[Consistency of peripheral whole blood and venous serum procalcitonin in children: a multicenter parallel controlled study]

Objective: To explore the consistency of peripheral whole blood and venous serum procalcitonin (PCT) levels, and the value of peripheral whole blood PCT in evaluating pediatric bacterial infection. Methods: This multicenter cross-sectional parallel control study was conducted in 11 children's hospital. All the 1 898 patients older than 28 days admitted to these hospitals from March 2018 to February 2019 had their peripheral whole blood and venous serum PCT detected simultaneously with unified equipment, reagent and method. According to the venous serum PCT level, the patients were stratified to subgroups. Analysis of variance and chi-square test were used to compare the demographic characteristics among groups. And the correlation between the peripheral blood and venous serum PCT level was investigated by quantitative Pearson correlation analysis.The PCT resultes were also converted into ranked data to further test the consistency between the two sampling methods by Spearman's rank correlation test. Furthermore, the ranked data were converted into binary data to evaluate the consistency and investigate the best cut-off of peripheral blood PCT level in predicting bacterial infection. Results: A total of 1 898 valid samples were included (1 098 males, 800 females),age 27.4(12.2,56.7) months. There was a good correlation between PCT values of peripheral whole blood and venous serum (r=0.97, P<0.01). The linear regression equation was PCT_{venous serum}=0.135+0.929×PCT_{peripheral whole blood}. However, when stratified to 5 levels, PCT results showed diverse and unsatisfied consistency between the two sampling methods (r=0.51-0.92, all P<0.01). But after PCT was converted to ordinal categorical variables, the stratified analysis showed that the coincidence rate of the measured values by the two sampling methods in each boundary area was 84.9%-97.1%. The dichotomous variables also showed a good consistency (coincidence rate 96.8%-99.3%, Youden index 0.82-0.89). According to the severity of disease, the serum PCT value was classified into 4 intervals（<0.5、0.5-<2.0、2.0-<10.0、≥10.0 μg/L）, and the peripheral blood PCT value also showed a good predictive value (AUC value was 0.991 2-0.997 9). The optimal cut points of peripheral whole blood PCT value 0.5、1.0、2.0、10.0 μg/L corresponding to venous serum PCT values were 0.395, 0.595, 1.175 and 3.545 μg/L, respectively. Conclusions: There is a good correlation between peripheral whole blood PCT value and the venous serum PCT value, which means that the peripheral whole blood PCT could facilitate the identification of infection and clinical severity. Besides, the sampling of peripheral whole blood is simple and easy to repeat.

[Methylene blue play a role in preventing septic liver injury by inducing macrophage polarization]

Thirty mice were used to establish a sepsis model with cecal ligation and puncture. 15 mg/kg methylene blue or isotonic saline were injected intraperitoneally to observe liver tissue pathological changes. Changes in macrophage frequency and expressional condition of M1 and M2-type hepatic inflammatory factors were detected. After LPS stimulation, the expression level of macrophage inflammatory factor were detected. The results showed that the pathological liver injury was significantly reduced in the MB mice group (P < 0.05), and the frequency of liver macrophage was not statistically significantly different (P > 0.05). MB elevation had promoted the expression of M2-type hepatic inflammatory factor (P < 0.05) and macrophage inflammatory factor (P < 0.05). MB can play a role in preventing septic liver injury by inducing macrophages polarization to M2-type.

[Caloric test and hearing characteristics in patients with vestibular migraine and Meniere's disease]

Objective:This study was designed to distinguish vestibular migraine(VM) from Meniere's disease(MD) by comparing age, sex, family history, audiological and vestibular test results in patients with VM or MD. Method:Forty-six patients with suspected VM, 60 patients with confirmed VM, and 60 patients with confirmed MD were studied. All patients were asked for detailed medical history, and then underwent bithermal caloric test and audiological test. The hearing function and vestibular function were analyzed. Result:①General conditions: the sex ratio with suspected VM, confirmed VM and confirmed MD was 1∶4.75, 1∶5.67 and 1∶1. Family history in these three groups was 80.43%（37/46）,66.67%（40/60）,6.67%（4/60）, respectively. ②In the three groups, the abnormal rates of caloric test were 50.00% (23/46), 31.67% (19/60) and 78.33%(47/60), respectively.③The rate of pure tone audiometry abnormality in the three groups was 60.87% (28/46), 63.33% (38/60) and 100.00% (60/60), respectively. Of 46 suspected VM patients, 18 (39.13%) had high frequency hearing loss, 7 (15.22%) had full frequency hearing loss, and 3 (6.52%) had low frequency hearing loss. Among 60 confirmed VM patients, 18 (30.00%) had high frequency hearing loss, 15 (25.00%) had full frequency hearing loss, 4 (6.67%) had low frequency hearing loss, and 1 case (1.67%) with low frequency and high frequency hearing loss. Among 60 confirmed MD patients, 56 (93.33%) had full frequency hearing loss, and 4 (6.67%) had low frequency hearing loss. ④The difference of audiological test between patients with confirmed VM and patients with suspected VM was not statistically significant（P>0.05）. The difference of bithermal caloric test between patients with confirmed VM and patients with suspected VM was not statistically significant（P>0.05）.Compared with MD patients, the incidence of hearing loss and the incidence of abnormal bithermal caloric test in VM patients is lower（P<0.05）. Conclusion:The abnormality rate of caloric test and the incidence of hearing loss in MD patients were higher than VM. The confirmed and suspected VM patients can be accompanied by hearing loss mainly with high hearing frequency decline. There was no difference in clinical characteristics between confirmed and suspected VM patients.

Gene expression profiling of Duchenne muscular dystrophy reveals characteristics along disease progression

Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy with no cure currently available. In this study, using two microarray data sets obtained from the Gene Expression Omnibus database, we conducted a dysfunctional pathway-enrichment analysis and investigated deregulated genes that are specific to different phases of the disease in order to determine pathogenic characteristics in the progression of DMD. We identified 41 and 33 dysfunctional pathways that were enriched with differentially expressed genes in presymptomatic patients and in symptomatic patients, respectively. Over 70% of pathways were shared between both phases and many of them involved the inflammatory process, suggesting that inflammatory cascades were induced soon after the birth of the patients. Further investigation showed that presymptomatic patients performed better with respect to muscle regeneration and cardiac muscle calcium homeostasis maintenance. Neuronal nitric oxide synthase, dihydropyridine receptors, sarcoplasmic/endoplasmic reticulum calcium ATPase, and phospholamban may serve as potential targets for further molecular diagnostic tests. Our results may provide a better understanding for the treatment of DMD.

[Effect of berberine on slow inward ionic current in guinea pig ventricular papillary muscle]

Using a single sucrose gap voltage clamp technique, it was found that berberine hydrochloride (Ber-HCl) had a dose-dependent biphasic effect on Isi of guinea pig papillary muscle. It was more difficult to wash out the inhibitory effect of Ber-HCl on Isi. In the initial stage of the experiment, Ber-HCl 72 mumol/L and 365 mumol/L greatly improved the influx of extracellular Ca2+ and increased the amplitude of Isi. As the drug perfusion was prolonged, however, Ber-HCl dramatically blocked Ca2+ channels and decreased the influx of extracellular Ca2+ consequently, Isi was reduced in amplitude and later disappeared. This experiment further revealed the mechanisms of action of Ber on cardiac contractility and for the treatment of arrhythmias.