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    OVERSEAS PEDIATRIC RESEARCH
  • ● OVERSEAS PEDIATRIC RESEARCH
    Fereshteh Baygi, Mostafa Qorbani, Ahmad Reza Dorosty, Roya Kelishadi, Hamid Asayesh, Aziz Rezapour, Younes Mohammadi, Fatemeh Mohammadi
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    OBJECTIVE: The prevalence of obesity is increasing in Iranian youngsters. This study aimed to assess some dietary determinants of obesity in a representative sample of children in Neishabour, a city in northeastern, Iran. METHODS: This case-control study was conducted among 114 school students, aged 6-12 years, with a body mass index (BMI) ≥95th (based on percentile of Iranian children) as the case group and 102 age- and gender-matched controls, who were selected from their non-obese classmates. Nutrient intake data were collected by trained nutritionists by using two 24-hour-dietary recalls through maternal interviews in the presence of their child. A food frequency questionnaire was used for detecting the snack consumption patterns. Statistical analysis was done using univariate and multivariate logistic regression (MLR) by SPSS version 16. RESULTS: In univariate logistic regression, total energy, protein, carbohydrate, fat (including saturated, mono- and poly-unsaturated fat), and dietary fiber were the positive predictors of obesity in studied children. The estimated crude ORs for frequency of corn-based extruded snacks, carbonated beverages, potato chips, fast foods, and chocolate consumption were statistically significant. After MLR analysis, the association of obesity remained significant with energy intake (OR=2.489, 95%CI: 1.667-3.716), frequency of corn-based extruded snacks (OR=1.122, 95%CI: 1.007-1.250), and potato chips (OR=1.143, 95%CI:1.024-1.276). The MLR analysis showed that dietary fiber (OR=0.601, 95%CI: 0.368-0.983) and natural fruit juice intake (OR=0.909, 95%CI: 0.835-0.988) were protective factors against obesity. CONCLUSIONS: The findings serve to confirm the role of an unhealthy diet, notably calorie-dense snacks, in childhood obesity. Healthy dietary habits, such as the consumption of high-fiber foods, should be encouraged among children.

  • CLINICAL RESEARCH
  • ● CLINICAL RESEARCH
    WANG Zhuo, LIANG Huan-Huan, LI Ben-Shang, HUANG Xiao-Hang, ZHANG Jing, WANG Xiang, DING Li-Xia, JIANG Hua
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    OBJECTIVE: To study the expression of zinc finger protein X-linked (ZFX) in bone marrow mononuclear cells (BMMCs) of children with B lineage acute lymphoblastic leukemia (B-ALL) and its relationship with prognosis. METHODS: The expression of ZFX in human leukemia cell lines (REH, HL-60, NB4 and K562) was measured by Western blot. ZFX gene was cloned by PCR from one patient and DNA sequencing technology was used to confirm it. Real-time PCR was used for detecting ZFX mRNA expression in the BMMCs of 82 children with newly-diagnosed B-ALL, 24 children with complete remission (CR) after induction therapy and 64 control children (fracture or congenital heart disease patients). According to the presence of bone marrow or central nervous system relapse during a follow-up of 3 years, the patients were identified as having a good or poor prognosis. Their ZFX mRNA levels in BMMCs at diagnosis were compared. RESULTS: ZFX protein was expressed in human leukemia cell lines REH, HL-60, NB4 and K562. ZFX mRNA expression was significantly higher in the newly-diagnosed ALL group than in the control group (P<0.01). ZFX mRNA expression in the ALL CR group was significantly reduced compared with the newly-diagnosed ALL group (P<0.01). Children with a poor prognosis had significantly higher ZFX mRNA levels at diagnosis than those with a good prognosis (P<0.05). CONCLUSIONS: ZFX is over-expressed in children with B-ALL and its levels are higher in those with a poor prognosis than those with a good prognosis, which suggests that ZFX is important in the prognosis evaluation of B-ALL.

  • ● CLINICAL RESEARCH
    XI Wei-Bo, WANG Dao, LIU Yu-Feng
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    OBJECTIVE: To explore the clinical features, diagnosis and treatment of pediatric myelodysplastic syndrome (MDS). METHODS: Twenty-eight children with MDS between January 2006 and March 2012 were enrolled in the study. Clinical symptoms, signs, laboratory examinations, treatment and outcomes were retrospectively studied. RESULTS: Anemia (96%), bleeding (68%), fever (68%) and hepatosplenomegaly (61%) were main clinical manifestaions in the 28 patients. Three cases (11%) converted into acute monocytic leukemia (M5), erythroleukemia (M6) or acute megakaryocytic leukemia (M7) one to two months later. Bone marrow proliferation mainly demonstrated as active or obviously active. One or two lineages of hematopoietic dysplasia were mostly observed in all 28 cases and obvious iron metabolism disorders were found in these patients. Cytogenetic abnormalities were detected in 45% of the 28 cases, most of which were numeral chromosome abnormalities. T cell, B cell and NK cell numbers decreased, Th cell numbers decreased, Ts cell numbers increased and Th /Ts inversed. Eight cases gave up treatment when confirmed. Of the 8 cases receiving symptomatic and supportive treatment alone, one was lost, one showed disease stability, and the remaining 6 cases showed disease progression. One patient who underwent induced differentiation and one who received hematopoietic therapy showed disease progression. Ten patients underwent chemotherapy. Two cases had no bone marrow remission after single agent chemotherapy. Of the 8 cases who underwent multi-drug combination chemotherapy, 4 cases achieved partial or complete remission of bone marrow. CONCLUSIONS: Pediatric MDS is characterized by a lack of typical clinical manifestations, and a high rate of conversion to leukemia. Bone marrow proliferation is mainly active in children with MDS. One or two lineages of hematopoietic dysplasia is common. Among the cytogenetic abnormalities, numeral chromosome abnormalities are common. Obvious iron metabolism disorders and abnormal cellular immunity are found in children with MDS. Multi-drug combination chemotherapy appears to slow the course of the disease.
  • ● CLINICAL RESEARCH
    REN Jing, SUN Bin, MIAO Po, FENG Xing
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    OBJECTIVE: To study the correlation between serum vitamin D level and severity of community acquired pneumonia (CAP) in young children, and explore related risk factors for CAP. METHODS: One hundred and three children with CAP between October 2011 and April 2012 were enrolled in the study, including 15 cases of severe CAP and 88 cases of mild CAP. Ninety healthy children were used as the control group. 25-(OH)D3 concentrations were measured by enzyme linked immunoassay. RESULTS: The mean vitamin D concentration in the severe CAP group was significantly lower than in the mild CAP and control groups (P<0.01), and there was no significant difference between the mild CAP and control groups (P=0.674). Premature birth and vitamin D<50 nmol/L were risk factors for severe CAP in the multivariate analysis. CONCLUSIONS: Vitamin D deficiency might be associated with the severity of CAP in young children.
  • ● CLINICAL RESEARCH
    YANG Ai-Mei, SONG Jian-Hui, HUANG Rong, JIN Shi-Jie, YANG Ping
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    OBJECTIVE: To investigate the Mycoplasma pneumoniae (MP) infection and drug resistance in children with respiratory tract infection and to provide a rational basis for the clinical diagnosis and treatment of MP infection. METHODS: Throat swabs were collected from 3529 children with respiratory tract infection, who visited the pediatric outpatient department or received treatment in the pediatric ward of our hospital from September 2010 to September 2011. The swabs were cultured to detect MP. The drug sensitivity of MP to azithromycin, roxithromycin, erythromycin, acetylspiramycin and clarithromycin was evaluated. RESULTS: Of the 3529 children with respiratory tract infection, 1026 (29.07%) were MP-positive. There were cases of MP infection in all four seasons of the year but infection rates in summer and autumn were significantly higher than in spring and winter (P<0.05). The infection rate in females was higher than in males (30.43% vs 28.32%; P>0.05). The infection rate was negatively correlated with age in these children, and there were significant differences in the infection rate among all age groups (P<0.05). For macrolide antibiotics suitable for children, the cultured MP developed the highest resistance to roxithromycin, followed by erythromycin, acetylspiramycin, clarithromycin, and azithromycin, with significant differences among them (P<0.01). CONCLUSIONS: MP infection rate is very high among children with respiratory tract infection. The incidence of MP infection is relatively low among school-age children and children are more susceptible to MP infection in summer and autumn than in spring and winter. Throat swabs should be cultured and drug sensitivity tests should be performed as early as possible in children with respiratory tract infection, so that proper intervention can be undertaken in time to reduce drug-resistant strains of MP.
  • ● CLINICAL RESEARCH
    JIN Jiang-Bing, SONG Xian-Xiang, ZHOU Yong-Hai, LI Chang-Chong
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    OBJECTIVE: To study the clinical effect of continuous thoracic close drainage using central venous catheter instead of repeated thoracocentesis in the treatment of tuberculous pleurisy in children. METHODS: Thirty-nine children with tuberculous pleurisy, who received continuous thoracic close drainage using central venous catheter in addition to conventional antituberculous chemotherapy, were used as the observation group and 42 children with tuberculous pleurisy who underwent repeated thoracocentesis in addition to conventional antituberculous chemotherapy served as the control group. The two groups were compared in terms of time to pleural effusion absorption, improvement in pleural thickening, length of hospital stay, and puncture-related expenses. RESULTS: Compared with the control group, the observation group had significantly faster pleural effusion absorption (8±4 d vs 12±6 d; P<0.01), significantly more improvement in pleural thickening (1.50±0.25 mm vs 3.10±0.30 mm; P<0.05), a significantly shorter length of hospital stay (11±3 d vs 18±6 d; P<0.01), and significantly lower puncture-related expenses (269±24 yuan vs 475±50 yuan; P<0.05), as well as alleviated pain. CONCLUSIONS: Continuous thoracic close drainage using central venous catheter is superior to repeated thoracocentesis in the treatment of tuberculous pleurisy in children, and it holds promise for clinical application in pediatric patients.
  • ● CLINICAL RESEARCH
    ZHANG Du-Fei, FENG Xiao-Wei, LIN Tao, Wu Kai-Fang
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    OBJECTIVE: To study risk factors for the occurrence of intra-abdominal hypertension (IAH) in children with sepsis. METHODS: A nest case-control study was employed. According to intra-abdominal pressures (IAP) measured by cystometry, 119 children with sepsis were classified into normal IAP (control, n=80) and IAH groups (n=39). Risk factors for the occurrence of IAH were investigated by monovariable and multivariable logistic regression analysis. RESULTS: Monovariable analysis showed that there were significant differences in pediatric critical illness score (PCIS), procalcitonin (PCT) level, PaCO2, blood lactate level, rates of intestinal or intra-abdominal infection, ascites, gastrointestinal dysfunction, mechanical ventilation, shock and multiple organ dysfunction syndrome (MODS) between the IAH and control groups (P<0.05). Multivariable logistic regression analysis demonstrated that decreased PCIS, MODS, shock, gastrointestinal dysfunction and ascites were major risk factors for the occurrence of IAH. CONCLUSIONS: Children with sepsis who have decreased PCIS, MODS, shock, gastrointestinal dysfunction and ascites are at risk for the occurrence of IAH.
  • ● CLINICAL RESEARCH
    XUE Jing, CHEN Li-Zhang, XUE Lei, ZHOU Quan
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    OBJECTIVE: To investigate major risk factors for childhood cerebral palsy (CP) during pregnancy and to provide evidence for the prevention of CP. METHODS: Using the search terms of “cerebral palsy”, “pregnancy”, “risk factor”, and “case-control”, a search was performed to collect case-control studies on the risk factors for childhood CP from 1998 to 2011. The obtained data were subjected to metaanalysis using fixed effects model and DersimonionLaird random effects model to quantitatively evaluate risk factors for childhood CP during pregnancy. RESULTS: Eighteen studies involving 11050 cases and 15941 controls were collected. The results of the multivariate analysis for risk factors of childhood CP during pregnancy were as follows: maternal age (≥35 years) (OR=4.172, 95%CI=1.670-10.426, P<0.05), multiple pregnancy (OR=8.402, 95% CI=2.386-29.584, P<0.05), medicine use in early pregnancy (OR=3.974, 95% CI=2.217-7.123, P<0.05), harmful environment (OR=3.299, 95% CI=1.058-10.289, P<0.05), recurrent vaginal bleeding during pregnancy (OR=4.736, 95% CI=1.792-12.517, P<0.05), pregnancy infectious diseases (OR=1.238, 95%CI: 0.284-5.395, P>0.05), pregnancy induced hypertension (OR=4.096, 95%CI: 2.246-7.469, P<0.05), meat intake (OR=1.436, 95%CI:0.382-5.393, P>0.05), father smoking (OR=2.376, 95%CI: 0.801-7.049, P>0.05). CONCLUSIONS: The major risk factors for childhood CP during pregnancy include advanced maternal age (≥35 years), multiple pregnancy, medicine use in early pregnancy, harmful environment, recurrent vaginal bleeding during pregnancy and pregnancy-induced hypertension.
  • ● CLINICAL RESEARCH
    XIA Hua, HE Qing-Nan, LI Xiao-Yan, SHUAI Lan-Jun, CHEN Hai-Xia, YI Zhu-Wen
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    OBJECTIVE: To investigate the urinary neutrophil gelatinase-associated lipocalin (NGAL) concentration in children with idiopathic nephrotic syndrome (INS) and its clinical significance. METHODS: Thirty-four children newly diagnosed with INS received oral prednisone for 4 weeks. Patients whose urinary protein did not become negative were classified as steroid-resistant nephrotic syndrome (SRNS) group, while those whose urinary protein did become negative were classified as steroid-sensitive nephrotic syndrome (SSNS) group. Morning midstream urine specimens were collected from all patients before use of prednisone and after 1, 2, 3, and 4 weeks of treatment with prednisone. Enzyme-linked immunosorbent assay was used to measure the urinary NGAL concentration. Meanwhile, urinary creatinine (Cr) concentration was measured, and urinary NGAL concentration in a single urine collection was adjusted according to the urinary Cr excretion. The two groups were compared in terms of urinary NGAL/Cr ratio. RESULTS: Compared with the SRNS group, the SSNS group had significantly decreased urinary NGAL/Cr ratios after 3 and 4 weeks of prednisone treatment (P<0.05). Compared with the SRNS group, the SSNS group had a significantly decreased urinary β2-MG/Cr ratio after 4 weeks of prednisone treatment (P<0.05). In both groups, urinary NGAL/Cr ratio was positively correlated with urinary protein/Cr ratio (r=0.510, P<0.01). The results of ROC curve analysis showed when diagnostic cut-off point of urinary NGAL/Cr was 0.043 by 3 weeks after treatment, sensitivity and specificity achieved 100% and 79.2% respectively. CONCLUSIONS: Urinary NGAL/Cr ratio remains high in children with SRNS, while this ratio decreases gradually during prednisone treatment in children with SSNS, and it falls ahead of urinary β2-MG/Cr ratio. These results suggest that dynamic monitoring of urinary NGAL/Cr ratio is useful for early judgment of response to prednisone in patients with INS.
  • ● CLINICAL RESEARCH
    LUO Yan-Hong, YOU Jie-Yu, LIU Li, ZHAO Hong-Mei, OU-YANG Hong-Juan, CHEN Wei-Jian
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    OBJECTIVE: To investigate the diagnostic value and safety of single-balloon electronic enteroscopy in children with small intestinal bleeding. METHODS: Seventy children with clinically suspected small intestinal bleeding, including 38 males and 32 females aged 4-13 years, underwent single-balloon enteroscopy under general anesthesia. Twenty-six cases underwent the procedure through the mouth, 32 cases through the anus, and 12 cases through both. RESULTS: Of the 70 children, 58 (83%) had small bowel disease according to the single-balloon enteroscopy results, including 24 cases of non-specific inflammation, 12 cases of allergic purpura, 8 cases of Crohn′s disease, 8 cases of Meckel′s diverticulum, and 6 cases of Peutz-Jeghers syndrome. CONCLUSIONS: Single-balloon enteroscopy is a safe, effective means for the diagnosis of small intestinal bleeding among children.
  • ● CLINICAL RESEARCH
    LIU Xiao-Juan, ZHU Ting-Ting, ZENG Rong, CHANG Li, LI Feng-Yi, LI Wen-Sheng, JIANG Yong-Mei
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    OBJECTIVE: To investigate the epidemiological characteristics of intolerance to 14 foods in children and the relationship between food intolerance and disease of various systems. METHODS: Serum samples of 2434 children with diseases were collected for food intolerance testing between January 2009 and October 2012. Allergen-specific IgG antibodies to 14 foods were detected using enzyme-linked immunosorbent assay. The children’s intolerance to different foods and its relationship with age, sex and disease of various systems were analyzed. RESULTS: Among these children, positive rates of intolerance to milk and eggs were as high as 74.16% and 66.47% respectively, while positive rates of intolerance to chicken and pork were relatively low (0.29% and 0.21% respectively). The overall positive rates of food intolerance were 12.579% and 12.470% in males and females respectively. For infants, the highest intolerance rate was to milk; for preschool and school-age children, the highest intolerance rates were to milk and eggs respectively; for children in adolescence, the highest intolerance rate was to eggs. Among children with food intolerance involving single system, those with developmental abnormality or immune system disease had the highest overall positive rate of food intolerance. Children with double-system diseases had an overall positive rate of food intolerance as high as 13.393%. Among the children involving various systems, the positive rate of intolerance to milk and eggs were higher than other food. CONCLUSIONS: Factors influencing food intolerance in children include food categories and age. There may be a relationship between food intolerance and disease of various systems, and this is significant to the growth and development of children.
  • ● CLINICAL RESEARCH
    XIANG Ping-Xia, DAI Xiang, LENG Pei, LIU Ling, HU Xi-Jiang
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    OBJECTIVE: To investigate the value of direct sequencing of sex-determining region Y (SRY) gene, as well as peripheral blood karyotype analysis, in the diagnosis of disorders of sex development (DSD) among children and adolescents with ambiguous genitalia. METHODS: The karyotypes of 20 children and adolescents with ambiguous genitalia were determined by conventional G-banding analysis. PCR amplification was used to detect SRY gene in these patients, and direct sequencing was used to judge whether there was SRY gene mutation. RESULTS: Of the 20 cases, 17 were positive for SRY gene, and 3 were negative for SRY gene. Direct sequencing revealed no SRY gene mutation in the positive cases, however karyotype analysis found 4 special karyotypes in these patients: 46, XY, del(Y) (q12)/45, X; 46, XY, add(Y) (p11); 46, XY, r(9); 46, XY, 9qh+. CONCLUSIONS: SRY gene detection can help determine the type of DSD among children and has the advantage of quick detection. Used together with G-banding analysis, it is helpful for primary diagnosis of DSD among children.
  • ● CLINICAL RESEARCH
    MO Qing-Yi, HUANG Dong-Ming, XIE Guang-Qing, LIANG Gui-Ming, MA Li-Zhong, FU Si-Mao
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    OBJECTIVE: To investigate the causes of unintentional injuries in children and to provide reference for reducing the incidence of unintentional injuries in children. METHODS: A retrospective analysis was performed on the clinical data of 924 children with unintentional injuries who were hospitalized in Zhongshan Boai Hospital from January 2008 to December 2010. RESULTS: Of the 924 cases, 26.4% suffered falls, which was the most common cause of injuries, 15.7% suffered burns and scalds, 14.0% were injured by foreign bodies, and 13.1% were injured in traffic accidents. Unintentional injuries occurred mainly among children aged 0-3 years (67%). The proportion of cases in summer (July to September) was significantly higher than in any other season (P<0.05), and burns were the common causes of injuries in summer. Home was the most common place where unintentional injuries occurred (36.9%). The incidence of traffic accidents was significantly higher in non-local children than in local children (P<0.001). As for the parents′ educational levels, the children whose parents had an education level below junior middle school accounted for the highest proportion of all cases of unintentional injury (45.5%). Injuried cases in rural areas accounted for a significantly higher percentage than in urban areas (P<0.05). CONCLUSIONS: Falls are the principal cause of unintentional injuries in children. Young children (0-3 years) are most vulnerable to unintentional injuries. Unintentional injuries mostly occur at home. The incidence of traffic accidents is higher in non-local children than in local children. Parents′ education levels are associated with the incidence of unintentional injuries. In order to reduce the incidence of unintentional injuries in children, preventive measures must be carried out, and safety education should be enhanced in consideration of children′s age, sex and family background.
  • ● CLINICAL RESEARCH
    MA Jing, YU Shun-Ying, LIANG Shan, DING Jun, FENG Zhe, YANG Fan, GAO Wei-Jia, LIN Jia-Ni, HUANG Chun-Xiang, LIU Xue-Jun, SU Lin-Yan
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    OBJECTIVE: To investigate whether the genetic polymorphism, upstream variable number of tandem repeats (uVNTR), in the monoamine oxidase A (MAOA) gene, is associated with major depressive disorder (MDD) in adolescents and to test whether there is gene-environment interaction between MAOA-uVNTR polymorphism and stressful life events (SLEs). METHODS: A total of 394 Chinese Han subjects, including 187 adolescent patients with MDD and 207 normal students as a control group, were included in the study. Genotyping was performed by SNaP-shot assay. SLEs in the previous 12 months were evaluated. The groups were compared in terms of the frequency distributions of MAOA-uVNTR genotypes and alleles using statistical software. The binary logistic regression model of gene-environment interaction was established to analyze the association of the gene-environment interaction between MAOA-u VNTR genotypes and SLEs with adolescent MDD. RESULTS: The distribution profiles of MAOA-u VNTR genotypes and alleles were not related to the onset of MDD, severity of depression, comorbid anxiety and suicidal ideation/behavior/attempt in adolescents. The gene-environment interaction between MAOA-u VNTR genotypes and SLEs was not associated with MDD in male or female adolescents. CONCLUSIONS: It is not proven that MAOA-u VNTR polymorphism is associated with adolescent MDD. There is also no gene-environment interaction between MAOA-u VNTR polymorphism and SLEs that is associated with adolescent MDD.
  • ● CLINICAL RESEARCH
    ZHANG Jing, XU Wei, YAN Chao-Ying
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    OBJECTIVE: To study the incidence of early complications and treatment outcomes in premature infants conceived via test tube. METHODS: A retrospective analysis and comparison was conducted on the clinical data of 122 test-tube premature infants and 183 naturally conceived premature infants (control group), including maternal complications, birth conditions and early complications. RESULTS: There was no statistically significant difference in maternal complications between the two groups (P>0.05). The incidence of respiratory distress syndrome (25.4% vs 12.0%; P<0.05) and malformations (3.3% vs 0%; P<0.05) in the test-tube group was statistically higher than in the control group. The mortality rate in the test-tube group was statistically higher than in the control group (9.0% vs 2.2%; P<0.05). CONCLUSIONS: Test-tube premature infants are more likely to suffer from respiratory distress syndrome and have higher incidences of congenital malformations and mortality. Asisted reproductive technique should therefore be chosen cautiously, and enhanced assessment and monitoring is needed during pregnancy.
  • EXPERIMENTAL RESEARCH
  • ● EXPERIMENTAL RESEARCH
    LU Zhong, SHEN Shui-Xian, ZHI Di-Jing, LUO Fei-Hong
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    OBJECTIVE: To develop a simple, rapid and reliable method of purifying SpragueDawley (SD) rat islets by sequential filtration through two cell strainers of different sizes and to evaluate the efficacy of the method. METHODS: Islets were isolated from 8 to 12-week-old clean grade Sprague-Dawley rat pancreases using the standard collagenase digestion procedure and purified with either the generally used Ficoll density gradient method or the innovative two-step sequential filtration method. The purity and vitality of the isolated islets were visualized and assessed with DTZ and AO/PI staining. Glucose stimulating tests were performed to assay cell activity, and immunohistochemical staining was used to evaluate the synthesis function of islet cells. RESULTS: The yield of islets in the two-step filtration method group was 782±115 IEQ per rat, which was significantly higher than in the conventional Ficoll density gradient method group (598±135 IEQ per rat, P<0.01). Purity of the isolated islets in the two-step filtration method group was 90%-100% and vitality was over 95%. In the conventional Ficoll density gradient method group, islet purity was 65%-85% and vitality was 85%-95%. With regard to the high-sugar stimulation test in the two-step filtration method group, insulin concentrations in islets cultured for 24 hours were significantly higher than in those that were freshly purified (76.9 ± 6.1 μg/L vs 49.4 ± 3.9 μg/L; P<0.01). CONCLUSIONS: A two-step sequential filtration method for rat islet purification was developed and the method was simple and reliable, with high islet vitality, purity and yield.

  • ● EXPERIMENTAL RESEARCH
    WANG Ying-Chao, FENG Lei, YIN Chu-Yun, MA Li-Na, WEI Yong-Wei, WANG Chun-Mei, SHENG Guang-Yao
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    OBJECTIVE: To study the prognostic significance of CD47 in a NOD/SCID mouse model of acute myeloid leukemia (AML) and the best strategy for targeted therapy for this disease. METHODS: CD34+CD38- leukemia stem cells (LSCs) were separated and transplanted into NOD/SCID mice to establish a mouse model of acute monocytic leukemia (AMoL). Anti-human CD47 antibody, alone or combined with cytosine arabinoside (Ara-C), was used to treat the mice with AMoL for 7-14 days, and therapeutic efficacy was assessed. LSCs were cultured together with mouse macrophages in culture medium containing anti-CD47 or anti-CD45 monoclonal antibody for 2 hours, to observe the phagocytic ability of macrophages to LSCs. RESULTS: CD34+CD38- LSCs existed among THP-1 cells, with a content of about (0.12±0.06)%, and a mouse model of AML was successfully established after the purified CD34+CD38- LSCs (97.0%±1.7%) were transplanted into NOD/SCID mice. The in vivo experiment showed that mice with AMoL had the most significant decrease in CD33+CD45+ leukemia cells in peripheral blood and bone marrow and survived the longest after being treated with Ara-C (7 days) plus anti-CD47 monoclonal antibody (14 days) (P<0.01). After 2 hours of in vitro culture, the phagocytic index in the culture medium containing anti-CD47 monoclonal antibody was significantly higher than in the culture medium containing anti-CD45 monoclonal antibody (76.9%±12.2% vs 7.60%±2.4%; P<0.05). CONCLUSIONS: High expression of CD47 is an adverse prognostic factor in AML. Combination therapy with anti-CD47 monoclonal antibody and Ara-C can effectively eliminate leukemia cells and LSCs, demonstrating great clinical significance in curing AML.
  • ● EXPERIMENTAL RESEARCH
    GU Ming-Xiao, LIU Xuan-Cheng, JIANG Lu
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    OBJECTIVE: To investigate the effects of peroxisome proliferator-activated receptor-gamma (PPARγ) agonist rosiglitazone on the expression of cyclin D1 in lung tissue, and the proliferation of airway smooth muscle cells (ASMCs) in mice with bronchial asthma. METHODS: Thirty clean BALB/c mice were randomly divided into control group (n=10), asthma group (n=10), and rosiglitazone treatment group (n=10). A mouse model of asthma was established by ovalbumin (OVA) sensitization and challenge. The treatment group received rosiglitazone (5 mg/kg) by gavage 1 hour before each challenge and the control group received saline instead of OVA sensitization and challenge. Leukocytes and eosinophils in bronchoalveolar lavage fluid (BALF) were counted under a microscope. Airway structural changes were observed by hematoxylin-eosin staining. Protein and mRNA expression levels of cyclin D1 were measured by immunohistochemical staining and RT-PCR. Perimeter of the basement membrane (Pbm), total bronchial wall area (WAt), airway smooth muscle area (WAm), and number of nuclei in ASMCs (N) were determined using image analysis software, and WAt/Pbm, WAm/Pbm, and N/Pbm were calculated. RESULTS: Compared with the control group, the asthma group showed significant increases in the total number of leukocytes and percentage of eosinophils in BALF, as well as in the mRNA and protein expression of cyclin D1, but changes in these indices were significantly reduced in the rosiglitazone treatment group (P<0.05). In addition, compared with the control group, the asthma group had significantly increased WAt/Pbm, WAm/Pbm, and N/Pbm, but rosiglitazone significantly decreased these ratios (P<0.05). CONCLISONS: Rosiglitazone may delay the process of airway remodeling by inhibiting the proliferation of ASMCs, so it can be used for preventing and treating chronic asthma.
  • CLINICAL EXPERIENCE
  • ● CLINICAL EXPERIENCE
    CHANG Jian, ZHANG Yu-Tong, ZHONG Xiao-Dan, WANG Li-Zhe
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    No abstract available
  • CASE REPORT
  • ● CASE REPORT
    MAO Jun-Qing, SONG Hua, YANG Shi-Long, ZHAO Fen-Ying, SHEN Di-Ying, TANG Yong-Min
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    No abstract available
  • ● CASE REPORT
    CHEN Shao-Quan, LIN Mao-Zeng
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    No abstract availabole
  • REVIEW
  • ● REVIEW
    LI Xi-Yuan, YANG Yan-Ling
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    The mammalian mitochondrial ATP synthase, also as known as mitochondrial respiratory chain complex V, is a large protein complex located in the mitochondrial inner membrane, where it catalyzes ATP synthesis from ADP, Pi, and Mg2+ at the expense of an electrochemical gradient of protons generated by the electron transport chain. Complex V is composed of 2 functional domains F0 and F1. The clinical features of patients are significantly heterogeneous depending on the involved organs. Most patients with complex V deficiency had clinical onset in the neonatal period with severe brain damage or multi-organ failure resulting in a high mortality. Neuromuscular disorders, cardiomyopathy, lactic acidosis and 3-methylglutaconic aciduria are common findings. Complex V consists of 16 subunits encoded by both mitochondrial DNA and nuclear DNA. On MT-ATP6, MT-ATP8, ATPAF2, TMEM70 and ATP5E gene of mitochondrial DNA, many mutations associated with Complex V deficiency have been identified. Here, the pathology, clinical features, diagnosis, treatment and molecular genetics of Complex V deficiency were summarized.