Anti-Bacterial Agents ; adverse effects ; Child, Preschool ; Clindamycin ; adverse effects ; Humans ; Infant ; Male ; Paraplegia ; chemically induced

Objective To compare clinical effects of appendicectomy and conservative treatment of uncomplicated acute appendicitis.Methods Searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared conservative treatment with appendicectomy in patients with uncomplicated acute appendicitis were included from January 1983 to May 2013 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 soft-ware.Results Four randomized trials met our inclusion criteria (821partiCI:pants).Antibiotics compared with appendicectomy resulted in similar outcomes with regards to the incidence of complicated appendicitis (RR:0.89,95％ CI:0.29-2.68) and intra-abdominal infection(RR:0.54,95％ CI:0.13-2.35).Antibiotics carries a lower risk of complications (RR 0.46,95％ CI:0.32-0.67),but requires more length of hospital stay (Mean Difference 0.52,95％ CI:0.16-0.88).Conclusions The effect of conservative treatment is safe and effective.But the recurrent uncomplicated appendicitis recommends operation.

Objective To study the relationship between VEGF-C,CD34 expression and thyroid papillary tumor tissue by combining assays of VEGF-C and CD34 in thyroid tumor tissue.Methods The expression of VEGF-C and CD34 were dectected by immunohistochemistry in 61 cases(thyroid papillary cancer 38.thyroid adenoma 23).Results VEGF-C level in thyroid papillary cancer(38.24±19.58)were significantly hisher than that in thyroid adenoma(16.49±9.25,P<0.01);CD34 in thyroid papillary cancer (23.68 ±9.07)/HP were higher than that in thyroid adenoma(18.70±6.34,t=4.9889,P<0.01).We found a significant relationship between the VEGF-C expression and cancerometastasis or tumor size(P<0.01;P<0.05).There was also a relationship between the CD34 expression and cancerometastasis or tumor size or age (P<0.01 or P<0.05).There Was positive relationship between the expression of VEGF-C and CD34(r=0.46.P<0.01).Conclusion It is suggested that combined detections of VEGF-C and CD34 may have important reference value on the differential diagnosis between thyroid papillary tumor tissue.

Objective To compare the pros and cons of endoscopic papillary balloon dilation (EPBD) with those of endoscopic sphincterotomy (EST) in the treatment of common bile duct stones.Methods We searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared EPBD with EST for the removal of common bile duct stones were included from January 1983 to September 2012 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 software.Results A total of 18 randomized trials with 2385 participants met our inclusion criteria.EPBD compared with EST resulted in similar outcomes with regards to stone removal on 1 st attempt,overall stone removal,perforation,total short-term complication,long-term cholangitis or mortality.EPBD carries a higher risk of pancreatitis (RR =1.99,95％ CI:1.41-2.81) and severe pancreatitis (RR =4.68,95 ％ CI:1.36-16.11),and requires higher rates of mechanical lithotripsy (RR =1.31,95％ CI:1.14-1.50).Conversely,EPBD not only has statistically significant lower rates of bleeding (RR =0.14,95％ CI:0.06-0.34),but also leads to significantly less long-term cholecystitis (RR =0.38,95％ CI:0.19-0.76),long-term stone recurrence (RR =0.67,95％ CI:0.47-0.96) and total longterm complications (RR =0.52,95 ％ CI:0.40-0.67).Conclusion On the basis of lower rates of bleeding or long-term complications,EPBD should be the preferred strategy over EST for endoscopic management of common bile duct stones,however,the rate of pancreatitis,especially the severe pancreatitis is higher with EPBD.

Equipment Design ; Humans ; Nebulizers and Vaporizers

OBJECTIVETo investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones.

METHODSA total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects.

RESULTS(1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05).

CONCLUSIONSGan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

Adult ; Case-Control Studies ; Diarrhea ; etiology ; Dyspepsia ; blood ; complications ; psychology ; Gastrointestinal Hormones ; blood ; Humans ; Irritable Bowel Syndrome ; blood ; complications ; psychology ; Psychological Tests ; Qi ; Serotonin ; Surveys and Questionnaires ; Yang Deficiency

Objective To evaluate the role of mitochondrial fission in anoxia-reoxygenation injury to rat hippocampal neurons.Methods Neurons were enzymatically isolated from hippocampi of newborn Sprague-Dawley rats (less than 24 h old).The primary hippocampal neurons were cultured and seeded in 25 mm × 25 mm culture flasks at a density of 7 × 105/ml.The cultured neurons were randomly assigned into 3 groups (n =18 each) using a random number table:control group (C group),anoxia-reoxygenation group (I/R group),and mitochondrial fission inhibitor mdivi-1 group (M group).In group I/R,the vehicle dimethyl sulfoxide (DMSO,final concentration ＜ 0.1％) was added prior to anoxia and the cells were then incubated for 40 min.In group M,mdivi-1 (dissolved in DMSO,final concentration of DMSO ＜ 0.1％) was added prior to anoxia and the cells were then incubated for 40 min.The hippocampal neurons were subjected to oxygen-glucose deprivation (OGD) for 6 h followed by restoration of O2 supply for 20 h.After 20 h of reoxygenation,the level of reactive oxygen species (ROS) (by ELISA),cell apoptosis (using flow cytometry),and expression of mitochondrial fission protein Drp1,Bcl-2 and Bax (by Western blot) were measured.The apoptosis rate and the ratio of Bcl-2 to Bax were calculated.Results Compared with C group,ROS content and apoptosis rate were significantly increased,the expression of Drp1 and Bax was up-regulated,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2 to Bax was decreased in I/R group (P ＜ 0.05).Compared with I/R group,ROS content and apoptosis rate were significantly decreased,the expression of Drp1 and Bax was down-regulated,the expression of Bcl-2 was up-regulated,and the ratio of Bcl-2 to Bax was increased in M group (P ＜ 0.05).Conclusion Mitochondrial fission is involved in anoxia-reoxygenation injury to rat hippocampal neurons via mitochondria-mediated apoptotic pathway.

BackgroundPterygia is a clinical common disease.A lot of surgical methods are developed to decrease the recurrence rate.Resent years,the application of fibrin glue is receiving more and more attention.Objective This study was to explore the effects of fibrin glue in decreasing inflammatory irritation and its mechanism. Methods Pterygia models were created in 12 clean rabbits by exsection of limbal tissue and topical administration of 1.25％ diluted hydrochloric acid,and then the conjunctival autograft surgery was performed in the experimental rabbits.The conjunctival flap was sutured in the left eyes,and the conjunctival wound was closed using fibrin glue in the right eyes.The operation duration for each group was documented and compared.The irritation sign was examined under the slit lamp in all the rabbits 1 week and 4 weeks respectively.The expressions of vascular endothelial growth factor (VFGF) and basic fibroblast growth factor (bFGF) proteins in the conjunctiva tissue were detected by immunochemistry,and the expressions of VFGF mRNA and bFGF mRNA in the conjunctival tissue were determined by reverse transcription polymerase chain reaction (RT-PCR).Results The operative duration was (21.3±0.2) minutes in suture group and( 10.1 ±0.1 )minutes in the fibrin glue group with a significant difference between two groups( t =102.242,P＜0.05 ).From 1 week through 4 weeks,the hyperemiain degree was obviously slight in fibrin glue group compared with suture group.Immunochemistry showed that VEGF and bFGF proteins were expressed mainly in the cytoplasm of conjunctival epithelium layer.The positive response intensity was weaker in the fibrin glue group than in suture group 1 week and 4 weeks after operation.RT-PCR revealed that the expression level of VEGF mRNA was significantly lower in fibrin glue group than in suture group,and the VEGF mRNA was gradually decreased with the time lapse ( Fgroup =174.443,P =0.000 ; Ftime =231.459,P =0.000 ).The similar outcomes were found in the expression of bFGF mRNA(Fgroup=41.727,P=0.000;Ftime=55.417,P=0.000). ConclusionsThe use of fibringluecanshortentheoperationdurationandreducepostoperationinflammatoryreaction.The downregulation of VEGF and bFGF in tissue is the possible mechanism of remitting irritation sign,which allows a reduce of the recurrence rate of pterygia.

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

OBJECTIVE:To explore the effects of the different compatibility ratios of rutin with quercetin on the pharmacoki-netics of rutin in rats in vivo. METHODS:30 rats were randomly divided into rutin group(rutin-quercetin molar ratio of 4:0,the same below),quercetin group(rutin-quercetin ratio of 0:4),BL1 group(rutin-quercetin ratio of 3:1),BL2 group(rutin-quercetin ratio of 2:2)and BL3 group(rutin-quercetin ratio of 1:3),6 rats in each group,all group was administrated 10 mg/kg(calculat-ed by quercetin core of rutin and quercetin) intragastrically. The blood sample 0.3 mL was respectively taken from tail vein after 0.25,0.5,0.75,1,1.5,2,3,4,6,8,10,12,16,20,24 h of administration,the plasma concentration of quercetin(rutin me-tabolite) was determined by HPLC. DAS 2.0 software was used to calculate the pharmacokinetic parameters. RESULTS:The AUC0-24 h in rutin group,quercetin group,BL1 group,BL2 group and BL3 group were (4.908 ± 0.877),(8.382 ± 3.671), (8.473 ± 0.709),(4.366 ± 2.297),(8.914 ± 2.642)μg·h/L;MRT0-24 h were (9.675 ± 1.359),(3.142 ± 0.489),(3.517 ± 1.128), (3.376 ± 1.046),(4.494 ± 1.653) h;tmax were (5.726 ± 5.645),(1.375 ± 0.703),(1.125 ± 1.438),(1.417 ± 2.300),(1.292 ± 0.954) h;and cmax were (0.609 ± 0.202),(2.341 ± 0.539),(2.425 ± 1.217),(1.464 ± 0.677),(3.325 ± 2.425)μg/L. Compared with rutin group,AUC0-24 h and cmax in quercetin group,BL1 group and BL3 group were significantly increased(P<0.05),tmax and MRT0-24 h were significantly decreased(P<0.05);cmax in BL2 group was significantly increased(P<0.05),tmax and MRT0-24 h were significantly decreased(P<0.05). Compared with quercetin group,except AUC0-24 h was significantly decreased in BL2 group(P<0.05),there were no significant differences in AUC0-24 h,MRT0-24 h,tmax or cmax in BL1 group,BL2 group and BL3 group(P>0.05). CONCLUSIONS:Quercetin can inhance the related indexes of rutin in rats in vivo.