Objective To discuss the influence of preoperative family purge care for the quality of life of patients with long type of congenital Hirschsprung′s disease (HD) who had enterocolitis history in neonatal period. Preoperative family purge care, which can shorten the HD postoperative treatment, improve the quality of life. Methods A total of 40 cases of patients with long type of congenital HD who had enterocolitis history in neonatal period received 1-stage radical preoperative by family phone call. Nineteen cases from January 2010 to February 2013 were as normal group and 21 cases from March 2013 to April 2016 were as improved group. Routine family purge nursing care 3-6 months were used in both the groups, while the combined nursing care of expanding anus were used in the improved group in addition. Evaluated the effects of postoperative observation indicates: the first defecation time, length of hospital stay, time needed for expanding anus, patency rate of defecation and not patency rate in 9-12 days, need enema intervention to assist defecate rate after postoperative 1 year, the recurrence of enterocolitis at 1-3 years after operation. Results The first defecation time, length of hospital stay, time needed for expanding anus were (39.15±8.23) h, (7.89±0.82)d, (5.17±0.98) min in normal group, (23.79± 7.54) h, (7.10± 0.29) d, (3.15±0.73) min in improved group, and there were significant differences between two groups (t=6.13, 5.46, 15.54, all P<0.01). The patency rate of defecation and not patency rate in 9-12 days were 12/19, 7/19 in normal group, 100.00%(21/21), 0 in improved group, and there were significant differences between two groups (χ2=9.38, P<0.01). The intervention rate of no need for enema, occasionally enema, often enema were 2/19, 12/19, 5/19 in normal group, 76.19%(16/21), 23.81%(5/21), 0 in improved group, and there were significant differences between two groups (χ2=18.25, P<0.01). There was no significant difference in the recurrence of enterocolitis at 1, 2, 3 years after operation between two groups (χ2=2.33, P>0.05). Conclusions Patient with long type of congenital HD who had enterocolitis history in neonatal period neonatal period,received family enema and expanding anus in 3- 6 months before 1-stage radical preoperative can shorten the postoperative HD treatment, improve the quality of life.

Objective To investigate the current status of secondary prevention of cerebral infarction in Longquanyi District of Chengdu. Methods Prospective Investigation on the secondary prevention was conducted in 94 pa-tients with cerebral infarction at 3, 12 and 24 months following stroke. Results The percentages of patients receiving anti-platelet therapy, antihypertensive treatment, antidiabetic drug treatment and statin therapy were 96.8%, 92.1%, 91.7%and 63.8%at hospital discharge, 79.8%, 88.9%, 91.7%and 55.3%at 3 months, 76.1%, 75.0%and 41.4%, 63.8%at 12 months and 33.0%, 71.4%;58.3%and 22.3%at 24 months, respectively. None of stroke patients with atrial fibrillation re-ceived anticoagulation therapy. Conclusion There is a large gap between the current practice of secondary prevention and guideline in patients with cerebral infarction in Longquanyi District of Chengdu.

Objective To observe the effects of exogenous adrenomedullin(ADM)on expressions of IL-4 and IFN-γ following mechanical renal trauma in the rats. Methods A total of 104 healthy adult plain grade Wistar rats were,randomly divided into four groups,ie,normal control group(eight rats),simple trauma group(32 rats),prevention group(32 rats,injected with ADM before trauma)and treatment group(32 rats,injected with ADM after trauma).The experimental model of rat with mechanical renal trauma was prepared by striking the ridge of the left rib area with free dropping forrous hammer in all groups except for the control group.Ten minutes before and after mechanical renal trauma,ADM ly.All rats were sacrificed by draining out all the blood in their hearts at 1,6,12 and 24 hours after mechanical renal trauma.Then,the renal tissues were removed and fixed with 10% formalin for observing the positive expressions of IL-4 and IFN-γ by means of SABC staining. Results Compared with the simple trauma group,the positive expression of IL-4 in the prevention group Wag observed at 1 hour,gradually increased at 6 and 12 hours and reached the peak at 24 hours after mechanical renal trauma,with statistical difference(P<0.05).The positive expression of IL-4 in the treatment group WaS increased at one hour and reached the peak at 6 hours after mechanical renal trauma,with statistical difference(P<0.05).Compared with the simple trauma group,the IFN-γ expression in the prevention group was,increased at 6 and 24 hours but decreased at 12 hour,while that in the treatment group was decreased significantly at 1,12 and 24 hours.Compared with the normal control group,the IFN-γ expression in the treatment group was significantly decreased at 1 and 12 hours.The IFN-γ expression in the treatment group was lower than that in the prevention group at every time points,with statistical difference(P<0.05). Conclusions Preventive and therapeutic administration of exogenous ADM can enhance the expression of IL-4.IL-4 and IFN-γ play an antagonistic role in repair ofthe renal injury.The primary role of exogenous ADM is the dynamic regulation of IFN-γ expression.

Objective To investigate the influence of tethered cord syndrome (TCS) on the up-per urinary tract and its etiology. Methods Forty patients with TCS diagnosed by spinal MRI were enrolled in this study. There were 21 males and 19 females with mean age of 23 years old. The course of disease ranged from 1 to 40 years. Urinalysis, mid-stream urine culture, serum creatinine(SCr), urinary system ultrasound, IVU, eystography and urodynamic study were carried out on all patients. Results Urinary tract infection was found in 17 patients and increased level of SCr was found in 6 pa-tients (251.64±98.5μmol/L). Of the 29 patients who underwent urinary system ultrasound examina-tion, 12 cases had hydronephroais and dilated upper ureter. Of the 30 patients who underwent IVU, 10(33.3%) had ureterectasia and hydronephrosis, 22 cases had bladder turriform or Christmas tree like deformity with diverticulum and trabeculum. Of the 22 patients accepted cystography, 17 cases had vesieoureteral reflux on 27 sides. Post-void residual (PVR) was evaluated in 35 patients and found increased in 31 cases. Cystometry had been done in 33 patients. The mean value of maximal detrusor pressure (Pdetmax) during filling phase was 41.2±20.9 cm H2O. The detrusor compliance was 22.35±18.8 ml/cm H2O. During voiding phase, detrusor-sphincter dyssynergia(DSD)was observed in 16 patients, detrusor areflexia was observed in 16 patients and detrusor underactivity was observed in 13 patients. Resting urethral pressure profilemetry was measured in 16 patients. Maximal urethral closure pressure (MUCP) was 76.1±33.1 cm H2O. The upper urinary tract deterioration was de-fined as increased SCr, hydronephrosis or vesicoureteral reflux. There were 20 patients diagnosed as upper urinary tract deterioration. The compliance of the upper urinary tract deteriorating group and the no-deteriorating group was 9.4±7.8 vs 19.3±15.8 ml/cm H2O, Pdetmax was 43.1±21.2 vs 24.0±11.9 cm H2O, PVR 189.0±138.0 vs 47.8±36.8 ml, MUCP 86.2±32.4 vs 46.8 5±20.8 cm H2O, incidence of damaged detrusor 100.0% vs 69.2% and DSD 65.0% vs 23.1%, respectively. There were significant differences between the 2 groups(P<0.05). And when comparing the VUR group with no VUR group, the incidence of urinary tract infection was 94.1%(16/17) vs 20.0%(1/ 5) (P=0.003). And when comparing urinary tract infection group with no infection group, the inci-dence of upper urinary tract deterioration was 88.2% (15/17) vs 21.7%(5/23)(P=0.000). Condn-sion Low compliance bladder, high Pdetmax during filling phase, increased PVR, high MUCP, damage of detrusor contractive function and DSD are the risk factors for upper urinary tract deteriora-tion in the TCS patients.

Objective To evaluate multi-slice three-dimensional CT angiography (MS 3D-CTA) for the follow-up of intracranial aneurysm clipping.Methods MS 3D-CTA of 16 patients with intracranial aneurysm clipping were retrospectively analyzed.The patients were scanned on a 16-slice spiral CT(GE Lightspeed pro).Volume rendering(VR),thin maximum intensity projection(thin MIP) and multi-planar reconstruction (MPR) were employed in image postprocessing in all cases.Results There were 17 clips in the 16 patients with aneurysm clipping.Six clips were located at the posterior communicating artery,5 at the anterior communicating artery,4 at the middle cerebral artery,and the remaining 2 clips were located at the pericallosal artery in 1 patient.There were no abnormalities found in the aneurysm clipping region in 7 cases by MS 3D-CTA.There were residual aneurysm in 2 cases,parent artery stenosis in 4 cases,and artery spasm in 3 cases.There was no parent artery occlusion and clip displacement in all cases.VR showed excellent 3D spacial relations between the clip and parent artery in 12 cases,and showed good relations in 3 cases.The 1 case with 2 clips in the pericallosal artery showed heavy beam-hardening artifacts.The size and shape of aneurysm clips were clearly depicted by MPR and thin MIP,while 3D spacial relation of aneurysm clip and parent artery were poorly showed.Conclusion MS 3D-CTA is a safe and efficient method for the follow-up of intracranialaneurysm clipping.Combined VR with MPR or thin MIP can well reveal postoperative changes after aneurysm clipping.

Objective To study the expressions of intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1) and E-selectin on the aorta of artherosclerosis and explore the relationship between these molecules and artherosclerosis(AS).Methods Human arterial specimens were collected from 18 cadavers,including 5 with normal arterial tunica intima(control) and 13 with pathologically identified AS(AS group).Analysis were carried out in consecutive sections by immunohistochemical staining for ICAM-1,VCAM-1 and E-selectin.Results ICAM-1,VCAM-1 and E-selectin positive cells were mainly located in the tunica intima and adventitia of AS aorta.More positive cells were observed obviously in AS group than in control(P

Objective To observe the correlation between the C-myc expression and pathologic lesions of kidney to explore the role of C-myc re-expression in children's primary nephrotic syndrome(CPNS). Methods The C-myc expression of renal tissue in 30 cases of CPNS was detected using immunohistochemical method, and the correlation between C-myc expression and renal pathological lesions was analyzed. Results There were various degrees of C-myc positive staining in the renal tissue of all patients with CPNS, while no C-myc positive expression in the renal tissue of control group. C-myc expression was mainly located in podocytes and less in endothelial cells of glomeruli. There was high level of C-myc expression in nephric tubules, especially in proximate tubules. There was no C-myc expression in the Henle's loop,tubulous matrix and vessel areas. There was no obvious difference in C-myc expression level in the podocytes and proximate tubules among the different pathological types of CPNS. The level of focal segmental glomerulosclerosis(FSGS) in proximate tubules obviously reduced compared with mesangil proliferative glomerulonephritis(MsPGN) and minimal change disease(MCD)(P

Objective To investigate the efficiency of antitumor immune responses induced by a controlled live dendritic cell(DC)vaccine Methods DC precursors were isolated from Fischer 344 rat bone marrow and cultured with granulocyte macrophage colony stimulating factor and interleukin 4 The rat ovarian tumor cell line NuTu 19 was genetically modified by retroviral mediated suicide gene(HSV 1 TK), and the positive clones were selected using G418 Live DC vaccine was then fused with DC and NuTu 19/TK cell by polyethylene glycol The characteristics of live DC vaccine were assayed with flow cytometry and confocal laser scanning microscopy The specific expression of HSV 1 TK gene in live DC vaccine was evaluated by RT PCR and western blot The sensitivity of live DC vaccine to ganciclovir (GCV) was evaluated by methylthiazoletetrazolium assay In vivo, rats vaccinated twice with live DC vaccine were compared to those vaccinated with killed DC vaccine, unfused DC and NuTu 19/TK cell or phosphate buffered saline Seven days following the last immunization, the rats were sacrificed to test the specific cytotoxic T lymphocyte (CTL) activity by lactate dehydrogenase release assay, or challenged with NuTu 19 and tumor incidence was observed Results The fusion efficiency was approximately (23?14) Live DC vaccine displayed an up regulated expression of major histocompatibility complex (MHC) IIOX6 (87 6?3 4)%, costimulatory molecule B 1 2 (71 1?9 3)%, integrin OX 62 (68 0?7 4)%, and adhesion ICAM 1 (77 1?2 0)%, and specifically expressed HSV 1 TK gene. Our data showed that spleen T lymphocytes from rats vaccinated with live vaccine displayed enhanced CTL aetivity (61 8?8 3)% contrast to that of rats vaccinated with killed vaccines (26 0?3 8)% ( P

Objective To study the expression of intercellular adhesion molecule-1 (ICAM-1 ) in the rat cardiac heterotopic allo- grafts and the effect of cyclosporin A on prevention of allograft rejection. Methods Heart transplantated animals were divided into three groups: Group Ⅰ(control), Group Ⅱ(CsA 7. 5mg/kg B W, daily) and Group Ⅲ(CsA l5mg/kg B W, daily). Acute cardiac rejection grade was valued by the standrd of ISHLT(1990 ). Immunohistochemistry was performed to analyze the expression of ICAM-1 in heart grafts and donor aorta segments. Results After heart transplantation, it was found that from day 1 to 3, there was sligtly inflammatory infiltratiation, the rejection was graded 1A of 1B, But from day 11 to 12, there were disseminated inflammation and cardiac necrosis with serous hyperemia, exutation, edema, acute vasculitis and myocarditis. The rejection grade was 3B or 4, and could be reduced 1to 2. 5 grades by administration of CsA. It was also found that both in heart graft and donor aorta segments the expression of ICAM-1 on the endothelium cells, infiltrated lymphocytes was clearly increased. It was time-dependent and could be down-regulated by administra- tion of CsA. On Day 1 and Day 3 the suppressing function of CsA on expressing of ICAM-1 showed singificant dosage-dependent. But from Day 7 to Day 11, it appeared dosage- independent. Conclusiou Trea tment with CsA is an effect ive methed to down- regulate I - CAM-1 expression and could reduce the lympphocyte migration and filtration. These results may explain, in part, the mechanism of CsA reducing acute rejection in a rat cardiac transplantation medel.

Objective The present study was designed to investigate whether pulsing DCs with tumor-derived extracts is an ef- fective way to induce CTL. and antitumor immunity, Methods DCs were propagated from bone marrow (BM)of C57BL/6J(H-2Kb. I- Ab)mice in vitro with GM-CSF + IL-4tumor associated antigen (TAA) extracted from actively growing Hepa 1-6 cells was used to activate DCs. The phenotypes of DCs were detected by FACS, the cytotoxicity of CTL was as- sayed by 3H-TdR labbel assay. Result and Conclusion The TAA extract pulsed DCs exhibited much more and longer cell processes and increased expression of MHC- Ⅰ, MHC-Ⅱ, CD80 (B7-1 ) 、 CD86 (B7-2 ). This experiment has shown that DCs pulsed with TAA extracts of C57B/6J cells could stimulate effectively the responsiveness of syngenic splenic T cells to induce specific CTL against C57BL/6J cells.