Objective To explore the effect of mon-suturing peritoneum in perforating purulent infection of incisional wound of appendicitis. Methods907 patients suffered purulent perforating and gangrenous appendicitis were divided randomly into two groups:the non-suturing group of 355 patients and the control group of 552 patients.Of the non-suturing group,peritoneum was not sutured when his/her abdominal cavity was closed.It was just on the contrary to the control group.Then examined whether eoncotic rythrogenic or tender incision occurred,or whether purulent secretion flowed outside from the operative incision.These items below were also been recorded carefully:the average number of days when the temperature was abnormal,the grades of healing of incision and the average hospital stay. ResultsIn the non-suturing group,21(5.9%)patients suffered postoperative infection,the number of days of abnormal temperature was(3.8 ± 1)d on average,and the average hospital stay was(7.5 ± 1)d;in the control group,119(21.6%)patients suffered postoperative infection,the number of days of abnormal temperature was(4.3 ± 1)d on average,and the average hospital stay was(12.9 ± 1)d.First rate healing of incision in the non-suturing group was far higher than that in the control group(P＜0.05). ConclusionNon-suturing peritoneum could help internal drainage peritoneum,which was an efficient way to guard against the postoperative infection.And non-suturing was also of great significance to reduce the average number of days of abnormal temperature and hospital stay.Meanwhile,the probability of ankylenteron and incisional hernia was not increased.

Objective: To investigate the effects of morphine,tramadol and lornoxicam on the secretion of inflammatory mediators by rats'peripheral blood mononuclear cells(PBMC) at their analgesic concentrations. Methods: Mononuclear cells were isolated from peripheral blood of male SD rats by the Ficoll-Hypaque method,and treated with Morphine(50 ng/ml),Tramadol(500 ng/ml) or Lornoxicam(300(ng/ml)) respectively with or without stimulation by Lipopolysaccharide(LPS) 2 ?g/ml.After incubation for 24 h,concentrations of TNF-?,IL-6 and IL-10 were determined in the cell culture supernatants by ELISA. Results: Levels of TNF-?,IL-6 and IL-10 were reduced significantly in morphine groups with or without LPS;Tramadol reduced levels of these inflammatory mediators significantly in the groups stimulated with LPS,while it had no effects on the cells cultured in normal conditions;Lornoxicam reduced IL-6 and increased IL-10 levels in either groups. Conclusion: Morphine nonselectively suppressed mediator secretions either under inflammatory or physiological conditions;Tramadol reduced inflammatory mediator secretion in LPS stimulating group,thus could benefit patients with potential sepsis;Lornoxicam significantly reduced proinflammatory cytokine IL-6 secretion and increased anti-inflammatory cytokine IL-10 secretion,and may be a choice for postoperative hyperinflammation.

Methods A cluster random sampling method was used to select left-behind students in Grade 3 to 6 in 5 primary schools in the southern rural area of Ningxia Hui Autonomous Region. Their general information were collected, their social anxiety and loneliness were evaluated by the Child Social Anxiety Scale ( SASC ) and Children's Loneliness Scale ( CLS ). The multivariate linear regression model was used to analyze the influencing factors for the social anxiety of left-behind children.

Perioperative stroke refers to acute ischemic or hemorrhagic stroke that occurs before operation,during operation and within 30 days after operation.Although the levels of anesthesia and surgical treatment have improved in recent years,there is no significant decrease in the incidence of perioperative stroke.The traditional vascular risk factors,such as advanced age,hypertension,and diabetes,are also the risk factors for stroke onset.In addition,perioperative stroke is closely associated with the operation site,operation mode,anesthesia,and other perioperative events.The treatment and prevention of perioperative stroke is attracting more and more attention,including surgery,anesthesia,neurology and other clinicians.This article reviews the risk assessment,prevention,and treatment of perioperative stroke.

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Objective To apply early comprehensive rescue including embolism and microsurgery for trea- ting acute ruptured intracranial aneurysm in order to lower mortality and disability.Methods 120 patients with rup- tured intracranial aneurysm were treated by early comprehensive rescue.An cases were given support treatment,e- mergency rescue and DSA after hospitalization.Embolism and microsurgery were done within 72 hours and releasing bleeding CSF were done after surgery to prevent complications.Results Good recovery was over 80%(excellent in 95 ases,light disability in 18 cases,heavy disability in 4cases,and death in 3 cases).2 cases relapsed during hospi- talization.5 cases were coma induced by serious cerebral vesospasm.Conclusion Early comprehensive treatment including embolism and microsurgery complication prevention may reduce rebleeding,serious vasospasm and hydro- cephalus,1ower mortality and improve prognosis.

MYO1E gene is located on chromosome 15 and encodes myosin 1e,which acts as an actin-based molecular motor of cytoskeleton. Myosin 1e is critical to maintain the podocyte function and the conse-quent integrity of the glomerular filtration barrier. Mutations in MYO1E gene has been indentified to be the cause of childhood-onset,familial steroid-resistant focal segmental glomerulosclerosis. Surprisingly,three patients with MYO1E mutations had partial remission by cyclosporine therapy. Detection of the MYO1E gene in the patients suffering from steroid-resistant nephrotic syndrome will be beneficial to make therapeutic decisions and predict prognoses.

Objective: To observe the clinical effects of comprehensive treatmenton cutaneous region for low back pain.
Methods: One hundred and twenty outpatients with low back pain who met the diagnostic criteria were randomly divided into a cutaneous region group or a medication group, 60 cases in each group. The cases in the cutaneous region group were treated by Nie-pinching up the skin of the lumbosacral region, cupping and acupuncture. Those in the medication group were treated by oral administration of Celecoxib capsule. The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess the therapeutic effects.
Results: After treatment, the VAS scores of both groups were different from those before treatment, showing statistical significances (allP<0.01). The D-valuse of VAS scores of both groups were different from those before treatment, showing statistical significances (allP<0.01). The D-value of OID scores in the cutaneous region group was significantly different from that in the medication group(P<0.01). After treatment, the total effective rate was 91.7% in the cutaneous region group versus 76.7% in the medication group, there was a significant difference in comparing the clinical effect (P<0.01).
Conclusion: Both comprehensive treatment on the cutaneous region and Celecoxib capsule can obviously relieve low back pain. But comprehensive treatment on the cutaneous region is better than Celecoxib capsule in the therapeutic effects.

Objective To explore the efficacy of shugan -jieyu capsule and escitalopram in treating post -stroke depression (PSD).Methods 80 cases with PSD were randomly divided into the study group(administered with shugan -jieyu capsule and escitalopram)and the control group(administered only with escitalopram),40 cases in each group.Hamilt Depression Rating Scale(HAMD),Modified Einberg -Scandinavian Stroke Scale(MESSS)and Treatment Emergent Symptoms Scale(TESS)were used to assess treatment effect before treatment and at the weekend of 2nd,4th,8th after treatment.Results The scores of HAMD and MESSS in the study group were much lower than those in the control group.The scores of HAMD at 4th weekend and 8th weekend in the study group were (16.92 ± 3.75),(8.60 ±3.25),those in the control group were (19.27 ±4.11),(11.13 ±3.72)(t2w =-2.671,t4w =-3.239,P <0.05).The scores of MESSS at 4th weekend and 8th weekend in the study group were (20.06 ±3.87), (12.47 ±3.97),which in the control group were (21.68 ±3.12),(15.09 ±3.20)(t2w =-2.061,t4w =-3.250, P <0.05),while the effective rate in the study group(80.0%)was significantly higher than that in the control group (45.0%)(χ2 =5.227,P <0.05).Conclusion The efficacy of shugan -jieyu capsule combined with escitalopram for PSD is superior to use escitalopram alone.

BACKGROUND:Studies have shown that neural stem cel transplantation has a certain effect on neuropathic pain, but the efficacy of transplanted cel number on neuropathic pain is not exactly understood. OBJECTIVE:To observe the effect of different amount of neural stem cels administered intrathecaly on the neuropathic pain and expression of glial-derived neurotrophic factor in the spinal cord dorsal horn and dorsal root ganglion in rats after partial sciatic nerve transaction. METHODS:A Sprague-Dawley rat at 14-16 days of pregnancy was used to prepare neural stem cel suspensions that were injected intrathecaly into rat models of partial sciatic nerve transaction at doses of 1×103, 1×104, 1×105, 1×106, 1×107cels per 30 μL, respectively. Additionaly, model group and sham-operated group were set up. Threshold values of mechanical and thermal pain were recorded 1 day before operation, 1, 3, 7, 14, 21 days after operation. Expressions of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were detected by immunohistochemistry and RT-PCR, respectively, at 7 and 21 days after partial sciatic nerve transaction. RESULTS AND CONCLUSION: Pain threshold values were decreased in al the groups except the sham-operated group at 1 day after operation, and reached the peak at 7 and 14 days after operation (P < 0.05). Compared with the model group, the pain threshold values and the expression of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were increased gradualy in a dose-dependent manner in the 1×104, 1×105, 1×106, 1×107 groups at 7 days after operation (P < 0.05). At 21 days post-operation, the pain threshold values showed no differences from the preoperative findings in the 1×105, 1×106, 1×107 groups, but the expression of glial-derived neurotrophic factor was significantly higher in the 1×105 group than the other groups (P < 0.05). Taken together, intrathecal transplantation of neural stem cels at a dose of 1×105 is the most effective in aleviating partial sciatic nerve transaction-induced neuropathic pain in rats.