Child ; Consensus ; Diarrhea ; diagnosis ; therapy ; Humans

Objective To evaluate the efficacy and safety of endoscopic mucosal resection (EMR) for rectal carcinoid tumors. Methods From January 2006 to January 2009, EMR was performed in 28 patients with rectal carcinoids, who were followed up to evaluate the therapeutic effect and safety. Results Tumor diameters varied from 0.4 cm to 1. 2 cm (mean 0.7± 0. 2 cm). Negative resection margin was a-chieved in 26 cases (92. 9% ), tumor margin within 0. 1 cm of resection margin in 1 (7. 1% ) , and two margins coincided in 1 patient (7. 1% ). Hemostasis was performed with metal clips in 14 patients (50% ) and argon plasma coagulation (APC) in 9 (32. 1% ). Except for rectal bleeding in 1 patient (3. 6% ) , no other complications were observed. There was no recurrence in any patients during a follow-up of 6-36 months. Conclusion EMR is a useful and safe method for treatment of small rectal carcinoid tumor which does not cross submucosal layer.

Objective:Researching physical-chemic and biologic speciality of VacA-HpaA IgY,which provide a solid experimental basis for the preparation of vaccine against H.pylori infection.Methods:The purified antigen of fusion protein VacA-HpaA was used to immunize hens and the VacA-HpaA IgY was extracted from the yolk by water dilution methods.(1)After the VacA-HpaA IgY was purified by deposition technique with ammonium sulfate,the purity of IgY was analyzed by SDS-PAGE,and protein content of IgY was analyzed by Bradford method.(2)The indirect ELISA was used to detect its heat-stability,acid-stability and pepsin-stability.(3)The specificity of VacA-HpaA IgY to the antigens was identified by Western blot.(4)MTT was applied to assay the neutralization of VacA-HpaA IgY to The cytotoxity of H.pylori.(5)The neutralization of IgY to AGS cells was observed with scanning electron microscopy(SEM).Results:(1)The purity of VacA-HpaA IgY was about 60%,and the protein content of IgY was 22g/L;(2)The IgY showed a good heat-stability,a favorable acid-stability,and a well ability of anti-pepsin digest;(3)Western blot exhibited the protein bands with molecular weight of 27 000 and 30 000.The titer of VacA-HpaA IgY to VacA and HpaA were 1∶3 200 and 1∶6 400;(4)A dose and time dependent correlation of the IgY to counteract the cytotoxic activity of VacA;(5)VacA-HpaA IgY could interrupt the adhesive attraction of H.pylori.Conclusion:The VacA-HpaA IgY has good stabilities and well biologic speciality,which imply that the IgY could be used to prepare treatmental antibody against H.pylori infection.

Objective The study was performed to analyze the diagnosis and treatment of blue rubber bleb nevus syndrome of Chinese patients by evaluating the researches in China.Methods Chinese Journal Full-text Database,Wangfang Data and Weipu Chinese Medical Journal Database were searched for the clinical data of the patients with blue rubber bled nevus syndrome.Results Among the 50 patients,31 cases were male,and 19 cases were female.All patients (100％) had the venous malformations of the skin.Thirty-five (70％) cases had melena,13 (26％) cases had bloody stool,and 35(70％) had dizziness and palpitation.Blue rubber bled nevus syndrome were diagnosed with gastroscopy (40/48,83.33 ％),coloscopy (30/41,73.17％) and small intestinal examination (23/25,92％).Fourteen cases received symptomatic treatment.Twelve cases received therapeutic endoscopy,which lesions were located in stomach and colon.Sixteen cases received operation,and 2 cases were treated by laparoscopy and endoscopy.Conclusions Blue rubber bleb nevus syndrome is a rare disease.The skin and gastrointestinal system are involved in all patients with blue rubber bleb nevus syndrome in China.The routine examination for diagnosis of blue rubber bleb nevus syndrome should include examination of the small intestine.It still needs further research about effective treatment of blue rubber bleb nevus syndrome.

This study was designed to summarize the clinical experience of harvesting the lung of a brain-death donor by international standardized methods so as to establish a set of standards and regulations that are applicable for harvesting the lung of brain-death donors in China. The patient was strictly determined according to international standardized method by two or more advanced neurologists, neurocranial surgeon, anesthetists, and ICU specialists using brain death diagnostic standards and brain death diagnostic technological specification. The family members signed a informed consent of abandoning treatment for brain death and he was a volunteer organ donor. The operation was performed on 1 brain-death donor who had endured 50 hours of mechanical ventilation to evaluate brain death and organ function. The donor was assessed by donor lung function test and international brain death standard. Then the organ was ready for lung transplantation.

Objective To explore the efficiency and safety of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosis and treatment of children with pancreaticobiliary diseases.Methods A retrospective study was conducted by data collection from 74 children with biliary and pancreatic diseases undergoing ERCP from January 2012 to December 2016 for observation of therapeutic efficacy and postoperative complications.Results A total of 96 ERCPs were performed on 74 patients.The success rate was 94.8％ (91/96) using 29 operating methods.The complication rate of pancreatitis was 10.8％ (8/74),as well as hyperamylasemia was 13.5％ (10/74) and stress hyperglycemia was 10.8％ (8/74).Conclusion The application of ERCP in children with biliary tract and pancreatic diseases is effective and safe.

Objective To observe the clinical features of acute macular neuroretinopathy (AMN).Methods Six patients (11 eyes) with AMN were included in this study,with every 2-week follow-ups till six months.Among them,five had preceding dengue fever (83.3％),one had history of head trauma (16.7％).All patients received routine examination,fundus photography,infrared reflectance (IR) imaging,spectral-domain optical coherence tomography (SD-OCT) scanning and fluorescein fundus angiography (FFA) initially,and fundus photography,IR,SD-OCT during follow-up.Results Sudden onset of central/paracentral scotoma in one eye or both eyes was the main visual symptom.There were 1 eye with normal fundus,2 eyes with wedge-shape lesions,8 eyes with yellow-white or brown sheet lesion.IR imaging demonstrated localized areas of hypo-reflection in the macula.SD-OCT scanning through these areas revealed hyper-reflection in the photoreceptor layer and disruption of its normal reflective structures.Subsequent SD-OCT demonstrated that the hyper-reflection of the photoreceptor layer regressed gradually,followed by thinning of the outer nuclear layer.The external limiting membrane and ellipsoid zone became continuous;however,the interdigitation zone was not restored.There was no remarkable findings of the AMN lesions on FFA.The scotomas persisted in all 6 patients (11 eyes) by the last visit.Conclusions IR imaging demonstrated localized areas of hypo-reflection in the macula.SD-OCT revealed hyper-reflection in the photoreceptor layer in acute stage and the interdigitation zone was not restored in late stage.AMN has a relative poor prognosis with persistent scotomas through at least 6 months.

Objective Although heart transplantation surgery has become more common,little is known about the psychological status of patients waiting for a heart transplant.Method Ninety-three patients registered for heart transplantation from March 2013 to March 2014 in a large general hospital in Shanghai were assessed by a psychiatrist using the Hamilton Depression Scale (17 items) and the Hamilton Anxiety Scale.Out of them 36 were preoperatively admitted to the Cardiac Surgery Department.The scales were assessed repeatedly at the 1st day,3rd day,7th day,10th day and so on until the operation took place.Result The mean scores of HAMD and HAMA of 93 patients in the waiting list were separately 13.11 ±3.81 and 14.20±4.57.Among them 18(19.4％) were classified as moderately depressed,31(33.3％) had moderately anxious symptoms,and 14(14.1％) had severe anxious symptoms.Thirty-six patients were preoperatively admitted to hospital.Their mean scores of HAMD and HAMA were separately 13.19-± 3.82 and 16.17 ± 4.35.Among them 7(19.4％) were classified as moderate depression at the time of admission,16 (44.4％) had moderately anxious symptoms and 9 (25.0％) had severe anxious symptoms.The scores of HAMD had significant difference (t =3.383,P =0.002) before and after admission.Paired t test was separately conducted to analyze the first assessment and the 3rd-day assessment of HAMA and HAMD total scores after admission of all the inpatients.The results showed the scores were statistically different (for HAMA,t =2.786,P =0.009; for HAMD,t =14.024,P =0.000).Repeated ANOVA was used to analyze the recipients who had three assessments.The results had statistical difference (for HAMA,F =4.568,P=0.020; for HAMD,F=5.626,P =0.034) and the difference of HAMD score at different time points had a linear trend (F =8.273,P =0.013).Conclusion After hospital admission,the depression symptoms will be significantly alleviated.When waiting for the transplant in the hospital,the anxiety symptoms alleviate slightly in three days and then aggravate significantly.The depression symptoms alleviate slightly continuously.

This study was designed to summarize the clinical experience of harvesting the lung of a brain-death donor by international standardized methods so as to establish a set of standards and regulations that are applicable for harvesting the lung of brain-death donors in China. The patient was strictly determined according to international standardized method by two or more advanced neurologists, neurocranial surgeon, anesthetists, and ICU specialists using brain death diagnostic standards and brain death diagnostic technological specification. The family members signed a informed consent of abandoning treatment for brain death and he was a volunteer organ donor. The operation was performed on 1 brain-death donor who had endured 50 hours of mechanical ventilation to evaluate brain death and organ function. The donor was assessed by donor lung function test and international brain death standard. Then the organ was ready for lung transplantation.

ObjectiveTo investigate the relationship between 10 cGy whole brain radiation and cognitive dystunction.MethodsThirty-two male Sprague-Dawley rats at age one month were randomized into irradiation and sham exposed groups.Behavioral and histopathological tests were performed 3 months after irradiation in the order of open field,Morris water maze,passive avoidance,and histopathological test.Comparison between the two groups was conducted using independent samples t-test.ResultsIn the place navigation test of Morris water maze,irradiation group showed significantly longer latency than sham exposed group on day 3 and 4 ( t =2.91 and 2.65,all P ＜ 0.05 ).In the total latency of the place navigation,irradiation group also presented longer latency comparing with sham exposed group ( t =2.63,P ＜ 0.05 ).In the spatial probe test of Morris water maze,the open field test and the passive avoidance test showed no significant difference between the two groups ( t =0.92,0.59,0.83,all P ＞ 0.05 ).The histopathological examination had no significant difference either.ConclusionWhole brain radiation of 10 cGy could partly injury the cognitive function of the rat.