Objective To study the clinical characteristics,treatment and prognosis of neonatal intestinal muscle defect with perforation.Methods The clinical data of 8 cases of newborns who had intestinal muscle defect with perforation in Department of Surgical Intensive Care Unit,Nanjing Children's Hospital Affiliated to Nanjing Medical University,were analyzed retrospectively.Results These 8 cases included 1 premature infant,1 term low birth weight infant,6 cases of term infants with normal birth weight,and all had no history of perinatal asphyxia.The ages of onset of all cases were ＜ 7 d.Clinical manifestations were crying and sudden onset of obvious abdominal distention.Bile or fecal vomiting occurred in 5 cases.These patients included 5 cases with congenital anorectal malformations,of which 3 cases had low deformity,1 case with middle deformity and 1 case with high deformity,with no other complications of gastrointestinal malformation.Surgical treatment was used in 8 cases,in which 7 cases of rectal perforation and 1 case of ileal perforation were confirmed.All cases were isolated perforation with a diameter of about 0.8-2.0 cm.The perforated periphery of the intestine was membranous.Intestinal repair was performed after total removal of the diseased tissue,and the patients with rectal perforation were performed at the same time for the proximal colostomy.The histopathologic examinations showed that the periphery of perforation had intact mucosa,muscularis propria was absent,myenteric plexus was absent in the region of muscle loss.Two cases were discharged within 1 d after colostomy.Except for 1 case with high anorectal malformation in the control of poor defecation functions,there were no other postoperative gastrointestinal complications in these 6 cases.Conclusions Rectal perforation is the most common in neonatal intestinal muscle defects,and it is an isolated and large diameter perforation.Most cases are term infants with normal birth weight.These patients are often associated with congenital anorectal malformations.High,middle and low deformity can be accompanied by intestinal muscle defect.Surgical excision of diseased tissue should be complete,in principle,and intestinal stoma should be performed proximal to the perforation.In case of congenital anorectal malformations complicated with gastrointestinal perforation,the rectum should be explored as an important region.Neonatal intestinal muscle defect maybe a primary lesion according to clinical characteristics of early sudden onset after birth and pathological examinations.Except for complications caused by associated malformations,the prognosis is satisfactory.

Objective: To observe the effects of electroacupuncture (EA) at Tianshu (ST25) on pro- and anti-inflammatory cytokines in sodium taurocholate-induced severe acute pancreatitis (SAP) in rats. Methods: Sixty-six male Sprague-Dawley rats were randomly divided into three groups: sham-operation group, SAP group and EA group. An SAP model was established by injecting 3.5% sodium taurocholate at a dose of 1 mL/kg through puncturing the pancreatic duct. In the EA group, EA at ST25 was performed with sparse-dense wave (2/100 Hz, 2 mA for 30 min) immediately after sodium taurocholate injection and 30 min before sacrifice. Rats were sacrificed at 3 (n=7), 6 (n=7) and 12 h (n=8) after operation. Levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10 in serum were estimated by enzyme-linked immunosorbent assay. Pathological changes of pancreatic tissues were examined by hematoxylin and eosin staining and observed under a microscope and also scored. Results: The levels of serum TNF-α and IL-6 of SAP rats were significantly higher than those of sham-operation rats at 3, 6 and 12 h. The level of IL-10 in serum of SAP rats was significantly higher than that of sham-operation rats at 3 and 6 h (P<0.05). EA at ST25 down-regulated the levels of TNF-α and IL-6 in serum and up-regulated the level of IL-10 and the ratio of IL-10/TNF-α, also attenuated the morphological damages at 6 and 12 h (P<0.05) in rats with SAP. The pathological scores of pancreatic tissues in the EA group were significantly less than those in the SAP group at 6 and 12 h (P<0.05). Conclusion: EA at ST25 may have a therapeutic effect on rats with SAP by down-regulating the levels of TNF-α and IL-6 and up-regulating the level of IL-10 to re-establish the balance of pro- and anti-inflammatory cytokines, and to ameliorate the inflammatory response of SAP.

Objective To study the relationship between the activity of GSP ?, intestinal metaplasia(IM) of gastric mucosa, and proliferation typing.Method Immunohistochemical method was used to detect GSP ? in 167 cases undergoing biopsy or surgery ,among them slices of 112 pathology proved chronic atrophic gastritis(CAG) were counter stained by mucohistochemistry.Results[WT5”BZ] The result showed that the positive rates of GSP ? in gastric adenocarcinoma, CAG with IM or gastric dysplasia were significantly higher than in chronic superficial gastritis (CSG).The positive rate of GSP ? in high proliferation typing (HPT) was significantly higher than in middle or low proliferation typing ( MPT or LPT).Conclusion GSP ? activity could be used as a marker of precancerous lesions and HPT highly correlates to the occurence of gastric cancer.

Objective To explore how to improve the curative effects and reduce the complications of duodenoscopy in the treatment of bile duct diseases. Methods Clinical data of 292 cases of endoscopic sphincterotomy (EST) and 104 cases of endoscopic nose biliary drainage (ENBD, including 9 post-EST cases) from February 1995 to February 2003 were retrospectively reviewed. Results The success rate of EST was 92.1% (269/292). Among 272 cases of common bile duct calculus, stones were completely taken out in 235 cases (86.4%). Among 15 cases of intrahepatic duct calculus, stones were completely removed in 4 cases. Biliary duct foreign bodies were removed at once in 3 out of 5 cases. EST related complications were found in 16 cases (7 cases of acute pancreatitis, 5 cases of bleeding at the site of incision, 2 cases of severe cholangitis, 1 case of duodenal perforation and 1 case of instrumental break-off), with an incidence rate of 5.5% (16/292). Satisfactory outcomes were achieved in 92 cases receiving ENBD. No death occurred in the study. Conclusions Proper selection of patients and skillful performance of EST is the key to improve its curative effects and reduce its complications.

0.05) while other indicators did not. All the data were simply related to each other. The primary influencing factors to NDS score 1, in decreasing order of impact were volume of infarction, position of infarction, hs-CRP and FBS. While the primary influencing factors to NDS score 3 at the end of 1 month treatment, in decreasing order of impact, were NDS score 1, size of infarction, FG, hs-CRP and TC. Conclusions Volume of infarction and hs-CRP are very important determining factors in both NDS score 1 at the beginning of the treatment and NDS score 3 at the end of 1 month treatment. However, in determining NDS score 3 at the end of 1 month treatment, the impact of FG is greater than hs-CRP. The other influencing factors include FBS, TC and so on. Therefore we conclude that it is helpful to recover from neurologic deficit through lowing these influencing factors directly by medication.

Objective To clarify the factors influencing development of cholecystopathy in schis-tosomiasis portal hypertension. Methods The data of 116 schistosomiasis portal hypertension patients from 1998 to 2002 were retrospectively analyzed and compared with non-liver disease pa-lients. Results Of the incidence of cholecystitis, the schistosomiasis portal hypertension patients vs non-liver-disease were 87.9% (102/116) vs 36.6% (15/41) (P0. 05). Of the incidence of cholecystolithiasis, the schistosomiasis portal hypertension patients vs non-liver-disease were 38.8% (45/ 116) vs 19.5% (8/0.41) (P0. 05). Conclusion The incidences of cholecystolithiasis and cholecystitis are closely correlated with portal hypertension in schistosomiasis, and are not closely correlated with hypersplenism.

10.3969/j.issn.2095-4344.2013.24.004

Objective To Analyze CD4+ cell count which embodies curative effect in HIV and patients with AIDS, who have treated with TCM for half a year. Methods According to CD4+cell count, the patients were divided into 4 phases. Their CD4+cell count were analyzed before and after the treatment. Results 1.Rank sun test showed that CD4+cell count were significantly improved in people who used TCM treatment. On the whole, CD4+cell count was(317.76±175.61) in 1 cu mm before treatment, which was(350.60±175.92) in 1 cu mm after treatment, P<0.01. 2. Ridit showed that patients whose CD4+cell count more than 500 were in phase I. Their R=0.614, and the 95%confidence interval was 0.5702 to 0.6579. Patients whose CD4+cell count more than 350 and less than 500 were in phase II. Their R=0.575, and the 95%confidence interval was 0.5439 to 0.6062. Patients whose CD4+cell count more than 200 and less than 350 were inphase III. Their R=0.460 and the 95%confidence interval was 0.4347 to 0.4849. Patients whose CD4+cell count less than 200 were in phase IV. Their R=0.428, and the 95%confidence interval was 0.3971 to 0.4589. There was no overlap between phase III, phase IV and phase I, phase II in 95% confidence interval. Conclusion TCM has the advantages in strengthening vital qi, but that is worse than western medicine in effort of expelling pathogen.

Objective To increase the awareness of the incidence trend of ischemic colitis and improve the level of diagnosis and treatment.Methods From January 2004 to December 2013,the clinical data of 89 in patients with ischemic colitis were retrospectively analyzed.At the same period,100 patients diagnosed as chronic colitis were enrolled as control group.The laboratory findings of patients with ischemic colitis were compared with those of control group.Non normal distribution data were analysed by non parametric test.Results The annual person-times of patients with ischemic colitis and the percentages accounted in the whole hospital annual person-times increased year by year in recent 10 years,which was one person time and 0.01％ in 2004 increased to 41 person-times and 0.11％ in 2013.The average age of the 89 patients was (63.5±12.7) years,and the male to female ratio was 1∶2.18.The most common underlying disease in the 89 patients was hypertension,accounted for 43.8％.Thirty-eight patients had a history of abdominal surgery,and eighteen patients with appendectomy,accounted for 20.2％.Seventy-eight patients had abdominal pain and defecation desire.Seventy-four patients complained of hematochezia.Compared with control group,there was no statistically significant difference in fasting blood glucose,triglyceride,total cholesterol,blood platelet levels and prothrombin time (all P＞0.05).While the levels of C reactive protein and Ddimer were higher than those of control group (89.21 mg/L vs 61.29 mg/L,90.13 μg/L vs 59.39 μg/L; Z=-3.959,-4.377; both P＜0.05).The images of computed tomography (CT) indicated thickened bowel wall in lesion segment.The results of colonoscopy showed that in the left colon and rectum were the predilection sites,accounted for 93.88％ (138/147).The average hospital stay was (10.59 ± 5.97) days and t he recurrence rate was 3.37 ％ (3 / 89).The percentage of chronic cases was 2.25 ％ (2/89),and no death was reported.Conclusions The incidence of ischemic colitis significantly increased in recent years.Patients with abdominal pain and/or hematochezia should be considered,especially those over 60 years old.Receiving colonoscopy as earlier as possible was helpful for the diagnosis.

Objective To analyze the difference of soft and hard tissues between beautiful face and ordinary face in young Han women for providing data basis for modification of lower facial contour.Methods 38 cases of young Han women were selected with craniofacial spiral CT scanning,three-dimensional reconstruction and histomorphometry of the mandibular angle region (12 cases of beautiful face and 26 cases of ordinary face).Results The difference of bony bigonial breadth,lower face width,angle of mandibular angle,mandibular branch width and height,the distance between the mandibular angle point and pogonion in mandibular angle region had statistical significance (P ＜ 0.05);the difference of mandibular angle thickness had no statistical significance (P＞0.05);the difference of masseter muscle length,width and thickness had statistical significance (P ＜ 0.05).Conclusions In clinical lower facial contour modification practice,we can refer to the data of soft and hard tissue of mandibular angle region of beautiful face,combining with the specific circumstances of the pursuit of beautiful people and select the appropriate surgical approach for lower facial contour modification.