Kasabach-Merritt syndrome(KMS) is a massive haemangioma with thrombocytopenia and consumptive coagulopathy. The histopathology of KMS is thrombocytopenia and disseminated intravascular coagulation associated with massive haemangioma.A standard treatment regimen for KMS has not been established. Therapy includes surgery, embolism and medicine(steroids,α-interferon , immunosuppressant , etc).

Objective To investigate the changes and role of elastic fibers during the progression of ventricular remodeling after myocardial infarction(MI) in rats. Methods Male Sprague Dawley rats were induced by ligating the anterior descending coronary artery and were divided into the 2nd,4th,8th,12th and 21st week groups.Elastic fibers were evaluated in the infarct region using Masson trichrome staining,Uana orcein staining and image analysis.The expressions of TNF? and IL-1? were also detected by immunohistochemistry. Results Elastic fibers could be found within the infarct region in the 2nd week after MI,increased with time and reached the peak during the 8th to 12th weeks,decreased or were absent in the 21st week.The expressions of TNF-? and IL-1? were also detected in the infarct zone and increased with time.Conclusion Elastic fibers were involved in infarct healing and may play an important role in promoting ventricular remodeling.

Objective To study the effects of high concentration oxygen exposure on the Sox17 expression of vascular endothelial cells of neonatal mice lungs,and to explore the pathogenesis of blocked lung vascular development.Methods Thirty two C57B1/6J newborn mice within six hours after birth were randomly divided to hyperoxia group (n=16) and room air group (n=16).Mice of hyperoxia group were exposed to 85％ oxygen.Eight mice of either group were sacrificed at 7 and 14 days after birth respectively to observe the lung morphology and calculate radial alveolar counts (RAC),which is the number of alveoli on the straight line from the center of respiratory bronchioles to the nearest fibrous septa or the pleura.Sox 17 expression in the pulmonary vessels was detected by immunohistochemical staining.Sox17 mRNA was measured by reverse transcription polymerase chain reaction.Sox17 protein level was measured by Western blot.Two independent samples t-test was used for statistical analysis.Results Compared with day 7,the lung structures matured with more uniformed alveoli and the septas became thinner on day t4 in room air group.However,the lungs developed slowly with simplified and non-uniformed alveoli on day 14 in hyperoxia group.The Sox17 protein was positive on endothelial cells of pulmonary arteries,veins and alveolar capillarys,as well as the alveolar epithelial cells.The RAC on day 7 and day 14 in hyperoxia group were both lower than that in room air group (3.7±0.7 vs 5.0±0.8,5.3±0.6 vs 8.3±0.9,respectively,t=3.057 and 8.148,both P ＜ 0.01).Sox17 mRNA on day 7 and day 14 in hyperoxia group were both lower than that in room air group (0.62±0.10 vs 0.88±0.11,0.44±0.06vs 0.90±0.15,t=3.607 and 6.926,both P ＜ 0.01).Sox17 protein level on day 7 and day 14 in hyperoxia group were both lowered than that in room air group (0.32±0.04 vs 0.76±0.04,0.36±0.07 vs 0.96±0.06,t=3.102 and 8.421,both P ＜ 0.01).Conclusions Exposure of high concentration of oxygen may cause impairment of lung vascular development by inhibiting Sox17 expression in lungs of neonatal mice.

Objective To study the long term effect and practical value of unilateral cleft lip repair with extended Mohler surgery based on over 10 years experiences.Methods A lot of 320 cases with unilateral cleft lip were repaired with extended Mohler surgery at average age of 5 months and 20 days.65 repaired cases were followed up and long term treatment result was evaluated.26 cases were evaluated in 10.5 to 15 years after surgery.39 cases were evaluated in 6 to 24 months after surgery.And the details of surgery were described.Results Excellent results for most of cleft patients (63 cases, 97%) were achieved, which included unobvious vertical scar symmetric to unaffected philtrum column, symmetric cupid's bow, nostrils and intermedial nasal columellae.Conclusions Extended Mohler surgery is great valuable for unilateral cleft lip repair.Appropriate indications should be stressed.

Objective:To evaluate the vomer development of cleft palate patients.Methods:38 patients over 1 4 years(averaged 23.4 years)of age with cleft palate and 76 controls of normal people(aged 22.8 year on average)were included.The 3D computed tomo-graphy reconstruction images of the bony nasal septum were measured.The development of the vomer was evaluated by comparing the L1 (the length of the lower edge of the vomer),L2 (the length from nasal spine to the point of the sella)and S (the approximate area of vomer)among deferent groups.Results:The L1 ,L2,and S of cleft palate patients were smaller than those of the controls(P <0. 05).Compared with the postoperative cleft cases,the S and L2 of preoperative cases were bigger(P <0.05).Conclusion:The vomer development is adversely affected by cleft palate.Not only the vomer-palate fusion is lower,but also the sutura between vomer and na-sal septum cartilage and ethmoid bone are short.And the latter is greatly influenced by surgical trauma.

Objective To discuss the techniques and the prevention and cure of preoperative complications of the endovascular embolization in managing the intracranial aneurysms. Methods A total of 90 aneurysms in 88 patients were treated by detachable coils embolization. The clinical results and the management of complications were reported. Results Seventy aneurysms were occluded at 100%, 13 aneurysms at 90% to 95% and 5 aneurysms at only 80. The perioperative complications occurred in 9 patients, including the coil escaping from the aneurysm sac into its parent artery in 3 patients, re-rupturing of aneurysm in 4 patients during operation and serious vasospasm in 2 patients. Two patients died. Conclusion The endovascular embolization is a safe, effective and micro invasive method in managing intracranial aneurysms. The exact embolizing techniques chosen are very important to improve the curative results and decrease the complications of embolization of intracranial aneurysms.

An efficient technique for the determination of multiclass pesticide residues ( glyphosate, aminomethyl phosphonic acid ( AMPA) and glufosinate) in four kinds of tea ( green tea, black tea, Oolong tea and Puer tea) was developed based on ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Samples were extracted with 0. 05 mol/L NaOH solution, regulated pH value with HCl, followed by purification by Oasis HLB column, and then precolumn-derived with 9-fluorenylmethyl chloroformate ( FMOC-CL ) in borate buffer. All pesticide residues studied showed good linearity with correlation coefficient ( R2 ) greater than 0. 99 in the concentration range of 5-1000 μg/L. Limits of quantitation (LOQs) of three pesticide compounds ranged from 0. 03 to 0. 08 mg/kg (S/N=10). Tea samples spiked with 0 . 1 , 0 . 4 and 4 mg/kg showed the recovery ranging from 72 . 1% to 109 . 9%, and RSDs from 0. 5% to 9. 8% (n=6). In addition, the validated method was applied to commercial samples, and all the detections were confirmed by acquiring transitions for each pesticide in samples.

Objective To study the occurrence of nosocomial infection ( NI ) situation in the neonatal intensive care unit ( NICU ) of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2012 to October 2013,and analyze risk factors of NI. Methods A retrospective study was per-formed in the NICU,of which all neonates hospitalized over 48 hours were included and the occurrence situation and risk factors of NI were analyzed. Results This study included 1 357 neonates,and 175 neonates developed 202 times NI. The overall incidence of NI was 14. 89% (202/1 357),and the incidence density was 10. 44 per 1 000 NICU patient-days (202/19 355). The lower the birth weight is,or the smaller gestational age is,the higher the NI rate is. The NI rate was 75. 00% in neonates whose birth weight <1 000 g,and the NI rate was 52. 63%in neonates whose gestational age <30 weeks. The most common infection type was pneumonia[43. 07% (87/202)]and sepsis[26. 73% (54/202)]. The hospital stay of the NI neonates was longer and the cost of hospitali-zation is higher than non-NI neonates ( Median stay:20 days and 10 days. Median cost:21 045. 32 yuan and 8 108. 23 yuan)(both P<0. 01). Univariate analysis showed there were significant differences between NI neo-nates and non-NI neonates on gestational age,birth weight,5 min Apgar score,asphyxia rescue history,previons antibiotics use,mechanical ventilation,peripherelly inserted central catheter( PICC) ,closed thoracic drainage tube and chest or abdominal surgery before NI. The logistic regression analysis indicated that previous antibiotics use, mechanical ventilation and PICC were important risk factors for NI. Conclusion The NI rate in NICU is still high. Previous antibiotics use,mechanical ventilation and central venous catheter are risk factors of NI.

Objective To explore the availability and safety of conducting low-pressure TURP assisted by a home-made cystometry and warning system.Methods 167 benign prostatic hyperplasia (BPH) patients admitted from Jan 2014 to Jan 2016 were randomly assigned into cystostomy group (group A) and non-cystostomy group (group B). In group A (n = 85), 42 patients (group A1) were performed percutaneous cystostomy + TURP, and 43 (group A2) were performed continuous flushing sheath TURP. In group B (n = 82), 42 patients (group B1) were received percutaneous cystostomy + TURP, and 40 (group B2) were received continuous lfushing sheath TURP. In group A, bladder pressure was monitored in real time with a cystometry and was monitored by bladder puncture using a home-made siphon, ensuring low bladder pressure throughout TURP. Serum Na+ levels were measured before and after operation in all four groups. The operation time, the intraoperative bleeding, the weight of resected prostates and the time before which urine turned clear were recorded. The IPSS, maximum lfow rate (Qmax), postvoid residual volume (PVR) and life quality score (QOL) were evaluated.Results While no significant differences were found between group A1 and A2, there were significant differences between group B1 and B2, indicating cystostomy group was safer than non-cystostomy group. When compared group A1 with B1, or group A2 with B2, it showed that the safe operation time to perform prostate tissue resection was longer in cystostomy group; the weight of the resected prostates was heavier; the time before which urine turned clear were shorter; and the IPSS improvement was better. These findings presented better therapeutic effects in cystostomy group than in non-cystostomy group.Conclusions This home-made cystometry and warning system could timely detect high bladder pressure state during TURP, making it possible to avoid of high pressure, ensuring low bladder pressure lfushing during the operation, lengthening the safe operation time, increasing tissue resection ratio, reducing transurethral resection syndrome, thus helping TURP to be safer.

Objective To establish the theoretical basis of the probiotic application among very low birth weight(VLBW) infants,the efficacy of probiotics on the gut microbiota of VLBW infants on the 14th postnatal day was studied.Method The VLBW infants admitted to BaoAn Maternal and Child Care Hospital from January 2015 to December 2015 were randomly assigned into probiotics group and placebo group.From the first feeding to corrected gestational age of 36 weeks,probiotics group was treated with a combination of Bifidobacterium and Lactobacillus while placebo group with placebo.Fecal samples were collected on the 1st and 14th postnatal day.Total bacterial DNA was extracted and sequenced using high-throughput 16S rRNA gene sequencing on MiSeq sequencing platform.Result A total of 21 VLBW infants were enrolled,9 in probiotics group and other 12 placebo group.No significant differences of clinical data existed between the two group (P ＞ 0.05),The abundance and diversity of microflora (P ＞ 0.05) on the first day between the two group were similar.Compared with placebo group,the relative abundance of Bifidobacterium and Lactobacillales in stool samples on the 14th day was significantly increased,while the Halomonas was significantly decreased.The relative abundance of the Shannon-index was increased,but without significant difference (P =0.16).Conclusion Enteral supplementation of probiotics in VLBW infants may increase probiotic bacterium and microflora diversity.