Objective To explore the value of laparoscopic appendectomy (LA) in children. Methods A total of 52 children underwent laparoscopic appendectomy by using the 3-port technique from October 2002 to December 2004. Results The operations were performed smoothly in all the 52 cases. The operating time was 20~50 min (mean, 30 min). The patients were discharged from hospital at 2~4 postoperative days. Peri-port subcutaneous emphysema occurred in 2 cases. No other complications were found. Follow-up checkups for 3~29 months (mean, 14 months) in 49 cases found no intestinal obstruction or abdominal residual infection. Conclusions Laparoscopic appendectomy in children is safe, effective and minimally invasive.

Objective To provide basis for the formulation of policies and measures that will reduce the work pressure on nurses and to provide them with a better working environment. Methods An investigation was made via questionnaires into 942 nurses working in designated SARS hospitals and a comprehensive analysis was conducted by means of multivariant stepwise regression. Results The major factors affecting the pressure on nurses include: lack of support from and communications with families, arduousness of tasks to an unbearable point, extreme strictness in management, and unsoundness of treatment and living conditions. Conclusion Good communications with families are of great significance to nurses working in isolated areas. It is imperative to rationally allocate the human resources of nurses, show more concern for them, encourage them to participate in management, and strengthen scientific prevention so as to create a better working environment.

Distribution channel of Chinese herbal medicines has been changing. From Han to Ming Dynasty, Chinese herbal medicine were mainly trafficked to urban by dealers or farmers; From the Ming Dynasty to the foundation of new China, distribution channels are primarily intermediated with township "bazaar" and national distribution center with fixed place and regularly trading hours. In the planned economy period, the state-owned herbal medicine company was the sole medium with monopoly nature. From the mid1980s to the end of last century, planned economy and market economy have been co-existing. Stepping into 21st century, producing area highlighted in the distribution channels. Presence or absence and rise or fall of different types of distribution market went throughout the changing process of distribution channels, which became an important clue. Changes were motivated by economical consideration of channel subject, which originated from commodity characteristic and social environment changes.
Cities ; Drugs, Chinese Herbal ; economics ; supply & distribution ; Economic Development ; Marketing

Objective To investigate the effects of electro-acupuncture on gastric emptying and Fos expression in the neuron of vagal-solitary complex (VSC) of rat bulbus after lipopolysaccharide (LPS) intraperitoneal injection (i.p.). Methods 40 male SD rats were randomly assigned to 4 groups: control group, LPS i.p. group, LPS i.p. plus electro-acupuncture at Tsusanli point group and LPS i.p. plus electro-acupuncture at non-meridian-non-acupoint group, 10 rats for each group. Immunohistochemical techniques were used to detect the Fos expression in VSC. The animal's gastric emptying was measured by phenol red method. Results The rats with gastric emptying decreased greatly to (20.7±4.5)% 2.5 hours after LPS injection, and Fos-positive neurons were significantly found in VSC (83.2±6.6) compared with control group. However, in the group of LPS i.p. plus electro-acupuncture at Tsusanli point, the gastric emptying was up-regulated to (44.1±6.2)%, and the expression of Fos -positive neurons were down-regulated to (37.9±3.8) compared with LPS i.p. group. No significant difference was found between the group of LPS i.p. plus electro-acupuncture at non-meridian-non-acupoint and the group of LPS i.p. Conclusion LPS i.p. can retard the gastric motility in rats, electro-acupuncture at Tsusanli point may well regulate the function in LPS model rats. This function may be connected with its protective effects on Fos immunoreactive neurons activity in VSC of rat bulbus.

Objective To study and evaluate islet cell adenoma of preliminary diagnosis.Method Retrospective analysis Wag done on 22 patients clinical data of preliminarily diagnosed islet cell adenoma.They were divided into two groups according to final diagnosis,group of islet cell adenoma(n=16)and group of reacfional hypoglycemia n=6).Results There were significant differences between the two groups in term of fames,cold sweat,cataphora,Whipple triad,hungry test,the ratio offasting blood insulin and fasting blood glucose exceeding 0.3 (I/G＞0.3) (P＜0.05).No statistical differences were found on blood glucose level in hypoglycemia onset,psychiatric symptom.Conclusion The clinic data is helpful for preliminary diagnosis,and Whipple triad,hungry test,I/G＞0.3 above all.

Objective To identify and analyze the plasmid (pR_ ST98 ) encoding multi-resistance to anti-microbial agents in S.typhi presenting the Salmonella plasmid virulence gene (spv).Methods Plasmid pR_ ST98 ,which could mediate virulence to its host bacteria, was used as the templete. The spv-specific PCR and Southern blot were employed to identify the spv virulence gene on this plasmid. The amplified spv fragments (spvR and spvB) were cloned into pGEM-T EASY.Then the DNA sequences were analysed. Results The date of PCR and Southern blot showed that spv,which had been found in other pathogenetic Salmonella spp. except S. typhi was also presented on pR_ ST98 . The ORF of spvR and spvB of pR_ ST98 were 894bp and 1 776bp respectively. They had more than 99% homologus with that of spvR and spvB on virulence plasmid in S.typhmurium.Conclusion From the results of PCR,Southern blot and nuclei acid sequencing, we concluded that this is the first report of revealing a mosaic-like plasmid carrying genes encoding not only drug resistance but also virulence in S.typhi.

Objective To study the anti-tumor effect of Zhongjiefeng Injection in vitro and its combination with adriamycin.Methods MTT assay was adopted to determine the in-vitro anti-tumor effect,IC50 was used to measure the direct anti-tumor effect,and Jing' s formula was applied to analyze the combination of the drugs.Results Zhongjiefeng Injection can inhibit the proliferation of Bel 7402(human hepatoma cells),HCT-8(human colon cancer cells),and the IC50 was 33.13 mg/mL for Bel 7402 and 52.39 mg/mL for HCT-8 respectively.Zhongjiefeng Injection at the concentrations of 3.125,6.25,12.5 mg/mL showed an efficancy potentiation action with doxorubicin on the inhibition of HCT-8 cells in vitro,and 25,50 mg/mL showed a synergic effect on HCT-8 .Conclusion Zhongjiefeng Injection has a certain in-vitro inhibitory effect on the growth of Bel 7402 and HCT-8,its combination with doxorubicin in vitro can produce synergic effects(a simple combined or enhanced effects)to HCT-8 cells,especially high concentrations of Zhongjiefeng Injection with doxorubicin.It is suggested that Zhongjiefeng Injection in the doubled dosage may have a better synergistic effect with doxorubicin in clinical treatment of colon cancer.

protrusion measured by ultrasound for diagnosing bladder outlet obstruction.Methods A literature search of medline (1966.1-2011.6),embase(1984.1-2011.6),CNKI (1994.1-2011.6) and WEIPU Data (1989.1-2011.6) from 1999 to 2009 was performed by two reviewers independently.QUADAS items was applicated to assess trial quality.Golden standard was BOOI measured by urodynamics (BOOI more than 40 indicates bladder outlet obstruction).Heterogenous studies and meta-analysis were conducted by Meta-Disc 1.4 software.Results Totally 6 studies was included at last,involving 682 subjects.No threshold effect was found,but there was heterogeneity due to other factors.The meta-analysis showed that the sensitivity was 70.8 ％,specificity was 87.6 ％,positive LR was 5.132,negative LR was 0.303,the diagnostic OR was 22.18,the area under SROC curve was 0.8723 and Q index was 0.8028.Conclusions Intravesical prostatic protrusion measured by ultrasound is a good index for diagnosing bladder outlet obstruction in patients with benign prostate hyperplasia when intravesical prostatic protrusion is equal or more than 10mm.

Objective To study the applications and outcomes of using autogeneic cartilage in hearing recon-struction surgery in patients with chronic otitis media or cholesteatoma .Methods A total of 165 patients (173 ears) in whom autogeneic cartilage was used were analyzed retrospectively .Forty -three patients (48 ears) had simple tympanic membrane perforations ,61 patients (61 ears) had cholesteatomas including 12 retraction pockets ,23 pa-tients (23 ears) had tympanoscleroses and 38 patients (41 ears) had otitis media with granulations .The cartilage grafts were used for tympanic perforation reparing in 133 patients (139 ears) ,for ossiculoplasty in 102 patients (104 ears) ,for attic reconstruction in 31 patients (31 ears) and for canal wall reconstruction of external auditory canal in 3 patients (3 ears) .The auditory outcome (0 .5 ,1 ,2 ,and 4 kHz pure tone average hearing threshold ,the average air-bone gap) and local architecture status were followed up for 1 year after surgery .Results In 133 patients (139 ears) with tympanic perforation ,the rate of successful repair of a tympanic membrame perforation in one -stage was 97 .84% with perforation repair in 136 ears and postoperative perforation in 3 ears .In 102 patients (104 ears) of os-siculoplasty ,there was no ossicular prostheses prolapse .In 31 patients (31 ears) of attic reconstruction ,no local graft shift or collapse was found .In 3 patients (3 ears) of external auditory canal repair ,no canal wall collapse occurred . In myringoplasty group (43 patients ,48 ears) ,preoperative and postoperative air -bone gap (ABG) was 23 .8 ± 3 .1 dB and 11 .6 ± 8 .7 dB ,respectively .In cholesteatoma group (61 patients ,61 ears ) ,preoperative and postoperative ABG were 39 .2 ± 24 .7 dB and 19 .0 ± 12 .1 dB ,respectively .In tympanosclerosis group (23 patients ,23 ears) ,pre-operative and postoperative ABG were 31 .2 ± 12 .4 dB and 19 .8 ± 11 .2 dB ,respectively .In otitis media with granu-lation group (38 patients ,41 ears) ,preoperative and postoperative ABG were 41 .6 ± 9 .9 dB and 15 .3 ± 13 .4 dB ,re-spectively .Conclusion Autogeneic cartilage is very valuable in hearing reconstruction surgery ,especially in compli-cated tympanic perforation ,combination with ossiculoplasty prostheses ,or reconstruction of mastoid cavity or exter-nal call wall defect .

Continuous exposure to conventional glucose-containing lactate-buffered solutions will ultimately lead to irreversible changes of the structure and function of peritoneum.Therefore,the development of novel peritoneal dialysis(PD) solutions has become the focus in the PD fields in recent years.Icodextrin,which has more adventages than conventional PD solutions,is one of the most important advancements in the past decade.Icodextrin has better biocompatibility,and can reduce the absorption of carbohydrates to decrease the metabolic complications in PD patients.Apart from increasing ultrafiltration,icodextrin can also improve the fluid status and protect the residual renal function of PD patients.However,adverse consequences may result from the pseudo-hyperglycaemia caused by limited measurement of serum glucose.This article reviews the features and applications of the new PD solutions—icodextrin solutions.