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 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

Localization and expression of two subunits (IGF ⅠR? and IGF ⅠR?) of insulin like growth factor Ⅰ receptor and phosphorylated tyrosine proteins (P Tyr) in skins at different developmental stages were studied in order to explore their potential biological significance. Immunohistochemistry and pathological methods were used to detect the expression intensity and distribution of IGF ⅠR?, IGF ⅠR? and P Tyr in skins of 12 fetuses with different gestational ages and 8 adults. The results showed that positive immunohistochemical signals of IGF ⅠR?, IGF ⅠR? and P Tyr could be found in fetal and adult skins. Along with growth and development of the fetus, the positive cell rates of IGF ⅠR?, IGF ⅠR? and P Tyr in skins elevated progressively. In adult skins, IGF ⅠR was mainly located in the cell membrane of epidermal cells, while P Tyr was chiefly distributed in epidermal cells and some fibroblasts. These results suggested that IGF ⅠR and its mediating signaling pathway might be involved in cutaneous development at embryonic stage, in cutaneous structure and function maintenance, and in wound healing at postnatal stage.

To explore the change in gene expressions of p38 mitogen-activated protein kinase (p38MAPK) and its upstream signal-regulated molecule (mkk3 and mkk6) in normal skin versus hypertrophic scars underlying its potentially biological significance. Total RNAs were isolated from 8 specimens of hypertrophic scars and 8 specimens of normal skin, then they were purified to mRNAs, and the gene expression of mkk3, mkk6 and p38MAPK was examined with reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the intensities of gene expression of mkk6 and p38MAPK were weak in normal skins, while the expression of these 2 genes was significantly elevated in hypertrophic scars compared with normal skins (P0.05). In hypertrophic scar, the elevation of mkk6 and p38MAPK gene expression, which plays pilot roles in cell proliferation, may be one of the mechanisms controlling the formation of hypertrophic scars.

To study the location and expression characteristics of epidermal stem cells in normal skin and scar epidermis of children, and to explore the relationship between the differences of these two epidermal stem cells and wound healing after burn. ?1 integrin and keratin 19 (K19) were used as the biochemical markers to identify stem cells and transit amplifying cell, keratin 14 (K14) and keratin 10 (K10) were used as the markers for post-mitotic cells and terminally-differentiated cells, respectively. Normal skin and scar tissue were obtained from children of 4 to 12 years of age. Elivision two-step immunohistochemistry was used. The results showed that in the immunostained tissue sections, the positive ?1 integrin and K19 expression cells were observed in 2～3 layers above the basal layer, whereas K10 expression cells were observed in all epidermal cells except basal cell layer in the scar tissue. Observations revealed that the number of stem cells and transit amplifying cells were less in the scar tissue than that in the normal skin, the differentiation process of scar epidermal stem cells was different from that of normal skin, and the proportion between post-mitotic cells and terminally-differentiated cells was abnormal. The results indicated that the self-renewal ability of the scar epidermis was lowered, and the differentiation process of it was deranged, and this might be considered to be a reason of abnormality of structure and function of the epidermis of scar tissue, and its poorer ability in wound healing.

To investigate the expression characteristics of fibroblast growth factor 10 (FGF10) and its receptor (Bek) underlying their effect on the formation of fetal skin appendages (SA). Expressions of FGF10, Bek, cytokeratin (CK19), Bcl-2 and proliferating cell nuclear antigen (PCNA) were detected with pathological and immunohistochemistry techniques in 130 skin specimens, which were obtained from 5 different sites (head, lower jaw, ear lobe, shoulder and presternal region) of 26 fetuses at different embryonic ages (E 8～31weeks). Results showed that FGF10, PCNA and Bcl-2 were over-expressed in interstitial cells distributed in clumps under the epidermis, and all proteins were strongly expressed in epidermal cells and pericytes at E 11weeks. In E 13weeks fetal skin, epidermal cells formed SA anlage through focal proliferation; then they developed, differentiated and migrated towards the dermis. In the skin of E 11～13weeks fetus, the expression of FGF-10, PCNA and Bcl-2 in interstitial cells in the dermis, and the expression of FGF10, Bek, PCNA, CK19, and Bcl-2 proteins in the epithelial cells in SA showed the expression characteristics of these proteins which were in accordance with growth and development of fetal SA. The results suggested that the specific binding of FGF10 from interstitial cells with Bek on the membrane of epithelial cells was the important signal to induce the proliferation and morphogenesis of embryonic SA epithelial \{cells.\ \ \ \}

To investigate the effect of FGF-10 on the secretion of GM-CSF by adult keratinocytes in vitro and to understand the mechanisms involved in the stimulation of granulation tissue formation by FGF-10 during wound healing. Concentrations of FGF-10 used were 4, 16, 125 and 500 ng/ml. Cells were seeded in the amount of 2 500 cells/cm 2 or 5 000 cells/cm 2 in dishes in serum-free medium, and supernatants were collected at 24, 48 and 72 hours after culture. The amounts of GM-CSF in cell culture supernatants were determined using GM-CSF ELISA kits, and cell numbers were counted by haemocytometer. For cells seeded in low density (2 500 cells/cm 2), GM-CSF was not detected at 24 hours. At 48 hours, both in absolute concentrations and on a per-cell basis, the amounts of GM-CSF secreted in cultures with 125 and 500ng/ml FGF-10 were significantly higher than that in negative control (P0.05). At 48 hours, the keratinocytes in the middle area were confluent, and a number of cornified cells were observed, while the productions of GM-CSF in FGF-10 cultures were not higher than that in negative control. There was a clear negative correlation between the secretion production of the growth factor and the total cell number in each dish with a correlated coeffecient of 0.881 (P

Objective To study expression intensity and distribution of phosphorylated forms of extracellular signal-regulated protein kinase1/2 (ERK1/2), stress-activated protein kinase (SAPK) and P38MAPK in normal skin and hypertrophic scars and their potential biological significance. Methods The morphological characteristics of hypertrophic scars in different periods after wound healing and normal skin were examined histopathologically. Protein expression of p-ERK1/2, p-SAPK and p-P38MAPK was also assessed with immunohistochemical technique. Results In normal skin, phosphorylated forms of ERK1/2, SAPK and P38MAPK were mainly located in epidermal basal cells, in which the positive cellular rates of all the three proteins were low. Along with the maturation of hypertrophic scars, protein contents of p-ERK1/2 and p-SAPK were progressively increased. In mature hypertrophic scars, positive signals of these two proteins were mostly distributed in keratinocytes and some fibroblasts. The positive cellular rate of p-P38MAPK ascended in active hypertrophic scar, then decreased to a level which was still higher than that of normal skin. Conclusion The formation of hypertrophic scars may be associated with the alteration in signaling pathways which results in the increment of protein contents of p-ERK1/2, p-SAPK and p-P38MAPK.

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.