Efficacy of noninvasive correction on congenital auricle deformities at different time points: a meta analysis / 中华医学美学美容杂志

Objective:To evaluate the efficacy and safety of nonsurgical methods in early postnatal correction of congenital auricle malformation.Methods:The clinical trials regarding non-surgical treatment for congenital ear deformity published before May 2021 were searched in databases of Cochrane Library, PubMed, Medline, CNKI, VIP and Wanfang. The information of included studies was extracted. The Meta-analysis was performed by using RevMan 5.3 software.Results:A total of 15 trials were included, involving 1 349 patients. The Meta-analysis results showed that the effect of the group <6 weeks was better than the group over 6 weeks ( OR=4.67, 95% CI: 3.21, 6.78, Z=8.09, P<0.001); The complications incidence of the group < 6 weeks was lower than the group over 6 weeks ( OR=0.27, 95% CI: 0.08, 0.88, Z=2.18, P=0.03); The correction time required of the group <6 weeks was shorter than the group over 6 weeks ( MD=-11.81, 95% CI: -18.36, -5.26, Z=3.54, P=0.001). Conclusions:Non-surgical correction of congenital ear malformation within 6 weeks after birth has better efficacy and safety.

Present Situation Investigation of Trace Elements of 0～7 Years Old Children in Shenzhen District / 现代检验医学杂志

Objective To understand the Shenzhen Dapeng new district and Longhua district 0～7 years old children in copper (Cu),zinc (Zn),calcium (Ca),magnesium (Mg),iron (Fc) and lead (Pb) 6 kinds of trace elements,in order to establish the reasonable dietary structure and provide a scientific basis for scientific and rational supplement of trace elements.Methods Collected 2 190 cases of 0～7 years old children for health physical examination in Dapeng New District Maternal and Child Health Care Hospital of Shenzhen form March to November 2015.According to the age,they were divided into the baby group (0～1 years old) of 637 cases,children group (2～4 years old) of 723 cases and preschool group (4～7 years old) of 830 cases of three groups.Used QL8000 automatic whole blood trace elements analyzer to test Fe,Zn,Ca,Cu,Mg and Pb 6 kinds of trace elements in whole blood,and the detection results were statistically analyzed and compared.Results Test results of 5 kinds of whole blood trace element(Fe,Zn,Ca,Cu,Mg) had different degrees lack in 2 190 cases of children aged 0 ～7,and lack of different level,lack of rate were 36.26％,32.83％,14.20％,0.64％ and 0.50％,respectively.Fe and Ca deficiency in young children group was most serious,lack of Zn in infant group was most serious,other microelement lack rate had no statistically significant difference between different groups (P＞ 0.05).Pb poisoning rate was 15.71％,the Pb poisoning rate decreases along with the age growth,and boys than girls,the difference was statistically significant (x2=3.15,P ＜0.05),different gender children other microelement lack rate differences had no statistical significance between the results.Conclusion The whole blood trace element of 0～7 years old children had different lack,mainly by Fe,Zn and Ca deficiency in Shenzhen Dapeng New District and Longhua District.But Children's Pb poisoning problem could not be ignored.Therefore,to streng then the 0～ 7 years old children's whole blood trace elements level survey,microelement lack of prevention and treatment of children is of great significance.

Efficacy Observation of Piperacillin/Tazobactam in the Treatment of Children with Congenital Megacolon Enteritis / 中国药师

Objective:To evaluate the curative effect and safety of piperacillin/tazobactam in the treatment of children with con-genital gegacolon enteritis. Methods:122 cases of congenital intestinal enteritis were randomly divided into two groups. The 72 pa-tients in the treatment group were treated with piperacillin/tazobactam sodium, and the 50 patients in the control group were treated with cefoperazone/sulbactam. The course of treatment was 714 days. The differences in C-reactive proteins, bolld leukocytes count and neutrophilic granulocyte percentage before and after the treatment, and the average treatment time in both groups were compared, and the efficacy and bacterial clearance were evaluated. Results:Between the treatment group and the control group, the differences in C-reactive protein, blood leukocytes count and neutrophilic granulocyte precentage before and after the treatment had no statistical signifi-cance(P>0. 05). The effective rete of the treatment group was 86. 11%,and that of the control group was 88%(P>0. 05). The pos-itive detection rate of pathogenic bacteria was 75. 41%, in which Escherichia coli was the first pathogenic bacteria. The bacterial clear-ance in the treatment group was 85. 96%, which was higher than that (80%) in the control group(P>0. 05). Conclusion:The effi-cacy of piperacillin/tazobactam in the treatment of children with congenital megacolon enteritis is more obvious with promising safety.

Study on detection value of noninvasive cerebral hemodynamics and serum nerve function indexes in patients with craniocerebral injury / 国际检验医学杂志

Objective To study and investigate the detection value of noninvasive cerebral hemodynamics and serum nerve func‐tion indexes in the patients with craniocerebral injury .Methods Totally 64 patients with craniocerebral injury in our hospital from September 2013 to May 2015 were selected as the observation group ,meanwhile 64 healthy persons with the same age were selected as the control group .Then the noninvasive cerebral hemodynamics and serum nerve function indexes were compared between the two groups ,furthermore the detection results in the observation group were compared among the patients with different severity de‐grees and intracranial pressures .Results The middle cerebral artery blood flow indexes of the observation group were all higher than those of the control group ,the serum nerve function indexes were also higher than those of the control group ,and the middle cerebral artery blood flow indexes and serum nerve function indexes of the observation group had obvious differences among the pa‐tients with different severity degrees and intracranial pressures too (P< 0 .05) ,showing statistical significance .Conclusion The noninvasive cerebral hemodynamics and serum nerve function indexes have highe detection value in the patients with craniocerebral injury ,and have active clinical role for the understand of disease severity degree and intracranial pressure situation .

Influence and clinical significance of chemotherapy on angiogenesis in pediatric difficult removal solid tumor / 中华实用儿科临床杂志

Objective To explore the influence and clinical significance of chemotherapy on the expressions of micro-vessel density (MVD) and vascular endothelial growth factor (VEGF) in pediatric difficult removal solid tumor.Methods From Jan.2002 to Jan.2012,totally 80 cases of the hospitalized pediatric patients with solid tumor (Ⅲ b-Ⅳb stage) were enrolled in this study in Department of Pediatric Surgery of the Second Hospital of Hebei Medical University.All of the tumors were identified as difficult removal malignant tumor by imageology and physical examinations.After biopsy of the tumors,these patients were divided into neuroblastoma group (25 cases),hepatoblastoma group (25cases) and Wilms' tumor group (30 cases).All patients in these 3 groups underwent chemotherapy respectively according to their different pathologic findings,thereafter,the tumor resections were performed.The resection rates of tumor in each groups were recorded and the expressions of MVD and VEGF between preoperative biopsy and postoperative specimens were detected and compared by immunohistochemistry in different groups.Results With chemotherapy,the resection rate of neuroblastoma was 80.00％ (20/25 cases),hepatoblastoma was 92.00％ (23/25 cases) and Wilms' tumor was 96.67％ (29/30 cases).There was no significant difference among them (x2 =4.286,P =0.117).Before chemotherapy,the positive expressions of VEGF in neuroblastoma,hepatoblastoma and Wilms' tumor were 80.00％ (20/25 cases),90.00％ (18/20 cases) and 83.33％ (25/30 cases) respectively,at the same time,the values of MVD were 48.39 ± 15.87,52.16 ± 16.12 and 46.82 ± 19.07.After chemotherapy,the expressions of VEGF and MVD in neuroblastoma,hepatoblastoma and Wilms' tumor were 52.00％ (13/25 cases),45.00％ (9/20 cases),30.00％ (9/30 cases) and 31.31 ± 14.21,25.19 ± 15.31 and 29.06 ± 13.05.Compared with the expressions of them in each group before chemotherapy,significant differences were found (all P ＜ 0.05).Conclusions Chemotherapy can efficiently promote the resection rate for pediatric difficult removal solid tumor.MVD and VEGF can be considered as the markers in evaluating the outcomes of chemotherapy and promoting the resection rate of tumors.

Research advances on the pathogenesis of congenital biliary atresia / 中华肝胆外科杂志

Biliary atresia is the most common obstructive cholangiopathy in infants.Its etiology and pathogenesis still remains unclear.Hypothetical mechanisms include genetic predisposition,viral infection,chronic inflammation or autoimmune-mediated bile duct injury,and congenital malformations of vessels or biliary tracts.The key pathogenesis is related to viral infection and immunoreaction.This review overviewed the research progress in the pathogenesis of biliary atresia in the past few years.

Effector cells derived from naive T cells used in tumor immunotherapy of mice bearing B16 melanoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adoptive cell transfer (ACT) immunotherapy has been used clinically for years to treat malignancies. Improving the killing efficiency of effector cells, such as tumor-specific cytotoxic T lymphocytes (CTLs), is an important component for enhancing the clinical response of cancer immunotherapy. Hence, we explored a novel method for preparing cancer-specific CTLs using naive T lymphocytes.</p><p><b>METHODS</b>C57BL/6 mice bearing B16 melanoma tumors were pretreated with cyclophosphamide (CTX) by peritoneal injection. The immunosuppressive influence of CTX on tumor regression and the tumor microenvironment was assessed. Naive T cells and T cell pools were isolated via negative selection using immunomagnetic beads. The proliferative potential and cytokine production of different T cell subpopulations were evaluated in vitro. Tumor-specific CTLs derived from naive T cells (naive CD4+ T cells: naive CD8+ T cells = 2:1) and pooled T cells were generated in vitro, respectively. B16 melanoma-bearing C57BL/6 mice were pretreated with CTX, followed by ACT immunotherapy using dendritic cell-induced CTLs. The homing abilities of the effector cells and interleukin-2 (IL-2), interferon-γ, granzyme B, and perforin mRNA levels in tumor tissues were evaluated, and the change in tumor volume was measured.</p><p><b>RESULTS</b>Mice receiving CTX peritoneal pretreatment injections did not display tumor regression compared with control mice. However, a significant downregulation of splenic Tregs and tumor growth factor-β1 (TGF-β1) and interleukin-10 (IL-10) serum levels was observed (P < 0.05). Naive T cells showed a stronger proliferative capacity and elevated cytokine production than did pooled T cells (P < 0.05). In addition, effector cells generated from naive T cells displayed more potent antitumor activity in vivo than those derived from pooled T cells (P < 0.05).</p><p><b>CONCLUSION</b>Effector cells derived from the naive T cells possess a stronger proliferative potential, homing capacity, and enhanced cytokine production, which leads to a superior antitumor response.</p>

Laparoscopic surgery for complex choledochal cysts / 中华普通外科杂志

Objective To summarize our experience of laparoscopic surgery for complex choledochal cysts (type Ⅳ-A). Methods The clinical data of 65 children of choledochal cyst undergoing laparoscopic choledochal cyst resection were retrospectively reviewed from 2002 to 2009 in our institute.Among those type Ⅳ-A cyst was found in 16 patients. Hepaticojejunostomy was performed using a Roux-en-Y jejunal loop after extrahepatic cyst excision and ductoplasty. Results Laparoscopic procedures were successfully performed in 16 patients with type Ⅳ-A cysts. The stenotic segment was splited or excised and a wide hepaticojejunostomy was completed at the porta hepatis in 8 patients with a stricture extending to the level of common hepatic duct. The constrictive confluence of the bilateral hepatic duct was incised and the bi-ductal cystojejunostomy was achieved at the bifurcation in 4 cases. A septum was found at the orifice of right hepatic duct and was excised through the hilar stoma in 2 cases. A downstream stricture of the left hepatic duct was incised from the hilum to the dilated segment along the lateral wall in 2 patients, so that a long intrahepatic cystojejunostomy was completed in an oblique course. Postoperative complications developed in 2 cases including temporary bile leakage in one case and anastomotic stricture in another. The intrahepatic cysts were remarkably reduced in size during the follow-up. Conclusions With the magnified laparoscopic view, the radical resection of extrahepatic cyst and correction of the intrahepatic bile ductal stenosis can be easily performed. Laparoscopic hepaticojejunostomy and/or intrahepatic cystojejunostomy is effective and safe for children with type Ⅳ-A choledochal cysts.

Splenic vessels thread ligature in laparoscopic splenectomy / 中华普通外科杂志

Objective To study the anatomy of splenic hilum blood vessels in order to thread ligature(endoligature)instead of using stapler during the process of laparoscopic splenectomy and to evaluate the prelimnary clinical results.Methods 41 children patients underwent laparoscopic splenectomy with this technique(endoligature)for various hematologic and autoimmune disorders,including 25 cases of hereditary spherocytosis,13 idiopathic thrombocytopenia purpura,and 3 hypersplenic granulocytopenia.The anatomy of splenic pedicle,the adjacent relation between splenic vessel and pancreas were detected by color Doppler ultrasonography preoperatively.The above-mentioned parameters were compared with that found intraoperatively.Results The relationships of splenic vessel and pancreas was of type Ⅰ in 24 cases and type Ⅱ in 17.In 31 cases,the major splenic blood vessels were ramified into branches 2 cm away from the hilum and in 10 it was within 2 cm as detected by preoperative ultrasonography.These characters were largerly identified by laparoscopic laparotomy,and in all the 41 cases laparoscopic splenectomy was successfully accomplished using this endoligature instead of vasculature stapler.There was no serious complication.The mean operating time was(114 ±31)min,the estimated blood loss was(51 ±23)ml.Conclusions Ultrasonography could identify the anatomic type of splenic vessel,and its relation with the pancreas.Endoligature in the management of splenic pedicles during laparoscopic splenectomy is safe and reliable.

Pathogen Distribution and Drug Resistance of Nosocomial Infection Caused by S. aureus in Traditional Chinese Medical Hospital / 浙江中医药大学学报

[Objective] To investigate the antibiotic resistance and nosocomial infections status of Staphylococcus aureus(SAU)and provide scientific evidence for disease diagnosis and reasonable use of antibiotics.[Methods]The clinical isolates were identified by VITEK-2 compact.AST-GP61 was used to detect the antibiotic susceptibility.[Results] Among 310 S.aureus isolates,SAU was isolated from ICU and department of dermatology,from sputum/throat and secretion.The drug sensitivity rate to glycopeptide antibiotics and linezolid was 100%,the incidence of oxacillin-resistant S.aureus was 53.1%.[Conclusions] S.aureus showed multidrug resistance to the commonly used antibiotics,while curing infections caused by oxacillin-resistanct S.aureus,Vancomycin,teicoplanin and linezolid were the best choice.

Laparoscopic resection of massive splenomegaly for hereditary spherocytosis in children: Report of 7 cases / 中国微创外科杂志

Objective To explore the feasibility and t he efficacy of laparoscopic splenectomy of massive splenomegaly in the treatment o f hereditary spherocytosis in children. Methods Seven children with massive splenomegaly underwent laparoscopic splenectomy. Their age ranged 1~14 years (mean, 8.8 years), and their body weight was 10~57 kg (mean, 33.8 kg) . Three children had an accompanying cholelithiasis: 2 of them received a concom itant cholecystectomy and 1 of them, cholecystotomy. Results A ll the operations were successfully performed under laparoscope, and hand-assist ed splenectomy through a small incision was applied in 1 child because of bleedi ng of the splenic vein. The duration of operation was 50~150 min (mean, 90 min), the intraoperative blood loss was 30~500 ml (mean, 117 ml), and the length of h ospitalization, 4~10 d (mean, 5.5 d). The red blood cell counts had significantl y increased 3 days following the operation (t=2.652, P