Objective To study the clinical characteristics and misdiagnostic causes of acute perforation of peptic ulcer (APPU) in children ,ao as to improve the diagnosis and treatment . Methods The clinical data of 26 cases of APPU in children were analysed retrospectively. Results The clinical manifestations include abdominalgia , abdominal distension, nausea and vomiting, fever; tension of abdominal muscle , epigastrium tenderness, rebounding pain,and gurgling sound attenuation or disappearance . The diagnosis was made preoperatively in 10 cases , and misdiagnosed in the other 16 cases . All patients underwent perforation repairing operation . There was no mortality in this series. All the patients were followed up for 1 to 2 years,and only 2 cases (7.7%) had peptic ulcer reccurrence. Conclusions Peptic ulcer in children often occurrs in schoolage and most of ulcers were duodenal ulcer. The clinical manifestation of APPU in children has no specific clinical presentation . The early diagnosis of APPU in children is difficult. Combined use of X ray with B ultrasonic examination can apparently improve the accurate rate of diagnosis. Once the diagnosis is made ,the surgical treatment should be performed as early as possible. The perforation repair should be chosen at first. Anti-Hp treatment should be given postoperatively.

Objective To observe the nucha electrical acupuncture Intervening at early times preventing the occurrence of poststroke depression(PSD)in acute cerebral infarction(ACI)patients.MethodsACI patients whose scores of Hamilton Rating Scale for Depression(HAMD-24)were not above to the the level of mild depression were divided into acupuncture group(30 cases)and control group(30 cases).They were assessed with HAMD-24 before and after treatment respectively.ResultsThere were 5 cases in acupuncture group whose scores of HAMD-24 were above the level of depression,which were mild in 3 cases,medium in 1 case,severe in 1 cases.While there were 12 cases in control group,which were mild in 6 cases,medium in 4 cases,severe in 2 cases(P<0.05).ConclusionThe nucha electrical acupuncture intervening early can reduce the incidence and relieve the degree of PSD.

Objective To evaluate the clinical outcomes of the reformed microlumbar discectomy preserving partial ligamentum flavum to prevent lumbar spinal instability and .scar tissue oppression and adhesion after operation. Methods A prospective, randomized, controlled clinical study was conducted.The patients with unilateral lumbar disc herniation were randomly divided into two groups. The control group (41 cases) underwent classic mien)lumbar disceetomy,.and the test group (44 cases) underwent the same procedure but with a curved incision on the lumbo-dorsa fascia and with partial preservation of the ligamentum flavum. Visual analog scale (VAS) scores and Oswestry scale scores were used to appraise the outcomes. Results Chnieal parameters were significantly improved after the operation in two groups. In the test group the postoperative VAS scores showed a less intensity of pain after the operation than that in the control group, and this superiority disappeared 1 year after the operation. After the operation, the VAS scores in the test group and contnd group were (1.8±0.6) and (3.8±1.3) scores at 3 days (P <0.05), (1.3±0.6) and (3.5±2.1) scores at 12 weeks (P<0.05), and (1.9±0.6) and (2.8±1.7) scores at 1 year (P>0.05) respectively. After the operation, the Oswestry scale scores in the test group and control group were (18.2±6.6) and (34.4±11.8) scores at 12 weeks (P <0.05), (12.0±9.2) and (22.6±10.0) scores at 1 year (P<0.05) respectively. In both groups, there was no patient who had recurrence of intervertebral disc hernia and reoperation. Conclusions Minimally invasive discectomy has satisfactory clinical outcomes,however, with partial preserved ligamentum flavum shows a less intensity pain and a better lumbar function state. Preserving the ligamentum flavum is helpful to prevent the fibrosis-related complication and to preserve the stabihty of the spine.

Objective To explore the value of CT venography (CTV) in diagnosis of cerebral venous sinus thrombosis (CVST) . Methods 16 patients with CVST were examined by CTV. 2D and 3D vascular images were reconstructed through workstation. Results Filling-defect was seen as "empty triangle sign" on the axial image.Multiple CVST were displayed in 11 patients,among them,8 cases involved superior sagittal sinus,3 cases involved lateral sinus. Single CVST was displayed in 5 patients,2 cases involved superior sagittal simes,2 cases involved straight sinus,1 case involved inferior sagittal sinus. The irregular narrowing or occlusion of the sinus and dilation of the branch of vein were observed in all 16 patients on 2D or 3D images. Hydrocephalus, cerebral infarction and cerebral hemorrhage were seen in 11 cases, 6 cases and 4 cases respectively. Conclusion CTV is a sensitive and distinctive technique in diagnosing CVST.

0.05).The ratio of human CD3+,CD4+ and CD8+ T cells were 46.86%?9.14%,31.68%?10.17% and 17.91%?1.38% in experiment group,whereas human T cells could not found in control group.In experiment group,specific cytotoxicity were 15.37%?1.58% and 19.86%?2.86%(P

Objective To make clear the clinical safety of ultrasound guided percutaneous 125I radioactive seed interstitial implantation for treatment of pancreatic cancer.Methods 92 cases of pancreatic cancer treated with ultrasound guided percutaneous 125I radioactive seed interstitial implantation were retrospectively ana lyzed.Results All the 92 cases were performed successfully according to the preoperative plan.25 cases suffered puncture-hemorrhage and blood loss about 2 to 20 ml,and all got hemostasis successfully.2 cases had pancreatic duct injury during puncture,but no pancreatic fistula was found after conservative treatment.No case had bile duct injury.No digestive tract perforation occurred in the 55 cases whose puncture path was through the gastrointestinal tract.No serious complications occurred during the surgery.Conclusions Ultrasound guided percutaneous 125I radioactive seed interstitial implantation for treatment of pancreatic cancer is safe and reliable.

Objective We compare the effects of fibrinogen gel and chitin on BMSCs to chondrocytes differentiation in order to explore the relationship between three-dimensional scaffold and cartilage tissue engineering seed cells BMSCs differentiation. Methods BMSCs together with chitin and fibrin gel complexes were cultured in vitro and implanted into rat's articular cartilage defect location. After 14 days in vitro culture, HE staining, toluidine blue staining and type II collagen immunohistochemical staining were performed;After transplantation in vivo, for 2 weeks, 4 weeks and 6 weeks, morphology observations, expression of cartilage-specific protein analysis and BMSCs in vivo tracer method were performed. We analyzed the differentiation of BMSCs into chondrocytes by statistical methods. Results The comparison of positive cell rate of type II collagen immunohistochemical staining in BMSCs-fibrin gel group and BMSCs-chitin group which were cultured in vitro, showed no significant difference with control group. Integrated absorbance(IA) change rate of toluidine blue staining and type II collagen immunohistochemical staining in BMSCs-fibrin gel group which was cultured in vivo, showed significantly different with other groups and control group.Conclusion The results showed that in vitro fibrin gel or chitin has very weak induction of BMSCs to cartilage differentiation, while in vivo BMSCs-fibrin gel can facilitrate BMSCs to differentiate into chondrocyte-like cells.

objective To clarify the significance and puncture path of 125I radioactive seeds implantation in treatment of postoperative local recurrence and pelvic metastasis in patients with rectal cancer.Methods Clinical data of 8 rectal cancer patients with postoperative local recurrence and pelvic metastasis treated by ultrasound guided 125I radioactive seed implantation were retrospectively analyzed and the therapeutic effects were observed.Results After the treatment,the symptoms of 5 cases suffering from hematochezia and 2 cases with vaginal bleeding disappeared within 21 to 30 days.7 patients with preoperative pain relieved after treatment.There was no tumor progression from postoperative imaging examination.Conclusion 125I radioactive seed implantation can effectively improve the life quality of rectal cancer patients with postoperative local recurrence and pelvic metastasis.

Objective To study the clinical significance of the changes of brain natriuretic peptide(BNP) in children with incomplete Kawasaki disease (IKD). Methods Of 25 cases of acute IKD ,20 cases were at the re-covery stage after 2 weeks treatment. 30 cases of upper respiratory tract infection at the same period were taken as controls. The plasma level of BNP,peripheral blood WBC count and C-reaction protein (CRP) levels were detected. Results BNP, WBC and CRP levels in acute IKD children were higher than that of control group (P < 0.01) , which were higher in 20 cases of acute phase than in recovery phase (P < 0.01). Conclusion BNP contributes to the early diagnosis of IKD in children.

BACKGROUND: Odontogenic infection factor has been given much importance in the study of the etiology of secondary trigeminal neuralgia,and the theory of jaw bone cavities is proposed. OBJECTIVE: To study the relationship of the jaw bone cavities and the etiology of trigeminal neuralgia.DESIGN: A self-controlled trial.SETTING: Department of oral and maxillofacial surgery of a university hospital.PARTICIPANTS: The patients with the trigeminal neuralgia were treated in Department of Oral and Maxillofacial Surgery, Affiliated Hospital of the Medical College of Qingdao University from February 1994 to December 2003, from whom 45 were selected for this study, including 15 males and 30 females with altogether 74 jaw bone cavities.METHODS: Curettage of the jaw bone cavities was performed in these cases, and visual analogue scale(VAS) was adopted for evaluation of the postoperative pain.MAIN OUTCOME MEASURES: ① VAS; ② Pathological examination and bacteria culture of the specimens.RESULTS: Pain relief was achieved in 33 cases(73.3% ) after the first surgery and in 10 cases(22.2% ) after a second or third surgery. In 2 cases (4.5%), the pain was alleviated but medication was still needed for pain control. Pathological examinations in most cases identified predominantly in flammatory and granulation tissues.CONCLUSION: Jaw bone cavities may be one of the major etiologic factors of trigeminal neuragia.