Objective To explore the relationship between promoter methylation of RASSF1 A gene and clinico-pathological characteristics in hepatocellular carcinoma.Methods MS-PCR was used for analyzing the status of aberrant promoter methylation of RASSF1A in 100 primary HCC samples and adjacent noncancerous tissues,10 normal liver tissues,and six HCC cell lines.RT-PCR was used to assess reactivation of RASSF1A expression after HCC cell lines treated with demethylating agent 5'-aza-2' deoxycytideing.Results Abnormal promoter methylation of RASSF1A gene was found in 69(69％) cases of HCC,15 (15％) cases of adjacent normal tissues,and no abnormal promoter methylation of RASSF1A gene was found in normal liver tissues,and the difference was statistically significant (x2 =67.75,P ＜0.001).The methylation of RASSF1A gene was correlated to HBsAg (x2 =11.341,P ＜ 0.05) and histological differentiation(x2 =10.575,P ＜ 0.05).Four cell lines with abnormal CpG island methylation of RASSF1A gene were all re-expressed after treated with 5'-Aza-CdR.Conclusions RASSF1A gene promoter methylation was correlated to HBsAg and histological differentiation and this is one of the most important mechanism for low expression of RASSF1A in HCC.

Objective To evaluate a combination hemihepatectomy and hilar blood vessel resection plus reconstruction for hilar cholangiocarcinoma. Methods Ten cases of hilar cholangiocarcinoma at the stage of Ⅲa, Ⅲb, and Ⅳ, underwent this surgical procedure including right - hemihepatectomy + pancreatoduodenectomy + right portal vein branch resection and reconstruction (1case), right - hemihepatectomy + right portal vein branch resection and reconstruction (5cases), left - hemihepatectomy + left caudectomy + left portal vein branch resection and reconstruction + left hepatic artery resection (1case), and left - hemihepatectomy + left caudectomy + left portal vein branch resection plus and reconstruction (3cases). Results There was no postoperative mortality and severe complications. All the 10 cases were followed up with 1,2,3-year survival rate of 50%,30%and 20%, respectively. Conclusion Hepatectomy plus hilar blood vessel resection and reconstruction helps to increase the resection rate in cases of hilar cholangiocarcinoma and prolong patients' survival.

Objective To investigate the expressions of RUNX3 and CyclinDl in pancreatic carcinoma and their significance. Methods Expressions of RUNX3, CyclinD1 in 47 cases with pancreatic carcinoma, 18 cases with cystadenoma of pancreas and 12 normal pancreas cases were detected by immunohistochemistry, and the relationship between their expressions and clinicopathological parameters was analyzed. Results The positive expression rates of RUNX3 in pancreatic carcinoma, cystadenoma of pancreas, normal pancreas cases were 57.4％ (27/47), 94.4％ (17/18), 100％ (12/12); the positive expression rates of CyclinD1 in pancreatic carcinoma, cystadenoma of pancreas, normal pancreas cases were 72.3％ (34/47), 44.4％(8/18), 8.3％ (1/12). RUNX3 expression was not related to the age and sex, but it was negatively associated with clinical staging, lymph node metastasis, the differentiation degree (P ＜0.05 ). CyclinD1 expression was not related to the age and sex, but it was positively associated with clinical staging, lymph node metastasis, the differentiation degree (P ＜0.05 ). The expression of RUNX3 and CyclinD1 was negatively associated (r = - 0.375, P = 0.009). Conclusions The expression of RUNX3 is decreased in pancreatic carcinoma. The expression of CyclinD1 is increased in pancreatic carcinoma. They may play an important role in the carcinogenesis and progression of pancreatic carcinoma.

Objective To investigate the evolution of pancreaticoduodenectomy and its significance in different time periods. Methods The clinical data of 165 patients from 1988 to 2008 in the department of general surgery, Zhangzhou Municipal Hospital with pancreaticoduodenectomy were retrospectively analyzed.Among 165 cases, simple pancreatoduodenectomy (PD) were performed in 138 cases, pylorus preserving pancreatoduodenectomy (PPPD) were performed in 14 cases, and extended pancreaticoduodenectomy were performed in 13 cases. The methods of pancreato-enteric reconstruction in pancreaticoduodenectomy included 68 cases with binding pancreaticojejunostomy (Peng's type Ⅰ ); 61 cases with pancreaticogastrostomy; 30 cases with traditional pancreaticojejunostomy; and 6 cases with duct-to-mucous pancreaticojejunostomy.Results From 1988 to 1998 (the first 10 years), 50 patients underwent pancreaticoduodenectomy, including 42 cases of PD and 8 cases of PPPD, and no case of extended pancreaticoduodenectomy. The mean amount of blood loss was (620 ± 180)ml, mean amount of blood transfusion was (530 ± 120)ml, the mean operation time was (6.5 ±3.5)h. Anastomotic fistula occurred in 7 cases, the incidence of anastomotic fistula was 14.0%(7/50); and 2 cases died during perioperative period with a mortality rate of 4.0% (2/50). From 1999 to 2008 (the latter 10 years), 115 patients underwent pancreaticoduodenectomy, including 96 cases of PD, 6 cases of PPPD, and 13 cases of extended PD. The mean amount of blood loss was (360 ± 110)ml, mean amount of blood transfusion was (400 ± 6 ) ml, the mean operation time was ( 3.0 ± 2.5 ) h, Anastomotic fistula occurred in 4 cases with an incidence of 3.5% ( 4/115 ); and one case during perioperative period with a mortality rate of 0.61%. The postoperative follow up time was ranging from 6 months to 5 years in 109 patients, the 1, 3,5 year survival rate was 87.2%, 54.1% and 39.5%. Conclusions In the latter 10 years, the amount of blood loss, the operation time, the mortality, and the incidence of pancreatic fistula have decreased significantly compared to the first 10 years.

Objective To study the diagnosis and treatment of protracted bacterial bronchitis (PBB) in children. Methods Children with PBB conifrmed by bronchoscopy were recruited from May 2013 to April 2015 . The clinical data were retrospectively analyzed. Results All 31 cases include 18 boys and 13 girls were recruited. 28/31 were younger than 6 years old. They all complained of wet cough, some of them were reported with wheeze ( 17/31 ) and with ruttle in the lungs ( 16/31 ). White blood cell were in normal range ( 18/31 ) or slightly elevated ( 13/31 ). The C-reactin protein was in normal range ( 28/31 ). Chest X-ray test of 16 cases were normal. Twenty-four cases taken chest computerized tomograph scan, 5 had a sign of tracheobronchial stenosis. The purulent bronchitis without tracheobronchial stenosis were conifrmed by bronchoscopy. Four cases had tracheomalacia. The medians of proportion of neutrophil were 80% in bronchoalveolar lavage lfuid (BALF). The pathogens were identiifed in BALF in 17 cases, 6 with Streptococcus pneumoniae, 6 with Haemophilus parainfluenzae, 3 with Moraxella catarrhalis, 2 with Staphylococcus aureus and 1 with Haemophilus influenzae. The symptoms were improved in all cases and co-amoxiclav was prescribed to most cases when discharged. The course of antibiotics therapy was 2-4 weeks in 23 cases, and more than 4 weeks in 8 cases. Twenty-three ( 23 ) cases were cured but 8 of them relapsed. Another 8 cases were improved but not completely remitted, 7/8 were cured by further treatment for concomitant diseases such as nasosinusitis and allergic rhinitis. Conclusions Children with PBB are typically younger than six years old, and presented with prolonged wet cough and parent-reported wheeze, normal or with ruttle in the lungs. A conifrmed diagnosis was reached by bronchoscopy. The antibiotics therapy were effective, the course should be more than 2-4 weeks, however, relapse were common. When antibiotics therapy does not lead to complete remission, concomitant diseases should be considered.

Objective:To investigate the etiological characteristics and changes of plastic bronchitis(PB)in children from 2010 to 2019 at Shenzhen Children′s Hospital, and provide reference basis for improving the understanding of PB etiology.Methods:The clinical data of children diagnosed with infectious-associated PB at Shenzhen Children′s Hospital from Jan 2010 to Dec 2019 were retrospectively analyzed, and the etiological characteristics and changes were summarized.Results:There were 94 cases of mycoplasma pneumoniae, 38 cases of influenza virus, 41 cases of adenovirus, 16 cases of mixed infection, 11 cases of bacteria, and 57 cases of unclear etiology in 266 infectious-associated PB children.The distribution of PB in each age group: 15 cases were infants, 63 cases were toddlers, 112 cases were preschoolers, and 76 cases were school-age children.Adenovirus was the main pathogen of PB in infants and toddlers(60.0%, 28.6%), and mycoplasma pneumoniae(34.8%, 60.5%) as well as influenza virus(13.4%, 22.4%) were the main pathogen in preschool and school-age children, with statistically significant difference( P<0.001). From 2010 to 2019, the annual positive rates of pathogens were 62.5%, 60.0%, 66.7%, 74.1%, 64.0%, 50.0%, 93.3%, 57.1%, 75.0%, and 84.7%, respectively.PB was caused by mycoplasma pneumoniae infection every year.From 2016 to 2019, PB caused by mycoplasma pneumoniae infection increased year by year, while PB caused by adenovirus infection increased every other year. Conclusion:Mycoplasma pneumoniae was the most common pathogen of PB, followed by adenoviruses and influenza viruses, while bacteria, fungi and other viruses were relatively rare.In the infant group, adenovirus infection was predominant, while in preschool and school-age children group, mycoplasma pneumoniae and influenza virus infection were predominant.

Objective To explore the characteristics of respiratory tract microbiota and its clinical significance in children with protracted bacterial bronchitis (PBB).Methods Twelve children aged from 5 months to 2 years old with PBB (PBB group) and 12 age-matched tracheomalacia(TM) children (TM group) were included in this study,who were admitted into the Respiratory Department of Shenzhen Children's Hospital.Their bronchoalveolar lavage fluid (BALF) samples were collected.Bacterial DNA was extracted from their BALF samples and the 16S rRNA V3-V4 region was sequenced by using Illumina MiSeq TMII system,and the findings were analyzed by bioinformatics methods.Results Principal component analysis revealed the difference in microbiota composition between 2 groups.Compared with TM group,PBB group exhibited lower microbial diversity:the Shannon indices were also 1.683 ± 0.703 and 2.324 ± 0.142 for PBB group and TM group respectively,and the differences were also significant(all P ＜ 0.05),and the Simpson indices were 0.416 ± 0.216 and 0.191 ± 0.025 for PBB group and TM group,respectively,and the differences were also significant (all P ＜ 0.05).The relative abundance of Actinobacteria was significantly lower in PBB group [(0.215 ± 0.228) ％] than that in TM group [(3.028 ± 0.592) ％] (P ＜ 0.01).The proportions of beneficial genera obviously decreased in PBB group,including Lactococcus [(13.464±7.319)％ in PBB group,and (44.784 ± 5.020)％ in TM group,P ＜0.01],Lactobacillus [(0.153 ±0.076)％ in PBB group,and (0.313 ±0.060)％ in TM group,P＜0.01],andArthrobacter [(0.024 ±0.018)％ in PBB group,and (2.970 ±0.584)％ in TM group,P＜0.01].On the other hand,the relative abundances of opportunistic pathogenic genera increased in PBB group significantly,including Haemophilus [(14.319 ± 29.532) ％ in PBB group,and (0.047 ± 0.127) ％ in TM group,P ＜ 0.Ol],Pseudomonas [(10.406 ± 25.439) ％ in PBB group,and (7.228 ± 0.948) ％ in TM group,P ＜ 0.01],and Escherichia [(0.432 ±0.441)％ in PBB group,and (0.055 ±0.035)％ in TM group,P ＜0.01].Conclusion These findings confirmed the existence of respiratory tract microbiotia dysbiosis in PBB,which probably was one of the pathogenetic mechanisms for PBB.

OBJECTIVETo evaluate the 8 main quality characteristic indexes of fruit-using Chaenomeles speciosa and C. sinensis fruits produced in Chongqing and explore the comprehensive assessment for the fresh eating-quality of the samples based on the theory of fuzzy comprehensive.

METHODThe total sugar content, titratable acid content, ascorbic acid content and superoxide dismutase (SOD) activity of fresh samples were determined, and the oleanolic acid, ursolic acid, total flavones and total saponins content of dried sample were determined by HPLC and colorimetry method. The fuzzy probability method was used to comprehensively evaluate their fresh eating-quality of the fruit-using C. speciosa and C. sinensis fruits produced in Chongqing.

RESULTThe mean SOD activity of C. speciosa and C. sinensis fresh fruits separately was 15.99 U x mg(-1) and 27.40 U x mg(-1), respectively. And the fresh fruit titratable acid content, total sugar content, ascorbic acid content separately was 0.357 g x L(-1), 0.854 mg x L(-1), 1.118 mg x L(-1) and 0.252 g x L(-1), 0.845 mg x L(-1), 1.260 mg x L(-1), respectively. The oleanolic acid, ursolic acid, total flavones and total saponins content was 0.320%, 0.461%, 43.90 mg x g(-1), 23.11 mg x g(-1) and 0.255%, 0.176%, 41.24 mg x g(-1), 15.01 mg x g(-1), respectively. The Chaenomeles speciosa and C. sinensis sample quality mean comprehensive evaluation value was 0.599 and 0.367 based on the fuzzy probability method.

CONCLUSIONThe edible quality of fruit-using C. speciosa fruits are better than C. sinensis fruits produced in Chongqing. And the fuzzy probability method could be used to quality comprehensive evaluation of samples containing many trait paramaters.

Ascorbic Acid ; China ; Chromatography, High Pressure Liquid ; Colorimetry ; Fruit ; chemistry ; Rosaceae ; chemistry ; Superoxide Dismutase ; metabolism

Objective:To investigate the feasibility of nebulizing injectable Tobramycin for the treatment of Pseudomonas aeruginosa (Pa) in pediatric cystic fibrosis (CF) patients. Methods:The clinical data of 3 CF children with Pa infection who were treated by nebulizing injectable Tobramycin in Shenzhen Children′s Hospital from September 2017 to March 2021 were retrospectively analyzed.The efficacy and safety were explored.The nebulized injectable Tobramycin (160 mg/dose) was given twice daily after airway clearance.After one-month treatment course, oral Ciprofloxacin would be given [30 mg/(kg·d)] to patients for another 1 month if Pa was still positive in repeat sputum cultures.Results:There were 2 males and 1 female in 3 cases recruited.The youngest patient was 1-year-old when receiving Tobramycin treatment.After airway clearance and inhalation of injectable Tobramycin, all had improvements in respiratory symptoms and chest CT scan.Two cases took additional oral Ciprofloxacin as Pa was still positive after the 1-month treatment course of Tobramycin.Pa turned to negative in all 3 cases after treatment for 3 months to 1.5 years.Besides, after treatment all the 3 patients had normal liver and renal functions, and normal hearing in multiple follow ups.One patient had a normal brainstem auditory evoked potential in the reexamination.Conclusions:Nebulizing injectable Tobramycin would be a reasonable alternative to inhaled Tobramycin solution for treating pediatric CF patients with Pa in view of the present condition in mainland China.However, it is still worth further study and discussion.

Objective:To investigate the clinical characteristics and risk factors of postinfectious bronchiolitis obliterans(PIBO)after severe adenovirus pneumonia(SAP).Methods:We retrospectivly analyzed 78 children who were hospitalized for SAP at Shenzhen Children′s Hospital from April 2015 to April 2020.The cases were divided into PIBO group( n=26) and non-PIBO group( n=52) based on the diagnosis results.The general conditions, clinical characteristics, and laboratory data from two groups were analyzed, and the risk factors for PIBO were explored. Results:A total of 78 children were included in this study.There were 18 (69.2%) males and eight (30.8%) females in PIBO group; the average age of onset in PIBO group was younger than that in non-PIBO group[(11.77±3.24)months vs.(15.08±6.48)months, P=0.027]. The cough duration[(11.35±7.35)days vs.(7.15±5.67)days, P=0.010], and heat duration[(13.12±6.78)days vs.(8.62±4.76)days, P=0.007] were longer in PIBO group than those in non-PIBO group.The white blood cell count[(12.46±7.23)×10 9/L vs.(9.17±3.66)×10 9/L), P<0.05], platelet count[(390.12±209.03)×10 9/L vs.(284.69±83.33)10 9/L, P<0.05], C-reactive protein[(37.04±32.16)mg/L vs.(18.14±18.33)mg/L, P<0.05], procalcitonin[(3.51±3.33)μg/L vs.(1.09±1.37)μg/L, P<0.05], lactate dehydrogenase(LDH)[(1 155.88±842.94)IU/L vs.(414.00±218.94)IU/L, P<0.01] were all higher in PIBO group than those in non-PIBO group; The roportion of patients with mycoplasma pneumoniae infection[5(19.2%) cases vs.4(7.7%) cases, P<0.05], admitted to PICU[18(69.2%) cases vs.8(15.4%) cases, P<0.01] , using invasive mechanical ventilation[10(38.5%) cases vs.5(9.6%) cases, P<0.01], using hormones[23(88.5%) cases vs.21(40.4%) cases, P<0.01], and using human immunoglobulin[20 (76.9%) cases vs.10(19.2%) cases, P<0.01] were higher in PIBO group than those in non-PIBO group.The multivariate Logistic regression using stepwise method showed that older age ( OR=0.942, 95% CI 0.890-0.997) was a protective factor for PIBO, while higher LDH levels ( OR=1.005, 95% CI 1.002-1.008), using intravenous corticosteroids ( OR=6.622, 95% CI 0.924-47.436), and using human immunoglobulin ( OR=9.681, 95% CI 1.742-53.802) were the risk factors for PIBO in SAP ( P<0.05). The receiver operating characteristic curve was constructed through the combination of age of onset, LDH level, using intravenous hormone, and using human immunoglobulin.The area under the curve reached 0.954.The overall best cut-off value of the prediction model was 0.272, the sensitivity was 92.3%, and the specificity was 86.5%.When LDH=462 IU/L, the area under the curve reached the maximum value of 0.882, the sensitivity was 100.0%, and the specificity was 61.5%. Conclusion:SAP children with characteristics such as younger age, long cough and fever duration, high inflammatory index, LDH level higher than 462 IU/L, admitted to PICU, mechanical ventilation and need hormones and human immunoglobulin, should be alert to the risk of PIBO.