Objective To evaluate the diagnosis and treatment of children′s appendicitis.Methods Retrospective analysis of 2390 children patients with appendicitis undergoing appendectomy, and pathological classification was made.Results The simple type was in 237 cases (9.91%); purulent in 1798 (75.23%), among which 568 (31.59%) cases suffered perforation; Gangrenous in 212 (8.87%), with perforation in 159 (71.36%).During this period, there were 192 cases (7.4%) of appandiceal abscess.The perforation rate was 30.12%.That was 41.46% in children under 1-year of age, 44.96% in 1 to 4-year of age; 28.17% in 5 to 10 year of age; and 20.94% in over 10-year of age.Conclusion The incidence of postoperative pathology-proved simple type appendicitis is in inverse proportion to that of perforation.As a whole it reflects the strictness in which an individual case is indicated for a laparotomy.It is our believe that an incidence of 30% perforation is acceptable.

Abstract Vanadium is widely used in the steel manufacturing, aerospace and medical industries because of its good plasticity and malleability, and is released into the environment in large quantities. Human were exposed mainly through environmental and occupational exposure. Vanadium and its compounds can cause multi-system damage to the reproductive, respiratory, neurological, and immune systems, and the toxic mechanisms may be related to oxidative stress, epigenetic damage, DNA damage and repair, apoptosis, and dysregulation of cell proliferation. This article summarizes the health hazards caused by vanadium exposure and its mechanism, providing the reference for the studies into the toxic effects of vanadium and its compounds.

Objective To explore main influencing factors of postgraduate entrance examination of medical students in medical universities and to provide guidance for postgraduate entrance examination and employment.Methods Totally 300 2008 and 2009 grade undergraduates of Kunming Medical University were enrolled and divided into postgraduate entrance examination group (n =181)and non postgraduate entrance examination group (n =97).Self-designed questionnaire was used.Intentions of postgraduate entrance examination of two groups and main factors of not taking postgraduate entrance examination were analyzed.Softwares of Excel 2003 and SPSS 17.0 were applied to do constituent ratio analysis and x2 test of gender and residence.Results Among all enrolled students,71.2％ paid attention to the entrance exam and 65.1％ said that they would take part in the entrance exam.There was no significant differences in taking entrance exam between males and females (x2 =3.213,P=0.073).Age (74.1％),family economic situation (71.1％) and current employment status (68.1％) were the main influencing factor of graduate entrance exam.There were significant differences between factors of age and family economic situation and factors of gender and census register (x2 =4.810,P =0.028 and x2 =9.612,P =0.002).There was no significant difference between factors of age and family economic situation and factor of current employment status (x2 =0.279,P =0.597).Conclusions Age,family economical situation and current employment situation are major influencing factors of postgraduate entrance examination for medical students.Postgraduate entrance examination for medical students needs positive guidance and more care from schools,society and family.Medical students should form correct view for employment and postgraduate entrance examination according to their own condition.

Objective To perform facial nerve monitoring in patients under the low level of neuromuscular blockade during resection of acoustic neurinomas.Methods Twenty-eight patients with large,or medium acoustic neuroma underwent the surgery of acoustic neurinomas resection. During the operation,TOF and EEG monitoring were performed in order to detect the degree of muscle relaxation and the depth of anesthesia. Neuromuscular relaxation was maintained at T_4/T_1=25%～50% by adjusting doses of muscle relaxant and aneasthetic. Free-run EMG and Triggered EMG of orbicularis oris, orbicularis oculi, masseter and trapezius were recordered to monitor the function of the facial, trigeminal and accessory nerves, respectively. The function of the facial nerve was evaluated at first week and half year postoperatively according to House-brackmann classification.Results The facial never was successfully identified and mapped by neurominitoring in all 28 patients. successfully, tThe electrical stimulation was 0.1 mA-0.3 mA and no any involuntary body movement was observed in all patients ne of patients have moved during operation. The preservation of the facial nerve function following surgery was good. Five patients had a HB grade I, 13 a HB grade II, 8 a grade III and 2 a HB grade IV The facial nerve function was HB Grade Ⅰin 5 of 28 patients, HB GradeⅡ in 13, HB Grade Ⅲ in 8 and HB Grade Ⅳ in 2 immediately after operation. Six months after surgery, 10 casespatents showed demonstrated a HB GradeⅠof facial never function, 12 cases exhibited a slight palsy (HB Grade II) , and 5 cases exhibited a HB Grade III palsy and . Another 1 cases a exhibited severe palsy (HB Grade IV).Conclusions Facial nerve monitoring in patients under the low level of neuromuscular blockade can ensure the surgical safety and preserve the facial never function.

Objective To establish a new method for quantitating leukocyte fragments (LFs) in apheresis platelet concentrates (AP-PCs) by using real-time quantitative polymerase chain reaction (RQ-PCR) and flow cytometry(FCM) and discuss the factors influencing LFs concentrations such as storage time, filtration and PLT concentration. Methods 67 qualified donors were selected. Each of them donated one therapeutic dose of AP-PCs. AP-PCs samples were collected as soon as possible and divided into si xfractions. One was analyzed by hematology analyzer. For the Others, DNA was extracted under differen tconditions (filtrated or unfiltrated, before or after centrifugation) at 4 hours, 24 hours, 48 hours, 72 hours, 96 hours after blood draw, respectively. Then the amounts of albumin gene of the AP-PCs and the cell-free DNA in supematant were quantitatively determined using RQ-PCR and the results were calculated into leukocytes equivalent(WBCs/μl). Intact leucocytes were counted by FCM. The concentrations of LFs were calculated by subtracting cell-frce DNA and intact leucocytes from the total DNA amount. Then the differences of LFs concentrations among groups with different storage time were compared and the differences of LFs concentrations between unfihrated and filtrated groups were also compared. After grouping all the AP-PCs according to their PLT concentrations, LFs contents of AP-PCs before filtration among groups were compared. Meanwhile, bivariate correlation analysis between PLT concentrations and LFs contents was carried out. ResultsLFs contents of all the AP-PCs samples were quantitated successfully.The concentrations of LFs in AP-PCs before filtration in 4 hours,24 hours,48 hours,72 hours , 96 houres after blood draw were(31.4±17. 6), (47.5±25.3), (100.7±53.5), (89.5 ±47.2) and (16.1±7.8) WBCs/μl ; After filtration the results were (16. 9±8. 7), (24. 3 ± 12. 2), (83. 1±42. 6), (78.2 ±40. 2) and (13.6 ± 6. 6) WBCs/μl respectively. There were statistically significant differences among groups of different storage time (Fwithin subjects = 472. 756,P < 0.01). The concentrations of LFs kept on increasing within 48 hours after collections, and then decreased gradually. The peaks appeared between 48 hours and 72 hours after collections. The differences of LFs contents between unfiltered and filtered AP-PCs in 4 hours, 24 hours, 48 hours, 72 hours, 96 hours after collections were 14. 5, 23. 2, 17. 6, 11.3 and 2. 5 WBCs/μl, respectively.There was statistically significant difference between unfiltered and filtered samples (Fbetween subjects=9. 216,P < 0. 05). The differences were considerable within 48 hours, and then declined gradually. The results of bivariate correlation analysis showed that there were no statistically significant correlation between PLT concentrations and LFs contents (at 4, 24, 48, 72, 96 hours after collections the correlation coefficients rs were -0.002, 0.015, 0.027, 0.042 and 0. 037,respectively,P2-tailed>0.05). ConclusionsRQ-PCR and FCM can be used to quantitate LFs in AP-PCs. The concentration of LFs in AP-PCs is influenced by storage time and filtration, but it is not affected by PLT concentration.

ObjectiveToanalyzetheclinicalandimagingcharacteristicsinpatientswithcarotidsteal syndrome ( CSS ) and to investigate its compensatory pathw ays, diagnosis, and treatment. Methods The medical history and imaging data of the patients with CSS were colected. Their vascular lesions, colateral circulation, treatment, and prognosis w ere analyzed. Results A total of 11 patients w ith CSS (8 males and 3 females, mean age 66.7 ±5.1 years) were enroled in the study. Their clinical manifestations were posterior circulation transient ischemic attack (TIA) ( n=9, 81.8%), posterior circulation infarction ( n=1, 9.1%), and anterior circulation TIA ( n=1, 9.1%). A total of 19 pathological arteries w ere found:12 (63.1%) w ith occlusion, 2 (10.5%) w ith subtotal occlusion, 4 (21.0%) w ith severe stenosis and 1 (5.2%) w ith artery dissection. Seven patients (63.6%) w ere bilateral internal carotid artery lesions, 3 (27.2%) w ere unilateral bilateral internal carotid artery lesions, and 1 (9.1%) w as bilateral common carotid artery occlusion. Eleven patients had primary col ateral circulation, including posterior communicating artery patency in 10 patients (90.9%) and anterior communicating artery patency in 1 patient (9.1%). Four patients (36.3%) had secondary col ateral circulation and 1 (9.1%) had tertiary col ateral circulation. Al patients w ere treated w ith medication on the basis of the management of risk factors. Three patients w ere treated w ith stenting and tw o were treated with carotid endarterectomy. No stroke occurred in al patients during folow -up til September 2014. Conclusions The vascular lesions of patients w ith CSS often occur in the extracranial segment of internal carotid artery. Usual y the compensatory blood is through the circle of Wil is. The presentation is ischemia in the stolen arteries. Its diagnosis needs to be examined by digital subtraction angiography. On the basis of medication therapy, some patients may be treated w ith surgery or endovascular intervention.

Objective To investigate the effectiveness of bone marrow mesenchymal stem cell (MSC) and different transplantation methods of MSC on adriamycin (ADR) model of nephropathy in rats. Methods The ADR model of nephrop-athy was induced by left nephrectomy plus injection of ADR (2.5 mg/kg) in Sprague-Dawley (SD) rats, once a week for two weeks. The model rats with nephropathy were randomly divided into three groups: adriamycin nephropathic model control group (ADR, n=12), MSCs transplantation through right renal artery group (M-A, n=12) and MSCs transplantation through peripheral veins group (M-V, n=12). Another 12 SD rats were served as normal controls (N, n=12). MSCs were cultured, transplanted via right renal artery (2×106/mL) to rats in M-A group, and were transplanted via peripheral veins 2×106/mL) to rats in M-V group. The same procedure was repeated in two weeks. The blood urea nitrogen, serum creatinine, 24 h urine protein and 24 h uromicroprotein were detected before transplantation and in one and two weeks after the second transplanta-tion. The renal morphology and labeled cells were examined in the kidney one week after the second transplantation. Results The values of blood urea nitrogen, serum creatinine, 24 h urine protein and 24 h uromicroprotein were significant-ly higher in M-A group, M-V group and ADR group than those of N group (P<0.01). The level of 24 h uromicroprotein was significantly lower before the second transplantation in M-A group than that of ADR group (P<0.01). The serum level of cre-atinine was significantly decreased in M-A group than that of ADR group and M-V group (P<0.01). The levels of 24 h urine protein and 24 h uromicroprotein were significantly lower after one week transplantation in M-A group than those of M-V group (P<0.01). The serum level of creatinine was significantly lower two weeks after the second transplantation in M-A group than that of ADR group and M-V group (P<0.01), but no significant differences in the levels of urine protein and uro-microprotein between M-A group and M-V group. Conclusion Transplantation of MSCs can alleviate renal damage of chronic ADR-induced nephropathy, which is more effective in rats with MSCs transplantation via renal artery than that in rats with MSCs transplantation via peripheral vein.

Objective:To investigate the expression and its possible role of Oct4B1 subtype of Embryonic stem cell transcription factor Oct4 in colorectal cancer stem cells. Methods: 3D microspheres were cultured by suspension culture to human colorectal cancer cell line SW480 cells. The 3D microspheres and SW480 cells were used as the research objects. Whether 3D microspheres were enriched cancer stem cells,we used the methods of cell differentiation experiments,soft agar cloning experiments,and the expression levels of cancer stem cells markers CD133,CD44 detected by flow cytometry. The expression levels of Oct4B1 mRNA were detected by RT-qPCR. Results:3D microspheres could differentiate into normal cancer cells. Compared with the parental SW480 cells,in vitro colony formation was significantly enhanced(P<0. 01),the percentage of positive cells of CD133 and CD44 were significantly increased ( P < 0. 01 ), the expression levels of Oct4B1 mRNA were obviously higher ( P < 0. 01 ) in 3D microspheres. Conclusion: Oct4B1 subtype of Embryonic stem cell transcription factor Oct4 in 3D microspheres enriched human colorectal cancer stem cells,which may be involved in the regulation of colorectal cancer stem cells.

Objective To evaluate the embolic effect on rabbits arteries using self-made copper plated platinum coil.Methods 1 7 New Zealand Big Ear Rabbits were selected.Unilateral subclavian artery or carotid artery was embolized with self-made secondary level copper plated platinum micro-coils (experimental group)through 3F-catheter.Contralateral subclavian artery or carotid artery was also embolized using secondary level platinum micro-coils (control group)as a control.The level of serum copper ions and the liver and renal function were recorded during different intervals before and after embolization.The arteriography and the tissue his-tology were observed respectively during different intervals after the embolization.Results 1 5 of 1 7 rabbits were embolized success-fully.After embolization,the level of serum copper ions increased in 2 weeks(P <0.05).However,it returned to preoperative level after 4 weeks (P >0.05).The liver and renal function was similar to that of the preoperation after 2 weeks.After embolization,an-giography showed that vascular embolization effect between two groups was not significantly different at 10 min and 30 min;howev-er,the embolization effect of experimental group was superior to that of control one (P <0.01)at 3 days and 1 week,2 weeks,4 weeks,6 weeks and 12 weeks.Pathological results showed that there were a lot of thromboses inside,outside and around the copper coil.Few thromboses appeared around platinum coil in control group.The thrombosis situation in experiment group was better than that in control one (P <0.01).However,no significant difference in inflammatory cell infiltration between two groups was found. Conclusion Self-made secondary level copper plated platinum coil has good physical property,rememorability,flexibility and con-trollability.

OBJECTIVE: To figure out the etiological factors and overall mortality of the patients with acute intestinal obstruction, and to explore the rational period of conservative therapy before operation. METHODS: Medical records of all the patients with acute intestinal obstruction admitted to West China Hospital from 1995 to 2002 were retrospectively reviewed. The etiology of the obstruction was categorized, and the correlation of mortality and time interval between conservative therapy and operation was analyzed. RESULTS: There were 705 patients with acute intestinal obstruction included. There were 71.1% of the obstruction lesions located on the small bowel, and 82.6% of the patients experienced simple obstruction. The most frequent cause was adhesions (62.0%), and next was neoplasms (23.7%). There were 57.6% of the patients underwent the surgical treatment. The overall mortality rate was 1.6%, and the mortality rates in conservative therapy and surgical intervention groups were 1.3% and 1.7% respectively. The intestinal necrosis rate was increased gradually with the prolongation of time interval between conservative therapy and operation, and the death might occur 24 hours after strangulation. CONCLUSION: The epidemiological transition to adhesive obstruction still exists in China, and it is similar to that in Western countries. In our experience, near half of the patients with simple obstruction may achieve palliation by conservative therapy. Surgical intervention is indicated for the patients with prolonged and non-palliated simple obstruction, or strangulation disease within the first 24 hours.