Objective To investigate the feasibility of laparoscopy assisted Meckel’s diverticulum resection in children. Methods Meckel’s diverticulum resection was performed under laparoscope in 12 children from October 2000 to April 2002.Two 3 mm incisions were made on the McBurney point and the midpoint between the umbilicus and the pubis,respectively.Three 3 mm trocar were introduced.When the diverticulum was found,the incision was prolonged to 2 cm long along the inferior border of the umbilicus.The lesion was removed externally and the intestine was anastomosed. Results All operations were completed smoothly under laparoscope. The intraoperative blood loss was 2～3 ml and the operation time was 1 2～2 5 h.The diverticulum was 1 cm?2 cm～3 cm?4 cm in size.The patients were dismissed 5～7 days after surgery,without obvious scar formation. Conclusions Laparoscopic Meckel’s diverticulum resection is feasible, with the advantages of the minimal invasion, rapid recovery and unobvious scars.

We studied 22 Wilms'tumors of children immunohistochemically.We've found that the positive rate of p53 in slices was 31.8% (7),of nm23 was 50% (11),and of p16 was 86.4% (19).It suggested that mutation rate of p53 was high in tumors,expression of nm23 in favorite histology(FH)was higher than that in unfavorite histology(UFH) group,and p16 showed very high positive rate in tumors.All of the three showed no relation with sex,age,or pathological type.So each one may be useful in clinic to evaluate pathogenesis and prognosis.

Objectives To explore the clinical intervention of prenatal diagnosed congenital choledochal cyst in infants. Methods 37 infants with prenatally diagnosed congenital choledochal cyst from September 2006 to February 2013 were di-vided into early (0-3 month) operation group (Group A, n=20) and late (>3 month) operation group (Group B, n=17) according to the timing of surgery. The clinical characteristics, the preoperative and postoperative liver function, postoperative com-plications and pathological examination of liver biopsy were retrospectively analyzed. Results Five infants in group A and 2 infants in group B became jaundiced after birth. No statistical difference was found in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) between two groups (P>0.05). Preoperative and postoperative levels of total bilirubin (TBIL) and direct bilirubin (DBIL) in group A were signiifcantly higher than those in group B (P<0.05). Two cases had anastomotic stricture and one case had bile leakage in group A while no postoperative complication was found in group B. Liver biopsy re-sults showed that there were 11 cases of biliary cirrhosis, including 4 cases in group A (36.36%) and 7 cases (63.64%) in group B, but no statistical difference in incidence of cirrhosis between two groups (P=0.160). Conclusions Infants with prenatally diagnosed congenital choledochal cyst should be closely observed. Once jaundice, clay-coledstool, increased ALT and AST, fast growing enlarged cysts were found, infants should be surgically treated as soon as possible to reduce liver damage and the incidence of liver cirrhosis.

Objective To compare the efficacy between transumbilical laparoscopic and conventional three-trocar laparoscopic surgery for Meckel's diverticulum in children. Methods We did a retrospective search on 41 patients under 12 years old admitted to our department with the diagnosis of Meckel's diverticulum from January 2010 to December 2015. According to the operation method, they were divided into two groups: transumbilical laparoscopy group (n=18) and conventional three-trocar laparoscopy group (n=23). Comparative analyses on operation time, blood loss, complications, hospital stay, and cost were made between the two groups. Results All of them were operated by laparoscopy. The cost was significantly lower in the transumbilical laparoscopy group than that in conventional three-trocar laparoscopy group [(19 ± 2) thousand RMB vs. (22 ± 2) thousand RMB, t= -4. 766, P=0. 000]. There were no differences between operative time [(90. 3 ± 13. 0) min vs. (85. 7 ± 10. 5) min, t=1. 254, P=0. 217], intra-operative blood loss [(2. 8 ± 1. 2) ml vs. (2. 9 ± 1. 3) ml, t= -0. 253, P=0. 802], and hospital stay [(4. 9 ± 0. 6) d vs. (5. 1 ± 0. 7) d, t= -0. 965, P=0. 340]. No operative complications occurred in both groups. The cosmetic outcome was better in the transumbilical laparoscopy group than that in conventional laparoscopy group. Conclusion Transumbilical laparoscopic surgery for Meckel's diverticulum in children has advantage in cost and better cosmetic outcome by reducing the number of incisions.

Objective: To explore the role of iTr35 cells in the pathogenesis of children with pulmonary artery hypertension (PAH) in children, and the percentage of iTr35 cells and serum interleukin(IL)-35 levels in peripheral blood of patients with PAH were investigated.Their inhibitory effects on the expression of vascular cell adhesion molecule-1 (VCAM-1) on vascular endothelial cells were also analyzed. Methods: After 3 mL peripheral blood of 30 congenital heart disease (CHD) patients with PAH, 22 CHD patients without PAH and 30 age or gender matched healthy controls (HC) were collected, the percentage of iTr35 cells were detected by flow cytometry and the concentrations of serum IL-35 were detected by Luminex, as well as soluble VCAM-1 (sVCAM-1). Human pulmonary artery endothelial cells (HPAECs) were cultured in vitro and divided into control group, tumor necrosis factor (TNF)-α group and IL-35+ TNF-α group.The expression of VCAM-1 and nuclear factor(NF)-κB P65 protein of each group were detected by flow cytometry and Western blot.The adhesion of peripheral blood mononuclear cells (PBMCs) to HPAECs was observed by fluorescence microscope. Results: Compared to CHD patients without PAH, the percentage of iTr35 cells[0.86(0.45-1.63)% vs.1.14(0.46-2.11)%](H=20.52, P<0.05) in peripheral blood and serum IL-35 levels[2.43(1.76-2.85) μg/L vs.3.17(2.92-5.66) μg/L](H=119.56, P<0.05) were significantly decreased in CHD patients with PAH.However, serum sVCAM-1 concentration[923.1(892.6-1 118.7) μg/L vs.776.1(743.5-932.3) μg/L ] in CHD patients with PAH were significant increased (H=65.65, P<0.05). In addition, the concentration of serum IL-35 were negatively correlated with sVCAM-1 in PAH patients (r=-0.374 P=0.042). In vitro, the positive rate of VCAM-1 on HPAECs was significant decreased in IL-35+ TNF-α group as compared to the TNF-α group [(2.07±0.82)% vs.(5.83±1.34)%, F=1 197.18, P<0.05]. In addition, the protein expression of NF-κB P65 in HPAECs was significantly decreased in TNF-α+ IL-35 group as compared to TNF-α group, as well as the adhesion of PBMCs to HPAECs (F=212.04, 2 533.51, all P<0.05). Conclusions The percentages of iTr35 and levels of IL-35 are reduced in the peripheral blood of patients with PAH.Through in vitro experiments, IL-35 is found to reduce PBMCs adhesion by inhibiting VCAM-1 expression in HPAECs.