OBJECTIVE: To compare the efficacy of laparoscopic pyloromyotomy with open pyloromyotomy in treatment of congenital hypertrophic pyloric stenosis(CHPS). METHODS: Fifteen patients (age 20%ape;90 days, body weight 2.5 approximate, equals 5.0 kg) with CHPS underwent laparoscopic pyloromyotomy (Group I) and 10 patients (age 26 approximate, equals 90 days, body weight 2.8 approximate, equals 4.5 kg) with CHPS underwent open pyloromyotomy (Group II). Ambulatory 24 hr esophageal pH metry and gastroesophageal mamometry were studied in two groups before and after surgery. RESULTS: All patients presented gastroesophageal reflux (GER) before operation and all reflux parameters were significantly decreased after operation (P<0.01). There was no significant difference between two groups in reflux parameters after surgery. Intragastric pressure (GP) significantly reduced in two groups after operation(3.83+/-1.45)mmHg compared with (2.38+/-0.54)mmHg P<0.01 in Group I,(4.52+/-1.96)mmHg compared with (2.38+/-0.72)mmHg P<0.05 in Guoup II). There was no significant difference in lower esophageal sphincter pressure (LESP), lower esophageal sphincter length (LESL) before and after operation in two groups. The mean operative time for Group I was (32+/-19) mins, which was close to that of Group II after an initial trail. Oral feeding was started 6 h postoperatively in Group I, which was earlier than that in Group II. No technical failures and complications in Group I were encountered. One wound infection and dehiscense was seen in Group II. CLUSION: Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis is safe and feasible, which has lesser complication and similar effect of antireflux as open pyloromyotomy.

OBJECTIVE: A systematic study of Laggera pterodonta was performed in order to identify its bioactive compounds. METHODS: Solvent partition and column chromatography used to isolate and purify Laggera pterodonta compounds. The isolated compounds were further elucidated by high field NMR spectroscopy. RESULTS: Fifty-two compounds were separated and the structures of 39 compounds were elucidated. Twenty-four compounds have not been previously reported. For example, the structure of compound 19, a previously undetected compound was elucidated as 4gamma, 9alpha,11-triol-enantio-eudesmane using both 1D and 2D NMR spectroscopy. Major secondary metabolites of the Laggera pterodonta included eudesmane-type sesquiterpenes and flavone derivatives. CONCLUSION: A systematic study of a yunnan herbal medicine Laggera pterodonta resvealed several novel compounds that may have clinical significance. Further in vivo animal studies should be performed to assess their bioactive role.

Animals ; Arthropods ; Child ; Humans ; Male ; Parasitic Diseases ; diagnosis ; parasitology ; pathology

OBJECTIVETo investigate the effect of nifedipine on the non-selective inward current of cochlear Hensen cell induced by ATP in high concentrations.

METHODSThe organ of Corti was treated using enzyme, and then dissociated mechanically to isolate Hensen cells. The whole cell patch-clamp technique was used to record ion currents in Hensen cells which had integrated border, round shape and translucent intracellular cytoplasm. Drugs were delivered to the cell by a micro-manifold consisting made by three 100 microm diameter microtubules, including 0.1 mmol/L ATP, 1 mmol/L ATP, 10 mmol/L ATP, 0.1 mmol/L ATP + 0. 1 mmol/L suramin (purinergic antagonist), stimulation of extracellular fluid alone, 140 mmol/L CsCl (replace KCL in intracellular fluid) + 1 mmol/L ATP, 40 mmol/L TEA (blocker of potassium channel) + 1 mmol/L ATP, and 1 mmol/L ATP + 10 micromol/L nifedipine, respectively.

RESULTSWhen isolated Hensen cell was given 0.1 mmol/L (n = 10), 1 mmol/L (n = 10), 10 mmol/L( n = 6) ATP separately, an inward ion current could be recorded, which enhanced with increased ATP concentration and showed dose-dependence. Further study indicated that the inward ion current could be inhibited by 0.1 mmol/L suramin (n = 5), 140 mmol/L CsCl (n = 5) and 40 mmol/L TEA (n = 5). There was no ion current be recorded when the cell was stimulated with the extracellular fluid alone, neither inward nor outward. However, the inward ion current vanished and an outward ion current appeared instead, when 1 mmol/L ATP and 10 micromol/L nifedipine were given together (n = 5).

CONCLUSIONSAn inward current was evoked in isolated Hensen cell by ATP in high concentrations. This inward current seems to be associated closely with potassium channels without the participation of mechanical channels. Nifedipine can inhibit this inward current and induce an outward current, which is similar to the normal potassium current in isolated Hensen cell. It suggests that nifedipine have partly protective effect on the function of cochlea by inducing modulate of the potassium circle of cochlea in Hensen cell's tache.

Adenosine Triphosphate ; pharmacology ; Animals ; Cochlea ; cytology ; Female ; Guinea Pigs ; Labyrinth Supporting Cells ; drug effects ; metabolism ; Male ; Nifedipine ; pharmacology ; Patch-Clamp Techniques ; Potassium Channels, Inwardly Rectifying ; drug effects

OBJECTIVEThe history of clinical application of extracorporeal membrane oxygenation (ECMO) has been more than 30 years. But in China, there were only a few ECMO centers with limited successful cases reported by the end of twentieth century. The high morbidities and mortalities in current pediatric ECMO practice are noted in China. Therefore, it is necessary to review the experience on rescue use of ECMO in critically ill pediatric patients.

METHODA retrospective analysis was done for patients who had been receiving ECMO treatment to rescue refractory cardiorespiratory failure from different causes in a hospital between July 2007 and May 2011.

RESULTA total of 12 patients were treated with ECMO; 7 of them were male and 5 female, they aged 6 days to 11 years, weighed 2.8 - 35 (17.21 ± 11.64) kg. The underlying causes of cardiorespiratory failure were as follows: two cases with acute respiratory distress syndrome (ARDS) leading to respiratory failure, 4 with failure of weaning from cardiopulmonary bypass, 3 with fulminant myocarditis, 1 with right ventricular cardiomyopathy leading to repeated cardiac arrest, 1 with preoperative severe hypoxemia, and 1 with anaphylactic shock complicated with massive pulmonary hemorrhage and severe hypoxemia. Of the 12 cases, 3 were established ECMO (E-CPR) while underwent chest compression cardiopulmonary resuscitation (CPR). The mean ECMO support time was 151.75 (15 - 572) h. Seven patients (58.33%) were weaned from ECMO, 6 patients (50.00%) were successfully discharged. Six cases had bleeding from sutures, 2 cases with severe bleeding underwent thoracotomy hemostasis, 2 presented with acute renal failure. Infection was documented in 3 cases, hyperbilirubinemia in 2 cases, lower limb ischemia in 1 case, hyperglycemia in 3 cases, disseminated intravascular coagulation in 1 case, membrane lung leakage in 2 cases, systemic hemolysis in 3 cases, oxygenator failure in 2 cases and oxygenator thrombosis in one case. During the follow-up between 6 months and 4.5 years, 5 patients survived with good quality of life, without any documented central nervous system disorders. One case survived with the right lower extremity disorder from ischemic damage. His motor function has been improved following orthopedic operation at one year after discharge.

CONCLUSIONECMO is a justifiable alternative treatment for reversible severe cardiopulmonary failure in critically ill children.

Cardiac Output, Low ; etiology ; therapy ; Cause of Death ; Child ; Child, Preschool ; Critical Illness ; mortality ; therapy ; Extracorporeal Membrane Oxygenation ; adverse effects ; Female ; Heart Failure ; etiology ; mortality ; therapy ; Hemorrhage ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; mortality ; therapy ; Respiratory Insufficiency ; etiology ; mortality ; therapy ; Retrospective Studies ; Survival Analysis ; Thrombosis ; epidemiology ; etiology ; Treatment Outcome

OBJECTIVETo establish the differential expression profiles for exploring new immune mechanism of hepatitis B virus infection.

METHODSDCs were separated from the bone marrow of healthy mouse and cultured in vitro. Then DCs were stimulated with HBsAg, LPS, TNF-alpha, respectively. Twenty-four hours later, the total RNA of cell was extracted. cDNA microarray was used to compare the differential expression of RNA. The significant differential expression of miRNA after the stimulation of HBsAg was chosen. Subsequently, target genes of the significant differential miRNA were forecasted by using computer software.

RESULTSThere were 30 miRNAs whose significant differential expressions were beyond two times after the stimulation of HBsAg. Among them, 16 miRNAs expressions were increased and 14 miRNAs expressions were decreased. There was significant difference in differential expression of miRNA among the 3 different stimulations. The selected target genes included relevant elements of signal pathway of DC.

CONCLUSIONThe alteration of expression profiles of miRNA was specific after DC was stimulated by HBsAg. The selected target genes further demonstrated that miRNA could play important roles in the immune mechanism of HBV infection.

Animals ; Dendritic Cells ; drug effects ; metabolism ; Gene Expression Profiling ; Hepatitis B Surface Antigens ; pharmacology ; Lipopolysaccharides ; pharmacology ; Male ; Mice ; Mice, Inbred C57BL ; MicroRNAs ; analysis ; Oligonucleotide Array Sequence Analysis ; Tumor Necrosis Factor-alpha ; pharmacology

OBJECTIVETo study the commodity specification and grade standard of Pseudostellaria Radix, for standardizing market order and achieving industrialization, standardization and modernization of Pseudostellariae Radix.

METHODThe different areas and grade medicinal materials of Pseudostellariae Radix were respectively measured in quantitative characteristics of appearance, and the present grade classification of Pseudostellaria Radix was scientifically verified by the content of polysaccharide. Then the determination data were evaluated by spss correlation analysis, principal component analysis and cluster analysis. So combining with the actual production, the commodity grade standard of Pseudostellariae Radix was formulated.

RESULTCorrelation analysis indicated that the present grade classification of Pseudostellaria Radix was reasonable, and the more the grade of Pseudostellariae Radix was high, the more the content of polysaccharide was high. Meanwhile, length as a classification index was not suitable for the commodity grade standard of Pseudostellariae Radix. Using principal component analysis and cluster analysis, combining actual production, the thickest diameter, weight of single root tuber and the number of 50 g root tuber were filtrated and the grade was divided into 5 ranks: big, mid- dle, small selected goods, big ungraded goods and small ungraded goods.

CONCLUSIONthe commodity specification and grade standard of Pseudostellariae Radix that mainly included the thickest diameter, weight of single root tuber and the number of 50 g root tuber was formulated, the standard was divided into 5 grade. Each grade was not only consistent with the present situation of medicinal materials market, it could also reflected the intrinsic quality of Pseudostellariae Radix. In conclusion, the standard could be used as a classifica- tion basis to the commodity specification and grade.

Caryophyllaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; standards ; Quality Control ; Reference Standards

Objective To determine the curative effect of dilation for achalasia with temporary cardia stent in different diameters based on a long-term follow-up.Methods The study cohort was comprised of 135 patients of achalasia.Among them differentiated by stent diameters as followings:30 patients were treated under fluoroscopy with dilation of temporary cardia stent in 20 mm diameter(group A), 30 patients with dilation of temporary eardia stent in 25 mm diameter(group B),and 75 patients with dilation of temporary cardia stent in 30 mm diameter(group C).135 cardia stents were temporarily placed in the 135 patients and withdrawn after 3 -5 days via gastroscopy.All the stents were inserted and withdrawn successfully.The follow-up in all groups lasted 6-128 months.Results Six(20.0%)out of 30 patients,6(20.0%)out of 30 patients,5(22.7%)out of 22 patieuts,6(37.5%)out of 16 patients,5 out of 9 patients,3 out of 3 patients in group A exhibited dysphagia relapse during 6 months,1 year,3 years,5 years,8 years,and 10 years follow-up,respectively. Four(13.3%)out of 30 patients,4(13.3%)out of 30 patients,3(13.0%)out of 23 patients,4(22.2%)out of 18 patients,5(45.5%)out of 11 patients,and 3 out of 4 patients in group B exhibited dysphagia relapse during 6 months,1 year,3 years,5 years,8 years,and 10 years follow-up,respectively.No(0.0%)out of 75 patients, 1(1.5%)out of 66 patients,4(8.3%)out of 48 patients,6(18.2%)out of 33 patients,6(33.3%)out of 18 patients,2 out of 5 patients in group C exhibited dysphagia relapse during 6 months,1 year,3 years,5 years,8 years,and 10 years follow-up,respectively.Conclusion Dilation with temporary cardia metal stent in 30 mm diameter is the best dilation for achalasia in long-term follow-up.

Abnormalities, Multiple ; diagnosis ; surgery ; Anus, Imperforate ; surgery ; Colon ; abnormalities ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Ischium ; abnormalities ; Treatment Outcome ; Twins, Conjoined ; surgery

OBJECTIVETo look into the character of the expression of collagen type II and transforming growth factor beta1 (TGF-beta1), basic fibroblast growth factor (bFGF) in the apical articular process cartilages of adolescent idiopathic scoliosis (AIS) and congenital scoliosis (CS) patients.

METHODSThe articular processes of 22 AIS and 18 CS were collected. The techniques of HE staining, immunohistochemistry and in situ hybridization were adopted in this research. By comparing the apical processes with the end processes, the convex processes with the concave processes, the AIS processes with CS processes, the pathological changes of the articular process cartilages of these patients and the distribution of collagen type II and TGF-beta1, bFGF in them were studied. The images of immunohistochemistry and in situ hybridization were input into the image analysis system and were analyzed semi-quantitatively. The SAS software (8.01) was adopted, and P < 0.05 was defined as the significant level.

RESULTSThe expression of collagen type II and TGF-beta1, bFGF in AIS was similar to CS: the concave sides of apexes were higher than the convex sides. The comparisons had statistical significance. There was no statistical significance between upper and lower end vertebrae in convex and concave sides, between convex and concave sides in upper and lower end vertebrae. The apical vertebrae were significantly higher than the ipsilateral sides of upper or lower end vertebrae for collagen type II. There was no statistical difference of the expression at the concave, convex, upper, lower end vertebrae between AIS and CS.

CONCLUSIONSThe cartilages of the apical processes show some signs of regression and hypoplasia in scoliosis. The concave side is more severe than the convex side. Increase of collagen type II and TGF-beta1, bFGF in the concave sides of apical processes in scoliosis may be the results of reconstruction of extracellular matrix and the compensation reactions which are caused by abnormal biomechanical forces such as compressive stresses. Compressive stress on the concave sides has more influences on the expression of collagen type II than tensile stress on the convex sides.

Adolescent ; Cartilage, Articular ; metabolism ; pathology ; Child ; Collagen Type II ; metabolism ; Fibroblast Growth Factor 2 ; metabolism ; Humans ; Scoliosis ; metabolism ; pathology ; Transforming Growth Factor beta1 ; metabolism