Objective To investigate the value of lapa ro scopic surgery in the diagnosis and treatment of bile duct diseases in newborns and infants. Methods Clinical records of 9 newborns or infants with bile duct diseases diagnosed and treated under laparoscope from January 20 03 to August 2004 in this hospital were reviewed retrospectively. Resul ts Laparoscopic exploration in the 9 cases found 2 cases of congenital choledochal cyst, 5 cases of biliary atresia, 1 case of cholestasis, and 1 case of congenital bile duct hypoplasia. Cholangiography was successfully performed i n 8 cases. Two patients with choledochal cyst received an excision of the cyst a nd Roux-en-Y hepatico-jejunostomy. Among the 5 patients with biliary atresia, he patic porto-enterostomy was performed via open approach in 3 patients and via la paroscopic approach in 1, and surgery was refused in 1 patient. Open hepatic por to-enterostomy was also used in the patient with bile duct hypoplasia. The patie nt with cholestasis underwent a biliary tract irrigation. Conclusions Laparoscopy is simple and reliable in the diagnosis of bile duct disease s in newborns and infants. For the treatment of bile duct diseases, laparoscopic techniques have advantages of minimal invasion, good cosmetic results, less blo od loss, quick recovery, and reliable clinical effects.

Objective To explore the feasibility of tw o- port laparoscopy in the treatment of congenital hypertrophic pyloric stenosis. Methods A total of 21 infants with confirmatively diagnosed con genital hypertrophic pyloric stenosis were given a two-port laparoscopic pylorom yotomy. The procedure was performed using two trocars: a 5 mm trocar at the lowe r border of the umbilical ring was placed for the insertion of camera, and a 3 m m trocar was introduced below the costal margin at the midclavicular line to pas s the hook electrode and curved forceps. Results No conversion s to open surgery were required. The operation time was 23~65 min (mean, 31.3 mi n). The patients were discharged from hospital at 4~6 postoperative days. No com plications occurred. Follow-up for 2~7 months (mean, 3.2 months) showed a norma l development in all the 21 patients. Conclusions Two-port lap aroscopic treameat for congenital hypertrophic pyloric stenosis in infants is ef fective.

Objective To explore the causes and treatment of the complications after laparoscopic surgery in neonate and infants.Methods From January 2003 to June 2007,totally 287 neonates and infants received laparoscopic surgeries in our hospital, 10 of them developed postoperative complications.Results The complications included 7 cases of gastric mucosa rupture during pyloric resection,1 case of delayed rupture of the pylorus,1 case of intestinal malrotation complicated with duodenal stenosis,and 1 case of incisional hernia.The former 9 cases were cured by open surgery,and the last one recovered spontaneously in 4 months. Conclusions Mucosarupture caused by pyloric resection is the most common complication after laparoscopic surgery in neonates and infants,open surgery should be performed in such a situation.Delayed rupture of the bowel after laparoscopic surgery can be potentially fatal,and should be treated as soon as possible.Intestinal malrotation may lead to a high rate of malformation,which can be avoided by early diagnosis and treatment.

Objective To evaluate the clinical value of bedside echocardiography in full term infants in NICU.Methods The bedside echocardiography was performed for 313 full term infants,and then they were ana-lyzed.Results The main clinical characteristics of totally 313 cases of neonates were tachypnea,heart murmur and cyanosis.Patent foramen ovale and patent ductus arteriosus were common in the no cyanotic blood shunt,no cyanotic congenital heart disease(CHD)was mainly made of atrial septum defect(31 cases),followed by ventricular septal defect (20 cases).Cyanotic CHD was made of pulmonary atresia(6 cases),complete transposition of great artery (5 cases),tetralogy of fallot(5 cases),total anomalous pulmonary venous drainage(5 cases).Tricuspid regurgitation was common in abnormal blood flow,moderate to severe pulmonary hypertension was common for full term infants. Conclusion There were many abnormal echocardiography examination results,and atypical noise was common in neonatal CHD,routine examination of bedside echocardiography for full term infants in NICU was important for early detection of CHD and may help treatment timely to improve the prognosis.

Objective To observe the clinical effectiveness and adverse side effects of percutaneous embedding of ~(125)I particles in combination with chemotherapy for advanced non-small cell lung cancer(NSCLC).Methods Twenty-one patients with advanced NSCLC(IIIa-IIIb phase) received percutaneous embedding of ~(125)I particles in combination with concurrent chemotherapy.The chemotherapy was conducted in accordance with TP regime(paclitaxel at 135 mg/m~2 and cisplatin at 30 mg/m~2 were administered on day 1 and on day 2 to 4,respectively with 28 days as a cycle).12～75 ~(125)I particles were embedded with CT-guided percutaneous puncture one week after chemotherapy.The radioactivity quantum was 22～33 MBq per particle.The overall radioactivity quantum of embedded particles was 264-1650 MBq with one or more puncture points.Chemotherapy was then continued for two cycles.Results All the 21 patients completed the therapy,among whom,23.80% got complete response(CR),66.67% got partial response(PR) and 9.53% had stable or progressive disease(NC+PD) with an overall response(CR+PR) of 90.48%.The complications included hemopneumothorax(33.34%),hemorrhage(4.77%),particle migration(4.77%).The incidence rates of radiation esophagitis and radiation pneumonia with grade 1～2 were 4.77%(1/21) and 4.77%(1/21) respectively.No radiation esophagitis or radiation pneumonia with grade 3～4 was found.The incidence rate of grade 3～4 acute myelosuppression comprises 52.38% leucocytopenia,9.53% thrombocytopenia,28.58% decrease of hemoglobin,grade III-IV nausea and 42.86%vomiting,38.10% grade III-IV alopecia.The 1-year survival rate was 80.96%.The 12-month local control rate was 85.72%. Conclusion The results have shown that CT-guided percutaneous embedding of ~(125)I particles in combination with chemotherapy was effective and well-tolerable with few complications and good compliance.

To investigate the nature of syndrome of traditional Chinese medicine by means of pharmacokinetic (PK) method.

OBJECTIVETo summarize the complications after endorectal pull-through radical operation, Soave procedure, for Hirschsprung disease.

METHODSClinical data of 286 cases with Hirschsprung disease who received Soave procedure and were proved by postoperative pathology in our hospital from February 2003 to February 2010 were analyzed retrospectively. All the patients were diagnosed with barium enema and anorectal manometry. Among them, 233 cases(81.5%) were identified during neonatal period. All the patients underwent cleansing enema and anus dilation immediately after definite diagnosis. Radical operation with Soave endorectal pull-through procedure, including simple transanal endorectal pull-through in 251 cases(87.8%), transabdominal approach in 17 cases (5.9%), laparoscopy-assisted endorectal pull-through in 18 cases (6.3%). The operations were performed in 54 cases (18.9%) within 3 months of age, in 183 cases (64.1%) between 3 and 6 months, in 38 cases(13.3%) between 6 months and one year, in 10 cases (3.5%) older than 1 year. The rectosigmoid was resected in 259 cases. Subtotal colectomy was performed in 25 cases, and total colectomy in 2 cases. Postoperative regular anal dilation lasted for 6 months. A total of 286 cases (male:250, female:36) were followed up for 2 to 5 years.

RESULTSThere was wound infection in 1 case, ileus in 1 cases, anastomotic stricture in 1 case, which was cured by continuous anal dilation. Two cases had constipation and received re-operation because of refractory to conservative therapy for 6 months. Perianal erosion was found in 63 cases(22.0%) and was healed within 3 months, except 2 children undergoing total colectomy. During follow-up, enterocolitis occurred in 11 cases(3.8%), including healing in 8 cases with conservative therapy, death in 1 case, and recurrent attacks in 2 cases. Soiling occurred in 45 cases(15.7%), among them, 5 cases presented in kindergarten and primary school. Morbidities of perianal erosion, enterocolitis and soiling were higher in infants undergoing operation within 3 months as compared to those more than 3 months [90.7%(49/63) vs. 6.0%(14/63), P=0.000; 9.3%(5/54) vs. 2.6%(6/232), P=0.022; 25.9%(14/54) vs. 13.4%(31/232), P=0.022]. Morbidity of perianal erosion enterocolitis was higher in infants undergoing subtotal or total colectomy as compared to those partial colon resection[51.9%(14/27) vs. 18.9%(49/259), P=0.000; 18.5%(5/27) vs. 2.3%(6/259), P=0.000].

CONCLUSIONSPrimary transanal endorental pull-through procedure can be performed in most children with Hirschsprung disease. Postoperative short-term complications are mainly perianal erosion and long-term ones are enterocolitis and soiling. Early diagnosis, colon irrigation, avoiding premature operation and anal dilation can decrease the morbidities of enterocolitis and soiling.

Anastomosis, Surgical ; Colectomy ; Colon, Sigmoid ; Constipation ; Enema ; Female ; Hirschsprung Disease ; Humans ; Infant ; Laparoscopy ; Male ; Perineum ; Postoperative Complications ; Postoperative Period ; Rectum ; Retrospective Studies

OBJECTIVETo document morphological changes in hepatic microcirculation in liver tissue with hepatitis B and the pathogenesis of hepatic microcirculatory disturbances.

METHODSLiver tissue samples were obtained from patients with hepatitis B by liver biopsy. These samples were examined with a light microscope and transmission electron microscope.

RESULTSHepatic microcirculatory disturbances existed in patients with hepatitis B, including those with normal liver function, manifested by red blood cell aggregation in sinusoids seen under light microscope and sinusoidal capillarization seen under electron microscope. Weibel-Palade bodies in sinusoidal endothelial cells were seen in 26 out of 53 cases. Intimate contacts were found between lymphocyte/Kupffer cells and sinusoidal endothelial cells.

CONCLUSIONSHepatic microcirculatory disturbances exist in patients with hepatitis B. The appearance of Weibel-Palade bodies in sinusoidal endothelial cells may be a key step in the development of hepatic microcirculatory disturbances.

Adolescent ; Adult ; Aged ; Female ; Hepatitis B, Chronic ; pathology ; physiopathology ; Humans ; Liver ; blood supply ; pathology ; ultrastructure ; Liver Circulation ; Male ; Microcirculation ; pathology ; ultrastructure ; Microscopy, Electron ; Middle Aged

Objective To observe the clinical study of Xiaoaiping tablet combined AP regimen in the treatment of unresectable advance endometrial carcinoma. Methods A total of 268 patients with advance endometrial carcinoma in our hospital were divided into treatment group and control group, 134 cases in each group. The control group was treated by AP regimen and the treatment group was given Xiaoaiping tablet combined AP regimen. The treatment was 3 weeks per course, 4 periods performance, and the 2 year follow-up. After the treatment, the immune index, including IgG, IgA, IgM, CD3+ and CD4+ were detected by a chemical lighting method in the 2 groups. The KPS scores were observed to evaluate the life quality in the 2 groups. During the treatment, the adverse effects of chemotherapy in patients were observated during the treatment. And the survival rates, overall survival and progression-freely-survival were also observed. Results After the treatment, the control rate and efficiency rate were 86.5％ (116/134) and 64.2％(86/134) in treatment group, while the control rate and efficiency rate were 76.9％ (103/134) and 52.2％(70/134) in control group, where there were significantly difference in control rate and efficiency rate (Z values were 3.542 and 3.871, P values were 0.041 and 0.039). After the treatment, the levels of IgG, Ig A, IgM, CD3+ and CD4+ in treatment group were significantly higher than control group (t values were 4.725, 4.930, 4.259, 4.571 and 4.006, P<0.01). After the 1st-4th period of treatment, the KPS scores in treatment group were significantly higher than the control group (t values were 3.124, 3.452, 3.612 and 3.712, P<0.05). After the treatment, the PFS, OS, 1 year survival rate and 2 year survival rate were significantly lower in treatment group than control group (t values were 4.241, 4.421, 3.735 and 3.982, P<0.05). Conclusions The Xiaoaiping tablet combined AP regimen in the treatment of unresectable advance endometrial carcinoma has a good effect, could promote the immune function, decease the adverse effects and prolong the survival time in the patients.

Chronic myeloid leukemia (CML) appears an ideal and exciting immunological target. Novel and rational immunotherapy may therefore play an important adjuvant role in the treatment of CML patients. Peptides derived from the BCR-ABL fusion region have been shown to be immunogenic and are able to stimulate the production of BCR-ABL-specific T cell lines and clones. In this study, A 280 bp multiple epitope region of BCR-ABL fusion antigen was designed and synthesized. This region contains three BCR-ABL antigen epitopes which can bind to HLA-A2, HLA-A3 and HLA-DR11 molecules, respectively, and epitopes of cholera toxin B (CTB) and tetanus toxoid (TT) which are able to elicit vigorous T cell responses. The fusion antigen gene has highly been expressed in E. coli and the purified fusion protein reserved satisfied activity and antigenicity. The results of this investigation provided a basis for further research on the developing specific T cell immunotherapy of CML.