The clinical significance of pathological studies of congenital intestinal atresia

Objective

The purpose of this study was to explore the mechanisms of postoperative intestinal motility disorders in intestinal atresia patients by investigating the expression profiles of proteins, including calretinin (CR), glial-derived neurotrophic factor (GDNF), bone morphogenetic protein 2 (BMP-2), c-kit, α-smooth muscle actin (α-SMA), and S-100 protein; to decipher the correlation between the area of the pathological segment and the alteration of the above 6 proteins; and thereby to provide a clinical specific reference values to determine the removal length for intestinal tract resection.

Methods

Immunohistochemistry technique was applied to detect the CR, c-kit, GDNF, BMP-2, α-SMA, and S-100 protein in specimens of atretic, proximal, and distal intestine from 25 cases of intestinal atresia and samples of intestinal walls from 10 non-atresia control specimens. The alteration of the enteric nervous system, nerve growth and its regulatory factors, the interstitial cells of Cajal (ICCs), and the enteric muscle system were examined, with particular attention being paid to pathological changes and the lesion area.

Results

The expression of all of the abovementioned 6 proteins in the proximal side of the atresia was significantly lower than in control group. The expression of the abovementioned proteins tended to be higher farther away from the atresia site. The expressions of both GDNF and BMP-2 had returned to normal level at 10 cm proximal to the atresia site, whereas the expressions of CR, c-kit, α-SMA, and S-100 protein only returned to normal at 15 cm proximal to the atresia site. On the distal side, the expression of all 6 markers at 3 cm distal to the atresia site was normal.

Conclusion

Pathological deterioration of the myenteric ganglia, nerve growth factor, and ICCs are the causes of intestinal motility disorders after the surgical repair of intestinal atresia. Our data support resecting an intestinal segment extending from 15 cm proximal to 3 cm distal to the atretic segment. In proximal jejunal atresia, when it is not possible to resect 15 cm, we suggest resecting as much of the hypertrophic proximal intestine as possible. Based on our data, we believe this surgical practice could improve postoperative dysmotility in these patients.     

A allele of SNP12 in <Emphasis Type="Italic">estrogen receptor 1</Emphasis> was a risk factor for cryptorchidism in Asians: a systematic review with meta-analysis and trial sequential analysis

Objective

Some studies have been carried out to evaluate the association between SNP12 in estrogen receptor 1 and cryptorchidism, but the results remain inconsistent. We carried out a meta-analysis to explore the association between this polymorphism and cryptorchidism risk.

Methods

All eligible studies were searched in PubMed, Web of Science, Embase and Cochrane Library. Pooled odds ratios, with 95 % confidence intervals, were assessed for the association using fixed- and random-effects models.

Results

Overall, four case–control studies (363 cases, 415 controls) were included in the meta-analysis. No significant publication bias (P _Begg = 0.308, P _Egger = 0.288) was found. A allele of SNP12 in estrogen receptor 1 was protective factor to cryptorchidism in allele model, dominant genetic model and heterozygote comparison in Caucasians, but the result was turned out to be false positive by trial sequential analysis. However, A in allele model was risk factor to cryptorchidism in Asians (odds ratio 2.02, 95 % confidence interval 1.03–3.01, p = 0.946 for heterogeneity) and the result was turned out to be true positive by trial sequential analysis, even though there were merely two original studies.

Conclusions

The results of this meta-analysis suggest that A allele of SNP12 in estrogen receptor 1 may increase the risk of cryptorchidism in Asians. Meanwhile, further well-designed studies with large sample sizes are required to confirm the present findings, especially in Caucasians.

     

Protective effects of Radix Codonopsis on ischemia�Creperfusion injury in rats after kidney transplantation

Purpose  

Kidney ischemia–reperfusion injury (IRI) after kidney transplant remains a major problem, separate from immune rejection that can lead to kidney transplant failure and graft function loss. Free radicals, disturbance of microcirculation and the inflammatory cascade appear to be the main contributors. Radix Codonopsis, a traditional Chinese drug used in vascular diseases, is an antioxidant and free radical scavenger. This study investigates the protective effect and underlying mechanisms of Radix Codonopsis extract saponins on kidney transplantation.     

An Interaction of LPS and RSV Infection in Augmenting the AHR and Airway Inflammation in Mice

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection (LRTI) in children under 5 years of age, especially infants with severe bronchiolitis. Our preliminary clinical experiments showed that bacterial colonization was commonly observed in children with virus-induced wheezing, particularly in those with recurrent wheezing, suggesting that bacterial colonization with an accompanying viral infection may contribute to disease severity. In most cases, RSV-infected infants were colonized with pathogenic bacteria (mainly Gram-negative bacteria). LPS is the main component of Gram-negative bacteria and acts as a ligand for Toll-like receptor 4 (TLR4). Relevant studies have reported that the TLR family is crucial in mediating the link between viral components and immunologic responses to infection. Of note, TLR4 activation has been associated with disease severity during RSV infection. In the present study, we identified that LPS aggravated RSV-induced AHR and airway inflammation in BALB/c mice using an RSV coinfection model. We found that the airway inflammatory cells and cytokines present in BALF and TRIF in lung tissue play a role in inducing AHR and airway inflammation upon RSV and bacteria coinfection, which might occur through the TRIF-MMP-9-neutrophil-MMP-9 signalling pathway. These results may aid in the development of novel treatments and improve vaccine design.     

The impact of viral dynamics on the clinical severity of infants with respiratory syncytial virus bronchiolitis

The impact of dynamic respiratory syncytial virus (RSV) load on the clinical severity of hospitalized infants with bronchiolitis has not been clarified. Nasopharyngeal aspirates were obtained from 60 infants who were diagnosed with bronchiolitis within 96 hr of wheezing onset upon admission and on days 3, 5, and 7 in the hospital, and 17 respiratory viruses were detected. The RSV load was quantified by real‐time qPCR for RSV subtypes A and B at different time points. Scoring criteria were used to evaluate the degree of severity. A total of 40 infants were determined to be RSV‐positive, nine were identified as RSV subtype A (RSVA), and 31 were RSV subtype B (RSVB). The peak RSV load was observed upon admission, and the RSV load decreased significantly over time; in addition, this decrease began to have significant differences on day 5. There was a positive correlation between the RSV load and the clinical score (r² = 0.121 and P < 0.001). According to the clinical scores, the infants in the severe group tended to have higher RSV loads than those in the moderate and mild groups. Multivariate logistic regression models revealed that the viral load on day 3 was independently associated with the degree of severity. This study elucidated that a higher mean RSV load was associated with a more severe disease and a longer duration of hospitalization and symptoms. This study also clarified RSV replication in infants and provides a theoretical basis for specifying an anti‐RSV therapy strategy. J. Med. Virol. 87:1276–1284, 2015. © 2015 Wiley Periodicals, Inc.

     

The clinical classification and treatment of middle cranial fossa arachnoid cysts in children

Objective

The optimal management for middle fossa arachnoid cysts (MFAC) remains controversial, but cystocistern fenestration is effective. MFACs are divided into non-communicating arachnoid cysts (NCIAC) and communicating arachnoid cysts (CIAC). This retrospective observational study evaluated the role of phase-contrast cine magnetic resonance imaging (PC-MRI) in the diagnosis and postoperative evaluation of MFACs and assessed surgical outcomes.

Methods

Twenty-eight children with MFAC that were diagnosed by conventional neuroradiology were enrolled. PC-MRI was performed preoperatively. The clinical manifestations, cyst volumes and PC-MRI data were analyzed, and the flow of cerebrospinal fluid (CSF) at the fistula was qualitatively evaluated.

Results

No communication with the adjacent subarachnoid space was found on preoperative PC-MRI in 20 patients, and they were diagnosed with NCIAC. A statistically significant decrease in cyst volume was observed in all 20 patients postoperatively. Symptoms resolved or improved in the 14 patients who were symptomatic preoperatively, and a positive CSF flow was found in all 20 patients postoperatively. PC-MRI diagnosed eight patients with CIAC, and the cyst sizes did not increase during follow-up.

Conclusions

Cystocistern fenestration is an effective treatment for children with lateral fissure IAC. PC-MRI can be used to determine the IAC type and to evaluate the effectiveness of cystocistern fenestration.     

三维步态分析系统在儿童运动功能评价中的运用

背景：三维步态分析系统是一组通过网络将运动分析系统,动态体表肌电图和压力板连接起来的系统。 目的：利用三维步态分析提供的实时力学等数据,对步态进行运动学和动力学方法定量评定,为异常运动儿童患者提供相关客观依据。 方法：应用计算机检索1991-01/2010-02PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed),检索词为“Three-dimensional gait analysis,children”。检索文献量总计136篇,选择三维步态分析系统在儿童运动功能评价中科研及其临床应用方面的文献,排除陈旧及重复实验文章,同一领域文献则选择近期发表或发表在权威杂志的文章,最终纳入28篇符合标准的文献。 结果与结论：三维步态分析系统的可靠性优于视觉步态分析。可诊断并分析异常运动,作治疗前评价,治疗后的效果评价和预后评价。在国外科研和成人运动功能评估中运用广泛,但在儿童运动功能评价中的运用还不是很成熟。     

2,3,7,8-Tetrachlorodibenzo-p-dioxin induces a proteomic pattern that defines cleft palate formation in mice

Objective

To identify the differential protein pattern in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) induced cleft palates using a proteomic approach.

Methods

At gestation day (GD) 12, TCDD (64 g/kg; n = 30) or corn oil control (n = 30) was given to time-pregnant C57BL/6J mice by gavage. The anatomical, histological, proteomic changes in the palates of the fetal mice were studied on GD18. Total protein was extracted from the palate tissue and examined by 2-dimensional gel electrophoresis (2-DE). Spots differentially expressed between the two groups were selected for analysis by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). The proteins were identified by data searching in the Mascot database.

Results

In TCDD group, the incidence of cleft palate was 100%. Ten differential protein spots with the largest fold change were selected for further identification by mass spectrometry, 7 showed significantly higher volumes and 3 showed significantly lower volumes in TCDD palates than the control palates (all p < 0.05). Peroxiredoxin-1 were robustly up-regulated in the cleft palate group, as well proteins linked to energy metabolism, cell migration, and apoptosis.

Conclusions

Peroxiredoxin-1 protein may be associated with cleft palate in mice induced by TCDD. The embryo mouse palate tissues energy metabolism cells migration/apoptosis related proteins have the disorder.     

姜黄素对新生鼠坏死性小肠结肠炎模型的抗氧化作用及机制

目的：观察姜黄素作用于新生鼠坏死性小肠结肠炎（necrotizing enterocolitis,NEC）动物模型的疗效,初步探讨其可能的抗氧化作用机制。方法：健康新生SD大鼠24只,随机分成3组,每组8只。Ⅰ组：NEC模型组;Ⅱ组：姜黄素干预组;Ⅲ组：正常对照组。采用三因素联合造模法。姜黄素干预组实验动物以腹腔注射进行干预。实验动物每日定时称量体重,观察并记录动物生长发育及一般情况。实验结束后进行肠组织标本大体观察及HE染色后组织损伤评分,测定肠组织中丙二醛（MDA）及超氧化物歧化酶（SOD）含量,免疫组化法检测肠道组织血红素加氧酶（HO-1）的表达。结果： 与Ⅰ组相比,Ⅱ组大鼠的生长发育、一般情况及肠组织大体形态改善均优于Ⅰ组。HE染色组织损伤评分显示Ⅰ、Ⅱ组均高于Ⅲ组,比较有显著性差异（P〈0.05）,Ⅰ、Ⅱ组比较差异有统计学意义（P〈0.05）。MDA含量在Ⅰ、Ⅱ组较Ⅲ组明显升高,而Ⅱ组低于Ⅰ组（P〈0.05） 。SOD活性Ⅰ组较Ⅱ组 和Ⅲ组显著下降（P〈0.05）,Ⅱ组与Ⅲ组比较差异无显著性。HO-1Ⅰ、Ⅱ组表达较Ⅲ组均明显上调（P〈0.05）,而Ⅱ组大鼠肠道组织HO-1较Ⅰ组明显下降,差异具有统计学意义（P〈0.05）。结论：姜黄素是治疗NEC新生大鼠模型的有效药物。姜黄素可能是通过诱导NEC实验动物肠黏膜HO-1的表达从而发挥其对肠道组织的保护作用的。