Objective To compare the effects of different surgical time for the recovery of elderly patients with acute cholecystitis and provide reference for its clinical treatment. Methods Clinic data of 79 elderly patients with acute cholecystitis from January 2008 to September 2013 were analyzed retrospectively. Patients were divided into two groups according to different surgical time, 42 cases having surgery within 72 h as early surgery group, and 37 cases having surgery later than 72h as delayed surgery group then the curative effects of two groups were compared and analyzed. Results The success rate of early surgery group reached 97.6%, and that of delayed surgery group 91.9%, which showed no statistically significant difference (P > 0.05); with shorter operative time, less blood loss, shorter length of hospital stay and less medical cost, patients recovered better in early surgery group than those in delayed surgery group and there were statistically significant differences between two groups (P<0.05), while the postoperative discharge time of two groups had no significant difference (P>0.05).The complication rate of early surgery group was 2.4%, and that of delayed surgery group 18.9%, which indicated statistically significant difference (P<0.05). Conclusions Early surgical treatment for elderly patients with acute cholecystitis has a good therapeutic effect and is beneficial to the early rehabilitation of patients.

Objective To research for a new method of arthroscopic total meniscectomy with simple instru- ments. Methods One hundred and sixty nine cases were followed up for short period that had been operated on with a forward knife, a back cutting knife, a punch and a 30?scope from Nov. 1992. to Aug. 1998. Results The av- erage time of operation was 78 minutes. The operations had no injury to cartilage and ligament. It is necessary for only 7 .9 percent of patients to take analgesic intramuscularly after operation. Eight patients had a transient tourniquet paral- ysis. All of them could begin to work and exercise after postoperative 2 weeks. Conclusion As compared with the method introduced by David Sisk ,this method has the advantages of simple instruments, fewer ports and complications and minimal trauma Either lateral meniscus or medial meniscus can be cut off by the same method. This method is a safety and a better way to arthroscopic meniscectomy.

Objective To explore the diagnostic and therapeutic value of arthroscopy for ankle joint sports injury. Methods 52 patients (53 ankles) with ankle sports injury treated by arthroscopy were reviewed retrospectively from December 1992 to December 2001. The modified McGuire Scorting for ankle (1988) was used as efficacy criteria. Results The mean recovery time of daily activities and special sports for the athletes was 10 days and 2.5 months respectively. All of the athletes returned to their previous optimal athletic level except that 1 case recovered slowly due to reinjury. Complications occurred in 3 cases (5 8%). The preoperative score was (60 4?9 1) points and postoperative score (89 0?5 7) points ( t =24 1, P

Objective:To establish an HPLC method for the determination of Cinnamic acid、Cinnamaldehyde in Guzhi Decoction. Methods:Defferent decoction were preparded and analyzed by L16(215)orthogonal design,the contents of the Cinnamic acid and Cinnamaldehyde in each decoction was determined by HPLC.Results:Different compatibilities have significantly on content of Cinnamic acid and Cinnamald.Conclusions The method is simple,effective,sensitive and feasible.

Objective:To observe the clinical effect of the combined use of dexmedetomidine and propofol for anesthesia in the elderly patients with painless gastroscopy. Methods:Totally 70 elderly patients with painless gastroscopy were selected and randomly divided into the observation group (35 cases) and the control group (35 cases). The observation group was given dexmedetomidine and propofol for anesthesia, while the control group was given propofol for anesthesia. The anesthesia induction time, the vital signs and recovery time of the patients, intraoperative complications and postoperative adverse reactions were observed and compared between the two groups. Results:The anesthesia induction time of the observation group was shorter than that of the control group (P<0. 01). The mean arterial pressure (MAP) in T2, T3 and T4 stage in the two groups were significantly lower than that in T1 stage (P<0. 05, P<0. 01). The HR in T3 stage and RR in T2 stage in the control group were lower than those in T1 stage (P<0. 05). The RR in T2 stage in the observation group was significantly lower than that in T1 stage (P<0. 05). The MAP in T2 and T3 stage in the observation group was significantly higher than that in the control group (P<0. 01), while that in T4 stage in the observation group was significant-ly lower than that in the control group (P<0. 05). The HR in T3 stage in the observation group was significantly higher than that in the control group (P<0. 05). The incidence of intraoperative complications in the observation group was 5. 7%, while that in the con-trol group was 22. 9%, and there was significant difference between the two groups (P<0. 05). The recovery time in the observation group was shorter than that in the control group (P<0. 01). Conclusion:Dexmedetomidine combined with propofol has better anes-thesia effect and higher safety than propofol alone, which is worthy of clinical promotion.

Objective: To investigate the curative effect of acupuncture on senile benign prostate hyperplasia. Methods: The patients were given acupuncture treatment for 10-30 times;International prostate symptom score (IPSS) and quality of life index (QOL) were used to assess IPSS and QOL scores of the patients before and after treatment. Results: Before treatment IPSS and QOL of the patients were 22.1± 6.7 and 4.5± 0.6 respectively, and after treatment were 9.1 ± 4.3 and 1.9± 1.1 respectively, there were very significant differences in IPSS and QOL between pre-treatment and post treatment(P ＜ 0.01). Conclusion: Acupuncture can relieve the clinical symptoms of prostate hyperplasia and raise the patients' quality of life.

Objective To study the injury mechanism, diagnosis and therapy of traumatic dislocation of the peroneal tendons. Methods 18 cases with traumatic dislocation of the peroneal tendons were operated in our institute from 1986 to 2000. The mechanism of injury and clinical findings were investigated. 2 cases with acute dislocation were operated by suturing the peroneal retinaculum directly. 16 cases with recurrent dislocation were treated with Watson-Jones operation. Results 10 cases with recurrent dislocation were follow-up from 1 year to 15 years with an average of 6.2 years. Only one recurrence due to ankle sprain was found and the other 9 cases had no more dislocation and returned to sports without symptom.Conclusion Traumatic dislocation of the peroneal tendons can be caused by the injury of ankle joint in three positions:dorsiflexsion and eversion, dorsiflexsion and inversion, plantflexsion and inversion. Anti-resistant test of dorsiflexsion and eversion may help diagnosis. Watson-Jones operation has the advantages of simple to apply, minor trauma and sound clinical outcome.

Objective To investigate the association between genetic polymorphisms and protein levels of mannose-binding lectin (MBL) and the sensitivities of common infections in a pediatric Han population lived in Zhejiang Province.Methods MBL genetic polymorphisms of patients and controls were detected by PCR-based sequencing.MBL protein levels were measured using MBL ELISA Kit.Results No mutations at positions +223 and +239 of the exon 1 were detected in either patients or controls.No mutation at position +4 of the promoter was detected in controls.The frequencies of the three genotypes HH,HL,and LL at position-550 of the promoter were different between patients and controls(P＜0.05).The frequencies of genotypes YA and XB relevant to MBL protein levels were also different between patients and controls(P＜0.05).Comparing the frequencies of genotypes YA and XB in separate infectious disease with controls,significant differences were found in the group of RRI and CMV infection.The distributions of serum MBL level frequencies in patients and controls were both characterized by skewed distributions.MBL levels of patients with CMV infection were lower than those of controls(P＜0.05).Inversely,MBL levels of patients with acute respiratory infection and localized abscess were higher than those of controls (P＜O.05).Conclusion Genetic polymorphism of MBL gene is seemed to be relative to the sensitivity of common infections in children.

Background and Purpose:The recurrent rate of breast cancer after mastectomy was 5%~20%,high risk factors were included it could achieve 34%~40%,Chest wall recurrence was the most common.This paper explores the reason for chest wall recurrence of breast cancer after mastectomy,hoping to find an efficient way to prevent and reduce chest wall recurrence after mastectomy.Methods:For 39 patients with local recurrence on the chest wall after mastectomy clinical data was reviewed retrospectively.Results:This group of patients was 5.1% of all breast cancer patients in the same period.Most of recurrences(59.0%)occured within two years affer operation.The recurrent rate of T_1～T_4 was 1.6%、1.9%、9.7% and 37.2% respectively.Rate of chest wall recurrence in patients with negative axillary nodes and positive axillary nodes was 1.3%、7.6%,but if the amount of positive axillary nodes≥4,it was 13.4%.Conclusions:In the patients who had more positive axillary nodes,larger primary tumor and no proper adjuvant therapy,recurrence on the chest wall was seen more often.Adjuvant chemotherapy and postoperative radiotherapy are efficient ways to prevent recurrence on the chest wall.

Objective To investigate whether 5 different chemotherapeutic drugs and their combination of either two drugs could further promote the inhibition on the cell growth of HCC cell line (HepG2) in vitro in the hypoxic and hyponutritional culture medium (HHCM) mimicking the different scenarios of transcatheter arterial chemoembolization (TACE).Methods The cells were treated by 5 drugs for 2 h, 4 h,6 h and 24 h, which include epirubicin (EPI), cisplatin (DDP), mitomycin-C (MMC), oxaliplatin (OXA) and 5-fluorouracil (5-FU) in four concentrations of HHCM (5％, 10％, 25％ and 50％) mimicking the scenarios during TACE and the cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.The combinations of dual drugs treated for 24 h were also tested.Results The sensitive drugs with inhibition rates more than 30％ were EPI, MMC and OXA in 4 different concentrations of HHCM.The sensitivity of the drugs treated for 24 h was significantly increased compared with that for 2 h in 5％, 10％ and 25％ HHCM.The dual combinations did not increase the chemosensitivity of HepG2 cells.Conclusions EPI, MMC and OXA exhibited cytotoxic activity against HepG2 cells in various hypoxia and hyponutrition states.Prolonging the exposure time could increase the sensitivity of drug in HHCM, and the combination of dual drugs cannot enhance the cytotoxic effect.