Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of~260 million children...Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of~260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.展开更多
Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in chi...Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.展开更多
BACKGROUND: Despite the rapid development of pediatric intensive care medicine, there are still limited data in the literature regarding the follow-up of pediatric trauma patients in pediatric intensive care units(PIC...BACKGROUND: Despite the rapid development of pediatric intensive care medicine, there are still limited data in the literature regarding the follow-up of pediatric trauma patients in pediatric intensive care units(PICUs). In this study, we aim to evaluate our experience with children admitted and followed up with the diagnosis of trauma at our PICU.METHODS: We evaluated the retrospective data of 77 pediatric trauma patients who were admitted to the PICU at Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital from August 2020 to December 2022. The demographic data, clinical parameters and laboratory results were recorded. The primary outcome was the mortality in PICU. The performances of markers in predicting mortality were evaluated with receiver operating characteristic(ROC) curves.RESULTS: The median age of the patients was 70(33–157) months, and the median duration of hospitalization in the PICU was 6(2–11) d. Of the 77 patients, 9 died due to trauma(11,1%). Among the clinical parameters, Pediatric Risk of Mortality III(PRISM III) Score, inotrope requirement, extracorporeal treatment requirement, and mechanical ventilator requirement were significantly higher in non-survivors than in survivors. Among the laboratory parameters, procalcitonin(PCT), lactate/albumin ratio(LAR), neutrophil/lymphocyte ratio(NLR), and transfusion requirement were significantly higher in non-survivors than in survivors.CONCLUSION: In pediatric trauma patients, baseline PCT, LAR, and NLR values can be used to identify patients at risk for mortality.展开更多
Autism spectrum disorders are a group of neurodevelopmental disorders involving more than 1100 genes,including Ctnnd2 as a candidate gene.Ctnnd2knockout mice,serving as an animal model of autis m,have been demonstrate...Autism spectrum disorders are a group of neurodevelopmental disorders involving more than 1100 genes,including Ctnnd2 as a candidate gene.Ctnnd2knockout mice,serving as an animal model of autis m,have been demonstrated to exhibit decreased density of dendritic spines.The role of melatonin,as a neuro hormone capable of effectively alleviating social interaction deficits and regulating the development of dendritic spines,in Ctnnd2 deletion-induced nerve injury remains unclea r.In the present study,we discove red that the deletion of exon 2 of the Ctnnd2 gene was linked to social interaction deficits,spine loss,impaired inhibitory neurons,and suppressed phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt) signal pathway in the prefrontal cortex.Our findings demonstrated that the long-term oral administration of melatonin for 28 days effectively alleviated the aforementioned abnormalities in Ctnnd2 gene-knockout mice.Furthermore,the administration of melatonin in the prefro ntal cortex was found to improve synaptic function and activate the PI3K/Akt signal pathway in this region.The pharmacological blockade of the PI3K/Akt signal pathway with a PI3K/Akt inhibitor,wo rtmannin,and melatonin receptor antagonists,luzindole and 4-phenyl-2-propionamidotetralin,prevented the melatonin-induced enhancement of GABAergic synaptic function.These findings suggest that melatonin treatment can ameliorate GABAe rgic synaptic function by activating the PI3K/Akt signal pathway,which may contribute to the improvement of dendritic spine abnormalities in autism spectrum disorders.展开更多
Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluat...Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.展开更多
To date,several molecules have been found to facilitate iron influx,while the types of iron influx channels remain to be elucidated.Here,Piezo1 channel was identified as a key iron transporter in response to mechanica...To date,several molecules have been found to facilitate iron influx,while the types of iron influx channels remain to be elucidated.Here,Piezo1 channel was identified as a key iron transporter in response to mechanical stress.Piezo1-mediated iron overload disturbed iron metabolism and exaggerated ferroptosis in nucleus pulposus cells(NPCs).Importantly,Piezo1-induced iron influx was independent of the transferrin receptor(TFRC),a well-recognized iron gatekeeper.Furthermore,pharmacological inactivation of Piezo1 profoundly reduced iron accumulation,alleviated mitochondrial ROS,and suppressed ferroptotic alterations in stimulation of mechanical stress.Moreover,conditional knockout of Piezo1(Col2a1-CreERT Piezo1^(flox/flox))attenuated the mechanical injury-induced intervertebral disc degeneration(IVDD).Notably,the protective effect of Piezo1 deficiency in IVDD was dampened in Piezo1/Gpx4 conditional double knockout(cDKO)mice(Col2a1-CreERT Piezo1^(flox/flox)/Gpx4^(flox/flox)).These findings suggest that Piezo1 is a potential determinant of iron influx,indicating that the Piezo1-iron-ferroptosis axis might shed light on the treatment of mechanical stress-induced diseases.展开更多
BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is bei...BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is being researched.Previous studies assessing utility of fractional exhaled nitric oxide(FeNO)in EoE were low powered.None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.AIM To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.METHODS Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study.Patients on steroids and with persistent asthma requiring daily controller medication were excluded.FeNO measurements were obtained in duplicate using a chemiluminescence nitric oxide analyzer(NIOX MINO,Aerocrine,Inc.;Stockholm,Sweden)prior to endoscopy.Based on the esophageal peak eosinophil count(PEC)/high power field on biopsy,patients were classified as EoE(PEC≥15)or control(PEC≤14).Mean FeNO levels were correlated with presence or absence of EoE,eosinophil counts on esophageal biopsy,and abnormal downstream eosinophilia in the stomach(PEC≥10)and duodenum(PEC≥20).Wilcoxon rank-sum test,Spearman correlation,and logistic regression were used for analysis.P value<0.05 was considered significant.RESULTS We recruited a total of 134 patients,of which 45 were diagnosed with EoE by histopathology.The median interquartile range FeNO level was 17 parts per billion(11-37,range:7-81)in the EoE group and 12 parts per billion(8-19,range:5-71)in the control group.After adjusting for atopic diseases,EoE patients had significantly higher FeNO levels as compared to patients without EoE(Z=3.33,P<0.001).A weak yet statistically significant positive association was found between the number of esophageal eosinophils and FeNO levels(r=0.30,P<0.005).On subgroup analysis within the EoE cohort,higher FeNO levels were noted in patients with abnormal gastric(n=23,18 vs 15)and duodenal eosinophilia(n=28,21 vs 14);however,the difference was not statistically significant.CONCLUSION After ruling out atopy as possible confounder,we found significantly higher FeNO levels in the EoE cohort than in the control group.展开更多
Background:There is no gold standard sedation method for pediatric cardiac catheterization.In congenital heart diseases with intracardiac shunts,hemodynamic parameters are prone to change depending on the ventilation ...Background:There is no gold standard sedation method for pediatric cardiac catheterization.In congenital heart diseases with intracardiac shunts,hemodynamic parameters are prone to change depending on the ventilation conditions and anesthetics,although few studies have examined these effects.The purpose of this study was to investigate the effects of two different sedation methods on the hemodynamic parameters.Methods:This study retrospectively evaluated consecutive patients with ventricular septal defect(VSD)below 1 year of age who underwent cardiac catheterization at Aichi Children’s Health and Medical Center,who were divided into age-and VSD diameter-matched general anesthesia(GA)and monitored anesthesia care(MAC)under the natural airway groups(n=40 each),for comparison of hemodynamic parameters.Results:In the GA group,arterial blood pH and arterial partial pressure of oxygen were significantly higher(p<0.01),whereas arterial partial pressure of carbon dioxide was significantly lower than in the MAC group(p<0.01).Mean pulmonary artery pressure(p<0.05)and systemic blood pressure(p<0.01)were lower in the GA group.Pulmonary vascular resistance index(p<0.01)and systemic vascular resistance index(p<0.01)were also significantly lower in the GA group than the MAC group.There were no significant differences in pulmonary blood flow index,systemic blood flow index,and pulmonary/systemic blood flow ratio between the two groups.Conclusions:Cardiac catheterization under GA in VSD patients results in different hemodynamic parameters compared to that under MAC.In particular,when using pulmonary artery pressure and pulmonary vascular resistance measured under GA for judgment regarding the surgical indications or perioperative management,consideration should be given to the fact that these parameters might be lower compared to those measured under MAC.展开更多
BACKGROUND Warts are common in recipients of kidney transplantation(KT).Resistant warts which are not amenable to conventional therapies may lead to significant morbidity.Limited data exists on safety and efficacy of ...BACKGROUND Warts are common in recipients of kidney transplantation(KT).Resistant warts which are not amenable to conventional therapies may lead to significant morbidity.Limited data exists on safety and efficacy of local immunotherapy among immunocompromised KT recipients.CASE SUMMARY We report a seven-year-old child who presented with recalcitrant plantar periungual warts in the early KT period.Immunosuppression consisted of tacrolimus,mycophenolate and steroid.Due to failure of conventional anti-wart therapies,he was treated with two sessions of intralesional(IL)candida immunotherapy along with liquid nitrogen cryotherapy leading to complete resolution of the warts.Interestingly,de novo BK viremia was seen about three weeks following the last candida immunotherapy.This required reduction of immunosuppression and other anti-BK viral therapies.Allograft function remained stable but there were donor specific antibodies detected.There also was elevated level of plasma donor derived cell-free DNA.A pneumocystis jirovecii pneumonia occurred ten months following completion of immunotherapy that was successfully treated with trimethoprim-sulfamethoxazole.During this ten-month follow-up period,there have been no recurrence of warts,and transplant kidney function has remained stable.CONCLUSION Stimulation of cell-mediated immunity against the human papilloma virus induced by the IL candida immunotherapy is thought to be a cause for wart resolution.With this therapy,whether it is necessary to augment the immunosuppression to prevent rejection is unclear as that may come with a risk of infectious complications.Larger,prospective studies in pediatric KT recipients are needed to explore these important issues.展开更多
Acute alithiasic cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. It is a rare pathology in children. The aim was to describe the clinical, diagnostic and therapeutic ch...Acute alithiasic cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. It is a rare pathology in children. The aim was to describe the clinical, diagnostic and therapeutic characteristics of this disease. Materials and Method: This was a 3-year retrospective study (January 2008 to December 2010) including 66 patient records collected for CAA. Results: The frequency of AAC was 3.57%, the mean age of the patients was 8 ± 3.52 years, and there were 36 boys and 30 girls. The main clinical features were right hypochondrial pain (66 cases), positive Murphy’s (66 cases), fever (53 cases) and jaundice or sub-jaundice (51 cases). The main ultrasound signs were thickened vesicular wall 50 cas (75.76%), vesicular distension 50cas (75.76%) and positive ultrasound Murphy 47 cas (71.21%). Medical treatment was exclusive in 64 patients (96.97%) and surgical treatment in 2 patients (3.03%). Conclusion: Acute alithiasic cholecystitis is a rare pathology in children, the clinical picture is not very specific and abdominal ultrasound is the key to early diagnosis. Conservative treatment is the first choice in the absence of any complications.展开更多
Objective Sepsis is considered a major cause of health loss in children and had high mortality and morbidity.Currently,there is no reliable model for predicting the prognosis of pediatric patients with sepsis.This stu...Objective Sepsis is considered a major cause of health loss in children and had high mortality and morbidity.Currently,there is no reliable model for predicting the prognosis of pediatric patients with sepsis.This study aimed to analyze the clinical characteristics of sepsis in children and assess the risk factors associated with poor prognosis in pediatric sepsis patients to identify timely interventions and improve their outcomes.Methods This study analyzed the clinical indicators and laboratory results of septic patients hospitalized in the Pediatric Intensive Care Unit of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from January 1,2019,to December 31,2021.Risk factors for sepsis were identified by logistic regression analyses.Results A total of 355 children with sepsis were enrolled,with 333 children(93.8%)in the good prognosis group,and 22 children(6.2%)in the poor prognosis group.Among them,there were 255 patients(71.8%)in the sepsis group,and 100 patients(28.2%)in the severe sepsis group.The length of hospital stay in the poor prognosis group was longer than that in the good prognosis group(P<0.01).The levels of interleukin 1β(IL-1β)in the poor prognosis group were higher than those in the good prognosis group(P>0.05),and the platelet(PLT),albumin(ALB),and hemoglobin(Hb)levels were lower in the poor prognosis group(P<0.01).The IL-8 levels in the severe sepsis group were higher than those in the sepsis group(P<0.05).Multiple logistic regression analysis suggested that lower Hb levels,ALB levels,peak PLT counts,and higher IL-1βlevels were independent risk factors for poor prognosis in children with sepsis.Conclusion Lower Hb,ALB,and PLT counts and elevated IL-1βare independent risk factors for poor prognosis in children with sepsis.展开更多
Crohn’s disease(CD)is a chronic inflammatory disease of the digestive tract.The incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 world-wide.Notably,approximately 25%of children with CD dev...Crohn’s disease(CD)is a chronic inflammatory disease of the digestive tract.The incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 world-wide.Notably,approximately 25%of children with CD develop stricturing CD(SCD)that requires intervention.Symptomatic stricturing diseases refractory to pharmacological management frequently require non-pharmacological interventions.Non-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured seg-ment.However,strictures tend to recur postoperatively regardless of treatment modality.The lifetime risk of surgery in patients with childhood SCD remains at 50%-90%.Thus,new and emerging strategies,advanced diagnostic tools,and minimally invasive approaches are under investigation to improve the outcomes and overall quality of life of pediatric patients with SCD.展开更多
Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term foll...Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term follow-up and preliminarily explore the relationship between maternal body weight and human milk composition,including macronutrients,leptin,and adiponectin.Methods:The study included a longitudinal cohort(122 mothers),and a cross-sectional cohort(37 mothers).The human milk,maternal weight,and dietary surveys were collected in the longitudinal cohort at different follow-up time points(1-14 days postpartum,2-4 months postpartum,5-7 months postpartum,and 12-17 months postpartum).The maternal body weight was analyzed using the responses in the survey questionnaires.A milk analyzer based on the mid-infrared spectroscopy(MIRS)was used to determine milk composition,and nutrition analysis software evaluated dietary intakes.In the cross-sectional cohort,participating mothers were asked to provide blood and human milk samples and pertinent information related to maternal body composition.Maternal body composition was measured by bioelectrical impedance analysis(BIA),while ELISA analyzed leptin and adiponectin in milk and serum.Results:At 5-7 months postpartum,the PPWR of breastfeeding mothers was(2.46±3.59)kg.At 12-17 months postpartum,the PPWR was(0.98±4.06)kg.PPWR was found to be negatively correlated with milk fat content within 14 days postpartum and positively correlated at 2-4 months postpartum.In addition,the maternal weight and body muscle mass were positively correlated with leptin and adiponectin in milk.Plasma leptin was positively correlated with the mother’s body weight,body mass index(BMI),FAT percentage,and body fat mass,while plasma adiponectin did not correlate with any parameter.The results also indicate that the PPWR did not correlate with leptin and adiponectin in plasma or milk.Conclusions:Breastfeeding mothers may retain considerable weight gain one year after delivery.Human milk composition may be related to changes in maternal body weight.Leptin and adiponectin in breast milk and leptin in plasma are associated with the maternal body composition.This study supports the notion that maternal nutritional status may affect offspring health through lactation,and future research should focus on exploring weight management of postpartum mothers.展开更多
BACKGROUND Pediatric pancreatic tumors are rare and account for<0.1%of all childhood cancers.The primary treatment for pancreatic tumors is surgical resection.However,because of the lack of knowledge regarding pedi...BACKGROUND Pediatric pancreatic tumors are rare and account for<0.1%of all childhood cancers.The primary treatment for pancreatic tumors is surgical resection.However,because of the lack of knowledge regarding pediatric pancreatic tumors,no comprehensive treatment plans for pediatric pancreatic tumors have been developed.AIM To compared the clinical features,treatment methods,and prognosis of pediatric pancreatic tumors in Japan with those in other countries.METHODS Questionnaires were sent to 213 pediatric surgical units in Japan.Pancreatic tumors that were not surgically treated were excluded from the survey.The primary survey investigated the number of patients aged 0-18 years who underwent pancreatic tumor surgery and the type of tumors managed during the 22-year study period(from January 1,2000 to December 31,2021)by post card.The secondary survey assessed the clinical images,treatment methods,and tumor outcomes via email.RESULTS The primary survey enrolled 228 patients.In the secondary survey,213 patients were eventually enrolled.The most common type of pancreatic tumor was solid pseudopapillary neoplasm(SPN)[n=164(77.0%)],followed by pancreatoblastoma[n=16(7.5%)],pancreatic endocrine tumor[n=14(6.6%)],non-epithelial tumor[n=9(4.2%)],pancreatic tumor[n=7(3.3%)],and metastatic pancreatic tumor[n=3(1.4%)].Overall,123(57.7%)patients underwent distal pancreatectomy,of whom 49 underwent laparoscopic surgery.Forty-four(20.7%)patients underwent enucleation,of whom eight underwent laparoscopic surgery.Thirty-two(15.0%)patients underwent pancreaticoduodenectomy,of whom one underwent laparoscopic surgery.All patients with SPN,including those with distant metastases and recurrent disease,survived.CONCLUSION SPN was more common in Japan than in other countries.Regardless of the histological type,resection is the most effective treatment for pediatric pancreatic tumors.展开更多
Intestinal failure-associated liver disease(IFALD)is a common complication of long-term parenteral nutrition that is associated with significant morbidity and mortality.It is mainly characterized by cholestasis in chi...Intestinal failure-associated liver disease(IFALD)is a common complication of long-term parenteral nutrition that is associated with significant morbidity and mortality.It is mainly characterized by cholestasis in children and steatohepatitis in adults.Unfortunately,there is no effective approach to prevent or reverse the disease.Regulated cell death(RCD)represents a fundamental biological paradigm that determines the outcome of a variety of liver diseases.Nowadays cell death is reclassified into several types,based on the mechanisms and morphological phenotypes.Emerging evidence has linked different modes of RCD,such as apoptosis,necroptosis,ferroptosis,and pyroptosis to the pathogenesis of liver diseases.Recent studies have shown that different modes of RCD are present in animal models and patients with IFALD.Understanding the pathogenic roles of cell death may help uncover the underlying mechanisms and develop novel therapeutic strategies in IFALD.In this review,we discuss the current knowledge on how RCD may link to the pathogenesis of IFALD.We highlight examples of cell death-targeted interventions aiming to attenuate the disease,and provide perspectives for future basic and translational research in the field.展开更多
Dental stem cells(DSCs)have attracted significant interest as autologous stem cells since they are easily accessible and give a minimal immune response.These properties and their ability to both maintain self-renewal ...Dental stem cells(DSCs)have attracted significant interest as autologous stem cells since they are easily accessible and give a minimal immune response.These properties and their ability to both maintain self-renewal and undergo multi-lineage differentiation establish them as key players in regenerative medicine.While many regulatory factors determine the differentiation trajectory of DSCs,prior research has predominantly been based on genetic,epigenetic,and molecular aspects.Recent evidence suggests that DSC differentiation can also be influenced by autophagy,a highly conserved cellular process responsible for maintaining cellular and tissue homeostasis under various stress conditions.This comprehensive review endeavors to elucidate the intricate regulatory mechanism and relationship between autophagy and DSC differentiation.To achieve this goal,we dissect the intricacies of autophagy and its mechanisms.Subsequently,we elucidate its pivotal roles in impacting DSC differentiation,including osteo/odontogenic,neurogenic,and angiogenic trajectories.Furthermore,we reveal the regulatory factors that govern autophagy in DSC lineage commitment,including scaffold materials,pharmaceutical cues,and the extrinsic milieu.The implications of this review are far-reaching,underpinning the potential to wield autophagy as a regulatory tool to expedite DSC-directed differentiation and thereby promote the application of DSCs within the realm of regenerative medicine.展开更多
BACKGROUND Acute kidney injury(AKI)is a common clinical syndrome with high morbidity and mortality rates.The use of pluripotent stem cells holds great promise for the treatment of AKI.Urine-derived stem cells(USCs)are...BACKGROUND Acute kidney injury(AKI)is a common clinical syndrome with high morbidity and mortality rates.The use of pluripotent stem cells holds great promise for the treatment of AKI.Urine-derived stem cells(USCs)are a novel and versatile cell source in cell-based therapy and regenerative medicine that provide advantages of a noninvasive,simple,and low-cost approach and are induced with high multidifferentiation potential.Whether these cells could serve as a potential stem cell source for the treatment of AKI has not been determined.METHODS Stem cell markers with multidifferentiation potential were isolated from human amniotic fluid.AKI severe combined immune deficiency(SCID)mice models were induced by means of an intramuscular injection with glycerol.USCs isolated from human-voided urine were administered via tail veins.The functional changes in the kidney were assessed by the levels of blood urea nitrogen and serum creatinine.The histologic changes were evaluated by hematoxylin and eosin staining and transferase dUTP nick-end labeling staining.Meanwhile,we compared the regenerative potential of USCs with bone marrow-derived mesenchymal stem cells(MSCs).RESULTS Treatment with USCs significantly alleviated histological destruction and functional decline.The renal function was rapidly restored after intravenous injection of 5×105 human USCs into SCID mice with glycerol-induced AKI compared with injection of saline.Results from secretion assays conducted in vitro demonstrated that both stem cell varieties released a wide array of cytokines and growth factors.This suggests that a mixture of various mediators closely interacts with their biochemical functions.Two types of stem cells showed enhanced tubular cell prolif-eration and decreased tubular cell apoptosis,although USC treatment was not more effective than MSC treatment.We found that USC therapy significantly improved renal function and histological damage,inhibited inflammation and apoptosis processes in the kidney,and promoted tubular epithelial proliferation.CONCLUSION Our study demonstrated the potential of USCs for the treatment of AKI,representing a new clinical therapeutic strategy.展开更多
Objective:Currently,electrocautery devices have frequently been used in penile surgical procedures.We hypothesized that electrocautery using during penile surgical procedures may harm the taste rosea and the dorsal ne...Objective:Currently,electrocautery devices have frequently been used in penile surgical procedures.We hypothesized that electrocautery using during penile surgical procedures may harm the taste rosea and the dorsal nerve of the penis or clitoris.Methods:Eighteen young age male New Zealand rabbits were studied:five in the control(Group I,n=5),five in the penile surgery without using electrocautery(sham group,Group II,n=5),eight in the monopolar cautery(study group,Group III,n=8)groups under general anesthesia.The animals were followed for 3 weeks and sacrificed.Penile tissue—pudendal nerve root complexes and dorsal root ganglion of sacral 3 level were examined using stereological methods.The results were compared statistically.Results:The live and degenerated taste bud-like structures and degenerated neuron densities of pudendal ganglia(mean±standard deviation,n/mm^(3))were estimated as 198±24/mm^(3),4±1/mm^(3),and 5±1/mm^(3) in Group I;8±3/mm^(3),174±21/mm^(3),and 24±7/mm^(3) in Group II;and 21±5/mm^(3),137±14/mm^(3),and 95±12/mm^(3) in Group III,respectively.Neurodegeneration of taste buds and pudendal ganglia was significantly different between groups.Conclusion:Intact spinal cord and normal parasympathetic and thoracolumbar sympathetic networks are crucial for human sexual function.The present study indicates that the glans penis injury by using electrocautery may lead to pudendal ganglia degeneration.Iatrogenic damage to taste rosea and retrograde degeneration of the pudendal nerve may be the cause of sexual dysfunction responsible mechanism.展开更多
BACKGROUND Cholesterol stones affect a certain subpopulation of children.Concerns have been raised on the impact of gallbladder surgery on the growth of children and adolescents.AIM To study the population characteris...BACKGROUND Cholesterol stones affect a certain subpopulation of children.Concerns have been raised on the impact of gallbladder surgery on the growth of children and adolescents.AIM To study the population characteristics,clinical features,treatment,and prognosis of gallstones in children.METHODS The clinical data of 44 children with gallstones admitted to The First Affiliated Hospital of Naval Medical University from August 2009 to August 2021 were collected,the children were followed up by telephone to monitor their prognoses.The follow-up ended in August 2023.The shortest follow-up time was 2 years and 6 months,whereas the longest was 13 years and 11 months.The population characteristics,general clinical characteristics,and treatments were retrospectively analyzed.The children were divided according to whether they underwent surgical gallbladder removal into an operation group(n=28)and a non-operation group(n=16),The effects of surgical gallbladder resection on the growth and development of children were analyzed.RESULTS The male–female ratio in the population was 6:5 and 84.09%of the children had onset in adolescence.Furthermore,29.55%of the children were overweight or obese.The study identified 26 cases with metabolic abnormalities,9 with hemolytic anemia,and 4 with choledochal cyst.Of the population,68.18%had recurrent symptomatic cholecystolithiasis.Surgical treatment accounted for 63.64%,with laparoscopic cholecystectomy accounting for 71.43%of surgical treatment.No significant differences were observed in symptoms and complications between the surgery and non-surgery groups.Furthermore,no significant differences were found between the two groups in the attainment of genetic height target and the rightward shift of height curve during follow-up.CONCLUSION The sex characteristics of gallstones in children were not observed.Most gallstones occurred in adolescents and rarely in young children.A considerable proportion of children have inborn causes,which are often concurrent with metabolic abnormalities and hemolytic anemia.Most children had recurrent symptomatic gallstones.Surgical treatment,especially laparoscopic cholecystectomy,is still the main treatment for gallstones in children.Surgical treatment did not affect the growth and development of children who underwent gallstone removal.展开更多
Objective:This study aimed to elucidate the influence of IFN-gamma(IFN-γ)in neuroblastoma(NB)cells and reveal its potential underlying molecular mechanism.Methods:The Cell Counting Kit-8,Transwell apparatus,and flow ...Objective:This study aimed to elucidate the influence of IFN-gamma(IFN-γ)in neuroblastoma(NB)cells and reveal its potential underlying molecular mechanism.Methods:The Cell Counting Kit-8,Transwell apparatus,and flow cytometry were employed to assess cellular viability,migratory capacity,invasive potential,and apoptotic rates,respectively.RNA-seq combined with bioinformatics analysis revealed differentially expressed genes(DEGs)and their possible biological functions.Protein levels were determined by western blot analysis.Results:IFN-γtreatment resulted in diminished cell viability,mitigated migratory and invasive capabilities,and augmented apoptotic activity in the SK-N-BE(2)cell line,whereas it exhibited the opposite effect in SH-SY5Y cells.Furthermore,interferon regulatory factor 1(IRF-1)was the common DEG in both IFN-γ-treated SK-N-BE(2)and SH-SY5Y cells.Additionally,we found that it was underexpressed in NB tissues.The depletion of IRF-1 promoted the progression of both SK-N-BE(2)and SH-SY5Y cells.Moreover,IRF-1 knockdown effectively counteracted the effects of IFN-γon SK-N-BE(2)cells,while exacerbating them in SH-SY5Y cells.Conclusion:This study verified that IFN-γexerted a distinct role in both N-Myc-and non-N-Myc-amplified NB cells,partially by mediating the expression of IRF-1,suggesting that it may serve as a potent agent for treating patients with NB.展开更多
基金supported by the National Natural Science Foundation of China(82171001,82222015)Research Funding from West China School/Hospital of Stomatology Sichuan University(RCDWJS2023-1)Align Technology Specialized Scientific Research Fund(21H0922).
文摘Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of~260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.
文摘Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.
文摘BACKGROUND: Despite the rapid development of pediatric intensive care medicine, there are still limited data in the literature regarding the follow-up of pediatric trauma patients in pediatric intensive care units(PICUs). In this study, we aim to evaluate our experience with children admitted and followed up with the diagnosis of trauma at our PICU.METHODS: We evaluated the retrospective data of 77 pediatric trauma patients who were admitted to the PICU at Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital from August 2020 to December 2022. The demographic data, clinical parameters and laboratory results were recorded. The primary outcome was the mortality in PICU. The performances of markers in predicting mortality were evaluated with receiver operating characteristic(ROC) curves.RESULTS: The median age of the patients was 70(33–157) months, and the median duration of hospitalization in the PICU was 6(2–11) d. Of the 77 patients, 9 died due to trauma(11,1%). Among the clinical parameters, Pediatric Risk of Mortality III(PRISM III) Score, inotrope requirement, extracorporeal treatment requirement, and mechanical ventilator requirement were significantly higher in non-survivors than in survivors. Among the laboratory parameters, procalcitonin(PCT), lactate/albumin ratio(LAR), neutrophil/lymphocyte ratio(NLR), and transfusion requirement were significantly higher in non-survivors than in survivors.CONCLUSION: In pediatric trauma patients, baseline PCT, LAR, and NLR values can be used to identify patients at risk for mortality.
基金supported by the Chongqing Science and Technology CommitteeNatural Science Foundation of Chongqing,No.cstc2021jcyj-msxmX0065 (to YL)。
文摘Autism spectrum disorders are a group of neurodevelopmental disorders involving more than 1100 genes,including Ctnnd2 as a candidate gene.Ctnnd2knockout mice,serving as an animal model of autis m,have been demonstrated to exhibit decreased density of dendritic spines.The role of melatonin,as a neuro hormone capable of effectively alleviating social interaction deficits and regulating the development of dendritic spines,in Ctnnd2 deletion-induced nerve injury remains unclea r.In the present study,we discove red that the deletion of exon 2 of the Ctnnd2 gene was linked to social interaction deficits,spine loss,impaired inhibitory neurons,and suppressed phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt) signal pathway in the prefrontal cortex.Our findings demonstrated that the long-term oral administration of melatonin for 28 days effectively alleviated the aforementioned abnormalities in Ctnnd2 gene-knockout mice.Furthermore,the administration of melatonin in the prefro ntal cortex was found to improve synaptic function and activate the PI3K/Akt signal pathway in this region.The pharmacological blockade of the PI3K/Akt signal pathway with a PI3K/Akt inhibitor,wo rtmannin,and melatonin receptor antagonists,luzindole and 4-phenyl-2-propionamidotetralin,prevented the melatonin-induced enhancement of GABAergic synaptic function.These findings suggest that melatonin treatment can ameliorate GABAe rgic synaptic function by activating the PI3K/Akt signal pathway,which may contribute to the improvement of dendritic spine abnormalities in autism spectrum disorders.
文摘Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.
基金supported in part by the National Nature Science Foundation(81874022 and 82172483 to Xinyu Liu,82102522 to Lianlei Wang,82072478 to Yunpeng Zhao,82072435 to Qiang Yang,82073437 to Weiwei Li,81930070 to Shiqing Feng,82272548 to Lei Cheng)Key R&D Project of Shandong Province(2022CXGC010503 to Xinyu Liu)+1 种基金Shandong Natural Science Foundation(ZR202102210113 to Lianlei Wang,ZR2020YQ54 to Yunpeng Zhao)Shandong Province Taishan Scholar Project(tsqn202211317 to Lianlei Wang).The authors thank the Translational Medicine Core Facility of Shandong University for the consultation and instrument availability that supported this work.
文摘To date,several molecules have been found to facilitate iron influx,while the types of iron influx channels remain to be elucidated.Here,Piezo1 channel was identified as a key iron transporter in response to mechanical stress.Piezo1-mediated iron overload disturbed iron metabolism and exaggerated ferroptosis in nucleus pulposus cells(NPCs).Importantly,Piezo1-induced iron influx was independent of the transferrin receptor(TFRC),a well-recognized iron gatekeeper.Furthermore,pharmacological inactivation of Piezo1 profoundly reduced iron accumulation,alleviated mitochondrial ROS,and suppressed ferroptotic alterations in stimulation of mechanical stress.Moreover,conditional knockout of Piezo1(Col2a1-CreERT Piezo1^(flox/flox))attenuated the mechanical injury-induced intervertebral disc degeneration(IVDD).Notably,the protective effect of Piezo1 deficiency in IVDD was dampened in Piezo1/Gpx4 conditional double knockout(cDKO)mice(Col2a1-CreERT Piezo1^(flox/flox)/Gpx4^(flox/flox)).These findings suggest that Piezo1 is a potential determinant of iron influx,indicating that the Piezo1-iron-ferroptosis axis might shed light on the treatment of mechanical stress-induced diseases.
文摘BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is being researched.Previous studies assessing utility of fractional exhaled nitric oxide(FeNO)in EoE were low powered.None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.AIM To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.METHODS Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study.Patients on steroids and with persistent asthma requiring daily controller medication were excluded.FeNO measurements were obtained in duplicate using a chemiluminescence nitric oxide analyzer(NIOX MINO,Aerocrine,Inc.;Stockholm,Sweden)prior to endoscopy.Based on the esophageal peak eosinophil count(PEC)/high power field on biopsy,patients were classified as EoE(PEC≥15)or control(PEC≤14).Mean FeNO levels were correlated with presence or absence of EoE,eosinophil counts on esophageal biopsy,and abnormal downstream eosinophilia in the stomach(PEC≥10)and duodenum(PEC≥20).Wilcoxon rank-sum test,Spearman correlation,and logistic regression were used for analysis.P value<0.05 was considered significant.RESULTS We recruited a total of 134 patients,of which 45 were diagnosed with EoE by histopathology.The median interquartile range FeNO level was 17 parts per billion(11-37,range:7-81)in the EoE group and 12 parts per billion(8-19,range:5-71)in the control group.After adjusting for atopic diseases,EoE patients had significantly higher FeNO levels as compared to patients without EoE(Z=3.33,P<0.001).A weak yet statistically significant positive association was found between the number of esophageal eosinophils and FeNO levels(r=0.30,P<0.005).On subgroup analysis within the EoE cohort,higher FeNO levels were noted in patients with abnormal gastric(n=23,18 vs 15)and duodenal eosinophilia(n=28,21 vs 14);however,the difference was not statistically significant.CONCLUSION After ruling out atopy as possible confounder,we found significantly higher FeNO levels in the EoE cohort than in the control group.
文摘Background:There is no gold standard sedation method for pediatric cardiac catheterization.In congenital heart diseases with intracardiac shunts,hemodynamic parameters are prone to change depending on the ventilation conditions and anesthetics,although few studies have examined these effects.The purpose of this study was to investigate the effects of two different sedation methods on the hemodynamic parameters.Methods:This study retrospectively evaluated consecutive patients with ventricular septal defect(VSD)below 1 year of age who underwent cardiac catheterization at Aichi Children’s Health and Medical Center,who were divided into age-and VSD diameter-matched general anesthesia(GA)and monitored anesthesia care(MAC)under the natural airway groups(n=40 each),for comparison of hemodynamic parameters.Results:In the GA group,arterial blood pH and arterial partial pressure of oxygen were significantly higher(p<0.01),whereas arterial partial pressure of carbon dioxide was significantly lower than in the MAC group(p<0.01).Mean pulmonary artery pressure(p<0.05)and systemic blood pressure(p<0.01)were lower in the GA group.Pulmonary vascular resistance index(p<0.01)and systemic vascular resistance index(p<0.01)were also significantly lower in the GA group than the MAC group.There were no significant differences in pulmonary blood flow index,systemic blood flow index,and pulmonary/systemic blood flow ratio between the two groups.Conclusions:Cardiac catheterization under GA in VSD patients results in different hemodynamic parameters compared to that under MAC.In particular,when using pulmonary artery pressure and pulmonary vascular resistance measured under GA for judgment regarding the surgical indications or perioperative management,consideration should be given to the fact that these parameters might be lower compared to those measured under MAC.
文摘BACKGROUND Warts are common in recipients of kidney transplantation(KT).Resistant warts which are not amenable to conventional therapies may lead to significant morbidity.Limited data exists on safety and efficacy of local immunotherapy among immunocompromised KT recipients.CASE SUMMARY We report a seven-year-old child who presented with recalcitrant plantar periungual warts in the early KT period.Immunosuppression consisted of tacrolimus,mycophenolate and steroid.Due to failure of conventional anti-wart therapies,he was treated with two sessions of intralesional(IL)candida immunotherapy along with liquid nitrogen cryotherapy leading to complete resolution of the warts.Interestingly,de novo BK viremia was seen about three weeks following the last candida immunotherapy.This required reduction of immunosuppression and other anti-BK viral therapies.Allograft function remained stable but there were donor specific antibodies detected.There also was elevated level of plasma donor derived cell-free DNA.A pneumocystis jirovecii pneumonia occurred ten months following completion of immunotherapy that was successfully treated with trimethoprim-sulfamethoxazole.During this ten-month follow-up period,there have been no recurrence of warts,and transplant kidney function has remained stable.CONCLUSION Stimulation of cell-mediated immunity against the human papilloma virus induced by the IL candida immunotherapy is thought to be a cause for wart resolution.With this therapy,whether it is necessary to augment the immunosuppression to prevent rejection is unclear as that may come with a risk of infectious complications.Larger,prospective studies in pediatric KT recipients are needed to explore these important issues.
文摘Acute alithiasic cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. It is a rare pathology in children. The aim was to describe the clinical, diagnostic and therapeutic characteristics of this disease. Materials and Method: This was a 3-year retrospective study (January 2008 to December 2010) including 66 patient records collected for CAA. Results: The frequency of AAC was 3.57%, the mean age of the patients was 8 ± 3.52 years, and there were 36 boys and 30 girls. The main clinical features were right hypochondrial pain (66 cases), positive Murphy’s (66 cases), fever (53 cases) and jaundice or sub-jaundice (51 cases). The main ultrasound signs were thickened vesicular wall 50 cas (75.76%), vesicular distension 50cas (75.76%) and positive ultrasound Murphy 47 cas (71.21%). Medical treatment was exclusive in 64 patients (96.97%) and surgical treatment in 2 patients (3.03%). Conclusion: Acute alithiasic cholecystitis is a rare pathology in children, the clinical picture is not very specific and abdominal ultrasound is the key to early diagnosis. Conservative treatment is the first choice in the absence of any complications.
基金supported by the Health Commission of Hubei Province(No.WJ2023M005)Hubei Association of Pathophysiology(No.2021HBAP004).
文摘Objective Sepsis is considered a major cause of health loss in children and had high mortality and morbidity.Currently,there is no reliable model for predicting the prognosis of pediatric patients with sepsis.This study aimed to analyze the clinical characteristics of sepsis in children and assess the risk factors associated with poor prognosis in pediatric sepsis patients to identify timely interventions and improve their outcomes.Methods This study analyzed the clinical indicators and laboratory results of septic patients hospitalized in the Pediatric Intensive Care Unit of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from January 1,2019,to December 31,2021.Risk factors for sepsis were identified by logistic regression analyses.Results A total of 355 children with sepsis were enrolled,with 333 children(93.8%)in the good prognosis group,and 22 children(6.2%)in the poor prognosis group.Among them,there were 255 patients(71.8%)in the sepsis group,and 100 patients(28.2%)in the severe sepsis group.The length of hospital stay in the poor prognosis group was longer than that in the good prognosis group(P<0.01).The levels of interleukin 1β(IL-1β)in the poor prognosis group were higher than those in the good prognosis group(P>0.05),and the platelet(PLT),albumin(ALB),and hemoglobin(Hb)levels were lower in the poor prognosis group(P<0.01).The IL-8 levels in the severe sepsis group were higher than those in the sepsis group(P<0.05).Multiple logistic regression analysis suggested that lower Hb levels,ALB levels,peak PLT counts,and higher IL-1βlevels were independent risk factors for poor prognosis in children with sepsis.Conclusion Lower Hb,ALB,and PLT counts and elevated IL-1βare independent risk factors for poor prognosis in children with sepsis.
文摘Crohn’s disease(CD)is a chronic inflammatory disease of the digestive tract.The incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 world-wide.Notably,approximately 25%of children with CD develop stricturing CD(SCD)that requires intervention.Symptomatic stricturing diseases refractory to pharmacological management frequently require non-pharmacological interventions.Non-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured seg-ment.However,strictures tend to recur postoperatively regardless of treatment modality.The lifetime risk of surgery in patients with childhood SCD remains at 50%-90%.Thus,new and emerging strategies,advanced diagnostic tools,and minimally invasive approaches are under investigation to improve the outcomes and overall quality of life of pediatric patients with SCD.
基金supported by grants from the Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition(17dz2272000)Foundation of Shanghai Municipal Health Commission(Key weak discipline construction project 2019ZB0101)the Scientific research fund of China Nutrition Society(CNSHPNK2021-16)。
文摘Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term follow-up and preliminarily explore the relationship between maternal body weight and human milk composition,including macronutrients,leptin,and adiponectin.Methods:The study included a longitudinal cohort(122 mothers),and a cross-sectional cohort(37 mothers).The human milk,maternal weight,and dietary surveys were collected in the longitudinal cohort at different follow-up time points(1-14 days postpartum,2-4 months postpartum,5-7 months postpartum,and 12-17 months postpartum).The maternal body weight was analyzed using the responses in the survey questionnaires.A milk analyzer based on the mid-infrared spectroscopy(MIRS)was used to determine milk composition,and nutrition analysis software evaluated dietary intakes.In the cross-sectional cohort,participating mothers were asked to provide blood and human milk samples and pertinent information related to maternal body composition.Maternal body composition was measured by bioelectrical impedance analysis(BIA),while ELISA analyzed leptin and adiponectin in milk and serum.Results:At 5-7 months postpartum,the PPWR of breastfeeding mothers was(2.46±3.59)kg.At 12-17 months postpartum,the PPWR was(0.98±4.06)kg.PPWR was found to be negatively correlated with milk fat content within 14 days postpartum and positively correlated at 2-4 months postpartum.In addition,the maternal weight and body muscle mass were positively correlated with leptin and adiponectin in milk.Plasma leptin was positively correlated with the mother’s body weight,body mass index(BMI),FAT percentage,and body fat mass,while plasma adiponectin did not correlate with any parameter.The results also indicate that the PPWR did not correlate with leptin and adiponectin in plasma or milk.Conclusions:Breastfeeding mothers may retain considerable weight gain one year after delivery.Human milk composition may be related to changes in maternal body weight.Leptin and adiponectin in breast milk and leptin in plasma are associated with the maternal body composition.This study supports the notion that maternal nutritional status may affect offspring health through lactation,and future research should focus on exploring weight management of postpartum mothers.
文摘BACKGROUND Pediatric pancreatic tumors are rare and account for<0.1%of all childhood cancers.The primary treatment for pancreatic tumors is surgical resection.However,because of the lack of knowledge regarding pediatric pancreatic tumors,no comprehensive treatment plans for pediatric pancreatic tumors have been developed.AIM To compared the clinical features,treatment methods,and prognosis of pediatric pancreatic tumors in Japan with those in other countries.METHODS Questionnaires were sent to 213 pediatric surgical units in Japan.Pancreatic tumors that were not surgically treated were excluded from the survey.The primary survey investigated the number of patients aged 0-18 years who underwent pancreatic tumor surgery and the type of tumors managed during the 22-year study period(from January 1,2000 to December 31,2021)by post card.The secondary survey assessed the clinical images,treatment methods,and tumor outcomes via email.RESULTS The primary survey enrolled 228 patients.In the secondary survey,213 patients were eventually enrolled.The most common type of pancreatic tumor was solid pseudopapillary neoplasm(SPN)[n=164(77.0%)],followed by pancreatoblastoma[n=16(7.5%)],pancreatic endocrine tumor[n=14(6.6%)],non-epithelial tumor[n=9(4.2%)],pancreatic tumor[n=7(3.3%)],and metastatic pancreatic tumor[n=3(1.4%)].Overall,123(57.7%)patients underwent distal pancreatectomy,of whom 49 underwent laparoscopic surgery.Forty-four(20.7%)patients underwent enucleation,of whom eight underwent laparoscopic surgery.Thirty-two(15.0%)patients underwent pancreaticoduodenectomy,of whom one underwent laparoscopic surgery.All patients with SPN,including those with distant metastases and recurrent disease,survived.CONCLUSION SPN was more common in Japan than in other countries.Regardless of the histological type,resection is the most effective treatment for pediatric pancreatic tumors.
基金This work was supported by grants from the National Natural Science Foundation of China(82100950,81974066)Foundation of Shanghai Municipal Health Commission(shslczdzk05702).
文摘Intestinal failure-associated liver disease(IFALD)is a common complication of long-term parenteral nutrition that is associated with significant morbidity and mortality.It is mainly characterized by cholestasis in children and steatohepatitis in adults.Unfortunately,there is no effective approach to prevent or reverse the disease.Regulated cell death(RCD)represents a fundamental biological paradigm that determines the outcome of a variety of liver diseases.Nowadays cell death is reclassified into several types,based on the mechanisms and morphological phenotypes.Emerging evidence has linked different modes of RCD,such as apoptosis,necroptosis,ferroptosis,and pyroptosis to the pathogenesis of liver diseases.Recent studies have shown that different modes of RCD are present in animal models and patients with IFALD.Understanding the pathogenic roles of cell death may help uncover the underlying mechanisms and develop novel therapeutic strategies in IFALD.In this review,we discuss the current knowledge on how RCD may link to the pathogenesis of IFALD.We highlight examples of cell death-targeted interventions aiming to attenuate the disease,and provide perspectives for future basic and translational research in the field.
基金funded by grants from the National Natural Science Foundation of China(Nos.81771095,82071235)Key R&D Program of Shaanxi Province(2017SF-103,2021KWZ-26,2023-JC-ZD-56)State Key Laboratory of Military Stomatology(2020ZA01).
文摘Dental stem cells(DSCs)have attracted significant interest as autologous stem cells since they are easily accessible and give a minimal immune response.These properties and their ability to both maintain self-renewal and undergo multi-lineage differentiation establish them as key players in regenerative medicine.While many regulatory factors determine the differentiation trajectory of DSCs,prior research has predominantly been based on genetic,epigenetic,and molecular aspects.Recent evidence suggests that DSC differentiation can also be influenced by autophagy,a highly conserved cellular process responsible for maintaining cellular and tissue homeostasis under various stress conditions.This comprehensive review endeavors to elucidate the intricate regulatory mechanism and relationship between autophagy and DSC differentiation.To achieve this goal,we dissect the intricacies of autophagy and its mechanisms.Subsequently,we elucidate its pivotal roles in impacting DSC differentiation,including osteo/odontogenic,neurogenic,and angiogenic trajectories.Furthermore,we reveal the regulatory factors that govern autophagy in DSC lineage commitment,including scaffold materials,pharmaceutical cues,and the extrinsic milieu.The implications of this review are far-reaching,underpinning the potential to wield autophagy as a regulatory tool to expedite DSC-directed differentiation and thereby promote the application of DSCs within the realm of regenerative medicine.
文摘BACKGROUND Acute kidney injury(AKI)is a common clinical syndrome with high morbidity and mortality rates.The use of pluripotent stem cells holds great promise for the treatment of AKI.Urine-derived stem cells(USCs)are a novel and versatile cell source in cell-based therapy and regenerative medicine that provide advantages of a noninvasive,simple,and low-cost approach and are induced with high multidifferentiation potential.Whether these cells could serve as a potential stem cell source for the treatment of AKI has not been determined.METHODS Stem cell markers with multidifferentiation potential were isolated from human amniotic fluid.AKI severe combined immune deficiency(SCID)mice models were induced by means of an intramuscular injection with glycerol.USCs isolated from human-voided urine were administered via tail veins.The functional changes in the kidney were assessed by the levels of blood urea nitrogen and serum creatinine.The histologic changes were evaluated by hematoxylin and eosin staining and transferase dUTP nick-end labeling staining.Meanwhile,we compared the regenerative potential of USCs with bone marrow-derived mesenchymal stem cells(MSCs).RESULTS Treatment with USCs significantly alleviated histological destruction and functional decline.The renal function was rapidly restored after intravenous injection of 5×105 human USCs into SCID mice with glycerol-induced AKI compared with injection of saline.Results from secretion assays conducted in vitro demonstrated that both stem cell varieties released a wide array of cytokines and growth factors.This suggests that a mixture of various mediators closely interacts with their biochemical functions.Two types of stem cells showed enhanced tubular cell prolif-eration and decreased tubular cell apoptosis,although USC treatment was not more effective than MSC treatment.We found that USC therapy significantly improved renal function and histological damage,inhibited inflammation and apoptosis processes in the kidney,and promoted tubular epithelial proliferation.CONCLUSION Our study demonstrated the potential of USCs for the treatment of AKI,representing a new clinical therapeutic strategy.
文摘Objective:Currently,electrocautery devices have frequently been used in penile surgical procedures.We hypothesized that electrocautery using during penile surgical procedures may harm the taste rosea and the dorsal nerve of the penis or clitoris.Methods:Eighteen young age male New Zealand rabbits were studied:five in the control(Group I,n=5),five in the penile surgery without using electrocautery(sham group,Group II,n=5),eight in the monopolar cautery(study group,Group III,n=8)groups under general anesthesia.The animals were followed for 3 weeks and sacrificed.Penile tissue—pudendal nerve root complexes and dorsal root ganglion of sacral 3 level were examined using stereological methods.The results were compared statistically.Results:The live and degenerated taste bud-like structures and degenerated neuron densities of pudendal ganglia(mean±standard deviation,n/mm^(3))were estimated as 198±24/mm^(3),4±1/mm^(3),and 5±1/mm^(3) in Group I;8±3/mm^(3),174±21/mm^(3),and 24±7/mm^(3) in Group II;and 21±5/mm^(3),137±14/mm^(3),and 95±12/mm^(3) in Group III,respectively.Neurodegeneration of taste buds and pudendal ganglia was significantly different between groups.Conclusion:Intact spinal cord and normal parasympathetic and thoracolumbar sympathetic networks are crucial for human sexual function.The present study indicates that the glans penis injury by using electrocautery may lead to pudendal ganglia degeneration.Iatrogenic damage to taste rosea and retrograde degeneration of the pudendal nerve may be the cause of sexual dysfunction responsible mechanism.
文摘BACKGROUND Cholesterol stones affect a certain subpopulation of children.Concerns have been raised on the impact of gallbladder surgery on the growth of children and adolescents.AIM To study the population characteristics,clinical features,treatment,and prognosis of gallstones in children.METHODS The clinical data of 44 children with gallstones admitted to The First Affiliated Hospital of Naval Medical University from August 2009 to August 2021 were collected,the children were followed up by telephone to monitor their prognoses.The follow-up ended in August 2023.The shortest follow-up time was 2 years and 6 months,whereas the longest was 13 years and 11 months.The population characteristics,general clinical characteristics,and treatments were retrospectively analyzed.The children were divided according to whether they underwent surgical gallbladder removal into an operation group(n=28)and a non-operation group(n=16),The effects of surgical gallbladder resection on the growth and development of children were analyzed.RESULTS The male–female ratio in the population was 6:5 and 84.09%of the children had onset in adolescence.Furthermore,29.55%of the children were overweight or obese.The study identified 26 cases with metabolic abnormalities,9 with hemolytic anemia,and 4 with choledochal cyst.Of the population,68.18%had recurrent symptomatic cholecystolithiasis.Surgical treatment accounted for 63.64%,with laparoscopic cholecystectomy accounting for 71.43%of surgical treatment.No significant differences were observed in symptoms and complications between the surgery and non-surgery groups.Furthermore,no significant differences were found between the two groups in the attainment of genetic height target and the rightward shift of height curve during follow-up.CONCLUSION The sex characteristics of gallstones in children were not observed.Most gallstones occurred in adolescents and rarely in young children.A considerable proportion of children have inborn causes,which are often concurrent with metabolic abnormalities and hemolytic anemia.Most children had recurrent symptomatic gallstones.Surgical treatment,especially laparoscopic cholecystectomy,is still the main treatment for gallstones in children.Surgical treatment did not affect the growth and development of children who underwent gallstone removal.
基金funded by the Special Basic Cooperative Research Programs of Yunnan Provincial Undergraduate Universities’Association(No.202101BA070001-126).
文摘Objective:This study aimed to elucidate the influence of IFN-gamma(IFN-γ)in neuroblastoma(NB)cells and reveal its potential underlying molecular mechanism.Methods:The Cell Counting Kit-8,Transwell apparatus,and flow cytometry were employed to assess cellular viability,migratory capacity,invasive potential,and apoptotic rates,respectively.RNA-seq combined with bioinformatics analysis revealed differentially expressed genes(DEGs)and their possible biological functions.Protein levels were determined by western blot analysis.Results:IFN-γtreatment resulted in diminished cell viability,mitigated migratory and invasive capabilities,and augmented apoptotic activity in the SK-N-BE(2)cell line,whereas it exhibited the opposite effect in SH-SY5Y cells.Furthermore,interferon regulatory factor 1(IRF-1)was the common DEG in both IFN-γ-treated SK-N-BE(2)and SH-SY5Y cells.Additionally,we found that it was underexpressed in NB tissues.The depletion of IRF-1 promoted the progression of both SK-N-BE(2)and SH-SY5Y cells.Moreover,IRF-1 knockdown effectively counteracted the effects of IFN-γon SK-N-BE(2)cells,while exacerbating them in SH-SY5Y cells.Conclusion:This study verified that IFN-γexerted a distinct role in both N-Myc-and non-N-Myc-amplified NB cells,partially by mediating the expression of IRF-1,suggesting that it may serve as a potent agent for treating patients with NB.