Objective To explore the feasibility of transumbilical laparoscopic-assisted appendectomy in children. Methods From February 2005 to February 2006, transumbilical laparoscopic-assisted appendectomy was performed on 76 children with acute or suppurative appendicitis. After two 0.5-cm incisions were made at the inferior and right-lateral margins of the umbilical ring, two trocars sized 5.5 mm in outer diameter were inserted into the abdominal cavity. Under a laparoscope, the appendix was detected and clipped at the middle part. After the pneumoperitoneum was evacuated, the two incisions were connected, and the whole appendix was pulled out. Then, appendectomy was performed using the traditional method. Results In this series, the mean operation time was (20.6?6.4) min (range: 15-40 min), and the mean postoperative flatulence-relief time was (12.0?3.5) h (range: 4-18 h). In all the patients, the surgical wound healed primarily. One month after the operation, one patient developed suture foreign body reactions, and was cured without scars around the hilum after the suture material was removed. The 74 patients were followed up for 2-14 months [mean, (7.3?3.6) months], none of the patients had incision scars in the umbilical area. Conclusion Transumbilical laparoscopic-assisted appendectomy is feasible in children with simple suppurative appendicitis.

Objective To study the changes of serum and tissue soluble intercellular adhesion molecule(sICAM)-1 in colorectal cancer patients and their clinical significance. Methods Serum level of sICAM-1 was detected by the double antibody sandwich enzyme-linked immunosorbent assay method in 44 patients with colorectal cancer before and after operation, 28 patients with intestinal polyps and 30 controls.Simultaneously, tissue level of sICAM-1 was measured in the patients of colorectal cancer and intestinal polyps. Results The serum sICAM-1 level in colorectal cancer patients[ (693.22±276.25) mg/L]was significantly higher than that in the intestinal polyps patients [(61.99±27.39) mg/L]and healthy controls[(59.28±27.55) mg/L]. The tissue sICAM-1 level in the colorectal cancer [(706.92±286.09)mg/L ]was significantly higher than that in the intestinal polyps patients[ (63.06±27.06) mg/L,P<0.01 ]. The serum and tissue levels of sICAM-1 in Dukes C-D stages of the colorectal cancer showed significantly higher than those in Dukes A-B stages (P<0.01 ). The level of sICAM-1 declined remarkably after one month of radical operation. Conversely, it decreased illegibly after palliative operation. Conclusion Dynamic alterations of serum and tissue sICAM-1 level may be used as indicators of diagnosis, choice of operative method and judgment of prognosis in patients with colorectal cancer.

Objective To preliminarily test the value of gastroesophageal reflux disease questionnaire (GERD-Q) in auxiliary diagnosis of gastroesophageal reflux disease(GERD) in infants and young children.Methods From January 2011 to February 2014,148 infants and 87 young children with suspected GERD symptoms were enrolled in the outpatient and inpatient departments of Wuhan Women and Children's Medical Care Center.The diagnosis of GERD were made through 24 h esophageal pH monitoring and upper gastrointestinal hysterosalpingography.Those with any examinations being positive were brought into GERD group,and the others into the control group.All cases had been surveyed with GERD-Q.Using SPSS17.0 statistical software,the ratio was compared with chi-square test,and the difference of the scores between groups with t test.Results In infants (1 to 11 months),the individual symptom scores (ISS) of the 6 symptoms in the GERD group (n =111) were all higher than those in the control group (37 cases) (P ＜ 0.05),and the composite and symptom scores (CSS) [(131.43 ± 66.56) scores] in the GERD group was higher than that [(33.70 ± 40.03) scores] in the control group (t =8.42,P ＜ 0.05).In young children (1 to 3 years old),the ISS in the GERD group(55 cases) were all higher than those in the control group(32 cases),and the CSS[(98.58 ± 66.75) scores] in the GERD group was also higher than that [(28.50 ± 35.95) scores] in the control group(t =5.49,P ＜ 0.05).Conclusions There is a good correlation for age-specific GERD-Q to distinguish GERD symptoms in infants and young children,which is suitable for the assessment of GERD.

Objective To investigate the potential effect of Lactobacillus acidophilus (L. acidophilus) on prevention and treatment of neonatal mice infected with human rotavirus (HRV). Methods Sixty 4-day-old kunming mice were randomly divided into control group. HRV infected group, L. acidophilus pretreated group (treated before HRV infection ) and L. acidophilus treated group(treated after HRV infection). The manifestation and pathological changes in small intestine of neonatal mice were observed. The HRV antigen in the feces and intestines were measured by ELISA and fluorescent-focus assay, respectively. Results The severity and duration of diarrhea as well as mortality in L. acidophilus pretreated group and treated group were lower than those in HRV infected group. The duration of HRV-antigens shedding following infection was considerably prolonged in HRV infected group compared to that in L. acidophilus pretreated group and treated group. Furthermore, decreased expression of HRV antigen and little pathological changes in intestinal mucosa were found in L. acidophilus pretreated group and treated group when compared with HRV infected group. Conclusion L. acidophilus may be used as an alternative approach for the prevention and treatment of neonatal mice infected with HRV.

Objective To investigate SLC25A13gene mutation in neonatal intrahepatic cholestasis caused by citrin defi-ciency (NICCD). Method A total of 17 children with NICCD were collected. PCR-RFLP method was used to analyze the most common eight mutations of SLC25A13 gene in Chinese populations and results were analyzed together with routine laboratory examinations. Results In the 17 NICCD patients, there were six cases of homozygous mutation, three cases of compound heterozy-gous mutation and eight cases of single heterozygous mutation in SLC25A13 gene. Three kinds of mutations detected were 851del4 (73.1%), 1638ins23 (11.5%) and IVS6+5G>A (15.4%). The seventeen cases showed classical NICCD symptoms of low birth weight, pathological jaundice. And laboratory data suggested liver dysfunction, hyperbilirubinemia, hyperbileacidemia, hy-poproteinemia, hypoglycemia, coagulation disorders, hyperlactacidemia and hyperammonemia. Conclusions 851del4, 1638ins23 and IVS6+5G>A are hot spots of SLC25A13 gene mutation in Chinese populations. PCR-RFLP is a rapid, convenient and reliable technology for NICCD molecular diagnosis.