Abdominal pain is a common presentation to the family physician clinic and emergency departments and although common, it is often a symptom of serious disease, with many diagnostic challenges that the physician has to overcome. The missed surgical abdomen often results in high morbidity and mortality to the patient, and high medico-legal risk to physicians. In certain patient groups, such as the elderly, the women of childbearing age and the immunocompromised, presentation of abdominal pain can be atypical, and hence additional caution and consideration should be taken. In order to mitigate risk in the challenging primary healthcare environment that the primary physician faces where investigative resources can be limited, a careful diagnostic approach with regards to history taking and physical examination is used, coupled with good documentation of findings and patient discussion.

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Lobular ; metabolism ; pathology ; surgery ; Female ; Histiocytoma, Malignant Fibrous ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Middle Aged ; Receptors, Progesterone ; metabolism ; Retroperitoneal Neoplasms ; metabolism ; pathology ; surgery

ObjectiveTo explore a procedure to correct the multiple facial deformities by using the expanded frontal flap combined with the axial flaps.MethodsAccording to the face deformity we used the rectangle 100-350 ml expanders behind the frontal hairline,after finishing the tissue expanding,adopted two or three axial flaps based on the supraoribital,supratrochlear or temporal vessels. ResultsA total of 13 cases were treated with this approach.7 eases were nose and lip defect reconstruction after burn,in which temporal vessel-based flap was used in 2 cases and supraoribital or supratrochlear vessel-based flaps in 5 cases.The other 6 cases were nasal reconstruction combined with the frontal defect correction by using random flaps,including 2 cases of pigmented nevus,1 neurofibroma,and 3 burn scars.All the flaps survived and satisfactory appearance was obtained.Conclusions The expanded frontal flap combined with axial flap based on multiple vessels is a good approach to correct the multiple facial deformities.

Objective:To explore the possible specific perinatal risk factors in the development of autism through comparing the perinatal risk factors between patients with autism and other psychotic disorders.Methods: In this retrospective research,197 cases with autism and 93 cases with other psychotic disorders were selected and assessed with the self-made scale of perinatal risk factors.Statistical analyses were performed using t test and Chi-square test.Results:Compared with the control group,the autistic subjects had a significantly higher frequency of the perinatal risk factors(51 % vs.68%,P=0.003),particularly the rate of catching a cold during their mothers' pregnancy(14.2% vs.6.5%,P=0.038)and the rate of prematurity(10.7% vs.3.2%,P=0.022)than the control subjects.Feeding methods was different between the two groups(P=0.038).Conclusion:Catching a cold during mothers' pregnancy,prematurity and feeding methods may be related to the development of autism.

OBJECTIVE:To establish an LC-MS method for determination of picamilon in human plasma. METHODS:Picamilon and repaglinide(as internal standard)were separated on Agilent C18 column,using methanol-water(85 ∶ 15) as the mobile phase at a flow rate of 0.2 mL?min-1. Column temperature was set at 20 ℃. SIM was used for determination of picamilon in human plasma.Ion mass spectral(m/z) of 207.0→121.1 was selected for picamilon and 451.3→379.2 for repaglinide.RESULTS:The linear range was 50～10 000 ?g?L-1(r=0.999 1); the method recovery was within 99.14%～104.27%. The RSD of inter-day and intra-day validation were 2.12%～5.94% and 7.30%～8.44%,respectively. CONCLUSION:The method is sensitive and accurate for the determination of picamilon in human plasma and its pharmacokinetic study.

[Objective]To estimate the clinical effects of total hip arthroplasty(THA),bipolar and unipolar hemiarthroplasty for the treatment of femoral neck fractures(FNF) in the elderly.[Method]From February 1990 to February 2005,a follow-up study was done in 567 patients with femoral neck fractures in the elderly.The patients were divided into THA(n=275),bipolar hemiarthroplasty(n=195) and unipolar hemiarthroplasty(n=97) groups.The follow-up duration was from 3 to 15 years with an average of 8.5 years.The operation time,blood loss,volume of drainage,hospitalization time,complications and functional rehabilitation were compared.[Result]There were no statistical differences in the operation time,blood loss and volume of drainage between unipolar and bipolar hemiarthroplasty groups.There were no statistical differences in hospitalization time among the three groups.Compared with bipolar hemiarthroplasty,THR had a longer operation time and more blood loss,but had a higher functional scores and a lower rate of pain.Unipolar hemiarthroplasty had a lower functional scores and a higher rate of pain.[Conclusion]THR is especially suitable for those who are younger and active,bipolar hemiarthroplasty is suited to elderly patients,unipolar hemi-arthroplasty should be avoided because of its complications.

To observe the protective effect of lidocaine on acute lung injury(ALI) following intestinal ischemia/reperfusion(I/R). Adult SD rats were randomly divided into 4 groups ( n =8): control group, with super mesenteric artery isolation only; I/R group, intestinal I/R (60/180min); two lidocaine treated groups, in which lidocaine in a dose of 2mg/kg was administered intravenously immediately or 60min after reperfusion, respectively. Intestinal I/R resulted in deterioration of MAP, increased the lung permeability index, serum TNF ?level and lung TNF ?mRNA expression ,and produced histopathological changes in the lung. Lidocaine given immediately after reperfusion could attenuate these changes, while lidocaine 60min group showed no effects on the changes in MAP, serum TNF ? and pathological changes in the lung. These data suggested that lidocaine could attenuate lung injury following intestinal I/R,in part by inhibiting the sequestration of neutrophils and the production of TNF ?. Lidocaine given early after reperfusion seemed to be more effective .

Objective To design and construct the vector of protein-rich tyrosine kinase 2 small RNA interference and investigate the effect of the recombinant plasmid on the proliferation of adult rat cardiac fibroblasts. Methods The pAVU6+27-PYK_2 siRNA expression vector was constructed by gene recombination, then transfected into the cultured adult rat cardiac fibroblasts by DOTAP method. PYK_2 mRNA and protein in cardiac fibroblasts were determined by RT-PCR and Western blotting respectively. Cell proliferation was tested by MTT and ~3H-TdR incorporation. Results The pAVU6+27-PYK_2 siRNA expression vector was successfully constructed. The recombinant plasmid can inhibit the proliferation of adult rat cardiac fibroblasts, as compared with control. Conclusion pAVU6+27-PYK_2 siRNA expression vector is efficient to suppress DNA synthesis of cardiac fibroblasts, which will be beneficial to further study of myocardial fibrosis.

Objective To study the influence of perdipine on the proliferation and proline-rich tyrosine kinase 2 (PYK_ 2 ) expression in cultured adult rat cardiac fibroblast stimulated by angiotensin Ⅱ, and to explore the mechanism of perdipine on cardiac fibrosis. Methods Adult rat cardiac fibroblasts (CFs) were treated with angiotensin Ⅱ(AngⅡ) to establish fibrosis model. The effects of perdipine on proliferation of CFs were analysed by MTT colorimetric assay, and fibronectin was tested by immunohistochemistry method. PYK_ 2 mRNA and protein level were examined by RT-PCR and Western blot analysis respectively. Results Perdipine inhibited CFs proliferation and fibronectin synthesis stimulated by angiotensin Ⅱ in a dose dependent, and the levels of PYK_2 mRNA and protein were decreased significantly. Conclusion Perdipine can inhibit cardiac fibrosis stimulated by angiotensin Ⅱ by suppressing CFs proliferation and fibronectin synthesis. PYK_2 is involved in the effect of perdipine.