The clinical data of 275 appendix shistosomasis cases complicated with acute appendicitis were retrospectively analyzed,and the result showed that the incidence rate of appendix schistosomasis complicated with acute appendicitis whose complications were serious was high,which deserved to be concerned.

Local resection of duodenal papillary neoplasm has the advantages of small trauma,few complications and retaining the normal function of digestive tract.While this surgical procedure is not widely applied because of high demand of surgical techniques,difficulty in the management of complications and its efficacy still needs the verification of evidence based medicine.From January 2000 to June 2012,4 patients received local resection of duodenal papillary neoplasm at the Renji Hospital of Shanghai Jiaotong University.All patients were confirmed as with duodenal papillary neoplasm by endoscopic retrograde cholangiopancreatography,and the diameters of the tumors were under 1 cm.The results of duodenal papillary biopsy showed that 3 cases were with hyperplasia and 1 case with adenocarcinoma.Lymph node metastasis or distal metastasis was excluded by computed tomography and magnetic resonance imaging preoperatively.The results of postoperative pathological examination confirmed that 1 case of duodenal papillary adenoma and 3 cases of duodenal papillary adenocarcinoma were with negative margin and no metastasis in the hepatoduodenal ligament was detected.There was no complications except 1 case of pancreatic leakage.There was no recurrence during a follow-up period of 3-24 months.Strictly abiding the indications and technical manual of local resection of duodenal papillary neoplasm is a key point to acquire good clinical effect.

Objective To identify the cellular distribution of a my elin-associated protein (Nogo-A) in the central nervous system (CNS) of mice a nd explore its possible inhibition on the CNS axon regeneration after spinal cor d injury. Methods Brain, spinal cord, peripheral tissues and w eight-dropping injuried spinal cord from the adult C57BL/6 mice were studied. N ogo-A protein expression was localized immunohistochemically. Chick E12DRG neur ons were cultured and growth cone collapse assessed. Results N ogo-A protein expression detected was mainly in the oligodendrocyte cell body a nd the myelinated axons surrounded by cell processes rather than in the peripher al tissues. After spinal cord injury, Nogo-A was up-regulated at a moderate de gree in the area around the lesion. Chick E12 DRG growth cone collapse rate was as high as 70%, significantly higher than that in the blank control and vector control groups with a significant difference ( P

Professor GAO Yuchun is considered as the key successor of GAO's academic school of acupuncture and moxibustion in Yanzhao region. Professor GAO's clinical experience of, "sequential acupuncture" is introduced in details in this article. In Professor GAO's opinions, appropriate acupuncture sequence is the key to satisfactory clinical effects during treatment. Based on different acupoints, sequential acupuncture can achieve the aim of qi following needles and needles leading qi; based on different symptoms, sequential acupuncture can regulate qi movement; based on different body positions, sequential acupuncture can harmonize qi-blood and reinforcing deficiency and reducing excess. In all, according to the differences of disease condition and constitution, based on the accurate acupoint selection and appropriate manipulation, it is essential to capture the nature of diseases and make the order of acupuncture, which can achieve the aim of regulating qi movement and reinforcing deficiency and reducing excess.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Needles ; Qi ; history

Thrombotic thrombocytopenic purpura (TTP) is a kind of thrombotic microangiopathies which has low incidence but highly mortality.The outcome of TTP has been improved significantly since last decade due to the application of plasma exchange,however,early relapse occurs in some patients,and for relapsed/refractory patients the prognosis is still poor.This article reviews the recent progress in treatment and relevant influencing factors of TTP.

Totally,42 319 malaria cases and 57 787 suspected cases with 48 deaths were reported by the Annual Case Repor-ting System in 1186 counties of 21 Provinces/Municipality/Autonomous Region(P/M/A) in 2005,and the annual incidence was 0.59/10 000,an increase of 55.3% than that of the last year.Through the Case Reporting Information System,an internet reporting process started in 2004,40 371 malaria cases were reported from 1 075 counties of 31 P/M/A.The number of malaria cases and the rank of P/M/A were basically in concordance by the two systems.Among the 1186 counties with reported malaria cases,27 counties had an incidence of more than 10/10 000 distributed in Yunnan(15 counties),Hainan(7 counties) and Anhui(5 counties).There were 80 counties in which the malaria incidence was between 1/10 000 and 10/10 000.The number of Plasmodium falciparum malaria cases was 4 146,accounting for 9.8% of the total cases,of which 63.5%(2 632) were imported cases in 178 counties/cities of 18 P/M/A.Indigenous falciparum malaria was found in 47 counties/cities of Yunnan and Hainan Provinces,of which 31 counties/cities were in Yunnan,increased by 29,16 counties/cities were in Hainan,same with that of 2004.Yunnan and Hainan Provinces are still relatively high transmission areas.Yunnan ranked No.2 in the country in terms of the number of cases while Hainan ranked No.1 by malaria incidence in 2005.19 588 malaria cases were reported from the two provinces in 2005,accounting for 46.3% of the total reported cases in the country.There were 15 072 cases with 38 deaths reported from Yunnan,the incidence was 4.95/10 000,an increase of 60.2% than that in the last year.Among the reported cases,3 497 were falciparum malaria with 69.0% imported from the bordering nations.The number of reported cases in Hainan was 4 516,with an incidence of 5.46/10 000,53.1% decrease than the last year.In central China,the resurgence of malaria was considerable in provinces along the Huai River,especially in Anhui Province.The number of malaria cases in Anhui came to the highest in the country in 2005,with 15 681 malaria cases and 7 662 suspected cases reported,accounting for 37.5% of the total cases in the country,and an incidence of 2.45/10 000,increased by 77.5% than that in 2004.The number of reported cases in Henan Province was 2 349,increased by 55.2% in incidence.Hubei Province reported 1 564 malaria cases with an incidence of 0.27/10 000,decreased by 42.6%.651 cases were reported from Jiangsu Province,almost the same as that in 2004.Focal outbreaks occurred in 277 villages of 20 counties in Anhui,Hubei and Jiangsu,where Anopheles sinensis is the principal transmission vector.Malaria cases reported from the above 4 provinces accounted for 47.8% of the national figure,increased approximately by 10% than the last year.Cases reported from P/M/A in the South and East China occupied about 4.9% of the total,similar to that in 2004.Several hundreds were reported from each of Guizhou,Sichuan,Guangxi,Guangdong,Zhejiang,Shanghai and Hunan.Less than 100 cases were reported from each of Fujian,Chongqing,Shandong,Shanghai,Jiangxi,Liaoning,Shaanxi,Shanxi and Gansu Provinces in 2005.High attention should be paid to Guizhou and Tibet.Focal outbreaks occurred in Guizhou for consecutive 4 years,and malaria cases in 2005 double increased than the last year.77.8% of the reported cases were indigenous patients,which implied that local transmission resulting from imported malaria cases has become a major problem in Guizhou.93 malaria cases were reported from Linzhi District of the Tibetan Autonomous Region in 2005,76 cases more than that in 2004.In summary,malaria is still an important problem of public health in China,especially in the southern and central parts.Yunnan and Hainan still faced a severe situation of malaria endemics with the spread of Plasmodium falciparum,especially imported malaria in the 25 border counties in Yunnan.In the central part of the country,especially Anhui Province,the malaria prevalence was highly unstable with frequent focal outbreaks in areas along the Huai River,which revealed new challenges to the malaria control program in China.In addition,more attention needs to be paid to the malaria control in Guizhou and Tibet.

[ABSTRACT]OBJECTIVETo compare the difference of serum Leptin between obstructive sleep apnea hypopnea syndrome (OSAHS) patients and the control group, to analyze the genotype distribution and allele frequency of Leptin receptor gene Gln223Arg in OSAHS patients. To discuss the relationship between the gene polymorphism and OSAHS susceptibility.METHODSOSAHS group(221 cases) and control group (213 cases) were divided into obese OSAHS group (107 cases), non-obese OSAHS group (114 cases), obese control group (110 patients) and normal control group (103 cases). All participants were tested the level of serum Leptin after monitoring by polysomnography (PSG). The genomic DNA of Leptin receptor gene was extracted and the genotype was analyzed.RESULTSThe level of serum Leptin in non-obese OSAHS patients was 13.59±5.01μg/L and (13.10±1.87)μg/L in obese control patients. They were higher than that in normal control group, but there were no significant difference among them. The level of Leptin in obese OSAHS group was(19.01±3.43)μg/L, that was significantly higher than that in other three groups. Leptin receptor gene Gln223Arg genotype and allele frequency had no significant difference among the 4 groups. But neck circumference of GG genotype patients was greater than that of AA/AG patients.CONCLUSIONThe level of serum Leptin in obese OSAHS patients is significantly higher than that in control group. There is no relations between the gene polymorphism of two sites in Leptin receptor gene Gln223Arg and the onset of OSAHS. But Gln223Arg variation may be involved in regulating the OSAHS patients' neck fat distribution.

Objective To investigate the function of apoptosis in the renal injury by observing change of renal pathology and ultrastructure in the rat with obstructive jaundice(OJ) and if salvia miltiorrhiza(SM) can lighten the renal dysfunction of obstructive jaundice.Methods A total of 100 adult Sprague-Dawley rats were studied.Among them,the 80 models of obstructive jaundice were established by ligating bile duct(BDL),then divided into two groups: the OJ rats administered daily abdomen injections of SM(1.7g per rat) after operation of bile duct ligation(the SM group,n= 40);the OJ rats receiving only the same normal saline(the OJ group,n=40).The other rats with sham operation receiving only normal saline(the control group,n=20).Three groups of rats were sacrificed in groups at postoperation 1,2,3 and 4 week,respectively.Then serum BUN & Cr were tested and renal change of histopathology and ultrastructure were observed;Apoptosis of renal tissue were assayed by TUNEL method.Results With the time of BDL extending,the value of serum BUN & Cr increased;Apoptotic cells increased in renal tissue.After treatment with SM,the injury degree of renal function and histopathologic changes decreased.Conclusion Obstructive jaundice can lead to renal injury.Apoptosis had an important effect on renal function injury in the rat with obstructive jaundice.Salvia miltiorrhiza can ease the degree of renal function injury.

Objective Gastrointestinal dysfunction is closely correlated with the impairment of intestinal barrier caused by serious infection.We focused on the role of platelet activating factor(PAF)in the intestinal impairment caused by endotoxemia by studying on the morphology of intestinal epithelial ceils and diamine oxidase (DAO)levels with the application of Ginkgolide B(PAF receptor antagonist).Method Eighteen-day-old Wistar rats were randomized into lipopolysaccharide(LPS)(5 mg/kg),PAF receptor antagonist(pretreatment and treatment)and normal saline(Control)groups(n=8 at each time point).Ginkgolide B(PAF receptor antagonist BN52021)5 mg/kg was administered 30 minutes before(in pretreatment group)and after LPS injection(in treatment group).The ileum specimens(n=8)were harvested at 1.5,3,6,24,48 and 72 hours after LPS or NS injection.The ultrastructures of intestinal epithelial cells were studied by transmission electron microscopy (TEM)and with hematoxylin and erosin staining.The contents of DAO in ileum tissue and plasma were measured respectively with spectrophotometer.According to data Normality and Variance equality,ANOVA analysis and LSD (least significant difference)-t test were used for multiple group difference.The whole test Was performed in the animal laboratory,pathological laboratory,biochemical laboratory of our hospital and electron microscopy laboratory of Liao-ning University of Traditionary Chinese Medicine.Results Histologic examination of intestinal injury in LPS group showed the edema of intestinal villi,the capillary congestion in lamina propria,the dilation of interstitial lymphatic vessel.and the polymorphonuclear infiltration in enteric cavity in LPS group at 1.5,3,6,24 hours.The edema of the intestinal villi were shown in antagonist group.Ultrastructural study showed microvilli and tight junctions were intact in the control group.The tight junctions enlarged and the microvilli were thin,rare or disrupted in the experimental group.The pathological changes in PAF antagonist group were slightly lighter than that in the LPS group.The DAO content in the ileum tissue was obviously decreased in the LPS group compared with that in the control group.It reached to a nadir at 6 hrs[from(0.172±0.004)U/mg to(0.096±0.010)U/mg,F=13.372,P＜0.01).The DAO content in plasma was obviously higher in the LPS group than that in the control group.The patterns of DAO changes in the PAF antagonist group were as the same as that in the LPS group at each time point.Conclusions PAF may play a certain role in the injury of intestinal barrier in endotoxemia.Preventive and remedial administration of Ginkgolide B may relieve intestinal injury.The activity changes of DAO in plasma synchronized with that in ileum tissue.It may be deduced that the alterations of DAO in plasma may indicate the destruction of intestinal mucosa in the early stage sensitively.

Objective To investigate the effects of Xuebijing injection on expression of myeloid cell triggering receptor-1(TREM-1)and the plasma levels of soluble TREM-1(sTREM-1),tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)in patients with severe sepsis. Methods Twenty patients with severe sepsis admitted into Critical Care Medicine Department,Affiliated Hospital of Nantong University were given comprehensive treatments according to the guidelines for management of severe sepsis and septic shock(2004),and they were divided into Xuebijing group and control group(each 20 cases). The Xuebijing injection group was given Xuebijing injection 50 mL,3 times daily for 5-7 days followed by regular treatments. The changes in blood TREM-1 mRNA expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 were detected before and after treatments on the 3rd and 5th day,and the above indexes were compared between the two groups. Results Before treatments,there were no significant differences in TREM-1 mRNA expression and levels of sTREM-1,TNF-α,IL-6 between two groups (all P>0.05). The TREM-1 expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 of two groups were declined after treatments compared to their baselines,the degree of decline being more prominent in Xuebijing group〔TREM-1 mRNA 3 days:1.065±0.277 vs. 1.217±0.301,t=-3.267,P=0.047;5 days:0.912±0.239 vs. 1.071±0.254,t=-5.072,P=0.032;sTREM-1(ng/L):146.93±13.76 vs. 176.22±19.46,t=-5.442,P=0.033;TNF-α(ng/L):77.51±11.28 vs. 107.72±13.17,t=-4.355,P=0.032;IL-6(ng/L):288.35±14.59 vs. 323.89± 24.51, t=-3.941,P=0.028〕. Conclusion Early implication of Xuebijing injection is of great significance in patients with severe sepsis,it may reduce the expression level of TREM-1 and serum levels of downstream inflammatory mediators,that is beneficial to the control of inflammatory responses and improvement of systemic inflammatory response syndrome in such patients.