Objective To analyze the clinical effects, as well as its advantages and disadvantages, of laparoscopic surgery for appendicitis in obese patients. Methods Clinical data of 80 obese patients receiving appendectomy, including 38 cases of open appendectomy and 42 cases of laparoscopic appendectomy, were analyzed retrospectively.The operative time, blood loss, analgesic and antibiotic use, postoperative fever, postoperative complications, length of hospital stay, and hospitalization cost were compared between the two operative methods. Results Conversions to open surgery were required in 2 patients in the laparoscopic group. There was no significant difference in operative time between the 2 groups (P >0.05).Compared with the open group, the laparoscopic group had less blood loss [(14.98 ±12.77) ml vs.(31.58 ±19.00) ml, t=-4.550, P=0.000], shorter time of postoperative antibiotic use [(2.7 ±1.0) d vs.(4.1 ±1.2) d, t=-5.470, P=0.000], less postoperative analgesics needed [5.0%(2/40) vs.26.3%(10/38),χ2 =6.802, P=0.009], less drainage [2.5% (1/40) vs.18.4% (7/38), χ2 =5.367, P=0.021], less postoperative fever [5.0%(2/40) vs.23.7%(9/38),χ2 =5.616, P=0.018], less postoperative wound healing [5.0%(2/40) vs.21.1%(8/38),χ2 =4.493, P=0.034], and shorter hospital stay [(5.9 ±3.2) d vs.(8.7 ±4.1) d, t=-3.345, P=0.001], but the higher cost of hospitalization [(7800 ±396) yuan vs.(4914 ±434) yuan, t=30.716, P=0.000]. Conclusion For obese patients with appendicitis, laparoscopic appendectomy has less surgical trauma, faster recovery, less postoperative pain, fewer complications,and shorter hospital stay, being a preferred method of treatment.

Neuroanatomy knowledge is the key to improve the teaching quality of neurosurgery and anatomy teachers' participation in neurosurgery teaching can obviously improve teaching effect. Combined with case-based teaching, we enabled medical students to master the system knowledge from the basic to the clinical , cultivating their clinical thinking ability and the ability to solve clinical problems. Cooperation between clinical medicine teachers and basic medicine teachers can promote the update of knowledge, work out teaching plans together, and improve the quality of teaching.

Induced pluripotent stem(iPS)-cell technology is a great breakthrough in stem cell research field in recent years, it is not only injecting new vitality for the research of reprogramming of somatic cell, but also bringing a new dawn to the study of mechanism of disease and development of regenerative medicine. As key issues of iPS-cell technology, the study of iPS cell induction system has progressed in the composition of transcription factor, gene delivery, as well as induction efficiency. In this article, research advance of iPS cell induction system in recent years is reviewed and the prospect is discussed as well.

Objective To investigate the changes of thrombomodulin (TM) and von Willebrand factor (vWf) and their clinical significance in patients with severe brain injury. Methods The study involved 62 patients with severe brain injury who were divided into diffuse axonal injury group (28 patients) and focal brain injury group (34 patients). Then, the 62 patients were divided into young group (16-30 years old, 20 patients), middle-aged group (31-65 years old, 20 patients) and elderly group ( ＞65 years old, 22 patients). The serum levels of TM and vWf were determined at days 1 and 7 after injury respectively. ELISA method was employed to determine the serum levels of TM and vWf.Results The vWf in focal brain injury group was significantly higher than that of diffuse axonal injury group at days 1-7 after injury ( P ＜ 0.05 ). Compared with the young and middle-aged groups, the TM and vWf levels in the elderly group at day 1 after injury were significantly elevated ( P ＜ 0. 05 ). The TM levels in patients with delayed traumatic intracerebral hematoma (DTICH) were significantly higher than that in patients without DTICH (P ＜ 0. 05). Conclusions In the acute stage of severe brain injury,injury severity and activation of endothelial cells varies in patients with different types of injury and at different ages. TM is one of sensitive indicators to reflect the cerebal vascular endothelial cell injury. It is very meaningful to assess the prognosis of severe brain injury by measuring serum levels of TM and vWf and take TM as a predictive indicator for DTICH.

Child ; Humans ; Immunologic Deficiency Syndromes

Child ; Humans ; Pediatrics ; classification ; Research

Biomedical Research ; Child, Preschool ; China ; Humans ; Pediatrics

Education, Medical, Continuing ; methods ; Evidence-Based Medicine ; Humans ; Pediatrics ; Periodicals as Topic ; Physicians ; Problem-Based Learning

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Femur ; blood supply ; Humans ; Male ; Middle Aged ; Moxibustion ; Osteonecrosis ; therapy

Child ; Genetic Association Studies ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Mutation ; Pediatrics ; Phenotype ; Physicians ; Polymorphism, Single Nucleotide ; genetics