Objective To evaluate the accuracy of white cell count(WCC) and C-reactive protein(CRP) for diagnosing severity of acute paediatric appendicitis.Methods Clinicopathologic characters,WCC,CRP,histology were analyzed in 150 children undergoing open appendectomy for acute appendicitis.Results Appendix was grossly inflamed in 123 of which 24 had perforation.Histology revealed simple acute appendicitis in 99(66.0％),gungnenous appendicitis in 24(16.0％) and the rest were normal.The duration of symptoms(4.6±5.6) time,temperature (38.3±0.9)℃,WCC[(15.6±4.7) × 109/L]and CRP[(1610±653)mg/L]were significantly worse in the perforated group(P ＜ 0.01).WCC had a higher accuracy and sensitivity than CRP in diagnosing simple acute appendicitis.The combined sensitivities of WCC and CRP were 93％ and 99％ for diagnosing simple acute appendicitis and a perforated appendix,respectively.Conclusion Accuracy of WCC was higher than CRP for diagnosing simple acute appendicitis.The combined sensitivity of WCC and CRP increases for simple acute appendicitis as well as perforated appendix.

Objective To observe the effect of no tension repair in the treatment of inguinal hemia.Methods Notension hernia repair was used to treat 630 patients with inguinal hernia(648 sides):primary indirect inguinal hernia in 604 cases( 18 cases of bilateral),primary direct inguinal hernia in 15 cases(2 cases complicated with indirect inguinal hernia,1 case of double direct inguinal hernia complicated with the right indirect hernia),recurrent hernias( 11cases).The mesh plug and patch of American Bard Company production was selected as hernia repair material for inguinal hernia repair.The operation time,the wound pain day,postoperative ambulation time,complications,and the recurrence rate was observed.Results 630 cases were all successful in operation,and the operation time was 40 ～110min,average operation time about 50min.6 -24h after operation all patients were got out of bed.29 cases of the postoperative urinary retention,indwelling catheter 24 hours to 1 week;6 cases of the fat liquefaction under the incision;3 cases of postoperative foreign body sensation;recurrence in 2 cases(3 sides),1 case of bilateral infected and recurrence ; 11 cases of local swelling incision; 16 cases of incision with mild foreign body sensation.8 days after operation all patients were discharged.Conclusion The no tension repair in the treatment of inguinal hernia had good effect and low recurrence.

BACKGROUND:The Notch signaling pathway is evolutionarily highly conserved and mediated by cel-cel interactions, which is widely involved in cel differentiation, proliferation and apoptosis. This critical transduction system participates in coordinating various functions of vascular endothelial cels, thus playing a vital role in the formation and remodeling of vascular network. OBJECTIVE: To elucidate the components of Notch signaling pathway and its impact on angiogenesis. METHODS: A computer-based online search of PubMed and CBM databases was performed. High-quality articles related to mechanism of angiogenesis regulated by Notch signaling were included, and repetitive studies were excluded. RESULTS AND CONCLUSION:Totaly 31 literatures were selectively included in this review. Angiogenesis is a complicated and muti-stage biological event and has been delicately regulated. Notch signaling participates in the regulation of every stage of angiogenesis directly or indirectly via the crosstalk with vascular endothelial growth factor, BMP-SMAD signaling and extracelular matrix molecules. Furthermore, consistent output of Notch signaling is essential for maintaining the stability and integrity of adult vascular system. This review wil thoroughly clarify the latest progress on angiogenesis regulated by Notch signaling and provide theoretical basis and a potential target for designing therapeutic methods against vascular disease.

Objective:To study the teeth of the ancients in Xia Dynasty,the first dynasty in Chinese history about 4 000 years ago,and acquaint ourselves with their incidences of periodontal disease,and the evolution of oral diseases.Methods:The teeth and jaws excavated in Erlitoou,Henan Province and Youyao,Shanxi Province were observed with clinical methods.The specimens totaled 56 individuals(male 38,and female 18),including 894 teeth,and 86 dental arches.The objects were all permanent teeth.The major observation items were periodontal disease.The prevalence of periodontal disease of the people in Chinese Xia Dynasty were outlined.Results:The prevalence rate of periodontal disease was 19.80% in the 894 teeth,while prevalence rate was about 42.86% among the individuals.The premortal tooth lossrate was 7.45% in the observed teeth.Conclusion:Periodontal disease is an aging-related disease without sex difference and commonly seen in the mandible,which is quite similar to the situation at present.The periodontal disease was the main reason for tooth loss in people of Xia Dynasty.

Objective To determine whether preoperative embolization is a valuable adjunct to surgical excision of hemangioblastoma. Methods Eleven cases of hemangioblastoma, involving 8 of cerebellum , 1 of medulla oblongata and 2 of spinal cord shown by CT, MR and DSA were embolized preoperatively. The feeding arteries were catheterized with microcatheter and devascularized with polyvinyl alchol particles. Results The blood supplies of the tumor in 6 cases were completely eliminated, and partial occlusion through embolization were undergone for the other 5 cases. Surgical operation was undergone 1-7 days later with all, the 11 tumors totally resected acompanied by minimal blood loss and shortening of the operation time. In addition, manipulation and removal of these embolized tumors were actually easier than expected. No complications occurred during the procedures of embolization and operation. Conclusions Preoperative embolization of hemangioblastoma is a useful and relatively safe to surgical complete resection of this hypervascular tumor with significant reduction of blood loss and operation time.

[Objective]Observe the clinical effect of leverage replacement manipulation on lumbar intervertebral disc herniation.[Method]299 hospitalized patients were divided into two groups.153 cases were in trial group and 146 patients were in controlled group.Trial group accepted constant traction and leverage replacement manipulation.While the controlled group accepted the same traction and muscular massage.[Result]In trial group,90 patients were cured,57 improved and 6 no improvement.The total effective rate was 96.08%;in controlled group,21 were cured,75 cases improved,and 50 no improvement.The total effective rate was 65.75%.The effect of trial group was better than the controlled group(P

Objective To investigate the principles of diagnosis and treatment of postoperative intestinal obstruction.Methods The clinical datas of 89 cases of postoperative intestinal obstruction treated from 2001 to 2005 were analyzed retrospectively.Results All the 89 cases were cured without severe complications such as intestinal fistula and no death.The early postoperative inflammatory intestinal obstruction occurred in 2 cases.Recurrent intestinal obstruction occurred in 2 cases.Conclusions Intestinal obstruction can be caused by operation in abdomen.The diagnosis depends on the medical history,clinical manifestations,abdominal plain X-ray and computed tomography.Therapeutic procedure and operative opportunity play an important role in the treatment of postoperative intestinal obstruction.Non-operative approach should be the first choice for early postoperative inflammatory intestinal obstruction.Prompt surgery is clearly indicated and valuable for acute or being strangulative obstruction.Active operative treatment should be considered in recurrent chronic intestinal obstruction.

Objective To explore the changes of MR diffusion imaging (DWI) appearance in newborn rats with hypoxic‐ischemic brain damage(HIBD) ,and its relationship with the changes of Triphenyl tetrazolium chloride (TTC) staining .Methods Using liga‐tion of the left carotid artery method to establish three different degrees of HIBD animal models ;DWI was performed at each time point(6-12 h ,12-24 h ,3 d ,7 d);Fresh brain tissue taken from another model groups of newborn rats in 12 h ,24 h ,3 d ,7 d were staining in TTC ,then we observed its relationship with DWI .Results The lesion location of three model groups mainly distributed in the left side of cortex and subcortical region ,with prolonged hypoxia time ,hippocampus ,lateral side white matter ,thalamus were also have varying degrees of involvement .The right side of the cortex and subcortical in some cases involved .TTC staining showed posi‐tive results in 3 d ,its loss stained area were consistent with DWI abnormal signal area .Conclusion DWI can be evaluation of HIBD lesions early .The early lesions of HIBD mainly distributed in the left side of cortex and subcortical region .

Objective To observe the expression of uPA, tPA and PAI-1 in whole blood of rat membranous ne-phropathy ( MN) models induced by cationic bovine serum albumin ( C-BSA) , and to explore the effect of fibrinolytic sys-tem on podocyte apoptosis and pathological changes. To explore the possible preventive and therapeutic effects and the pos-sible mechanisms of early prevention of fibrinolysis. Methods We developed a MN model with the modified Border meth-od. At the end of the 1st, 2nd, 3th, and 4th week of immunization, respectively, the levels of whole blood uPA, tPA and PAI-1 were determined by ELISA. The rat kidney tissues were examined by light microscopy and electron microscopy to i-dentify the pathological changes. The expression levels of nephrin and WTl were detected with immumofluorescence staining and their correlation was analyzed. Results Compared the treatment group with control group, the levels of whole blood uPA, tPA and PAI-1 of the model group were decreased, while PAI-1 was elevated, showing a significant difference ( P<0. 05). The degree of renal interstitial fibrosis was more serious. Correlation analysis showed that the whole blood tPA and uPA levels were positively correlated with the changes of nephrin protein expression in the kidney tissue, while the whole blood PAI-1 level was negatively correlated with the nephrin protein expression in the kidney tissue. Conclusions In the process of MN development, the fibrinolytic system may have important significance for podocyte apoptosis. Determination of early phase of MN podocyte injury may be another therapy target for prevention of the disease development, and then pro-vide new ideas for clinical research and drug development for MN.

BACKGROUND:Establishing the animal model of membranous nephropathy is of importance to figure out the pathogenesis of membranous nephropathy.
OBJECTIVE:To investigate the expression of nephrin and podocin in the model of membrane nephropathy in rats, and to investigate their relationships with the pathogenesis of membranous nephropathy.
METHODS:A total of 40 Sprague-Dawley rats were equivalently randomized into model and control groups. Rats in the model group were in premunity by given subcutaneous and multi-point injection of 1 mg cationic bovine serum albumin firstly dissolved in 0.5 mL normal saline and then ful y emulsified with the equal incomplete Freund’s adjuvant for 1 week, and 16 mg/kg cationic bovine serum albumin was injected via vein tails, once every other day for 4 weeks. The same volume of normal saline was injected into the controls. The mRNA expressions of nephrin and podocin in renal tissues were detected using real-time PCR, and biochemical indicators and morphological observation were measured at 2 and 4 weeks after modeling.
RESULTS AND CONCLUSION:(1) In the model group, the total amount of urine and serum albumin levels were significantly decreased accompanying with overt proteinuria, and the serum creatinine, urea nitrogen, cholesterol and triglyceride levels were significantly increased al in a time-independent manner compared with the control group (P<0.01), and the difference was significant (P<0.05). (2) The pathological examination showed that rats in the model group had different degrees of renal tubular dilatation, glomerular basement membrane thickening, mesangial cel s and stromal hyperplasia, which was typical of membranous nephritis. (3) Moreover, the mRNA expressions of podocin and nephrin in the model group were lower than those in the control group. (4) In conclusion, the decreased expressions of podocin and nephfin may disturb the integrity of the slit membrane of podocytes giving rise to the damage of glomerular filtration barrier, and proteinuria appears in final.