Objective To evaluate the nasointestinal decompression intubation in acute small intestinal obstruction. Methods Ten patients with acute small bowel obstruction received nasointestinal decompression intubation under x-ray guidance. The nasointestinal decompression tube passing over a guidewire was inserted into small intestine near Tres ligament or further down distally with assistance of patients adopting in multi-physical positions. Results The intubation of nasointestinal decompression tubes into small intestine was technically successful in all patients with average procedural time of 16 min.(10 ～ 35 min). After placement of the tube, all patients obtained various degrees of symptoms relief including abdominal pain, distention, vomiting, etc. Four patients with simple adhesive obstruction recovered completely and the tube was removed 2 weeks later. Three patients were refered to surgical operation, and 3 others gave up for further treatment. There were no complications such as bleeding or perforation related to intubation. Conclusion Nasointestinal decompression intubation under guidance of X-ray is rather simple, less time consuming, especially with high efficiency for preoperative gastrointestinal decompression and treating simple adhesive bowel obstruction; ought to be recommended. [

Objective To investigate the expressions of P53,topoisomeraseⅡ(TopoⅡ)and multidrug resistance associated protein(MRP)in tissues of colorectal cancer of patients combined with chronic schistosomiasis.Method The retrospective case-control study was adopted.The clinicopathological data of 338 colorectal cancer patients who were admitted to the Zhejiang Cancer Hospital between January 2008 and December 2010 were collected.Cancer tissue specimens from surgical resection were collected.Among 338 patients,80 were combined with chronic schistosomiasis and 258 were combined with non-chronic schistosomiasis.The expressions of P53,TopoⅡand MRP were dectected using immunohistochemistry(IHC).Ranked data were presented as percentage and analyzed using the non-parametric test.Results The negative,weak positive,positive and strong positive expressions of P53 were respectively 5.00％(4/80),87.50％(70/80),3.75％(3/80),3.75％(3/80)in tissues of colorectal cancer of patients combined with chronic schistosomiasis and 28.68％(74/258),19.38％(50/258),16.67％(43/258),35.27％(91/258)in tissues of colorectal cancer of patients combined with non-chronic schistosomiasis,with a statistically significant difference(Z=-2.962,P＜0.05).The negative,weak positive,positive and strong positive expressions of TopoⅡwere respectively 8.75％(7/80),51.25％(41/80),22.50％(18/80),17.50％(14/80)in tissues of colorectal cancer of patients combined with chronic schistosomiasis and 12.01％(31/258),55.43％(143/258),22.48％(58/258),10.08％(26/258)in tissues of colorectal cancer of patients combined with non-chronic schistosomiasis,with no statistically significant difference(Z=-1.551,P＞0.05).The negative,weak positive,positive and strong positive expressions of MRP were respectively 7.50％(6/80),40.00％(32/80),28.75％(23/80),23.75％(19/80)in issues of colorectal cancer of patients combined with chronic schistosomiasis and 24.42％(63/258),38.37％(99/258),24.03％(62/258),13.18％(34/258)in tissues of colorectal cancer of patients combined with non-chronic schistosomiasis,with a statistically significant difference(Z=-3.408,P＜0.05).Conclusion There are abnormal expressions of P53 and MRP in tissues of colorectal cancer of patients combined with chronic schistosomiasis,which may be involved in the hypothetical mechanism of chronic schistosomiasis inducing carcinogenesis of colorectal cancer.

Objective To investigate the distribution of cytotoxin-associated gene A (cagA) of Helicobacter pylori (Hp) and the polymorphism of EPIYA motifs in patients with upper gastrointestinal diseases in Changchun area of China and to evaluate the association between EPYIA motifs patterns and gastrointestinal diseases.Methods Hp strains were isolated from clinical samples.Their cagA gene was analyzed by PCR and sequencing analysis.Nucleotide sequence of cagA gene was translated into amino acid sequence by using DNAMAN software,and then the amino acid sequence was imported into software MEGA6.0 for multiple comparisons and construction of a phylogenetic tree.Results A total of 60 Hp strains were isolated and identified from gastric mucosa specimens collected from 298 patients.Hp infection was not correlated with patient's age or sex (P>0.05).The isolation rate of Hp in peptic ulcer disease (PUD) group was higher than that in non-peptic ulcer dyspepsia (NUD) group (P<0.05).Of the 60 Hp strains,90% (54/60) carried cagA gene.Twenty-three out of 26 successfully sequenced strains (88.4%) were East Asian-type including 22 containing EPIYA-ABD motif and one containing EPIYA-ABBD motif.The other three strains (11.6%) were Western type including two carrying EPIYA-ABC motif and one carrying EPIYA-BC motif.Results of the phylogenetic tree showed that the sequences of cagA gene were clustered into two groups,East Asian-type and Western-type groups.East Asian-type strains caused no disease cluster of statistical significance.All Western-type Hp strains were isolated from patients with peptic ulcer disease (PUD).Four mutant Hp strains were detected in the PUD group and the amino acid mutations preferentially occurred in the EPIYA-B segment.Conclusion The positive rate of Hp cagA gene is 90% in this region.Its distribution is not related to the type of gastrointestinal diseases.EPIYA-ABD (84.6%,22/26) is the predominant EPIYA motif.The amino acid mutation of EPIYA-B segment is closely related to peptic ulcer disease.Neither significant change in the sequence of 3' region of Hp cagA gene nor regional difference is observed in those Hp strains circulating in Changchun area of China.

AIM: To study the effects of recombinant soluble MHC class Ⅰ chain-related protein A (sMICA) on the cytotoxicity, secretion of IFN-γ, proliferation and apoptosis of peripheral NK cells. METHODS: After NK cells were cocultured with recombinant soluble MICA proteins overnight, the cytotoxicity of NK cell on target cells was detected by flow cytometry. The supemant was collected to determine the concentration of IFN-γ by ELISA. The proliferation of NK cells to sMICA was detected by MTS/PMS. NK cells were labeled with annexin V and PI to analyze their apoptosis. RESULTS: Soluble MICA inhibited the cytotoxicity of NK cells and down-regulated the secretion of IFN-γ, but it showed no effects on the proliferation and apoptosis of freshly isolated peripheral NK cells. CONCLUSION: The soluble MICA shedding from tumor cells could be a pathway of cancer immune evasion by down-regulating the biologic activities of NK cells.

Objective To investigate the application value of 16S rDNA-based detection technique in the rapid screening for and confirmation of gonococcemia. Methods A 41-year-old male patient was hospitalized for recurrent regular fever and chills for 1 month. Several days before the admission, he developed urgent micturition, frequent micturition and pain in urination, anemia with emaciation appearance, slightly pale-looking skin and mucous membranes. No petechia, skin eruption or superficial lymphadenectasis was observed, but routine blood test and urine test results were abnormal. No abnormality was found in stool test or hepatic and renal function. DNA was extracted from the blood of the patient and subjected to PCR for the amplification of 16S rDNA followed by sequence analysis and homology analysis. At the same time, bacterial culture of blood and drug sensitivity test for the bacterial isolate were performed. Results Homology analysis indicated that the amplicon sequence was consistent with the known sequence of 16S rDNA of Neisseria gonorrhoeae in GeneBank, which agreed well with the culture result of peripheral blood. Conclusion The detection of 16s rDNA with PCR from peripheral blood is highly efficient, specific, sensitive, rapid and accurate for the screening for and confirmation of gonococcemia.

Objective: To observe the effect of ZuoGuiWan and YouGuiWan on induced experimental autoimmune encephalomyelitis(EAE) in Lewis rats,compare the therapeutic effect between ZuoGuiWan and YouGuiWan,and explore the underlying immunoregulatory mechanism between warming-yang and nourishing-yin therapy.Methods : 120 male Lewis rats were bred at Capital Medical University under specifi c pathogen-free conditions.24 rats were selected as normal group before immunization.The other rats were randomly devided into 4 groups after immunization,including EAE group,prednisone group,ZuoGuiWan group and YouGuiWan group.Rats of normal group were injected with normal sodium in the hind feet pad on both sides,the other rats were injected with the antigen consisted of myelin basic protein(MBP) and complete Freund’s adjuvant(CFA) to induce EAE.Rats of normal group and EAE group were administered with normal sodium after immunization,rats of prednisone group with prednisone(5mg/kg),rats of ZuoGuiWan group with ZuoGuiWan(2g/kg),rats of YouGuiWan group with YouGuiWan(3g/kg).On the day 15 and 27 after immunization,the peripheral blood was collected,lymphocyte subgroups and NK cells were detected by ? ow cytometer.Results: On day 15 after immunization: In peripheral blood,the number of CD4+lymphocyte in ZuoGuiWan group was signifi cantly higher(P

Objective: To observe the immunohistochemical expression of interferon-? (IFN-?), matrix metalloproteinase -9(MMP-9) in brain and spinal cord tissue, and explore the action mechanism of Zuogui Pills and Yougui Pills on rats with experimental autoimmune encephalomyelitis(EAE). Methods: Lewis rats were immunized with the myelin basic protein (MBP).120 Rats were grouped randomly into nomal group, EAE group, prednisone group, Zuogui Pills group and Yougui Pills group after post immunization (PI). Rats in normal group and EAE group were administered sodium, each 3ml/d, rats in prednisone-group were administered suspension of prednisone after developed clinical signs, each 5mg/kg, rats in Zuogui Pills group were administered suspension of Zuogui Pills, each 2g/kg, and rats in Yougui Pills group were administered suspension of Yougui Pills each 3g/kg. On days 15 and 27 PI, rats were killed and the immunohistochemical staining was performed on the sections of brain and spinal cord. Results: On days 15 and 27 PI, the expression of IFN-? and MMP-9 in central nervous system of EAE group were higher than those in nomal group (P

Objective To investigate the expression and significance of bone morphogenetic protein?2 (BMP?2) and phosphatase and tensin homolog deleted on chromosome ten (PTEN) in incipient,recurrent and malignant salivary gland pleomorphic adenoma??Methods A total of 93 cases of salivary gland pleomorphic adenoma in Kailuan general hospital from 2008 to 2017 were collected,including 54 in incipient group (group A,47 cases in benign group A1,7 cases in malignant group A2),39 cases in recurrent group (group B,26 cases in benign group B1,13 cases in malignant group B2)??The expression of BMP?2 and PTEN were detected by immunohistochemical detection and western blot,the correlation of BMP?2 and PTEN was analyzed by Spearman analysis??Results The immunohistochemical and western blot analysis both showed expression of BMP?2 in recurrent group was significantly higher than that in incipient cases((129??03 ±15??52) vs??(87??88±18??11),t＝－8??094,P＝0??000),and it was lower in malignant cases than that in benign cases(( 100??24 ± 25??07) vs ( 116??66 ± 26??19), t＝2??125, P＝0??040)??There was no significant difference in PTEN expression between incipient and recurrent groups (( 89??15 ± 13??92 ) vs??( 96??19 ±28??02),t＝1??055,P＝0??279),but lower PTEN expression was found in malignant cases than benign cases ((76??06±11??16) vs??(109??28±17??05),t＝7??543,P＝0??000)??BMP?2 was positively correlated with PTEN expression (r＝0??313,P＜0??05)??Conclusion BMP?2 is associated with the recurrence of salivary gland pleomorphic adenoma, and both BMP?2 and PTEN are associated with malignant in the salivary gland pleomorphic adenoma??

Objective To summarize the pathology of congenital intestinal atresia,the incidence and prenatal diagnosis rate of different types,and to analyze the location and type of intestinal atresia as well as the factors that affect the mortality of various types of intestinal atresia.Method We retrospectively analyzed the clinical data of 147 children with congenital intestinal atresia from January 2013 to March 2016,including gender,gestational age,parity,prenatal diagnosis or not,delivery methods,hospital admission,surgical methods,findings during surgery,combined malformations,complications and prognosis.They were analyzed statistically.Result A total of 147 cases,including 69 males and 78 females were enrolled.There were 40 premature infants and 107 full term cases.Twins were found in 3 cases.Hospital admission age range from 1 hour to 62 days;admission weight range from 1 480 g to 4 200 g;32 cases were diagnosed before birth.2 cases were abandoned before surgery because of trisomy 21.Postoperatively,the occlusion sites was confirmed as following:67 cases (46.2％) in ileum,43 cases (29.7％) in jejunum,26 cases (17.9％) in duodenum,and 9 cases (6.2％) in colon.The pathological types were as following:type Ⅰ 42 cases (29.0％),type Ⅱ 8 cases (5.5％),type Ⅲa 65 cases (44.8％),type Ⅲb 15 cases (10.3％) and type Ⅳ 15 cases (10.3％).22 cases (14.9％) were died because of refusal of treatment:7 cases were due to short bowel syndrome and meconium peritonitis,6 cases were due to postoperative chronic pseudo-obstruction,and 5 cases had anastomotic leakage requiring reoperation.1 case had postoperative enterocolitis and gave up treatment,1 case had anastomotic leak and sever systemic post-surgery infection and gave up further treatment,and 2 cases gave up because of 21-trisomy syndrome.Conclusion The operation plan of intestinal atresia should be based on the location and type of the blockade;the location and complications of the blockade (pseudo-obstruction,short bowel syndrome,and anastomotic leakage) are important factors affecting the treatment and prognosis.

Objective To investigate the effect of surgical treatment of necrotizing enterocolitis (NEC) with different surgical ages.Methods From January 2014 to December 2017,105 neonates with NEC in our hospital were divided into early operation group (operation age ＜ 7 days,n =47) and late operation group (7 ＜ operation age ＜ 28 days,n =58).The general data,surgical indications,intraoperative conditions,surgical methods,postoperative complications,and postoperative survival rates were compared between the two groups.Results Among the 105 neonates with NEC,74 were male and 31 were female.The average birth weight was (2 398 ± 927)g,and the average gestational age was (35 ± 4)weeks.Compared with the early operation group,the late operation group had lighter birth weight,smaller gestational age and higher rate of respiratory failure (P ＜ 0.05).There was no significant difference between the two groups in the proportion of surgical indications (diffuse peritonitis,pneumoperitoneum,and medical treatment ineffective) (P ＞ 0.05).The necrosis rate of small intestine in the late operation group was higher than that in the early operation group,but the necrosis rate of small intestine and colon was lower than that in the early operation group (P ＜ 0.05).There was no significant difference in the proportions of the two groups in the surgical methods (enterostomy,intestinal resection and anastomosis and enterostom,exploratory laparotomy,abdominal drainage,and intestinal resection and anastomosis) (P ＞ 0.05).The incidence of intestinal stenosis in early operation group was higher than that in late operation group (P ＜ 0.05).The survival rate of early operation group was 78.7％,while that of late operation group was 63.8％,with no significant difference (P ＞ 0.05).Conclusions The patients with NEC who were operated within 1 week after birth are more common in term infants and with colon necrosis,and are more likely to occur intestinal stenosis after surgery.The patients with NEC who were operated after 1 week of birth are more common in prematures and low-birth-weight patients,and are often associated with respiratory failure.Pneumoperitoneum and diffuse peritonitis are common surgical indications for NEC.Enterostomy is the major surgical method.Choosing the right timing and surgical method can improve the prognosis of patients with NEC.