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Astragalus membranaceus improves therapeutic efficacy of asthmatic children by regulating the balance of Treg/Th17 cells

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Chinese Journal of Natural Medicines 2019年第4期17卷 252-263页

作者： WANG Wei LIU Qing-Bin JING Wei Department of pediatric Affiliated Hospital of Changchun University of Traditional Chinese Medicine

Astragalus membranaceus may be a potential therapy for childhood asthma but its driving mechanism remains elusive. The main components of A. membranaceus were identified by HPLC. The children with asthma remission were divided into two combination group(control group, the combination of budesonide and terbutaline) and A. membranaceus group(treatment group, the combination of budesonide, terbutaline and A. membranaceus). The therapeutic results were compared between two groups after 3-month *** peripheral blood mononuclear cells(PBMCs) were isolated from venous blood by using density gradient centrifugation on percoll. The levels of Fox P3, EGF-β, IL-17 and IL-23 from PBMCs and serum Ig E were measured. The relative percentage of Treg/Th17 cells was determined using flow cytometry. The main components of A. membranaceus were calycosin-7-O-glucoside, isoquercitrin, ononin, calycosin, quercetin, genistein, kaempferol, isorhamnetin and formononetin, all of which may contribute to asthma therapy. Lung function was significantly improved in the treatment group when compared with a control group(P < 0.05). The efficacy in preventing the occurrence of childhood asthma was higher in the treatment group than the control group(P < 0.05).The levels of Ig E, IL-17 and IL-23 were reduced significantly in the treatment group when compared with the control group, while the levels of FoxP3 and TGF-β were increased in the treatment group when compared with the control group(P < 0.05). A. membranaceus increased the percentage of Treg cells and reduced the percentage of Th17 cells. A. membranaceus is potential natural product for improving the therapeutic efficacy of combination therapy of budesonide and terbutaline for the children with asthma remission by modulating the balance of Treg/Th17 cells.

关键词： Astragalus membranaceus Asthma Children Treg/Th17 Budesonide Terbutaline

Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy

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World Journal of pediatrics 2016年第1期12卷 103-108页

作者： MuratÇiftel Berrin Demir Günay Kozan Osman Yılmaz Hasan Kahveci Ömer Kılıç Department of pediatric Cardiology Erzurum Training and Research HospitalErzurumTurkey Department of Radiology Erzurum Training and Research HospitalErzurumTurkey Department of Ear Noseand ThroatErzurum Training and Research HospitalErzurumTurkey Neonatal unit Erzurum Training and Research HospitalErzurumTurkey Department of pediatric Infectious Diseases Erzurum Training and Research HospitalErzurumTurkey

Background:Adenotonsillar hypertrophy can produce cardiopulmonary disease in ***,it is unclear whether adenotonsillar hypertrophy causes *** study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar ***:The study included 40 children with adenotonsillar hypertrophy(age:5-10 years)and 36 healthy children with similar age and body mass *** blood pressure,diastolic blood pressure,and pulse pressure were measured in all *** intima-media thickness,carotid arterial systolic diameter,and carotid arterial diastolic diameter were measured using a high-resolution ultrasound *** on these measurements,carotid arterial strain,carotid artery distensibility,beta stiffness index,and elasticity modulus were ***:Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy(0.36±0.05 mm vs.0.34±0.04 mm,P=0.02)compared to healthy *** stiffness index(3.01±1.22 vs.2.98±0.98,P=0.85),elasticity modulus(231.39±99.23 vs.226.46±83.20,P=0.88),carotid arterial strain(0.17±0.06 vs.0.17±0.04,P=0.95),and carotid artery distensibility(13.14±3.88 vs.12.92±3.84,P=0.75)were similar between children with adenotonsillar hypertrophy and the healthy ***:The present study revealed increased carotid intima-media thickness in children with adenotonsillar *** risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.

关键词： adenotonsillar hypertrophy carotid artery stiffness carotid intima media thickness subclinical atherosclerosis

Clinical presentation and early predictors for poor outcomes in pediatric myocarditis:A retrospective study

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World Journal of Clinical Cases 2019年第5期7卷 548-561页

作者： Moises Rodriguez-Gonzalez Maria Isabel Sanchez-Codez Manuel Lubian-Gutierrez Ana Castellano-Martinez Department of pediatric Cardiology Puerta del Mar University Hospital Department of pediatrics Puerta del Mar University Hospital Department of pediatric Nephrology Puerta del Mar University Hospital

BACKGROUND Myocarditis is an important cause of morbidity and mortality in children, leading to long-term sequelae including chronic congestive heart failure, dilated cardiomyopathy, heart transplantation, and death. The initial diagnosis of myocarditis is usually based on clinical presentation, but this widely ranges from the severe sudden onset of a cardiogenic shock to asymptomatic patients. Early recognition is essential in order to monitor and start supportive treatment prior to the development of severe adverse events. Of note, many cases of fulminant myocarditis are usually misdiagnosed as otherwise minor conditions during the weeks before the unexpected *** To provide diagnostic clues to make an early recognition of pediatric *** investigate early predictors for poor *** We conducted a retrospective cross-sectional single-center study from January 2008 to November 2017 at the pediatric Department of our institution, including children hospital discharge(early poor outcome), or after 1 year of follow-up(late poor outcome). We analyzed different clinical features and diagnostic test findings in order to provide diagnostic clues for myocarditis in children. Multivariable stepwise logistic regression analysis was performed using all variables that had been selected by univariate analysis to determine independent factors that predicted a poor early or late outcome in our study *** A total of 42 patients [69% male; median age of 8(1.5-12) years] met study inclusion criteria. Chest pain(40%) was the most common specific cardiac symptom. Respiratory tract symptoms(cough, apnea, rhinorrhea)(38%),shortness of breath(35%), gastrointestinal tract symptoms(vomiting, abdominal pain, diarrhea)(33%), and fever(31%) were

关键词： Myocarditis Children Echocardiography N-terminal pro-brain natriuretic peptide Myocardial ischemia Cardiac magnetic resonance imaging Heart transplantation Dilated cardiomyopathy

Gastric transposition as a valid surgical option for esophageal replacement in pediatric patients:experience from three Italian medical centers

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Gastroenterology Report 2017年第1期5卷 47-51,I0002页

作者： Rossella Angotti Francesco Molinaro Carmine Noviello Giovanni Cobellis Ascanio Martino Carmine Del Rossi Adrian Bianchi Mario Messina Division of pediatric Surgery Department of MedicineSurgical and Neurological SciencesUniversity of SienaSienaItaly pediatric Surgery unit Academic Salesi Children HospitalMarche Polytechnic UniversityAnconaItaly Department of pediatric Surgery University of ParmaParmaItaly Neonatal and Paediatric Reconstructive Surgery Royal Manchester Children’s HospitalManchesterUK

Background:Esophageal replacement in children is an option that is confined to very few situations including long-gap esophageal atresia and esophageal strictures unresponsive to other therapies(peptic or caustic ingestion).The purpose of our work was to describe the experience of gastric transposition in three Italian ***:This is a retrospective *** data were extrapolated from a prospective *** included all patients who had undergone gastric transposition in the last 15 ***:In the 15-year period,eight infants and children(3 males and 5 females)underwent gastric transposition for esophageal *** patients had long-gap esophageal atresia,and two had caustic esophageal *** were no deaths in the *** patients had an early postoperative complication:two had a self-limited salivary fistula at three weeks,and one(a patient with jejunostomy)had a jejunal perforation treated *** late complication,anastomotic stricture,was recorded that required two endoscopic *** median follow-up was 60 months(range:18–144 months).At final clinical follow-up,six patients had no eating problems,and two patients had some difficulties with eating(jejunostomy in situ),but they underwent logopedic therapy with improved *** patients had an increase in body weight and height ***:Our small study reports the clinical experience of three Italian centers in which gastric transposition was performed with excellent results,both in terms of surgical technique(simplicity,reproducibility,complication rate)and clinical follow-up(good oral feeding of young patients,normal social life and regular growth curves).

关键词： gastric transposition children esophageal atresia caustic ingestion

Assessment Postpartum Glucose Status among Women with Gestational Diabetes: Experience of a Sub-Saharan African Endocrinology Department

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Journal of Diabetes Mellitus 2020年第3期10卷 124-131页

作者： Ngoné Diaba Diack Aminata Mbaye Nafy Ndiaye Yakham Mohamed Leye Abdoul Aziz Diouf Mamadou Ba Khadidja Samb Papemomar Guisse Abdoulaye Leye Alassane Diouf Endocrinology-Diabetology Department Teaching Hospital of Pikine Dakar Senegal Obstetrics and Gynécology Department Teaching Hospital of Pikine Dakar Senegal

Background: Women with gestational diabetes mellitus (GDM) have a significantly increased risk for developing type 2 diabetes after delivery. The purpose of this study was to determine the postpartum glycemic status among women with GDM in an Endocrinology-Diabetology department in Sub-Saharan Area. Methods: It was a prospective cohort study conducted between January 1, 2013, and July 31, 2018 (over period of 5 years and 7 months) at pikine National hospital, Dakar, Senegal. Postpartum glucose status was evaluated at least 6 weeks post-partum among women with history of GDM according to IADPSG criteria. The glycemic status after delivery was pointed referring to 2006 WHO criteria. Results: Overall 53 patients were included in this study. Fasting plasma glucose was performed as a screening test in 94% of the cases. A type 2 diabetes after GDM as diagnosed in 6 patients, accounting for a prevalence of 11.32%. An Impaired Fasting Glucose (IFG) was revealed in 5 patients (9.43%). The patients underwent a screening test in the first year after delivery in 54.70% of the cases, over a half of whom during the post-partum period range from the 6th to the 12th week. Insulin usage during pregnancy was statistically correlated with the occurrence of postpartum diabetes. Conclusion: Diabetes prevention and early diagnosis require a glycemic status monitoring among women with history of GDM.

关键词： Gestational Diabetes Mellitus Postpartum Glucose Status Type 2 Diabetes Africa IADPSG

Kaposi’s Disease (KS) in a Senegalese Child Living with HIV

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Open Journal of pediatrics 2020年第1期10卷 85-93页

作者： F. Ly B. Niang Y. Keita C. Dial A. Sow A. Sakho Kane B. S. Ndiaye A. Sylla B. Camara A. Ly Ba O. Ndiaye pediatric Service of the pikine National hospital Dakar Senegal pediatric Department of the Albert Royer National Children’s hospital Dakar Senegal pediatric Department of the Aristide Dantec hospital Center Dakar Senegal Department of Anatomopathological of General hospital Idrissa Pouye Dakar Senegal Department of Dermatology of the pikine National hospital Center Dakar Senegal Radiology Department of the Albert Royer National Children’s hospital Dakar Senegal

Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.

关键词： Kaposi’s Sarcoma Antiretroviral Therapy HIV Child

Significant exercise limitations after recovery from MIS-C related myocarditis

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World Journal of pediatrics 2023年第12期19卷 1149-1154页

作者： Gur Mainzer Merav Zucker-Toledano Moneera Hanna Ronen Bar-Yoseph Einat Kodesh pediatric Heart Institute Edmond and Lily Safra Children’s HospitalSheba Medical Center52621 Tel HashomerIsrael pediatric Cardiology Department Hadassah Medical CenterJerusalemIsrael pediatric Cardiology unit Padeh Medical CenterPoriyaIsrael pediatric Cardiology Institute Ruth Children’s HospitalRambam Health Care CampusHaifaIsrael pediatric Pulmonary Institute Ruth Children’s HospitalRambam Health Care CampusHaifaIsrael The Technion Faculty of Medicine HaifaIsrael Department of Physical Therapy Faculty of Social Welfare and Health ScienceUniversity of HaifaHaifaIsrael

Background Myocarditis is one of the presentations of multisystemic infammatory syndrome in children(MIS-C)following coronavirus disease 2019(COVID-19).Although the reported short-term prognosis is good,data regarding medium-term functional capacity and limitations are *** study aimed to evaluate exercise capacity as well as possible cardiac and respiratory limitations in children recovered from MIS-C related *** Fourteen patients who recovered from MIS-C related myocarditis underwent spirometry and cardiopulmonary exercise testing(CPET),and their results were compared with an age-,sex-,weight-and activity level-matched healthy control group(n=14).Results All participants completed the CPET with peak oxygen uptake(peak.V O2),and the results were within the normal range(MIS-C 89.3%±8.9%and Control 87.9%±13.7%predicted.V O2).Five post-MIS-C patients(35%)had exerciserelated cardio-respiratory abnormalities,including oxygen desaturation and oxygen-pulse fattening,compared to none in the control *** MIS-C group also had lower peak exercise saturation(95.6±3.5 vs.97.6±1.1)and lower breathing reserve(17.4%±7.5%vs.27.4%±14.0%of MVV).Conclusions Patients who recovered from MIS-C related myocarditis may present exercise *** assessment(e.g.,CPET)should be included in routine examinations before allowing a return to physical activity in post-MIS-C ***,longer term studies assessing functional capacity and focusing on physiological mechanisms are needed.

关键词： Cardiopulmonary exercise testing COVID 19 Hypoxemia Myocarditis

Disruption of interstitial cells of Cajal networks after massive small bowel resection

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World Journal of Gastroenterology 2013年第22期19卷 3415-3422页

作者： Jie Chen Lei Du Yong-Tao Xiao Wei Cai Department of pediatric Surgery Xin Hua Hospital Shanghai Jiaotong University School of Medicine Department of pediatric Surgery School of Medicine Affiliated Hospital of Nantong University Shanghai Key Laboratory of pediatric Gastroenterology and Nutrition Shanghai Institute of Pediatric Research Shanghai Jiaotong University

AIM: To investigate the disruptions of interstitial cells of Cajal (ICC) in the remaining bowel in rats after massive small bowel resection (mSBR). METHODS: Thirty male Sprague-Dawley rats fitting entry criteria were divided randomly into three experimental groups (n = 10 each): Group A rats underwent bowel transection and re-anastomosis (sham) and tissue samples were harvested at day 7 post-surgery. Group B and C rats underwent 80% small bowel resection with tissue harvested from Group B rats at day 7 post-surgery, and from Group C rats at day 14 postsurgery. The distribution of ICC at the site of the resid-ual small bowel was evaluated by immunohistochemical analysis of small intestine samples. The ultrastructural changes of ICC in the remnant ileum of model rats 7 and 14 d after mSBR were analyzed by transmission electron microscopy. Intracellular recordings of slow wave oscillations were used to evaluate electrical pacemaking. The protein expression of c-kit, ICC phenotypic markers, and membrane-bound stem cell factor (mSCF) in intestinal smooth muscle of each group were detected by Western blotting. RESULTS: After mSBR, immunohistochemical analysis indicated that the number of c-kit-positive cells was dramatically decreased in Group B rats compared with sham tissues. Significant ultrastructural changes in ICC with associated smooth muscle hypertrophy were also observed. Disordered spontaneous rhythmic contractions with reduced amplitude (8.5 ± 1.4 mV vs 24.8 ± 1.3 mV, P = 0.037) and increased slow wave frequency (39.5 ± 2.1 cycles/min vs 33.0 ± 1.3 cycles/min, P = 0.044) were found in the residual intestinal smooth muscle 7 d post mSBR. The contractile function and electrical activity of intestinal circular smooth muscle returned to normal levels at 14 d post mSBR (amplitude, 14.9 ± 1.6 mV vs 24.8 ± 1.3 mV; frequency, 30.7 ± 1.7 cycles/min vs 33.0 ± 1.3 cycles/min). The expression of Mscf and c-kit protein was decreased at 7 d (P = 0.026), but gradually returne

关键词： Interstitial cells of Cajal c-kit Slow wave Massive small bowel resection Intestinal dysfunction

Evaluation of proximal tubule functions in children with COVID‑19:a prospective analytical study

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World Journal of pediatrics 2022年第9期18卷 607-612页

作者： Fatma Devrim Elif Böncüoğlu Elif Kıymet ŞahikaŞahinkaya Ela Cem Mine Düzgöl Aybüke Akaslan Kara KamileÖtiken Arıkan AslıKantar Ebru Yılmaz Nida Dinçel Nuri Bayram İlker Devrim Department of pediatric Nephrology University of Health Sciences Dr.Behçet Uz Child Disease and Pediatric Surgery Training and Research HospitalİzmirTurkey Department of pediatric Infectious Diseases University of Health Sciences Dr.Behçet Uz Child Disease and Pediatric Surgery Training and Research HospitalİzmirTurkey

Background There are limited numbers of studies focusing on renal efects of coronavirus disease 2019(COVID-19)infection and proximal tubular dysfunction in children with COVID-19 *** purpose of this study was to evaluate the functions of the proximal tubule in hospitalized children with confrmed acute *** The children who were hospitalized for confrmed COVID-19 were included in this prospective descriptive *** presence of at least two of the following four abnormalities was used to diagnose proximal tubule injury:abnormal tubular reabsorption of phosphate,normoglycemic glycosuria,hyperuricosuria,and *** A total of 115 patients were included in the *** a third of the individuals had elevated blood creatinine levels or *** addition,abnormal renal tubular phosphate loss measured by renal tubular phosphate loss was found in 10(8.7%)patients,as was hyperuricosuria in 28.6%.As a result,total proximal tubular dysfunction was found in 24(20.9%)*** One in every fve children with acute COVID-19 infections had proximal tubular dysfunction,according to our ***,the rate of proximal tubular dysfunction was lower than in adults,it should be *** recovery of proximal tubular function in children with COVID-19 should be followed.

关键词： Coronavirus disease 2019(COVID-19) Proteinuria Proximal tubular dysfunction Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Tubular reabsorption of phosphate