Objective To explore clinical effects and operative experience of transanal pull-through procedure for Hirschsprung's disease (HD).Methods The clinical data of 126 children aged from 13 days to 14 years with HD were reviewed.There were 30 cases of short-segment type,85 of common type,and 11 of long-segment type.A total of 95 cases was operated with modified Soave and the other 31 cases were operated with modified Swenson.Results Except two-stage resection in 7(5.6％) cases who already underwent transanal Soave procedure early,one-stage transanal pull-through procedure was performed in the other cases.Laparotomy assisted operation was used for 5 cases and laparoscope assisted operation for 12 cases.The complications were occurred in 35 (27.8％) cases post-operation,including 15 perianatitis,9 enterocolitis,5 anastomotic stenosis,2 soiling,and 4 reoperation.The statistical analysis indicated no difference between two procedures and postoperative complications could be noted between different types (P ＞0.05).A total of 103 patients were followed up from 1 to 10 (mean 2) years.Of all patients,96 (93.2％) were cured,5 (4.9％) symptoms were improved and 2(1.9％) were failed.There were no significant differences in two procedure and the excellent rate of defecation function(P ＞ 0.05).Conclusions Two transanal procedures for HD both had a good efficacy and similar complications.By comparison,transanal Swenson procedure was simpler than Soave procedure,and did not need to enlarge anus post-operation as well.

Objective: To investigate the roles of tooth mass and bon e mass in dental crowding. Methods: Tooth mass and basal bone mass were measured with electronic vernier and a computer aided dental cast measurem ent and analysis system developed by faculty of stomatology of Kunming Medical C ollege in 91 individuals with normal occlusion and 101 with dental crowding aged from 16 to 26 years old(on the average age of 21). Ttest was applied in st atistic analysis. Results :Teeth width was bigger (P05), PMBAW U and PMBAW L were smaller (P

Objective To investigate the effect of small dose of dexmedetornidine on venous continuous infusion combined with oxycodone or fentanyl during brachial plexus blockade.Methods Sixty thyroid patients (ASA Ⅰ or Ⅱ) undergone brachial plexus anesthesia for cutting or cutting thyroid tumor patients were randomly and double-blindly into three groups (n =20 in each group).Group A:single brachial plexus anesthesia;group B:dexmedetornidine combined with fentanyl;group C:dexmedetornidine combined with oxycodone.Blood pressure (Bp),heart rate (HR),the determination of plasma norepinephrine (NE),cortisol (Cor),the concentration of blood glucose (Glu),VAS,Ramsay calm score,local anesthetics dosage and side effect formation rate at the beginning operation (To),skin incision (T1),separation of the glands (T2),gland excision (T3),and the end of the surgery (T4) were recorded.Results Compared to group A,the mean arterial pressure (MAP),HR,NE,Cor,and Glu were much lower at each time point (P ＜ 0.05) in groups B and C;Ramsay calm score and VAS score were significantly better at each time point (P ＜ 0.05);the incidence of chills and lidocaine additional quantity were significantly lower (P ＜0.01).However,compared to groups A and C,choking cough response rates were much higher in group B (P ＜ 0.01).Conclusions Small dose of dexmedetornidine on venous continuous infusion combined with oxycodone during brachial plexus blockade for thyroid patients both can eliminate the preoperative patients nervous anxiety,and effectively restrain perioperative stress response,maintain hemodynamics stable,implementation of intraoperative awaken to reduce complications.It is the new choice of anesthetic adjuvant.

Objective To assess the effects of p27mt gene transfection on the proliferation and apoptosis of human hepatocellular carcinoma cell (HCC) lines SMMC-7721. Methods A replication deficient adenovirus vector encoding p27mt (Ad-p27mt) was used and p27mt cDNA was transfected into human SMMC-7721 cell lines in vitro. The synthesis of DNA in SMMC-7721 cells was determined by using 3H-thymidine incorporation; the cell apoptosis was determined by flow cytometry, TUNEL method and DNA fragmentation analysis. Results The virus titer was 7.95?1012 cfu/ml, the transduction efficiency was 100 % when multiplicity of infection ≥50, FCM analysis revealed a sub-G1 cell peak in Ad-p27mt transduced hepatocellular carcinoma cell lines. Agarose electrophoresis showed marked ladder .The difference of apoptotic index between the Ad-p27mt group and the control group was statistically significant (58.6?4.3, vs 4.5?1.6, P

Animals ; Glutamine ; pharmacology ; Kidney ; drug effects ; metabolism ; Liver ; drug effects ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serum ; metabolism ; Stress, Physiological ; Swimming ; physiology

Objective To evaluate the blood-saving effect of prophylactic use of tranexamic acid in patients undergoing orthotopic liver transplantation.Methods Sixty ASA physical status Ⅰ-Ⅲ patients of both sexes,aged 18-60 yr,weighing 45-80 kg,scheduled for elective orthotopic liver transplantation,were randomly assigned to one of 2 groups (n =30 each) using a random number table:prophylactic use group (group P) and therapeutic use group (group T).Immediately after induction of anesthesia (T1),at 30 min of anhepatic phase (T2),and at 30 min and 2 h of neohepatic phase (T3,4),central venous blood samples were collected to determine plasma fibrinogen concentration (Fib) and platelet count,and the arterial blood samples were obtained to detect thromboelastography (TEG) parameters.In group T,when lysis after 30 min＞7.5％ and Clot Index ≤ 1.0 according to the results of TEG,which indicating that primary hyperfibrinolysis occurred,tranexamic acid 15-20 mng/kg was injected intravenously.In group P,immediately after beginning of skin incision,immediately after occlusion of portal vein,and immediately after portal vein unclamping,tranexamic acid 1 g was injected intravenously,and a single injection of tranexamic acid 15-20 mg/kg was given when primary hyperfibrinolysis occurred.The intraoperative blood loss,fluid input and output and transfusion of blood components were recorded.The duration of stay in ICU,amount of abdominal drainage during stay in ICU,volume of blood transfused within 72 h after operation,and hepatic artery and portal vein thrombosis within 1 week after operation were recorded.Results Compared with group T,the intraoperative blood loss,volume of succinylated gelatin injection transfused,and requirement for platelet and cryoprecipitate were significantly reduced,Angle at T2 and lysis after 30 min at T2,3 and maximum amplitude at T3 were increased,and no significant change was found in the duration of stay in ICU,postoperative amount of abdominal drainage and volume of blood transfused in group P.No patients developed primary hyperfibrinolysis in group P.No hepatic artery and portal vein thrombosis was detected within 1 week after operation in the two groups.Conclusion Prophylactic use of tranexamic acid can effectively prevent hyperfibrinolysis and reduce intraoperative blood loss without increasing the risk of development of thrombosis,and it provides better blood-saving effect than therapeutic use guided by TEG in patients undergoing orthotopic liver transplantation.

Objective To evaluate the effect of dexmedetomidine on renal functions during the anesthesia of liver transplantation patients.Methods Forty patients (male 31 cases,female 9 cases, aged 40-60 years,ASA grade Ⅱ or Ⅲ)received liver transplantation were randomly divided into two groups(n =20):dexmedetomidine group (group D)and normal saline group (group C).Patients in the group D received a loading dose of dexmedetomidine (0.5 μg/kg within 10 min)and a continuous infusion of dexmedetomidine (0.4 μg·kg-1 ·h-1 )until the end of surgery,while patients in group C received saline.Central venous blood and urine were collected after induction of anesthesia (T1 ),the anhepatic phase of liver 30 min (T2 ),new liver stage 30 min (T3 ),new liver stage 6 h (T4 ),postop-erative 24 h (T5 )and postoperative 1 week (T6 )to detect the serum cystatin C,endogenous creati-nine clearance rate,blood urea nitrogen,blood creatinine,urinary NAG enzyme,urinary albumin, and red blood cells.The use of vasopressors and diuretics,blood loss,fluid,urine,and blood transfu-sion (including RBC,fresh frozen plasma,and platelets)were all recorded.Results Compared with T1 ,serum cystatin C,blood urea nitrogen,serum creatinine of group D increased significantly and en-dogenous creatinine clearance rate reduced significantly at T3 ,T4 (P < 0.05 ).Microalbuminuria in-creased at T3-T5 (P <0.05).Serum cystatin C,blood urea nitrogen,serum creatinine of group C in-creased significantly and endogenous creatinine clearance rate reduced significantly(P < 0.05 ).Com-pared with group C,serum cystatin C,blood urea nitrogen,serum creatinine of group D reduced signif-icantly at T3-T5 and endogenous creatinine clearance rate increased(P <0.05).Microalbuminuria re-duced significantly at T4 ,T5 (P <0.05 ).Perioperative use of diuretics in group D patients was less than that in group C,but the use of vasopressors in group D patients was more than that in group C (P <0.05).Urine volume in group D was more than that in group C (P < 0.05 ).There was no difference in perioperative blood loss, fluid, and blood transfusion between two groups. Conclusion Perioperative continuous infusion of dexmedetomidine might effectively alleviate acute kidney injury during operation and decrease the use of diuretics.

OBJECTIVE To explore the influence of superoxidase (SOD)-enriched cili juice (CJSOD)on immune function of arseniasis rats,in order to provide a experi mental basis for the search of drugs of immune regulation of the ende mic arsenic poisoning.METHODS Wistar rats were rando mly divided into arsenic 25,50 and 100mg·g-1 groups to be fed 164.67 pp marsenic conta minated grain at levels of 15%,30% and 60%,experi mental period was 90d,CJSOD intervention group was fed with feed contained arsenic 100mg·kg-1 for 90d,then CJSOD was ad ministered at 10mL·kg-1 (6d /week) for 45d.The urine arsenic contents,blood T-ly mphocyte subsets (CD3 +,CD4 +,CD8 + T cell),seru mimmunoglobulin (IgG,IgM,IgA)and complement (C3,C4)were analyzed.RESULTS Co mpared with the normal control group,As 50 and 100mg·kg-1 group had significantly lower CD3 +(46.21 ± 21 .62,31 .31 ±7.73),CD4 +(30.36 ±9.97,25.94 ±12.94)and the ratio of CD4 +/CD8 +(1 .12 ±0.41 , 1 .12 ±0.41 ).As 100mg·kg-1 group showed clearly high levels of C4(81 .18 ±13.23)(P <0.05). Co mpared with the As 100mg·kg-1 group,after intervention with CJSOD,the positive rate of CD3 +(54.06 ±25.77),CD4 +(42.50 ±17.01 ),and the ratio of CD4 +/CD8 +(1 .80 ±0.71 )were significantly increased,while the result of C4 (68.70 ±10.30)and the urine arsenic contents 〔253.82 (158.21 ~494. 11 )〕was significantly decreased(P <0.05).The levels of urine arsenic in rat and CD3 +,CD4 +and CD4 +/CD8 + were negatively correlated,while positive correlation existed between the level of urine arsenic and C4(P <0.01 ).CONCLUSION Arsenic inhibit the immune function in rats.Arsenic load levels were positively correlated with the degree of inhibition.CJSOD preparation can i mprove the immune function of arseniasis rats.

The strain F12-11-1-2 was isolated from the East China Sea,which had antimitosis activity using Pyricularia oryzae mode.Ac- cording to phenotypical study,salt-aggregation test and 16S rDNA sequence analysis,the strain F12-11-1-2 has been identified to be Bacillus subtilis.

Objective To explore the duration of blood blocking effect and recovery process induced by low-frequency ultrasound combining microbubbles (USMB) on prostate cancer xenografts.Methods A total of 88 nude mice undergoing USMB was studied.Contrast enhanced ultrasound,Hemotoxylin and eosin staining,and modified Martius-Sarlet-Blue staining were used to compared the average peak intensity(API),time to peak intensity(TP) and histological alteration before and after treatment.Results Immediately after the treatment,the tumor contrast perfusion completely disappeared,API dropped from 68.63±5.25 to 18.01±2.73 (P<0.001,vs pre-treatment) and TP increased from (32.28±6.18)s to (72.63±7.47)s (P<0.001,vs pre-treatment).At 30 minutes and 1 hour after treatment,the tumor perfusion remained defect.At 2 hours after treatment,rarely dotted enhancement was showed.The differences among the three groups in API and TP at 30 minutes,1 hour and 2 hours after treatment were not significant (all P>0.05).From post-3 hours after treatment ,the tumor perfusion began a process of perfusion recovery,and showed nodular or large patch of heterogeneous enhancement.API at 3 hours after treatment was 51.99±6.20 (P<0.001,vs post treatment immediately),and TP decreased to (50.41±6.51)s (P<0.001,vs post treatment immediately).At 4 hours,5 hours,6 hours,12 hours and 24 hours after treatment ,CEUS showed homogeneous and rich enhancement,and there was no significant difference in both API and TP,compared with those pre-treatment (all P>0.05,vs pre-treatment).Histological examinations showed that,immediately after treatment,microvessels severely dilated,ruptured and intravascular and extravascular thrombi formed.At 30 minutes,1-hour and 2-hour after treatment,extravascular thrombi and hematomas gradually disappeared.From 3-hour after treatment,vessel dilation was lessened,and intravascular thrombi gradually shrank.At 12-hour after treatment,microvessels had almost fully recovered as pre-treatment.Conclusions USMB could block blood perfusion of prostate cancer xenografts in nude mice for 2 hours.The blood reperfusion is probably mainly caused by thrombolysis in microvessels.