongtao,YIN Xiaoling,ZHOU Jianhua

. 2014, 32(5): 471-475.

Abstract ( 340 )

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　Objective　To study the protective effects of vitamin D (VitD) on podocyte insulin resistance and its mechanisms. Methods Immortalized mouse podocytes in vitro were randomly divided into 4 groups: podocytes+5mmol/L glucose group (group A); podocytes+5mmol/L glucose+1nmol/L propylene glycol group (group B); podocytes+30mmol/L glucose+1nmol/L propylene glycol group (group C); podocytes+30mmol/L glucose+1nmol/L propylene glycol+1nmol/L VitD group (group D). The percentage of podocyte apoptosis was determined after 48 h of incubation. Podocyte viability was assessed by MTT assay. The mRNA expressions of vitamin D receptor (VDR) and insulin receptor substrate protein 1 (IRS1) in podocyte were detected by RT-PCR. Western blot analysis was performed to measure the protein levels of p-IRS1/IRS, p-Akt/Akt and p-ERK1/2/ERK1/2. Results There were significant differences in apoptosis percentage, viability and the expression of VDR, IRS1, p-ERK1/2 of podoctyes（P<0.05）among 4 groups. There was no difference in p-Akt/Akt expression among 4 groups（P>0.05）. Compared with group A, B , and D, the percentage of podocyte apoptosis in group C was significantly increased, the cell viability was decreased, the expressions of VDR and IRS1 mRNA and p-IRS1 and p-Akt proteins were down-regulated, whereas p-ERK1/2 was up-regulated in group C. The levels of p-IRS1/IRS1, p-Akt/Akt, p-ERK1/2 / ERK1/2 had no statistical differences in group A, B, and D (P>0.05). Conclusions VitD-VDR system alleviates podocyte apoptosis induced by high glucose, and activates insulin signaling pathway and counteracts insulin resistance signal to improve podocyte insulin resistance.

Effects of erythromycin on glutathione hormone and γ- glutamyl cysteine synthetase in premature newborn rats’ hyperoxia-induced lung injury　

CAI Cheng,QIU Gang,GONG Xiaohui,WEI Dong,HU Yong,ZHAO Huanhu

. 2014, 32(5): 476-479.

Abstract ( 274 )

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　Objective　To explore the effect of erythromycin on glutathione hormone (GSH) and γ-glutamyl cysteine synthetase (γ-GCS) in premature newborn rats exposed to hyperoxia, to study the intervention effect of erythromycin on hyperoxia-induced lung injury. Methods One-day old preterm SD rats were randomly divided into four groups: control group, erythromycin group, hyperoxia group, erythromycin + hyperoxia group. Hyperoxia group and hyperoxia + erythromycin group were continuously exposed to oxygen (oxygen concentration > 0.85), control group and erythromycin group were in room air. Via caudal vein, the preterm rats was injected with erythromycin in erythromycin group and hyperoxia + erythromycin group, sodium chloride in control group and hyperoxia group daily. After 1,7,14 day(s) of hyperoxia (or air ) exposure, the preterm SD rats of four groups were killed, whole lung of these rats were isolated and histological changes were observed by hematoxylin -eosin (HE) staining, GSH and γ-GCS of pulmonary tissue homogenate were detected by Double antibody sandwich enzyme linked immunosorbent assay. Total lung RNA was extracted and γ-GCS mRNA was detected by reverse transcription polymerase chain reaction. Results The results showed that: After 1 and 7 day(s) of exposure, the expression of GSH、γ-GCS and γ-GCS mRNA in four groups showed significant differences（P<0.05）. Among them, GSH expression in erythromycin + hyperoxia group was higher than that in the other three groups in 1,7,14 day(s) of exposure with significant differences (P<0.05); GSH expression in erythromycin + hyperoxia group and hyperoxia group reached the peak after 7 days of exposure. The expression of γ-GCS and γ-GCS mRNA in erythromycin + hyperoxia group and hyperoxia group were higher than the other two groups after 1and 7 day(s) of exposure, the expression of γ-GCS mRNA in erythromycin + hyperoxia group were higher than that of hyperoxia group with significant differences (P<0.05). Conclusions The expressions of GSH and γ-GCS in the lung of premature SD rats were abnormal by oxidation outbreak. Erythromycin may increase the activity of γ- GCS, improve the anti-oxidation ability of GSH, and alleviate hyperoxia mediated lung injury in premature rats.

The effect of melatonin on galectin-3, TNF-α, and IL-1β in newborn rats brain damage after hypoxia-ischemia and its impact on long-term behavior　

QIAO Lili,SHEN Weiqin

. 2014, 32(5): 480-484.

Abstract ( 315 )

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　Objectives　To investigate neuroprotective effect of melatonin on preterm rats brain damage after hypoxia-ischemia (HI). Methods In this study, 5-day-old Wistar rats were divided into four groups: Normal saline ()group, melatonin group, HI+NS group and HI+melatonin group. HI was conducted by unilateral ligation of the left common carotid artery (ischemia) and 50 min of hypoxia. Melatonin was injected at a dose of 5mg/kg intraperitoneally three times: before ischemia, after hypoxia and 24 h after the second dose. The pups were sacrificed at 24 h, 72 h, and 7 w after HI; for galectin-3 cells count at 72 h and 7 w; TNF-α, IL-1β protein were measured in 24 h and 72 h after HI; and fear condition and elevated plus maze were tested in 7 w after HI. Results The number of galectin-3- positive cells was lower after melatonin treatment than vehicle treatment in 72 h and 7 w after HI (all P<0.05). TNF-α protein and IL-1β protein both increased at 24 h and 72 h after HI, and reduced after melatonin treatment (all P<0.05). Melatonin treatment improved memory ability and learning ability, reduced anxiety in 7 w after HI. Conclusion Melatonin has long-term and short-term protective effect on developing brain damage after HI.

Report of a case withsevere congenital neutropeniaand literature review

YANG Hu,GAO Zongyan,LI Lindi,LAN Dan

. 2014, 32(5): 485-488.

Abstract ( 462 )

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　Objective　To investigatethe clinical features and pathogenesis of severe congenital neutropenia (SCN) by detectingthe gene mutation of a SCN patientsuspected by clinical diagnosis. Methods　The intravenous anticoagulant and clinical data and laboratory results of this child were collected; the phagocyte and oxidation function of neutrophils were evaluated by flow cytometer; ELANE, HAX1, WAS, GFI1, CSF3R and CXCR4geneswere screened by PCR amplification and sequencing. Results　The neutrophil function of this patient was normal; sequencing results revealed no mutationoccurred in ELANE, HAX1, WAS, GFI1, CSF3R and CXCR4; and granulocyte colony-stimulating factor (G-CSF) can obviously enhance the level of neutrophils. Conclusion　SCN is a kind of genetic heterogeneity syndrome associated with multiple gene mutations, gene diagnosis will contribute tounderstand the pathogenesisof the disease and provide theoretical basis for treatment, although more and more pathogenic genes were　found to be connected with SCN, the cases of unknown mutationstill account for a large proportion.

The research progress of galactose-deficient IgA1 in the related kidney diseases

Reviewer: Zhang Yuheng,Reviser: Gao Jin

. 2014, 32(5): 489-493.

Abstract ( 507 )

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In recent years, IgA nephropathy and Henoch-Sch?nlein purpura nephritis attract more and more attention on their unclear pathogenesis, single diagnostic criteria, long duration and poor prognosis, etc.. Research suggests that IgA nephropathy and purpura nephritis are IgA immune complex diseases, and serum galactose-deficient is elevated in patients with these two diseases, which might become a noninvasive biomarker for the diagnosis, prognosis prediction and disease development monitoring for IgA nephropathy and purpura nephritis. Galactose-deficient IgA1 is reviewed for its discovery, structure, process, the possible pathogenic mechanism and its significance in details in this paper.

Relationship between IL-33 and children autoimmune disease

Reviewer: ZHANG Chunxia,CHEN Baiyu

. 2014, 32(5): 491-493.

Abstract ( 325 )

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Interleukin-33 is regarded as the orphan receptor ST2 that belongs to the cytokine family of Interleukin-1 in 2005. IL-33 is found to play a potentially pathogenic roles in the autoimmune disease, allergic disease, vascular disease, inflammatory disease and it might be a useful sera marker for the diagnosis and prognosis in related diseases. Here we make a review on the relationship between IL-33 and autoimmune disease in recent years

Prevention of ventilator-associated pneumonia in neonatal intensive care unit　

WANG Jin,JU Rong

. 2014, 32(5): 494-497.

Abstract ( 392 )

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Ventilator-associated pneumonia (VAP) is a common hospital acquired infection in neonatal intensive care unit with high incidence in China. There is no diagnostic gold standard of VAP. The risk factors include premature birth, low birth weight, duration of mechanical ventilation, episodes of intubation, blood stream infections. The recommended precautions include rising head of bed, closed tracheal suction, sucralfate, selective decontamination in digestive tract, improvement of mechanical ventilation, oral and skin care, hand hygiene. However, it is controversial that sucralfate, selective decontamination in digestive tract, passive humidifiers, oral and skin care can reduce the incidence of VAP.

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