Objective To investigate the diagnostic and treatment methods of appendiceal mucoceles and peritoneal pseudomyxoma. Methods Thirteen cases of appendiceal mucoceles were enrolled in this study. Six cases underwent appendectomy, two cases ileocecal resection, two cases right colectomy, and two cases appendectomy in emergency followed by right colectomy because their postoperative pathological diagnosis was appendiceal muco-cystadenocarcinoma. Ruptured appendiceal mucocele and peritoneal pseudomyxoma were found during operation in one case, then right colectomy was performed, ascites was removed and abdominal cavity was washed with normal saline and 5-Fu solution. Systemic chemotherapy was given to this patient after operation. Results Operation was successful in all the patients. Except one case not followed up, the other patients remained free of disease after operation. Conclusion Appendiceal mucoceles is uncommon. The patients should be suspected suffering from this disease when chief complaints are right lower abdominal pain and mass. B-type ultrasonography and other necessary digestive image examinations are economical and inexpensive diagnostic method of appendiceal mucoceles. It is necessary to explore the whole abdominal cavity carefully when this disease is suspected during operation.

Objective To establish normal reference ranges for serum cystatin C (Cys C)in relatively healthy middle-aged and elderly(＞50 years)Chinese individuals.Methods A total of 1087 candidates were consecutively selected and serum Cys-C levels were measured by transmission turbidimetry.Frequency analysis and histogram were used to establish the 95％ confidence reference range according to methods provided by CLSI (C28-A2).Results Based on the definition and verification procedures for clinical laboratory reference ranges(CLSI C28-A2,second edition),Cys-C levels of 1087 participants fell within the range of 0.30-1.55 mg/L;Male participants had higher serum Cys-C levels than female participants(Z=-10.19,P＜0.01).The serum Cys-C level increased with age,regardless of gender(R =0.600,P＜ 0.01).Differences in Cys-C levels between age groups were statistically significant (x2=411.17,P＜ 0.01).The reference ranges of normal serum Cys-C levels for different age groups (50-,55-,60-,65-,70-,75-,) were 0.42-0.98mg/L,0.45-1.04mg/L,0.47-1.34mg/L,0.46-1.38mg/L,0.61-1.33mg/L,0.61-1.28 mg/L,respectively,for males,and 0.39-0.94mg/L,0.42-1.01mg/L,0.40-0.91mg/L,0.46-1.03mg/L,0.57-1.04mg/L,0.55-1.27mg/L,respectively,for females.Conclusions This study established preliminary normal serum Cys-C reference ranges for healthy middle-aged and elderly(＞ 50 years)individuals in this region,which can serve as parameters for disease diagnosis and treatment evaluation.

Objective To investigate the cause and management of postsplenectomy fever in portal hypertensive patients . Methods The clinical data of 295 portal hypertension patients undergoing splenectomy from 1990 to 2003 were reviewed. Among these,80 patients suffered from a continuous fever higher than 38.5℃ for more than 2 weeks postoperatively. Results Except for two patients with unknown cause, 78 of 295 patients with continuous fever were caused by complications such as splenoportal thrombosis(35 cases), infection of hematocele or hydrops in splenic recess(20 cases), left subphrenic infection(7 cases), pneumonia and hydrothorax or empyema(5 cases), 3 cases each of postoperative abscess of tail of pancreas,winary tract infection and inteclion of surgical incision, 1 case of leakage of esophageal anastomosis and intraabdominal infection in 1 case. The lasting fever was related to the grade of liver function(P0.05). Conclusions Splenoportal thrombosis, and hematocele, hydrops or infection in the splenic recess were the main causes of persistent fever after splenectomy. Prevention and treatment of infection and amelioration of hepatic function will help to reduce the rate of postoperative continuous fever.

OBJECTIVE To understand the relationship between the detection rate of Pseudomonas aeruginosa in Children′s Hospital wards from Jan 2008 to Sep 2008 and disinfection and isolation in the department and investigate the change in antimierobial resistance of P.aeruginosa to provide basis for reasonable use of antibiotics in clinical practice.METHODS The clinically isolated P.aeruginosa strains were collected,cultured and identified by paper diffusing method.The results were evaluated according to the relevant documents of NCCLS of USA.RESULTS The resistant rates of P.aeruginosa to Ampicillin,Ampicillin/Sulbactam,ceftriaxone,cefazolin and SMI were higher than 98%.Their resistant rate to Levofloxacin and IMP was the lowest(about 2% or so).CONCLUSIONS Effective disinfection and isolation of P.aeruginosa should be performed.Selection of antimicrobial drugs should be according to the results of drug susceptibility,reduce the rate of bacterial resistance.

Objective To investigate the molecular mechanism how edaravone reduces cytotoxicity caused by hypoxia/reoxygenation-induced injury.Methods Ischemia model-hypoxia/ reoxygenation model which also called oxygen and glucose deprivation/reoxygenation model (OGD-R) was established.Cells were divided into control group,OGD-R group,OGD-R with edaravone of different concentration groups Cells of OGD-R model were pretreated with the appropriate concentration of edaravone or combine with the specific channel blockers LY294002 and MK2206 individually,the expression levels of ERK,AKT and Bcl-2 were detected with Western-blot,while the expression levels of BDNF and Bcl-2 mRNA detected with RT-PCR,the expression levels of BDNF protein detected with ELISIA,the levels of LDH releasing and Hoechst33258 staining used with homologue assay kit or regents.Results The pretreatment of cultured neurons with edaravone alleviated hypoxia/reoxygenation induced neuronal injury in a dose-dependent manner (LDH releasing reduced,Caspase-3 activity and ratio of nuclear pyknosis declined).The edaravone pretreatment did not increase significantly the p-ERK expression levels,but the amount of p AKT expression was significantly increased(P＜0.01).Pretreatment of edaravone(10 μmol/L) remarkably reduced the LDH release and declined the ratio of nuclear pyknosis after reoxygenation (P＜0.01),which was inhibited by MK2206.Compared to OGD-R,edaravone pretreatment markedly promoted BDNF and Bcl-2 mRNA expression at each time point,and the most pronounced effects occured at 8 h after OGDR.ELISIA analysis showed that BDNF protein level was significantly elevated after edaravone pretreatment at the same point.Western blot analysis indicted that edaravone pretreatment significantly enhanced Bcl-2 protein expression at 8 h after OGD-R,which was blocked by MK2206.Conclusions Edaravone may alleviate hypoxia/reoxygenation induced neuronal injury by enhancing BDNF and Bcl-2 expression and inhibiting Caspase-3 activity through activation of the PI3K/Akt pathway.

Objective To explore the role and expression of cell apoptosis regulatory genes in patients with temporal lobe epilepsy characterized by hippocampus sclerosis.Methods The experimental specimens were obtained from 15 patients with temporal lobe epilepsy (epilepsy group) and 6 control samples (control group) were obtained from temporal lobe excision of brain trauma decompression,investigated neuron apoptosis by HE stain,TdT-mediated dUTP-biotin nick end labeling (TUNEL) method,and determined the expression of bcl-2,bax and caspase-3 by immunohistochemistry.Results The evidence of neuron apoptosis was not found by HE stain in both control group and epilepsy group.Positive cells was not found in control group,but was obviously observed in epilepsy group by TUNEL staining [(4.39 ± 2.04) numbers/100].Unlike that in normal adult brain,bcl-2 immunoreactivity was obviously observed in some neurons in epilepsy group[(6.72 ± 3.36) numbers/100] (P ＜ 0.01).Compared with control group,bax protein in epilepsy group was mild expression (P ＞ 0.05).Two cases in control group were detected the expression of caspase-3 protein,and caspase-3 significantly increased in epilepsy group [(1.07 ± 0.43),(9.54 ± 3.68) numbers/100] (P ＜ 0.01).Conclusions Neuron apoptosis is an important cause of hippocampal sclerosis of human epilepsy.bcl-2 and caspase-3 may play an important role in this process.

OBJECTIVETo compare the effect of the two methods of back propagation network (BPN) test on TCM syndrome typing of depression.

METHODSTest was carried out by two methods as following: (1) Cross train-test method: 1731 patients with depression typed to 5 syndrome types were randomly divided into 2 groups, and they were trained and tested in turn; (2) Round-Robin method: Test was conducted in an altered cycle mode, that is, in a cycle, one out of the 1731 patients were selected to be tested, while the others were trained, the next cycle started when the test on the selected patient was finished and another one for test was selected. In this way, one cycle after the other, until all patients had been tested.

RESULTThe total training sensitivity of the two methods was 97.9% and 98.2% respectively, and the total testing sensitivity was 72.7% and 74.2% respectively.

CONCLUSION(1) The five TCM syndrome types of depression could be well differentiated by BPN, which is valuable for TCM syndrome typing in certain extent; (2) The sensitivity of Round-Robin method is slightly higher than that of Cross train-test method, but in comparison between them no remarkable significance was shown.

Adolescent ; Adult ; Depressive Disorder ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Neural Networks (Computer) ; Sensitivity and Specificity

Objective To explore the clinical treatment strategies of laparoscopic hepatocellular carcinoma ablation for patients with severe cirrhosis background.Methods We analyzed the clinical data of 430 patients and analyzed the indications,key techniques,efficacy and safety of laparoscopic hepatocellular carcinoma ablation for patients with severe cirrhosis background,and summarized the related experiences.Results The first complete ablation rate for the entire cohort was 94％,the 2-year local recurrence rate was 2.8％.No significant complications were found postoperatively.Conclusions Laparoscopic hepatocellular carcinoma ablation is a minimally invasive,safe and effective treatment strategy for patients with small cancer under severe cirrhosis background.Especially when the tumor is located in the " high-risk parts" for ablation,it could be a preferred method for pre-transplant treatment of these patients.

Objective To screen the formulation of self-microemulsifying drug delivery system (SMEDDS) for sirolimus (SRL) and prepare the SRL-SMEDDS pellets.Methods Co-emulsifier,oil phase and emulsifier were chosen by solubility test and ternary phase diagrams,central composite design and response surface method were adopted to screen and optimize the preparation and formulation of liquid SRL-SMEDDS.The selected liquid SRL-SMEDDS formulations were prepared into pellets by extrusion-spheronization method.Results The final pellets from liquid SRL-SMEDDS formulation :SRL 0.4%,Labrafil M1944CS 9.3%,Cremophor EL 15.9%,Transcutol P 8.0%,MCC 49.8%,lactose 13.3%,CMS-Na 3.3%.Dissolution test showed superphosphate (SSP) in the dissolution water is much greater than the commercially available sirolimus tablets ;while in 0.4% SDS solution,the two formulations showed similar dissolution.Conclusion SMEDDS can improve the dissolution of SRL in v itro.

Objective: To investigate the expression of Apelin and Snail proteins in breast cancer and their relationship with the clinicopathological features and prognosis. Methods: The expression of Apelin and Snail proteins was detected by immunohistochemistry in 89 cases of breast cancer and 50 cases of mammary adenosis collected from January to June in 2008 at Fujian Cancer Hospital; the expression was correlated with the clinicopathological features and outcome of the patients. Results: Apelin and Snail were expressed in 42 cases(47.2%)and 36 cases(40.4%)of breast cancers, respectively, and the expression was higher than that of control group (P<0.01). The expression of Apelin was positively correlated with Snail (r=0.230, P<0.05). Apelin expression was associated with lymph node metastasis and TNM staging(P<0.05). Snail expression was associated with lymph node metastasis(P<0.05). Kaplan-Meier survival curve showed that the prognosis of Apelin positive group was worse than that of Apelin negative group (P<0.01). There was no significant difference in prognosis between Snail negative and positive groups (P>0.05). The prognosis of Apelin and Snail in both positive groups was worse than that of Apelin and Snail both negative groups (P<0.01). Multivariate COX regression analysis showed that Apelin and TNM staging could be used as independent prognostic factors for breast cancer (P<0.05). Conclusions Apelin and Snail are highly expressed in breast cancer, and associated with lymph node metastasis and TNM stage. There is a positive correlation between Apelin and Snail expression, which may suggest a role in breast carcinogenesis. The prognosis of breast cancer with expression of Apelin and co-expression of Apelin and Snail is poor. Therefore, Apelin may be used as an effective indicator to evaluate the prognosis of breast cancer patients.