Acute appendicitis is the most common general surgical problem encountered during pregnancy, which may be associated with serious maternal and /or fetal complications such as appendiceal perforation or premature delivery.Clinical presentation and imaging remains vital in the diagnosis of appendicitis.As a general rule,the clinical suspicion of acute appendicitis during pregnancy is an indication for an urgent surgical intervention.Appendectomy is the preferred treatment.Laparoscopic appendicectomy(LA)can also be performed safely and effectively in pregnant patients without bringing additional maternal complications.

Objective To explore the relationship between serum levels of unconjugated estriol (uE3)and human placental lacto-gen (hPL)and preeclampsia.Methods 123 cases of pregnant women diagnosed as preeclampsia were enrolled into observational group,and 1 50 cases of healthy pregnant women were enrolled into control group.Blood specimen were collected from the two groups in 28-<32 gestational weeks and 32-36 gestational weeks.Serum levels of uE3 and hPL were determined and compared between the two groups.Results The pregnancy outcomes of the control group were better than those of the observation group. With the increase of gestational age,there was increasing trend of serum levels of uE3 and hPL in the two groups.However,com-pared with the observation group,the serum levels of uE3 and hPL were higher in the control group,and the differences were statis-tically significant(P <0.05).Conclusion The decrease of serum levels of uE3 and hPL in pregnant women with preeclampsia may be associated with the pregnancy outcomes.

Objective: To establish a fluorescence method based on turncated aptamer for the determination of bisphenol A in water. Methods: The bisphenol A truncated aptamer containing 38 bases was selected as a recognition module, and was modified with the fluorophore 6-FAM at the 5'end. The 3'end of the complementary sequence cDNA was modified with the quencher DABCYL. The standard solutions of bisphenol A and interfering compounds were configured. The detection system was established after optimizing the number of bases in cDNA, the concentration ratio of truncated aptamer to cDNA, the incubation temperature and time, and the pH of the buffer. The specificity and recovery experiments were carried out. Results: When the complementary sequence cDNA included 9 bases, the concentration ratio of the truncated aptamer to cDNA was 1:1.5, the pH value of the buffer solution was 7.5, the cDNA was incubated at 55 ℃ for 60 minutes, in the concentration range of 10-75 pmol/L, the linear regression equation was y=2 230.7x+110 825, the correlation coefficient was 0.926. The limits of detection was 3.3 pmol/L. The difference values of fluorescence intensity between tetrabromobisphenol A, estradiol, estriol, bisphenol S and bisphenol A were obviously different, so there was no significant interference to the test result. The recovery rates were 97.8%, 98.8% and 102.3% with the spiked concentrations of 20.0, 40.0 and 60.0 pmol/L. The relative standard deviations were 4.4%, 2.1% and 2.6% (n=5), respectively. Conclusion The fluorescence method based on turncated aptamer has the advantages of easy operation, high sensitivity and specificity, which can be used for the determination of bisphenol A in water.

Objective To assess the efficacy and safety of over-the-scope clip(OTSC) system in treatment of the perforation ,fistula and bleeding of the digestive tract .Methods The data of 33 patients who were treated with OTSC in our department were analyzed retrospective-ly,and the technical success rate ,clinical success rate and complications were statistically analyzed .Among the 33 patients,there were 14 pa-tients with upper gastrointestinal bleeding , 8 patients with postoperative fistula , and 11 patients with endoscopic full-thickness resection (EFTR) of gastric or duodenal bulb.Results The technical success rate and clinical success rate of 33 cases were 96.97% and 93.94%respectively,and there was no complication in all patients .Among them,the clinical success rate of the upper gastrointestinal bleeding was 92.85%,the anastomotic fistula was 75.00%,and the EFTR was 100%.Conclusion As a new type of clinical endoscopic suture system , OTSC is safe and effective in gastrointestinal bleeding ,perforation and fistula .

Animals ; Humans ; Integrin alphaVbeta3 ; physiology ; Receptors, Virus ; physiology ; Signal Transduction ; Virus Diseases ; etiology

Objective To investigate the status of the disease of the fluorosis and arsenism caused by coal-burning in Ankang city of Shaanxi. Methods Nine survey spots were chosen to carry out the epidemiological investigation of adult skeletal fluorosis and arsenism in the coal-polluted areas of Ankang, respectively using Determination of Fluorine in Coal (GB/T 4633-1997) to determine the coal fluorine and using hydride generation atomic fluorescence spectrophotometry(HCAFS) to determine coal arsenic. The diagnose of the adult skeletal fluorosis followed the Diagnosis of Clinical Classification for Endemic Skeletal Fluorosis Standard(GB 16396-1996), that of arsenism using Standard of Diagnosis for Endemic Arsensim (WS/T 211-2001). Results Totally 569 adults were investigated over the age of 16, among which 121 cases were skeletal fluorosis, with a total detection rate of 21.27%. Four cases of II degree and higher skeletal fluorosis patients were identified, accounting for 0.70% of the number of subjects. One hundred and thirty-two cases of arsenic poisonin were detected, in a rate of 23.20%. Ninety-five patients were identified with moderate or severe arsenic poisoning, accounting for 16.69% of subjects. A positive correlation was found between the detection rates of the skeletal fluorosis and the arsenism(r = 0.816, P < 0.01), as well as between the detection rate of skeletal fluorosis and fluoride content of coal(r = 0.775, P < 0.05). The detection rate of arsenism and arsenic content of coal also had close relationship (r = 0.761, P < 0.05). The detection rate of skeletal fluorosis in the group aged 40 - ,50 - , and 60 - [27.20%(34/125) ,29.27%(36/123), 28.13%(36/128)] was increased, compared the group of less than 40 years age[7.77%( 15/193), X~2 = 21.969,25.648,23.856,P<0.01].For the detection rate of arsenism,male[33.67%(99/294)]was obviously higher than female[12.00%(33/275),)(X~2=37.162,P<0.01].Conclusions A high detection rate of fhorosis is correlated with arsenic poisoning,but the probability of the two diseases simultaneously occurred in a person is not high.In this polluted area.when fluoride accumulates to a certain level as in aduh,the detection rates no longer varies obviously;however,that of arsenism increases along with the age.

Objective To know the condition and feature of water-born endemic arsenism in Shaanxi province, and to provide scientific evidences for prevention and treatment of the disease. Methods In 2009, 8 villages of Duhe, Miaogou, Sanhe, Caiyuan in Shanyang county and Shuanglong, Guangming, Donghekou in Zhen'an county and Guojiawan in Mian county as monitoring sites from both the found water-born arsenic poisoning areas and potential ones of drinking water arsenic ＞ 0.15 mg/L were selected. The disease conditions of residents who lived for more than six months of continuous residence, were investigated according to "Endemic Arsenism Diagnostic Criteria" (WS/T 211-2001 ) and arsenic level in the drinking water were determined. Results Seven thousand six hundred and ninety-three individuals were investigated and 612 cases of arsenism were diagnosed in the 8 villages, the prevalence rate was 7.96%(612/7693). Mild patients accounted for 33.17%(203/612), moderate patients accounted for 50.16%(307/612), and severe patients accounted for 16.67%(102/612). The detection rate for male was 9.99%(408/4085), for female was 5.65%(204/3608), the former was higher than the latter(x2 = 49.138,P ＜ 0.01 ). The older the age was, the higher the rate was(x2 = 770.708, P ＜ 0.01 ). Main clinical manifestation of the patients was depigmentation and pigmentation in skin. Patients with one symptom accounted for 43.30% (265/612), with two symptoms accounted for 56.70% (347/612). Three hundred and seventy drinking water samples were detected, the median of arsenism content was 0.005 mg/L, ranged 0 - 1.660 mg/L. The over-limit rate of arsenic level in the drinking water were 11.62% (43/370). Conclusion Water-born endemic arsenism is mildly prevailing in Shaanxi province, however, great attention should be given to control and monitoring of the disease.

Objective To investigate the current situation of endemic fluorosis associated with drinking water in Shaanxi province in 2008, providing prevention and control work with scientific evidence. Methods According to data of drinking water endemic fluorosis in Shaanxi, 15 counties in Yulin, Weinan and Xianyang city were divided into mild, moderate and severe diseased areas according to fuoride level in the drinking water or the fluorosis severity, and 12,39,45 endemic fluorosis villages were selected respectively from each area. Dental fluorosis for all the children aged 8 - 12 years old and clinical skeletal fluorosis for the people over the age of 16 were examined. In mild, moderate and severe areas, 30% of the survey villages received X-ray to examine skeletal fuorosis. Five water samples were collected from villages with unimproved water respectively from the east, the west, the south, the north, the middle; if there was less than 5 that could be sampled, then all were collected, moreover 3 peripheral and 1 central water samples were collected from villages with improved water. Also in mild, moderate and severe illness areas, 50% of the surveyed villages were selected; in each village, 30 urine samples of the children aged 8 - 12 were collected, 6 portions in each age group. If Less than 30 children in all the age groups or less than 6 in each age group, all their urine samples were collected to determine fluoride. Results Totally 3652 children aged 8 - 12 years old were examined and 1930 cases of dental fluorosis were diagnosed, the rate was 52.85% and the index was 1.22. The rates in Dinghian, Jingbian and Pucheng village were higher, being 90.43% (170/188) ,82.89%(126/152),80.65% (325/403) respectively. A total of 40 543 adults over the age of 16 were examined and 5935 cases of skeletal fluorosis were diagnosed, in a rate of 14.64%. The rates of the mild, moderate, severe skeletal fluorosis were respectively 9.17%(3717/40 543),4.36%(1769/40 543),1.11%(449/40 543).All 706 adults were taken X-ray films.and 280 cases of positive change were diagnosed,the positive rate was 39.66%. The rates of the mild,moderate,severe change were respectively 17.28%(122/706),17.00%(120/706),5.38%(38/706).All 427 water samples were collected,the fluoride content waS(2.22±1.41)ms/L,and the abnormal rate was 85.01%(363/427).All 1393 portions of urine sample were collected in children and the median of fuoride was 2.37 mg/L Conclusions The endemic fluorosis associated with drinking water is still comparatively serious in Shaanxi.The preventive measures for improving water must be improved.

ObjectiveAfter intratympanic gadolinium administration through the tympanic membrane,three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease.MethodsTwenty-four hours after intratympanic gadolinium administration through the tympanic membrane,19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner.The enhanced imaging of perilymphatic space in bilateral cochlea,vestibular and (or) canal were observed.Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively.The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used.ResultsThe gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal,so the endolymphatic space was clearly visualized on 3D-FLAIR imaging.The score of scala vestibuli between the affected side (3 cases scored 2,9 cases scored 1,7 cascs scored 0) and the healthy side ( 15 cases scored 2,2 cases scored 1,2 cases scored 0 ) were significantly different ( U =3.090,P ＜ 0.05 ).The area of enhanced vestibular were (5.77 ± 2.33) mm2 and (8.11 ± 3.32) mm2 for the affected side and the healthy side,which were significantly different ( U =3.090,P ＜ 0.05 and t =2.638,P ＜ 0.05 ).Conclusions According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space,3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops,thus providing radiographic evidence for the diagnosis of Meniere's disease.

ObjectiveTo investigate the effect of vacuum sealing drainage (VSD) with different negative pressures on variation of oxygen partial pressure (PtO2 ) and wound healing in the rabbits.MethodsTwelve rabbit wound models were made and randomly (random number) divided into two groups, namely vacuum group ( n =6 )in which rabbits were treated with VSD by different negative pressures ( - 75 mmHg,- 125 mmHg,- 225 mmHg and - 350 mmHg) for 7 days, and routine treatment group ( n =6). At each interval of measurement, variation of PtO2 was measured by oxygen partial pressure admeasuring device, and area of VSD dressing and surface of wound were measured by vernier caliper, and growth of anaerobic bacteria was detected by bacterial culture, and morphological change and the course of wound healing were observed under by light microscope after HE tissue staining. Meanwhile anther two groups (n =6, in each) were set for comparing, including normal group, sham operation group. ResultsAverage PtO2 value of vacuum group was in the range of ( 1.87 +0. 19) kPa to ( 1.54 ±0. 21 ) kPa which was decreased gradually in 7 days under different negative pressures. Average PtO2 value of routine treatment group and normal group were ( 2. 82 ± 0. 37 ) kPa and ( 5.79 + 0. 50 ) kPa, respectively which weresignificant higher than that in vacuum group ( P ＜ 0. 01 ). PtO2 was fell to 80. 94％ of its original value after VSD for 5 seconds, and continued the downward trend with the increasing of negative pressure at the same interval of measuring. Area of VSD dressing significantly decreased to 65. 36％ of its original area after VDS for5 minutes (P＜0.01). Surface of wound was minimized to 62. 82％ of its original area after VSD for 7 days ( P ＜ 0. 01 ), and variations of those in - 350 mmHg group were significant greater than those in other groups ( P ＜ 0. 01 ). There was no evidence of anaerobic bacteria growth in vacuum group during this experiment. ConclusionsPtO2 could be down-regulated by VSD significantly without growth of anaerobic bacteria, and minimization of VSD dressing at - 350 mmHg was significantly helpful to reduce the area of wound for promoting the healing.