Objective To explore the clinical characteristics of eosinophilic gastroenteritis. Methods The clinical data of 2 children with eosinophilic gastroenteritis was retrospectively analyzed. Results Eosinophilia was found in both cases and path-ological examination indicated eosinophil infiltration in intestinal mucosa. The clinical symptoms were improved after hypoaller-genic diet, amino acid formula and anti-allergy treatment. Conclusions Eosinophilic gastroenteritis is characterized by eosino-phil infiltration with unknown pathogenic factor leading the treatment of eosinophilic gastroenteritis lacking of sound evidence.

Objective To investigate the application effect of nasojejunal feeding tube nutrition in patients with severe traumatic brain injury. Methods The clinical data of 54 patients with severe traumatic brain injury admitted to the Department of Surgical Critical Care Medicine,the Third Affiliated Hospital,Sun Yatsen University between June 2012 and December 2014 were analyzed retrospectively. They were divided into either a nasojejunal feeding tube nutrition support group (nasojejunal group,n = 26)or an asogastric feeding tube nutrition support group (asogastric group,n = 28)according to the different ways of enteral nutrition. All patients began to receive nasal feeding whole protein preparations (enteral nutritional emulsion,TPF-D)from the second day after admission to intensive care unit (ICU). The time to reach the enteral nutrition support target,the time of parenteral nutritional support,nutritional index (albumin and hemoglobin),the time admission to ICU,and the incidences of infection and gastrointestinal complications in both groups were observed. Results (1)According to the body weight to calculate calorie demand, the nasojejunal group reaching the time of enteral nutrition support target was faster than that of the asogastric group (3. 0 ± 0. 8 d vs. 7. 7 ± 2. 5 d). There was significant difference between the 2 groups (P < 0. 01). The time of the combined parenteral nutrition support in the nasojejunal group was reduced significantly compared with the asogastric group (2. 0 ±0. 8 d vs. 6. 7 ±2. 5 d). There was significant difference between the 2 groups (P <0. 01). (2)At day 30after treatment,the levels of total serum protein and hemoglobin in the nasojejunal group were higher than those of the asogastric group (64 ± 6 g/ L vs. 61 ± 6 g/ L and 120 ± 17 g/ L vs. 106 ± 16 g/ L,respectively. There were significant differences (P < 0. 05). (3)The mean length of stay in the ICU was obviously shorter in nasojejunal group compared with the asogastric group (11 ± 5 d vs. 14 ± 6 d). There was significant difference between the 2 groups (P < 0. 05). (4)There were no significant differences in complications of the patients,such as the incidences of pulmonary infection,hyperglycemia,and diarrhea between the 2 groups (P > 0. 05). Conclusion Nasojejunal feeding tube nutrition support may be faster to achieve the target of enteral nutrition supports and shorten the time in ICU.

[Objective] To investigate the mesenchymal stem cells (MSC) in treating acute lung injury (ALI) via ALI mouse model.[Methods] By monoclonal antibody Anti-GD2 of specific antigen ganglioside (GD2) only expressed on MSC as a carrier,new fluorescent molecule probe were synthesized through covalently coupling Anti-GD2 and fluorescent group CyDye mono-reactive NHS Esters (Cy7).Synthetic Anti-GD2-Cy7 and MSC were labeled by the specific binding of antigen and antibody in vitro.Total 84 balb/c male mice were selected and randomly selected 48 mice were divided into three groups:sham group (n =16),MSC+ ALI group (n =16),NS + ALI group (n =16).The lung histopathology and scores,lung W/D ratio and permeability of lung microvasculature were examined at 24 h,48 h after ALI mouse model.Other 36 mice were randomly divided into three groups:normal group (n =12),sham group(n =12),MSC +ALI group(n =12).Labeled MSC-GD2-Cy7 were transplanted into MSC+ALI group and sham group mice via tail vein injection.At 30 min,1 d,3 d,and 7 d post-MSC-GD2-Cy7 injection,the mice were sacrificed after anesthesia and then the lung was removed.Excised lung was detected on small animal fluorescent imager.[Results] Contrast to NS+ ALI group,the lung histopathology and scores,lung W/D ratio and permeability of lung microvasculature of MSC +ALI group were more greatly improved at both 24 h and 48 h.Fluorescent results showed that the signal intensity in thc lung of MSC +ALI group was significantly higher than that of sham group at each time point [(3.37 ± 0.02)× 10-4 vs (2.05 ± 0.04) × 10-4 scaled counts/s;(35.54 ± 0.47)× 10-4 vs (25.29 ± 1.48) × 10-4 scaled counts/s;(11.17 ± 0.75)×10-4 vs (6.09 ± 0.62)× 10-4 scaled counts/s;(3.10 ± 0.14) vs (0.00 ± 0.00)× 10-4 scaled counts/s;all P ＜ 0.05].[Conclusion] Our study showed that a proportion of cells migrated into normal and injured lungs 30 min after cell transplantation,and the cells started to recruit and largely gather in injured lungs at day 1 and persisted to day 7,these results suggest that MSC possess the ability to home into injured tissues.

Organ transplantation is the primary effective treatment for end-stage organ failure. Donor-derived infection (DDI) is significantly associated with the incidence of infection and mortality of the recipients after organ transplantation. Improvement of donor screening technology and early prevention and treatment can improve the safety of transplantation. In this article, the pathogenic characteristics of DDI bacterial infection, fungal infection, viral infection and parasitic infection were summarized, and the research progress upon the prevention and treatment were briefly introduced, aiming to provide reference for reducing DDI.

Children′s esophageal stenosis is mainly benign stenosis. Esophageal foreign bodies and corrosion are common causes of esophageal stenosis in children requiring emergency management. Endoscop￣ic treatment of esophageal stricture includes endoscopic balloon dilatation,endoscopic radial incision,medical treatement,endoscopic stenting and so on. According to the cause of the stenosis,the nature of the lesion and the morphological structure of the lesion,formulating appropriate endoscopic treatment strategy are important for therapeutic effect and reducing the incidence of complications.

Objective To investigate the cause,prevention and treatment of intra-abdominal hemorrhage after liver transplantation. Methods Clinical data of 82 patients undergoing liver transplantation were retrospectively analyzed. All participants were divided into the intra-abdominal hemorrhage (n =12)and control groups (n =70). Preoperative parameters including age,model for end-stage liver disease (MELD)score,prothrombin time (PT),prothrombin time international normalized ratio (PT-INR),fibrinogen (FIB),activated partial thromboplastin time (APTT),platelet (Plt) were statistically compared between two groups. Intraoperative hemorrhage volume,cold ischemia time of donor liver, anhepatic phase time and operation time were also compared between two groups. Postoperatively,the mortality rate was compared between two groups. Results Among 82 patients,1 2 (1 5%)presented with intra-abdominal hemorrhage and required twice surgical hemostasis. In the intra-abdominal hemorrhage group,4 cases (33%)died,and 8 (1 1%)died in the control group. No statistical significance was documented between two groups (P>0. 05 ). Age,MELD score,PT-INR, FIB,APTT and PLT did not significantly differ between two groups (all P>0. 05 ). Compared with patients in the control group,those in the intra-abdominal hemorrhage group yielded significantly more blood loss intraoperatively,longer operation time and longer cold ischemia time of donor liver (all P<0. 05 ). Anhepatic phase time did not significantly differ between two groups (P>0. 05 ). Conclusions After liver transplantation,intra-abdominal hemorrhage is associated with longer cold ischemia time of donor liver,more intraoperative blood loss and longer operation time. In order to decrease the incidence of postoperative intra-abdominal hemorrhage,coagulation function should be completely corrected prior to surgery and the surgical skills should also be enhanced.

Objective To explore the cognitive impairment of stroke survivors using magnetic resonance spectra (MRS) and the Loewenstein occupational therapy cognitive assessment (LOTCA),and to analyze their correlation and their clinical significance.Methods Thirty stroke survivors diagnosed with cognitive impairment using the mini-mental state examination formed a cognitive impairment group.Another 30 stroke survivors without cognitive impairment served as stroke controls,while a third group of 30 healthy counterparts were the normal controls.All were assessed using magnetic resonance imaging and the LOTCA and the results were correlated.Results The average LOTCA total score and sub-scores of the impaired group were significantly lower than those of the other two groups.The average LOTCA total scores and the orientation and spatial perception,apparent motion and thinking operation sub-scores of the stroke control group were also significantly lower than those of the normal control group,though their average visual perception and motor praxis scores were not.The average levels of N-acetyl aspartate and creatine (NAA and Cr) in the bilateral hippocampus of the cognitively impaired group were significantly lower than among the controls,while their choline and creatine (Cho/Cr) levels were significantly higher.The average NAA/Cr and Cho/Cr levels in the bilateral hippocampus of the stroke control group were similarly significantly lower and higher than among the healthy controls.The average NAA/Cr levels in the left and right hippocampus were weakly to moderately correlated with the total LOTCA scores and the LOTCA sub-score for attention (r=0.376-0.661 and r=0.396-0.691 respectively).The average value of Cho/Cr in the left hippocampus showed weak to moderate negative correlation with the LOTCA total scores (r=-0.368-0.619),but not with the attention scores.The value of Cho/Cr in the right hippocampus had weak to moderate negative correlation with the LOTCA total score and with the orientation,visual perception,visuo-motor organization and thinking operations sub-scores (r=-0.391-0.632),but no obvious correlation with the scores for spatial perception,motor praxis or attention.Conclusion MRS can be used to assess the cognitive impairment of stroke survivors.MRS and LOTCA scores are closely correlated.MRS combined with LOTCA can evaluate cognitive dysfunction more comprehensively and objectively.

OBJECTIVE To identify potential mutations in five infants with neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). METHODS The SLC25A13 gene was analyzed by next-generation sequencing. Suspected mutations were confirmed by PCR and Sanger sequencing in the probands and their parents. Impact of novel mutations was predicted with PolyPhen-2 software. RESULTS All neonates have harbored mutations of the SLC25A13 gene. Eight mutations were discovered, which included two novel mutations (c.1357A>G and c.1663dup23). All parents were found to be carriers of the mutations. CONCLUSION Mutations of the SLC25A13 gene probably underlie the NICCD among the five patients, among which 851del4 and 1638-1660dup were the most common ones. This has enriched the spectrum of SLC25A13 mutation in association with NICCD.

Objective To summarize the treatment experience of sepsis after liver transplantation.Methods The clinical features and treatment methods of 1 patient developing sepsis after liver transplantation, who was admitted and treated in the Surgical Intensive Care Unit of the Third Affiliated Hospital of Sun Yat-sen University in September 201 4,were retrospectively studied.The interpretation of International Guidelines for Management of Severe Sepsis and Septic Shock (SSC Guidelines)and relevant literature were reviewed.Results One male patient at the age of 50 years old developed high fever and decrease of blood pressure at 1 d after liver transplantation,and was diagnosed as septic shock.The symptoms were relieved after the appropriate treatment like goal-directed fluid resuscitation,anti-infection and blood purification,etc.And the patient was discharged in stable conditions.Conclusions It is easy to develop infection after liver transplantation and the fatality rate of sepsis caused by infection is high.Once the sepsis occurs,clinicians must perform early goal-directed therapy and bundle therapy according to the SSC Guidelines positively,and select the appropriate drugs according to the pathogen culture results in order to reduce the fatality rate.

Objectives To explore the clinical features of allergic colitis and the expression of eosinophil cationic protein (ECP) in intestinal mucosa in infant and young children. Methods The clinical data of 24 cases of allergic colitis treated from September 2011 to February 2014 were analyzed retrospectively. Immunohistochemical staining was used to detect expressions of ECP in intestinal mucosa in 24 cases of allergic colitis, gastric and duodenal mucosa in 16 cases of helicobacter pylori infection and proximal normal intestinal mucosa in 18 cases of postoperative resection of congenital megacolon, and the results were compared. Results In the 24 subjects (15 males and 8 females) with allergic colitis,. they were infants except for 1 subject, and 20 subjects were <6 months old. All of them had bloody stool, in which there were 15 cases of diarrhea, 1 case of eczema and 3 cases of drug allergy. The endoscopic lesions were mainly showed in the sigmoid colon (12 cases) and the rectum (11 cases). The most common manifestations were mucosal erythema (21 cases), pox like nodules (18 cases), erosions (3 cases), and ulcers (3 cases). Histopathological findings were eosinophilic infiltration of the mucosa. The number of eosinophils in intestinal mucosa was 42(30~60)in patients with allergic colitis whose ECP was positive,18(15~23)in patients with Helicobacter pylori infection and 25.5 (14~35) in patients with congenital megacolon children, and the differences are statistically significant mong three groups (H=28.14,P<0.001). Conclusions Allergic colitis is more common in infants and young children. The main endoscopic findings are mucosal erythema and eruption like nodules. In addition, the increase of ECP positive eosinophils in intestinal mucosa is the characteristic manifestation of allergic colitis.