Anorectal malformations (ARM)comprise a broad spectrum of congenital disorders that account for 25 ％ of gastrointestinal malformations.Despite numerous technical advances for treatment of ARM,complications such as fecal incontinence and constipation still occur and can greatly deteriorate patients' quality of life.It is recognized that lumbosacral spinal cord anomalies in ARM has been an important factor affecting the fecal function after procedure.Researchers have found that lumbosacral myelodysplasia is the common seen complication of ARM and neural cells decreased in lumbosacral spinal cord by the study on animals and human.Due to numerous factos affecting nerve innervation on annrectus and pelvic floor muscle,this review summarizes the nervous system complications and abnormal intervention of human and rats ARMs.The developments of study on ARM complications and intervention are detailed.Then the new direction of the research about the anorectal malformation nervous system is put forward,and the new strategy of improving the prognosis of anorectal malformation surgery is explored.

Objective To investigate the value and nursing of persistent balloon dilatation for anastomotic stricture after choledochojejunostomy. Methods The clinical data of 14 cases of anastomotic strictures after choledochojejunostomy accepted the treatment of persistent balloon dilatation were analyzed retrospectively. The effect, adverse reactions and approriate nursing were evaluated. Results Five patients were performed with persistent balloon dilatation thorough the output loop of intestine after choledochojejunostomy and 9 patients through percutaneous transhepatic cholangiography. There was no hemobilia, bile leak or other serious complications. There were 2 cases of balloon dilatation catheter damage, 5 cases of pressure pump damage and 4 cases of balloon migration with 25.0% (7/28) instrument damage rate and 4 cases of balloon migration. After persistent balloon dilation for 6 to 8 months, no anastomotic stricture was found by choledochoscopic examination. Follow up for 6 to 18 months, 2 cases had recurrent anastomotic stricture. Conclusions Persistent balloon dilatation by percutaneous transhepatic cholangiography is a simple, safe and effective method for anastomotic stricture after choledochojejunostomy. In the course of nursing, the balloon catheter and pressure pump damage, and balloon migration should be noted.

Objective To investigate the nursing points of endoscopic full-covered self-expanding removable metal stents (FCSERMS) implantation for bile duct anastomotic strictures after liver transplantation. Methods The clinical data of patients who were treated by endoscopic full-covered self-expanding removable metal stents implantation for bile duct anastomotic strictures after liver transplantation from January 2013 to July 2015 were retrospectively analyzed, and the nursing process were summarized. Results The group of 9 patients were successfully placed and removed with FCSERMS. There was no postoperative complication, such as stent migration, acute pancreatitis, biliary bleeding and intestinal leakage. All the bile duct strictures were relieved after FCSERMS removement. Followed up for 10-32 months, there was no symptom and sign of bile duct anastomotic stricture recurrent. Conclusions The key in nursing points of FCSERMS implantation for bile duct anastomotic strictures after liver transplantation are introducing the function of FCSERMS and therapeutic process to improve patient compliance, mastering the endoscopic operations, the placement and removal method of FCSERMS to short operation time, strengthening postoperative nasal bile duct care, paying attention to the observation, detection and treatment of postoperative complications after the metal stent placement and removement, as well as the continuing care during the period between placement and removment of FCSERMS.

0.05).But the cell purity and the survival rate by mechanical procedure were significantly higher than that by combination of enzymatic digestion(P

OBJECTIVE To analyze the status of concomitant or combined infection in patients presented with hepatitis B for investigation of the nosocomial infection control. METHODS We determined the serum virus marker of hepatitis A,C,D,E and G from 786 cases infected with hepatitis B virus. RESULTS Double and multiple infections accompanied by hepatitis B were found to be 16.67%(131/786) and 1.78%(14/786),respectively,especially with hepatitis C which amounted to 45.52%(66/145) of those with concomitant infections(double or multiple). CONCLUSIONS It is commonness that the patient of hepatitis B to preexist other kinds of hepatitis virus infections.We determine other hepatitis markers in patients of hepatitis B to be probative for nosocomial infection.

Objective To investigate the effects of genistein on the mRNA expressions of collagen (Col), matrix metalloproteinase (MMP ) and tissue inhibitor of matrix metalloproteinase (TIMP) in human embryonic skin fibroblasts (CCC-ESF-1).MethodsThe cultured CCC-ESF-1cells were divided into a black control group, an estradiol group and genistein groups of different doses. The mRNA expressions of ColⅠ, ColⅢ , MMP-1, TIMP-1 and TIMP-2 were detected by RT-PCR.Results Compared with the black group, estradiol and medium dose of genistein (0.451 ± 0.037, 0.446 ± 0.047vs.0.385 ± 0.061, allP<0.05) could promote the proliferation of the CCC-ESF-1 cells, estradiol and medium dose of genistein could up-regulate the mRNA expressions of ColⅠ (0.960 ± 0.012, 0.929 ± 0.015vs.0.812 ± 0.014, allP<0.01), ColⅢ (0.892 ± 0.009, 0.824 ± 0.022vs.0.768 ± 0.025, allP<0.01), TIMP-1 (0.841 ± 0.023, 0.838 ± 0.053vs.0.751 ± 0.027, allP<0.01) and TIMP-2 (0.456 ± 0.017, 0.448 ± 0.036vs.0.381 ± 0.029, allP<0.01), and down-regulate MMP-1 mRNAexpression (0.398 ± 0.043, 0.402 ± 0.044vs.0.525 ± 0.006, allP<0.01).Conclusions Genistein could promote the proliferation of the CCC-ESF-1 cells, and that may be related with up-regulating the mRNA expressions of ColⅠ, ColⅢ , MMP-1, TIMP-1and down-regulating MMP-1 mRNA expression.

Object: To investigate the effects of Huaiqihuang Granule, a compound Chinese herbal medicine, on expressions of nephrin and podocin of slit diaphragm of glomerular podocytes in rats with adriamycin-induced nephrosis and to explore the mechanism in reducing the proteinuria. Methods: Twenty SD rats were randomly divided into five groups: control group, model group, glucocorticoid group, Huaiqihuang Granule group and Huaiqihuang Granule plus glucocorticoid group. The 24-hour urine was collected 7, 14, 21 and 28 days after adriamycin injection respectively to measure 24-hour urinary protein, and all rats were sacrificed after 28-day treatment. Pathological changes in renal tissues were observed under a light microscope and an electron microscope. Expressions of nephrin and podocin mRNAs in renal cortex were determined by real-time polymerase chain reaction, and protein levels of nephrin and podocin were detected by Western blotting. Results: (1) In the model group and the treatment groups, the level of urinary protein increased significantly from the 14th day. (2) Under the light microscope, inflammatory cells and slight fibroplasia were found in renal interstitium of the model group, but there were less inflammatory cells in renal interstitium in the intervention groups than in the model group. Under the electron microscope, 29 days after adriamycin injection, extensive fusion of foot processes was observed. (3) The expressions of nephrin and podocin were higher in treatment groups than in the model group. (4) Proteinuria level was negatively correlated with the expressions of nephrin mRNA and nephrin and podocin proteins. Conclusion: The above results indicate that Huaiqihuang Granule can maintain the integrity of the slid diaphragram in podocyte, alleviate the lesion of glomerular filtration membrane, and decrease the proteinuria by up-regulating the expressions of nephrin and podocin. Huaiqihuang Granule plus glucocorticoid maybe has better effects than glucocorticoid alone.

Objective To study the pinoresinol diglucoside (PDG) on gene regulation role of ESF-1 cells in collagen secretion, to reveal PDG repair mechanisms on scalded skin.Methods The cells cultured in vitro were divided into the control group, the estradiol group and the three different PDG doses groups. The concentration of the high, medium and low dose groups were 100, 10, 1μmol/L, and that of estradiol group were 10-3μmol/L. The activity of proliferation was detected by MTT. Then collagen type I (Col I), collagen typeⅢ (ColⅢ), tissue inhibitors of metalloproteinase 1 (TIMP-1), tissue inhibitors of metalloproteinase 2 (TIMP-2) and matrix metalloproteinase 1 (MMP-1) expression levels of mRNA after administration of cells were detected by RT-PCR.Results Compared with the control group, the proliferation of ESF-1 cells (0.559 ± 0.027, 0.552 ± 0.034vs. 0.489 ± 0.027,P<0.05) in the estradiol and medium-dose PDG was significantly higher. The expression level of mRNA of ColⅠ(0.958 ± 0.021, 0.929 ± 0.031, 0.916 ± 0.015vs. 0.844 ± 0.022), ColⅢ (0.783 ± 0.038, 0.918 ± 0.021, 0.855 ± 0.017vs. 0.678 ± 0.024), TIMP-1 (0.939 ± 0.025, 0.889 ± 0.036, 0.853 ±  0.015 vs. 0.780 ± 0.023), TIMP-2 (0.507 ± 0.024, 0.655 ± 0.037, 0.572 ± 0.025vs. 0.405 ± 0.062) in the estradiol, low-, medium-dose PDG groups were significantly higher than those in the control group (P<0.05 or P<0.01). Besides, the MMP-1 (0.343 ± 0.038, 0.407 ± 0.046, 0.435 ± 0.037vs.0.519 ± 0.041) mRNA expression level in the middle and low dose PDG groups significantly decrease (P<0.05 orP<0.01). Conclusions The PDG could enhance the activity of ESF-1 cell proliferation, increase the expression of related collagen and tissue inhibitor of metalloproteinases and inhibit that of matrix metalloproteinases to repair scalded skin.

The finite element method was used for simulating the mechanical performance and fatigue safety of three different structures of Nitinol stent. According to the actual situation, after proposing reasonable assumptions and simplification, the geometry model and finite element model establishment, material mode selection and boundary condition setting are completed. The strain and fatigue life of different stent edges wide (omega) or strut angle (theta) are computed. The result can provide a valuable reference for the optimal design of stent.
Alloys ; Finite Element Analysis ; Prosthesis Design ; Stents

ObjectiveTo understand the behavioral characteristics,strength on suicide ideation and mental disorder diagnosis among suicide attempers,so as to provide consultation for crisis intervention of suicide.Methods232 suicide attempters from emergency of 5 general hospital in south-west of Shandong province were enrolled.They were assessed using questionnaires on attempted suicide behaviors and scale on the strength of suicide ideation,and were diagnosed using the Structured Clinical Interview for DSM-Ⅳ Disorders axis Ⅰ for patient (SCID/I-P).Results( 1 ) In the total of 232 cases,female was more than male with the gender ratio of 2.87 (female vs male).The highest proportion rate (56.9％) existed between 16 years old to 35 years old.Oral application pesticide was the most commom suicide pattern (83.2％),91.4％ of the suicide attempt occurred in the their homes.The top three reasons leading to suicide were family contrary (61.2％),depressive mood (15.1％)and fail in love (9.5％).(2) In all cases,83.6％ did not think if they were found,84.1％ did not adopted any precaution measures,over 60.0％ did not tell anyone their attempted plans,and 90％ had no dying structions and /or dying testaments before their attempted behaviors.At the moment of attemp behaviors,62.9％ did not contact with someone.The 60.0％ of all the cases had wanted strongly to die,otherwise 7.3％ had wanted to manipulate others.(3) The diagnosis rate of mental disorder on DSM-Ⅳ was 45.3％,in which the mood disorder was most.ConclusionThere are no changes on the behavioral characteristics among the suicide attempters in the south-west rural area of Shandong province.Their strength of suicide ideation are moderate,and a certain proportion of suicide attempters may be impulsive suicide attempters.There is more relationship between mental disorder and suicide attempt.