Objective To explore the application and efficacy of one-stage gastric transposition in long-gap esophageal atresia.Methods 11 patients of long-gap esophageal atresia who received one-stage gastric transposition treatment from March 2008 to December 2013 were analyzed.8 male and 3 female babies were included in the study.The diagnosis was made based on esophageal radiography.And there were 2 cases of type Ⅰ and 9 cases of type Ⅲ a.Results All procedures were completed,9 cases were cured,1 case died and 1 case refused further treatment after operation.6 cases developed pneumonia postoperatively,2 cases had signs of stoma leakage.All cases were followed up for 6 months to 5 years.3 cases had anastomotic stricture and they were cured by balloon dilation.6 cases had mild gastroesophageal reflux but no anti-reflux procedure was needed.And gastroesophageal reflux symptoms were improved by smaller meals and appreciate the feeding treatment.Conclusion One-stage gastric transposition is feasible and acceptable in treating long-gap esophageal atresia in neonates,it can avoid staging operation,shorten the treatment period,and help to improve the cure rate.

Objective To explore the dynamic alteration of intracellular free calcium concentration([Ca 2+ ]i),ATP level and membrane Ca 2+ Mg 2+ ATPase activity of erythrocyte in the patients with acute cerebral infarction(CI).Methods we examined [Ca 2+ ]i,ATP level and membrane Ca 2+ Mg 2+ ATPase activity of erythrocyte in 30 patients with acute CI and 28 health controls by Fluorescence Activated Cell Sorter.Results [Ca 2+ ]i in erythrocyte increased significantly in CI group( P

Objective To explore the dynamic alteration of intracellular free calcium concentration([ Ca2+]i),ATP level and membrane Ca2+-Mg2+ATPase acti vity of erythrocyte in the patients with acute cerebral infarction(CI).Methods we examined [Ca2+]i,ATP level and membrane Ca2+-Mg2+ATPase activity of erythrocyte in 30 patients with acute CI and 28 health controls by Fluorescence Activated Cell Sorter. Results [Ca2+]i in erythrocyte increased significantly in CI group(P<0.01),while the ATP level and membrane Ca2+-Mg 2+ATPase activity were lower than the controls(P<0.05,P<0.0 01).The above result was more remarkable in the elderly group than the young one .The dynamic alteration of [Ca2+]i in erythrocyte increased obv iously during 1～2 days after the attack,and reached the peak in 3～7 day s,it decreased slowly to the slightly low level at the beginning of th e attack in about two weeks,but it was still higher than the controls.The dynamic alteration of ATP level and Ca2+-Mg2+ATPase activit y after acute CI,it decreased significantly during 1～2 days after the at tack,and reached the lowest in 3～4 days.this status could last about one week.Then both of them increased slightly. There was remarkable negative correlation betwe en RBC [Ca2+]i and ATP level or membrance Ca2+-Mg2+ A TPase activity (r=-0.904,r=-0.978,P<0.05).There was positive correl ation between ATP lev el and membrane Ca2+-Mg2+ATPase activity(r=0.835,P<0.05 ).Conclusion There was calcium overload [Ca2+]i in th e intracellular of erythrocyte in acute CI,ATP level and membrane Ca2+ -Mg2+ATPase activity of erythrocyte CI was involved in the pathologi cal course of calcium overload,and related to the age.

Objective To investigate clinical characteristics of smear- or culture-positive pulmonary tuberculosis (TB) in patients hospitalized at a general hospital to improve its diagnosis. Methods Clinical data of smear- or culture-positive pulmonary TB diagnosed in 50 patients hospitalized at Peking Union Medical College Hospital, Beijing during 2006 to 2009 were analyzed retrospectively. Results Seventeen (34%) of 50 cases of smear- or culture-positive pulmonary TB aged more than 60 years, with 30 males (32%), 16 retirees and nine farmers (18%). Their main symptoms included fever (80%), cough (94%) and sputum expectoration (92%), with elevated erythrocyte sedimentation rate (ESR) in 38 of 45 patients (84%). Chest X-ray examinations showed that lesions located mostly in the upper lobes or in both of the lungs diffusedly, with patchy infiltrations, nodular opacities and cavities. Acid-fast bacilli were demonstrated on sputum smear in 41 ( 82% ) and in specimens of six ( 12% ) cases obtained through bronchoscopy with brush or bronchoalveolar lavage fluid ( BALF), and M. Tuberculosis was cultured from sputum specimens in three (6%). Mean time interval between admission and diagnoses averaged 14 days.Conclusions Basic knowledge about prevention and control of pulmonary tuberculosis should be publicized comprehensively in general hospital keeping alert in its diagnosis with acid-fast staining for sputum smear as a routine test for patients with respiratory symptoms, and in some cases, bronchoscopy procedures ( brush or BALF) are reasonable options to improve its detection.

Objective To explore the baggy eyelids anaplasty through posterior orbital septum fat displacement. Methods Orbital septum and posterior orbital septum fat were exposed through palpebral margin incision, internal orbital septum fat was released and sutured with arcuate expansion of capsulopalpebral fascia at the middle lower eyelid, which was taken as the function of tighting the flaccid lower eyelid at transverse direction. On such a basis, the muscle and skin were repaired and so did orbital septum and baggy eyelids.Results Ofthe 38 patients with this operation, baggy eyelids anaplasty was performed with satisfactory results.Conclusion The method of baggy eyelids plasty through posterior orbital septum fat displacement could reduce hemorrhage, prevent enophthalmos and decrease baggy eye palindromia, with better long-term effects.

OBJECTIVE:To discuss the risk factors for lung infection of CRAb in ICU,and to provide reference for clinical di-agnosis and treatment. METHODS:The univariate analysis and multivariate Logistic regression analysis were conducted with the method of case-control study,in which the clinical data of 105 cases of lung infection of CRAb in ICU were collected from our hospital during Jun. 2012 to Jun. 2014,with the 81 cases of CRAb and 24 cases of CSAb. RESULTS:The univariate analysis showed that those factors were significantly correlated with lung infection of CRAb in ICU,such as ICU hospitalization days be-fore isolation of Ab,total stay in ICU,respiratory failure,hypoproteinemia,mechanical ventilation,mechanical ventilation days, the application of carbapenem antimicrobial agents and combined use of antimicrobial agents within 15 days before isolation of Ab, abnormal C-reactive protein detection,abnormal procalcitonin detection. The multivariate analysis showed that ICU hospitalization days before isolation of Ab,the application of carbapenem antimicrobial agents within 15 days before isolation of Ab,mechanical ventilation,hypoproteinemia were the independent risk factors of CRAb. CONCLUSIONS:Based on risk factors,the measures should be taken for high-risk patients as soon as possible in ICU to prevent and treat lung infection of CRAb.

ObjectiveTo analyze the clinical features and prognostic factors of occult breast cancer. MethodsThe clinical features and prognostic factors of 62 occult breast cancer patients,who were treated in Tianjin Cancer Hospital from October 1997 to October 2011,were retrospectively analyzed.ResultsThe 3-year,5-year and 10-year overall survival rates of 62 cases were 87.4％,76.4％,73.2％ respectively,a median of 53 months.The 3-,5-,and 10-year overall survival rates of the patients with ＞4 positive lymph nodes are lower than that of patients with ≤4 nodes (77.8％,64.8％,38.9％ vs.90.7％,86.7％,86.7％,P =0.015 ) ;The 3-year and 5-year overall survival rates of patients with primary cancer found in removed breast tissue are lower than that in those primary tumor was not found (60.0％,40.0％,40.0％ vs.92.0％,83.6％,79.2％,P =0.023).The 3-year,5-year and 10-year overall survival rates in patients with recurrence and metastasis are lower than that of patients without (63.5％,28.6％,19.0％ vs.97.1％,97.1 ％,97.1％,P =0.000). ConclusionsThe prognosis of occult breast cancer is related with the number of positive lymph node,pathology,recurrence and metastasis.

Objective To observe the cerebral edema occurrence ,evolution and prognosis of intra-arterial thrombolytic recanali-zation in patients with acute ischemic stroke .Methods From October 2010 to October 2012 ,36 patients who underwent the intra-arterial thrombolytic therapy were cerebral recanalization .They were randomly divided into two groups :1-3 h group and >3-6 h group .The alteration of brain edema was observed by cranial CT .Their mRS .NHISS and BI were scaled and recorded before and after intra-arterial thrombolytic therapy .Results After intra-arterial thrombolytic therapy ,the occurrence rate of cerebral edema was 94% ,appeared at the onset of more than 1 hours in all patients .Long-term follow-up showed ,cerebral edema location appeared obvious cerebromalacia .Cerebral edema and clinical outcome had not significant difference between 1-3 h group and 3-6 h group . Conclusion Cerebral edema and loss of cerebral tissue occurred almost inevitability in patients who received intra-artery thromboly-sis and recanalized their cerebral artery .It indicates that good local circulation and general condition may be favorable factors that can gradually reduce brain edema .

OBJECTIVE:To systematically evaluate therapeutic efficacies of perioperative application of single-dose and multipie-dose of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation,and to provide evidence-based reference.METHODS:Retrieved from PubMed,EMBase,CBM,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about perioperative application of single-dose (trial group) and multiple-dose (control group) of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation were collected.Meta-analysis was performed using Rev Man 5.3 statistical software after literature screening,data extraction and quality evaluation by improved Jadad.RESULTS:Finally 8 clinical studies were included,involving 3 457 patients.The results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection [OR=1.02,95％ CI(0.63,1.66),P=0.94)].Cefazolin stadies were included in subgroup analysis according to drug use,and results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection[OR=1.33,95％CI(0.55,3.20),P=0.52].CONCLUSIONS:Prophylactic application of single-dose of antibiotics is recommended for preventing surgical site infection after closed fractures patients receive incision and internal fixation.

(P < 0.05 ).Scanning electron microscopy showed that the three-dimensional structure of mix-biofilm in control group was more complex.As real-time PCR showed,after 6-hour culture,the expressions of icaA,fbe,aap,hwp1, als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group and after 24-hour culture the expressions of aap,hwp1,als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group.Conclusion With the intervention by fungal quorum sensing molecules Farnesol,the structure in control group became denser and more complex than that in Farnesol group.This change may have a closer correlation with the down-regulated expressions of als3,hwp1 and efg1 genes,which are related to the formation of Candida albicans biofilms.