Adolescent ; Child ; Humans ; Male ; Neuroectodermal Tumors, Primitive, Peripheral ; pathology ; Sarcoma, Ewing ; pathology

Objective:To summarize the clinical experience of surgical treatment abdominal gastrointestinal foreign body in children, thus to provide a theoretical basis for clinical decision-making.Methods:The clinical data, including age distribution, clinical manifestations, surgical treatment strategy and prognosis, from 60 children with abdominal gastrointestinal foreign body treated by operation in Children's hospital of Hu′nan Province from January 2015 to June 2020, were retrospectively analyzed. Among the 60 children, 38 males and 22 females, with a median age of 2.9 years. Observation data included the type and location of foreign bodies in the digestive tract, clinical manifestations and surgical methods, operation time, intraoperative blood loss, postoperative hospital stay. The following-up time was 6 months to 2 years by telephone or clinic. The short/long-term complications was observed.Results:Children under 3 years old accounted for 56.7%. Types of foreign bodies included magnetic foreign bodies, sharp objects[paper clips, nails, screws, fish bone and others, etc], crystal ball, jujube pit, gastric hair stone, batteries and badminton holder. The foreign bodies were mainly located in stomach and small intestine. Abdominal pain and vomiting were the most common symptoms. The patients of foreign body with long residence time had peritonitis such as fever and abdominal pain, among 21 cases were combined with gastrointestinal perforation. There were varieties kind of operaion methods, including gastrointestinal incision and foreign bodies removal( n=22), appendectomy and foreign bodies removal( n=7), repair of gastrointestinal perforation( n=6), intestinal resection and anastomosis( n=17), intestinal resection plus enterostomy( n=5)but whose fistula was closed after 3 months, lateral wall of rectum repair( n=3). Fifty-two patients underwent common open abdomen operation, 8 patients underwent laparoscopic operation. The operating time was(93.5±19.3) min. Intraoperative blood loss was(20.2±4.3) mL. The postoperative hospitalization was 13(5, 19) d. The postoperative complications occurred in 3 patients who were nonoperative treatment recovery. Conclusions:Magnetic foreign body, sharp foreign body, crystal ball, jujube nucleus and corrosive foreign body are the main causes of digestive tract obstruction and perforation in children. Individualized operation plan should be selected as soon as possible according to the number of foreign bodies, retention position and whether or not digestive tract perforation.

Objective To investigate the effects of heart displacement on hemodynamics during off-pump coronary artery bypass grafting (OP-CABG) while the sites for anastomosis were being exposed. Methods Forty-seven patients of both sexes (36 male, 11 female) aged 50-82 years undergoing OP-CABG were enrolled in the study. Preoperative cardiac function was assessed : class Ⅱ in 22 patients; Ⅲ in 23 and Ⅳ in 2 according to NYHA classification.The mean ejection fraction was 0.55?0.14 before surgery.They received on average 3.2 grafts. Premedication consisted of intramuscular morphine 10 mg, midazolam 3-5 mg and scopolamine 0.3 mg.Before induction of anesthesia ECG and SpO2 were monitored and radial artery was cannulated for continuous direct BP monitoring. Anesthesia was induced with midazolam 0.1 nig?kg-1 , fentanyl 4?g?kg-1 and pancuronium 0.1 mg?g-1 iv.The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at about 40 mm Hg. Anesthesia was maintained with isoflurane and 50%-60% N2O in O2 and intermittent intravenous boluses of fentanyl and pancuronium. Swan-Ganz catheter which can continuously monitor mixed venous blood O2 saturation (SvO2) was placed in pulmonary artery via right internal jugular vein. SvO2, cardiac output (CO), BP, pulmonary arterial pressure (PAP) and HR were continuously monitored. Right atrial pressure (RAP) and PAWP were measured intermittently. Cardiac index (CI),stroke index (SI),systemic vascular resistance index (SVRI),PVRI, left and right ventricular work index (LVWI,RVWI) and left and right ventricular stroke work index (LVSWI,RVSWI) were calculated. The hemodynamic parameters were recorded after induction of anesthesia before surgery (T1,baseline),before heart displacement (T2), while anastomosis to anterior descending branch was being made (T3), while anastonosis to right coronary artery or posterior descending branch (T4) and to left circumflex artery or diagonal branch (T5) was being made, after normal heart position was resumed (T6) and at the end of operation (T7). Results While anastomosis to the anterior descending branch was being made (T3) SI and LVSWI significantly decreased as compared with the baseline (P

OBJECTIVETo compare mid-term clinical outcomes between amputation and limb salvage in treating severe open tibial fractures with type Gustilo III B, III C.

METHODSFrom July 2007 to June 2010,68 patients with severe open tibial fractures with type Gustilo III B, III C treated by amputation and limb salvage were retrospectively analyzed. In amputation group, there were 26 males and 12 females with an average age of (44.9±16.3) years old; and 21 cases were type Gustilo (III B, 17 cases were Gustilo III C; amputation were performed in accordance with soft tissue injury degree of shank, fracture types and surgical exploration. In limb salvageg group, there were 21 males and 9 females with an average age of (43.5±14.7) years old; and 23 cases were type Gustilo III B, 7 cases were Gustilo III C; the method of internal fixation and and wound healing were performed in accordance with patients's specific condition. Operative time, blood loss, hospital stay and postoperative infection was compared between two groups; time of loading and rate of return to work was compared; VAS scoring was used to evaluate condition of pain; SF-36 health queationaire was used to assess postoperative life quality.

RESULTSTotally 60 patients were followed up (33 cases in amputation group and 27 cases in limb salvage group) with an average time of 49.1 months. Operative time, blood loss, hospital stay and postoperative infection in amputation and limb salvage group respectively was (109.0±25.7) min, (245.0±58.6) min; (168.0±49.0) ml, (311.0±137.0) ml; (13.8±2.7) d, (28.8±13.1) d; 7.9%, 36.7%. At the final following-up, there was no significance meaning between two groups in VAS scoring and rate of return to work, but time of loading in amputation group was shorter than that of in limb salvage group. Physiological function in amputation group was better than limb salvage group, while body pain was worse; and there was no signicance meaning in psychological health between two groups.

CONCLUSIONAmputation and limb salvage both can treat severe open tibial fractures, and mid-term clinical outcomes between two groups has equivalent efficacy.

Adolescent ; Adult ; Aged ; Amputation ; methods ; Case-Control Studies ; Female ; Humans ; Limb Salvage ; methods ; Male ; Middle Aged ; Tibial Fractures ; surgery

Cerebral Palsy ; classification ; etiology ; psychology ; Child, Preschool ; Humans ; Infant ; Intelligence ; Intelligence Tests ; Risk Factors

Carcinoma, Non-Small-Cell Lung ; genetics ; Exons ; genetics ; Genes, erbB-1 ; genetics ; Humans ; Lung Neoplasms ; pathology

Objective To discuss the effect of QGY/CDDP hepatoma lines multi-drug resistance (MDR) reversed by gene transfection of mdr1,mrp-ASODN+ultrasound contrast agent+ultrasound.Methods The QGY/CDDP cells were transfected by mdr1,mrp ASODN+ultrasound contrast agent+ultrasound irradiation respectively and detected of the various indicators:cell adhesion rate,cell sensitivity to cell drug-resistance,the mRNA expression of mdr1 and mrp gene,the expression of P-gp and MRP protein. Results After mdr1-ASODN transfection,the drug sensitivity and expression of P-gp,MRP protein of QGY/CDDP cells were smaller changes(P＞0.05),and the rate of cells adherent and expression of resistance gene mRNA were obvious changes(P＜0.05).After mrp-ASODN transfection,the cells adherent rate,the drug sensitivity,the expression of resistance gene mRNA and P-gp,MRP protein were obvious changes respectively(P＜0.05),the experiment group(group 2')had bigger effects(P＜0.05).Conclusions mdr1. mrp-ASODN+ultrasound contrast agent+ultrasound irradiation could safely partly reverse MDR of hepatoma cells,which is a potential new approach for gene therapy.

Objective To evaluate the value of CT guided percutaneous lumbar diskectomy (CT PLD) at plateau area. Methods Sixty eight cases of lumbar disc herniation was reated with CT PLD. (1)Before operation, diseased intervertebral disc was scanned, cases were selected, and operation plan was plotted . (2)The best puncture arrangement was chosen on the current video CT picture by designing the puncture path, noting down the puncture parameter, and marking the puncture spot on patient′s body surface. (3)Puncture was performed according to fixed parameter. (4)Operation was performed after the puncture needle was put into the disc ascertained by scan.(5)CT scan was done again after operation to observe if the puncture path had bleeding and intervertebral disc recovery. Results After 3 to 18 months′ follow up, 28 cases were prominent effective and 36 cases effective. The lumbar disc backed 1 to 4 mm. The total effective rate was 94.12%. Conclusion CT PLD is an ideal therapeutic method for lumbar disc herniation at plateau area because it is safe and effective and with less complications.

The roles of voltage-dependent K(+) channels during activation and damage in alveolar macrophages (AMs) exposed to different silica particles were examined. Rat AMs were collected by means of bronchoalveolar lavage, and were adjusted to 5x10(5)/mL. After AMs were exposed to different concentrations (0, 25, 50, 100, 200 mug/mL) of quartz particles and 100 mug/mL amorphous silica particles for 24 h, the voltage-depended K(+) current in AMs was measured by using patch clamp technique. Meanwhile the leakage of lactate dehydrogenase (LDH) and the viability of AMs were detected respectively. Patch clamp studies demonstrated that AMs possessed outward delayed and inward rectifying K(+) current. Exposure to quartz particles increased the outward delayed K(+) current but it had no effect on inward rectifier K(+) current in AMs. Neither of the two K(+) channels in AMs was affected by amorphous silica particles. Cytotoxicity test showed that both silica particles could damage AM membrane and result in significant leakage of LDH (P<0.05). MTT studies, however, showed that only quartz particles reduced viability of AMs (P<0.05). It is concluded that quartz particles can activate the outward delayed K(+) channel in AMs, which may act as an activating signal in AMs to initiate an inflammatory response during damage and necrosis in AMs induced by exposure to quartz particle. K(+) channels do not contribute to the membrane damage of AMs.

Objective To investigate the effect of Shensong Yangxin capsule on cardiac remodelling of myocardial infarction mouse model and the possible molecular mechanisms. Methods Adult male C57BL/6J mice were divided into sham operation group(n=10), model control group(n=20)and Shensong Yangxin group(n=20)according to random number table. Left anterior descending branch of coronary artery was ligated to establish myocardic infarction model in the model control group and Shensong Yangxin group. From the 2nd day after the surgery, Shensong Yangxin ( 400 mg . kg-1 ) was intragastrically administered, and the death rate of the mice was observed.Four weeks after the surgery, echocardiography was used to measure the cardiac function;myocardiac infarction area was detected by pathological staining;the expression levels of cardiac remodelling markers and extracellular matrix proteins were detected by RT-PCR. The possible molecular mechanisms were screened by Western blotting. Results As compared with the model control group, Shensong Yangxin significantly reduced the mortality after myocardial infarction in mice(P<0.05), as well as the myocardial infarct size(P<0.05).The mRNA expression levels of cardiac remodelling markers ANP, BNP, and β-MHC and the extracellular matrix proteins(collagenⅠ, collagen Ⅲ, CTGF, TGFβ) decreased significantly in the Shensong Yangxin group as compared with the model control group. Western blotting showed that Shensong Yangxin significantly decreased activation of smad3, and reduced expression level of smad4. Conclusion Shensong Yangxin attenuates cardiac remodelling after myocardial infarction and the mechanism may be related with blockage of smad signaling pathway.