Acute appendicitis is the most common surgical or acute abdomen in childhood.Rapid and correct diagnosis is the premise of rational therapy,but there are still some problems in diagnosis and differential diagnosis.Sufficient comprehension about clinical features and differential diagnostic diseases,typical clinical symptoms,physical examination,laboratory examinations,ultrasonography or CT would make a definite diagnosis.Laparoscopy is also used to make a diagnosis if necessary.

Many reasons cause low back pain, such as muscles and ligaments injury, vertebral joints retrogression, spinal canal stenosis, lumbar disc herniation, lumbar spondylolisthesis, spondyloarthritis, infection, tumor and metabolic bone disease. It is in recent years that discogenic low back pain be recognised, especially after the MRI widely applied in clinics. This article makes a summary on discogenic low back pain of recent years from etiology, pathogenesis, diagnosis and therapy.

Objective To observe the influence of low epidural anesthesia on heart rate variability (HRV) and blood pressure,heart rate in elderly hypertensive patients.Methods 125 patients who were adopted routine selective pelvic cavity operation or lower limb operation were divided into the two groups,the observation group(56 cases) complicate with hypertension,control group (69 cases)with normal blood pressure.The heart rate,blood pressure and low frequency,high frequency of HRV before and 5min,15min,45min after anesthesia were monitored and compared.Results Before operation and 5,15,45 min after anesthesia,the systolic blood pressure were (150.2 ±12.4)mmHg,(142.6 ±12.9)mmHg,(127.6 ±12.9)mmHg,(123.7 ±11.3)mmHg,diastolic blood pressure were(84.2 ±12.3)mmHg,(75.3 ±10.4)mmHg,(73.7 ±8.61)mmHg,(71.7 ±7.3)mmHg,heart rates were (88.4 ±11.3)times/min,(82.3 ±9.1)times/min,(78.4 ±10.5)times/min,(77.5 ±10.5)times/min,low frequency ofHRV were (87.5 ±23.7)Hz,(76.4 ±22.2)Hz,(55.4 ±22.1)Hz,(62.4 ±21.3)Hz,high frequency of HRV were(50.2 ±22.2)Hz,(32.3 ±16.7)Hz,(29.5 ±18.3)Hz,(26.3 ±18.4)Hz in the observation group;The systolicblood pressure were (133.6 ±11.4)mmHg,(123.1 ±9.5)mmHg,(121.6 ±10.1)mmHg,(120.3 ±16.3)mmHg,diastolic blood pressure were (77.3 ±11.8)mmHg,(71.4 ±10.5)mmHg,(70.4 ±10.2)mmHg,(71.2 ±8.6)mmHg,heart rate were (85.8 ±10.7 )times/min,(85.8 ±10.7 )times/min,(84.3 ±11.4)times/min,(84.5 ±11.9)times/min,low frequency of HRV were (69.1 ±20.7)Hz,(59.6 ±22.1)Hz,(45.7 ±26.8)Hz,(56.3 ±17.4)Hz,high frequency of HRV were (39.5 ±20.3)Hz,(34.6 ±18.9)Hz,(40.6 ±21.7)Hz,(41.1 ±18.1)Hzin the control group;The systolic blood pressure and diastolic blood pressure in the observation group after anesthesiawere lower than those before operation(systolic blood pressure:t =4.622,5.361,5.732,all P <0.05;diastolic bloodpressure:t =4.778,5.246,5.835,all P <0.05),The systolic blood pressure and diastolic blood pressure in the control group after anesthesia were lower than those before operation(systolic blood pressure:t =3.135,3.526,3.778,allP <0.05;diastolic blood pressure:t =3.636,3.578,3.467,all P <0.05),The systolic blood pressure and diastolicblood pressure in the observation group declined by a larger margin than those in the control group(t =3.782,3.825,3.562,all P <0.05),the heart rate after anesthesia were lower than those before operation both groups(observationgroup:t =4.613,5.724,6.146,all P <0.05;control group:t =3.143,3.672,3.572,all P <0.05),the heart rate inthe observation group declined by a larger margin than those in the control group(t =3.052,3.462,3.782,all P <0.05),low frequency of HRV and high frequency of HRV in the observation group after anesthesia were lower thanthose before operation(low frequency of HRV:t =4.144,5.156,4.714,all P <0.05;high frequency of HRV:t =4.614,4.352,4.667,all P <0.05),low frequency of HRV and high frequency of HRV in the control group after anesthesia were lower than those before operation(low frequency of HRV:t =2.625,3.622,3.725,all P <0.05;highfrequency of HRV:t =3.273,3.605,3.726,all P <0.05),low frequency of HRV and high frequency of HRV in theobservation group declined by a larger margin than those in the control group(low frequency of HRV:t =3.578,3.061,3.136,all P <0.05;high frequency of HRV:t =3.851,3.414,3.684,all P <0.05).Conclusion Low epidural anesthesia would exert huge impact to the autonomic nervous system of elderly hypertensive patients.

Objective To investigate the clinical features and treatment programs in children with Takayasu arteritis (TA) in order to improve awareness of the disease. Methods A retrospective study of hospi-talized children with TA in our hospital from Jan. 1999 to Dec. 2012 was performed. Results Between the 15 patients with TA, the ratio of male to female was 1∶2. The onset was from 14 months to 15 years old, with average age at (10 ±4) years old. It is according to (the European League against Rheumatism/the Pediatric Rheumatology European Society (EULAR/PRES) criteria for the diagnosis of TA. The most common clinical manifestations are hypertension, which occurred in 13 cases(87%), weak pulse or pulseless in 11 cases (73%), and heart failure in 10 cases (67%). About two-thirds of patients were diagnosed when the onset of heart failure occurred. The most common clinical type was type Ⅱ, which occrred in 9 cases (60%). Antihypertensive drugs, oral steroid and congestive heart failure controlling were the main treatment. Three patients with positive purifiedproteinderivative (PPD) test received anti-TB treatment. Three patients had vascular bypass surgery, one patient had percutaneous transluminal angioplasty. Conclusion TA may be life-threatening and progressive. Many patients are with advanced disease at the time of treatment, so the prognosis is generally poor. Early recognition is necessary to initiate appropriate therapy. The disease should be considered in patients with unexplained arterial hypertension or unexplained inflammatory syndromes without local signs.

China ; History, 20th Century ; Humans ; Integrative Medicine ; history ; Medical Oncology ; history ; Physicians ; Portraits as Topic

OBJECTIVE To investigate the evolution of drug-resistance of Staphylococcus aureus in children in Hubei tertiary level hospitals during four years and provide the evidence for clinically reasonable use of antibiotics.METHODS The summary data of drug sensitivity in clinical isolates of meticillin-resistant S.aureus(MRSA) and meticillin-sensitive S.aureus(MSSA) in children in Hubei tertiary level hospitals from 2004 to 2007 were investigated retrospectively and the results were analyzed statistically.RESULTS The tendency of infections with MRSA upgraded yearly during four years(5.7%→10.7%→40.8%→46.9%);the resistance rates of MRSA to various antibiotics were all higher than that of MSSA.The vancomycin-resistant S.aureus had not been detected.CONCLUSIONS The drug-resistance status of SA in Hubei is still very serious.We should adopt effective measurement to control the occurring and epidemic outbreak in combination with children physiological characteristic.

[Objective] Through a meta-analysis to compare the effectiveness and safety of traditional Chinese medicine and western medicine in the treat-ment of chronic atrophic gastritis(CAG) with dysplasia . [Methods] Randomized clinical trials(RCTs) which compared traditional Chinese medicine and western medicine for chronic atrophic gastritis with dysplasia in PubMed, Cochrane library, WanFang and CNKI were searched. The patients which were analyzed were divided into two groups: western medicine and traditional Chinese medicine.Statistical heterogeneity between trials was evaluated by RevMan5.0. Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Publication bias was investigated through visual inspection of funnel plots and Egger's regression model.[Results] 6 RCTs including 632 patients were analyzed. The total odd ratios(OR) of clinical symptoms,gastroscope symptoms,pathological symptoms by traditional Chinese medicine were higher than western medicine, the OR values were 3.40(95%CI:2.18~5.31,P<0.01),4.14(95%CI:2.37~7.20,P<0.01),2.94(95%CI:1.77~4.90,P<0.01),3.71(95%CI:2.29~6.02,P<0.01),4.41(95%CI:2.75~7.07,P<0.01),5.21 (95%CI:3.65~7.43,P<0.01). Inspection of the funnel plots for al outcome measures did not reveal evidence of publication bias( P=0.81, 0.41, 0.29, 0.88, 0.44, 0.82, respectively).[Conclusions] The treatment of chronic atrophic gastritis with dysplasia by traditional Chinese medicine can improve the excel ent response rate, overal response rate of clinical symptoms,gastroscope symptoms,pathological symptoms better than its purely western medicine treatment efficacy.

AIM To develop a comparative method for studying on the HPLC/UV/MS fingerprints of triterpene acid in the leaves and the seeds of Lagerstroemia specious L. METHODS Separation was performed on LunaC_ 18 (2.6 mm?250 mm, 5 ?)analytical column, The mobile phase was composed of acetonitrile and 0.1 % formic acid as gradient eluent. The flow rate was 1.0 ml?min -1 . RESULTS Both of corosolic acid and maslinic acid existed in the leaves and the seeds of Lagerstroemia specious L. Ursolic acid existed in the leaves and the oleanolic acid contained in the seeds of Lagerstroemia speciouswere L. CONCLUSION The method can be used for quality control of the leaves and the seeds of Lagerstroemia specious L.

The physicochemical properties and functional activities of chitooligosaccharides are more superior than chitin and chitosan, so chitooligosaccharides becomes a new developing kind of functional oligosaccharides worldwide in recent years. Research development of the physiological activities of chitooligosaccharides such as antibacterial activity, antitumor activity, protective effect on bacterial infection in vivo , regulation of plant physiology, proliferation of bifidobacteria and anti-mutagenic activity was reported in China and a-broad, meanwhile, application prospect were forecasted as well in the paper.

OBJECTIVE To investigate the resistance of Staphylococcus to erythromycin and clindamycin and detect the percentage and gene for inducible resistance in Tai'an.METHODS The susceptibilities of Staphylococcus to erythromycin and clindamycin were examined by Kirby-Bauer disc agar diffusion test and the inducible erythromycin resistance to clindamycin was checked by D-test according to the standards of NCCLS,and the resistance genes msrA,Vgb,sat4,ermA,ermB and ermC were detected by using PCR technology.RESULTS Among the 326 strains,162(44.12%)were all resistant to erythromycin and clindamycin;68(20.86%)were resistant to erythromycin and sensitive to clindamycin but they were positive in D-test;42(12.88%)were resistant to erythromycin and sensitive to clindamycin but they were negative in D-test.The rates of inducible resistance of MRSA,MSSA,MRCNS and MSCNS to clindamycin were 40.00%,56.25%,63.38% and 66.67%,respectively among the Staphylococcus which were resistant to erythromycin and sensitive to clindamycin.The gene ermC was the main one for inducible erythromycin resistance to clindamycin.The percentage of gene ermC was 85.29% and that of ermC and sat4 either was 7.35%;all the others were negative.CONCLUSIONS The rate of inducible erythromycin resistance to clindamycin in our area is relatively high,and D-test in clinical microbiology laboratory should be done so that the physicians can select the reasonable MLSB antimicrobial agents.