Objective To investigate the clinical efficacy of magnetic compression anastomosis for congenital esophageal atresia and stenosis.Methods The retrospective and descriptive study was conducted.The clinical data of 4 children who underwent magnetic compression anastomosis for congenital esophageal atresia and stenosis in the Northwest Women and Children's Hospital from December 2017 and February 2019 were collected.There were 2 males and 2 females.The children were aged 11 days,7 days,5 days,and 3 years,respectively.The children underwent magnetic compression anastomosis.Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect food intake and complications of children up to May 2019.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M (range).Results (1) Surgical and postoperative situations:four children underwent magnetic compression anastomosis successfully.Of the 4 children,3 with esophageal atresia underwent open tracheoesophageal fistula repair and endoscopeassisted magnetic compression anastomosis,and 1 with congenital esophageal stenosis underwent endoscopic gastrostomy combined with magnetic compression anastomosis.The operation time of 4 children was (2.3±0.9) hours.The length of esophageal blind ending in the 3 children with esophageal atresia and length of esophageal stenosis were in the children with esophageal stenosis 30-35 mm and 8 mm.Four children has good magnet apposition,and time of postoperative magnet removal was (29± 10)days.Three children with esophageal atresia had oral removal of magnet,and 1 with esophageal stenosis had magnet removed by gastrostomy.One child complicated with postoperative fistula and anastomotic stenosis was cured by unobstructed drainage and nutritional support treatment.The duration of postoperative hospital stay was (39± 10)days.(2) Follow-up:4 patients were followed up for 3-17 months,with a median time of 10 months,and restored to oral intake after oral removal of magnet and removal of magnet by gastrostomy on the days 14-36 postoperatively.One child was detected anastomotic stenosis by esophagography at the postoperative 3 months,and was improved after esophageal dilatation.The other 3 children recovered to normal connectivity of esophagus postoperatively and maintain unobstructed.Four children had normal eating,without dysphagia or other serious complications.Conclusion Magnetic compression anastomosis is safe and feasible for congenital esophageal atresia and stenosis,with good short-term efficacy.

Objective: To investigate whether elevated levels of C-reactive protein (CRP) and neutrophil (NE) in the blood is associated with an increased risk of lung cancer incidence. Methods: From 2006 to 2007, all employees and retirees from Kailuan (Group) Limited liability Corporation were included in this Kailuan Cohort study. The last follow-up date was December 2015. Data on new cases of lung cancer were collected, and multivariable Cox proportional hazards regression models were used to the relationship between baseline CRP and NE at baseline and risk of lung cancer. Results: A total of 92 735 participants were enrolled in this study. During the follow-up, 850 new cases of lung cancer were identified. All subjects were divided into four groups according to the combination level of CRP and NE at baseline: CRP≤3 mg/L and NE≤4×10⁹/L(Group A), CRP≤3 mg/L and NE>4×10⁹/L(Group B), CRP>3 mg/L and NE≤4×10⁹/L(Group C), CRP>3 mg/L and NE>4×10⁹/L(Group D). The cumulative incidence of lung cancer were 950/100 000, 1 030/100 000, 1 081/100 000 and 1 596/100 000 in these four groups, respectively (P<0.001). Multivariate Cox proportional risk model showed that participants from Group D had an significantly increased 72% risks of lung cancer when compared to Group A (95% CI: 1.40~2.12, P<0.001). Stratified analyses gender showed that males in Group D had higher risk of lung cancer when compared with participants in Group A (HR=1.73, 95% CI: 1.40~2.15, P<0.001). Conclusion Elevated levels of CRP and NE might increase the risk of lung cancer.

Objective To establish a stably overexpressing miR-31 transgenic mouse and detect the expression of miR-31 in the organs and tissues,and to provide qualified tool mice with overexpression of miR-31 in vivo. Methods The miR-31 overexpression vector was constructed by Gateway cloning technology. The vector was injected into fertilized ovum by DNA microinjection technology,then transferred to the pseudopregnant mice and waited for eutocia. Newborn mouse tail DNA was extracted and PCR and agarose gel electrophoresis were performed to identify the positive miR-31 transgenic mice. microRNA was extracted from the organs and tissues of miR-31 transgenic mice and the expression of miR-31 was de-tected by RT-PCR. The expression of Nestin and number of neural stem cells in the nervous system were compared in the positive and WT mice. Results The miR-31 transgenic mice were constructed successfully and bred more than 14 genera-tions in barrier environment. Expression of miR-31 was increased in major organs and tissues. The expression of Nestin and the number of neural stem cells in the positive mice were higher than those in the wild type mice. Conclusions MiR-31 overexpressing transgenic mice are constructed by Gateway cloning technology and the expression of miR-31 is stable in sub-sequent generations. The number of neural stem cells in the nervous system is higher than that in wild-type mice. The miR-31 overexpressing transgenic mice can be a good tool for experimental research of the function of overexpressed miR-31 in vivo and the treatment of nervous system diseases.

Objective To analyze the clinical characteristics in children with pertussis,and to provide a scientific basis for treatment of pertussis.Methods Retrospective analysis of general data,symptoms,signs,auxiliary examinations,treatment and prognosis was performed on the patients with pediatric pertussis in Xi'an from January 2015 to December 2016;the epidemiological data were analyzed by using descriptive approach.Results In a total of 857 patients with pertussis,there were 469 males and 388 females (the gender ratio of 1.21 ∶ 1.00),183 cases (21.3％) from the urban areas and 674 cases (78.7％) from the rural areas.The cases were reported throughout the year,indicating 2 peak times of onset:355 cases (41.5％) from July to September and 218 cases (25.4％) from February to April.And 473 cases (55.2％) were younger than 6 months;479 cases (55.9％) were inoculated with diphtheria,tetanus and pertussis combined vaccine(DTP) vaccine;492 cases (57.4％) were exposed to their family members who coughed at that time.Cough was the main symptom,and the median duration of pertussis from onset to diagnosis was 20 days.Concomitant symptoms included spasmodic cough was relieved in 836 cases (97.5 ％),facial suffusion in 806 cases (94.0％),peri-oral cyanosis in 308 cases (35.9％),asthma in 269 cases (31.4％),crow-like echo in 248 cases (28.9％),and apnea in 46 cases (5.4％);pulmonary moist rale was found by check-up in 761 cases (88.8％),and fever was observed in 159 cases (18.5％).The increased proportion of the peripheral blood lymphocytes was found in 702 cases (81.9％),the increased total count of leukocytes in 505 cases (58.9％),the increased procalcitonin(PCT) in 36 cases (4.2％) and the elevated level of high sensitivity C reactive protein(hsCRP) in 17 cases (2.0％);pneumonia was suggested by chest radiography in 673 cases (78.5％);in the blood-gas analysis,hypoxemia was suggested in 50 cases (5.8％) and respiratory failure in 9 cases (1.1％).In the 857 patients with pertussis,59 cases (6.9％) were with severe-type pertussis.At 1 week of the treatment,no spasmodic cough was reported in 515 cases (60.1％) and obviously relieved spasmodic cough in 198 cases (23.1％),and no deaths occurred.Conclusions The cases of pertussis occur throughout the year in Xi'an,predominately from July to September and February to April.A higher incidence is reported in the rural areas,compared with the urban areas,particularly in those younger than 6 months with incomplete DTP vaccination,who usually have severe conditions.In many cases,those with pediatric pertussis are infected by family members;most of them have spasmodic cough with good prognosis,without typical clinical signs.

Objective To compare the effect of aerobic and resistance exercise on brown adipose tissues in rats.Methods Sprague-Dawley rats were randomly assigned to a control(C)group,an aerobic exercise (T) group and a resistance exercise(L)group.The rats of group T performed treadmill exercise 5 days per week for 8 weeks,while those of group L climbed vertical ladders with progressively increased weights once in 3 days for 8 weeks.All rats were weighed before and after the intervention.Then the bilateral interscapular brown adipose tissue was isolated and weighed at 48h after the last exercise.The hematoxylin-eosin staining was used to observe the morphology of adipocytes,and the quantitative real-time PCR and Western blotting were employed to detect the mRNA and protein expression of browning genes [PR-domain-containing 16 (PRDM 16),PPAR gamma coactivator-1α (PGC-1 α) and uncoupling protein 1(UCP1)] respectively.Results After the intervention,the increment of weight of group T and group L were only 52％ and 70％ of group C(P＜0.01 and P＜0.05).The weight of BAT in both group T and L was lower than group C,but without significance(P＞0.05).The average size of lipid droplets in group T decreased significantly(P＜0.01) and slightly in group L(P＞0.05) compared with group C.The PRDM16,PGC-1α and UCP1 mRNA expression of group T was 1.78(P＜0.01),2.2(P＜ 0.01) and 1.3(P＞0.05) times of group C,while that of group L was 1.30(P＞0.05),1.25(P＞0.05) and 1.21(P＞0.05) times of group C.The PRDM16,PGC-1α and UCP1 protein level in group T was 1.46-fold(P＜0.05),1.56-fold(P＞0.05)and 1.20-fold(P＞0.05),while that of group L was 1.08-fold(P＞0.05),0.94-fold(P＞0.05) and 1.20-fold(P＞0.05) of group C.Conclusion Eight weeks of aerobic exercise can significantly make the lipid droplets of adipocyte smaller,increase the differentiation and metabolic activity of BAT,and weakly stimulate BAT thermogenesis.However,8 weeks of resistance exercise has no significant effect on BAT.

OBJECTIVE: The Tubridge flow diverter (FD) is a novel device aimed at reconstructing the parent artery and occluding complex aneurysms. Retreatment of recurrent aneurysms using the FD is challenging. We report our initial experience in the repair of aneurysm recurrence with the FD. MATERIALS AND METHODS: A database was reviewed prospectively, and 8 patients with 8 recurrent aneurysms (mean size, 16.7 mm) were identified. Four aneurysms had previously ruptured. The previous aneurysm treatment consisted of coiling in 1 aneurysm and single-stent-assisted coiling in 7 aneurysms. The procedural complications and clinical and angiographic outcomes were analyzed. RESULTS: Six aneurysms were treated by using a single Tubridge FD alone, while the remaining 2 were treated with FD + coiling. The immediate results of the 8 aneurysms were that they all showed incomplete occlusion. Neither major ischemic nor hemorrhagic complications occurred; however, 1 patient experienced a vasospasm. Follow-up angiographies were available for 7 aneurysms; the mean follow-up was 16.9 months (7–36 months). Five aneurysms were completely occluded, whereas 2 had a residual neck. Severe asymptomatic stenosis of 1 parent artery of a vertebral artery dissecting aneurysm was found. All visible branches covered by the FD were patent. All patients were clinically assessed as having attained a favorable outcome (modified Rankin Scale score ≤ 2) at discharge and follow-up. CONCLUSION: In selected patients, the Tubridge FD can provide a safe and efficient option for the retreatment of recurrent aneurysms. Nevertheless, attention should be paid to several technical points.
Aneurysm* ; Aneurysm, Dissecting ; Angiography ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Parents ; Prospective Studies ; Recurrence ; Retreatment ; Vertebral Artery

Objective To evaluate the safety and effectiveness of Pipeline embolization device (PED) for the treatment of large and giant intracranial aneurysms.Methods Frorn November 2014 to May 2016,the clinical and radiological data of 33 patients with intracranial aneurysm confirmed by DSA or head CT angiography (CTA) or head magnetic resonance angiography (MRA) at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.Its safety and effectiveness were evaluated.Results The Pipelines were successfully released in 33 patients with 35 aneurysms,10 aneurysms were implanted by using PED alone,25 were implanted by using PED combined with coil embolization (including 2 were implanted by using Pipeline bridging technology).During the perioperative period,1 thrombotic event(one aneurysm) occurred and had hemorrhagic transformation.One(one aneurysm) died of fatal aneurysm delayed bleeding.Thirty-one patients (33 aneurysms) were followed up clinically,the follow-up time was 4-18 months,no bleeding or thrombosis events occurred.Eighteen aneurysms received a short-term postoperative imaging follow-up (3-5 months,enhanced MRA or DSA),of which 10 had neck residue or aneurysm development,and 8 aneurysms did not have development at all,and 19 achieved postoperative mid-term imaging follow-up (6-16 months,enhanced MRA or DSA).Two of them had neck residue and 17 did not develop at all.Conclusion Pipeline for the treatment of intracranial large and giant aneurysms may be safe and effective.However,the complications of intracranial hemorrhage cannot be ignored after implantation of embolization device.Its related mechanism needs to be further studied.

Objective To study the clinical application of laparoscope combined with gastroscope surgery in patients with gastric stromal tumor. Methods The clinical data of 50 patients with gastric stromal tumor were retrospectively analyzed. Among them 20 cases were treated with traditional laparotomy (laparotomy group), and 30 cases were treated with laparoscope combined with gastroscope surgery (combination group). The intraoperative bleeding, operation time, postoperative recovery time, postoperative hospitalization time and complications were compared between 2 groups. Results One case in combination group received open surgery (3.33%, 1/30), mainly because of obesity, and tumor rupture occurred in 1 case during operation. All specimens of the 2 groups had no tumor residue. There were no statistical differences in tumor diameter and operation time between 2 groups (P>0.05); the intraoperative bleeding, postoperative recovery time and postoperative hospitalization time in combination group were significantly lower than those in laparotomy group:(26.33 ± 14.21) ml vs. (42.57 ± 15.67) ml, (37.96 ± 8.80) h vs. (60.14 ± 13.41) h and (6.42 ± 2.80) d vs. (12.04 ± 4.69) d, and there were statistical differences (P<0.05). The 2 groups had no death, stomach bleeding, anastomotic stenosis and anastomotic leakage. The laparotomy group had postoperative incision fat liquefaction in 3 cases and incision infection in 2 cases, and the combination group had pulmonary infection in 1 case. All were cured after symptomatic treatment. Conclusions Laparoscope combined with gastroscope surgery in the treatment of gastric stromal tumors has a short operation time, less blood loss, faster postoperative gastrointestinal function recovery, shorter hospitalization time, and no major complications. It is a more ideal and minimally invasive surgery.

Objective To investigate the effects of aerobic exercise on tau phosphorylation and PI3K/ Akt pathway in the hippocampus of obese rats,and provide some theoretical basis for physical activity improving obesity-related neurological disorders.Methods Male Sprague-Dawley rats aged 3 weeks were randomly assigned to either a high-fat or a normal diet protocol for 12 weeks.Animals submitted to the high-fat diet were further divided into two groups:a sedentary group (HF-Sed) and an exercise group (HF-Ex).The rats fed the normal diet were also divided into a sedentary group (ND-Sed)and an exercise group (ND-Ex).The rats in the HF-Ex and ND-Ex groups underwent a treadmill training for 8 weeks.Then the hippocampus was isolated at 48h after the last exercise.The protein and phosphorylation levels of tau,glycogen synthase kinase 3β (GSK3β),phosphoinositide 3-kinase (PI3K) and Akt were assayed using Western blotting.Results After 12 weeks of feeding,55％ of rats in the high-fat diet group reached the conditions for the obesity model.After 8 weeks of treadmill exercises,in the HF-Sed group the phosphorylation level of tau was significanlty higher than that in the ND-Sed group,while in the HF-Ex group that was significantly lower than the HF-Sed group.Moreover,in the HF-Sed group the phosphorylation level of GSK3β Ser9 was significantly lower,and the phosphorylation level of GSK3β Tyr216 was significantly higher than the ND-Sed group,indicating the activity of GSK3β was significantly higher than the ND-Sed group.However,after 8 weeks of treadmill exercise,in the HF-Ex group the phosphorylation level of GSK3β Ser9 was signfiicantly higher,and the phosphorylation level of GSK3β Tyr216 was signficanlty lower than the HF-Sed group,indicating significantly lower activity of GSK3β than the HF-Sed group.Then,in the HF-Sed group the protein levels of PI3K p110 and p85 subunits,and the phosphorylation levels of Akt Thr308 and Ser473 were significantly lower than those in the ND-Sed group,indicating inhibited activity of the PI3K/Akt pathway.However,in the HF-Ex group the protein levels of PI3K p110 and p85 subunits and the phosphorylation levels of Akt Thr308 and Ser473 were significanlty higher than those in the HF-Sed group,showing the activity of PI3K/Akt pathway was enhanced.Conclusion Obesity induces tau hyperphosphorylation in the rats hippocampus and long-term aerobic exercises can reduce tau hyperphosphorylation by increasing PI3K/Akt pathway activity and inhibiting GSK3β activity.It has a positive effect on delaying the formation of neurofibrillary tangles and improving obesity-related neurological disorders.

Objective To observe the effect of 8-week climbing ladder exercise with load on the expression of proliferator-activated receptor gamma coactivator 1-alpha (PGC1α)/ fibronectin type Ⅲ domain containing 5 (FNDC5)/ myostatin (MSTN)in soleus and extensor digitorum longus muscle and the serum concentration of irisin in Sprague-Dawley (SD)rats.Methods Twenty SD rats were randomly divided into a control (Con,n=10)group and a climbing ladder (Lad,n=10)group.The Lad group took an 8-week and once-every-3-day program of resistance exercise using an improved model of climbing ladder with load.Then the soleus and extensor digitorum longus muscles were isolated at 48 h after exercise.The PGC1α/FNDC5/MSTN mRNA and protein expression in the skeleton muscle were detected using quantitative PCR and Western blotting respectively.The serum concentration of irisin was measured using enzyme-linked immunosorbent assay.Results Compared with Con group,the expression of PGC1α in the soleus muscle reduced significantly (P＜0.05),that of FNDC5 reduced but without significance and that of MSTN increased significantly (P＜0.05)in Lad group.However,the expression of PGC1α in the extensor digitorum longus muscle increased significantly (P＜0.05),that of FNDC5 increased but without significance and that of MSTN decreased significantly (P＜0.05)in Lad group compared with Con group.There were no significant differences in the serum concentration of irisin between the two groups.Conclusion Eight-week climbing ladder exercise with load on rats induces differential expression of PGC1α/FNDC5/MSTN in soleus and extensor digitorum longus muscle,but doesn't influence the serum concentration of irisin.It is suggested that there may be a complex mechanism of balancing and antagonism in the body after long-term resistance exercises.