Objective To investigate the clinical characteristics and management of congenital hypertrophic pyloric stenosis (CHPS) associated with intestinal malrotation (IM) in infants.Methods The clinical data of 6 cases with CHPS and IM admitted in our hospital from Jan 2003 to Dec 2009 were reviewed,including clinical presentation,symptoms and information of imageology.Results Through barium meal examination and sonography,4 cases were diagnosed CHPS and IM,pyloromyotomy and Ladd's procedure were performed;two cases were diagnosed CHPS,only pyloromyotomy was done,secondary operation was performed for recrudescence of vomiting.All the cases were followed up for 1 to 3 years with good prognosis.Conclusion The etiology of CHPS with IM isn't clear.The diagnosis of IM may be delayed because the symptoms of IM can be masked by that of CHPS.It is helpful for diagnosis of this disease to have barium meal and sonography examination.Good prognosis will be achieved if prompt preoperative diagnosis and operation can be done.

[Objective]To explore the effect of combined acupuncture and medicine on learning--memory abilities,and free radical system of hippocampus in vascular dementia(VD)rats.[Methods]The 48 Sprague Dawley rats were randomly divided into control(1),VD model(2),VD plus removed olfactory bulb model(3)and XIU Three Needles(4),Eugenol(5),combined acupuncture and medicine(6)groups.Morris maze tests were conducted for valuating the learning and memory abilities.The contents of MDA,SOD and GSH-Px activity of hippocampus were detected.[Results]In comparison with group 1,the average escape latency and travel distance prolonged significantly in group 2.In comparison with group 2,it shortened remarkably in groups 4 and 5.No significant differences were found between groups 1 and 2.In comparison with group 6,it prolonged in groups 4 and 5.No significant differences were found between them.The MDA content of hippocampus in VD model group was higher than that of control group(P

Objective To analyze the factors associated with the outcome of pyeloplasty in term of renal function and morphology improvement in children with unilateral ureteropelvic junction obstruction,in order to provide clinical evidence for the treatment of hydronephrosis in children.Methods Clinical data of 174 children who underwent unilateral dismembered pyeloplasty from January 2009 to June 2014 were retrospectively studied.Differential changes in renal function and renal morphology after pyeloplasty were assessed by serial renal scan and ultrasound.On the basis of preoperative split DRF,these patients were divided into three groups:group Ⅰ with DRF ≥40％ (n =99),group Ⅱ with DRF 30％-40％ (n =29) and group Ⅲwith DRF ＜ 30％ (n =46).According to their age at surgery,the children were divided into four groups,including group A aged 1-3 months (n =52),group B aged 3 months-3 years (n =44),groupCaged3-6years (n =37),and group D aged more than 6 years (n =41).Results Inall 174 children,postoperative complication occurred in 7 cases,including urinary tract infection in 6 cases and renal atrophy in 1 case.A significant improvement of both function and morphology was confirmed in most patients (P ＜ 0.01).Patients in group Ⅰ showed stable renal function after operation(DRF 48.46％ ±4.80％ vs.50.78％ ± 5.45％,P ＜ 0.01),of them who underwent pyeloplasty at 1-3 months of age showed the best obvious recovery of renal morphology.Renal function of patients in group Ⅱ recovered obviously and most of them reached to the initial values (DRF 35.18％ ± 2.95％ vs.43.91％ ± 6.89％,P ＜ 0.01).While renal function of patients in group Ⅲ recovered significantly after surgery,most of them failed to restore the initial values(DRF 20.70％ ± 6.90％ vs.33.78％ ± 12.49％,P ＜ 0.01),and among them,the aged 1-3 months group possessed the best recovery.Moreover,the morphological improvement was similar to the functional improvement.The time for hydronephrosis recovered to less than Grade 2 of Society for Fetal Urology(SFU)was 6,24 and over 24 months respectively in group Ⅰ,Ⅱ and Ⅲll,and the renal morphology gradually improved with the increasing duration of follow-up.Conclusions The renal function and morphology of most patients improved significantly after pyeloplasty.Recovery of renal function and morphology after surgery was significantly correlated with the preoperative DRF.Early surgical intervention may improve the function and morphology recovery of the involved renal unit.

OBJECTIVE: To study the apoptosis-promoting effect of the serum from Panax notoginseng extracts-fed dog on precancerous gastric cells by means of flow cytometry. METHODS: In the experiment, we adopted eternalized human gastric mucosa epithelium GES-1 cells transformed by N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) (MC cells) as the model of precancerous lesions for study in vitro. We took the serum of a dog before and at two different points of time (2 and 6 hours) after feeding the dog with Panax notoginseng extracts for experiment. The MC cells were cultured in mediums with different concentrations of the medicated serum at 2- or 6-hour point of time for 72 hours. By means of flow cytometry, we examined the apoptosis-promoting effects of the serums on the MC cells. RESULTS: The medicated serums at these 2 points of time had significant effects in promoting MC cell apoptosis. The proportions of apoptotic cells in culture mediums with medicated serums had a significant increase as compared with those in culture mediums with non-medicated serums (serum obtained before administration of extracts to the dog) under the same conditions (P<0.05). The number of MC cells in G(0)/G(1)phase was decreased (P<0.05) and that in G(2)/M phase increased (P<0.05), while no consistent changes were observed in S phase. CONCLUSION: The medicated serums obtained at the two different points of time have significant apoptosis-promoting effects on MC cells. They decrease the number of MC cells in G(0)/G(1) phase and increase the number of MC cells in G(2)/M phase. This is probably responsible for the effects of Panax notoginseng extracts in inhibiting the proliferation of MC cells and promoting its apoptosis.

OBJECTIVE: Through cell cultivation, we studied the inhibiting effects of the serum of the dog fed with Panax notoginseng extracts on precancerous gastric cells, trying to find the best time points or periods when the extracts' function was the strongest after administration of the extracts to the dog. METHODS: The experiments adopted eternalized human gastric mucosa epithelium GES-1 cells and MC cells gained from GES-1 cells transformed by N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) as the model of precancerous lesions for study in vitro. We took the serum of a dog before and at different points of time after feeding the dog with Panax notoginseng extracts for experiment. By means of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay, we examined the inhibiting effects of the serum after culturing the GES-1 and MC cells for 72 hours with different concentration (8%, 4%, 2%) of medicated serum obtained from the dog at different points of time, so as to find that, at which points of time the medicated serum obtained, it would be the most effective. RESULTS: The results showed that the GES-1 and MC cells inhibition rates of medicated serum from the points of 2-hour and 6-hour were the highest, and the culture medium containing 8% of medicated serum from these two points had prominent inhibiting effects on both kinds of cells. The GES-1 cells inhibition rate in culture medium containing 8% of medicated serum from the point of 2-hour was 70.8% (P<0.01) and that of the MC cells was 45.3% (P<0.01). The GES-1 cells inhibition rate in culture medium containing 8% of medicated serum from the point of 6-hour was 88.5%(P<0.01) and that of the MC cells was 42.4% (P<0.01). CONCLUSION: The points of time with the strongest inhibiting effects are 2 hours and 6 hours after being fed with Panax notoginseng extracts. At these two points, the serum is most effective in inhibiting the proliferation of GES-1 and MC cells.

OBJECTIVE: To investigate the effects of Radix notoginseng extracts drug-containing serum on the expressions of apoptosis-regulating proteins including Bax, bcl-2 and p21WAF1 in precancerous gastric cells. METHODS: The N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) transformed eternalized human gastric mucosa epithelium GES-1 cell line (MC cell) was used in vitro as a model of gastric precancerous lesion. The medicated canine serum was prepared by feeding to the adult Beagle dog with Radix notoginseng extracts and obtaining the serum after 2-hour medication. MC cells were cultured with medicated canine serum (medicated serum group) or non-medicated canine serum (normal control group) for 72 hours. Expressions of Bax, bcl-2 and p21WAF1 proteins were detected by immunocytochemical assay and the average optical density of the cells was determined by an image analysis system. RESULTS: Compared with those of the normal control group, Bax and p21WAF1 expressions in medicated serum group were significantly enhanced (P<0.01), while the expression of bcl-2 was significantly reduced (P<0.01). CONCLUSION: Radix notoginseng extracts may inhibit the proliferation and promote the apoptosis of precancerous gastric cells through altering expressions of the bcl-2, Bax and p21WAF1 genes.

BACKGROUND:Lysophosphatidic acid (LPA) had 3 kinds of receptors in vitro. Some researches had showed that LPA1, LPA2 and LPA3 receptors distributed widely in mouse cerebral cortex, nephritic external medulla layer and internal medulla layer, spermary, thymus, heart, lung, stomach, spleen, whereas less in liver, small intestine and skeletal muscles. Whether there are various LPA receptors in mouse VSMC membrane deserves further study.OBJECTIVE: To observe the mRNA expression of LPA receptors in vascular smooth muscle cells (VSMC).DESIGN: Observational comparative experiment.SETTING: Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: A total of 24 C57BL/6 mice aged 7-8 weeks, of either sex, with the body mass of approximately (25±3) g,were purchased from the Animal Department of Tongji Medical College, Huazhong University of Science and Technology. Trizol was purchased from America Invitrogen; dNTP Mix, Rnasin were obtained from TaKaRa; M-MLV reverse transcriptase and buffer system were from Promega; Taq DNA-polymerase and buffer system were from Biostar.Oligo(dT)18 primer were from Sangon, Shanghai. Primer sequences were designed referring to literature and nucleotide sequence database and synthesized by Sangon, Shanghai.METHODS: The experiment was conducted at the Comprehensive Laboratory, Tongji Medical College, Huazhong University of Science and Technology between August 2005 and January 2006. Mice were anaesthetized by abdominal cavity with 20 g/L ketamine (5 mL/kg). Thoracic aorta was obtained sterilely, and VSMC was cultured with adherence method. The 4th-6th passage cells were used in the trial. Cell purity was over 95%. Reverse transcriptase-polymerase chain reaction (RT-PCR) was applied to determine the mRNA expression of LPA receptors gene in mouse VSMC.MAIN OUTCOME MEASURES: Detection of mRNA expression of LPA receptors in mouse VSMC and comparison of receptor types.RESULTS: There were no significant differences between the expressions of LPA1 receptors and LPA2 receptors (P ＞ 0.05). Compared with LPA1 receptors and LPA2 receptors (0.79±0.05,0.82±0.06), the LPA3 receptor expression was lower (0.53±0.05, q =23.78,26.53, P＜ 0.01 ).CONCLUSION: There are 3 kinds of LPA receptors in VSMC, and their molecular masses are 600 bp, 463 bp and 899 bp,respectively. There are no differences for the expressions between LPA1 receptors and LPA2 receptors, while the LPA3 receptor expression is less.

Objective To improve the understanding of the implications of testicular microlithiasis(TM)in paediatric patients by summarizing the clinical characteristics of TM. Methods One hundred and eighteen boys diag-nosed as TM based on ultrasound between March 2006 and December 2014 at Shengjing Hospital Affiliated to China Medical University were retrospectively reviewed. Demographic data,imaging data,indications for ultrasound,associated inguinoscrotal pathologies and follow - up data were collected. Results There were 118 cases of patients aged from 0. 25 to 14. 00 years(averaging 7. 98 years). The indication for ultrasound included health check(22 cases),testicular discomfort(28 cases),small testes(6 cases),scrotal mass(10 cases),with history of cryptorchidism(36 cases),with history of hydrocele(15 cases). Concomitant diseases included congenital anomaly of testis in 44 cases[cryptorchidism (34 cases),testicular absence(4 cases),testicular hypoplasia(6 cases)],hydrocele of tunica vaginalis or hernia(15 cases),testicular epididymitis(12 cases),varicocele(6 cases),epididymal cyst(5 cases),testicular teratomas(2 ca-ses),adrenal cortical hyperplasia(1 case),testicular torsion(1 case),and none associated disease(32 cases). Bilateral TM was in 87 cases(the typical TM in 38 cases,limited TM in 49 cases),while unilateral TM was in 31 cases(the typi-cal TM in 8 cases,limited TM in 23 cases). Fifty - three cases were followed up for 1 month to 36 months(averaging 12. 5 months),and the condition was stable,no testicular malignancy was observed during follow - up. Conclusions The TM in children is not a rare disease. The etiology of TM is not clear and there are no special clinical symptoms. TM is often associated with testicular abnormality in pediatric patients and the correlation between children′s TM and adult testicular tumor can not be determined yet. The distribution and involving degree of TM is stable in the short term with infrequent testiculoma,but an appropriate follow - up scheme is required,especially during and after puberty.

Objective: To explore the application value of computed tomography angiography (CTA) and three-dimensional reconstruction in repairing high-voltage electrical burn wounds in necks, shoulders, axillas, and upper arms with tissue flaps. Methods: From December 2014 to December 2018, 12 patients with high-voltage electrical burns in necks, shoulders, axillas, and upper arms were hospitalized. The size of wounds ranged from 13 cm×10 cm to 32 cm×15 cm after complete debridement. Before tissue flap repair, the subclavian artery-axillary artery-brachial artery and their branches were examined by CTA. The main target vessels and their branches were conducted by three-dimensional reconstruction, and the development of the axis vessels for the tissue flaps planning to dissect and their branches were observed. For wounds in upper arms, amputation stump bone exposed wounds, and wounds in axillas and the anterior, the latissimus dorsi myocutaneous flap is the first choice for repair, if the thoracodorsal artery and internal and external branches are well developed according to CTA examination. Latissimus dorsi myocutaneous flaps were used in 6 patients with the area of myocutaneous flap ranging from 16 cm×12 cm to 32 cm×17 cm. All the donor sites were covered by split-thickness skin graft of thighs. For large wounds in occiputs, necks, and scapulas, the contralateral lower trapezius myocutaneous flap is the first choice for repair, if the superficial descending branch and deep branch of the contralateral transverse cervical artery are well developed according to CTA examination. For small wounds in necks and scapulas, the ipsilateral lower trapezius myocutaneous flap can be used for repair, if the superficial descending branch of the ipsilateral transverse cervical artery is well developed according to CTA examination. Lower trapezius myocutaneous flaps were used in 4 patients with the area of myocutaneous flap ranging from 18 cm×12 cm to 25 cm×17 cm. The donor site of one patient was sutured directly and the donor site of the other 3 patients was covered by split-thickness skin graft of thighs. For wounds in the posteromedial side of upper arms and the anterior side of axillas, the lateral thoracic skin flaps can be used for repair, if the latissimus dorsi myocutaneous flap can not be utilized for reasons of back burn or no muscle is needed for dead space, when the blood supply of side chest skin is reliable according to CTA examination. Lateral thoracic skin flaps were used in 2 patients with the area of skin flap ranging from 16 cm×12 cm to 17 cm×14 cm. The donor site of one patient was sutured directly and the donor site of the other one patient was covered by split-thickness skin graft of thigh. Results: During the operation of tissue flap repair in 12 patients, the orientation and starting position of the axis vessels were consistent with those observed by CTA examination before operation. All the tissue flaps survived after operation. During follow-up of 1 to 24 months, the patients were satisfied with no serious scar contracture affecting the function nor secondary infection or chronic ulcer. Conclusions CTA and its three-dimensional reconstruction technique can clearly reconstruct the subclavian artery-axillary artery-brachial artery and their branches before repair of high-voltage burn wounds in necks, shoulders, axillas, and upper arms. It can be used to observe whether the vessels are embolized or not and the starting position and orientation of blood vessels, which can provide an important reference for the selection of tissue flap transplantion.

Objective To study the effect of high mobility group box B1(HMGB1)gene knockout on alleviating a-cute lung injury and inhibiting toll-like receptor 4(TLR4)/nuclear factor-KB(NF-κB)pathway of sepsis mice.Methods Wild-type(WT)mice were divided into WT-Sham group and WT-model group,and HMGB1 knockout(KO)mice were divided into KO-sham group and KO-model group.Sepsis ALI model was established by cecal ligation and perforation in WT-model group and KO-model group.Sham operation was performed in WT-Sham group and KO-Sham group.24 h after modeling,the partial pressure of arterial oxygen(PaO2)was detected,oxy-genation index(OI)was calculated,pathological changes of lung tissue were detected and lung injury score was calculated,the concentrations of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),interleukin-6(IL-6),reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),in serum and lung tissues and the expression of HMGB1,TLR4 and nuclear NF-κB in lung tissues were detected.Results The PaO2,OI and the concentration of SOD in serum and lung tissue of WT-model group were lower than those of WT-Sham group,the lung injury scores,the concentrations of TNF-α,IL-1 β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of HMGB1,TLR4 and nuclear NF-κB in lung tissue were higher than those in WT-Sham group(P＜0.05).HMGB1 was not expressed in lung tissue of KO-model group,and the concentrations of PaO2,OI and the concentration of SOD in serum and lung tissue of KO-model group were higher than those of WT-model group,the lung injury scores,the concentrations of TNF-α,IL-1β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of TLR4 and nuclear NF-κB in lung tissue were lower than those of the WT-model group(P＜0.05).Conclusion HMGB1 gene knockout alleviates acute lung injury of sepsis mice,the re-lated molecular mechanism may be the inhibition of TLR4/NF-κB pathway mediated inflammation and oxidative stress.