Objective To compare laparoscopic appendectomy (LA) with open appendectomy (OA) in the treatment of appendicitis complicating gangrene,perforation and abscess in children.Methods This study included 614 consecutively admitted patients with acute complicated appendicitis undergoing laparoscopic (267 cases) or open (347 cases) appendectomy.Clinical outcomes were compared between the 2 groups in relation to operative time,length of hospital stay,postoperative complications and in hospital cost. Results There was no mortality.Conversion to open surgery was necessary in 7 patients in LA group.Laparoscopic appendectomy was associated with a shorter hospital stay (4.6 d vs.8.1 d,P =0.00),lower incidence of wound infection(5.3％ vs.12.8％,P =0.03),less bowel obstruction(5.0％vs.10.0％,P =0.04) and nosocomial infection (9.7％ vs.18.3％,P =0.04).Intra-abdominal abscess formation was significantly higher after laparoscopic surgery (4.1％ vs.1.1％,P =0.04 ).The cost of treatment and operative time were higher in the laparoscopic group than in open appendectomy,however,there was no statistically significant difference. Conclusions Laparoscopic technique is a safe and clinically beneficial operative procedure for complicated appendicitis in children with short hospital stay,early recovery,good cosmetic appearance,and low complication rate,except for a higher incidence of intraabdominal abscess.

Bone marrow stromal stem cells have been used in cartilage tissue engineering for nearly 20 years. This has been a key focus in stem cell research. This article serves to review application, progress and facing problems of bone marrow mesenchymal stem cells (BMSCs) in cartilage tissue engineering by retrieving publications. With the development of molecular biology, biomaterial, computer and nano-biotechnology, tissue-engineered cartilage constructed with BMSCs as seed cells combined with biomaterial stent has a widely application perspective in repairing articular cartilage defect.

BACKGROUND: To understand mechanism, biological property and morphological component of nanometer bone material and discuss present status and applied prospect.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify articles about mechanism, biological property and morphological component of nanometer bone material in English from January 1966 to February 2006, and the key works were novel bioactive materials and bone tissue engineering; meanwhile, Chinese relevant articles were retrieved in Chinese in Tsinghua database from January 2001 toOctober 2004, and the key words were nanometer bone and clinical application.STUDY SELECTION: Articles in disposal group and control group were retrieved firstly. Those obviously non-random and repetitive researches were excluded. Full text of the rest articles was looked up finally.DATA EXTRACTION: Tlere were 124 articles about mechanism, biological property and morphological component of nanometer bone material. Among them, 27 experiments or clinical researches were included.DATA SYNTHESIS: Nanometer bone has favorable conductibility and induction of bone; meanwhile, it is characterized by human-like grading structure and multi-well structure of rangu, favorable biocompatibility and stable biodegradation.Nanometer bone material also can be used in confluence of vertebral body, the buccal surgery fields, the gene therapy of uncompleted osteogenesis, rheumatic arthritis (RA) and malignant tumor. Nanometer bone material is tendency to perfection through improvement of technology.CONCLUSION: Nanometer bone material with many particular properties overcomes many difficulties and achieves a satisfactory effect at clinical pilot phase.

OBJECTIVE: The interrelationship between various growth factors and chondrocytic regeneration has drawn the attentions of scholars and the study on growth factors and repair of articular cartilage defects has been carried on to summarize the latest progression of transforming growth factor-β (TGF-β) in articular cartilage repair so as to provide theoretical evidence for its application in cartilage histoengineering.DATA SOURCES: The relevant papers about studies on mechanism and types of articular cartilage injury, TGF-β and interrelationship between TGF-β and articular cartilage repair were looked up on http:∥www.ncbi.nlm. nih.gov/PubMed from January 1995 to December 2004. The retrieval words were "TGF-β, articular cartilage" limited only in English version.The relevant papers about studies on TGF-β and articular cartilage repair were also looked up on http:∥www.zglckf. com and linked database from January 1999 to December 2004, with the retrieval words of "TGF-β, articular cartilage" limited only in English version.STUDY SELECTION: During the initial evaluation of data and after looking up the quotation of each paper, the inclusive criteria were determined as follows: the paper should be relevant with TGF-β repair of articular cartilage injury; and the exclusive criteria: repeated research and Meta analysis papers. The papers that had not been excluded applied randomized design, control and blind comparison.DATA EXTRACTION: Altogether 95 papers were collected on TGF-βand TGF-β repair of articular cartilage injury, of which, 15 papers were in conformity of inclusive criteria, 56 papers were excluded due to dated research and 24 papers were due to repeated research. Of 15 papers, 3 papers were on the mechanism and types of articular cartilage injury, 6 papers were on biological function of TGF-β and 6 papers were on TGF-βand TGF-β repair of articular cartilage injury.pact, cut, torsion and friction, which is beyond the physiological endurance of articular cartilage. Articular cartilage defects are divided into defects of partial thickness and entire layer of cartilage. The auto-repair growth factor with various functions, which is produced by either autocrine or paracrine. It starts transmitting information by integrating with lagen and stromatin by irritating osteocytes and chondrocytes to form rapidly extracellular matrix so as to promote repair of bone and cartilage injury.CONCLUSION: TGF-β plays the importance in histoengineering repair of articular cartilage injury. By bringing induction of cartilage into play,TGF-β promotes differentiation of stem cells into cartilage or enhances specific matrix synthesis of cartilage, such as collagen Ⅱ and proteoglycan. Due to the limitation of various repair methods of cartilage defects at present, being a cell factor with good cartilage induction, TGF-βwill present extensive prospects in the application of cartilage histoengineering.

With the development of minimally invasive surgery,great developments have been made in laparoscopie techniques and digestive endoscopy.However,laparoscopy may cause injury by abdominal puncture,and digestive endoscopy is a painful examination for patients and is difficult to localize the tumor.Magnetic anchor makes use of magnetic attraction in positioning,and it improves laparoscopy and endoscopy by external magnetic field or magnetic handle.Nowadays,combined application of magnetic anchor and laparoscope and endoscope in the treatment of digestive diseases has been accepted by many medical centers,and further researches need to be carried out to realize the aim(small trauma,little pain and quick recovery)of minimally invasive surgery.

Male genital lichen sclerosus (MGLSc) is a chronically relapsing disease characterized by a long course, gradual aggravation, and a tendency towards malignancy. Once called balanitis xerotica obliterans, MGLSc has a distinct predilection for the prepuce and glans, involving the urethra when aggravating, forming scarring tissues, and causing urethral stricture, which may seriously affect the patients'quality of life with such symptoms as urinary stream narrowing, dysuria, and painful penile erection. The etiology and pathogenesis of MGLSc have not yet been adequately explained though it is generally thought to be associated with autoimmune mechanism, genetic factors, infections, local trauma, and chronic urinary irritation. MGLSc can be fairly easily diagnosed according to its clinical manifestations and histopathological results, but can be hardly cured. Early diagnosis and prompt treatment are the most important approaches, which may relieve its symptoms, check its progression, and prevent its long-term sequelae. Ultrapotent topical corticosteroids are the choice for the treatment of MGLSc. For those who fail to respond to expectant medication or have dysuria due to urethral stricture and painful erection, rational surgery may be resorted to, with importance attached to long-term follow-up. This article presents an update of the diagnosis and treatment of MGLSc and MGLSc-induced urethral stricture.
Genital Diseases, Male ; diagnosis ; etiology ; therapy ; Humans ; Lichen Sclerosus et Atrophicus ; complications ; diagnosis ; therapy ; Male ; Urethral Stricture ; etiology

AIM: To study the possible role of nitric oxide (NO) in the development of periodontitis and the relationship between the NO concentration and the attachment loss. METHODS: Seventy- two Sprngue- Dawley rats were randomly assigned to two groups, the control group and periodontitis group. Experimental periodontitis in rats was produced by a ligature of braided silk. The nitric oxide concentration was indirectly ascertained by the concentration of nitrite (NO2-) and nitrate (NO3-)in the gingival tissue, which was assayed by spectrophotometry. The attachment loss (AL) was measured by the technology of the cellular graphics engineering research. The histopathologic change in periodontium was observed under a light microscope by using the histotomy. RESULTS: Compared to control group, the NO2-/NO3 - concentration in gingival tissue was significantly higher in periodontitis group at four weeks and eight weeks following ligation (P＜0.01). In periodontitis group, the NO2-/NO3 - concentration in gingival tissue was higher at eight weeks than that at four weeks following ligation (P＜0.01). At four weeks and eight weeks, the AL in experimental periodontitis in rats was significantly increased than that at one week after ligation ( P＜0.01); and the AL was also much higher at eight weeks than that at four weeks (P＜0.01). CONCLUSIONS: The NO2-/NO3- concentration in the gingival tissue in periodontitis group was significantly higher than that in control group. These results demonstrate that the NO2-/NO3- concentration is related to the severity of AL, and NO synthesis is very important to the process of inflammation and lesion in periodontium. Reducing NO production may be of great therapeutic value in the treatment of periodontitis.

Objective To compare the effectiveness and safety of radiofrenquency ablation(RFA) with other therapeutic methods for patients with early hepatocelluar carcinoma(HCC). Methods Randomized clinical trials(RCTs)which compared the efficacy or safety of RFA with other therapeutic methods for primary hepatocellular carcinoma in Cochrane library,EMBASE,PubMed,OVID and CBM were searched.Trials were considered of high quality if methodological quality score was 3 or more according to Jadad standard.Statistical heterogeneity between trials was evaluated bv STATA 9.0 and considered to exist when P＜0.1.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Sensitivity analysis was performed and publication bias was investigated through visual inspection of funnel plots and Egger regression model.Results Six RCTs including 862 cases were analyzed.As compared with other therapeutic approaches,RFA significandy increased 3-year overall survival rate and reduced local recurrence rate of early hepatocelluar carcinoma:the total OR were 2.06(95%CI being 1.54-2.77,P=0.000)and 0.40(95%CI being 0.28-0.57,P=0.000)respectively.As compared with other therapeutic approaches,the total OR of new HCC recurrence rates,extrahepatic metastasis rate and major complications in patients with HCC treated with RFA were 0.92 (95%CI being 0.68-1.24),0.98(95%CI being 0.30-3.22),1.35(95%CI being 0.49-3.77)respectively,showing no significant differences(P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias(P=0.670,0.160,0.884,0.087,0.317,respectively,by Egger regression model).Conclusions RFA is superior to other treatment methods with respect to local recurrence and 3 year overall survival in early HCC and is the preferred tberapeutic method for small HCC because it is minimally invasive,simple and convenient.

Objective Diagnosis of contrast-enhanced ultrasound ( CEUS) for small focal liver lesions under the background of hepatocirrhosis has been a difficult problem in clinical practice .CEUS has significantly improved the accuracy of liver cancer diagno-sis, but little research has been done in minimal lesions .The article was to investigate the diagnostic value of CEUS in liver cirrhosis with small focal liver lesions (≤2 cm) . Methods 70 patients with cirrhosis and 76 small focal hepatic lesions who were admitted in our hospital from March 2015 to August 2015 were examined by conventional ultrasound and CEUS .Comparative analysis was made be-tween the results of tests and pathology to calculate the sensitivity , specificity and accuracy of CEUS and conventional ultrasound . Results The sensitivity , specificity and accuracy in diagnosing small hepatic cancer lesions complicated with cirrhosis by CEUS and conventional ultrasound were 47.6%、79.4%、61.8%and97.6%、97.1%、97.4%,respectively.CEUS was in high consistence with the results of pathology ( Kappa 0.947) and significantly higher than those of conventional ultrasound (Kappa 0.259). Conclusion CEUS has high application value in the differential diagnosis of small focal he-patic lesions complicated with cirrhosis .

Objective To investigate the effect of butylphthalide and sodium chloride injection postconditioning on focal cerebral ischemia-reperfusion (I/R) injury and endoplasmic reticulum stress in rats.Methods Thirty-six male SPF Sprague-Dawley rats,aged 2-3 months,weighing 260-280 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),focal cerebral I/R group (group I/R) and butylphthalide and sodium chloride injection postconditioning group (group Buty).The animals were anesthetized with intraperitoneal 10 ％ chloral hydrate 300 mg/kg.Focal cerebral I/R was induced by occluding right middle cerebral artery for 2 h followed by 24 h reperfusion in I/R and Buty groups.Butylphthalide and sodium chloride injection 2.5 mg/kg was injected via the tail vein immediately after onset of reperfusion in Buty group,while the equal volume of normal saline was injected in I/R group.Neurological deficits were assessed and scored at 24 h of reperfusion,and then the brain was isolated for detection of neuronal apoptosis (by TUNEL) and the expression of glucose-regulated protein 78 (GRP78) and caspase-12 in ischemic cerebral cortex (by immunohistochemistry) in brain tissues.Apoptosis index was calculated.Results Compared with group S,the neurological deficit scores and apoptosis index were significantly increased,and the expression of GRP78 and caspase-12 was up-regulated in I/R and Buty groups (P ＜ 0.05 or 0.01).Compared with group I/R,the neurological deficit scores and apoptosis index were significantly decreased,the expression of GRP78 was up-regulated,and the expression of caspase-12 was down-regulated in group Buty (P ＜ 0.05).Conclusion Butylphthalide and sodium chloride injection postconditioning can reduce focal cerebral I/R injury in rats,and inhibition of endoplasmic reticulum stressmediated cell apoptosis is involved in the mechanism.