Objective To evaluate the accuracy of white cell count(WCC) and C-reactive protein(CRP) for diagnosing severity of acute paediatric appendicitis.Methods Clinicopathologic characters,WCC,CRP,histology were analyzed in 150 children undergoing open appendectomy for acute appendicitis.Results Appendix was grossly inflamed in 123 of which 24 had perforation.Histology revealed simple acute appendicitis in 99(66.0％),gungnenous appendicitis in 24(16.0％) and the rest were normal.The duration of symptoms(4.6±5.6) time,temperature (38.3±0.9)℃,WCC[(15.6±4.7) × 109/L]and CRP[(1610±653)mg/L]were significantly worse in the perforated group(P ＜ 0.01).WCC had a higher accuracy and sensitivity than CRP in diagnosing simple acute appendicitis.The combined sensitivities of WCC and CRP were 93％ and 99％ for diagnosing simple acute appendicitis and a perforated appendix,respectively.Conclusion Accuracy of WCC was higher than CRP for diagnosing simple acute appendicitis.The combined sensitivity of WCC and CRP increases for simple acute appendicitis as well as perforated appendix.

Objective To observe the effect of no tension repair in the treatment of inguinal hemia.Methods Notension hernia repair was used to treat 630 patients with inguinal hernia(648 sides):primary indirect inguinal hernia in 604 cases( 18 cases of bilateral),primary direct inguinal hernia in 15 cases(2 cases complicated with indirect inguinal hernia,1 case of double direct inguinal hernia complicated with the right indirect hernia),recurrent hernias( 11cases).The mesh plug and patch of American Bard Company production was selected as hernia repair material for inguinal hernia repair.The operation time,the wound pain day,postoperative ambulation time,complications,and the recurrence rate was observed.Results 630 cases were all successful in operation,and the operation time was 40 ～110min,average operation time about 50min.6 -24h after operation all patients were got out of bed.29 cases of the postoperative urinary retention,indwelling catheter 24 hours to 1 week;6 cases of the fat liquefaction under the incision;3 cases of postoperative foreign body sensation;recurrence in 2 cases(3 sides),1 case of bilateral infected and recurrence ; 11 cases of local swelling incision; 16 cases of incision with mild foreign body sensation.8 days after operation all patients were discharged.Conclusion The no tension repair in the treatment of inguinal hernia had good effect and low recurrence.

Objective To determine whether preoperative embolization is a valuable adjunct to surgical excision of hemangioblastoma. Methods Eleven cases of hemangioblastoma, involving 8 of cerebellum , 1 of medulla oblongata and 2 of spinal cord shown by CT, MR and DSA were embolized preoperatively. The feeding arteries were catheterized with microcatheter and devascularized with polyvinyl alchol particles. Results The blood supplies of the tumor in 6 cases were completely eliminated, and partial occlusion through embolization were undergone for the other 5 cases. Surgical operation was undergone 1-7 days later with all, the 11 tumors totally resected acompanied by minimal blood loss and shortening of the operation time. In addition, manipulation and removal of these embolized tumors were actually easier than expected. No complications occurred during the procedures of embolization and operation. Conclusions Preoperative embolization of hemangioblastoma is a useful and relatively safe to surgical complete resection of this hypervascular tumor with significant reduction of blood loss and operation time.

Objective:To study the teeth of the ancients in Xia Dynasty,the first dynasty in Chinese history about 4 000 years ago,and acquaint ourselves with their incidences of periodontal disease,and the evolution of oral diseases.Methods:The teeth and jaws excavated in Erlitoou,Henan Province and Youyao,Shanxi Province were observed with clinical methods.The specimens totaled 56 individuals(male 38,and female 18),including 894 teeth,and 86 dental arches.The objects were all permanent teeth.The major observation items were periodontal disease.The prevalence of periodontal disease of the people in Chinese Xia Dynasty were outlined.Results:The prevalence rate of periodontal disease was 19.80% in the 894 teeth,while prevalence rate was about 42.86% among the individuals.The premortal tooth lossrate was 7.45% in the observed teeth.Conclusion:Periodontal disease is an aging-related disease without sex difference and commonly seen in the mandible,which is quite similar to the situation at present.The periodontal disease was the main reason for tooth loss in people of Xia Dynasty.

[Objective]Observe the clinical effect of leverage replacement manipulation on lumbar intervertebral disc herniation.[Method]299 hospitalized patients were divided into two groups.153 cases were in trial group and 146 patients were in controlled group.Trial group accepted constant traction and leverage replacement manipulation.While the controlled group accepted the same traction and muscular massage.[Result]In trial group,90 patients were cured,57 improved and 6 no improvement.The total effective rate was 96.08%;in controlled group,21 were cured,75 cases improved,and 50 no improvement.The total effective rate was 65.75%.The effect of trial group was better than the controlled group(P

BACKGROUND:The Notch signaling pathway is evolutionarily highly conserved and mediated by cel-cel interactions, which is widely involved in cel differentiation, proliferation and apoptosis. This critical transduction system participates in coordinating various functions of vascular endothelial cels, thus playing a vital role in the formation and remodeling of vascular network. OBJECTIVE: To elucidate the components of Notch signaling pathway and its impact on angiogenesis. METHODS: A computer-based online search of PubMed and CBM databases was performed. High-quality articles related to mechanism of angiogenesis regulated by Notch signaling were included, and repetitive studies were excluded. RESULTS AND CONCLUSION:Totaly 31 literatures were selectively included in this review. Angiogenesis is a complicated and muti-stage biological event and has been delicately regulated. Notch signaling participates in the regulation of every stage of angiogenesis directly or indirectly via the crosstalk with vascular endothelial growth factor, BMP-SMAD signaling and extracelular matrix molecules. Furthermore, consistent output of Notch signaling is essential for maintaining the stability and integrity of adult vascular system. This review wil thoroughly clarify the latest progress on angiogenesis regulated by Notch signaling and provide theoretical basis and a potential target for designing therapeutic methods against vascular disease.

Objective To investigate the principles of diagnosis and treatment of postoperative intestinal obstruction.Methods The clinical datas of 89 cases of postoperative intestinal obstruction treated from 2001 to 2005 were analyzed retrospectively.Results All the 89 cases were cured without severe complications such as intestinal fistula and no death.The early postoperative inflammatory intestinal obstruction occurred in 2 cases.Recurrent intestinal obstruction occurred in 2 cases.Conclusions Intestinal obstruction can be caused by operation in abdomen.The diagnosis depends on the medical history,clinical manifestations,abdominal plain X-ray and computed tomography.Therapeutic procedure and operative opportunity play an important role in the treatment of postoperative intestinal obstruction.Non-operative approach should be the first choice for early postoperative inflammatory intestinal obstruction.Prompt surgery is clearly indicated and valuable for acute or being strangulative obstruction.Active operative treatment should be considered in recurrent chronic intestinal obstruction.

Objective To evaluate the efficacy of perioperative antibiotic prophylaxis for tension-free repair of inguinal hernia. Methods A randomized, prospective double-blind control trial was performed to evaluate the efficacy of perioperative antibiotic prophylaxis for tension-free mesh repair in 180 cases of inguinal hernia from March 2007 to March 2008. Intravenous cefuroxime ( 1.5 g ) was given immediately before the surgery in two groups followed by postoperative administration of cefuroxime 1.5 g twice a day for 3 days in test group compared with NS infusion in the control group. Postoperatively 16 patients (8. 89 per cent) could not be contacted at any point, giving a response rate of91. 11%. The total number of subjects for per- protocol (PP) analysis was 180, 84 cases in test group and 80 cases in control group. Results Complete data were available for 164 patients, 3 ( 1.83 per cent) developed surgical site infection (SSI) including 2 cases of surgical site infection in test group and 1 case of superficial incision surgical site infection in control group. The differences were not statistically significant. The time to follow up was 12 -29 months, the mean follow up time in test group was (15.6 ±2.2) months and (18 ±3)months in control group respectively. 93.33% patients in test group were followed up and 88. 89% patients in control group. There were not hernia recurrence and side effect of antibiotics reported in the two groups.Conclusions To prevent SSI, it is necessary to use preoperative antibiotics prophylaxis just one time for inguinal hernia repair.

Objective:To investigate the effectiveness and safety of early combined with tirofiban in the treatment of elderly patients with acute ischemic stroke after intravenous thrombolysis with alteplase.Methods:Elderly (60-75 years old) patients with acute ischemic stroke received intravenous alteplase thrombolysis in the Department of Neurology, Traditional Chinese Medicine Hospital of Huangdao District, Qingdao from January 2018 to May 2020 were enrolled prospectively. According to whether tirofiban is combined or not, they were divided into tirofiban group and non-tirofiban group. Tirofiban was pumped intravenously 2 h after intravenous thrombolysis, first 0.4 μg/(kg·min) for 30 min, then 0.1 μg/(kg·min) for 24 h. The efficacy endpoints included National Institutes of Health Stroke Scale (NIHSS) score at 7 d after treatment and modified Rankin Scale (mRS) score at 90 d after onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. The safety endpoints included the incidence of hemorrhagic transformation, symptomatic intracranial hemorrhage (sICH) and mortality within 90 days after onset.Results:A total of 124 patients with acute ischemic stroke were enrolled. The median age was 68 years (range, 60-75 years). There were 73 males (58.9%) and 51 females (41.1%). There were 62 patients (50%) in the tirofiban group and 62 (50%) in the non-tirofiban group. The median baseline NIHSS score was 14. Hemorrhagic transformation occurred in 7 patients (5.6%), of which 2 were sICH (1.6%). The follow-up at 90 d after onset showed that 68 patients (54.8%) had a good outcome, 56 (45.2%) had a poor outcome, of which 4 (3.2%) died. The NIHSS score at 7 d after treatment (5.52±4.79 vs. 7.35±3.80; t=2.357, P=0.020) and the rate of good outcome at 90 d after onset (64.5% vs. 45.2%; χ2=4.689, P=0.030) in the tirofiban group were significantly better than those of the non-tirofiban group, and there were no significant differences among the incidence of hemorrhagic transformation (4.8% vs. 6.5%; P=1.000), sICH (1.6% vs. 1.6%; P=1.000), and 90 d mortality (3.2% vs. 3.2%; P=1.000). Conclusion:After intravenous thrombolysis with alteplase, the early combined treatment with tirofiban in elderly patients with acute ischemic stroke can significantly improve the efficacy and outcome, and will not increase the risk of hemorrhagic transformation, sICH and death.

BACKGROUND:Establishing the animal model of membranous nephropathy is of importance to figure out the pathogenesis of membranous nephropathy.
OBJECTIVE:To investigate the expression of nephrin and podocin in the model of membrane nephropathy in rats, and to investigate their relationships with the pathogenesis of membranous nephropathy.
METHODS:A total of 40 Sprague-Dawley rats were equivalently randomized into model and control groups. Rats in the model group were in premunity by given subcutaneous and multi-point injection of 1 mg cationic bovine serum albumin firstly dissolved in 0.5 mL normal saline and then ful y emulsified with the equal incomplete Freund’s adjuvant for 1 week, and 16 mg/kg cationic bovine serum albumin was injected via vein tails, once every other day for 4 weeks. The same volume of normal saline was injected into the controls. The mRNA expressions of nephrin and podocin in renal tissues were detected using real-time PCR, and biochemical indicators and morphological observation were measured at 2 and 4 weeks after modeling.
RESULTS AND CONCLUSION:(1) In the model group, the total amount of urine and serum albumin levels were significantly decreased accompanying with overt proteinuria, and the serum creatinine, urea nitrogen, cholesterol and triglyceride levels were significantly increased al in a time-independent manner compared with the control group (P<0.01), and the difference was significant (P<0.05). (2) The pathological examination showed that rats in the model group had different degrees of renal tubular dilatation, glomerular basement membrane thickening, mesangial cel s and stromal hyperplasia, which was typical of membranous nephritis. (3) Moreover, the mRNA expressions of podocin and nephrin in the model group were lower than those in the control group. (4) In conclusion, the decreased expressions of podocin and nephfin may disturb the integrity of the slit membrane of podocytes giving rise to the damage of glomerular filtration barrier, and proteinuria appears in final.