Objective To study the pathological characteristics of allied Hirschsprung's disease (allied HD) by using NSE and S-100 protein immunohistochemical markers techniques,improve the early diagnosis rate. Methods 97 cases with HD were included in this study.The morphological and numeral change of the neuron and ganglion cell of the lesions was observed and compared with the normal controls.NSE and S-100 protein immunohistochemical markers were performed in 21 cases.Result The number of the neuron and ganglion cell of allied HD was statistically significantly higher than those in the normal control or HD group (P

Objective[WT5”BZ] To evaluate the effect of stump anorectal longitudinal incision and colorectal heart shape anastomosis for the treatment of Hirschsprung′s disease (HD). Methods Ninety eight children with HD underwent colorectal resection and GI reconstruction by our method from April 1991 to April 2000. Results All patients were followed up for 5～96 months. There were no postoprative infection in pelvic and celiac cavities or wound infection,nor anastomotic strictures. One patient had an anastomotic fistula that was treated successfully by early repair. Recurrent constipation in 3 cases was successfully treated by dilatation. One patient experienced occasional fecal seepage. Enterocolitis occured in six patients. The overall complication rate was 11 2%.[WT5”HZ] Conclusion[WT5”BZ] Anorectal longitudinal incision and heart shape colorectal anastomosis has the advantage of satisfactory clinical result and less complication in the treatment of HD.

OBJECTIVE To improve the knowledge on the early diagnosis and treatment of the isolated fungus ball sphenoid sinusitis.METHODS A retrospe ctive study was made on10cases of isolated fungus ball sphenoid sinusitis to discuss the clinical manifestation,radiographic features and treatment with endoscopic sinus surgery.RESULTS The common symptoms in10cases were headache and/or bloody nasal discharge.Radiographic features of the disease were a soft tissue image occupying the sphenoid sinus with bones wall thickening.A soft tissue image with calcification in the sphenoid sinus was the feature of CT image.All the patients were treated by nasal endoscopic sinus surgery and cured after followed up for3to18.CONCLUSION Isolated fungus ball sphenoid sinusitis was difficult to diagnose in early stage because of its non-specif ic symptoms.The nasal endoscopy and CT scan make the early diagnosis possible.The diagnosis can be def initely confi rmed by pathological studies.Treatment with endoscopic sinus surgery is an effective method for fungus ball sphenoid sinusitis.

Objective To explore the relationship of the (CA)n dinucleotide repeats polymorphism of the eNOS gene with type 2 diabete mellitus (DM) and the serum NO level in DM patients. Methods The eNOS genotype was assessed in 179 unrelated Chinese of Han nationality,including 93 patients with DM and 86 normal controls(NC).Genotype was determined by polymerase chain reaction(PCR) and denature polyacrylamide gel electrophoresis (PAGE) with silver stain.Fasting serum NO level was measured by nitrate reductase and fasting serum NOS level was measured by spectrophotometer. Results Twenty two different alleles were identified containing 19-40 CA repeats,in which the frequency of (CA) 30 (166bp)was the highest. The heterozygosity (H) and polymorphism information content (PIC) were 0.85 and 0.83 respectively. Frequency of allele (CA) 34 was higher in DM (7.5%) than in NC (2.9%) significantly. Compared with NC,the serum NO level was significantly lower in T2DM with genotype (CA)n 1 (CA)n 2 when n 1≥34 or n 2≥34. Conclusions The allele(CA) 34 is associated with the susceptibility to DM and may be involved in the development of DM. The eNOS gene polymorphism is connected with the serum NO level.

Objective To systematically review the effect of telephone intervention on colostomy patients.Methods The randomized controlled trials (RCTs) of telephone intervention on colostomy patients were searched in CBM,VIP,CNKI and Wanfang database and analyzed by RevMan5.2 software.Results Nine RCTs were included.Results of systematic evaluation showed that there were statistical difference in the self-care status,obeying doctors' order,satisfaction degree,self management ability,quality of life.Conclusions The effect of telephone intervention on colostomy patients was better than that of the traditional intervention.

Objective To weight the proper treatment for ischemic mitral regurgitation (IMR) patients who require coronary artery bypass grafting (CABG). Patients and Methods 37 CABG patients with IMR during January 2001 and October 2003 were analyzed retrospectively. Results 24 patients underwent CABG alone, there were no operation mortality. The left ventricular diastolic diameter decreased from 52 95 mm to 48 18 mm (P=0 001), LVEF increased from 0 46 to 0 55 (P

Objective Background and objective The Cox maze Ⅲ procedure has been considered the gold standard for the surgical treatment of atrial fibrillation (AF) and the modified Cox maze use bipolar radiofrequency ablation instead of the cut-and-sew technique,while also reducing the connecting lines in left atrium.This study was to understand whether completely isolation the posterior left atrium by increasing left atrium ablation lines can enhance the survival after modified Cox maze procedure.Methods From Jan 2009 to Dec 2009,all the patients underwent the Cox maze procedure,following the same examination,were divided into two groups (case-control): box lesion group (n =60),which is means the right and lefi pulmonary vein lesions were connected inferiorly by adding ablation lines,thereby completely isolating the posterior left atrium and the non-box lesion group (n =60).Similar interventions were given during the perioperative periods.Comparing the risk factors before surgeries,then follow-up was 100％ complete,and the mean follow-up was 9 ± 8.4 months.Results Except the box lesion had long time of extracorporeal circulation,the characteristics of the 2 groups were similar because there were no differences in age,AF duration,left atrial diameter,left ventricular ejection fraction or homochronous operation between the groups and there was no operative death.No patient was lost to follow-up.In the mean follow-up duration,a patient was died of intracerebral hemorrhage at 2 months postoperationly in the box lesion group and a patient suffered from stroke at 12 months postoperationly in the non-box lesion.The overall freedom from AF recurrence was higher in the box lesion group at 1 (70％ vs 51.2％,P =0.039) and 3 (78.3％ vs 60％,P =0.030) months.While it was 80％ vs 71.7％ (P =0.286) at 6 months.Eight patients wrere readmitted because of the recurrence of AF,4 and 2 patients underwent catheter ablation in box and non-box group respectively,one patient in each group underwent electrical conversion.After treatment,all of the patients were recovered to sinus rhythm and continued to take cordarone.Conclusion Compared to the single connecting between right and left pulmonary vein,isolating the entire posterior left atrium by creating a box lesion showed higher freedom from AF in the earlier months (1-3months).However,half a year after the surgery,there were no significant differences between the two groups.

Objective To investigate the practical efficacy and safety of ultrasound with microbubbles mediated rAAV2-EGFP to retina of rat after intravitreal and subretinal injection. Methods Gene transfer was examined by rAAV2-EGFP intravitreal and subretinal injection into the Wistar rats with or without microbubbles. The eyes were exposed to US (1 MHz,2 W/cm2, duration 5 minutes,duty cycle 50%,pulse recurrent frequency 100 Hz). The onset of EGFP gene expression, lightness of fluorescence, area of fluorescence and its distribution in the fundus in vivo via fluorescence stereosocope were investigated on the 4th,7th, 35th,49th and 120th day respectively. The value of gene transfer was quantified through the EGFP fluorescence quantitative methods by Axiovision 3. 1 software. HE staining was used to observe tissue damage. Results There was no fluorescence observed by fluorescence stereosocope after intravitreal injection after two-month study. After subretinal injection, ultrasound-targeted microbubbles destruction (UTMD) strongly increased gene transfer efficiency. UTMD used in the experiment did no harm to the rat retina structure. Conclusions UTMD could not enhance rAAV2-EGFP transfecion efficiency to rat retina after intravitreal injection but the transduction could be enhanced significantly after subretinal injection.

Objective To establish intellectual critique of nursing thesis course in postgraduate nurse,and to evaluate teaching effectiveness and the reasonableness of the course.Methods A total of 44 postgraduate nurses were involved in the study,which were carried out through action research of planning,acting and observing,and reflecting.After the course,researchers evaluated the reasonableness of the course and teaching effectiveness through the self-control.Results There was significant difference in the scientific research ability score of research object before and after the course:(60.09±16.26) scores vs.(71.27±13.22) scores,t=-3.264,P＜0.01.But there was no significant difference in the critical thinking ability scores of research object before and after the course:(295.55±29.71) scores vs.(292.71±26.67) scores,t=0.478,P＞0.05.Conclusions The course of intellectual critique of nursing thesis can improve the research ability of postgraduate nurse,but the role of the critical thinking ability remains to be discussed.And the course needs to be further improved.

Objective Heart transplantation is an effective treatment of end-stage heart diseases and extending the time of donor heart preservation helps to make up for the shortage of donor hearts. This study was to investigate whether high-pressured mixed gas ( HPMG) of carbon monoxide and oxygen could prolong the time of donor heart preservation and its mechanisms. Methods Forty-eight C57BL/6 male mice aged 4-6 weeks were randomly divided in-to four groups of equal number:control ( the donor heart isolated but not transplanted) , immediate transplantation ( the donor heart transplanted right after isolated) , HTK-preservation ( the donor heart preserved in histidine-tryptophan-ketoglutarate solution for 24 hours after isolated, and HPMG preservation ( the donor heart preserved in an HPMG chamber with the oxygen partial pressure of 3200 hPa and carbon monoxide partial pressure of 800 hPa for 24 hours after isolated) .Another 36 recipient mice aged 6-8 weeks were randomly assigned to receive the donor heart immediately after harvested (n=12), preserved in HTK solution (n=12), or preserved in HPMG (n=12).At 2 hours after transplantation, the status of heart re-beating and cardiac function were compared among different groups of recipient mice.At 24 hours, tissues were taken from the transplanted hearts for examination of pathologic changes by HE stai-ning, detection of the apoptosis of cardiac cells by TUNEL, and determination of the expressions of microtubule-associated protein 1 light chain 3 -Ⅱ(LC3-Ⅱ) and B cell lymphoma/leukemia-2 (Bcl-2) by Western blot. Resul ts The re-beating rates of the imme-diately transplanted and HPMG-preserved hearts were significantly higher than that of the HTK-preserved ones (P<0.05).At 2 hours after transplantation, the cardiac function scores were 2.5 (2.0-2.9), 0.8 (0.5-1.0), and 4.5 (4.0-4.5) in the immediate implantation, HPMG-preservation and HTK-preservation groups respectively, with statistically significant differences between any two groups (P<0.05).The expressions of LC3-Ⅱand Bcl-2 were 2.06 ±0.29 and 0.87 ±0.18 in the HPMG-preserved heart recipients and 1.24 ±0.20 and 2.07 ±0.32 in the immediately transplanted heart recipients, both higher than 0.13 ±0.03 and 0.19 ±0.02 in the controls and 0.16 ±0.06 and 0.26 ±0.08 in the HTK-preserved heart recipients (P<0.05), the Bcl-2 higher in the HTK-pre-served heart recipients than in the controls (P<0.05), and the LC3-Ⅱ expression higher in the HPMG-preserved heart recipients than in the immediately transplanted heart recipients (P<0.05).HE staining showed that cell edema and inflammatory cell infiltration were more obvious in the HPMG-preserved heart recipients than in the controls and immediately transplanted heart recipients but less obvious than in the HTK-preserved heart recipients.The rate of cell apoptosis was dramatically increased in the HPMG-and HTK-pre-served heart recipients ([5.04 ±1.77]%and [26.72 ±5.23]%) in comparison with the controls ([1.08 ±0.56]%) (P<0.01) and immediately transplanted heart recipients ([2.13 ±1.71]%) (P<0.01) but decreased in the HPMG as compared with the HTK-preserved heart recipients (P<0.01). Conclusion High-pressured mixed gas preservation can reduce cold ischemia-reperfu-sion injury of the donor heart, which may be associated with its promotion of autophagy, provision of energy to cells, and apoptosis of cardiocytes in the donor heart.