Objective To study the effects of intravenous immunoglobulin (IVIG) on neonatal lymphocyte immune function. Methods Cord blood mononuclear cells (CBMCs) and CD3+ T lymphocytes were isolated from 8 neonates and were cultured with IVIG and/or/without phytohemagglutinin (PHA)based on which divided into five groups, i. e. (l)control group, (2)PHA activation group, (3) IVIG pre-inhibition group, (4) PHA pre-activation group and (5) PHA+IVIG group. The production of IFN-? and IL-4 of CBMCs and cord blood CD3+ T lymphocytes was measured with ELISA and the expression of IL-2 and IL-4 mRNA was measured with RT-PCR. The results were compared with peripheral blood mononuclear cells(PBMCs) of 8 adults. Results The production of IFN-y by CBMCs and cord blood CD3+ T lymphocytes induced by PHA decreased after IVIG was given, while more remarkable decrease in the CBMCs was shown without any association with IVIG was given or not before or after PHA was used [Group 2; (313. 34?108. 00)pg/ml, Group 3: (17. 68?17. 98) pg/ml, group 4 : (170. 72?38. 25) pg/ml, group 5: (11. 10?8. 92)pg/ml]. For the CD3+ T lymphocytes, the decrease of IFN-? production was only observed in group 3, 4 and group 5 [(35. 30 ?12. 21)pg/ml, (8. 61?6. 21) pg/ml and (8. 54?1. 57)pg/ml]. The degree of decrease of IFN-? production by CBMCs was much lower [group 2: (1121. 11 ? 344. 58)pg/ml, group 3: (29. 08 ? 11. 20)pg/ml, group 4: (339. 63?47. 43) pg/ml, group 5: (26.40?21. 97)pg/ml]. The secretion for IL-4 did not changed when stimulated by PHA alone, but IL-2 and IL-4 mRNAs expression can be detected in CBMCs after repeated stimulation by PMA, PHA and rIL-2 which decreased after IVIG was given. Conclusions IVIG can suppress the production of IFN-? in cord blood T lymphocyte directly or mediated by other immune cells or molecules. IVIG can also decreased the expression of IL-2 mRNA and IL-4 mRNA in CBMCs. The effect of IVIG on the proliferation of cord blood lymphocytes and production of immunoglobulin in B lymphocytes might be associated with these inhibition.

Objective To investigate the advantages, indications and efficiency of video-assited thoraco-scopic sugery in spontaneous pneumothorax. Methods 31 patients with spontaneous pneumothorax underwent video-assited thoracoscopic sugery, performed with endoscopic manual suture without use of endoscopic cutters. Results All patients were cured without recurrence. Conclusions Video-assited thoracoscopic sugery is the first choice in treating spontaneous pneumothorax,with minimal trauma,less bleeding. Endoscopic manual suture can obviously re-duce the treatment cost.

Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia in Jiaxing,and to provide a therapy for clinical doctor to make a correct diagnosis,choose reasonable anti-biotics and avoid abuse of antibiotics.Methods Took expectoration from trachea in condition of asepsis to conduct culture and perform drug-sensitive test from 3025 cases.Results Totally 1 156 strains of aerobic bacteria were iso-lated.875 strains were gram negative bacilli(75.7%),269 strains were gram positive cocci(23.3%),and 12 strains were fungi(1.0%).Klebsiella pneumoiae,Escherichia coil,Acinetobacter baumanni,Enterobacter cloacae were com-mon in gram negative bacilli( respectively 178 cases,151 cases,87 cases,113 cases) .The proportion of the Staphylo-coccus aureus was the largest in gram positive cocci(245 cases) .The results showed that gram-negative bacilli were resistant to cefazolin, ampicillin, piperacillin and sensitive to meropenem, imipenem, piperacillin-tazuobatanna and cefoperazone-sulbactam.The drug resistance was severe of ESBL-positive.Staphylococcus aureus was resistant to penicillin, ampicillin, erythrocin, clindamycin and sensitive to linezolid, vancomycin, nitrofurantoin.Conclusion Gram-negative bacilli are the main bacteria in neonatals with infectious pneumonia.The drug resistance is severe.It is important to make a standard management and isolation.

Objective To observe the curative effect of head hypothermia combined with mouse nerve growth factor in the treatment of neonatal moderately severe hypoxic ischemic encephalopathy (HIE).Methods 50 cases of severe HIE were randomly divided into observation group and control group,with 25 cases in each group.Both two groups were given the conventional treatment.The observation group was given head hypothermia treatment in 6 hours after born,to maintain the nasopharyngeal temperature (34.0 ±0.5)℃,anal temperature (35.5 ±0.5)℃,72 hours continuously.At 96 hours after the birth,the nerve growth factor was given.The control group did not give the head mild hypothermia treatment.At 96 hours after birth,the nerve growth factor (methods,dosage and treatment were the same as the observation group)was treated with nutrition and brain nerve.After treatment,the improvements of heart rate,muscle tension,convulsions and disturbance of consciousness were observed in two groups.After 3 days,2 weeks and 4 weeks,the neonatal behavioral neurological assay (NBNA),1 and 3 months after birth,the outfit cranial MRI plain scan and brainstem auditory evoked potential (BAEP)were evaluated.Results NBNA scores of the two groups were compared in 3 days,2 weeks and 4 weeks after birth,the differences were statistically significant (t=2.53, 2.89,3.23,all P<0.05).In the observation group,the abnormal brain MRI was significantly less than the control group,the difference was statistically significant (χ2 =24.125,P<0.05).In the observation group,the number of abnormal auditory evoked potential was significantly less than that of the control group,the difference was statistically significant (χ2 =21.312,P<0.01 ).Conclusion Head hypothermia combined with mouse nerve growth factor therapy for the treatment of neonatal moderately severe HIE has protective effect,it can improve the treatment efficacy, reduce the long-term neurological sequelae,and without adverse reaction.

Objective To investigate the risk factors of spontaneous rupture of BCLC stage A and stage B hepatocellular carcinoma (HCC),and to review the surgical outcomes.Methods From April 2002 to November 2006,89 patients who suffered from spontaneous rupture of HCC of BCLC stage A and stage B were included into this study.A control group of 171 patients was selected by matching the sex,age and BCLC stage.Clinical data and survivals were collected and analysed.Results On multivariate analysis,hypertension (HR 7.38,95％CI:1.91 ～28.58,P＜0.05),cirrhosis (HR6.04,95％ CI:2.83 ～12.88,P ＜ 0.05) and tumor location in segments Ⅱ,Ⅲ,Ⅵ (HR 5.03,95％ CI:2.70 ～ 6.37,P ＜ 0.05) were predictive factors of spontaneous rupture of HCC.In the study group,the median survival and median disease-free survival were 12 months (range,1 ～ 78 months) and 4 months (range,0 ～ 78 months) respectively.The overall survival rates and disease-free survival rates at 1-,3-and 5-year were 66.3％,23.4％,10.1％ and 57.0％,16.8％,4.5％,respectively.Only radical resection remained predictive of overall survival (HR 0.32,95％ CI:0.08 ～ 0.61,P ＜ 0.05) and disease-free survival (HR 0.12,95％ CI:0.01 ～ 0.73,P ＜ 0.05).Conclusions Tumor location,as well as hypertension and cirrhosis were associated with spontaneous rupture of HCC.One-stage hepatic resection should be recommended to patients with ruptured HCC of BCLC stage A and stage B.

Objective To investigate the appropriate cutoff point of CA19-9 in prognosis and to determine other potential prognostic factors which may affect survival of patients with hilar cholangiocarcinoma (HC) after radical surgery.Methods 168 patients who had undergone radical surgery for hilar cholangiocarcinoma with R0 and R1 resection were selected for the study.Categorized versions were used in univariate model to determine the appropriate cutoff point of CA19-9.CA19-9 and other clinicopathologic factors were analyzed for their influence on survival using multivariate methods.Results The strongest univariate predictor among the categorized preoperative CA19-9 measures was CA19-9 of less than 150 IU/L (P ＜0.001).On univariate analysis,age,differentiation,tumor size,Bismuth-Corlette classification,portal vein invasion,lymph node metastasis,hepatic artery invasion,liver invasion,preoperative biliary drainage,resection margin and preoperative CA19-9 levels were identified as significant prognostic factors.On multivariable analysis,lymph node metastasis,resection margin and preoperative CA19-9 levels were independent prognostic factors of survival.Conclusions A raised preoperative CA19-9 level was an independent prognostic factor of survival for hilar cholangiocarcinoma.The most discriminative cutoff point of CA19-9 for prognosis was at 150 kU/L.

Objective To identify clinicopathologic factors which predict survival following hepatectomy in HBV-related cirrhotic patients with early hepatocellular carcinoma (HCC).Methods A database was used to identify patients with histologically confirmed early HCC (≤5 cm,no nodal involvement,metastases,or major vascular invasion) who underwent surgical resection (excluding ablation or transplantation).Among 20 700 patients with HCC who were diagnosed at the Eastern Hepatobiliary Surgery Hospital from April 2005 to November 2010,537 (2.6％) patients with early HCC were studied retrospectively.Prognostic factors were evaluated using the Kaplan-Meier curves,Cox proportional hazards models and the receiver operating characteristic (ROC) curves.Results The study included 537 patients.The median tumor size was 2.9 cm,and 33％ of patients had tumors ≤2 cm.Most HCC lesions were solitary (63％) and had no evidence of vascular invasion (64％).Following surgery,the overall median and 5-year survival were 45 months and 33％ respectively.After adjusting for demographic factors and histological grade,tumor size ＞2 cm (hazard ratio [HR]:1.56),multifocal tumors (HR:1.34),and vascular invasion (HR:2.03) remained independent predictors of poor survival (all P ＜ 0.05).Based on these findings,a prognostic scoring system was developed that allotted 1 point each for these factors.Patients with early HCC could be stratified into 4 distinct prognostic groups (median and 5-year survival,respectively):0 points (97 months,96％),1 point (85 months,76％),2 points (76 months,54％),3 points (56 months,39％) (P ＜0.01).Conclusions The present study emphasized the importance of pathologic staging even in patients with small HCC.Anatomical resection of HCC should be the preferred surgical procedure in cirrhotic patients.

Objective To investigate the natural history and growth pattern of hepatic hemangioma in adults.Methods From April 2010 to March 2013, adult patients with hepatic hemangioma who had no prior treatment were enrolled.A routine follow-up was performed to observe the natural history and complications of these lesions.Results 236 patients were enrolled in the study.The median size of the hemangiomas was 4.5 cm (range 0.6 ～ 19.2 cm).During a median follow-up of 48 months (range 3 ～ 266 months), the hemangiomas increased in size in 61.0％ of patients, remained stable in size in 23.7％, decreased in size in 8.5％.The peak growth period was in patients ＜ 30 years age (0.46 ± 0.41 cm/year) and the growth rate decreased significantly after 50 years of age (0.21 ±0.40 cm/year).Hemangiomas with a size ＜2.0 cm had the lowest growth rate (0.16 ± 0.42 cm/year).The peak growth rate was in hemangiomas 8.0 ～ 10.0 cm (0.80 ± 0.62 cm/year) , but for hemangiomas ＞ 10.0 cm, the growth rate was only (0.47 ±0.91)cm per year.Only 9 patients had severe symptoms caused by the hemangioma.No patients presented with hemangioma-related complications.Conclusions The majority of hepatic hemangiomas have the tendency to increase in size but they rarely caused complications.All the hemangiomas could be safely managed by observation, and surgery should only be considered in patients with complications.

Objective:To explore the mediating effect of positive emotion on relationship between cognition reappraisal and meaning of life in freshmen.Methods:Totally 192 freshmen[62 males and 130 females,aged 18 to 22 years,mean age (20 ± 2) years] were assessed with the Chinese version of the Emotion Regulation Questionnaire (ERQ),Positive words of the Positive and Negative Affect Scale (PANAS) and Chinese version of the Meaning of Life Questionnaire (MLQ).Interval of 3 months of longitudinal data was used to investigate the mediating role of positive emotions in cognitive reappraisal sense and meaning of life.Results:The EPQ scores were positively correlated with the scores of PA,MLQ-P,and MLQ-S(r =0.17-0.26,Ps ＜ 0.05).The PA scores were positively correlated with the scores of MLQ-P and MLQ-S (r =0.16-0.35,Ps ＜0.05).Bootstrap test showed that positive emotions mediated meaning of life through cognitive reappraisal (95％ CI:0.065-0.295).The structural equation model proved to exhibit an appropriate data fit (x2/df=1.58,RMSEA =0.06,CFI =0.98,GFI =0.95).Conclusion:It indicates that cognitive reappraisal is related to meaning of life and positive emotions,and positive emotions mediate the relationship between cognitive reappraisal and meaning of life among freshmen.

Objective To investigate the clinical significance of serum procalcitonin (PCT),C reactive pro-tein(CRP),and lymphocyte subsets CD +19 CD +23 in children with Kawasaki disease (KD).Methods From August 2013 to July 2015 in hospital,30 cases of acute phase KD were selected.According to cardiac color Doppler ultra-sound results,30 patients were divided into coronary artery disease (CAL)group and non coronary artery disease (NCAL)group.The intravenous immunoglobulin (IVIG)before and after treatment,serum PCT,CRP,CD +19 CD +23 were detected.And 30 healthy children were selected as normal control group.Serum PCT was detected by chemilumines-cence immunoassay,CRP was determined by immune latex ratio method,CD +19 CD +23 was measured by flow cytometry. Results The levels of PCT,CRP and CD +19 CD +23 were (1.37 ±0.39)μg/L,(52.24 ±12.99)mg/L,(25.45 ± 11.06)% respectively in KD before IVIG treatment,which were significantly higher than those of KD after treatment [(0.49 ±0.24)μg/L,(37.48 ±6.27)mg/L,(17.23 ±1.97)%]and the control group[(0.05 ±0.00)μg/L, (16.08 ±5.21)mg/L,(15.76 ±2.39)%],the differences were statistically significant (t =6.108,5.983,8.172, all P <0.01).In CAL group,PCT[(1.75 ±0.53)μg/L,(65.95 ±14.55)mg/L]and CRP[(0.93 ±0.42)μg/L, (26.18 ±6.71)mg/L]were higher than NCAL group,the differences were statistically significant (t =5.504,5.621, all P <0.05).While CAL group CD +19 CD +23 [(24.70 ±11.86)%]and NCAL group[(25.79 ±10.59)%]had no statistically significant difference (t =0.559,P >0.05 ).Conclusion PCT,CRP and CD +19 CD +23 can be used as important index for early diagnosis and prediction of KD,the levels of CRP and PCT have clinical significance in the assessment of coronary artery lesions.