Objective To compare the applied value of the pressure aggravation test and breath aggravation test in the diagnosis of early acute appendicitis. Methods A total of 101 cases with epigastralgia, middle or upper abdomen pain, disease duration within 6 hours undergoing pressure aggravation test and breath aggravation test respectively in our hospital between October 2010 and December 2012 were prospectively enrolled. By comparing with the postoperative pathological diagnosis (early acute appendicitis and other abdominal pain), the sensitivity and specificity of these two tests were calculated. Through analyzing the receiver operating characteristic (ROC) curve, the diagnostic value of early acute appendicitis was evaluated. Results Fifty-two cases of early acute appendicitis and 49 cases of other abdominal pain were diagnosed by postoperative pathologic results. The sensitivity and specificity of the pressure aggravation test were 87.5% and 72.1% and of the breath aggravation test were 53.8% and 83.7% respectively. The area under the ROC curve of the pressure aggravation test was 0.786 (95% CI: 0.693-0.878), similar to that of the breath aggravation test (0.688, 95% CI: 0.583-0.792). Conclusion The pressure aggravation test has higher value to diagnose early acute appendicitis, while the breath aggravation test has better specificity.

<正>编者按肝内胆管结石是肝胆外科较为常见疾病,其发生与环境因素、营养状态、胆道感染、胆汁淤积、病毒感染、寄生虫及胆管变异等因素有关.胆道造影、超声、CT及MRCP等影像学方法仍是有效的检查手段,合理选择并联合应用能够提高检出率和诊断准确率.有效的治疗手段仍是外科手术,"去除病灶、取尽结石、矫正狭窄、通畅引流、防治复发"

肝内胆管结石术后复发是肝内胆管结石手术后最常见的并发症,其再处理方法是当今胆道外科最为棘手的问题之一.目前临床上处理方式很多但大部分患者远期效果并不能令人满意.非手术方法包括溶石、碎石、取石等.手术方法有肝实质切开取石、肝叶（段）切除、胆肠吻合术及肝移植等.其中肝叶（段）切除及肝移植能一次手术完成肝胆管结石外科治疗原则要求的彻底的根治性手术.应该根据每个患者的具体情况制定个体化的治疗方法.

Aim: To investigate the possibility of mesenchymal stem cells derived from human umbilical cord differentiation in liver partially hepatectomized rat model. Methods: Mesenchymal stem cells(MSCs) were isolated from human umbilical cord by digestion of collagenase.The cells were cultured and the surface markers were determined by flow cytometry.At passage 5,the human umbilical cord MSCs were labeled by PKH26 in vitro.The partially hepatectomized rat models were made.And the labeled human umbilical cord MSCs were transplanted through portal vein injection.The labeled cells' survival,differentiation condition and hepatic maker albumin expression were observed at post-transplantation 1,2 and 3 weeks using fluorescence microscope. Results: The human umbilical cord MSCs cultured in vitro.After they were transplanted to the partially hepatectomized rat's liver,they survived and expressed the hepatic maker albumin in vivo.When they were labeled by PKH26,they show the red fluorescence under the fluorescence microscope.In the frozon sections of liver,the marked cells were scattered and most of them expressed albumin with green fluorescence under the fluorescence microscope. Conclusion:The transplanted the human umbilical cord MSCs can survive and differentiate into hepatocytes.May be the human umbilical cord MSCs are a main source of hepatocyte transplantation.

OBJECTIVE:To investigate the indications for non-surgical management of traumatic splenic rupture.METHODS:From Jan. 2002 to Jan. 2008, 36 patients with traumatic splenic rupture underwent non-surgical management in the First Affiliated Hospital of Jinan University.RESULTS:Of the 36 cases, 32 were successfully managed without surgical interventions, and 4 converted to open surgery. No death occurred in these patients, nor was delayed splenic rupture identified 1 to 5 years after the treatment.CONCLUSION:Hemodynamically index is an important reference to select the patients, and the degree of splenic rupture, the patient's age and conditions of the hospital should be considered.

AIM:To observe the expression of β-catenin in colonic adenocarcinoma and to investigate its clinical significance and prognostic value. METHODS:The integrated clinical and follow -up data of 52 patients,who were undergone radical operation,were retrospectively analyzed from June 2000 to June 2004 in our hospital. The paraffin -embedded tissues of 52 colonic adenocarcinoma specimens and 20 cases of normal paraneoplastic colonic mucous tissues were detected for β-catenin expression by immunohistochemical method. The relationships between β-catenin and clinical variables and prognostic value were statistically analyzed. RESULTS:β-catenin was normally expressed in all 20 normal cases. In the cases of colonic adenocarcinoma,the abnormal expression rate of β-catenin was 71%. The abnormal expression of β-catenin did not correlated with gender,age,histological differentiation and blood CEA (P 0. 05),but it was correlated with lymph node metastasis and clinical stage (P 0. 05). The abnormal expression of β-catenin were also correlated with the postoperative survive time (P 0. 05). CONCLUSION:The abnormal expression of β-catenin is correlated with the lymph node metastasis and clinical stage,and the abnormal expression is an important adverse prognostic factor for survival in the patients with colonic adenocarcinoma. β-catenin may be a molecular prognostic marker in the patients with colonic adenocarcinoma.

<正>1引言胃、十二指肠溃疡是基层医生在临床工作中经常遇到的常见病和多发病。近年来的研究发现,胃溃疡和十二指肠溃疡的发病虽然都与胃酸分泌异常有密切的关系,但是这两种疾病的发生部位、临床特点、溃疡本身及其并发症

<正>1引言急性穿孔是胃、十二指肠溃疡的严重并发症之一。尽管新型的H2受体拮抗剂、质子泵抑制剂和抗幽门螺杆菌药物三联治疗明显提高了溃疡病的治愈率,使得目前溃疡病的药物治愈率高达95％,胃、十二指肠溃疡择期手术率

1 引言 急性穿孔是胃溃疡最严重的并发症.由于溃疡病变向深度发展使得胃壁变薄,有时候再遇到胃内压突然增加,溃疡可向腹腔内穿破,胃内容物流入腹腔,称为胃溃疡合并穿孔.如果不及时处理,胃内容物会污染整个腹腔,产生严重的急性弥漫性腹膜炎,进而给患者带来严重后果.