Analysis of Physiological Function of Escherichia coli Heme Peroxidase EfeB Based on Transcriptome / 中国生物化学与分子生物学报

Heme peroxidase EfeB in E. coli belongs to the dye-decolorizing peroxidase (DyP) superfamily. Peroxidases in this superfamily have a good ability in degradation of synthetic dyes, but their physiological functions in organisms are unclear. In order to further understand the physiological function of EfeB, the mutant strain EcoΔefeB was constructed by homologous recombination. The differences between parental strain E. coli BL21 and EcoΔefeB at genome transcription level as well as cell growth under different conditions were compared. The response of efeB to iron ion was also investigated. The results showed that the deletion of efeB gene caused the differential expression of 1 765 genes, which were mainly related to cell metabolic pathway, cell membrane synthesis and flagellum movement. There was no significant difference in cell growth between BL21 and EcoΔefeB at pH 7. 0, but the growth of BL21 was much better than that of EcoΔefeB at pH 4. 5. The functional expression of efeB may support the survival of E. coli at low pH. EfeB was significantly up-regulated when Fe

Application of the Virtual Reality-Pattern Visual Evoked Potential in Forensic Visual Acuity Evaluation / 法医学杂志

Objective To explore a kind of visual evoked potential test equipment and method that is more suitable for the application of forensic clinical visual acuity evaluation. Methods Thirty-four volunteers （68 eyes） were selected, including 15 males and 19 females, aged between 20 and 40 years. Test lenses were placed before the tested eyes of volunteers to induce refractive myopia with insert method, and the diopter lenses were adjusted so that the visual acuity level of one eye of volunteers was above 0.8, and the visual acuity of the other eye was at moderate damage level （<0.3 and ≥0.1）. The tests were carried out under the binocular simultaneous asynchronous stimulation mode （hereinafter referred to as "binocular mode"） and monocular separate stimulation mode （hereinafter referred to as "monocular mode"） of virtual reality-pattern visual evoked potential （VR-PVEP）, and the amplitude of PVEP of volunteers under the two modes was compared at four spatial frequencies of 8×8, 16×16, 24×24 and 32×32. Results The differences in the amplitude of P100 wave between monocular and binocular modes at 8×8 spatial frequency had no statistical significance and the differences in amplitude of P100 wave between monocular and binocular modes at 16×16, 24×24, and 32×32 spatial frequencies had statistical significance （P<0.05）. The amplitude of the same eye in monocular mode was higher than that in binocular mode. Through correlation analysis, it was found that the amplitude of P100 wave in monocular mode was moderately correlated with amplitude of P100 wave in binocular mode. Conclusion In forensic identification practice, VR-PVEP is helpful for overcoming the disturbance of poor fixation, and to increase the reliability of PVEP evaluation results. It can greatly shorten the detection time of PVEP and improve work efficiency.

Study on active ingredients of Jingfang Baidu San for preventing COVID-19 based on network pharmacology and molecular docking / 药学实践杂志

Objective To investigate the active ingredients of Jingfang Baidu San for the prevention and treatment of COVID-19 by using network pharmacology and molecular docking, and to provide references for clinical applications. Methods The chemical constituents and action targets of all medicinal materials in Jingfang Baidu San were retrieved from TCMSP. Uniprot database was used to search the corresponding genes of targets. Cytoscape software was used to construct the network of medicinal materials-compounds-targets for visualization. The target proteins of COVID-19 were searched by disease databases. The intersection of both was considered to be analyzed to establish the protein-protein interaction (PPI) network by STRING database. GO function enrichment analysis and KEGG pathway enrichment analysis were performed through Metascape database to predict its mechanism. The effective strength of core constituents on preventing COVID-19 was calculated by molecular docking method. Results A total of 159 effective ingredients and 277 potential targets were obtained in Jingfang Baidu San within the given screening conditions [oral bioavailability (OB) ≥30%; drug-like (DL) ≥ 0.18], including 55 core targets with the intersection of 273 targets of COVID-19. According to the results of GO and KEGG enrichment analysis performed on the core targets, 1376 GO items and 136 KEGG pathways were obtained, involving infectious diseases, cancer, cell progress, immune system, signaling pathways etc. The results of molecular docking indicated strong binding capacity between the core ingredients and SARS-CoV-2 3CL hydrolase or angiotensin-converting enzyme II (ACE2). The hydrogen binding and hydrophobic effect were the main forms of the interaction. Conclusion The active ingredients in Jingfang Baidu San can inhibit the binding between SARS-CoV-2 protein and ACE2, thus regulating multiple targets and signal pathways, which plays a role in the prevention and the treatment of COVID-19.

Clinical effect modified Chevron osteotomy combined with lateral tissue loosening in treating mild-moderate hallux valgus through internal signal approach / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effect of modified Chevron osteotomy combined with lateral tissue loosening for the treatment of mild-moderate hallux valgus through internal signal approach.</p><p><b>METHODS</b>From July 2015 to June 2016, 26 patients with mild-moderate hallux valgus treated with modified Chevron osteotomy combined with lateral tissue loosening through internal signal approach, including 2 males and 24 females aged from 45 to 65 years old with an average of(54.6±4.8) years old;the courses of diseases ranged from 1 to 5 months with an average of (7.5±3.3) months. Hallux valgus angle(HVA), inter metatarsal angle(IMA) were measured at 12 months after operation, and AOFAS score was applied to evaluate clinical effect before and after operation.</p><p><b>RESULTS</b>All incisions were healed at stage I. No incision occurred infection, metatarsal necrosis and recurrence of hallux valgus deformity. Two patients occurred skin numbness caused by musculocutaneous nerve injury. Twenty-six patients were followed up from 6 to 12 months with an average of(9.12±2.06) months. HVA, IMA were(30.01±3.71)°, (14.00±1.50)° before operation and(9.41±4.16)°, (7.00±0.60)° after operation, which had significant difference. There was statistical significance in AOFAS score before operation 54.77±9.59 and after operation 92.73±5.47, and 19 cases obtained excellent results and 7 moderate.</p><p><b>CONCLUSIONS</b>Modified Chevron osteotomy combined with full thread headless pressure screw fixation and lateral tissue loosening for the treatment of mild-moderate hallux valgus has advantages of excellent exposure, simple operation, stable fixation, rapid recovery. Akin osteotomy with internal capsulorrhaphy were used with lateral loosening and could recover soft tissue balance between lateral and internal, and could receive satisfied clinical effects.</p>

Correlation between Helicobacter pylori infections and serum lipid abnormality in adult population of healthy physical examination / 重庆医学

Objective To explore the relationship between Helicobacter pylori (HP) infection and dyslipidemia in adult people undergoing the healthy physical examination in Kunming city.Methods The intact population data of adult people undergoing the healthy physical examination and conducting the HP detection by adopting the 13C breath test (13 C-UBT)in the Cadres Physical Examination Center,Yunnan Provincial Second People's Hospital from January 2013 to February 2015 were retrospectively analyzed.The data included the basic information and serum fipids indexes[total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)].All subjects were divided into the HP positive group and HP negative group according to whether having HP infection.The levels of TC,TG,HDL-C,LDL-C and the incidences of single index of dyslipidemia and total dyslipidemias were compared between 2 groups and Logistic regression analysis was performed for investigating the relationship between HP infection and dyslipidemia.Results A total of 1 354 subjects were included in the study.The HP infection rate was 33.2％.The levels of TC,TG,HDL-C and LDL-C were no statistical significance between positive HP group and negative HP group (P＞0.05).The incidence rate of TC≥6.22 mmol/L of HP positive group was lower than that of HP negative group (P＜0.05).The occurrence rate of TC increase abnormality in the HP positive group was lower than that in the HP negative group (P＜0.05);the occurrence rate of dyslipidemia had no statistical difference between the HP positive group and HP negative group in the stratification according to sex,age and BMI (P＞0.05).The regression analysis showed that the HP infection was an independent influencing factors of TC increase abnormality (OR=0.644,P＜0.05).Conclusion The HP infection affects the incidence of TC increase abnormality,but might not affect the occurrence rate of dyslipidemia.

Epidemiological survey of Helicobacter pylori infection and analysis of related factors among adult population receiving physical examination in Yunnan plateau area / 重庆医学

Objective To survey the infection status and related factors of Helicobacter pylori(H.pylori) among adult population receiving physical examination in Yunnan plateau area so as to provide a basis for control and treatment of H.pylori infection at the present stage.Methods The epidemiological survey method was applied to collect the intact data on adult health physical examination from Jan.2013 to Feb.2015,including the results of survey by adopting the unified national questionnaire and 13 C-urea breathe test for detecting H.pylori.The guestionniare contents had the basic conditions,socid economy stalus,personal and family health status cinecluding whether sufferring from digestive diseases or symptoms,dietary habit,etc.Results A tatae of 1 680 eligi ble subjects were included in this study.The total infection rate of H.pylori was 33.5％,which of male and female were 33.2％ and 34.5 ％ respectively,the difference was not statistically significant (P＞0.05).The peak of H.pylori infection rate was in the age group 40-49 years(36.7 ％),but the difference among different age groups had no statistical significance(P＞0.05).The univariate analysis indicated that H.pylori infection was not correlated with nationality,permanent residence,occupation,education level,marital status and number of living together members(P＞0.05);H.pylori infection had no correlation with whether the individual or family members having digestive system disease or symptoms(P＞0.05);washing hands before meals and after defecation,stress of work,living and study,mainly used latrine type,daily means of transportation,work and rest time,sharing cutlery,diets habits,brushing teeth frequency per day and source of drinking water had no influence on H.pylori infection(P＞0.05),and smoking,alcohol drinking and frequently contacting with animals also had no influence on H.pylori infection(P＞0.05).H.pylori infection was significanly correlated with the social economical status,daily means of transportation and alcohol drinking(P＜0.05).The multiple unconditional Logistic regression analysis results indicated that there was negative correlation between H.pylori infection and monthly income,the OR (95％CI)value was 0.848(0.759-0.949).Conclusion The H.pylori total infection rate in adult population receiving physical examination in Yunnan plateau area is lower than the national population natural infection rate.It should focus on middle-aged population and low-income people.

Evaluation on dosage-based efficacy-toxicity correlation of Tripterygium wilfordii against immune inflammation in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To study the anti-immune inflammation efficacy and toxicity of Tripterygium wilfordii decoction, in order to provide experimental basis for studies on its "efficacy-toxicity" correlation.</p><p><b>METHOD</b>The delayed hypersensitivity model was established by dinitrofluorobenzene in mice. Different doses of T. wilfordii decoction was administered for 5 consecutive days. The ear swelling inhibition ratio and the toxic action were observed. After the final administration, the biochemical indexes of PGE2, TNF-α, IL-2, ALT, AST, PA, TBA, TBIL in serum were detected, and the visceral indexes of heart, liver, spleen and kidney were measured.</p><p><b>RESULT</b>The DNFB-induced ear swelling could be notably inhibited by multiple oral administration of T. wilfordii decoction, with the ED50 and its 95% confidence limit of 0.34 (0.21-0.42) g x kg(-1). The contents of PGE2, TNF-α, IL-2 in serum decreased in a dose-dependent manner. The activities of serum AST, ALT, TBA, TBIL and the PA content reduced.</p><p><b>CONCLUSION</b>T. wilfordii decoction shows a significant anti-immune inflammation efficacy within the dosage range between 0.59 and 2.34 g x kg(-1) in a dose-dependent manner. With a certain hepatotoxicity, high dose (2.34-4.68 g x kg(-1)) of T. wilfordii decoction can cause substantial liver injury, with a dose dependence in liver function index. Therefore, the efficacy and toxicity of T. wilfordii is dose dependent, which provides reference for preventing adverse drug reactions in clinic and developing early-warning schemes and ensure the clinical medication safety of T. wilfordii.</p>

Study on effect of aqueous extracts from aconite on "dose-time-toxicity" relationships in mice hearts / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of single administration of aqueous extracts from aconite on "dose-toxicity" relationship and "time-toxicity" relationship of mice hearts, through changes in electrocardiogram (ECG) and serum biochemical indexes.</p><p><b>METHOD</b>Mice were grouped according to different drug doses and time points, and orally administered with water extracts from aconite for once to observe the changes of mice ECG before and after the administration, calculate visceral indexes heart, liver and kidney, and detect levels of CK, LDH, BNP and CTn-I in serum.</p><p><b>RESULT</b>According to the "time-toxicity" relationship study, at 5 min after oral administration with aqueous extracts from aconite in mice, the heart rate of mice began rising, reached peak at 60 min and then slowly reduced; QRS, R amplitude, T duration and amplitude and QT interval declined at 5 min, reduced to the bottom at 60 min and then gradually elevated. The levels of CK, LDH, BNP and CTn-I in serum elevated at 5 min and reached the peak at 60 min, with no significant change in ratios of organs to body at different time points. On the basis of the "dose-toxicity" relationship, with the increase in single dose of aqueous extracts from aconite, the heart rate of mice. QRS, T duration and amplitude and QT interval declined gradually, and levels of CK, LDH, BNP and CTn-I in serum slowly elevated, with a certain dose dependence and no significant change in ratios of organs to body in mice.</p><p><b>CONCLUSION</b>Single oral administration of different doses of aqueous extracts from aconite could cause different degrees of heart injury at different time points, with a certain dose dependence. Its peak time of toxicity is at 60 min after the administration of aqueous extracts from aconite.</p>

Assessment of efficacy-toxicity-syndrome correlation based on anti-inflammation of Sophorae Tonkinensis Radix et Rhizoma in excess-heat mice / 中国中药杂志

Models of throat excess-heat mice were established and different dosages of water extract of STRR were ig given to mice to observe anti-inflammatory effect and its mechanism. The activities of ALT, AST and the contents of TNF-α, T3, rT3, T4, SOD, MDA, PEG2, NO, NOS, Cr, BUN, GSH and GSH-Px in serum were tested while liver index, kidney index, spleen index and thymus index were measured. The anti-inflammatory efficacy accompanied by side effects and mechanisms of water extract of Sophorae Tonkinensis Radix et Rhizoma (STRR) in excess-heat mice were investigated to clear safety dose-dependence range and the relationship of efficacy, toxicity and syndrome. In the experiment, water extract of STRR showed a strong inhibitory effect on ear edema by croton oil in throat excess-heat mice. The activities of ALT, AST in serum and liver index were all higher than that of normal group after multiple administration. PEG2, SOD, MDA, NO, NOS, GSH and GSH-Px had obvious changes. According to the results, water extract of STRR has an anti-inflammatory effect on acute inflammation in throat excess-heat mice and it is stronger than that in normal mice. The anti-inflammatory effect of STRR is related to the reduction of inflammatory mediators release. Side effects and hepatotoxicity will be produced on clinical efficacy dosage. The mechanisms of anti-inflammation and hepatotoxicity are all in connection with oxidative damnification.

Association between both triglyceride level, newly identified carotid plaque and middle-aged and elderly population, Beijing / 中华流行病学杂志

Objective To evaluate the association between triglyceride(TG) level and newly identified 5-year carotid plaque and to explore the prediction value of TG level on the newlyidentified carotid plaque with risk factors of traditional atherosclerosis.Methods A cohort study was adopted.The baseline survey including CVD risk factors and B-mode ultrasound of carotid artery was performed in 2002,and the second follow-up examination was performed in 2007.We evaluated 1949participants with lipid measurements and B-mode ultrasound of carotid arteries in the two surveys (with mean age as 57.9 ± 8.1 years and 39.2％ were men).The baseline TG levels were divided into four groups:group 1 (TG＜1.13 mmol/L),group 2 (TG=1.13-1.69 mmol/L),group 3 (TG=1.70-2.25 mmol/L) and group 4 (TG≥2.26 mmol/L).Newly identified carotid plaque was regarded as the indicator of progression of carotid atherosclerosis.New relationship between fasting TG levels and newly identified carotid plaque was analysed.Results Compared to newly identified carotid plaque which including different TG level groups,the incidence of newly artery plaque had significantly increased along with the increase of baseline triglyceride level (30.8％,38.8％,41.9％and 44.2％ respectively,with x2=21.22,P＜0.01 ).Compared to individuals (TG＜ 1.13 mmol/L),TG seemed a risk factor of plaque progression (P＜0.01).After adjusted for age,sex,dyslipidemia and other risk factors,high TG group (TG ≥2.26 mmol/L) appeared a significant independent predictor of newly identified carotid plaque (OR=1.37,95％ CI:1.00-1.86).When further stratifying the traditional atherosclerosis risk factors,we found that high TG group with smoking or hypertension was an independent factor of atherosclerosis progression.Conclusion With the increase of triglyceride levels,the rate of newly identified carotid plaque also increased.After adjusting age,sex,dyslipidemia and other risk factors,serum fasting TG ≥2.26 mmol/L appeared to be an independent predictor of newly developed carotid plaque.

Treatment of femoral neck fractures after the fixation of ipsilateral femoral shaft by antegrade intramedullary nail / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the treatment of femoral neck fractures after the fixation of ipsilateral femoral shaft fracture by antegrade intramedullary nail.</p><p><b>METHODS</b>A retrospective study on 12 patients with femoral neck fractures after the fixation of ipsilateral femoral shaft fracture by antegrade intramedullary nail, which were identified intraoperatively or postoperatively from January 2000 to January 2010. All the patients were treated with 2 supplemental screws placed anteriorly and posteriorly to intramedullary nail seperately. All the patients were periodic followed-up, fractures union and functional recovery were evaluated.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 10 to 36 months (averaged 16.5 months). The mean healing time was 3.6 months in femoral neck fractures and 5.4 months in femoral shaft fractures. No osteonecrosis of femoral head was found. According to Harris scoring system for hip function, 7 patients got an excellent result, 3 good, 2 fair.</p><p><b>CONCLUSION</b>Treatment of femoral neck after the fixation of ipsilateral femoral shaft by antegrade intramedullary nail with 2 screws placed anteriorly and posteriorly to intramedullary nail separately is feasible, and has the advantages of reliable fixation, less trauma and high rate of fracture healing.</p>

Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history.</p><p><b>METHODS</b>Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed.</p><p><b>RESULTS</b>Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications.</p><p><b>CONCLUSIONS</b>The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.</p>

Hg(0) absorption in potassium persulfate solution / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The aqueous phase oxidation of gaseous elemental mercury (Hg(0)) by potassium persulfate (KPS) catalyzed by Ag(+) was investigated using a glass bubble column reactor. Concentration of gaseous mercury and potassium persulfate were measured by cold vapor atom absorption (CVAA) and ion chromatograph (IC), respectively. The effects of pH value, concentration of potassium persulfate and silver nitrate (SN), temperature, Hg(0) concentration in the reactor inlet and tertiary butanol (TBA), free radical scavenger, on the removal efficiency of Hg(0) were studied. The results showed that the removal efficiency of Hg(0) increased with increasing concentration of potassium persulfate and silver nitrate, while temperature and TBA were negatively effective. Furthermore, the removal efficiency of Hg(0) was much better in neutral solution than in both acidic and alkaline solution. But the influence of pH was almost eliminated by adding AgNO(3). High Hg(0) concentration has positive effect. The possible reaction mechanism of gaseous mercury was also discussed.

A quantitative DNA methylation assay using mismatch hybridization and chemiluminescence / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To develop a quantitative method for methylation analysis of the p16 gene based on mismatch hybridization and chemiluminescence.</p><p><b>METHODS</b>Genomic DNA was modified by sodium bisulfite to convert all unmethylated but not methylated cytosines to uracil, and subsequently a pair of primer having no CpG sites was designed for amplification target DNA containing methylated or unmethylated CpG sites. The PCR product spanning CpG sites were hybridized with two oligonucleotide probes which perfectly matched the methylated and unmethylated CpG sequences respectively, and the hybrids were detected by chemiluminescent method. The percentage of methylated target sequences could be estimated by calculating the ratio of signals obtained with two probes.</p><p><b>RESULTS</b>The percentage of methylation of artificial mixtures DNA showed a linear relation. There was a negative correlation between the methyaltion index with p16 transcriptional mRNA of p16 gene in tumor cell lines.</p><p><b>CONCLUSION</b>Compared with existing methods, this assay is nonisotopic, rapid, simple, and can be widely applied to the study of DNA methylation.</p>

Study on the cost of expanded programme on immunization in areas with different economic levels / 中华流行病学杂志

<p><b>OBJECTIVE</b>The expanded programme on immunization (EPI) is an important part of the social commonwealth projects providing health care service by the government, which benefits communities. Government has the responsibility for EPI's financing which should be covered by the national budget. It is essential that the cost of EPI service be scientifically estimated to provide propriety information for policy makers.</p><p><b>METHODS</b>This study, using the cost accounting theory of health economics, to calculate EPI service cost at different levels. 3 provinces, 3 prefectures, 9 counties, 18 towns and 12 villages were selected from three provinces Guizhou, Heilongjiang and Zhejiang from the western, central and eastern regions of the country.</p><p><b>RESULTS</b>The average costs for one EPI-targeted child in Guizhou, Heilongjiang and Zhejiang, were 15.68 Yuan, 29.00 Yuan and 31.09 Yuan, and the costs for one dose were 10.99 Yuan, 18.64 Yuan and 16.51 Yuan, respectively. The costs for complete immunization program for one child were 131.88 Yuan, 242.32 Yuan and 280.67 Yuan, respectively. The main factors affecting the cost would include the average personnel cost (salary and benefit cost) by different economic levels of areas, the number of EPI items developed, and the number of total doses for one child.</p><p><b>CONCLUSION</b>(1) Obvious differences were found between different areas. (2) The proportion of the cost was not reasonably set because of the shortage of input. (3) Guideline for different areas to compensate the working item cost according to the number of the items should be formulated.</p>

Clinical Analysis of 11 Patients with Congenital Esophageal Atresia and Tracheoesophageal Fistula / 实用儿科临床杂志

Objective To explore early diagnosis and treatment of congenital esophageal atresia and tracheoesophageal fistula.Methods Clinical data of 11 patients with congenital esophageal atresia and tracheoesophageal fistula were analyzed retrospectively.Definite diagnoses were made for all cases in 24 hours through making an esophagus opacification with acetrezoic acid or iodinated oil.And an esophagus anastomosis outside pleura was made.Some experience of diagnosis and therapy were summarized.Results All of the 11 cases underwent operation.Among them,9 cases were cured (81.8%),and 2 cases died(18.2%).Anastomosis stenosis of esophagus was found in 1 case after operation,which was cured through esophagus dilatation.Tracheoesophageal fistula was found in another case after operation and it was cured through combined treatment including anti-infection, nutritional support and sufficient draining.Conclusion Early diagnosis and surgical treatment, postoperative care,prevention and cure of complication are very important to improve the survival rate of the patients with congenital esophageal atresia and tracheoesophageal fistula.