Objective To explore the feasibility and t he efficacy of laparoscopic splenectomy of massive splenomegaly in the treatment o f hereditary spherocytosis in children. Methods Seven children with massive splenomegaly underwent laparoscopic splenectomy. Their age ranged 1~14 years (mean, 8.8 years), and their body weight was 10~57 kg (mean, 33.8 kg) . Three children had an accompanying cholelithiasis: 2 of them received a concom itant cholecystectomy and 1 of them, cholecystotomy. Results A ll the operations were successfully performed under laparoscope, and hand-assist ed splenectomy through a small incision was applied in 1 child because of bleedi ng of the splenic vein. The duration of operation was 50~150 min (mean, 90 min), the intraoperative blood loss was 30~500 ml (mean, 117 ml), and the length of h ospitalization, 4~10 d (mean, 5.5 d). The red blood cell counts had significantl y increased 3 days following the operation (t=2.652, P

Objective:To explore the effect of bifidobacterium tetravaccine tablets combined with low-dose erythromycin on the efficacy and motilin (MTL) levels in the treatment of children with functional dyspepsia (FD).Methods:One hundred and fifty children with FD admitted to Shanghai Public Health Clinical Center from January 2019 to June 2020 were selected and were divided into two groups by random number table, with 75 cases in each group. The control group was treated with bifidobacterium tetravaccine tablets, and the observation group was treated with low-dose erythromycin on the basis of control group. The clinical efficacy and the disappearance time of the clinical symptoms of the two groups were compared. The changes in the frequency of gastric antrum contraction (ACF), the amplitude of gastric antrum contraction (ACA), the gastric antral movement index (MI) were detected by ultrasonic developing-out unit before and after treatment. The levels of 5-hydroxytryptamine (5-HT), nitric oxide (NO), gastrin (GAS) and MTL were detected before and after the treatment using enzyme linked immunosorbent assay. The incidence of adverse reactions was counted. The recurrence rate was recorded after 6 months of the treatment.Results:The total effective rate in the observation group was higher than that in the control group:93.33% (70/75) vs. 78.67% (59/75), and the difference was statistically significant ( χ2 = 6.700, P<0.05). The disappearance time of symptoms of nausea and vomiting, loss of appetite, abdominal distension, and abdominal pain in the observation group were shorter than those in the control group: (2.58 ± 0.45) d vs. (3.22 ± 0.68) d, (3.56 ± 0.62) d vs. (4.10 ± 0.70) d, (2.54 ± 0.46) d vs. (3.24 ± 0.69) d, (2.66 ± 0.56) d vs. (3.40 ± 0.67) d, and the differences were statistically significant ( P<0.05). The levels of ACF, ACA and MI in the observation group after the treatment were higher than those in the control group: (4.32 ± 0.90) times/min vs. (3.58 ± 0.83) times/min, (0.34 ± 0.12) vs. (0.30 ± 0.10) mm, (1.33 ± 0.42) vs. (1.14 ± 0.30), and the differences were statistically significant ( P<0.05). The levels of 5-HT and NO in the observation group after the treatment were lower than those in the control group: (164.77 ± 30.34) mg/L vs. (184.45 ± 28.90) mg/L, (38.27 ± 10.20) mmol/L vs. (46.54 ± 9.48) mmol/L; and the levels of GAS and MTL were higher than those in the control group: (115.23 ± 15.70) ng/L vs. (98.50 ± 14.29) ng/L, (266.67 ± 32.76) ng/L vs. (238.40 ± 28.97) ng/L, and the differences were statistically significant ( P<0.05). Conclusions:The treatment of pediatric FD with bifidobacterium tetravaccine tablets combined with low-dose erythromycin can significantly improve the efficacy, quickly improve the clinical symptoms of children, promote physical recovery, and regulate MTL levels to improve gastric motility. The recurrence rate is low.

OBJECTIVE To prevent and control the incidence of nosocomial infection,and improve the inner quality of nosocomial infection management.METHODS A total of 49 363 cases of inpatients in the recent four years were retrospectively analyzed.RESULTS Of them 2 409 cases were infected,the incidence was 4.88%.The lower(respiratory) tract ranked the first place (34.16%) and the highest infected rate was in medicine(department)((8.29%).) Totally 505 isolates of bacteria were found,of which Gram-negative ones accounted for 45.15%,(Gram-)positives 25.15%,fungi were for 29.70%.CONCLUSIONS The incidence of nosocomial infection is(connected) with following factors such as age,inpatient factor,invasive diagnosis and treatment manipulation,the misusage of(antibiotics),and the environment quality.

Objective To investigate the expressions of cell phenotypes CD_8 and CD_(28) of peripheral blood lymphocytes in patients with colorectal cancer. Method CD_8 and CD_(28) of cell phenotypes were measured by flow cytometry in 50 patients with colorectal cancer (cancer group) and 30 nontumorous patients (control group). Results The expression of CD_8 in cancer group was significantly higher than that in control group [(32.24±8.38)% vs (22.18±7.55)%](P < 0.01). CD_(28) and CD_8~+/CD_(28)~+ were much lower than those in control group [(52.03±10.94)% vs (60.60±7.98)%,12.18±4.28 vs 16.38±4.94](P<0.01). CD_8~+/CD_(28)~+ in Dukes D stage patients were significantly lower than that in Dukes B stage patients (P<0.05). CD_(28) and CD_8~+/CD_(28)~+ in lymph node metastasis patients were much lower than those in lymph node negative patients (P < 0.01). CD_(28) and CD_8~+/CD_(28)~+ in serosa involved patients were lower than those in no serosa involved patients (P < 0.01). Conclusions The expressions of cell phenotypes CD_8 and CD_(28) of peripheral blood lymphocytes in patients with colorectal cancer are closely related to biological characteristics of the tumor. The assays of cell phenotypes CD_8 and CD_(28) might be useful for evaluating the immunal statement and prognosis of patients with colorectal cancer.

Objective To study and establish a high quality digital 3D anatomical modeling of the mandible with full teeth.Methods A set of accurate digital models of standard anatomical specimens of mandibular teeth were obtained by laser scanning, and the 3D mandible model was reconstructed by CT scan data;then, a registration deformation method based on the geometry and image anatomical landmark was employed to do the registration of each tooth to the mandible model, and finally the tooth enamel , dentin, periodontal ligament were generated .Results A high quality digital 3D anatomical modeling of the mandible with full teeth was built , each tooth had detail crown and whole root , the distinction between the enamel , dentin, periodontal ligament , and any anatomical regions can be zoomed and rotately displayed . Conclusion The digital 3D anatomical modeling of the mandible with full teeth has realistic 3D imaging view and convenient teaching-learning function , and has tremendous apllication futures in the stomatology , maxillofacial and other medical departments .

Objective To study the anatomy of splenic hilum blood vessels in order to thread ligature(endoligature)instead of using stapler during the process of laparoscopic splenectomy and to evaluate the prelimnary clinical results.Methods 41 children patients underwent laparoscopic splenectomy with this technique(endoligature)for various hematologic and autoimmune disorders,including 25 cases of hereditary spherocytosis,13 idiopathic thrombocytopenia purpura,and 3 hypersplenic granulocytopenia.The anatomy of splenic pedicle,the adjacent relation between splenic vessel and pancreas were detected by color Doppler ultrasonography preoperatively.The above-mentioned parameters were compared with that found intraoperatively.Results The relationships of splenic vessel and pancreas was of type Ⅰ in 24 cases and type Ⅱ in 17.In 31 cases,the major splenic blood vessels were ramified into branches 2 cm away from the hilum and in 10 it was within 2 cm as detected by preoperative ultrasonography.These characters were largerly identified by laparoscopic laparotomy,and in all the 41 cases laparoscopic splenectomy was successfully accomplished using this endoligature instead of vasculature stapler.There was no serious complication.The mean operating time was(114 ±31)min,the estimated blood loss was(51 ±23)ml.Conclusions Ultrasonography could identify the anatomic type of splenic vessel,and its relation with the pancreas.Endoligature in the management of splenic pedicles during laparoscopic splenectomy is safe and reliable.

Objective To investigate the relationship between 4G/5G polymorphism in the promotor of plasminogen activator inhibitor-1 (PAI-1) gene and pulmonary thromboembolism (PTE). And to detect whether it plays an important role in the pathogenesis of PTE. Methods The 76 patients with PTE, 74 gender and age matched healthy controls were recruited in this study. Genome DNA was extracted from whole blood using phenol-chloroform. Subjects were genotyped for the 4G/ 5G polymorphism of PAI-1 gene using polymerase chain reaction and restriction fragment length polymorphism analysis. Results Significant difference was found in the frequency of 4G/4G genotype between PTE group and control group (50.0% vs.24.3%,P<0.01). And there were no significant differences in 4G/5G and 5G/5G genotype between the two groups. The 4G allele frequency was higher in PTE group than in control group (72.4% vs. 55.4% , P<0.01) . The recessive allele model was informative and the odd ratio of 4G/4G genotype was much higher than of other two genotypes (OR=3.40, P<0.01). Further stratification showed 4G/4G genotype was associated with high risk of PTE for those individuals without traditional environment risk factors. Conclusions The 4G/5G polymorphism of PAI-1 gene is associated with PTE and 4G allele is recessive. 4G/4G genotype increases the risk of PTE for individuals who have no traditional risk factors of PTE.

Objective To study the gene mutation of a Chinese family with Alport syndrome and to perform preimplantation genetic diagnosis before embryo implantation.Methods Next generation sequence analysis was done for checking COL4A3,COL4A4 and COL4A5 genes in the Alport syndrome family members.Array comparative genomic hybridization(CGH) was used to detect the embryos.Results A mutation c.2605G ＞ A was found and identified in COL4A5 gene of all of the Alport syndrome patients in the family,but COL4A3 and COL4A3 genes were normal in all of the detected people.After searching for the mutation database,the mutation c.2605G ＞ A of COL4A5 gene was related to the X-linked dominant Alport syndrome.Three embryos were detected by using the preimplantation genetic diagnosis.Among these embryos,there were two male and one female.One of the male embryos was chromosomal aneuploidy,which was 45,XY,-16 and the other was normal.This normal embryo was implanted,and after 20 weeks the prenatal amniocentesis diagnosis approved that the fetus was normal.Conclusions The mutation of COL4A5 gene (c.2605 G ＞ A) is the cause of Alport syndrome in this family,which indicates that next generation sequence analysis proves to be an accurate and rapid method to detect Alport syndrome disease.Meanwhile array CGH can be used to reduce birth rates as a useful preimplantation genetic diagnosis method.

Objective To investigate the correlation between XRCC1 R280H,XRCCl TSS+29C/T genetic polymorphisma and susceptibility to non-Hodgkin lymphoma (NHL). Methods The MassARRAY method was applied to detect the DNA repair gene XRCC1 genetic polymorphisms in 73 cases of NHL and 540 cases of normal healthy controls. Chi-square test was performed to calculate the adjusted odds ratios (OR) and 95% confidence intervals (CI). Results For XRCCl R280H genotypes, there was a significant difference between frequencies of the G and A among patients and controls (P=0.001). However, XRCCl TSS+29C/T genotypes had no statistical difference as for the T and C frequencies between patients and controls (P = 0.383). The frequency of XRCCI R280H with at least one A genotype was lower in the NHL cases than in controls, indicating a decreased risk for NHL development (OR=0.309, 95 % CI =0.168-0.567), comparing with GG genotype. In XRCC1 TSS+29C/T genotypes, the frequeney of TC and CC genotype was higher in NHL cases than in controls and associated with an increased risk of NHL development (P=0.472, OR =1.262, 95 % CI =0.669-2.379). Conclusion DNA repair XRCCl gene possesses significant correlation with NHL.

ObjectiveTo investigate the delineation of gross tumor volume (GTV) in locally advanced nasopharyngeal carcinoma (LANC) according to imageological changes before and after induction chemotherapy (IC) in order to decrease high dose area and protect normal tissue better.MethodsBetween Mar 2010 to Jan 2011,11 patients with LANC were enrolled and treated with TPF regimen followed by intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy,target volumes were delineated based on fused CT imaging before and after IC following project determination.Tumor target volumes after and before IC were respectively delineated according to imaging tumor residues and were overlaid by CTVnx in order to ensure radical doses for the imaging tumor volume before IC,the resulting differences of tumor target volumes of IC before and after were measured and analyzed by paired t-test.ResultsBefore and after IC,the average volumes of GTVnx were respectively 44.72 cm3 and 28.87 ( t =3.89,P =0.003 ),the average volumes of GTVnd were respectively 32.76 cm3 and 19.82 cm3 ( t =2.47,P =0.033 ),the volumes of maximum dose area in brainstem and spinal cord as well as eyeball decreased ( t =2.93-4.59,all P ＜0.05).ConclusionsLANC treated by 3 cycle TPF regimen followed by IMRT with concurrent chemotherapy showes significant shrinkage of tumor volume.The volume of high dose region which caused by normally recovered tissues were decreased by re-delineation of target volume in brainstem and spinal cord as well as eyeball of CT images after IC.