AIM:To analyze the effect of non-exchange transfusion therapy, including simple phototherapy or phototherapy combined with albumin therapy, on severe jaundice in full-term neonates.METHODS: The full-term neo-nates (n=110) with serum total bilirubin (TBIL) level over 342 μmol/L recewed simple phototherapy or phototherapy combined with albumin therapy.The changes of serum bilirubin levels and neurological signs of these neonates were ob-served.RESULTS:Serum TBIL and indirect bilirubin ( IBIL) levels in the 2 groups of hospitalized cases significantly re-duced after the first day of treatment and at discharged (P<0.01).The reduced degrees of TBIL and IBIL levels in the neonates given phototherapy combined with albumin therapy were higher than those in the neonates given simple photothera-py.All these neonates did not have bilirubin encephalopathy on admission or at discharged.CONCLUSION:Both simple phototherapy and phototherapy combined with albumin therapy treat severe jaundice effectively and prevent acute bilirubin encephalopathy in full-term neonates.

This paper introduces the basic concept of man-machine interaction technique and the pathological and physiology basis of its application in guiding equipment. Based on the analysis of demands of blind people, the design for novel intelligent guiding equipment based on man-machine interaction technique was proposed. This method used multiple sense information mainly by infrared technique to detect obstruction and control the advancing direction of whole guiding equipment through the intellectualized judgment and processing by microprocessor to guide the blind. In addition, the principle and process of detecting method, control function, command definition, program design and debugging improvement of the guiding equipment were introduced, and its application and prospect were discussed.

Objective To investigate the risk factors of gallbladder neoplastic polyps,to determine the proper surgical indications,and to understand more about the clinical characteristics of gallbladder adenoma.Methods The clinical data of 748 patients diagnosed to have polypoid lesion of gallbladder (PLG) and underwent cholecystectomy from January 1998 to December 2012 in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively reviewed.Results Among 748 patients,340 had abdominal symptoms.Postoperative histopathology showed non-neoplastic polyps (n =659),gallbladder adenoma (n =68),gallbladder cancer (n =15) and no polyps (n =6).The mean diameters of the nonneoplastic lesions and the neoplastic polyps were (9.38 ± 3.44) mm and (14.55 ± 5.71) mm,respectively (P ＜ 0.01).The average age of the patients with non-neoplastic lesions was (44.14 ± 11.42) years and (47.39 ± 12.82) years in those with neoplastic polyps (P ＜ 0.05).The proportion of solitary PLG was 41.4％ (253/611) and 59.59％ (47/79) for the non-neoplastic lesions and the neoplastic polyps respec tively (P ＜ 0.01).The size of PLG (13.34 ± 4.18 mm vs.20.07 ± 8.19 mm,P ＜ 0.05) and the age of the patient (45.78 ± 11.66 years vs.54.13 ± 15.82 years,P ＜0.05) between the gallbladder adenoma and gallbladder cancer groups were significantly different.Gallbladder adenoma or dysplasia was identified in 66.7％ (10/15) of gal1bladder cancer specimens.Conclusions Patients with PLG and with abdominal symptoms,large size (≥ 10 mm),old age (≥50 y) and solitary polyp are indications for cholecystectomy.Gallbladder adenoma may develop to gallbladder cancer within 10 years.

Objective To study the association between paternal CD3, CD4 and CD8 antigenecity to their pregnant spouses and the development of pregnancy induced hypertension (PIH). Methods Maternal serum from 15 women with PIH in the third trimester and 82 in normal pregnancies (16 in the first, 32 in the second and 34 in the third trimester) were incubated with paternal T lymphocytes. Monoclonal CD3, CD4 and CD8 fluorescent conjugated antibodies were then added and the percentage of paternal T cell differentiation antigen CD3, CD4 and CD8 were measured by flow cytometry. Results During normal pregnancy, the levels of maternal serum blocking antibodies on paternal CD3, CD4 and CD8 were (4.14?1.02, 2.02 ?0.24, 2.37?1.05)% in first trimester, (-0.29?0.13, 1.03?0.27, 0.65?0.23)% in the second trimester and (-1.33?1.47,0.15?0.01, -1.04? 0.37)% in the third trimester. There were significant difference between them( P

Phthalate esters (PAEs)are by far the most widely used plasticisers and are categorized as high and low,depending on their molecular weight.Because of their extensive use,humans are most likely exposed to PAEs in the workplace and home environment through direct as well as indirect sources.Injection,inhalation,intravenous injection and skin absorption are potential pathways of expo-sure.With respect to health effects,phthalates are often classified as endocrine disruptors because of their ability to interfere with the endocrine syste m in the body.Furthermore,PAEs possess reproductive toxicity because of their influence on development of the reproductive system in infancy and development and differentiation of germ cells in adults.PAEs promote pathogenesis and development of liver cancer by activating peroxisome proliferator-activated receptor (PPAR)and DNA methylation.In addition, PAEs,which inhibit the i mmune functions of macrophages and pro mote hypersensitive response,pos-sess immunotoxicity.PAEs are also carcinogens that promote pathogenesis and development of cancers including breast,ovarian and so me other cancers.

Objective To evaluate the levels of high-sensitivity-CRP(hs-CRP),interleukin-10(IL-10) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Fifty cases with obstructive sleep apnea-hypopnea syndrome from Jul.2012 to Dec.2013 in the People's Hospital of Pudong New Area were selected as our subjects,of which,22 patients were with mild-moderate OSAHS and 28 patients were with severe OSA.Twenty-seven health people were served as control group.The levels of hs-CRP,IL-10 were measured.Information of sleep study and other clinical characteristics were collected.Results There were no significant differences in terms of age,hip circumference and waist-to-hipratio (WHR) among three groups (P ＞0.05).Body mass index (BMI),neck circumference,waist circumference,Apnea-Hypopnea Index (AHI),the lowest arterial oxygen saturation(SaO2％) and hs-CRP in mild,severe OSA and control group were (28.01 ±3.41),(28.55±2.87) and (5.51±3.28) kg/m2,(41.18±4.37),(41.46±3.32) and (38.76±2.66) cm,(101.86±8.05),(102.32±7.97) and (94.56±10.25) cm,(44.55±16.26),(10.54±7.08) and (2.02 ±1.51) time/h,(85.05±6.40)％,(72.85±15.07)％,(88.59±3.43)％,(8.35±2.71),(9.19±2.85),(7.06 ± 1.30) mg/L,and the differences were significant(P＜0.05).In patients with OSA,SaO2％ was related to BMI (r =-0.274,P =0.027) and AHI (r =-0.651,P ＜ 0.001).Level of hs-CRP was associated with AHI (r =0.336,P =0.006) and BMI (r =0.247,P =0.047),and weakly associated with IL-10 concentrations.Conclusion Levels of hs-CRP is an important inflammation marker of OSAHS severity.However,levels of IL-10 shows an increasing in mild-moderate OSA patients,then decreasing in patients with severe OSA.

Gastrointestinal stromal tumors are the common mesenchymal tumors of the gastrointestinal tract. The constitutive activation of KIT is one of the earlies ttransforming events in GISTs and occurs mainly through activating mutations in the kit gene. PDGFRa is associated with the pathogenesis of GISTs too. The main mutative site of KIT gene are exon11, exon9, exon13 and exon17 and those of PDGFRA are exon18, exon12 and exon14.The clinical parameter and the response to imatinib of GISTs are associated with the site and type of gene mutation. Imatinib mesylate is a small-molecule inhibitor that selectively inhibit the tyrosine kinase and the clinical use of it is one milestone of the targeted therapy of GISTs. We review the gene mutation and targeted therapy development of gastrointestinal stromal tumors in this article.

Objective To evaluate the sampling efficiency of rotary biopsy forceps in gastric precancerous lesions. Methods A total of 60 gastric lesions with suspected pre-cancerous characters under narrow band imaging were enrolled,and consecutive samples were taken from same lesion by one endoscopist with routine and rotary forceps,respectively. The most severe pathological diagnosis was regarded as the final diagnosis. Results There was a significant difference between rotary biopsy forceps and routine ones in regarding of sample quality and capability of minimize tissue damage (P＜0. 05). The concordance rate with final pathological diagnosis from sample taken by rotary biopsy forceps was higher than that from routine ones,but without significance (P＞0. 05). Conclusion The rotary biopsy forceps is superior to routine ones in sampling of gastric pre-cancerous lesions.

Objective Diterpene ginkgolides meglumine injection (DGMI) is widely used in patients with stroke, but its efficacy and safety are not consistent.We performed a Meta-analysis to comprehensively evaluate the efficacy and safety of DG-MI in acute ischemic stroke and recovered stroke.Methods The wanfang, VIP, CNKI and PubMed were searched, the randomized controlled trials (RCTs) were enrolled.Data collection and quality evaluation of the included RCTs were performed according to Cochrane systematic evaluation method.Meta-analysis was performed by using Stata software.Results 9RCTs involving 1 129subjects were included with 706subjects in DGMI treatment group and 423subjects in control group. (1) For acute ischemic stroke, DGMI group had superior effective rate compared to conventional therapy group (RR=1.19, 95％CI:1.09, 1.31, P＜0.000 1), improvement of neurologic impairments (SMD=3.23, 95％CI:2.87, 3.60, P＜0.000 1) and improvement of living quality (SMD=3.23, 95％CI:2.87, 3.60, P＜0.000 1). (2) For recovered stroke, DGMI group had better effective rate than Shuxuening injection group (RR=1.17, 95％CI:1.05, 1.30, P＜0.05) and improvement of neurologic impairments (SMD=-0.69, 95％CI:-0.88, -0.49, P＜0.000 1).There was no significant difference in adverse events between DGMI and control groups (P＞0.05).Conclusion DGMI had superior efficacy over control group for both acute ischemic stroke and recovered stroke.There was no significant difference in adverse events between these two groups.However, we still need better quality RCTs to confirm these results.

Objective To investigate the abnormality of intrahepatic biliary epithelial cells autophagy in primary biliary cirrhosis (PBC) mice,and explore the mechanism of UC-Mesenchymal stem cell (MSCs) in treating PBC.Methods After establishing the PBC model,we divided them into the PBC model group;the UC-MSCs treatment group and the Stattic group [Signal transducer and activator of transcription 3 (STAT3) inhibitor group].Six mice were used as the control group.Liver pathology and the serum pyruvate dehydrogenase complex E2 subunit (PDC-E2) antibody titers were detected.Autophagosome of the intrahepatic biliary epithelial cell was observed by electronic microscope.Protein levels of STAT3/pSTAT3,Beclin-1 were detected by western blot.We cultured human intrahepatic biliary epithelial cells in vitro,and down regulated STAT3.After stimulated by GCDC,we co-cultured them with UC-MSCs,and collected the cells in order to detect LC3 Ⅱ.The measurement data were compared with t test or single factor analysis of variance.Results Compared with the control group,periportal inflammatory cell infiltration and granuloma formation were observed in the PBC group.MSCs treatment decreased the infiltration of inflammatory cells.The level of antiPDC-E2 of the PBC group (107±18) ng/ml was higher than that of the control group (42±6) ng/ml (q=6.326,P＜0.01),MSCs treatment down regulated anti-PDC-E2 level (43±4) ng/ml (q=5.801,P＜0.01).More autophagosomes in the PBC group (5.00±1.29) than the control group (1.75±0.25) were observed (q=4.061,P＞0.05).Western blot showed that the level of Beclin-1 was higher in PBC group (1.80±0.36) than the control group (0.40±0.20) (q =6.757,P＜0.01),MSCs reduced the expression of Beclin-1 (0.86±0.06)(q=4.536,P＜0.05) as well as Stattic (0.72±0.03) (q=5.226,P＜0.05).PBC group had a higher expression level of STAT3 (1.80±0.42) (q=5.730,P＜0.05) and pSTAT3 (2.04±0.29)(q=6.492,P＜0.01) than the control group (0.50±0.05)(0.91±0.14).MSCs treatment decreased the expression of STAT3 (0.51±0.13)(q =5.703,P＜0.01) and pSTAT3 (0.76±0.07) (q =7.388,P＜0.01) in intrahepatic biliary epithelial cells.After down regulated STAT3 of HiBECs,MSCs reduced the expression of LC3 Ⅱ of HiBECs.Conclusion The intrahepatic biliary epithelial cells autophage of PBC mice is abnormal,MSCs can alleviate PBC by down regulating the autophage of intrahepatic biliary epithelial cells via STAT3.