Objective To analyze the clinical effects, as well as its advantages and disadvantages, of laparoscopic surgery for appendicitis in obese patients. Methods Clinical data of 80 obese patients receiving appendectomy, including 38 cases of open appendectomy and 42 cases of laparoscopic appendectomy, were analyzed retrospectively.The operative time, blood loss, analgesic and antibiotic use, postoperative fever, postoperative complications, length of hospital stay, and hospitalization cost were compared between the two operative methods. Results Conversions to open surgery were required in 2 patients in the laparoscopic group. There was no significant difference in operative time between the 2 groups (P >0.05).Compared with the open group, the laparoscopic group had less blood loss [(14.98 ±12.77) ml vs.(31.58 ±19.00) ml, t=-4.550, P=0.000], shorter time of postoperative antibiotic use [(2.7 ±1.0) d vs.(4.1 ±1.2) d, t=-5.470, P=0.000], less postoperative analgesics needed [5.0%(2/40) vs.26.3%(10/38),χ2 =6.802, P=0.009], less drainage [2.5% (1/40) vs.18.4% (7/38), χ2 =5.367, P=0.021], less postoperative fever [5.0%(2/40) vs.23.7%(9/38),χ2 =5.616, P=0.018], less postoperative wound healing [5.0%(2/40) vs.21.1%(8/38),χ2 =4.493, P=0.034], and shorter hospital stay [(5.9 ±3.2) d vs.(8.7 ±4.1) d, t=-3.345, P=0.001], but the higher cost of hospitalization [(7800 ±396) yuan vs.(4914 ±434) yuan, t=30.716, P=0.000]. Conclusion For obese patients with appendicitis, laparoscopic appendectomy has less surgical trauma, faster recovery, less postoperative pain, fewer complications,and shorter hospital stay, being a preferred method of treatment.

Objective To evaluate the imaging quality and diagnostic value of different MR sequences for abnormalities of knee cartilage. Methods Three sequences of MR, including double echo steady state (DESS), multi echo data imagine combination (MEDIC) and true fast imaging with steady state precession (TrueFISP) were performed in 18 healthy volunteers. Signal-to-noise ratio (SNR) of knee cartilage and contrast-to-noise ratio (CNR) to surrounding tissues were measured and compared. Results SNR of cartilage was the highest in MEDIC sequence imaging, CNR of cartilage-synovia was the highest in DESS sequence imaging among three sequences (P<0.05). Conclusion Compared with the other sequences, DESS seems to be optimal in diagnosis of abnormalities in knee cartilage.

Objective:To investigate the use of antibacterial drugs during the perioperative period of a cesarean section and observe the differences before and after antibacterial drug remediation. Methods:1 569 cesarean cases from 2010 to 2012 were investigated, and the use of antibacterial drugs, drug categories, drug combinations, medical expenses, and so on was statistically analyzed with the use of the statistical software SPSS13. 0. Results:The rate of antibacterial drug usage within the 1 569 cesarean cases was 100%;for pre-operative antibacterial drug remediation, azithromycin, cefathiamidine, and ornidazole were the top three, while the top three antibacterial drugs for post-oper-ative remediation were arecefathiamidine, cefuroxime, and clindamycin. There was no significant difference between the two groups of incision infections, and the rate for combined use of drugs dropped. The analysis of drug costs is of statistical significance. Conclusion:The analysis of antibacterial drug remediation is useful for the rational use of anti-bacterial drugs and a reduction of costs.

OBJECTIVE: To study the absorption and transport of pachymic acid (PA) isolated from the sclerotium of Poria cocos (Schw.) Wolf. in human intestinal epithelium. METHODS: By using Caco-2 (the human colonic adenocarcinoma cell lines) cell monolayers as an intestinal epithelial cell model, the permeability of PA was studied from apical side (AP side) to basolateral side (BL side) or from BL side to AP side. The PA was measured by reversed-phase high performance liquid chromatography coupled with UV detector at maximum absorption wavelength of 210 nm. Transport parameters and apparent permeability coefficients (Papp) were then calculated and compared with those of propranolol and atenolol, which were the transcellular transport markers for high and poor permeability respectively. RESULTS: The Papp values of PA were (9.50+/-2.20) 10(-7) cm/s from AP side to BL side, and (11.30+/-5.90) 10(-7) cm/s from BL side to AP side, respectively. Under the condition of this experiment, the Papp values were 1.45x10(-5) cm/s for propranolol and 4.22x10(-7)cm/s for atenolol. CONCLUSION: PA is transported through the Caco-2 cell monolayer in a concentration-dependent manner and the transport was linear with time. The absorption in apical to basolateral direction and secretion in basolateral to apical direction were poor and their Papp values were comparable to atenolol. Besides passive diffusion of PA, ATP is partially involved in its transport.

In this article,we explained the pathogenesis of bony paralysis,‘disharmony between bone and muscle',recorded in Huangdi NeiJing,by researching the dependability between bone and muscle both in traditional Chinese medicine and modem medicine.

Objective To investigate the internal relationship between the expression of inducible nitric oxide synthase (iNOS) and the activation of NF-κ Bp65 in the skin of patients with psoriasis vulgaris(PV) and their roles in the pathogenesis of PV.Methods The expression and distribution of iNOS and NF-κ Bp65 were studied by in situ hybridization and immunohistochemistry in 20 patients with PV and 12 healthy controls.The severity of PV was assessed by Psoriasis and Severity Index(PASI) score.Results ① The expression of both iNOS mRNA and protein was significantly higher in lesional epidermis than those in non-lesional epidermis and epidermis of the controls (P<0.01).Weak exprssion of iNOS mRNA was found in basal cell layer in a small number of healthy controls, however, strong expression was observed in entire basal cell layer and focal parts of prickle cell layer in all PV epidermis.② There was significantly positive correlation between iNOS and NF-κ Bp65 protein expression in lesional epidermis (P< 0.01).③ There was significantly positive correlation between the level of expression of iNOS mRNA in lesional epidermis and PASI score of patients (P< 0.01).Conclusions The expression of iNOS and NF-κ Bp65 is markedly increased in lesional epidermis of patient with PV.The activation of NF-κ B probably takes part in the pathogenesis of PV.High-level expression of iNOS may be due to the activation of NF-κ B.

Histone acetylation and deacetylation is an important regulatory way of gene expression in eukaryotic cells. As a key regulatory enzyme, histone deacetylase is overexpressed in many malignant tumors, including hepa- tocellular carcinoma. In addition, it has been suggested to be a potential therapeutic target for solid tumors. In this study, we review the classification, mechanisms, as well as the expression and regulation of histone deactylases in hepatocelhlar carcinoma.

Expansive type of hepatocellular carcinoma (HCC) is a subtype of HCC. Correlation between the preoperative sonography and postoperative pathology was studied in 35 cases of HCC. According to the classification of nakashima, 21 cases belonged to the expansive type whereas the other 14 cases the infiltrative type. Different from the infiltrative type. the expansive type of HCC had four specific sonographic appearances: hypoechoic ring, hypoechcic halo, pedunculated and small nodular echo which had different pathological bases. Expansive tyje of HCC was not so commonly seen as infiltative type but its rate of surgical resection was mu~h higher than that of infiltratine type (JP< 0. 01). Thus, it is the kind of HCC with significant clinical importance. Preoperative ultrasonographic diagnosis help to decide the way of treatment.

Objective To evaluate the preoperative diagnostic procedures and treatment choice of primary tumor of the duodenum (PTD).Method The clinical data of 52 cases with PTD in the last 10 years was analyzed retrospectively.Results The correct diagnostic rate of auxiliary examination was:duodenal endoscopy of 90.5%,air barium double radiography of 80%.Six primary benign tumors of duodenum (PBTD)were resected completely with a 5 year's survival of 100%.Among the 46 cases of primary malignant tumors of duodenum (PMTD),28 cases underwent pancreatoduodenectomy,4 cases received segmental duodenectomy,the remaining 13 cases in which the tumors were unresectable were treated bypass.The resection rate was 69.6% and the 5 years' survival rate was 32.6%.Conclusions Duodenal endoscopy and air barium double radiography are mainstays for the diagnosis of PTD.Segmental duodenectomy and simple tumor resection are curable for PBTD; while for PMTD,the therapy of choice should be pancreatoduodenectomy.

Objective:To improve the prediction of the resectability of esophageal carcinoma by computed tomography.Methods:Eighty-five esoghageal carcinoma cases diagnosed by conventional upper GI tract radiography were enrolled.Three CT signs i.e. angularity,triangular area,and angularity combined with posture were used to observe and to determine the >45。Results:The prediction of resectability by CT were accurate which was confirmed by surgical interventions.Conclusion:Determination of the triangular fat pad between the aorta and the tumor lesion by Ct is reliable and practical in the predication of resectability in the patients with esophageal carcinoma.