Objective To investigate the optimized parameters of dye (SYBR Green Ⅰ) realtime fluorescent polymerase chain reaction (RF-PCR) for detecting αβT lymphocyte clones in the peripheral blood and its application in monitoring specific T cell clone in the peripheral blood mononuclear cells (PBMC) from patients with chronic hepatitis B (CHB). Methods The total RNA was extracted from the PBMC of six healthy donors, and was reversely transcripted into cDNA. Then the cDNA was amplified using RF-PCR with the primers specific for T cell receptor β viable region (TCRBV) gene families as upstream primers and the primer for T cell receptor (TCR) β constant region (TCRBC) as downstream primer. The annealing temperature,concentration of primers and the total number of cycles were comparatively analyzed. The optimized PCR was performed to investigate the 24 TCRBV gene families from 12 patients with CHB, and the PCR products were monitored by melting curve analysis, and the clone expansion of peripheral blood T cell was detected by peak-motif of melting curve analysis. Results The optimized annealing temperature, final premier concentration,the number of cycles were 60.6 ℃, 0.5 μmol/L and 40 cycles, respectively. The begin temperature for melting curve analysis was better as 80 ℃ compared to 75 ℃. There was mono-peak on melting peak chart for TCRBV gene families in PBMC from patients with CHB, and PCR products of the single peak were determined as monoclonal T cell by sequencing. Conclusions The optimized reaction parameters of RF-PCR for monitoring 24 TCRBV gene families are determined. The melting peak chart could be used to monitor the clone expansion of the peripheral lymphocytes and to detect the clone-specific T cells in the peripheral blood from patients with CHB.

Objective To explore the distributions of genotypes of HPV infection in CIN and cervical carcinoma. Methods Cervical exfoliated cells were collected from 365 patients with abnormal cervical histology , and subjected to genotyping assay. Results The most prevalent HPV types were 16, 18,52, 58 and 33. The prevalence ratio of HPV 33,52,58 was signi cantly lower in squamous cell carcinoma. Multiple infections decreased from CIN II/III to cervical cancer. Conclusion Besides HPV 16/18, the 52/58/33 subtypes are also important in the development of cervical cancer.

Objective:To compare the nutritional status of inpatients after enteral nutrition (EN) and parenteral nutrition (PN). Method: A multi-center survey of 1 142 inpatients from the Department of gastrointestinal surgery, thoracic surgery, gastroenterology, respiratory disease, neurology, neurosurgery and the intensive care unit of 6 general hospitals in Beijing and Shanghai was adopted in this study. Body weight (BW), haemoglobin (Hb) and serum albumin (sALB) were compared before and after EN or PN respectively. Results: BW, Hb and sALB all decreased after the nutritional support both in EN and PN groups, but only significantly in BW and sALB (BW: -1.58?2.36 kg/m2 vs -2.09?2.66 kg/m2, P

AIM: To investigate the effects of berberine (Ber) on ion transport and hypersecretion induced by cholera toxin(ChT) in ileum and its mechanism. METHODS: Ussing Chamber technique was used to measure the potential difference(PD), short-circuit current(SCC), and the resistance(R) in isolated guinea-pig ileum. The effects of Ber on PD, SCC and R in glucose Tyrode solution or glucose-free Tyrode solution were examined. The secretory diarrhoea model was made by ChT to investigate the effects of ChT and ChT+Ber on PD, SCC and R. RESULTS: (1)The PD and SCC were decreased in glucose Tyrode solution by the Ber added in mocosal side or in serosal side in ileum of normal guinea-pig and which was with secretory diarrhoea ( P

OBJECTIVE To discuss the related factors of toxigenic Helicobacter pylori(Hp) infection among adult population in Futian District,Shenzhen.METHODS A total of 1164 adults who had health examination in community centers were investigated through questionnaire and detected Hp antibodies.RESULTS The Hp and toxigenic Hp infection rates among them were 45.5% and 14.2%.Among them 46.3% and 14.8% were in males,and 44.7% and 13.4% in females.People less than 60 years old had higher incidence of Hp and toxigenic Hp,but decrease in people rnore than 60 years old.Hp and toxigenic Hp infection rate in married people were higher than those of unmarried.In workers,farmers and doctors were higher than staff and other occupations.The incidence were higher in drinking raw water than those drinking boiling water.in taking antibiotics before serologic examination were lower than no taking antibiotics;in peptic ulcer disease were higher than in no peptic ulcer disease;in per capita housing area over 6 m2 were higher than less 6 m2.CONCLUSIONS The infection rates of Hp and toxigenic Hp among our adult population are low,and positively correlated with age but gender.The social environment such as living condition,economic income,culture level and residential density maybe influence the infection of Hp.The route of transmission of Hp is unknown yet,water perhaps is an important dissemination medium.

Objective: To investigate the difference in the clinical efficacy by thoracoscopy or thoracotomy for treating esophageal atresia. Methods: Thirty-one cases of type-Ⅲ esophageal atresia undergoing surgical treatment from February 2015 to May 2018 at the Department of Pediatric Surgery of Fujian Provincial Maternity and Children′s Hospital were included, and according to the different surgical methods they were divided into thoracoscopic group (15 cases) and thoracotomy group (16 cases). The operation duration, blood loss, postoperative chest drainage time, posto-perative hospital stay and postoperative complications were analyzed between 2 groups. Results: The mean time of operation was (181.33±13.86) min in the thoracoscopic surgery group and (139.06±10.98) min in the thoracotomy group, the thoracoscopic group had longer operation duration than thoracotomy group, and there was a significant difference in operation duration between two groups (t=9.44, P=0.000); mean blood loss was (3.07±0.96) mL in the thoracoscopic surgery group and (5.06±1.12) mL in the thoracotomy group, the thoracoscopic group had less amount of blood loss than thoracotomy group, and there was a significant difference in blood loss between two groups(t=-5.29, P=0.000); mean postoperative chest drainage time was(11.67±1.34) d in the thoracoscopic group and (12.25±1.06) d in the thoracotomy group, and there was no significant difference in postoperative chest drainage time between two groups(t=-1.34, P=0.19); mean time of postoperative hospitalization time was(15.20±0.94) d in the thoracoscopic group and (16.00±0.96) d in the thoracotomy group, and there was a significant difference in the postoperative hospitalization time between two groups (t=-2.33, P=0.027); the anastomotic leak rates were 33.33% (5 cases) versus 25.00% (4 cases) with closed or open approaches, respectively; anastomotic stricture rates were 40.00%(6 cases) versus 31.25% (5 cases) with closed or open approaches, respectively.There was no significant difference in postoperative incidence of anastomotic fistula and anastomotic stenosis between two groups. Conclusions Compared with thoracotomy in the treatment of esophageal atresia, thoracoscopic approach has smaller incision and less bleeding, less chest deformity, short hospital stay postoperatively, so it is safe and effective.However, the surgeon must have experience in doing thoracoscopic operation.

OBJECTIVEA first report of 3 patients who developed hypofibrinogenemia due to long-term administration of hemocoagulase.

METHODSThe clinical data of three patients with hypofibrinogenemia due to long-term administration of hemocoagulase were analyzed, and the related literature was reviewed.

RESULTSCase 1, a two-year old girl, had liver traumatic rupture and then treated with massive transfusion and fibrinogen infusion in addition to intravenous recombinant factor VIIa (two times) and hemocoagulase (2 U/d). The liver wound bleeding was soon stopped. However, her plasma fibrinogen level decreased to 0.12 g/L after continuous administration of hemocoagulase for 18 days. Case 2, a three-year old boy, had liver traumatic rupture and was treated with surgical repair, and then received hemocoagulase (2 U/d). On the 8th day, a large amount of blood was found to exude from abdominal cavity drainage tube and indwelling venous catheter, and his fibrinogen dropped to 0.24 g/L. Case 3 was a 45 year-old man who underwent a total mandibular resection because of malignant tumor, and he was given hemocoagulase (4 U/d). A continuous blood oozing was noted from his operation incision, and his fibrinogen level decreased to 0.25 g/L. All the three patients'plasma fibrinogen levels and coagulation tests returned to normal ranges after discontinuation of hemocoagulase administration and supplement of fibrinogen, and the bleeding stopped in cases 2 and 3.

CONCLUSIONLong-term use of hemocoagulase could induce hypofibrinogenemia and severe bleeding.

Afibrinogenemia ; chemically induced ; Batroxobin ; administration & dosage ; adverse effects ; Blood Coagulation ; Child, Preschool ; Female ; Fibrinogen ; analysis ; Humans ; Male ; Middle Aged

OBJECTIVETo observe the clinical efficacy differences between electroacupuncture (EA) and regular treatment for severe acute pancreatitis accompanied with paralytic ileus.

METHODSThis was a prospective pragmatic randomized controlled trial. A total of 140 cases of severe acute pancreatitis accompanied with paralytic ileus were randomly assigned into an EA group and a regular treatment group, 70 cases in each one. The patients in the regular treatment group were treated with regular treatment, including intensive care, gastrointestinal decompression, fasting, blood capacity supplement, acid suppression treatment, internal environment maintenance, infection prevention, inhibition of pancreatic exocrine secretion, etc. Based on the regular treatment, patients in the EA group were treated with EA at Zusanli (ST 36) and Zhigou (TE 6), 30 min for each treatment, once a day for totally 5 days. The VAS-based abdominal distension severity scale and abdominal pain severity scale were compared before and during treatment in the two groups, moreover, the number of patients who transferred to surgery or ICU was compared.

RESULTS(1) After the 1st EA, the abdominal pain and distension severity scales were both improved in the EA group, which were superior to those of the regular treatment group (all<0.05); afterwards, the abdominal distension and pain severity scales of each day in the EA group were all significantly superior to those of the regular treatment group (all<0.05). (2) The number of patients who transferred to surgery or ICU was not significantly different between the two groups (>0.05).

CONCLUSIONSEA at Zusanli (ST 36) and Zhigou (TE 6) can significantly reduce the abdominal distension and pain severity scales in patients of severe acute pancreatitis accompanied with paralytic ileus, indicating positive clinical significance; in addition, EA is safe and can be recommended to the treatment of severe acute pancreatitis in combination with treatment plan of integrated Chinese and western medicine.

Objective: To retrospectively analyze the differential diagnosis and treatment strategy of neonatal intestinal perforation caused by neonatal necrotizing enterocolitis (NEC) and Hirschsprung′s disease (HD). Methods: The clinical data of 42 cases with NEC and 22 cases with HD combined with intestinal perforation from Ja-nuary 2012 to January 2017 admitted at Fujian Provincial Maternity and Children′s Hospital were collected, the proportion of premature infants, and the proportion of low birth weight infants, age of onset, preoperative clinical symptoms and surgical treatment was compared between the two groups. Results: The proportion of premature infants[95.23%(40/42 cases) vs.27.27%(6/22 cases)], the proportion of low birth weight infant[90.48%(38/42 cases) vs.45.45%(10/22 cases)]and the age of onset [(14.48± 10.51) d vs.(3.18±3.43) d]were statistically different between the NEC group and the HD group, and the differences were statistically significant(all P<0.05). There were significant differences in the presence of normal defecation before the operation[71.4% (30/42 cases)vs.27.3%(6/22 cases)], and in the the defecation characteristics at the onset[95.2% (40/42 cases)vs.9.1%(2/22 cases)]between the NEC group and HD group(all P<0.05). Among 42 cases of NEC patients, 8 cases underwent intestinal anastomosis, and 34 cases underwent enterostomy because of the high risk of anastomosis.All of 22 patients with HD underwent double-lumen enterostomy. Conclusions The general conditions, preoperative manifestations and intraoperative fin-dings of the children should be comprehensively analyzed for identification.Enterostomy is recommended for NEC intestinal perforation, but if the risk of anastomosis is high, then fistula should be performed.Double-lumen fistula should be recommended for HD intestinal perforation, and enterostomy should be recommended if the two cannot be clearly distinguished.

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12^th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.