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Congenital portosystemic shunts (CPSS) are rare vascular anomalies that cause abnormal communications between the portal and systemic venous systems and may be incidentally detected on imaging or via abnormal laboratory parameters due to the lack of specificity in the condition's clinical presentation. Ultrasound (US) is a common tool for examining abdominal solid organs and vessels and is the initial imaging modality for diagnosing CPSS. Here we report the case of an 8-year-old Chinese boy with CPSS diagnosed using color Doppler US. Doppler US first found intrahepatic tumor, then revealed that the left portal vein was directly communicating with the inferior vena cava, and the boy was finally diagnosed with intrahepatic portosystemic shunts. Interventional therapy was employed to occlude the shunt. During the follow-up, the intrahepatic tumor disappeared and no complications. Hence, to be able to differentiate such vascular anomalies, clinicians should be fairly acquainted with the normal ultrasonographic anatomical features in daily clinical work. Furthermore, increased disease awareness and advances in imaging equipment and technology are essential for CPSS diagnosis.
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OBJECTIVE: Necrotizing enterocolitis (NEC) is a severe disease in newborns, this study aimed to investigate the protective effect of dimethyl fumarate (DMF) on NEC and its possible mechanism. METHODS: In vivo, the mice were divided into the control, NEC, and NEC+DMF group. The NEC model was established by artificial feeding, hypoxic for 4 days, and lipopolysaccharide (LPS) stimulation on day 2 and day 3. DMF (25 mg/kg/d) was administered to NEC mice on day 1 and day 3. On the 11th day, the blood and intestinal tissues of mice were taken for enzyme-linked immunosorbent assay (ELISA), pathological examination, quantitative real-time PCR (RT-qPCR), Western blot, and immunohistochemical (IHC) detection. In vitro, human colorectal cells (FHC) were induced by LPS (100 ng/mL) and was divided into the control, LPS, and LPS+DMF group. The effect of DMF (20 µM) on cell viability and TLR4 signal transduction was detected by MTT and RT-qPCR, respectively. RESULTS: Compared to the NEC mice, DMF attenuated NEC-induced weight loss and abdominal distension diarrhea in mice, and alleviated NEC-induced intestinal pathological injuries. In addition, DMF reduced the expression of IL-6, IL-1ß, TNF-α, NF-κB, and TLR4 in NEC mice intestinal tissues. Furthermore, DMF inhibited NEC-induced intestinal cell apoptosis as well as the protein expression of BCL2-Associated X (BAX), caspase-3, caspase-9, and increased Bcl-2 (B-cell lymphoma-2) expression. In vitro, DMF improved cell viability, and restrained NF-κB and TLR4 expression in LPS-induced NEC cells. CONCLUSION: DMF has a protective effect against intestine damage of NEC, which is related to the inhibition of the TLR signaling pathway, alleviating the inflammatory response.
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Enterocolitis Necrotizante , FN-kappa B , Animales , Ratones , Recién Nacido , Humanos , FN-kappa B/metabolismo , Dimetilfumarato/farmacología , Receptor Toll-Like 4/metabolismo , Enterocolitis Necrotizante/tratamiento farmacológico , Enterocolitis Necrotizante/prevención & control , Enterocolitis Necrotizante/metabolismo , Lipopolisacáridos/toxicidad , Transducción de Señal , Intestinos/patología , Modelos Animales de EnfermedadRESUMEN
BACKGROUND: Necrotizing enterocolitis (NEC) is a neonatal intestinal necrotizing disease caused by various factors in newborns. Sulforaphane (SFN) has a strong anti-inflammatory ability and a certain protective effect on intestinal diseases. OBJECTIVE: NEC is a common developed gastrointestinal exigency in an untimely baby. SFN is a naturally originated isothiocyanate that has beneficial effects on the intestinal system.The purpose of this study is to study the protective effect of SFN on endoplasmic reticulum stress (ERS)-related NEC. METHODS: The newborn mice were randomly divided into control (n = 15), NEC (n = 20), and NEC+SFN (n = 18) groups. Mice in NEC and SFN+NEC groups were injected with 0.1 µl normal saline or 20 mg/kg/d SFN, respectively. After that, the weight and survival of the mice were recorded every day. Then the mice were sacrificed after 96 h of modeling; ileum tissue and blood samples were collected for qPCR, Western blot, ELISA, HE staining, TUNEL staining, and immunohistochemistry assays. RESULTS: SFN significantly inhibited the mRNA expression of BIP, CHOP, IL-1ß and IL-6, and protein expression of Bax, Caspase-3, Caspase-9 and CHOP, and promoted the expression of Bcl-2 in ER-induced NEC mice intestinal tissues (P<0.01). Meanwhile, SFN could suppress the serum levels of IL-8, IL-10, IL-6, TNF-α, and IL-1ß, and positive expression of TLR4 and NF-κB (P<0.01), and promote the serum levels of IL-10. HE staining showed that SFN alleviated the NEC intestinal tissue injury, and TUNNEL staining showed that SFN could reduce the rate of NEC apoptotic cells (P<0.01). Moreover, SFN treatment improved the body weight and survival rate in NEC mice. CONCLUSION: SFN could effectively protect against ERS-induced inflammation and apoptosis in NEC mice.
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Enterocolitis Necrotizante , Mucosa Intestinal , Ratones , Animales , Mucosa Intestinal/metabolismo , Interleucina-10/metabolismo , Interleucina-10/farmacología , Interleucina-6/metabolismo , Enterocolitis Necrotizante/tratamiento farmacológico , Enterocolitis Necrotizante/metabolismo , Isotiocianatos/farmacología , Apoptosis , Inflamación/tratamiento farmacológico , Inflamación/metabolismo , Modelos Animales de EnfermedadRESUMEN
BACKGROUND: The brain is the most important organ to maintain life. However, the amount of brain tissue required for maintaining life in humans has not been previously reported. CASE SUMMARY: A 33-year-old woman fell from the third floor three months before admission to our department. She received a decompressive craniectomy soon after injury. After the operation, operative incision disunion occurred due to the high pressure. Brain tissue flowed from the incision, and intracranial infection occurred. She fell into deep coma and was sent to our hospital. Her right temporal surgical incision was not healed and had a cranial defect of 10 cm × 10 cm. Her intracranial cavity was observed from the skull defect, and the brain tissue was largely lost. In addition, no brain tissue was observed by visual inspection. Cranial computed tomography showed that only a small amount of brain tissue density shadow was compressed in the cerebellum and brainstem. Four days after hospitalization in our hospital, her parents transferred her to a hospital near her hometown. The patient died six days after discharge from our hospital. CONCLUSION: This rare case provides some proof of the importance of the brainstem in the maintenance of cardiac rhythm and vascular tension. Neurosurgeons should carefully protect brainstem neurons during operations. Clinicians can maintain the cardiac rhythm of patients who lose their major brain tissue with modern technology, but the family of the patients should be aware of death and end-life care.
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Objective: Necrotizing enterocolitis (NEC) is a serious neonatal disease; this study aims to investigate the role of sulforaphane (SFN) in NEC-induced intestinal injury. Methods: An animal model of NEC was established in newborn mice and intragastrically administrated with SFN; then, the general status and survival of the mice were observed. H&E staining was used to observe the pathological changes of intestinal tissues. ELISA, immunohistochemical staining, and flow cytometry assays were used to detect the levels of inflammatory factors, including TNF-α, IL-6, and IL-17, the expression of Bax, Bcl-2, TLR4, and NF-κB, and the percentages of the Th17 and Treg cells, respectively. GSK-3ß expression levels were measured by immunofluorescence. IEC-6 and FHC cells were induced with LPS to mimic NEC in vitro and coincubated with SFN; then, the inflammatory factor levels and cell apoptosis rate were detected. Finally, Western blot was used to assess the expression of PI3K/Akt/GSK-3ß pathway-related proteins in vitro and in vivo. Results: SFN improved the survival rate of NEC mice during modeling, alleviated the severity of the intestinal injury, and reduced the proportion of Th17/Treg cells. SFN could inhibit TLR4 and NF-κB levels, decrease the release of inflammatory factors TNF-α and IL-6, suppress Bax expression, increase Bcl-2 expression, and inhibit apoptosis both in in vitro and in vivo models of NEC. Meanwhile, SFN regulated the expression of PI3K/Akt/GSK-3ß pathway-related proteins in vitro and in vivo. Conclusion: SFN relieved the inflammatory response and apoptosis by regulating the PI3K/Akt/GSK-3ß signaling pathway, thereby alleviating NEC in model mice and cells.
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Enterocolitis Necrotizante , Isotiocianatos , Sulfóxidos , Animales , Humanos , Recién Nacido , Ratones , Proteína X Asociada a bcl-2 , Enterocolitis Necrotizante/tratamiento farmacológico , Enterocolitis Necrotizante/patología , Glucógeno Sintasa Quinasa 3 beta/metabolismo , Enfermedades del Recién Nacido , Interleucina-6 , Isotiocianatos/farmacología , FN-kappa B/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Transducción de Señal , Sulfóxidos/farmacología , Receptor Toll-Like 4 , Factor de Necrosis Tumoral alfaRESUMEN
Objective: Necrotizing enterocolitis (NEC) is one of the commonest gastrointestinal critical diseases in newborns. Several researches have proven the efficacy of melatonin (MEL) on NEC, but the latent mechanisms were ambiguous. We designed the current research to evaluate the function and mechanism of MEL on NEC in a neonatal mouse model. Methods: The newborn mice were subjected to formula milk containing LPS and hypoxia to establish a NEC model and also intraperitoneally injected with MEL. During the experiment, all mice were closely monitored and weighed. The effect of MEL on the histopathological injury of the terminal ileum tissues, inflammation, and oxidative stress of serum in NEC mice was examined by hematoxylin-eosin (H&E) staining and ELISA. The effect of MEL on the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome was assessed via quantitative real-time PCR and Western blot. Results: MEL intensified the survival rate and body weight in NEC mice. The H&E staining illustrated that MEL improved the histopathological injury in NEC mice. Moreover, MEL repressed the IL-1ß, TNF-α, and MDA levels of serum and enhanced the SOD and GSH-Px levels of serum in NEC mice. We also discovered that MEL attenuated the mRNA and protein levels of NLRP3, Toll-like Receptor 4 (TLR4), NF-κB, and caspase-1 of the terminal ileum tissues in NEC mice. Conclusion: Our research illuminated that MEL attenuated the severity of NEC via weakening the activation of the NLRP3 inflammasome.
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BACKGROUND: Hairy polyps are the most common congenital deformity of the oral-nasopharynx/oral cavity in infants, which may lead to severe complications in the newborns. However, few studies have been published with respect to their radiological features, and most are case reports. OBJECTIVE: This study aimed to analyze radiological features of the oralnasopharyngeal hairy polyps and to identify the radiological features with the highest diagnostic value. MATERIALS AND METHODS: From 2014 to 2019, pediatric cases pathologically diagnosed as hairy polyps and having received radiological examination at the Children's Hospital Affiliated to Zhejiang University were retrospectively analyzed. Radiological evaluations were conducted on tumor size, location, morphology, density or signal features as well as the enhancement pattern. RESULTS: A total of six infants were recruited. Clinical features observed in these cases included choking on milk with cyanosis, intermittent dyspnea, oropharyngeal mass, and snoring. Lesions were derived from the left tubal torus in three out of six cases, from the left lateral aspect of soft palate in one, from the left lateral pharyngeal wall in one, and from the right tubal torus in one. They were shown as pedicled polyp-like well-circumscribed mass with fat density or signal as well as a stalk on CT or MRI. In the contrast-enhanced scan, the fat components were not enhanced, while the stalk was mildly enhanced. CONCLUSION: Hairy polyps had typical radiological features. Hairy polyps should be considered for pedicled polyp-like well-circumscribed mass in the oral-nasopharynx of infants with fat density or signal as well as a stalk.
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Pólipos , Niño , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Paladar Blando/patología , Pólipos/diagnóstico por imagen , Pólipos/patología , Estudios RetrospectivosRESUMEN
Langerhans cell histiocytosis (LCH) is a rare disease, and the diagnosis of LCH is mainly based on clinical manifestation, imaging and pathological examinations. But during pregnancy, imaging examinations especially play an important role in the diagnosis and prognostic assessment of fetal LCH. Up to now, there has been no report about magnetic resonance imaging (MRI) features of fetal LCH. We reported a 32-year-old woman at 36 weeks' gestation took fetal MRI because of fetal anomalies diagnosed by ultrasonography. On the fetus's MR images, the thymus was slightly enlarged with smooth or lobulated contour in supra anterior mediastinum, displayed heterogeneous signals and contained multiple small cysts on T2WI. Innumerable irregular nodules and patchy shadows were present throughout both lungs. Pulmonary lesions were bilateral and diffuse with relative sparing of the costophrenic angles. The margins of these lesions were fluffy and indistinct. These lesions showed heterogeneous signals on T2WI. MRI showed no lesions in skin region. After birth, lots of round or oval skin lesions distributed all over the baby's body presenting as ulcerated or blister-like rashes. The chest computer tomography (CT) showed punctate calcification and heterogeneous enhancement in the thymus and bilateral diffuse reticular or reticulonodular opacities in both lungs with fluffy and indistinct margins. Pathological finding was consistent with LCH. Through reporting MRI features of LCH in one fetus, this study aims to improve awareness of fetal LCH in radiologists and clinicians, to improve the prenatal diagnostic rate of this disorder.
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Histiocitosis de Células de Langerhans , Enfermedades de la Piel , Adulto , Femenino , Feto , Edad Gestacional , Histiocitosis de Células de Langerhans/diagnóstico por imagen , Humanos , Lactante , Imagen por Resonancia Magnética , EmbarazoRESUMEN
OBJECTIVE: To investigate the effects of Shuwei Decoction (, SWD) on gastric emptying, serum stem cell factor (SCF), the content of serum nitric oxide (NO), and structure change of interstitial cells of Cajal (ICC) in functional dyspepsia (FD) rats. METHODS: Sixty Sprague Dawley rats were randomly divided into 6 groups: blank group (group A), model group (group B), mosapride group (group C), Muxiang Shunqi Pill (, MSP) group (group D), SWD low-dose group (group E), and SWD high-dose group (group F), 10 rats in each group. FD rat model was established by clasping rats' tails for 7 days, except the group A. After 3 days, group A and group B were given distilled water, and the medicated rats were given corresponding medicine for 14 days. The gastric emptying, structure change of ICC in gastric antrum by transmission electron microscope, the content of serum NO by nitrate reductant and SCF by enzyme linked immunosorbent assay were observed. RESULTS: Compared with group A, the rats in group B delayed gastric emptying, serum SCF decreased, serum NO increased (P <0.05). Compared with group B, the rats in groups D, E and F were improved on gastric emptying, obviously increased on serum SCF, decreased on serum NO (P <0.05), and structure change of ICC in gastric antrum improved. Compared with group B, structure change of ICC of group E after treatment was improved and was closed to group A. CONCLUSION: SWD recovered gastrointestinal motility of FD, possibly by regulating the levels of serum NO and SCF, and improving the structure of ICC in gastric antrum.