ObjectiveTo explore the relationship between anastomotic leakage of patients undergoing colonic surgery and the collagen metabolism of colonic wall.Method We measured the overall collagen content of colonic tissue by biochemistry and detected the collagen I, III, MMP-1,MMP-13 by immunohistochemistry in 16 patients with anastomotic leakage compared with 16 control cases. Resultthe overall collagen content and collagen I,III of colonic wall in the leakage group were lower than those in the control group (t=3.417,t=2.841, t=2.261,P

Objective To evaluate the clinical efficacy of transthoracic two dimensional echocardiography, cardioangiography (CAG), and MRI in the diagnosis of cor triatriatum. Methods Twelve cases of cor triatriatum were confirmed by operation. Imaging examination was performed in 12 cases by transthoracic two dimensional echocardiography, 6 cases by CAG, and 8 cases by MRI. Results The diagnostic accuracy of cor triatriatum was 7 out of 12 by UCG, 4 out of 6 by CAG, and 8 out of 8 by MRI, respectively. MRI provided excellent delineation of the intraatrial membrane and the size of the membrane orifice. Conclusion MRI was of great value in the diagnosis of cor triatriatum.

Objective To check serum protein of children′s Hirschsprung′s disease(HD) and sift specific protein marker which was used in constructing of HD screening and early diagnosis of serum protein fingerprint model.Methods Surface-enhanced laser desorption/ionization time of flight mass spectrometry(SELDI-TOF-MS) was applied to detect protein mass spectrometry of serum specimens in 82 cases(HD group 42 cases,20 cases of other types of obstruction,healthy control group 20 cases) and data were analyzed by bioinformatics methods(support vector machine).Results 1.For HD group and healthy control group:selected 3 M/Z in 3 221.7,5 639.2,6 884.2 protein markers were selected,HD early screening and diagnostic model was established,3 markers in HD low expression,the expressions of them in HD group and healthy control group were 378.29?273.34,295.65?159.38,444.13?254.06 and 1 428.18?1 192.61,1 039.60?785.64,1 115.72?680.48,respectively.There were significant differences in two groups(Pa0.05).Conclusions The establishment of serum protein fingerprint model of HD by SELDI-TOF-MS support vector machine could screen and diagnose HD early,which is a new method of better specificity,high sensitivity and is worthy of further research and application.

Objective To construct an RNA interference vector to down-regulate X-linked inhibitor of apoptosis(XIAP)gene and study the RNA interference effect on the cell cycle and growth of ovarian cancer.Methods Oligonucleotides of 64 base pairs for hairpin RNA targeting XIAP were designed, chemically synthesized,annealed,and cloned into the pSUPER vector.After identification by restriction digestion,the correct vectors were transiently transfected into SKOV3 cells,a human ovarian cancer cell line.The XIAP mRNA was detected by RT-PCR.The proteins were detected by western blot and indirect immunofluorescence staining.Flow cytometry(FCM)analysis and methyl thiazolyl tetrazolium(MTT)assay method were applied to measure cell cycle,cell growth and sensitiveness to cisplatin.Results SKOV3 cells had a high level expression of XIAP.The vector of RNA interference,which can interfere with XIAP gene was successfully constructed.After transient transfection,the expression of XIAP protein was significantly decreased in SKOV3 cells and the value of relative density was 3584?124,2138?65,1973?80 and 110 ?12,respectively(P=0.0334).At the same time,the expression of XIAP mRNA was decreased accordingly and the value of relative density was 6674?274,4532?107,2322?57 and 1864?78, respectively(P=0.0127).The FCM results showed that,the vector could increase the number of cells in G_1 phase compared with parent cells and compared with the cells transfected with pSUPER(P

Objective To investigate the dynamic changes of platelets (PLT) and white blood cells (WBC) after traumatic brain injury (TBI) and discuss its clinical significance. Methods The number of PLT and WBC were examined in 63 patients with TBI by using cytoanalyze and also analyzed together with Glasgow Outcome Scale and concurrent infection, in the meantime, enzyme-linked immu-nosorbent was used to investigate concentration changes of C reactive protein (CRP) and thrombospondin 1 (TSPI) and analyze the correlation between CRP and TSP1. Results The number of WBC in all pa-tients, whether concurred with infection or not, was significantly increased within 24 hours after TBI (P < 0.01), with no statistical difference between patients without infection at day 4 and normal patients (P >0.05). However, the number of WBC was decreased to below 10 × 109/L in patients without infec-tion, which was significantly higher than that in normal patients (P < 0.05). In patients with infection and unfavorable prognosis, the number of WBC was increased again ay days 7-14, whereas that of PLT rose significantly at days 14-21 (P <0. 01). The concentration of TSPI was positively correlated with that of CRP (r = 0.720, P < 0.01). Conclusions Monitoring the dynamic changes of PLT and WBC is promising. The change of WBC at day 4 post injury is a key indicator to provide evidences of prophylactic antibiotic usage. Much attention should be paid to the dynamic change of PLT at days 14-21 post injury so as to evaluate the condition of hypercoagulability that can be potentially caused by inflammation response. Secondary increase of WBC and later increase, of PLT may affect prognosis of the patients. TSP1 and CRP may participate in thrombosis formation induced by inflammation.

Objective To compare the efficacy between californium?252 ( 252 Cf ) neutron intraluminal brachytherapy combined with external?beam radiotherapy with lead?shielding pelvic parallel opposing field technique and non?lead?shielding four?field box technique for cervical cancer. Methods A total of 52 patients with stage Ⅱa?Ⅲb cervical squamous cell carcinoma who were admitted to our hospital from 2004 to 2007 were enrolled as subjects and paired by clinical stage, age, tumor size, and degree of anemia. The 26 pairs of patients were divided into lead?shielding pelvic parallel opposing field group (lead?shielding group) and non?lead?shielding four?field box group (non?lead?shielding group). For all patients in both groups, 252 Cf neutron brachytherapy was added in external?beam radiotherapy. The local control (LC), overall survival (OS), and disease?free survival (DFS) rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The difference in the incidence of late complications was analyzed using the McNemar method. Results There were significant differences in 5?year LC, OS, and DFS rates between the lead?shielding group and the non?lead?shielding group (85% vs. 81%, P= 0?? 014;89% vs. 73%, P=0?? 013; 89% vs. 73%, P= 0?? 013 ). There was also significant difference in the incidence of late complications between the lead?shielding group and the non?lead?shielding group ( 12% vs. 23%, P=0?? 008). Conclusions When intraluminal brachytherapy combined with external?beam radiotherapy is used to treat cervical cancer, the centers of the front and back fields should be shielded by lead, regardless of whether the parallel opposing field technique or the four?field box technique is used.

Objective: To study relationship among ambulatory pulse pressure (PP), pulse pressure index (PPI) and carotid intima-media thickness (IMT) in aged patients with hypertension. Methods: The 24h ambulatory blood pressures of 159 subjects were measured, and their ambulatory PP [(mean systolic blood pressure (SBP) - mean diastolic blood pressure (DBP)] and ambulatory PPI (ambulatory PP/mean SBP) were calculated. Color Doppler ultrasonography was used to measure carotid IMT. Relationship between ambulatory PPI and carotid IMT was analyzed. Results: Pearson correlation analysis indicated that carotid IMT was correlated with age (r=0.353), mean SBP (r=0.594), mean DBP (r=-0.355), ambulatory PP (r=0.855) and ambulatory PPI (r=0.883), P<0.001 all. Multivariant gradual regressive analysis indicated that carotid IMT possessed significant linear correlation with ambulatory PP and ambulatory PPI (R2=0.789), and standardized regression coefficient β of ambulatory PPI (β=0.621) was higher than that of ambulatory PP (β=0.284). Conclusion: Ambulatory pulse pressure index and ambulatory pulse pressure are good indicators for evaluation of carotid arteriosclerosis, and value of ambulatory pulse pressure index is more than.

Objective To evaluate early and mid-term results in infants,weighing less than 2 500 g,who underwent early cardiac surgery on cardiopulmonary bypass (CPB).Method Since November 2003 to December 2007,28 consecutive infants of less than 2 500 g underwent early cardiac surgery on CPB in Children's Hospital Affiliated to Fudan University.Sixteen infants were male,and 12 infants were female.The mean pregnancy period was 34 weeks (30 to 41 weeks) ,and 14 patients were premature,and the mean birth weight was 2 010 g(1 370-2 500 g).Mean age at operation was 27.46 d (range 1～61 d),and mean weight was 2 391 g (range 1 500～2 500 g).Deep hypothermia circulatory arrest was used in 9.Indications for surgery were:ventricular septal defect (10 infants),transposition of great arteries (6 iofants),totally anomalous pulmonary venom return (5 infants),pulmonary atresia with intact ventricular septum(2 infants),coarctation of aorta (1 infants) ,interrupted aortic arch (1 infants),cortriatriatum(1 infants),abnormal original of fight pulmonary artery (1 infants).Resuits Two (7.14%) infants died after operation at early phase.Mean duration of mechanical ventilation and intensive care unit stay were 113.9 h and 14.4 d,respectively.During follow-up (mean 16.87 months),one died.Two patients needed reintervention.About 84.4% infants didn' t need reintervention at the end of 12-month followup.Conclusions If medicine is aseless,infants woth low birth weight and congenital heart defect can obtain satisfactory outcome after CPB.Perioperative proration for virtual organs should be payed attention to.

Objective To analyze the effect of acromio-humeral interval on the occurrence of subacromial impingement syndrome (SIS) after the clinical application of clavicular hook plate in acromioclavicular joint dislocation (Tossy Ⅲ). Methods From July 2005 to October 2008, 63 cases of acromioclavicular joint dislocation (Tossy Ⅲ) were treated with clavicular hook plate. There were 48 males and 15 females with an average age of 33.6 years (range, 21-53 years). The relationship of the acromio-humeral interval (AHI)were analysed between the two groups by X-ray measurement. The AHI and plate-humeral interval (PHI)were measured on X-ray film to detect difference between the two groups. Results After the operation, all t he 63 cases were divided into two groups according the occurrence of SIS. There were 14 cases in the group of SIS and 49 cases in the group without SIS. The mean follow-up was 12.2 (average, 6-15) months.The average AHI of was (8.5±2.1) mm and (9.7±2.6) mm in the group of SIS and the group without SIS respectively. The difference between the two groups was statistically significant. The average PHI of the group of SIS and the group without SIS was (6.1±2.8) mm and (6.8±2.4) mm respectively. There was no difference between the two groups. After removal of the clavicular hook plate, the clinical sign disappeared in the group of SIS. According the Karlsson scoring system, the excellent and good rate of the shoulder function was 100%. Conclusion The occurrence of SIS after the clinical application of clavicular hook plate has related to the width of the subacromial interval. The syndrome could be treated by the removal of clavicular hook plate.

Objective To examine among preschool children the validity, reliability and sensitivity of a new assessment tool of Mandarin sentence recognition in babble noise, consisting of twenty-seven equivalent lists, as well as to investigate the effect of age and gender on children's speech recognition. Methods Fifty-four normalhearing children aged 4 to 6 years were recruited from Beijing and were divided into three age groups (4～, 4.5～,and 5.0～6.0 years) containing 18 children each, half boys and half girls. According to randomized split-plot design, we examined their speech recognition ability with 27 sentence-in-babble-noise lists in a sound-treated booth in a kindergarten (ambient noise ＜40 dB). The sentences were presented at fixed intensity of 65 dB SPL, paired with competing babble noise at three different signal to noise ratios (SNR= +1, -2, -5 dB) by the same loudspeaker with 0° azimuth. Speech recognition score were calculated based on the children's repetition of keySNR functions exhibited that the threshold was -1.96±0. 19 dB SNR and the slope was 15.8%±1.1%/dB for of variance and Post- Hoc Scheffe test indicated that significant differences in performance were most pronounced between the 4～ year group and the other two groups (P＜0.001), while there was no significant difference between 4.5～ year group and 5.0～6. 0 year group (P=0. 90). The girls' performance was also significantly better than boys' (P＜0. 001). Conclusion The 27 lists of Mandarin speech recognition in babble noise were equivalent among children, and the sensitivity of performance versus SNR was 15.8%/dB. Both of them were below the adult averchildren aged 4.5～ up years. Even though the performance differed between boys and girls, the difference was relatively small compared to 24.6%, the critical difference as the reliability indicator.