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Objective:To investigate and compare the therapeutic effect of Foley catheter balloon dilation and the traditional open reduction in the treatment of intussusception in children.Methods:A total of 68 children with intussusception treated by Foley catheter balloon dilatation by laparoscopic surgery or traditional open reduction in Department of Pediatric Surgery, the Second Hospital of Lanzhou University from August 2015 to July 2019 were retrospectively analyzed.Among them, there were 32 cases in the Foley catheter group and 36 cases in the traditional laparotomy group.Foley catheter group were treated with laparoscopic Foley catheter balloon dilatation, while the traditional open group were treated with traditional open surgery which was performed with finger dilatation.The results of surgical treatment, postoperative recovery, short-term complications, patient satisfaction and long-term complications were compared between the two groups.Results:Among the indexes of surgical treatment effect, the operation time[(0.4±1.1) h], intraoperative bleeding volume[(10.2±3.4) mL], incision size[(0.5±0.4) cm] and incidence of the rupture of intestine[6.3%(2/32 cases)] in the Foley catheter group were significantly lower than those in the traditional open group[(1.3±2.9) h, (40.5±2.1) mL, (5.1±0.7) cm, 30.6%(11/36 cases)], and the differences were statistically significant (all P< 0.05). Among the indexes of postoperative recovery and short-term complications, recovery time of gastrointestinal function[(1.2±3.1) d], length of hospital stay[(6.7±1.8) d], incidence of incision infection[9.4%(3/32 cases)]and incidence of incisional hernia(0) in the Foley catheter group were significantly lower than those in the traditional open group[(3.3±6.4) d, (7.3±0.9) d, 36.1%(13/36 cases), 16.7%(6/36 cases)], and the differences were statistically significant (all P<0.05). Among the indexes of family satisfaction and long-term complications, the score of family satisfaction in the Foley catheter group [(8.7±1.2) scores]was significantly higher than that in the traditional open group[(6.6±3.1) scores], and the incidence of adhesive intestinal obst-ructionin the Foley catheter group (0)was significantly lower than that in the traditional open group[0 vs.19.4%(7/36例)], and the differences were statistically significant(all P<0.05). Conclusions:Compared with traditional open reduction in the treatment of intussusception in children, Foley catheter balloon dilation has the advantages of short operation time, safe operation, low incidence of intestinal injury, less bleeding, and so on, and also has the advantages of small incision, fast recovery, short hospitalization time, high satisfaction of parents.In addition, the Foley catheter balloon dilation has a lower incidence of incisional infection, incisional hernia, postoperative intestinal adhesion and other complications.
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Objective To investigate the value of serum cholinesterase (S-ChE) levels in judgment of severity and prognosis in patients with severe pneumonia. Methods The clinical data of patients with severe pneumonia, who were admitted to the Department of Internal Medicine in the First Affiliated Hospital of Sun Yat-sen University, or the Department of Neurology in the Third People's Hospital of Foshan from May 2011 to May 2015, whose hospital time was longer than 24 hours, were retrospectively analyzed. They were divided into survival group and death group according to the final outcome. Lab data, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, multiple organ dysfunction syndrome (MODS) score, the improved pneumonia score of British Thoracic Society (confusion, uremia, respiratory, blood pressure, age 65 years, CURB-65), and S-ChE levels of all patients were collected after they were hospitalized into the intensive care unit (ICU) within 24 hours. Independent risk factors for prognosis were analyzed by binary logistic regression analysis, and receiver operating characteristic curve (ROC) was plotted. Best truncation point analysis was used to compare their estimated value for prognosis of patients with severe pneumonia. Results Eighty-six patients with severe pneumonia were studied. Among them 46 patients survived, and 40 patients died. By the single factor analysis, the following lab data in the death group were found significantly lower than those in the survival group: S-ChE levels (kU/L: 2.748±0.826 vs. 4.489±1.360, t' = 7.274, P = 0.000), arterial partial pressure of oxygen [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 52.55±18.29 vs. 60.83±16.65, t = 2.196, P = 0.031], oxygenation index (mmHg: 114.20±48.01 vs. 167.10±69.68, t' = 4.229, P = 0.000), and carbon dioxide combining power [CO2-CP (mmol/L): 22.85±5.44 vs. 26.00±7.63, t' = 2.225, P = 0.029]. The following clinical data were significantly higher in the death group than those in the survival group, namely body temperature (℃: 38.67±1.18 vs. 37.74±1.18, t = -3.627, P = 0.000), pulse (bpm: 130.65±15.72 vs. 107.26±19.61, t' = -6.133, P = 0.000), the ratio of concomitant chronic lung disease [45.0% (18/40) vs. 13.0% (6/46), χ2 = 10.860, P = 0.001], fraction of inspired oxygen [FiO2: 0.495 (0.410, 0.600) vs. 0.380 (0.290, 0.500), Z = -3.265, P = 0.001], APACHE Ⅱ score (25.80±5.07 vs. 16.39±5.12, t =-8.540, P = 0.000), CURB-65 score [3 (3, 4) vs. 2 (1, 2), Z = -5.562, P = 0.000], MODS score (8.15±2.49 vs. 4.35±2.01, t = -7.832, P = 0.000), international normalized ratio [INR: 1.22 (1.08, 1.31) vs. 1.07 (1.00, 1.10), Z = -4.231, P = 0.000], and activated partial thromboplastin time [APTT (s): 33.80 (32.13, 38.75) vs. 28.50 (25.70, 36.00), Z = -3.482, P = 0.000]. Binary logistic regression analysis showed that, S-ChE levels, APACHE Ⅱ score and MODS score were found to be the independent risk factors for prognosis in the patients with severe pneumonia, respectively [S-ChE: odds ratio (OR) = 0.084, 95% confidence interval (95%CI) = 0.017-0.424, P = 0.003; APACHE Ⅱ score: OR = 1.675, 95%CI = 1.098-2.556, P = 0.017; MODS score: OR = 2.189, 95%CI = 1.262-3.800, P = 0.005]. The area under ROC (AUC) for S-ChE levels, APACHE Ⅱ score and MODS score were 0.874±0.036, 0.889±0.033 and 0.884±0.035, respectively (all P > 0.05 as compared between any two means). At the best truncation points of S-ChE levels, APACHE Ⅱ score and MODS score were 3.372 kU/L, 19.5 score, and 6.5 score respectively. The sensitivity, specificity, positive predictive value and negative predictive value in predicting death risk in patients with severe pneumonia were (80.0%, 78.0%, 76.19% and 81.82%), (95.0%, 70.0%, 73.08% and 94.12%) and (70.0%, 91.0%, 87.50%, 77.78%), respectively. If S-ChE levels was combined with APACHE Ⅱ score or combined with MODS score, the sensitivity, specificity, positive predictive value and negative predictive value [S-ChE levels combined APACHE Ⅱ score: 100%, 92.0%, 93.75% and 100%; S-ChE levels combined MODS score: all 100%] were higher than single power of S-ChE levels, APACHE Ⅱ score or MODS score. Conclusions S-ChE levels can be considered as an effective and practical index to estimate the severity and prognosis in patients with severe pneumonia. The combined application of S-ChE levels and APACHE Ⅱ score or MODS score can obviously improve the prognostic power in patients with severe pneumonia.
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Objective To observe the effect of automobile exhaust pollutants in air of underground parking area on immune system of mice. Methods Thirty female Kunming mice were divided into a control(relatively clean) group and a polluted group(each n=15)by a random number table method. The control group was housed on the roof of a mechanical building located at the south campus of Sun Yat-sen University,while the polluted group was housed in the minus second layer of underground parking lot at the First Affiliated Hospital of Sun Yat-sen University. The data of atmospheric pollutants were recorded at both feeding sites. The mice's food-intake and body weight were also observed. After 3 months of observation,the mice were sacrificed and peripheral serum was harvested. Enzyme-linked immunosorbent assay(ELISA)was performed to detect the level of tumor necrotic factor-α(TNF-α),transforming growth factor-β1(TGF-β1)and interleukin-4(IL-4). Results The levels of air pollutants in pollution group were higher than those in control group〔carbonmonoxide(CO,mg/m3:16.784±3.093 vs. 2.249±0.112),nitrogen oxides(NOx, mg/m3:0.318±0.041 vs. 0.065±0.030)and particulate matter(PM2.5,mg/m3:0.309±0.051 vs. 0.055±0.013),all P<0.001〕. The amount of food intake and body weight of the polluted group were obviously lower than those of the control group〔food-intake:670 g vs. 960 g,body weight:(37.13±1.11)g vs.(41.23±1.34)g, both P<0.001〕. There was no abnormal death in both groups. The serum levels of TNF-α(ng/L:247.93±22.25 vs. 143.33±39.01), TFG-β1(ng/L:395.77±41.29 vs. 319.15±20.72) and IL-4(ng/L:231.89±20.04 vs. 194.09±3.57)were significantly higher in the mice of polluted group than those in the control group(all P<0.001). Conclusions The automobile exhaust pollutants in the air of underground parking lot have obvious effects on the levels of serum inflammatory cytokines of mice. It is suggested that the presence of pollutants activate the body's inflammatory process and lead to disturbance of immune system of female Kunming mice.
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Objective To investigate the change of the content of suppressor of cytokine signaling (SOCS-1) in the liver of septic mice and its working mechanism.Methods Adopted Cecalligation and puncture (CLP) to create models of sepsis and divided randomly adult male BALB/c mice into 8 groups,including normal controlled group,sham-operated group,and the killed groups 2 hours,6 hours,12 hours,24 hours and 48 hours after operation.After extracting the RNA and protein from the liver tissue of the mouse groups,reverse transcription polymerase chain reaction (RT-PCR) was adopted to determine the relative content of SOCS-1 mRNA in the tissue,Western blot was adopted to determine the relative content of protein and the SPSS statistics software was adopted to calculate the correlation.Then observed the pathological change of liver tissues,and detected SOCS-1 protein expression by immunohistochemistry.Results After CLP suergery,the expression of SOCS-1 on gene degree in the liver and the expression of SOCS1 on protein degree in the liver increased rapidly at the 6th hour ( P ＜ 0.05 ),with the former reaching peak ( P ＜ 0.05 ) at the 24th hour and the latter remaining high all the time.There were pathological changes such as fatty degeneration and necrosis in the septic liver tissue,hepatic SOCS-1 protein expression could be detected by immunohistochemistry.Conclusions CLP induced sepsis could lead to the increase of the expression of SOCS1 in the liver.
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Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.
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Objective To observe the mRNA and protein expression of SOCS-1 and SOCS-3 in the peripheral blood mononuclear cells(PBMCs) in patients with systemic inflammatory response syndrome(SIRS) and explore its clinical significance.Methods Peripheral blood of 20 patients with SIRS and 16 healthy people wag collected and the PBMCs were isolated by centrifugafion and Ficoll-Hypaque sedimentation.The mRNA of SOCS-1 and SOCS-3 was determined by reverse transcription-polymerase chain reaction(RT-PCR).And the protein content of SOCS-1 and SOCS-3 was determined by Western Blotting.Results The SOCS-1 mRNA expression in the PBMCs of SIRS group (0.642±0.112) was significant higher than that of control group(0.458±0.044)(P<0.05).There was no significant difference between the PBMCs,SOCS-1 content of control group(0.488±0.019) and SIRS group (0.471±0.041).The SOCS-3 mRNA expression in the PBMCs of SIRS group(0.989±0.324) was higher than that control group(0.459±0.046)(P<0.05).There was no significant difference between the PBMCs'SOCS-3 content of control group(0.400±0.025) and SIRS group(0.426±0.015).Conclusions The mRNA expression of SOCS-1 and SOCS-3 in the PBMCs were higher in SIRS patients.The SOCS-1 and SOCS-3 may participate in the development of SIRS.
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Objective To investigate the dynamic expression of SOCS-3, TNF-α in live and spleen of mice induced by AOPP, and to discuss the mechanism of MODS induced by AOPP, so that to give some intervention method over MODS in the future. Method Thirty-six adult BALB/c mice were divided into 3 groups randomly: AOPP group (n=12). Water normal group (n=12) and normal group (n=12). After post poison 2 hours, 6 hours, 12 hours and 24 hours,the fiver and the spleen tissue were taken out. The expression of SOCS-3 and TNF-α were detected by RT-PCR. And data were analyzed with ANOVA. Results After AOPP of 2,6,12,24 hours, the mRNA expression of SOCS-3 increased obviously in the liver and spleen compared with the normal group (P<0.05), it reached peak at the 24th hour in liver,and reached peak at the 12th hour in spleen, then descended at 24th hour (P<0.05). The mRNA expression of TNF-α increased obviously in the liver and spleen than normal group (P<0.05), and reached peak at the 12th hour,then descended at 24th hour (P<0.05), the electro-phoresis image of RNA was 5 s 15 s and 30 s,RT-PCR amplification of β-actin showed,the expression of SOCS-3, reached peak at the 24th hour in liver and it reached peak at the 12th hour in spleen, then descended at 24th hour (P<0.05), TNF-α reached peak at 12th hour in the liver and spleen, then descended at 24th hour. By statistic analysis, positive correlation was indicated among SOCS-3 and TNF-α mRNA expression in liver (y=0.089+0.758x, r=0.939, F=252. 168, P<0.01) positive correlation was indicated among socs-3 and TNF-α mRNA expression in spleen (y=0.057+0.361x,r=0.953,F=336.122, P<0.01). Conclusions At different point of time after Aopp,the mRNA expression of socs-3 and TNF-α showe the same trend in liver and spleen,the levels of SOCS-3, TNF-α all increase significenfly.
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Objective To study the level of cyclooxygenase-2 (COX-2) and platelet-activating factor acetyl-hydrolase(PAF-AH) and high sensitive C reactive protein(hsCRP) on peripheral blood mononuclear cells in Acute Coronary Syndrome(ACS) patients and the effect of atorvastatin on them and the clinical significance. Methods To measure and compare the content of COX-2,PAF-AH and hsCRP in normal control group and ACS group(before and after treatment). Result The content of COX-2,PAF-AH and hsCRP are significantly different between normal con-trol group and ACS group (before treatment) (P < 0.05), and between ACS group (before treatment) and ACS group (after treatment) too(P < 0.05). Conclusions The inflammatory cytokines COX-2,PAF-AH and haCRP have sig-nificant correlation with the occurance of ACS. Atorvastatin can decrease COX-2 and hsCRP level, and can increase PAF-AH level. So atorvastatin takes an important role in lessening inflamatory reaction level in ACS patients.
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Objective To investigate the incidence of systemic inflammatory response syndrome(SIRS) after cardiopulmonary resuscitation(CPR) and to observe the effect of Ulinastain in inhibition of inflammatory mediator.Methods Forty patients surviving more than 48 hours after CPR were divided into Ulinastain and control groups randomly. Activity of nuclear factor kappa B(NF-?B), IL-6,TNF-? of the patients was detected .All patients were evaluated by SIRS diagnosis standard and their general organ function was examined. All data were compared between two groups.Results Activities of NF-?B, IL-6,TNF-? of patients after CPR was significantly higher than that of normal people (P
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In order to explore the significance of cardiomyocyte apoptosis in coronary heart disease (CHD), the TUNEL and transmission electron microscopic (TEM) techniques were performed. The results showed that the permillage of cardiomyocyte apoptosis in infarct area in patients of sudden death from CHD was significantly higher than that in control group (557.94? 144.10‰ VS 34.30?20.68‰, p