Objective To study the clinical management of non-missile penetrating brain injury and intracranial foreign body.Methods Retrospectively analyzed 5 cases of non-missile penetrating brain injury and intracranial foreign body,and reviewed relative literature.Results Eady surgical management for all 5 cases,4 cases were cured except hemiparesis in 1 case.There were not active bleeding during surgical treatment,and there were not intracranial infection,epilepsy and cerebrospinal fluid leakage in post-operation in all 5 cases.Conclusions The surgical plan is rely on skull X-rays and brain CT scan.To keep the penetrating object in situ posttrauma,early surgical intervention,remove the penetrating object and prevent secondary brain injury may provide a better outcome.

Purpose To investigate the relationship between Helicobacter pylori L-form ( Hp-L) infection and expression of XPF and p53 in gastric carcinoma. Methods XPF, p53 and Hp-L were examined in 239 cases of gastric carcinoma and healthy individuals by means of Giemsa stain and immunohistochemical staining with ABC method. Results XPF and p53 expression in gastric carcinoma was significantly higher than that of the surrounding tissue (P<0. 01). There were positive correlation between the expression of XPF and p53 (r=0. 196, P<0. 01). The expression of XPF was related to the Laurén classification (P<0. 05). The expression of p53 was associated to the depth of invasion (P<0. 05). (2) 175 (73. 22%) cases were Hp-L positive by both Giemsa and immunohisto-chemical staining. Hp-L expression in gastric carcinoma were significantly higher than that of the surrounding tissue (P<0. 01). (3) In the Hp-L positive group, XPF and p53 were significantly higher than in that of the Hp-L negative group (P<0. 01). Positive corre-lation existed between positive Hp-L staining and the expression of XPF and p53 (r=0. 32, r=0. 296, P<0. 01). (4) Univariate a-nalysis showed that depth of invasion, distant metastasis, TNM stage, XPF and p53 were related to the prognosis of gastric carcinoma ( P<0. 05). Multivariate Cox model analysis showed that XPF was an independent prognostic factor for the patients (P<0. 05). The pa-tients with positive expression of XPF had a shorter survival time. When combined with the depth of invasion and distant metastasis, the correction risk increased by 3. 791 times. Conclusion XPF, p53 and Hp-L may play very important roles in the development of gastric carcinoma. The high expression of XPF implies poorer prognosis. Hp-L infection may be related to the up-regulated expression of XPF and p53.

In order to investigate the relationship between the expression of heme oxygenase-2 (HO-2) mRNA and the pathogenesis of Hirschsprung's disease (HD), total ribonucleic acid (RNA) was extracted in the aganglionic and ganglionic segments of colon respectively from 15 cases of HD. The single-stranded cDNA of HO-2 was synthesized and further amplified by reverse transcription-polymerase chain reaction (RT-PCR). The expression of HO-2 mRNA was normal in ganglionic segments, but absent in aganglionic segments. It is concluded that the absence of HO-2 mRNA expression may be an important mechanism responsible for HD.
Colon/enzymology ; Heme Oxygenase (Decyclizing)/biosynthesis ; Heme Oxygenase (Decyclizing)/*genetics ; Hirschsprung Disease/*enzymology ; Hirschsprung Disease/etiology ; Hirschsprung Disease/genetics ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics

Objective To improve the unsatisfactory situation of endoscope disinfection and develop endoscopic anti-cross- infection security protection sheath. Methods The protective sheath was processed by using tube and cylinder of medical flexible rubber that was non -toxic, harmless, tasteless and transparent, which size was coincide with the shank of endoscopic fore-end. The openings of fore-end and back-end were designed by immerse extra-strong circle. Every sheath was molded into barrel roll based on the midline axis of twist and bagging standby after disinfection and sterilization. Results The instruction of sheath was streamlined that could be unwound smoothly from back-end and accreted tightly to endoscopic mirror. Conclusion The sheath can be reduced effectively the risk of cross-infection in endoscope examination.

A case with the diagnosis of the onset of inflammatory bowel disease (IBD) with chronic granulo-matous disease (CGD) in Children′s Hospital Affiliated to Zhengzhou University in June 2016 was chosen, and the patient′s clinical data and whole treatment process were analyzed.According to the relevant literature from Chinese and foreign databases, the clinical characteristics were analyzed and summarized, principles of diagnosis and treatment for children who had the onset of IBD with CGD.This patient was a child of 1 year and 9 months old, and the initial symptoms included repeated diarrhea and bloody stools.He was diagnosed as " ulcerative colitis" in the local hospital.After admission, the neutrophil respiratory burst test was positive.The genetic analysis result suggested that the CYBB gene was mutated, thus obtaining the diagnosis of CGD.Then, he was given prophylactic antibiotic therapy and symptomatic treatment.After the 3 months of follow-up after discharge, the patient still had intermittent diarrhea and bloody stools.CGD is a rare primary immunodeficiency disease, and current treatment methods of CGD include hematopoietic stem cell transplantation and anti-infection treatment.When IBD patients have complications other than gastrointestinal symptoms, the IBD treatment is not effective, or there are suspected parents who are married to close relatives, or with the family history of IBD, CGD should be considered.

Objective To investigate the feasibility,safety and curative effect of combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity.Methods We retrospectively evaluated 357patients with esophageal carcinoma who received minimally invasive esophagectomy(MIE) in our center between October 2011 and March 2014.Of those 357 patients,219 underwent MIILE and 138 underwent MIME.The clinicopathologic factors,operational factors,postoperative complications and postoperative recurrence were compared.Results The 2 groups were similar in terms of age,sex,American Society of Anesthesiologists grade,tumor location,preoperative staging.The MILLE approach was associated with no significant decrease in surgical blood loss.Duration of operation,chest tube duration,hospitalization expenses and postoperative stay relative to the MIME approach(P ＞ 0.05).There was no significant difference between the 2 groups in postoperative complications(P ＞0.05).The MIILE approach was associated with significantly fewer anastomotic fistula,RLN injury,anastomotic stensis than the MIME approach(P ＜0.05).Conclusion Our MIILEtechnique can be safely and effectively performed for intrathoracic anastomosis during esophageal surgeries with favorable early outcomes.

Objective:To investigate the feasibility, safety, and short-term effect of minimally invasive McKeown esophagecto-my. Methods: We conducted a retrospective evaluation of 88 patients with esophageal carcinoma who received minimally invasive esophagectomy in our center from October 2013 to April 2014. Among the 88 patients, 46 patients underwent total endoscopy McKe-own esophagectomy (TEME) and 42 patients underwent thoracoscope combined with laparotomy Mckeown esophagectomy (TLME). The clinicopathologic factors, operational factors, and postoperative complications of the two approaches were compared. Results:The two groups were similar in terms of age, sex, American Society of Anesthesiologists grade, tumor location, preoperative staging, and co-morbidity. The TEME approach was associated with a significant decrease in abdominal blood loss and postoperative pain relative to the TEME approach (P<0.05). No significant differences were found between the two groups in terms of histologic type, postoperation TNM staging, abdominal operation time, intensive care unit stay, chest tube duration, postoperative stay, the number of total lymph nodes dissected or the stations of the total lymph nodes dissected, and lymph metastasis rate (P>0.05). The total morbidity and total re-spiratory complications in the TEME group were lower than those in the TLME group (P<0.05). Incidences of pneumonia, arrhythmia, wound infection of minor complications, and pneumonia of major complications were relatively low in the TEME approach. Conclu-sion:Our TEME technique can be safely and effectively performed for cervical anastomosis during esophageal surgeries to achieve fa-vorable early outcomes.

Objective To investigate the effects of acupuncture on gene expression profile of neurotrophin and its receptors in cerebral cortex of neonatal rats after cerebral hypoxic-isehemic injury,and to explore the molecu- lar mechanism of acupuncture in treatment of neonatal hypoxic-ischemic encephalopathy.Methods The model of cerebral hypoxic-ischemic injury was established with 10 neonatal Sprague-Dawley(SD)rats,who were subjected to acupuncture once daily for 14 days.The animals were sacrificed on the next day of the last acupuncture and their brain cortex was sampled for examination of gene expression,using GEArray Q series neurotrophin and receptors gene array.Results After 14 days of acupuncture,it was found that 48 genes(50% of total genes on the microarray) were expressed differently between the two groups,of which 40 genes(83.3% of differently expressed genes),such as those of the brain-derived neurotrophic factor(BDNF),ciliary neurotrophic factor(CNTF),ciliary neurotrophic factor receptor(CNTFR),basic fibroblast growth factor(bFGF)and fibroblast growth factor receptor type 1 (FGFR1)were up-regulated,and 8 genes(16.7% of differently expressed genes),such as genes of neuregulin-1 (Nrg1),neuregulin-4(Nrg4)and tyrosine kinase C(TrkC)were down-regulated.Conclusion Acupuncture can regulate the expression of various genes of neurotrophin and receptors in cerebral cortex of neonatal rats after cerebral hypoxic-ischemic injury,which might be the mechanism of acupuncture facilitating the recovery of the rats from hy- poxic-ischemic encephalopathy.

Background and purpose:High expression of excision repair cross-complementing 1 (ERCC1) is related to resistance in patients treated with platinum-containing regimens. The ERCC1 antibody 8F1 was usually used in past studies, but it was found to have no-speciifcity recently. This study aimed to investigate the predictive role of a new ERCC1 antibody 4F9 to platinum chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods:Expression of ERCC1 was detected using antibody 4F9 by immunohistochemistry (IHC) in 72 NSCLC tissues. The relationship between the expression of ERCCl and the clinical pathological parameters, the efficacy of platinum chemotherapy and overall survival of patients were explored by statistical analysis. Results: The high expression of ERCCl protein was 55.5%in 72 cases. There was no signiifcant correlation between the ERCC1 expression with gender, age, pathological type, clinical stage and lymphatic metastasis (P>0.05). Patients with low expression of ERCC1 had signiifcantly higher response rates to platinum chemotherapy, longer median survival time and 2-years survival rate comparing with those with high expression of ERCC1 (62.5%vs 37.5%;22.9 vs 18.4 month;46.9%vs 37.5%), respectively (P<0.05). Conclusion:The expression analysis of ERCC1 using new ERCC1 antibody 4F9 by IHC method is helpful to assign chemotherapeutic regimen, and guide individual platinum chemotherapy for post-operation patients.

Recently,the main treatment for esophageal cancer remains curative resection combined with adjuvant chemoradiotherapy.With the application of minimally invasive esophagectomy (MIE) in the surgical treatment in recent years,patients with esophageal cancer who received MIE are proved to have less postoperative complications,better quality of life,and better surgical effect.However,different operation methods of MIE have different advantages and disadvantages,that makes the clinical promotion of MIE need further clinical experience,surgical techniques and procedures.The long-term effect of MIE remains to be further verification.