Objective　To study the diagnosis and treatment of perforated congenital choledochal cyst(PTCC). Methods　The clinical data of 10 children with PTCC were retrospectively analysed.Results　6 males, 4 females, average age 4.5 years old. The cyst perforted time within 12 hours was in 4 cases, 12～72 hours in 3, and more than 72 hours in 3. Of these cases, 2 had infection and the others had no obvious discomfort before perforation. Of 7 cases undergoing cyst excision and biliary reconstruction, 5 cases were recovered without complications; 2 occurred anastomostic leakaged(1 case had infection before perforation and the other with perforcted time more than 72 hours). 3 cases subjected to external drainage at first, and cyst excision and biliary reconstruction were performed on three months later. Conclusions　If PTCC is treated earlier, cyst excision and biliary reconstruction can be performed as a primary operation.

To identify the stem cell islands in regenerated epidermis, the same biopsies used in our previous experiments were used in this study. CD87 immunohistochemicy and PAS staining were used. The scant CD87 positive cells could be found in basal membrane. Also, the positive staining of PAS could be seen in the basal membrane in both normal and regenerated epidermis. No CD87 positive cells were found in the spinous and granular layers. The results indicate that the error in metrology could be excluded from both CD87 immunohistochemicy and PAS staining, and that the stem cell islands may come from the cell reversion in regenerated epidermis.

Objective To study influence of travoprost eye drops in treatment of after anti-glaucoma surgery and its effects on visual function, the tear film stability and inflammatory index. Methods 90 patients of anti glaucoma who received therapy from August 2014 to August 2015 in the first hospital of Ninghai County Zhejiang Province were selected as research objects. The control group was treated with timolol maleate, while the observation group was treated with travoprost eye drops, then the visual acuity, intraocular pressure, tear film stability (rupture time, schirmer), inflammation (flashlight, cell count), visual field defect percentage range, curative effect after treatment were compared. Results After treatment, the vision in observation group (0.95±0.26)D was better than the control group (0.76±0.21)D, intraocular pressure in observation group (11.29±3.23) mmHg was less than the control group (13.89±3.72)mmHg, the difference was statistically significant (P<0.05), rupture time in observation group (12.93±1.90)s was higher than the control group (10.36±1.80)s, schirmer in observation group (13.01±1.60)mm was higher than the control group (11.10±1.02)mm, the difference was statistically significant (P<0.05), TNF-α, IL-6 in observation group was less than the control group, the difference was statistically significant (P<0.05), field of visual field defect in observation group (38.96±10.21)% was less than the control group (47.37±11.35)%, the difference was statistically significant (P<0.05), the total effective rate of observation group 95.56%(43/45) was statistically higher than that in the control group 77.78%(35/45), the difference was statistically significant (P<0.05). Conclusion Travoprost eye drops can improve glaucoma postoperative visual function, tear film stability, reduce inflammation.

As an effective therapeutic approach for acute ischemic stroke,endovascular interventional therapy has received increasing attention.However,a large number of revascularization clinical trials have shown that its mortality rate and the incidence of complications are higher than intravenous thrombolysis.This article reviews the perioperative complications of endovascular interventional therapy of acute ischemic stroke and thek treatment.

Objective To investigate the inductive role of traumatic microenvironment in dedifferentiation of epidermal cells and explore the potential role of Wnt signaling pathway in this biological process. Methods The sheets of human foreskin were digested overnight after removal of adipose tissue, and then the epidermis was separated from the dermis. The separated epidermis sheets were repeatedly adhered to type Ⅳ collagen and flushed to remove the epidermal stem cells. The obtained epidermis sheets were transplanted onto the full-thickness skin wounds on the back of BALB/c nude mice, five days after which the cell lineage was evaluated by immunohistochemistry and the expressions of Wnts and downstream components in the grafted epidermal sheets examined by RT-PCR and Western blot. Results The cells in the basal layer of full-thickness epidermal sheets were positive for CK19 and β1 integrin and negative for CK10. While the cells in uhrathin epidermal sheets treated with type Ⅳ collagen were fully positive for CK10. Five days after transplantation of the ultrathin epidermal sheets, cells negative for CK10 but positive for CK19 and β1 integrin emerged at the wound-neighboring side of the skin grafts. At the same time, the expressions of Wnt-10b, Wnt-4 and Wnt-7a mRNA were increased by about 3.1-fold, 2.2-fold and 1.4-fold independently after transplantation. Furthermore, the expressions of β-catenin and β-catenin target genes (cyclin D1 and c-myc) were elevated by about 3-fold, 1.5-fold and 2-fold respectively in the grafted epidermal sheets (P < 0.01). Conclusion Traumatic microenvironment can induce epidermal cell dedifferentiation, when the Wnt/β -catenin signaling pathway may play an important role.

Objective To evaluate the urodynamic outcome after bladder augmentation using double de-epithelialized segment of small intestine lined with urothelium. Methods Twenty-five children with neurogenical bladder (age range,4 to 14 years;16 males and 9 females) underwent bladder augmentation using de-epithelialized segment of small intestine lined with urothelium.Pre- and post-operative voiding cystoureterography,urodynamic and clinical evaluation were performed on them.Of them 21 cases were followed up for 6 to 24 months after operation. Results Bladder volume was increased from pre-operative (142.14?45.88)ml to post-operative (242.62?60.04) ml,compliance from (3.26?1.57) ml/cmH 2O (1 cmH 2O=0.098 kPa) to(8.10?3.00)ml/cmH 2O,and maximum urine flow rate from (3.00?1.00) ml/s to (7.60?2.90)ml/s,respectively(P

Objective To investigate the clinical features of anuria caused by pediatric congenital bilateral ureteral stenotic obstruction,and to improve the diagnosis and treatment of the disease.Methods This series included 7 infants(2 males and 5 females;age range,35-57 d) with congenital bilateral ureteral stenotic obstruction.The clinical presentations were characterized by sudden anuria or oliguria.B-ultrasound,cystography and puncture pyelography were performed in all of them,and magnetic resonance urography(MRU) in 3.Based on the definite diagnosis,resection of stenotic segment of the ureter or ureteral implantation was performed on them.Results The diagnosis was confirmed by puncture pyelography in all of the 7 cases.Six cases underwent phase I surgery and recovered.No ureteral stenosis and cystoureteral reflux occurred during a follow-up of 2-4 years.The renal function was normalized in them.One case had stenosis recurrence due to scar formation,and was cured by the second operation.Conclusions Anuria caused by pediatric congenital bilateral ureteral stenosis should be diagnosed and treated as early as possible.Definite diagnosis can be established by puncture pyelography and MRU.Resection of the obstructive segment of the ureter,protection of renal function,and ureteral implantation are the main therapies.

To gain insight into the mechanisms of an age related difference in ability of wound healing, the characteristics of stem cell differentiation in skins from fetus, child and adult were investiga ted. Integrin ? 1 and keratin 19 (K19) were used as the biochemical markers for stem cells and transit amplifying cells. Biopsies were taken from fetus (22～24week gestational age), children (4～12year) and adults (35～53year). Immunohistochemistry was used. As for the immunostainings of fetal tissue sections, integrin ? 1 and K19 expressions were observed in all epidermal basal cells. In children skin, the ratio of integrin ? 1 and K19 positive cells in the epidermal basal layer was 60%～80%. In adults, the ratio in the epidermal layer decreased. These results indicate that fetal skin epidermis contains a large number of stem cells and transit amplifying cells, and the proportion of stem cells and transit amplifying cells decreases with age after birth, which maybe a reason of the age associated difference in ability of wound healing.

To investigate the different expression of Fas, Fas L and Caspase 3 in hypertrophic scars and normal skins in order to explore their influences on scar formation, the expression intensity and distribution of Fas, Fas L and Caspase 3 were detected by immunohistochemistry and pathological methods in 8 cases of hypertrophic scars and 8 cases of normal skins. In normal skins, Fas and Fas L were mainly located in the cellular membranes and cytoplasms of epidermal cells and some fibroblasts. Caspase 3 was mostly distributed in epidermal basal cells and some fibroblasts. In hypertrophic scars, Fas and Fas L were principally existed in the membranes and cytoplasms of epidermal keratinocytes. The positive cellular ratio of two proteins was significantly reduced ( P

The purpose of this study was to investigate the localization and expression characteristics of phosphorylated form of extracellular-signal regulated-protein kinasel/2 (p-ERKl/2), Ras and C-fos in skin at different development stages and to explore their potential biological significance. Immunohistochemistry and pathological methods were used to detect the expression intensity and distribution of p-ERKl/2, Ras and C-fos in skin of 8 fetuses with different gestational ages (13 to 31 weeks) and 8 adults. Positive immunohistochemical signals of p-ERK1/2, Ras and C-fos. could be found in fetal and postnatal skins. Along with the increment in gestational age, the positive cell rates of p-ERK1/2, Ras and C-fos in the skin elevated progressively. In skins derived from the fetus of late-trimester pregnancy and adult, the positive rates of these three proteins were significantly increased in comparison with skin from the early-trimester fetus (P