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Objective:To detect the expression of MYBL2 gene in gastric adenocarcinoma tissue and its effects on cell proliferation and invasion. Methods:A total of 100 cases of gastric adenocarcinoma tissue and 100 cases of paracancerous tissue were selected from patients who received surgery in The People's Hospital of Yuhuan between January 2017 and December 2020. Gastric adenocarcinoma cell lines MGC-803 were transfected with MYBL2 siRNA and siRNA control. The cells not transfected were used as controls. MYBL2 gene expression in gastric adenocarcinoma tissue and paracancerous tissue as well as MGC-803 were determined by quantitative real time-polymerase chain reaction. MGC-803 cell proliferation was determined by MTT. The invasive ability of MGC-803 cells was determined by Transwell assay. The migration ability of MGC-803 cells was determined by Scratch testing. MYBL2 protein expression in gastric adenocarcinoma tissue and paracancerous tissue as well as MGC-803 cells was determined by western blotting. Results:The relative mRNA expression of MYBL2 in gastric adenocarcinoma tissue was significantly higher than that in paracancerous tissue [(0.65 ± 0.17) vs. (0.18 ± 0.05), t = 26.52, P < 0.05). The relative mRNA expression of MYBL2 in the MYBL2 siRNA group (0.29 ± 0.07) was significantly lower than that in the control group (0.73 ± 0.12) and siRNA group (0.71 ± 0.16, t = 5.48, 4.16, both P < 0.05). MTT assay showed that after 24 and 48 hours of culture, MGC-803 cell proliferation rate in the MYBL2 siRNA group [(40.95 ± 5.46)%, (52.12 ± 12.27)%] was significantly lower than that in the control group [(67.84 ± 6.45)%, (87.83 ± 9.96)%] and siRNA group [(66.98 ± 7.85)%, (85.98 ± 10.24)%, t = 5.51, 3.91, 4.71, 3.67, all P < 0.05]. MGC-803 cell invasion rate in the MYBL2 siRNA group [ (62.12 ± 6.43)%] was significantly lower than that in the control group [(89.74 ± 6.56)%] and siRNA group [(88.83 ± 7.85)%, t = 5.20, 4.55, both P < 0.05]. The number of MGC-803 cells migrated in the MYBL2 siRNA group [(4.32 ± 0.84) × 10 3] was significantly lower than that in the control group [(8.95 ± 1.64) × 10 3] and siRNA group [(8.83 ± 1.78) × 10 3, t = 4.35, 3.96, both P < 0.05]. The gray value of MYBL2 protein in the gastric adenocarcinoma tissue was (0.56 ± 0.15), which was significantly higher than that in the paracancerous tissue [(0.23 ± 0.07), t = 19.93, P < 0.001]. The gray value of MYBL2 protein in the MYBL2 siRNA group was (0.21 ± 0.03), which was significantly lower than that in the control group (0.67 ± 0.15) and siRNA group (0.65 ± 0.19) ( t = 5.20, 3.96, both P < 0.05). Conclusion:MYBL2 gene is highly expressed in gastric adenocarcinoma tissue. siRNA silencing MYBL2 can decrease the ability of MGC-803 cells to proliferate, invade and migrate and downregulate MYBL2 expression. This study is highly innovative and scientific.
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Objective:To explore the possibility of laparoscopic simple oblique duodenoduodenostomy in the management of congenital duodenal obstruction in neonates.Methods:The clinical data of neonates with congenital duodenal obstruction undergoing laparoscopic simple oblique duodenoduodenostomy at Huaian Women and Children′s Hospital from February 2015 to February 2018 were retrospectively reviewed.By a lower-pressure pneumoperitoneum of 5-8mmHg and a suspending suture for right liver elevator, the procedure was performed using 4 ports: a transumbilical 5-mm port for the camera and another three 3-mm ports for instruments.After kocherizing of the proximal and distant part of the duodenum, the lower duodenum was incised longitudinally 0.5-1cm distal to the blocked end, the upper duodenum incision was placed 0.5cm away from the blocked end extended downward obliquely.The duodenoduodenostomy was performed as a " simple" " oblique" anastomosis with 5-0 PDS suture.Results:Fifteen patients were identified with a median age at operation of 2 days.Of all the cases, 4 cases were duodenal atresia (type Ⅲ), 11 cases were annular pancreas, and 7 cases of them were annular pancreas complicated with congenital intestinal malrotation.All cases were treated with laparoscopic simple oblique duodenoduodenostomy.Ladd procedure was accomplished in 7 cases with congenital intestinal malrotation in the meantime.The average operative time was (115.0±25.5) min (70-145 min). Feedings were started on postoperative 4-10d (mean 6.0d), without abdominal distention and vomit, all patients were discharged in good health with a median postoperative hospital stay of 7-14d(mean 10.6d). There was no mortality rate, no conversion to laparotomy, and no intraopertive complications in the group.The cases were followed-up for 2-36 months (mean 15.6 months), and all cases were doing well.Conclusion:Laparoscopic simple oblique duodenoduodenostomy is safe and efficacious in neonatal period, and can be a viable option in the treatment of neonates with congenital duodenal obstruction.
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Objective:To explore the initial experience of thoracoscopic repair with simplified mattress sutures in the treatment of diaphragmatic hernia in neonates without posterolateral rim of diaphragm.Methods:A retrospective review of the new simplified technique in 10 cases from March 2015 to October 2017 was performed.Of the patients, 6 cases were male, 4 cases were female.The age was 10min-1d, 7 cases were term newborns, and 3 cases were premature.The mean weight was 2.88 kg(ranged 2.3-3.5kg). All the 4 cases were left-sided.Two to three primary suture sites were taken from the relative intercostal region of the body surface projection of the defect.A snip incision about 1 mm of the skin was done.Two 2-0 non-absorbable sutures round the rib were inserted between the front edged of the defect and the diaphragm muscle through a syringe needle.The first thread was brought out of the body by the ring of the second thread and knot tying was made extracorporally.The posterolateral defect was closed; the knot was under the skin of intercostals space.Results:Ten neonates with CDH were repaired successfully using this new simplified technique.The mean operative time was 37.5min(ranged 25-60min) for each CDH repair.No cases required conversion to open surgery, blood loss was minimal.The 10 cases were followed up for 16.5 months(ranged 5-24 months), with no death and no recurrence.One neonate complicated with subcutaneous emphysema postoperatively and healed in one week.Conclusion:The new technique of thoracoscopic repairing with simplified mattress sutures when no posterolateral rim of diaphragm exists has all the advantages of thoracoscopy in neonates combined with the advantages of reduced operative time, simplicity, feasibility and definite curative effect and has the value of clinical popularization.
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Objective To explore the clinical value of portal exposure in laparoscopic treatment of children with type Ⅲ biliary atresia (BA).Methods From June 2013 to October 2017,30 infants with type Ⅲ BA who treated with laparoscopic portoenterostomy in Huai'an Women and Children's Hospital were selected.A percutaneous suture was used to snare the round ligament and retract the liver,other percutaneous stay sutures were then introduced and fundus and neck of gallbladder were sutured to elevate the liver to expose the portal hepatis.The fibro cord and hepatic vessels were mobilized,and then two rubber bands were put around the left and right portal veins and hepatic arteries.The portal hepatis was exposed by laterally stretching the two elastic rubber bands.The fibro cord was removed and then laparoscopic portoenterostomy was accomplished.In 20 cases,the liver was enlarged,part of hepatic lobus quadratus was removed laparoscopiclly for exposure of the portal hepatis.Results There were 30 cases in this group,2 cases were converted to open surgery by a micro transverse incision.There was no surgical death.Time of laparoscopic procedure varied from 210 to 280 min.All cases survived the surgery without any intraoperative complications.Blood loss during operation was minimal,without necessity for blood transfusion.One case died of respiratory failure one week after surgery.Two cases were lost follow-up.Twenty-five cases were followed up for 3～51 months(mean 22.4 months).Three cases died because of repeated cholangitis and liver failure at 10,16,35 months postoperatively.Nineteen patients' total bilirubin had dropped to normal,three others' bilirubin levels dropped significantly after surgery.Conclusion The technique of laparoscopic hepatic porta exposure can help to complete hepatic portoenterostomy successfully,reduce the conversion rate of laparoscopic surgery,and improve the surgical effect.
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Objective To discuss the feasibility of laparoscopic simple oblique side-to-side duodenoduodenostomy in treating congenital annular pancreas in neonates.Methods Medical records of neonates with the diagnosis of congenital annular pancreas undergoing laparoscopic simple oblique side-to-side duodenoduodenostomy at Huai'an Women and Children's Hospital from January 2015 to May 2017 were reviewed.The age ranged from 1 d to 4d with a median age of 2d at operation.The body weight at operation was 2.5-3.5 kg with a mean of 3.1 kg.By a lower-pressure pneumoperitoneum of 5-8 mmHg (1 mmHg =0.133 kPa) and a suspending suture for liver elevator,the procedure was performed using 4 ports.A transumbilical 5-mm port was for the laparoscopy and 3 3-mm trocars were placed for inserting instruments.The diagnosis was made after laparoscopic exploration,and then the distal duodenum was incised longitudinally 0.5-1 cm away from the annular pancreas,the proximal duodenum was incised O.5 cm away from the annular pancreas obliquely.The duodenoduodenostomy was performed as a "simple oblique" side-to-side anastomosis with 5-0 PDS running suture.Results All the 6 cases were treated by laparoscopic simple oblique side-to-side duodenoduodenostomy.Three of cases were annular pancreas complicated with congenital intestinal malrotation,and Ladd's procedure was accomplished in the mean time.The average operative time was 98 min (70-120 min).The blood loss during operation was 3-10 ml.Fluid diet started on postoperative day 3 to 7 (mean 4.5 d),without abdominal distention and vomit,and all the cases were discharged uneventfully in a median of 7-14 (mean 9 d) postoperative day without any postoperative complications.No cases were transferred to open abdominal surgery,and there were no intraoperative and postoperatuve adverse events.The cases were followed-up for 1-30 months (mean 13 months),and all the cases grew well without intestinal obstruction.Conclusions The laparoscopic simple oblique duodenoduodenostomy in treating congenital annular pancreas was conveniently performed,the intestinal function recovered quickly,which can be safely done in neonatal period even if the neonate was complicated with congenital intestinal malrotation.
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Objective:To discuss the effect of pharmacist intervention on the use of antimicrobial agents in the clinical pathway of community-acquired pneumonia ( CAP) in our hospital to standardize the rational medication and promote the rational use of antimicro-bial agents. Methods:Totally 100 bacterial CAP patients in 2013 ( before the intervention) and 2014 ( after the intervention) in the pneumology department were studied. The antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospi-talization time, therapeutic effects and so on in the two groups were observed during the treatment. Results: There were significant differences between the two groups in antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospitaliza-tion time and so on, whereas there was no significant difference in the curative effect. Conclusion:After the pharmacist intervention, the application of antibiotics is more rational, the antibiotics use density and per capita cost are reduced, the hospitalization day is shortened and the value of pharmacists is also improved.
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<p><b>OBJECTIVE</b>To investigate the feasibility and efficacy of laparoscopic procedure in the diagnosis and treatment of congenital intestinal atresia and stenosis in neonates and infants.</p><p><b>METHODS</b>Between September 2009 and September 2013, 55 cases with intestinal atresia and stenosis underwent laparoscope-assisted procedures in our department. There were, 32 males and 23 females, Twelve cases were diagnosed as duodenal atresia and stenosis and 43 as intestinal atresia and stenosis. The age at hospitalization was 7 minutes to 7 months(mean 9.88 d). After the diagnosis by multiport or transumbilical single-site laparoscopic exploration, cases with duodenal atresia and stenosis and part of the cases with proximal jejunum were treated by laparoscopic operations to remove the septum and restore intestinal continuity. In other cases with intestinal atresia and stenosis, laparoscopic inspection was performed to make diagnosis and then the proximal and distal ends of the atresia were exteriorized through the umbilical port site for end-to-oblique anastomosis.</p><p><b>RESULTS</b>All the 55 cases underwent this minimally invasive approach, and no case was converted to open surgery. The operative time of laparoscopic procedure for duodenal atresia and stenosis (n=12) ranged from 80 to 145 min(mean, 110 min). During the follow-up of 3-34 months, one case had recurrent postoperative vomiting induced by giant duodenal expansion above anastomotic stoma and died the second day after operation. The operative time of laparoscopic surgery for intestinal atresia and stenosis (n=43) ranged from 35 to 70 min (mean 46 min). During the follow-up of 3-36 months, 3 cases complicated with meconium peritonitis had postoperative short bowel syndrome and died. One case died of intestinal perforation at 3 month postoperatively. One case died of intestinal adhesion at 7 month postoperatively. The rest of cases had favorable outcomes.</p><p><b>CONCLUSION</b>Laparoscopic surgery for the diagnosis and treatment of intestinal atresia and stenosis has advantages of small incision, less trauma, and rapid recovery.</p>
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Female , Humans , Infant , Infant, Newborn , Male , Follow-Up Studies , Intestinal Atresia , General Surgery , Laparoscopy , Methods , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To summarize our preliminary experience and evaluate the clinical value of laparoscope diagnosis and treatment for annular pancreas in neonates.Methods A retrospective review of laparoscope diagnosis and treatment for annular pancreas in 9 children from September 2009 to January 2013 was performed.Among them,5 were male,4 were female.The age was ranging from 1 to 13 d.A lowerpressure pneumoperitoneum of 5 ～ 8 mm Hg (1 mm Hg =0.133 kPa) was used.Eight cases of diamond duodenal anastomosis were performed under laparoscope after the diagnosis was established,and 1 case underwent procedure through slightly enlarged umbilical port site.Results Eight cases of diamond duodenal anastomosis were performed under laparoscope,and the operation time was 80 ～ 140 min (mean 105 min),in 1 case it was performed through umbilical port incision,the operation time was 64 min,and the length of incision was about 2.5 cm.Feedings were started at postoperative day 4 to 7 (mean 5 d),and patients were discharged at postoperative day 8 to 14 (mean 10 d).The cases were followed-up for 3 ～ 20 months (mean 6.7 months),and I case complicated with anal atresia died of pneumonia 6 months later.Other cases were uneventfully recovered and symptoms were alleviated with normal gastroenterological function,no preoperative symptoms recurred,and the nutrition and growth status was excellent.Conclusions Annular pancreas can be diagnosed through laparoscopy.Laparoscope diagnosis and treatment for annular pancreas has the advantages of small incision,micro-invasion and faster recovery,can be safely performed in neonatal period.
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Objective To investigate two fixation methods for reconstruction of anterior cruciate ligament(ACL)with autogenous patellar tendon graft and their instant stability.Methods 15 specimens were divided into three groups.The first group was treated with 1/3 bone-patellar ligament-bone replacement and in terference screw fixation,the second group was treated with 1/3 bone-patellar ligament and Krackow locked bilateral suture,and in the third group the intact ACL was not treated.The mono-axial tensile tests were performed on a versatile hydraulic material testing machine(WE-5A)to compare the linear load,maximum load,linear straining,maximum straining,linear displacement,maximum displacement,rupture displacement,destructive energy,elastic modulus,and ultimate strength of ACL in the three groups.Results The ACL stability and rigidity in the group of 1/3 bone-patellar-bone replacement and interference screw fixation were higher than those in the other two groups.The differences between test results were statistically significant.Conclusion The ACL reconstruction with 1/3 bone-patellar ligament-bone replacement and interference screw fixation is a good method to ensure higher strength of graft and better joint stability.
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AIM: To investigate the role of proliferation and apoptosis in hypertensive left ventricular hypertrophy (LVH) and the effect of AT 1 blockade with losartan. METHODS: Left ventricles (LV) from 12, 24-week-old SHR (SHR 12 , SHR 24 ), 24-week-old SHR treated with losartan (15 mg?kg -1 ?d -1 , SHR-L 24 ) during 12 weeks, and age-matched WKY rats (WKY 12 , WKY 24 ) were studied. Expression of PCNA was examined by immunohistochemistry. Apoptotic cells in LV sections were assessed by TUNEL method. Levels of fas mRNA were quantitated by RT-PCR. RESULTS: Compared with age-matched WKY, SHR 12 and SHR 24 showed increased LV hypertrophied index (HI), increased apoptotic index (AI) of myocytes ( P