Female ; Humans ; Infant ; Meningitis, Bacterial ; complications ; Salmonella Infections ; complications ; Salmonella typhi ; isolation & purification ; Sepsis ; complications

Anesthesia, General ; adverse effects ; Child, Preschool ; Humans ; Male ; Malignant Hyperthermia ; diagnosis ; etiology

Objective To investigate the effects of shRNA targeting a disintegrin and metalloproteinases 17(ADAM17)on the proliferation of human breast cancer MCF-7 cells in hypoxia environment.Methods The four specific ADAM17-shRNA se-quences aiming at ADAM17 were designed,transfected into MCF-7 cells by electroporation,and cultured in hypoxia environment. The experiment was divided into the control group (blank phosphate buffer solution,PBS),nonsense sequence group (transfected with ADAM17-shNC)and shRNA transfection group (transfected with ADAM17-shRNA,the highest silencing efficiency of shR-NA was selected for following experiments).Real-time PCR was used to detect the expression of ADAM17 mRNA.The prolifera-tion ability and cell cycle change of MCF-7 cells were detected by iCELLigence and flow cytometry (FCM),respectively.Results Compared with control group and nonsense sequence group,the four ADAM17-shRNA transfection groups all had the silence effect on ADAM17 gene expression (P <0.05 ),the difference was statistically significant(P <0.05 ),particularly shRNA1219 had the highest inhibitory rate (F =5.11,P <0.01 ).The cellular proliferation ability and cell growth speed in the shRNA transfection group were significantly decreased compared with the control group and nonsense sequence group (P <0.05).Most cells of shRNA transfection group remained in the G0/G1 phase (73.35 ± 2.45 ),which in the control group and nonsense sequence group was (62.56±2.35)and (62.68 ±1.20)respectively,the difference was statistically significant(P <0.05).The cell cycle progression was significantly delayed.Conclusion ADAM17-shRNA inhibits the proliferation of MCF-7 cells under hypoxic environment.

Objective To evaluate the effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children.Methods Three hundred and fifty-nine ASA Ⅰ or Ⅱ children (aged 3 months-14 years and weighing 5-74 kg) requiring allogeneic blood transfusion during operation were randomly divided into two groups:163 children receiving normal allogeneic blood transfusion (control group,group C) and 196 children receiving leukocyte-depleted allogeneic blood transfusion (group D).Blood samples were collected from the peripheral vein before blood transfusion,and 2 and 6 days after blood transfusion for determination of the levels of CD3+,CD4+,CD8 +,and CD56+ by flow cytometry.CD4+ /CD8+ ratio was calculated.The volume of allogeneic blood transfusion during operation,the duration of operation,postoperative drainage,antibiotic administration,hospital stay and the incidence of postoperative infection were recorded.Rssults The levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio significantly increased at 6 days after blood transfusion while the duration of postoperative drainage,postoperative antibiotic administration,hospital stay and the incidence of postoperative infection significantly decreased in group D compared with group C.Conclusion Leukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.

Objective To investigate the clinical feature , pathologic characteristics and prognosis of urothelial carcinoma of bladder with squamous differentiation . Methods From Jan.2010 to Jun.2013, the pathological and clinical data of 96 cases of urothelial carcinoma of bladder with or without squamous dif-ferentiation were compared .Of the group with squamous differentiation , there were 39 males and 9 females with a median age of 70 (29 to 87) years.44 cases presented with painless gross hematuria .4 cases presen-ted with finding of bladder tumors in annual physical examination .TURBT, partial cystectomy and radical cystectomy were performed in 25, 8 and 13 cases, respectively.In addition, one case was only underwent bi-lateral ureteral skin gastrostomy .The last one only performed cystoscopy .In accordance with sex , age, path-ological stage and classification and surgical approach , 48 controls were selected .For the other group , there were 40 males and 8 females with a median age of 68 (39 to 86) years.45 cases presented with painless gross hematuria.3 cases presented with finding bladder tumors by annual physical examination .TURBT, par-tial cystectomy and radical cystectomy were performed in 28, 7 and 13 cases, respectively.All patients with retaining bladder had postoperative intravesical instillation for one year .Some patients with or without bladder performed 3-6 cycles chemotherapy with the GC protocol . Results In squamous differentiation group , there were 1 (2.1%) pTa, 25 (52.1%) pT1, 17 (35.4%) pT2, 4 (8.3%) pT3 and 1 (2.1%) pT4 tumors. Whereas, 1 (2.1%) pTa, 28 (58.3%) pT1, 16 (33.3%) pT2, 2 (4.2%) pT3 and 1 (2.1%)pT4 tumors were selected in the control group .There were 2 (4.2%) cases with low grade and 46 (95.8%) cases with high grade carcinomain in both groups .Patients were followed up with a mean duration of 16 and 12 months in squamous differentiation and control group , respectively .In squamous differentiation group , eight recur-rences were recorded with a mean follow-up of 12 months.Of the 3 died patients, only one died from bladder cancer.In control group, seven recurrences were recorded with a mean follow-up of 22 months, and no pa-tient died.For patients with TURBT, 3 year recurrence rate of patients with squamous differentiation was 49.5%, while the control was 34.8%.The difference was statistically significant (P<0.05). Conclusions Urothelial carcinoma of bladder with squamous differentiation is at a high level of malignant and recurrence . The rate of myometrial invasion with squamous differentiation is higher than pure urothelial bladder cancer . Patients with squamous differentiation should be closely followed up .

Objective To study the methods and effect of the surgical treatment for intrahepaticolithiasis(IHL). Methods In recent 12 years, in our hospital,230 cases of IHL were treated by different operations companied with biliary fibrescopy to remove the residnal stones of biliary tract. Results (1) Hepatolobectomy combined with Y-type hepatocholangiojejunostomy was done in 103 cases,the success rate was 91.8%.(2)Y-type hepatocholangiojejunostomy was performed on 45 cases,the success rate was 81.2%.(3)Hepaticolithotomy combined with T-tube drainage was done in 72 cases,the success rate was 69.3%. Conclusions For intrahepaticolithiasis,combination of hepatolobectomy with other operation and with biliary fibrescopy during or after the operation shoul be done, which can effectively improve the curative effect.

ObjectiveTo investigate the effects of leukocyte-depleted allogeneic blood transfusion on perioperafive cellular immunity in children.MethodsThree hundred and fifty-nine ASA Ⅰ or Ⅱ children aged 3 month-14 yr,weighing 5-74 kg requiring allogeneic blood transfusion during operation were randomly divided into 2 groups:control group (group C,n =163) and leukocyte depletion group (group D,n =196).In group D allogeneic blood was filtered with a leukocyte filter before being transfused during operation.Blood samples were collected from peripheral vein before blood transfusion,and at 2 and 6 d after blood transfusion for determination of levels of CD3+,CD4+,CD8+,and CD56+ by flow cytometry.CD4+/CD8+ ratio was calculated.The volume of allogeneic blood transfused during operation,the duration of operation,postoperative drainage,antibiotics administration and hospital stay and incidence of postoperative infection were recorded.ResultsThe levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio were significantly increased at 6 d after blood transfusion while the duration of postoperative drainage,postoperative antibiotics administration and hospital stay and incidence of postoperative infection were significantly decreased in group D compared with group C.ConclusionLeukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.

Objective To validate a new standardized training program for urological surgeons to improve their laparoscopic surgical skills. Methods The laparoscopic surgical training program was carried out by using the traditional mechanical simulators and animal models. Thirty-three trainees participated the urological laparoscopic surgical training program. Initially, the novices were assigned to practise basic laparoscopic skills step by step on the simulator with fixed trocar positions. After a period of basic training, they were allowed to practise on animal models for some particular proce-dures. Results All trainees (33/33, 100.0%) participated were able to perform all basic techniques skillfully and completed laparoscopic anastomosis accurately after the training. The time required for performing the partial nephrectomy, dismembered pyeloplasty and ureteral reimplantation on animal models declined from 64.0±18.4, 127.54±17.5 and 75.84±11.6 min at the beginning to 30.94±3.8, 65.2±7. 5 and 37.7±7.2 min after practicing these procedures 8 times (P<0.01). They could un-derstand the crucial procedures of the laparoseopic surgeries after 6 to 8 special trainings on animal models. Fifteen trainees (15/33, 45.5%) had started to carry out laparoscopic surgeries after-finish- ing the training program. Conclusions Our program enables the participants to improve their techniques in complicated laparoscopic surgeries. The challenging parts of reconstructive laparoscopic surgeries such as laparoscopic dismembered pyeloplasty can be taught by using animal models. This program could be incorpo-rated easily by all urological departments developing a laparoscopie surgical training program.

Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; diagnosis ; therapy ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; Radiography, Thoracic

ObjectiveBy studying acupuncture at Neiguan (PC6), Shuigou (GV26), and Baihui (GV20) in septic shock patients, to observe the effect of acupuncture on T cell subsets, vital signs, white blood cell (WBC) count, and procalcitonin (PCT) level in septicshock patients.MethodSixty patients were randomized into a treatment group and a control group. The control group was intervened by symptomatic managements including supplementing blood volume, anti-inflammation, nutrition support, and organ protection, and the treatment group was by acupuncture at Neiguan, Shuigou, and Baihui in addition to the intervention given to the control group. The T cell subsets contents were detected before and after intervention, and serum PCT level, APACHEⅡscore, vital signs, and WBC count were determined on day 1, 3, 5, and 7.ResultIn the treatment group, T cell subsets including CD3﹢, CD4﹢, and CD4﹢/CD8﹢increased significantly after intervention (P<0.01,P<0.05), while CD8﹢dropped significantly afterintervention (P<0.05), and the changes in the treatment group were all markedly superior to that in the control group (P<0.05). The decrease of PCT level in the treatment group was more significant than that in the control group after treatment, the PCTlevel dropped significantly on the 5th day in the treatment group compared to that before treatment, and the inter-group difference was statistically significant after the 3rd day (P<0.01); the APACHEⅡscore in the treatment group was different from that in the control group after 3 d treatment, and the score was significantly changed in the treatment group after 5 d treatment (P<0.05); the body temperature, heart rate, inspiration, WBC count all showed decrease or improvement, and the improvements of vitalsigns in the treatment group were more significant than that in the control group (P<0.01,P<0.05).ConclusionAcupuncture at Baihui, Shuigou, and Neiguan can improve the immune function of septic shock patients, and its treatment effect is confirmed.