A hammerhead RZ DNA was designed and synthesized, which can specifically cleave the bcl-2 mRNA. After demonstration of right sequences by sequencing and cleavage activity of RZ by in vitro cleaving experiment, The RZ DNA was recombinated into the pDOR - neo vector to form the recombinant pDOR - RZ. Using lipofectin - mediated DNA transfectionpDOR-RZ was successfully introduced into HL - 60 cells. The RZ expression was observed by Southern, RNA dot blot hybridization and flow cytometry (FCM) . The results demonstrated that (a) the RZ was expressed in 72 hours after transfection; (b) the synthesis of Bel - 2 protein was inhibited by the expression of RZ; (c) apoptotic peak appeared in FCM.

ObjectiveTo assess the effectiveness and prognosis of different radical surgery for Hirschsprung disease (HD).MethodsThe bowel function of HD patients undergoing the anus modified Soave operation (84 cases,modified Soave group),modified Swenson operation (60 cases,modified Swenson group),modified Duhamel operation (76 cases,modified Duhamel group) was followed up by 3,6 months and 2 years after surgery.Long-term bowel function,clinical type,removal length,anorectal manometry,barium enema were analyzed and compared among three groups.ResultsThe occurrence rates of bowel dysfunction 3,6 months and 2 years after surgery in modified Soave group[17.9％(15/84),7.1％(6/84),4.8％ (4/84)] were significantly lower than those in modified Swenson group[41.7％ (25/60),21.7％(13/60),18.3％(11/60) ] and modified Duhamel group [ 36.8％ (28/76),18.4％ (14/76),13.2％(10/76) ].There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group(P＜ 0.05 ).There was no significant difference between modified Swenson group and modified Duhamel group (P ＞ 0.05).When the removal length ≤35 cm,the occurrence rate of bowel dysfunction after surgery in modified Soave group [ 18.7％ (14/75)] was lower than that in improved Swenson group [ 39.5％ ( 17/43 ) ] and modified Duhamel group [ 34.4％ (21/61 ) ].There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group (P ＜ 0.05).There was no significant difference between modified Swenson group and modified Duhamel group (P ＞ 0.05).When the removal length ＞ 35 cm,there was no significant difference in the occurrence rate of bowel dysfunction after surgery among three groups (P ＞ 0.05 ).The occurrence rates of bowel dysfunction in short-segment type and common type in modified Soave group was lower than those in modified Swenson group and modified Duhamel group.There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group(P ＜ 0.05).There was no significant difference between modified Swenson group and modified Duhamel group (P＞ 0.05).The anorectal angle 2 years after surgery in modified Soave group [(93.67 ± 10.50)° ] was less than that in modified Swenson group [(110.20 ± 11.88)° ] and modified Duhamel group [(106.33 ± 12.21)° ].There was significant difference (P ＜0.05).ConclusionThe complication and trauma are significantly lower in the anus modified Soave operation than the modified Swenson operation and modified Duhamel operation,but the choice of surgery should be strictly controlled according to the anal HD treatment indications.

Aim To clone apoptosis-related genes from human MCF-7 breast cancer cells and to analyze the character of the method used in the process. Methods A poptotic cell model of MCF-7 cells was established with the apoptotic tumor cells induced by the all-trans-retinoic acid. The apoptotic gene was cloned from the model by improved PCR-based subtractive hybridization. Results 5 clones were identified to be related to apoptosis by reverse dot blot, 4 of them were known genes, and 3 were related to apoptosis. A novel gene， named apmcf-1, coded for 47 amino acid was identified. This gene was accepted by Genbank, the accession number was AF141882. Conclusion This improved PCR-based subtractive hybridization may be an efficient way in cloning differential expression gene.

Objective:To investigate and compare the therapeutic effect of Foley catheter balloon dilation and the traditional open reduction in the treatment of intussusception in children.Methods:A total of 68 children with intussusception treated by Foley catheter balloon dilatation by laparoscopic surgery or traditional open reduction in Department of Pediatric Surgery, the Second Hospital of Lanzhou University from August 2015 to July 2019 were retrospectively analyzed.Among them, there were 32 cases in the Foley catheter group and 36 cases in the traditional laparotomy group.Foley catheter group were treated with laparoscopic Foley catheter balloon dilatation, while the traditional open group were treated with traditional open surgery which was performed with finger dilatation.The results of surgical treatment, postoperative recovery, short-term complications, patient satisfaction and long-term complications were compared between the two groups.Results:Among the indexes of surgical treatment effect, the operation time[(0.4±1.1) h], intraoperative bleeding volume[(10.2±3.4) mL], incision size[(0.5±0.4) cm] and incidence of the rupture of intestine[6.3%(2/32 cases)] in the Foley catheter group were significantly lower than those in the traditional open group[(1.3±2.9) h, (40.5±2.1) mL, (5.1±0.7) cm, 30.6%(11/36 cases)], and the differences were statistically significant (all P< 0.05). Among the indexes of postoperative recovery and short-term complications, recovery time of gastrointestinal function[(1.2±3.1) d], length of hospital stay[(6.7±1.8) d], incidence of incision infection[9.4%(3/32 cases)]and incidence of incisional hernia(0) in the Foley catheter group were significantly lower than those in the traditional open group[(3.3±6.4) d, (7.3±0.9) d, 36.1%(13/36 cases), 16.7%(6/36 cases)], and the differences were statistically significant (all P<0.05). Among the indexes of family satisfaction and long-term complications, the score of family satisfaction in the Foley catheter group [(8.7±1.2) scores]was significantly higher than that in the traditional open group[(6.6±3.1) scores], and the incidence of adhesive intestinal obst-ructionin the Foley catheter group (0)was significantly lower than that in the traditional open group[0 vs.19.4%(7/36例)], and the differences were statistically significant(all P<0.05). Conclusions:Compared with traditional open reduction in the treatment of intussusception in children, Foley catheter balloon dilation has the advantages of short operation time, safe operation, low incidence of intestinal injury, less bleeding, and so on, and also has the advantages of small incision, fast recovery, short hospitalization time, high satisfaction of parents.In addition, the Foley catheter balloon dilation has a lower incidence of incisional infection, incisional hernia, postoperative intestinal adhesion and other complications.

Objective:To evaluate the safety and efficacy of enhanced recovery after surgery(ERAS) in the perioperative period of congenital choledochal cysts in children.Methods:This is a multicenter prospective randomized controlled study. The clinical data of 273 pediatric congenital choledochal cysts(CCC) patients who underwent surgery at 14 medical centers with complete follow-up data were collected through the medical data analysis platform. Among them, 123 cases in ERAS group were managed perioperatively in strict accordance with ERAS mode, and 150 cases in conventional group were managed according to traditional mode. The length of hospital stay,time to first farting, time to complete feeding, the incidence of complications, cost and readmission rate within 30 days,stress indexes and liver function were compared between the two groups.Results:Compared with the conventional group, median time to start farting (2.0 d vs. 3.0 d, P<0.001), median time to complete feeding (5.0 d vs. 7.0 d, P<0.001), median postoperative hospitalization time (6.0 d vs. 9.0 d, P<0.001),the median total length of stay(13.0 d vs. 15.0 d, P<0.001) were shorter,the median hospitalization cost (37,000 yuan vs.43,000 yuan P<0.001) was lower, and stress indexes recovered quickly. The incidence of postoperative hospital stay and readimission rate within 30 d were not statistically different between the two groups. Conclusion:It is safe and feasible to implement ERAS for children with CCC in the perioperative period, which can reduce stress response, speed up recovery,and save medical costs.