Although the cesarean section has become an effective means to solve dystocia,high - risk pregnan-cy and other critical obstetrical disease,but the morbidity rate and hospitalization rate of newborn did not decreased obviously because of the continuous increasing of cesarean section rate. Contrary,in recent years,many domestic and foreign researches have found that,compared with normal vaginal delivery babies,cesarean section newborn infants have higher related disease incidence rate after birth,especially respiratory distress sydrome,transient tachypnea of newborn infants,persistent pulmonary hypertension and infection,and more attention should be paid to the fact that cesarean section children are more prone to allergic and immune system diseases as well as neuropsychiatric related diseases. Therefore,this article aims at integrating the researches and providing an overview on recent and long - term effection on newborn infants.

MicroRNAs (miRNAs) are a class of small endogenous RNAs, which handle post-transcriptional gene regulation activity through targeting messenger RNAs.As the deep understanding of them, miRNAs had been found to participate in numerous basic biological processes, including the normal growth process of tissues and organs ,as well as the pathologic course of diseases.Different miRNAs may be involved in different tissues and organs, the same miRNA may have different expression in various physiological process or stages of pathological conditions.Now, the recent studies about the miRNAs in the lung development and pulmonary diseases were reviewed.

Objective: To investigate the expression of the transcription factor GATA-4 in human heart development.Methods: Immunohistochemistry was used to detect the expression of GATA-4 in 45 normal human embryonic hearts of 6-23 gestational weeks.Results: In the early stage of the fetal heart morphogenesis,we observed no GATA-4 expression in the ventricle,weak expression in the atria and relatively high expression in the trabecular nets.With the heart development,the GATA-4 expression was enhanced in the atria,ventricle,trabecular nets and atrial-ventricular valves,as well as in the muscular and membranous interventricular septum,the highest in each part of the heart.Conclusion: The transcription factor GATA-4 plays an important role in human heart development.

Objective To investigate diagnostic methods and treatment of subcutaneous fat necrosis in neonate (ScFN). Methods The clinical data of a case with ScFN was reported and the etiology, pathogenesis, and differential diagnosis were reviewed. Results The case was a 2 days female newborn delivered via cesarean section at full-term, and she came to hospital because of indurated nodules and plaques in the back and shoulders. Anti-infection treatment after admission was not effective. On the 10th day in hospital, the back lesions appear as soft and lfuctuant and then diagnosed as ScFN by biopsy which showed a small amount of inflammatory cell infiltration and fatty degeneration. The patient was followed up with good prognosis. Conclusions ScFN is a benign self-limiting fat disease, mostly occurred in the first four weeks of full-term newborns with history of abnormal childbirth.

Objective To study the management of enterostomy in children.Methods The clinical data of 425 cases of enterostomy in children were analyzed retrospectively.Results The primary diseases of 425 cases underwent enterostomy included:intestinal perforation(119 cases),intestinal necrosis(36 cases),necrotizing enterocolitis(45 cases),congenital megacolon(61 cases),congenital anal atresia with rectourethral fistula(86 cases),and congenital anal atresia with rectovaginal fistula(78 cases).Among the 425 cases,159 cases underwent small bowel enterostomy and 266 cases had colostomy;single-stoma enterostomy was done in 225 cases,and double-stoma enterostomy in 197 cases.Follow-up was acquired in 389 patients,and all the stomas were closed successfully.The closure time of small bovvel enterostomy was 1-3 month(ayerage 1.87 months)later,and of colostomy was 3-12 month(averag 4.95 months)later.Conclusions When an enterostomy is to be adopted in pediatric surgery,a suitable time and enterostomal location should be chosen according to the state of illness.The timing of enterostomy closure is also very important.

Objective To introduce the method of arthroscopically assisted closed reduction and percutaneous screw fixation for intra-articular calcaneal fractures and to discuss its clinical indications, advantages and disadvantages. Methods From February 2003 to December 2004, 12 unilateral intra-articular calcaneal fractures were treated with the method of arthroscopically assisted closed reduction and percutaneous screw fixation. 7 cases were males and 5 cases were females. The average age was 36.8 years (range, 23-61 years). 8 feet were on right side and 4 feet were on left side. The mechanism of injury was fall from a height in 11 cases and vehicle accident in 1 case. According to Sanders classification, 8 cases were type Ⅱ fractures(1 type ⅡA, 5 type ⅡB, 2 type ⅡC) and 4 cases were type Ⅲ fractures(2 type ⅢAB,1 type ⅢAC,1 type ⅢBC). Results Arthroscopy in the operation showed the fracture space and step were less than 1 mm. The preoperative X-ray film showed that B?觟hler angle was 18.4??5.8?, Gissane angle was 109.1??10.2?, calcaneal width was (35.9?2.2) mm. The postoperative X-ray film demonstrated that B?觟hler angle was 25.4??3.5?, Gissane angle was 118.1??6.4?, calcaneal width was (32.3?1.1) mm. The average follow-up of nine patients was 17.4 months (range, 10-25 months). According to Maryland foot score, all patients had satisfactory results with the mean score of 92.5 score (range, 82-100 score), 6 were excellent and 3 were good. None of the patients had re-displacement of fracture, significant lame or other late complications. They regained normal shape of foot and wore normal footwear. Conclusion Arthroscopically assisted closed reduction and percutaneous screw fixation is an effective and applicable minimal-invasive treatment for Sanders type Ⅱ and selected type Ⅲ intra-articular calcaneus fractures. It can significantly reduce the risk of soft tissue injury and other complications while ensuring satisfactory reduction of the posterior calcaneal facet of the subtalar joint and reliable fixation.

Objective To investigate the effects of plateletpheresis on blood conservation following cardiopulmonary bypass.Methods 20 patients undergoing open heart surgery were divided randomly into experiment and control groups.All patients underwent routine CPB.Plateletpheresis was performed in experiment group by using COBE SPECTRA.Other blood conservation approaches were similar in two groups.Results The number of platelets collected in experiment group exceeded 20% of total platelets of every patients.In the experiment group,less transfusion was need.The changes of Hb and Hct at every time point were similar in the two groups.Platelet counts,aggregation,and prothrombin time in the experiment group restored to preoperative levels significantly earlier than in the control group.The chest tube drainage at 2,4,8,and 16 h and the total drainage after operation were significantly lower in the experiment group than those in the control group.Conclusion By protecting platelets from destruction by extracorporeal circulation,plateletpheresis is beneficial to the recovery of haemostatic system.It is a useful blood conservation method.

Objecttve To determine whether non-adherent bone marrow-derived mesenchymal stem cells (NA-BM-MSC) can differentiate into neuron-like cells in vitro and in vivo,especially in ischemic brain of mice. Methods NA-BM-MSC of mouse were indueed with conditioned medium containing epidermal growth factor and basic-fibroblast growth factor and demonstrated by immunocytochemistry for the expression of neuron specific nuclear protein and neurofilament-200. NA-BM-MSC from β-galactosidase transgenic mice constitutively expressing β-galactosidase were transplanted into the mice model of middle cerebral artery occlusion.LacZ staining and immunobistochemistry staining were performed to detect the survival,distribution and the differentiation of the donor cells in the ischemic brain. Results NA-BM-MSC can be induced into neuron specific nuclear protein and neurofilament-200 positive cells in vitro.LacZ staining showed that NA-BM-MSC can survive in ischemic brain and express β-galactosidase.Also,numbers of the neuron specific nuclear protein positive cells in β-galactosidase-positive cells were detected in the ischemic brain with double immunohistochemistry staining. Conclusions NA-BM-BMC can be induced to differentiate into neuron-like cells in vitro,and also can differentiate into neuron-like cells in ischemic brain tissue of the mice.

Objective To explore the effects of different courses of antenatal dexamethasone on brain development of premature SD rats. Methods The pregnant rats were randomly assigned to 3 groups: 3-dose dexamethasone (group 1), 1-dose dexamethasone group (group 2) and control group. The treated were sacrificed on 19 days of gestation, body and whole brain weight of the offspring rats were measured. Meanwhile the expression o{ neuron specific enolase (NSE) in brains of offspring rats was detected by immunohistochemical staining. The histological structures of baby rat brain were observed under transmission electron microscope. The differences among the three groups were analyzed by ANOVA. Results (1) The body and whole brain weight, the brain and body weight ratio were (1.543±0.052) g, (88.80±7.12) mg, and (5.75±0.38)% in group 1 and (1.584±0.035) g,(98.21±3.71) mg, and (6.20±0.26)% in group 2, both were lower than the control group [(1.696±0.076) g, (111.53±6.29) mg, (6.59±0.48)%], (P<0.01 or P<0.05, respectively). (2) The expression of NSE in cortex in group 1 and 2 were lower than that in control group (0.223±0.054, 0.381±0.041 vs 0.590±0.064) (P<0.01). The expression of NSE in hippocampi in group 1 and 2 were also lower than that in the control group (0.192±0.054, 0.359 ±0.046 vs 0.529±0.068) (P<0.01). (3) Disconnection of nuclei membrane, vacuolization in mitochondria, loss of nueleolus, and disconnection of neurofilaments were observed in the ultrastructure of baby rat brain tissue in both group 1 and 2. Conclusions Antenantal administration of dexamethasone can cause impairment of brain development in premature offspring rats and this might be related to the times of dexamethasone administered.