Objective:To discuss the effect of insulin and metformin on amethylation and glycolipid metabolism of peroxisome proliferator-activated receptor γ coactivator-1A(PPARGC1A) of rat offspring with gestational diabetes m...Objective:To discuss the effect of insulin and metformin on amethylation and glycolipid metabolism of peroxisome proliferator-activated receptor γ coactivator-1A(PPARGC1A) of rat offspring with gestational diabetes mellitus(GDM).Methods:A total of 45 pregnant rats received the intraperitoneal injection of streptozotocin to establish the pregnant rat model of GDM.A total of 21 pregnant rats with GDM were randomly divided into three groups,with 7ruts in each group,namely the insulin group,metformin group and control group.Rats in the insulin group received the abdominal subcutaneous injection of 1 mL/kg recombinant insulin glargine at 18:00 every day.Rats in the metformin group received the intragastric infusion of metformin hydrochloride at 18:00 every day,with the first dose of 300 mg/kg.The doses of two groups were adjusted every 3 d to maintain the blood glucose level at 2.65-7.62 mmol/L.Rats in the control group received the intragastric infusion of 1 mL normal saline at 18:00 every day.After the natural delivery of pregnant rats.10 offspring rats were randomly selected from each group.At birth,4 wk and 8 wk after the birth of offspring rats,the weight of offspring rats was measured.The blood glucose level of offspring rats was measured at 4wk and 8 wk,while the level of serum insulin,triglyceride and leptin was measured at 8 wk.Results:The weight of offspring rats at birth in the insulin group and metformin group was significantly lower than the one in the control group(P<0.05),and there was no significant difference at 4 wk and 8 wk among three groups(P>0.05).The fasting blood glucose and random blood glucose in the insulin group and metformin group at 4 wk and 8 wk were all significantly lower than ones in the control group(P<0.05);there was no significant difference between the insulin group and metformin group(P>0.05).The expression of PPARGC1 A mRNA in the insulin group and metformin group was significantly higher and the methylation level of PPARGC1 A was significantly lower than the one in the control group(P<0.05),but there was no significant difference between the insulin group and metformin group(P>0.05).Insulin and leptin at 8 wk in the insulin group and metformin group were significantly higher,while triglyceride was significantly lower than the one in the control group(P<0.05);triglyceride level of rats in the insulin group was significantly higher than the one in the metformin group(P<0.05).There was no significant difference in insulin and leptin level of offspring rats between the insulin group and metformin group(P>0.05).Conclusions:GDM can induce the methylation of PPARGC1 A of offspring rats to reduce the expression of PPARGC1 A mRNA and then cause the disorder of glycolipid metabolism when the offspring rats grow up;the insulin or metformin in the treatment of pregnant rats with GDM can reduce the methylation level of PPARGC1 A and thus improve the abnormal glycolipid metabolism of offspring rats.展开更多
Background The incidence of pediatric pulmonary embolism is increasing,with varying clinical characteristics,severity,and prognosis.Compared with data from adults,data and knowledge regarding the prognosis of pediatri...Background The incidence of pediatric pulmonary embolism is increasing,with varying clinical characteristics,severity,and prognosis.Compared with data from adults,data and knowledge regarding the prognosis of pediatric pulmonary embolism are scarce.This study aims to study the overall prognosis of pediatric pulmonary embolism and explore its influencing factors.Methods The study included patients diagnosed with pulmonary embolism aged 1–18 years across eight tertiary referral hospitals from January 1,2003,to December 31,2023.Pulmonary embolism was diagnosed on the basis of clinical presentation with imaging evidence.The overall prognosis of children with pulmonary embolism was reported,and its influencing factors were analyzed.Results A total of 196 children were enrolled,with a median age of 11.8(7.9,15.4)years,113 males(58%)and 186 Han(95%).The overall mortality rates were 2.2%at 30 days,3.4%at 90 days,and 5.1%during the entire follow-up period.The pulmonary embolism-related mortality rates were 1.6%(30 days),2.7%(90 days),and 2.6%(entire follow-up period).Deep vein thrombosis at other sites occurred in 2.7%(30 days),4.1%(90 days),and 7.6%(entire follow-up period)of the children.Among the 148 children who underwent repeat imaging examinations,119(81%)achieved complete remission;24(16%)achieved partial remission;and 4(3%)experienced recurrence or progression during the follow-up period.Multivariable logistic regression analysis revealed that tachypnea,co-infection,and underlying disease of the tumor were independent risk factors for compound adverse events(death,pulmonary embolism progression/recurrence,and deep vein thrombosis at other sites)within 90 days.Conclusions The short-term mortality of children with pulmonary embolism was relatively low.Children with pulmonary embolism who had tachypnea,co-infection,or underlying disease of the tumor were at increased risk of compound adverse events within 90 days.展开更多
Background This study aimed to identify survival risk factors in Chinese children with hepatoblastoma(HB)and assess the effectiveness of the new treatment protocol proposed by the Chinese Children's Cancer Group(C...Background This study aimed to identify survival risk factors in Chinese children with hepatoblastoma(HB)and assess the effectiveness of the new treatment protocol proposed by the Chinese Children's Cancer Group(CCCG)in 2016.Methods A multicenter,prospective study that included 399 patients with HB from January 2015 to June 2020 was con-ducted.Patient demographics,treatment protocols,and other related information were collected.Cox regression models and Kaplan-Meier curve methods were used.Results The 4-year event-free survival(EFS)and overall survival(OS)were 76.9 and 93.5%,respectively.The 4-year EFS rates for the very-low-risk,low-risk,intermediate-risk,and high-risk groups were 100%,91.6%,81.7%,and 51.0%,respec-tively.The 4-year 0S was 100%,97.3%,94.4%,and 86.8%,respectively.Cox regression analysis found that age,tumor rupture(R+),and extrahepatic tumor extension(E+)were independent prognostic factors.A total of 299 patients had complete remission,and 19 relapsed.Patients with declining alpha-fetoprotein(AFP)>75%after the first two cycles of neoadjuvant chemotherapy had a better EFS and OS than those≤75%.Conclusions The survival outcome of HB children has dramatically improved since the implementation of CCCG-HB-2016 therapy.Age≥8 years,R+,and E+were independent risk factors for prognosis.Patients with a declining AFP>75%after the first two cycles of neoadjuvant chemotherapy had better EFS and OS.展开更多
基金supported by Shandong Natural Science Fund(Y2008c170)
文摘Objective:To discuss the effect of insulin and metformin on amethylation and glycolipid metabolism of peroxisome proliferator-activated receptor γ coactivator-1A(PPARGC1A) of rat offspring with gestational diabetes mellitus(GDM).Methods:A total of 45 pregnant rats received the intraperitoneal injection of streptozotocin to establish the pregnant rat model of GDM.A total of 21 pregnant rats with GDM were randomly divided into three groups,with 7ruts in each group,namely the insulin group,metformin group and control group.Rats in the insulin group received the abdominal subcutaneous injection of 1 mL/kg recombinant insulin glargine at 18:00 every day.Rats in the metformin group received the intragastric infusion of metformin hydrochloride at 18:00 every day,with the first dose of 300 mg/kg.The doses of two groups were adjusted every 3 d to maintain the blood glucose level at 2.65-7.62 mmol/L.Rats in the control group received the intragastric infusion of 1 mL normal saline at 18:00 every day.After the natural delivery of pregnant rats.10 offspring rats were randomly selected from each group.At birth,4 wk and 8 wk after the birth of offspring rats,the weight of offspring rats was measured.The blood glucose level of offspring rats was measured at 4wk and 8 wk,while the level of serum insulin,triglyceride and leptin was measured at 8 wk.Results:The weight of offspring rats at birth in the insulin group and metformin group was significantly lower than the one in the control group(P<0.05),and there was no significant difference at 4 wk and 8 wk among three groups(P>0.05).The fasting blood glucose and random blood glucose in the insulin group and metformin group at 4 wk and 8 wk were all significantly lower than ones in the control group(P<0.05);there was no significant difference between the insulin group and metformin group(P>0.05).The expression of PPARGC1 A mRNA in the insulin group and metformin group was significantly higher and the methylation level of PPARGC1 A was significantly lower than the one in the control group(P<0.05),but there was no significant difference between the insulin group and metformin group(P>0.05).Insulin and leptin at 8 wk in the insulin group and metformin group were significantly higher,while triglyceride was significantly lower than the one in the control group(P<0.05);triglyceride level of rats in the insulin group was significantly higher than the one in the metformin group(P<0.05).There was no significant difference in insulin and leptin level of offspring rats between the insulin group and metformin group(P>0.05).Conclusions:GDM can induce the methylation of PPARGC1 A of offspring rats to reduce the expression of PPARGC1 A mRNA and then cause the disorder of glycolipid metabolism when the offspring rats grow up;the insulin or metformin in the treatment of pregnant rats with GDM can reduce the methylation level of PPARGC1 A and thus improve the abnormal glycolipid metabolism of offspring rats.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)(Grant Numbers 2022-I2M-C&T-B-009).
文摘Background The incidence of pediatric pulmonary embolism is increasing,with varying clinical characteristics,severity,and prognosis.Compared with data from adults,data and knowledge regarding the prognosis of pediatric pulmonary embolism are scarce.This study aims to study the overall prognosis of pediatric pulmonary embolism and explore its influencing factors.Methods The study included patients diagnosed with pulmonary embolism aged 1–18 years across eight tertiary referral hospitals from January 1,2003,to December 31,2023.Pulmonary embolism was diagnosed on the basis of clinical presentation with imaging evidence.The overall prognosis of children with pulmonary embolism was reported,and its influencing factors were analyzed.Results A total of 196 children were enrolled,with a median age of 11.8(7.9,15.4)years,113 males(58%)and 186 Han(95%).The overall mortality rates were 2.2%at 30 days,3.4%at 90 days,and 5.1%during the entire follow-up period.The pulmonary embolism-related mortality rates were 1.6%(30 days),2.7%(90 days),and 2.6%(entire follow-up period).Deep vein thrombosis at other sites occurred in 2.7%(30 days),4.1%(90 days),and 7.6%(entire follow-up period)of the children.Among the 148 children who underwent repeat imaging examinations,119(81%)achieved complete remission;24(16%)achieved partial remission;and 4(3%)experienced recurrence or progression during the follow-up period.Multivariable logistic regression analysis revealed that tachypnea,co-infection,and underlying disease of the tumor were independent risk factors for compound adverse events(death,pulmonary embolism progression/recurrence,and deep vein thrombosis at other sites)within 90 days.Conclusions The short-term mortality of children with pulmonary embolism was relatively low.Children with pulmonary embolism who had tachypnea,co-infection,or underlying disease of the tumor were at increased risk of compound adverse events within 90 days.
基金supported by the Shanghai Municipal Hospital New Frontier Technology Joint Key Project,Shanghai,China(No.SHDC12019115).
文摘Background This study aimed to identify survival risk factors in Chinese children with hepatoblastoma(HB)and assess the effectiveness of the new treatment protocol proposed by the Chinese Children's Cancer Group(CCCG)in 2016.Methods A multicenter,prospective study that included 399 patients with HB from January 2015 to June 2020 was con-ducted.Patient demographics,treatment protocols,and other related information were collected.Cox regression models and Kaplan-Meier curve methods were used.Results The 4-year event-free survival(EFS)and overall survival(OS)were 76.9 and 93.5%,respectively.The 4-year EFS rates for the very-low-risk,low-risk,intermediate-risk,and high-risk groups were 100%,91.6%,81.7%,and 51.0%,respec-tively.The 4-year 0S was 100%,97.3%,94.4%,and 86.8%,respectively.Cox regression analysis found that age,tumor rupture(R+),and extrahepatic tumor extension(E+)were independent prognostic factors.A total of 299 patients had complete remission,and 19 relapsed.Patients with declining alpha-fetoprotein(AFP)>75%after the first two cycles of neoadjuvant chemotherapy had a better EFS and OS than those≤75%.Conclusions The survival outcome of HB children has dramatically improved since the implementation of CCCG-HB-2016 therapy.Age≥8 years,R+,and E+were independent risk factors for prognosis.Patients with a declining AFP>75%after the first two cycles of neoadjuvant chemotherapy had better EFS and OS.
