One hundred and forty six elderly patients with constipation undergoing colonoscopy during March 2012 and August 2013 were randomly assigned to trial and control groups.Seventy patients in trial group received Macrogol electrolytes powder combined with Chinese herb medicine Simo decoction for bowel preparation and 76 patients in control group received macrogol electrolytes powder only.The first defecation,times of defecation and tolerance of patients were compared between two groups.The quality of bowel preparation was evaluated by endoscopists with Boston Bowel Preparation Scale (BBPS).The first defecation time was shorter in trial group than that in control group (55.7 ± 27.9 vs.72.9 ± 34.8,P ＜ 0.05).However,no statistical significance was found in the times of defecation and tolerance of patients between two groups.The mean BBPS score in trial groups was higher than that in control group (7.87 ± 1.08 vs.6.97 ± 0.96,P ＜ 0.05).Chinese herb medicine Simo decoction combined with conventional method shows satisfactory result for bowel preparation in elderly patients with constipation undergoing colonoscopy.

Eighteen patients with early cancer and precancerous lesions of esophagogastric junction underwent multiband mucosectomy (MBM) in Yangzhou First People's Hospital from January 2013 to February 2014.The clinicopathological data of patients were analyzed retrospectively and the short-term efficacy and safety of MBM were evaluated.Operations were successful in all 18 cases.The mean operative time was 35.8 min.Intraoperative bleeding occurred in 3 cases and successfully managed by endoscopic hemostasis.Small perforation occurred in 1 patient and was closed by metal clips.Pathological examination showed mucosal cancer in 5 cases,high-grade intraepithelial neoplasia in 8 cases and low-grade intraepithelial neoplasia in 5 cases.No relapse of cancer was found during follow-up.Results indicate that MBM is an effective and safe method in treatment of early cancer and precancerous lesions in the esophagogastric junction.

ObjectiveTo explore the safety and efficacy of endoscopic dilatation combined with submucosal injection of triamcinolone acetonide in treatment of benign esophageal stricture.MethodsThe patients of benign esophageal stricture proved by biopsy were randomly divided into three groups.Group A were treated by expansion only,group B were injected with triamcinolone acetonide submucosal combined with expansion,and we treated group C by another injection a week later on the basis of treatment in group B.A 12 months' follow-up was conducted,the dysphagia score,the cure rate.time to sustained symptom relief,re-expansion time interval and adverse reactions were recorded.ResultsSome patients experienced chest pain and regurgitation after the procedure and all improved by corresponding managements.No complications including massive bleeding,infection,perforation or local tissue atrophy were observed.The dysphagia scores in 3 groups after the procedure were all improved ( P ＜ 0.05 ),and no significant difference was noticed between 3 groups (P ＞ 0.05 ).At the end of the follow-up,the duration of dysphagia remission and the interval between 2 consecutive dilatation in Group A were 14.4 ± 3.2 weeks and 18.2 ± 3.7 weeks,respectively,which were significant shorter than those in Group B ( 19.3 ±3.9 weeks and 24.6 ±4.2 weeks,respectively) and those in Group C (20.2 ±4.2 weeks and 26.1 ±4.5 weeks,respectively),while there was no difference between Groups B and C.The cure rate in Group C (43.5％,10/23) was significantly higher than that of Group A (29.2％,7/24) or Group B (27.3％,6/22),while there was no difference between Groups A and B.ConclusionEndoscopic dilatation combined with submucosal injection of triamcinolone acetonide is safe and may improve the symptoms of dysphagia and delay the re-stenosis for patients with benign esophageal stricture,meanwhile,multi-frequency treatment may improve the cure rate.

BACKGROUND:Many scholars at home and abroad have already attempted to apply the technique of the internal fixation pedicle screw placement to cure children’s spinal injuries in recent years, because the children’s thoracic pedicle is more smal , anatomical structure variation is big and adjacent relationship is complicated, so the application of adult’s pedicle screw technology simply to children who was in a continuous growth and development can increase operation risk greatly. Above this, improving the accuracy of nailing and reducing error rate become keys for further development of cervical pedicle fixation. OBJECTIVE:To provide an individualized and accurate positioning method for screw placement in thoracic pedicle of children by computer aided design and rapid prototyping technology. METHODS:After computed tomography scan of four cases of child specimens, the original data were made for three-dimensional reconstruction by the software, then the specimens were randomly divided into two groups:one group used the traditional pedicle internal fixation method, and the other group, first created the individual navigation template using the principle of reverse engineering and rapid prototyping technology. The lumbar pedicle screws were put into the samples by the individual navigation template. The position of the pedicle screws was evaluated according to the computer tomography scan. RESULTS AND CONCLUSION:The accurate rate of screw placement of the traditional pedicle internal fixation method was 58%;and the accurate rate of screw placement of the individual digital navigation template method was 81%. The success rate was better than the traditional surgery group. Furthermore, chi square test showed that there was a significant difference between two groups (P<0.05). These findings suggested that there has a high accuracy of the screw placement in thoracic pedicle of children assisted by the individual navigation template, ful y reflects the principle of individualization of screw placement, and provides a new feasible method for accurate screw placement in thoracic pedicle of children.

Objective To investigate the effect of thymosin ?1 (T?1) on cellular immune function in gastric cancer patients through observing its treatment on the differentiation of T-lymphocyte subsets from screened peripheral blood mononuclear cells (PBMCs). Methods PBMCs were obtained by centrifugation of blood samples from 18 healthy subjects and 32 patients with gastric cancer,and then cultured in the presence of culture medium with addition of T?1 at 50,10 and 1 ?g/ml for 2 d. T lymphocyte subsets (such as CD4+,CD8+ and CD4+ CD25+ Foxp3+ T cells) and Th1/Th2 multiplex cytokines were detected by flow cytometry (FCM). Results After PBMCs isolated from healthy people and patients were incubated with or without T?1,there was no significant change in percentage of CD4+,CD8+ peripheral lymphocyte subsets and ratio of CD4+/CD8+. There was no obvious change in the percentage of CD4+ CD25+ Foxp3+ T lymphocyte subsets in the normal control,but a significant increase was observed in the cells from patients with gastric cancer after treatment (P

Objective:To evaluate the developmental toxicity of Cry1Ab protein by studying its effects on cell proliferation and differentiation ability using a developmental toxicity assessment model based on embryonic stem-cell.Methods:Cry1Ab protein was tested in seven dose groups(31.25,62.50,125.00,250.00,320.00,1 000.00,and 2 000.00 μg/L)on mouse embryonic stem cells D3(ES-D3)and 3T3 mouse fibroblast cells,with 5-fluorouracil(5-FU)used as the positive control and phos-phate buffer saline(PBS)as the solvent control.Cell viability was detected by CCK-8 assay to calculate the 50％inhibitory concentration(IC50)of the test substance for different cells.Additionally,Cry1 Ab protein was tested in five dose groups(125.00,250.00,320.00,1 000.00,and 2 000.00 μg/L)on ES-D3 cells,with PBS as the solvent control and 5-FU used for model validation.After cell treatment,cardiac differentiation was induced using the embryonic bodies(EBs)culture method.The growth of EBs was observed under a microscope,and their diameters on the third and fifth days were measured.The proportion of EBs differentiating into beating cardiomyocytes was recorded,and the 50％inhibition con-centration of differentiation(ID50)was calculated.Based on a developmental toxicity discrimination func-tion,the developmental toxicity of the test substances was classified.Furthermore,at the end of the cul-ture period,mRNA expression levels of cardiac differentiation-related markers(Oct3/4,GATAA-4,Nkx2.5,and β-MHC)were quantitatively detected using real-time quantitative polymerase chain reaction(qPCR)in the collected EBs samples.Results:The IC50 of 5-FU was determined as 46.37 μg/L in 3T3 cells and 32.67 μg/L in ES-D3 cells,while the ID50 in ES-D3 cells was 21.28 μg/L.According to the discrimination function results,5-FU was classified as a strong embryotoxic substance.There were no sta-tistically significant differences in cell viability between different concentrations of Cry 1 Ab protein treat-ment groups and the control group in both 3T3 cells and ES-D3 cells(P＞0.05).Moreover,there were no statistically significant differences in the diameter of EBs on the third and fifth days,as well as their morphology,between the Cry1Ab protein treatment groups and the control group(P＞0.05).The cardi-ac differentiation rate showed no statistically significant differences between different concentrations of Cry1Ab protein treatment groups and the control group(P＞0.05).5-FU significantly reduced the mRNA expression levels of β-MHC,Nkx2.5,and GATA-4(P＜0.05),showing a dose-dependent trend(P＜0.05),while the mRNA expression levels of the pluripotency-associated marker Oct3/4 exhibited an increasing trend(P＜0.05).However,there were no statistically significant differences in the mRNA expression levels of mature cardiac marker β-MHC,early cardiac differentiation marker Nkx2.5 and GATA-4,and pluripotency-associated marker Oct3/4 between the Cry1Ab protein treatment groups and the control group(P＞0.05).Conclusion:No developmental toxicity of Cry1Ab protein at concen-trations ranging from 31.25 to 2 000.00 μg/L was observed in this experimental model.

Objective·To analyze the diversity and composition of the maternal gut microbiota and vaginal microbiota in late pregnancy,neonatal meconium microbiota and vernix caseosa microbiota,and analyze the similarities,differences and correlations.Methods·This is a prospective study.Maternal stool samples and vaginal swabs in late-pregnancy,and neonatal meconium samples were collected from 11 mother-infant pairs at Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August to November 2018;the vernix caseosa from three sites(forehead,axilla,and inguinal crease)and meconium samples were collected from 14 healthy newborns at International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine in December 2018.All births were vaginal deliveries.The 16S rRNA gene V3?V4 region sequencing was used.The diversity,composition and similarities/differences of the maternal gut microbiota,the vaginal microbiota,and the neonatal meconium microbiota from the 11 mother-infant pairs,as well as the neonatal vernix caseosa microbiota and the meconium microbiota from the 14 newborns were analyzed.Results·The number of operational taxonomic units(OTUs),ACE index,Chao1 index,and Shannon index of maternal gut microbiota were all higher than those of vaginal microbiota;the ACE indices and the Chao1 indices of the vernix caseosa microbiota at three sites were all higher than those of meconium microbiota(P<0.01).The β diversity varied among the maternal gut microbiota,vaginal microbiota,and neonatal meconium microbiota(P<0.01).The β diversity of neonatal vernix caseosa microbiota from three sites(forehead,axilla,and inguinal crease)was similar,but different from meconium microbiota(P<0.01).At the phylum level,the dominant bacteria were Firmicutes(52.76%)and Bacteroidetes(41.67%)in the maternal gut microbiota,Firmicutes(74.36%)and Actinobacteria(21.25%)in the maternal vaginal microbiota,and Firmicutes(84.22%)and Proteobacteria(8.80%)in the neonatal vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Proteobacteria in the two batches of samples(81.11%and 88.72%,respectively).At the genus level,the dominant bacteria were Bacteroides(35.42%)and Faecalibacterium(10.12%)in the maternal gut microbiota,Lactobacillus(69.10%)and Bifidobacterium(11.30%)in the vaginal microbiota,and Lactobacillus(79.81%)and Pseudomonas(3.23%)in the vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Escherichia in the two batches of samples(55.21%and 31.18%,respectively).Conclusion·The α diversity of maternal gut microbiota is higher than that of vaginal microbiota and neonatal meconium microbiota,and it is higher in neonatal vernix caseosa than that in meconium microbiota.The Firmicutes is the predominant phylum in the maternal late-pregnancy gut microbiota,vaginal microbiota,and neonatal vernix microbiota.Lactobacillus is the predominant genus in both maternal vaginal and neonatal vernix caseosa microbiota.Proteobacteria in phylum and Escherichia in genus are predominant in meconium microbiota.The microbiota composition is similar in vernix caseosa at different body sites,but there are differences between the vernix caseosa microbiota and meconium microbiota.