Biliary atresia (BA) is a kind of disease of unknown etiology, characterized by progressive inflammation and fibrosis of obstructive biliary diseases. Kasai portoenterostomy is the only method to treat BA. However, about 80% of the patients treated by Kasai operation still need liver transplantation in the future. Many factors affect the survival of autologous liver in children with BA after Kasai operation, including the types of BA, laparoscopic Kasai surgery or traditional open surgery, patient’s age at surgery, condition of liver function, occurrence of cholangitis, jaundice clearance, using steroids and central hospitalization. This article reviews the factors that affect the survival of autologous liver in patients with BA after Kasai surgery.

Objective To investigate the protective effect of penotoxffylline (PTX) on renal iscbemia-reperfusion injury (IRI) and its mechanisns. Method Seventy-five male SD rats were randomly divided into three groups with 25 rats in each group: the sham operated controls, Iri group and FIX treated group. The rat model of renal IRI was established with occlusion of left and fight kidney pedicle for 45 minutes. Sham rats underwent laparotomy without IR.Treated mrs received FIX 20 mg/kg at 30 minutes before operation through their tail vein,tben PTX 6 mg/(kg·h) IV with pump. SO group and IRI group rots were IV normal saline equivalently. The pathological change of kidney, serum creatinine (sCr) values and the levels of MDA,SOD,TNF-α and ICAM-1 in homogenate of kidney tissue were measured before ischemia, 0, 1, 4, and 24 hours after reperfitsion. Results After IRI, renal tubular epithelial cells manifested swelling, degeneration, necrosis, and inflammatory ceils infiltration. After treated with PTX, the pathological change of the kidney was significantly alleviated, and inflammatory cells infiltration reduced. In FIX group,the kidney tissue pathological change was ameliorated, and the values of serum Cr, the scores of renal tubules were significantly lower than those in IRI group (P<0.05). Compared with IRI group, the levels of TNF-α in bemegenate of kidney in FIX group were significandy lower at 0 h, 1 h,4 h and 24 h after reperfiJsion (P<0.05). Compared with IRI group, the levels of MDA, ICAM-I in homogenate of kidney in FIX group were obviously lower at4 h, 24 h after reperfusion (P<0.05), while the level of SOD in homogenate of kidney was significantly higher (P<0.05). TNF-α correlated with levels of MDA, SOD, ICAM-1 ( r =0.801, -0.895,0.838,and P<0.01). Conclusions PTX had the protective effect on renal IRI by directly inhibited expression of TNF-α in kidney tissue,then decreased expression of MDA, ICAM-1 and ameliorated the inflammatory ceils infiltration in kidney.

Objective:To investigate the root and canal morphology of mandibular first permanent molars in adolescents by cone-beam computered tomography (CBCT).Methods:366 mandibular first permanent molars in 1 83 adolescents aged 1 2 -1 6 years were examined by CBCT from July,201 2 to December,201 3.The age,sex,the number of roots and canals and canal morphology were re-corded.The data were statistically analyzed by software SPSS 1 9.0.Results:365 mandibular first permanent molars showed single mesial root except one with C-shaped root;282(77.05%)teeth had one distal root,83(22.68%)had two.356(97.27%)teeth had two mesial canals and 9(2.46%)had one.229(62.57%)teeth had one distal root with one canal,53(1 4.48%)had one distal root with two canals.83(22.68%)had two distal roots with one canal in each root,one (0.27%)had C-shaped root with three canals. There were no significant differences between males and females and between the two sides on the number of roots and number of ca-nals.Conclusion:Majority of mandibular first molars have two roots,the root change occurs in distal root.The prevalence of three-rooted mandibular first molars has no significant difference between genders and 2 sides.

Objective The purpose of this study was to describe the clinical and CT features in Cryptogenic organizing pneumonia(COP),and method of managemant.Methods We reviewed characteristics of clinical,laboratory,chest CT and pulmonary function test of 6 patients with histologically proven COP,and evaluated their therapeutic response to corticosteroids.Results Most patients of 6 cases manifested as a persistent nonproductive cough,exerting dyspnea,pyrexia,malaise,and weight loss clinically.Less common symptoms include pleuritic chest pain and hemoptysis.Chest CT manifestations included ground-glass opacity,consolidation,diffusing reticular infiltration of parenchyma,pleural effusion,cavitation and migration.The patients had high level of peripheral WBC number,erythrocyte sedimentation,and C-reactive protein.Pulmonary function tests showed a impairment of restrictive pattern and diffusion capacity.All but one Patients responsed well to corticosteroids.Conclusions COP is a rapidly developing pneumonia-like illness characterized by lung inflammation,The clinical doctor must always be aware of the full view of COP so as to achieve successful diagnosis.Most of the patient can recover with corticosteroids therapy.

Case analysis method,which was a new teaching mode,was proposed for some problems in current traditional teaching mode.The concrete operation content of case analysis method in lemological teaching was described.The results of the survey analysis showed that the teaching effectiveness of the new teaching mode was obviously better than that of traditional teaching mode.

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS).Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College.In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis.Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively.Categorical variables were showed in rate and compared using chi-square test.Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05).In SFTSV infection group, the mean fever duration was (8.81±3.17) d.There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance.No patient received dialysis.The average length of hospital stay was (13.44±7.91) d.In HFRS group, the mean fever duration was (5.96±2.20) d.In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder.Twelve cases received dialysis treatment in this group.The average length of hospital stay was (18.04±15.75) d.Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05).The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05).However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115).Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases.

Objective To evaluate the changes of serum tumor markers of carbohydrate antigen 125 (CA125),carbohydrate antigen 199 (CA199),carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) during anti-tuberculosis treatment in patients with active pulmonary tuberculosis and tuberculous pleurisy.Methods This research was a prospective study.Sixty-three patients with active pulmonary tuberculosis and 24 patients with tuberculous pleurisy underwent blood samplings before treatment,2 and 6 months after treatment.Centaur XP chemiluminescent immunoassay was used to test serum levels of CA125,CA199,CEA and SCC.Thirty healthy subjects were included as controls.Student t-test was used to compare continuous variables,and chi-square test or Fisher exact test was used to compare categorical variables.Serial changes of serum tumor markers levels pre-and post-treatment were analyzed by repeated measures analysis of variance.Binary Logistic regression model was used for multivariate analysis.Results The mean serum CA125 level of the 63 patients with active pulmonary tuberculosis pre-treatment was (64.4± 30.4) U/mL,which was significantly higher than that of healthy controls ([12.7±5.5] U/mL,t=11.98,P＜0.01).The mean serum CA125 level decreased to (16.9±6.1) U/mL after 6 months standardized treatment,which was significantly lower than that before treatment (t=12.74,P＜0.01).While compared with healthy controls,the serum level of CA125 in patients who had completed the standardized treatment was not significantly different (t =0.94,P =0.348).When compared with the healthy controls,serum CA199,CEA,SCC levels in patients with active pulmonary tuberculosis before and after treatment showed no statistically significant difference (P＞ 0.05).Univariate analysis and multivariate analysis by Logistic regression analysis showed that bilateral pulmonary tuberculosis (x2 =7.746,P=0.006; OR=6.99,95％CI:1.73-28.22) and cavity pulmonary tuberculosis (x2 =6.254,P=0.012; OR=7.64,95％CI:1.64-35.35) were associated with increased serum CA125 level.The mean serum CA125 level of 24 cases of tuberculous pleurisy pre-treatment was (81.2 ± 37.6) U/mL,which was both significantly higher than that of patients with active pulmonary tuberculosis (t=2.153,P=0.034) and that of healthy controls (t=12.05,P＜0.01).Similarly,CA125 levels sharply decreased to (15.5 ± 7.3) U/mL after 6 months standardized treatment,which was not statistically significant compared with the control group (t=0.450,P=0.652).However,CA199,CEA and SCC levels in tuberculous pleurisy pre-and post-treatment were all not statistically different from those of healthy controls (all P＞0.05).Conclusion Serum CA125 can be used as a marker for assessing the disease progression and therapeutic efficacy for patients with active pulmonary tuberculosis and tuberculous pleurisy.

BACKGROUND:Currently, one of common methods is discectomy, nerve root decompression and fusion rigid fixation from the midline approach for disc herniation which is inefficient by conservative treatments. Thus, it is causing degeneration and limiting lumbar physiological activity of adjacent segments. The treatment of non-fusion lumbar disc herniation with the traditional posterior midline incision approach has some disadvantages such as big incision, wide peeling, and back muscle denervation.
OBJECTIVE:To observe therapeutic effects of dynamic stabilization system through Wiltse approach on lumbar disc herniation, and to compare the outcomes with traditional posterior approach.
METHODA total of 46 patients, who had undergone discectomy and internal fixation using dynamic stabilization systems for lumbar disc herniation at the Renmin Hospital of Wuhan University from January 2011 to January 2013, were enrol ed in this study. The operation was performed through the traditional posterior approach in 25 patients and Wiltse approach in 21 patients.
RESULTS AND CONCLUSION:Al 46 patients were fol owed up for 7 to 31 months (averagely, 13.8±2.4 months). The length of incision, intraoperative blood loss, and postoperative drainage amount were less in the Wiltse approach group than in the traditional posterior approach group (P<0.05). No significant difference in visual analog scale scores and operative time was detected between the two groups at 1 week and 6 months after fixation (P>0.05). Radiographs revealed that the position of implants was good in al patients, no loosing or breakage. These data verified that the early effect of dynamic stabilization system through Wiltse approach for lumbar disc herniation is similar to that of traditional posterior approach.

OBJECTIVE:To establish a method for the simultaneous determination of 7 active constituents in Tangshen qing-du granule. METHODS:HPLC was performed on the column of SHIMADZU Inert Sustain C18 with mobile phase of acetonitrile-0.1%phosphoric acid at a flow rate of 1.0 mL/min,detection wavelength was 327 nm for chlorogenic acid and caffeic acid,280 nm for baicalin,228 nm for arctiin and 276 nm for wogonoside,baicalein and wogonin,column temperature was 35℃,and injection volume was 10 μL. RESULTS:The linear range was 4.830-154.6 μg/mL for chlorogenic acid and(r=0.9998),0.750-24.1 μg/mL for caffeic acid(r=0.9997),22.859-731.5 μg/mL for baicalin(r=0.9997),8.491-271.7 μg/mL for arctiin(r=0.9993),2.471-79.0μg/mL for wogonoside(r=0.9996),6.656-213.0 μg/mL for baicalein(r=0.9994) and 2.756-88.2 μg/mL for wogonin (r=0.9998);RSDs of precision,stability and reproducibility tests were lower than 2.0%,recoveries were 96.86%-100.82%(RSD=1.46%,n=6),98.79%-101.09%(RSD=0.93%,n=6),97.57%-101.51%(RSD=1.37%,n=6),97.76%-99.63%(RSD=0.77%,n=6),97.99%-100.12%(RSD=0.76%,n=6),96.54%-101.07%(RSD=1.87%,n=6) and 96.60%-99.59%(RSD=1.14%,n=6). CONCLUSIONS:The method is simple with good precision,stability and reproducibilty,and can be used for the simultaneous determination of 7 active constituents in Tangshen qingdu granule.

Objective To evaluate the relationship between mRNA and protein expression of HtrA and Streptococcus mutans i-solated from the children with different caries experience and to provide the theoretical and experimental basis on prediction of dent-al caries in deciduous teeth .Methods The strains of Streptococcus mutans isolated from children with different carious experiences in the preliminary experiments were divided into three groups :high caries-susceptible group ,middle caries-susceptible group ,caries-free group .All strains were reanimated on the agar plate of MS ,and after smear pure culture examination ,typical bacteria were in-cubated in BHI ,then purified nucleic acid and extracted all the RNA of streptococcus mutans by reverse transcription PCR and de-tected it by agarose gel electrophoresis integrality .Synthetic cDNA and take further PCR amplification with cDNA products .Ob-serve records results by Gel imaging system .HtrA of target gene and electrophoresis image were gray scan by Gel quantitative soft-ware Gel-Pro analyzer 4 .0 was used to analyze relative expression value of gene .After purifying protein ,collected total protein of Streptococcus mutans strains by Western Blot method ,then tested the concentration of total protein sample .The results of Chemilu-minescence imaging were scanned into computer by Bio-Rad analyzing system ,calculated the gray value by software Quantity One 4 .4 .0 which showed the relative expression level of protein .Results There were significant differences in HtrA mRNA and protein expression of different Streptococcus mutans isolated from the children with different caries susceptibility .high caries-susceptible group> middle caries-susceptible group> caries-free group (P< 0 .05) .Conclusion There were significant differences in HtrA mRNA and protein expression of different Streptococcus mutans isolated from the children with different caries susceptibility .The higher caries susceptibility the group was ,the more HtrA mRNA and protein the strain express .