Objective To compare the curative effects of different surgery incisions on mammary gland fibroma.Methods 80 patients with mammary gland fibroma who would got surgery were randomly divided into observation group(by mammary areola arc incision) and control group (by radial incision).The surgery time,blood loss,first wound healing rate,symmetry rate of bilateral mamma,satisfactory appraisement of patients,postoperative complication and tumor recurrence rate of the two groups were observed and compared.Results Compared with control group,the surgery time of observing group was significantly longer(P ＜0.05),the blood loss was significantly less(P ＜0.05),.the symmetry rate of bilateral mamma and satisfactory appraisement of patients were significantly higher(P ＜ 0.05 or P ＜ 0.01),and the incidence rate of postoperative complication was significantly lower(P ＜ 0.05).But there was no difference of the first wound healing rate between the two groups (P ＞ 0,05).All the patients were followed up for 2-56 months,and only 1 case of recurrence in each group,and there was no significant difference between the two groups (P ＞ 0.05).Conchusion Treating mammary gland fibroma by mammary areola arc incision shows less blood-loss,maximum mamma symmetry preserving,high satisfactory appraisement of patients,low postoperative complication and does not increase the recurrence rate after surgery.

Objective To investigate the effect of compound preparation of Astragalus mongho-licus on subsets of lymphocytes in patients with myasthenia gravis (MG), and to explore its regulatory mechanism. Methods 60 MG patients were randomly divided into test group (n=30, given compoundpreparation of Astragalus mongholicus for 12 wks) and control group (n=30, given prednisone tablets for 12 wks). Flow cytometry was applied to examining the distribution change of the subsets of lym-phocytes in patients before and after treatment. Results After treatment, the percentages of CD4+ T cells and the ratio of CD4+/CD8+ in both groups decreased compared with those before treatment.The ratio of CD4+/CD8+ in test group was significantly lower than that in control group (P<0.05).The percentage of CD8+ T cells in test group after treatment increased significantly (P<0.05) com-pared with that before treatment, but had no significant difference compared with that in control group(P>0. 05). Conclusion The result from the current study suggests that one of the mechanisms of the compound preparation of Astragalus monghoticus regulating immune response may be achieved through its modulating effect on the distribution of subsets of lymphoeytes and humoral immune func-tion.

[Objective] The disease distribution of in-patients in different age groups from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of Traditional Chinese Medicine (TCM) was analyzed to provide evidence for clinical treatment. [ Methods ] A retrospective research was adopted. Fourteen categories of diseases and 3 age groups were classified according to the case history recorded from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of TCM. Reasons for hospitalization of the in-patients in different age groups during 10 years were analyzed by descriptive analysis and Vilfredo Pareto analysis. [Results] The principal and secondary reasons for hospitalization were respiratory tract infection, pulmonary tuberculosis and pneumothorax in the young age group while in the old age group, they were chronic bronchitis, pulmonary emphysema, chronic pulmonary heart disease and lung cancer. [Conclusion] The focus of daily medical treatment in the department of respiratory disease should vary with the age groups and disease categories, and the control of infectious diseases should be generally strengthened.

In artificial immune optimization algorithm, the mutation of immune cells has been considered as the key operator that determines the algorithm performance. Traditional immune optimization algorithms have used a single mutation operator, typically a Gaussian. Using a variety of mutation operators that can be combined during evolution to generate different probability density function could hold the potential for producing better solutions with less computational effort. In view of this, a linear combination mutation operator of Gaussian and Cauchy mutation is presented in this paper, and a novel clonal selection optimization method based on clonal selection principle is proposed also. The simulation results show the combining mutation strategy can obtain the same performance as the best of pure strategies or even better in some cases.

BACKGROUND:At present, the anatomic reconstruction of coracoclavicular ligament is a trend for the treatment of acromioclavicular joint dislocation. Endobutton plate is a new and effective surgical method found in recent years. Although the recent curative effect is satisfactory, as a method of internal fixation, its rigid fixation does not conform to the requirements of the biomechanics. Furthermore, a randomized control ed clinical study and systematic evaluation are absent.
OBJECTIVE:To systematical y evaluate clinical outcomes and safety between endobutton plate and the other surgical methods for treatment of acromioclavicular joint dislocation.
METHODCochrane (2014-01), PubMed (1966-01/2014-03), Medline (1966-01/2014-03), EMbase (1984-01/2014-03), CNKI (1979-01/2014-03), VIP (1989-01/2014-03) and Wanfang (1989-01/2014-03) databases were searched by computer. Six Chinese journals about orthopedics were searched by hand. References of relevant literatures were searched. Randomized control ed trials that were related to different surgical methods for the treatment of acromioclavicular joint dislocation were col ected. In accordance with inclusion criteria, some literatures were included and their qualities were assessed strictly. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Col aboration.
RESULTS AND CONCLUSION:Final y 7 published studies with randomized control ed trials met al the inclusion criteria. A total of 359 patients were included, containing 152 cases of endobutton plates fixation, 149 cases of clavicle hook plate fixation, and 58 cases of screw fixation. Except two researches addressed the comparison among three surgical ways, the remaining were about two ways. Meta-analysis showed that the excellent rate was better in endobutton plates fixation than in clavicle hook plate fixation (P=0.0002) and in screw fixation (P=0.009). Compared with other fixation methods, there were significant differences in shoulder joint pain (P=0.01), but no significant difference was detected in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection (P=0.44, P=0.10, P=0.37, P=0.21, P=0.96). Results indicated that, the efficiency of endobutton plates fixation for acromioclavicular joint dislocation was better than clavicle hook plate fixation and screw fixation, and caused less shoulder pain than clavicle hook plate fixation. There was no significant difference in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection among the three methods. Due to the limited number of cases in this study, the multicenter, large-sample and long-term clinical randomized control ed studies are needed to increase the strength of the evidence.

ncing analysis validated that all four-type base-quenched probes could provide unbiased genotyping results ( Kappa =1, P=0.00), although. Conclusion This method is simple, economic and suitable for large-scale genotyping studies.

We arranged for experienced doctors to carry out the programme of short-term strengthening training in obstetrics,gynecology and pediatrics to trainees before the end of their clinical practice,aiming at assisting trainees to systematize and categorize skill and knowledge that they had gained confusedly and disorderly during obstetrics,gynecology and pediatrics practice.It demonstrated that such programme was beneficial to their comprehensive examination of graduation and future clinical practice.

Objective To improve the experience of diagnosis and evaluate the clinical efficacy and safety of the surgical management for ureteral fibroepithelial polyp.Methods The clinical date of 29 patients with ureteral polyps admitted in Peking Union Medical College Hospital during 2001 to 2014 were analysed retrospectively.The patients' age was between 1 1 to 84 years and 19 were male.Twenty patients with frank pain and two patients with hematuria were enrolled.Seven patients were found hydronephrosis.Results Twenty-nine cases were treated surgically.Fifteen cases were treated by ureteroscopic laser ablation,10 cases local resection and reanastomosis,1 case of abnormalities duplex kidney and ureter underwent local resection and ureteroplasty,2 case Partial ureterectomy including the polyps and pyeloplasty,1 cases nephroureterectomy because of giant hydronephrosis and nonfunctional kidney.No recurrences were seen during a mean follow-up of 32 months (range 10-56 mos).No ureteral stricture occurs.Conclusions Ureteral fibroepithelial polyps represent a rare pathology.Local resection is the main treatment.Endoscopic management is recommended to minimize morbidity and complications in treatment of ureteral fibroepithelial polyps.Recurrences seem to be rare in these tumors.

ObjectiveTo investigate the effect and outcome of critically illness with acute kidney injury (AKI) treated with continuous veno-venous hemodiafiltration (CVVHDF) in children.Methods Twenty-four cases of critically illness with AKI were treated with CVVHDF in our pediatric intensive care unit from Jan 2008 to Dec 2010.The levels of creatinine (Cr),blood urea nitrogen (BUN),K +,Na + and HCO3- were observed before CVVHDF and 6,12,24,48,72 h after CVVHDF.ResultsCatheter was successfully established for CVVHDF in 24 cases of AKI.The average duration of CVVHDF was 46 h ( 16 ～142 h).The blood levels of Cr and BUN were significantly decreased at 6 h after CVVHDF [ ( 196.3 ±112.4) μmol/L,( 13.3 ± 8.5 ) mmol/L] and 12 h after CVVHDF [ ( 106.1 ± 84.2) μ mol/L,( 10.2 ± 9.7 )mmol/L] as compared to those before treatment [ (340.6 ±298.2) μmol/L,(31.6 ± 11.3) mmol/L] (P ＜0.05,P ＜ 0.01 ).After 48 h of CVVHDF,the Cr,BUN returned to normal range.The imbalance of blood K +,Na +,and HCO3- improved at 6 h after CVVHDF and returned to nomal levels at 24 h.Total 28 d fatality rate was 29.2％ (7/24),and all death cases were complicated with multiple organ dysfunction syndrome.ConclusionCVVHDF therapy for AKI can quickly clear Cr,BUN and excess water,correct electrolyte disorders,improve kidney function in children.