applied to replace each single-band section of the conventional branch-line coupler. The proposed multiband transmission line consists of Pi-type line with open-and short-ended stubs. The Pi-type line supports the dual-band operation at first two working frequencies, while the open-and short-ended stubs are tapped at the center of the Pi-type line to realize the operation at the third working frequency. To prove the design concept, a multiband branch-line coupler operating at 1/2.5/4.5GHz is designed and tested. Both the simulated and measured results have verified the design theory.

BackgroundSeveral types of congenital lesions can cause complete or incomplete obstruction of the intestine. Our purpose is to present 3 neonates with dual intestinal type I atresia, i.e., simultaneous obstructive lesions at 2 locations in which the atresia manifested as diaphragm-like tissue.Case presentationAll 3 cases were female infants ranging in age from 2 to 14 months. The common symptom in all cases was intermittent persistent vomiting. In some cases the vomitus was bilious, and other symptoms included abdominal distention and delayed meconium passage. Prior surgeries at another hospital were unsuccessful at relieving the symptoms in one case. One case had dual lesions in the colon, one dual lesions in the duodenum, and one atresia at both the distal portion of the ileum and the descending colon. Surgical exploration and removal of the lesions at our hospital was successful in all cases, and the infants were discharged in good condition.ConclusionsType I atresia can manifest as a diaphragm-like tissue obstructing the continuity of gastrointestinal tract, and in rare cases multiple areas may be present. Base on the intermittent nature of the associated symptoms, diagnosis can be difficult and is often delayed. Physicians should be aware of this condition during the work-up of an infant with persistent intermittent vomiting.

BackgroundPostoperative cholangitis is a common but severe complication after Kasai portoenterostomy for biliary atresia (BA). This study aimed to identify its prognostic factors.MethodsTwo sets of liver paraffin-embedded tissue samples were collected from BA patients who received Kasai portoenterostomy (n = 25 and n = 31, respectively). Patients were divided into non-cholangitis and cholangitis groups. The infiltration of CD4+, CD8+, CD45RO+, CD68+ cells and expression of Beclin1 were quantitatively evaluated in immunohistochemical analysis.ResultsCholangitis group had a significantly lower CD8+ T cell infiltration but a higher CD45RO+ cell infiltration, and a lower Beclin1 level than non-cholangitis group (all P < 0.01). Multivariate logistic regression analysis indicated that infiltration of CD8+ cells (odds ratio [OR], 0.112; 95% confidence interval [CI], 0.022–0.577) and CD45RO+ cells (OR, 3.88; 95% CI, 1.37–11.03), and Beclin1 level (OR, 0.088; 95% CI, 0.018–0.452) were independent influence factors for early postoperative cholangitis. Receiver operating characteristic (ROC) analysis showed that area under ROC curve (AUROC) values for CD8+ cells, CD45RO+ cells and Beclin1 were 0.857, 0.738 and 0.900, respectively.ConclusionOur findings demonstrated the CD8+ cells, CD45RO+ cells and Beclin1 level possessed the prognostic value for early postoperative cholangitis following Kasai operation, which may be helpful to develop new prevention and treatment strategies for postoperative cholangitis.

A 3.5-month-old boy was hospitalized because of an abdominal mass found accidentally. On physical examination, a smooth, firm, nontender mass was present in the right upper quadrant. Abdominal ultrasonography revealed a large, hyperechoic, heterogenous mass with clear boundaries, and scarce blood flow. Abdominal CT scan showed a bulky right retroperitoneal mass. Three-dimensional CT imaging demonstrated spine, iliac bone, and long bones of limbs. The mass was excised successfully. After opening the sac it was noted to contain an incompletely developed fetus with grossly visible limbs, clearly discernible male genitalia, hairs, and a poorly formed head. The fetus was connected to the sac via an 8 cm cord-like structure. Microscopic examination of the mass revealed the presence of skin, cartilage, bone, intestine, and cysts with simple cuboidal epithelium. The use of CT scans enhanced the accuracy of pre-operative diagnosis. Identification of the vertebral column and the long bones of limbs are important indications for the diagnosis. Pathologically, fetus in fetu has many characteristics different from teratoma.

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