In order to evaluate the changes in T cell subsets after acute irradiation injury, and investigate the mechanism of deficiency of cellular immunity in acute irradiation syndrome, Balb/c mice were exposed to a single total body irradiation of 5Gy gamma rays from a 60 Co source. On days 10, 28 and 120, the amounts of CD4 + and CD8 + subsets in spleen cells were evaluated by flow cytometry (FCM), and expression of IL 4 gene in ConA stimulated spleen cells was evaluated by reverse transcription linked polymerase chain reaction, in which ?-actin gene was used as an internal control. It was found that after irradiation, the ratio of CD4 + /CD8 + became significantly higher than that of the controls, and then the ratio lowered gradually until day 120. However, it still did not return to the level of the controls. On day 10, expression of IL 4 gene at mRNA level increased significantly. The results indicated that CD8 + subset was more radiosensitive than CD4 + , and the pattern of cytokine seeretion shifted to that of Th2 soon after irradiation.

To evaluate the effects of combined therapy of rhIL 11 and rhG CSF on monkeys irradiated with 8 0 Gy 60 Co ? ray. Animals were divided into control ( n =4) and rhIL 11+rhG CSF treatment group ( n =4). After irradiation the control was given no treatment, while the treatment group was given rhIL 11 50?g/(kg.d)+rhG CSF 10?g/(kg.d) and other symptomatic supportive treatment whenever needed. The results showed that all animals underwent nausea, diarrhea and fever. After irradiation, all blood cells in peripheral blood of the animals declined in quantity rapidly. Animals of the control died of hemorrhage and infection. Their mean surviving time after ? ray exposure was 18 2 days. Aninals of the treatment group all survived on the 45th day after exposure. Their peripheral blood cell counts recovered to near baseline level. Histopathological observation revealed that bone marrow cells of treated animals proliferated actively. The results suggested that a combination of rhIL 11 and rhG CSF treatment was significantly effective in extremely severe hematopoietic acute radiation sickness.

Objective To evaluate the effect of surgical therapy for hepatolithiasis by hepatectomy and choledochofiberscopy. Method We retrospectively analyzed hepatolithiasis patients in our hospital during the past 5 years, comparing the therapeutic effect of different surgical modality. Data were analyzed by chi-square test. Result A total of 469 patients underwent surgical treatment, 412(87.85%) cases were followed up for an average of 3 years and 6 months. The residual calculus rate was 5. 14% and 14. 81% (x2 =9.32,P

Objective To investigate the effect of different sputum suction methods on the incidences of pulmonary infections in patients with mechanical ventilation.Methods Four hundred and sixty-six patients with mechanical ventilation were randomly divided into study group(n=219)and control group(n=247).The two groups were treated with continued balloon filling and airway humidification.Besides,the control group received conventional open sputum suction and the study group closed continuous negative pressure sputum suction.The two groups were compared in terms of incidence of pulmonary infections.Result The incidence of the study group(8.2%)was significantly lower than that of the control group(14.6%)(χ2=4.58,P<0.05).Conclusion Compared with the traditional open conventional sputum suction method,closed continuous negative pressure sputum suction may be more effective in reducing the incidence of pulmonary infection in patients with mechanical ventilation.

Objective To survey the incidence of hepatocellular carcinoma (HCC) in patients with HBV-related cirrhosis receiving nucleos(t)ide analogues treatment and to assess its risk factors.Methods A total of 141 patients with HBV-related liver cirrhosis receiving nucleos(t) ide therapy from April 2008 to June 2011 were enrolled.The clinical data including virological and biochemical tests were retrospectively analyzed.Univariate and multivariate Cox proportional hazards regression model was used to identify the risk factors of HCC occurrence.Results Patients were followed up for 6.4 to 87.6 months with a median followup time of 32.5 months.During the follow-up period,15 out of 141 patients developed HCC with an average annual incidence rate of 3.8％.HCC incidence was higher in HBeAg positive cirrhosis and in those with family history of liver cancer ( RR =4.524 and 3.858,P ＜ 0.05 ).Conclusions Patients with HBV-related cirrhosis have a high incidence rate of HCC even they recieve nucleos (t) ide analogues treatment.HBeAg positive cirrhosis and family history of liver cancer are independent risk factors for HCC.

Objective: To explore the clinical features and genetic characteristics of myoclonic-atonic epilepsy (MAE) caused by SLC6A1 gene mutation. Methods: The clinical data of a patient with SLC6A1 gene mutation from Xiangya Hospital of Central South University was collected. The related literatures were reviewed from Wanfang Data, China National Knowledge Infrastructure, PubMed (until July 2019) by using keywords " SLC6A1" and " myoclonic-atonic epilepsy" . The characteristics of SLC6A1 gene mutation and the clinical phenotype of children with myoclonic-atonic epilepsy were summarized. Results: A 8 year and 8 months old girl was enrolled in the study. Her first attack happened at the age of 19 months, and multiple seizure types including myoclonic-atonic, atonic and absence were observed. The seizures were well controlled by valproate (VPA), but she has mild-moderate intellectual disability. Whole exome-sequencing study identified a de novo nonsense variant of c. 46G>T(p.Glu16*)in SLC6A1 gene. A total of 27 cases including the present case with SLC6A1 gene mutation were analyzed. 22 mutations were identified, including 11 missense mutations, 5 nonsense mutations, 3 frameshift mutations, 2 splicing mutation and 1 with chromosome microdeletion. Among them 26 patients had more one type of seizures, 20 cases had absence seizures, 17 cases had atonic seizures, 14 cases had myoclonic seizures, 11 cases had myoclonic-atonic seizures, 4 cases had generalized tonic-clonic seizures, 3 cases had eyelid myoclonias, 2 cases had nonconvulsive status epilepticus and 2 cases had tonic seizure. 24 patients had described intelligence assessment. Among them, 18 had developmental delay before epilepsy onset, 11 had developmental regression after onset. There were 9 cases with autistic features, 4 cases with attention deficit hyperactivity disorder and 3 cases with ataxia. The seizures of 17 cases were controlled, 4 cases had partial seizure control, 3 cases had no significant improvement, and other 3 cases were unclear. Conclusions The main clinical feature of MAE patients with SLC6A1 gene mutations is absence and atonic seizures, cognition before epilepsy onset can be impaired, and some patients had behavioral problems, such as autistic features or attention deficit hyperactivity disorders. VPA is recommend as first-line treatment.

Objective To summarize the clinical features of global developmental delay (GDD) children,and to explore the relationship between severity of GDD and social-culture factors.Methods Sign the informed consent before enrollment.Collect clinical data in detail about 100 GDD children (GDD group) and 95 children with normal development (healthy control group),and analyze their regular clinical data,physical examination,intellectual disability test,electroencephalography (EEG) and cranial imaging test.Spearman rank correlation was used to analyze the differences of social and cultural factors between GDD group and healthy control group,such as maternal reproductive age,parental education level and family economic status.At the same time,we compared the lag degree of total developmental quotient and the degree of developmental retardation of five energy areas with the above factors.Results Significant associations were found between GDD and maternal/paternal education,economic level of family,but no sgnificant association was found between maternal age and GDD.And analysis in the relationship between severity of delay in all domains of the child's developmental status about language and social-culture factors,we only obtained the severity of delay in abilities about language is related with maternal education.Spearman rank correlation statistics explains that if there are the lower level of education with mothers,the delay of language domain will more severe (rs =-0.505,P ＜ 0.05).Conclusions Significant associations were found between GDD and maternal/paternal education,economic level of family.The higher maternal education was an important protective factor against risk of GDD.Improving the cognition of parents in child health care,early be diagnosed,early be intervened,is the most important for children with language development.

OBJECTIVE: To evaluate the surgical outcomes of laparoscopic splenectomy and to investigate the learning curve of laparoscopic splenectomy. METHODS: Forty cases of laparoscopic splenectomy (performed by W.Y. between September 2008 and August 2010) in our general surgery department were reviewed, and the cases were divided equally into 4 groups (group I, II, III, IV) according the time sequence of the operations. The operating time, blood loss, conversion to open surgery, conversion to hand-assisted laparoscopic splenectomy, postoperative hospital stay, postoperative liquid diet recovery time, intra- and postoperative complications and the operative frequency were compared. RESULTS: There were no statistical differences among the groups in age and gender (P>0.05). The operating time, blood loss and postoperative hospital stay of groups III and IV were significantly less than those of groups I and II (P<0 .05). Postoperative liquid diet recovery time appear to show a gradual shortening trend from Group I to Group IV, but the differences were not at standard statistical thresholds (P>0.05). Frequency of conversion to open surgery, of conversion to hand-assisted laparoscopic splenectomy, of complications among the four groups were also not statistically different (P>0.05). The operative frequency of group I-IV increased from 1.25/month to 2.5/month. CONCLUSION The learning curve of laparoscopic splenectomy for surgeon who was experienced in open splenectomy and laparoscope cholecystectomy is approximately 20 cases, and the operative frequency is about 1.33/month.
Adult ; Aged ; Blood Loss, Surgical ; statistics & numerical data ; China ; epidemiology ; Female ; Humans ; Intraoperative Complications ; epidemiology ; Laparoscopy ; methods ; Learning Curve ; Male ; Middle Aged ; Retrospective Studies ; Splenectomy ; methods ; Young Adult

Objective:To summarize the clinical manifestations and determine the molecular etiology for three KCNMA1-related neurological disorders.Methods:A retrospective clinical data analysis was performed on 3 patients with clinically and genetically diagnosed neurological diseases related to KCNMA1 gene variants who were diagnosed and treated in the Department of Pediatrics, Xiangya Hospital of Central South University from January 2020 to December 2022.Results:Case 1, a 4-year-old and 8-month-old female, was diagnosed with " episodes of head-raising and lowering for 11 months". The electroencephalogram (EEG) showed background theta rhythm in the occipital area, with mainly sharp waves and peaks in the bilateral central, parietal, occipital and temporal areas. Slow waves were scattered or paroxysmal, affecting the central, parietal, and temporal areas on the right side. Levetiracetam was given as an anti-epileptic treatment, and the seizures were completely controlled. Physical examination revealed unclear articulation and short stature. The patient′s mental development has been delayed since childhood. After 2 years of rehabilitation treatment, his motor development was normal and his language development was slightly delayed. Whole-exome sequencing found a novel c. 1807A>G (p.Thr603Ala) mutation in the KCNMA1 gene, which was graded likely pathogenic (LP). Case 2, a male, 1 year and 4 months old, went to the hospital because of " recurrent stupor attacks for more than 6 months". Nearly 20 epileptic events were detected on the electroencephalogram. Levetiracetam, sodium valproate and clonazepam were administered successively. Seizure treatment, complete seizure control. Brain magnetic resonance imaging (MRI) showed poor cerebellar development. Development was lagging behind that of normal children of the same age. Whole-exome sequencing found a novel c. 756C>A (p.Phe252Leu) mutation in the KCNMA1 gene, which was graded LP. Case 3, a 16-month-old female, went to the hospital because of " trembling upper limbs, slurred speech for more than 10 years, and unsteady gait for 8 years." The electroencephalogram showed no abnormalities, and brain MRI showed cerebellar atrophy. Physical examination: unclear speech, unsteady grasping of objects with both hands, muscle strength of limbs level 4, and ataxic gait. Whole-exome sequencing found a novel c. 1051T>C (p.Ser351Pro) mutation in the KCNMA1 gene, which was graded LP.Conclusions:The core phenotypes of KCNMA1 gene mutation-related neurological diseases include epilepsy, neurodevelopmental disorders and paroxysmal dyskinesia, and cerebellar atrophy is common in brain MRI.

Objective To explore the application effects of evidence-based nursing in percutaneous endoscopic gastrostomy ( PEG ) postoperative enteral nutrition and the effects of prevention and treatment of complications. Methods A retrospective and prospective cohort study method was adopted. The control group was composed of 58 cases of PEG enteral nutrition patients, on whom evidence-based nursing was not conducted before January 2013, while the intervention group was composed of 60 cases of PEG enteral nutrition patients, on whom evidence-based nursing was conducted after January 2013. Intervention effects of nursing were compared and analyzed between two groups. Results The incidence of complications in the intervention group (11. 67%) was significantly lower than that of the control group (43. 10%) (P<0. 01), and the incidence of infectious complications in the intervention group (5. 00%) was significantly lower than that of the control group (20.69%) (P<0. 01). There was no significant association between feeding time and complications (P >0. 05);there was significant association between ways of nutrition infusion and replacement rate of skin dressing (P<0. 01). Conclusions Application of evidence-based nursing in postoperative enteral nutrition of PEG patients can effectively prevent complications from happening, promote recovery of patients′ gastrointestinal function and overall nutritional status, and eventually shorten the time of hospitalization.