Objective To compare the treatment effect of laparoscopic appendectomy(LA)and open appendectomy(OA).To investigate the worth of endoscopic technology in LA.Methods 123 cases of LA and 989 cases of OA performed were studied retrospectively.The clinical data of two groups were summarized,contrasted and analyzed respectively.Results The times of operation,taking food and hospitalization in LA group were obviously shorter than those in OA group.The postoperative pain and the rate of incision infection in LA group were obviously superior to those in OA group.While the cost of hospitalization in LA was obviously higher than that of OA.Conclusion LA have advantages of minimal invasion,quicker recovery.safety and reliability,has significant advantages in treaing appendicitis and should be promoted.

Objective To compare the clinical effect of procedure for prolapse and hemorrhoids(PPH)improved,Milligan-Morgan hemorrhoideeomy and Ferguson-Mitchell hemorrhoidecomy in the treatment of the Ⅲ～Ⅳdegree mixed hemorrhoids.Methods 45 cases admitted for surgical treatment of Ⅲ～Ⅳ degree hemorrhoids,were randomly divided into 3 groups,the improved PPH,MMH and FMH were retrospectively reviewed,and it is separately reviewed for the operation time,pain index,length of hospital stay,return to normal activity time,postoperation complication and patients satisfaction etc.Results There was reasonably evidence in favor improved PPH for operating time,hospital stay,pain,anal discharge,and patients satisfaction.Conclusion The improved PPH is a safe and effective procedure for Ⅲ～Ⅳ hemorrhoids and its short-term outcome is more better than Milligan-Morgan and Ferguson-Mitchdl group.

Objective To investigate the significance of combined detection of tumor markers in serum and pleural fluid on differential diagnosis of benign and malignant pleural effusion.Methods Three hundred and seventy six cases of pleural effusion were selected.The levels of carcinoembryonic antigen (CEA),neuronspecific enolase(NSE),cancer antigen 125 ( CA125 ),squamous cell carcinoma antigen (SCC) in serum and pleural fluid were examined and they were analyzed combined with histological or cytological evidence using statistical methods.Results There were 298 cases in malignant group and 98 cases in benign group.The levels of the four tumor markers in malignant group were significantly higher than in benign group both in pleural fluid (CEA:[279.9 ± 170.0]μg/L v.s.[ 12.6 ± 6.2 ] μg/L,t =6.29,P ＜ 0.01; NSE:[ 112.3 ± 86.8 ] μg/L v.s.[14.7 ±7.3] μg/L,t =5.13,P ＜0.01 ;SCC:[ 10.6 ± 5.4] μg/L v.s.[ 1.2 ±0.6 ] μg/L,t =2.34,P ＜0.01;CA125:[ 409.2 ± 206.7] U/ml v.s.[ 44.0 ± 20.5 ] U/ml,t =7.46,P ＜ 0.01 ) and in serum ( CEA:[ 86.7 ±42.0] μg/L v.s.[6.2±3.1]μg/L,t=3.14,P＜0.01;NSE:[31.6±18.2]μg/Lv.s.[11.2±5.0]μg/L,t=4.61,P＜0.01;SCC:[3.5±2.2]μg/Lv.s.[1.8±0.g]μg/L,t=1.70,P＜0.01;CA125:[134.0±72.6]U/ml v.s.[ 19.8 ± 9.6 ] U/m1,t =4.04,P ＜ 0.01 ).Moreover,the levels of tumor markers in pleural fluid were higher than in serum.The sensitivity were 100％ by combined detection of pleural fluid and serum tumor markers in parallel and the specificity were 100％ in sequence.Conclusion The levels of CEA,NSE,CA125,SCC in pleural effusion were more sensjtive than which in serum.Combined detection of tumor markers in pleural fluid and serum could improve the sensitivity of diagnosis for benign and malignant pleural effusion.

Objective To analysis the effect of compound betamethasone injection combined with radiation on keloid in frontal facial region. Methods 60 cases of keloid patients in zhejiangprovincial people's hospital from January 2014 to January 2016 were selected,all patients were treated with surgery,the patients were randomly divided into observation group and control group,30 cases in each group,radiotherapy was used in the control group,the observation group was treated with local injection of compound betamethasone on the basis of the control group,the therapeutic effects, pain scores, adverse reactions and complications were compared between the two groups. Results The recurrence rate of the observation group was 3.33% which was significantly lower than that of the control group 10%,the improvement rate of the observation group 93.33% was significantly higher than the control group 80%,the difference was statistically significant (P<0.05).one,two and three months after operation,the pain scores in the observation group were significantly lower than those in the control group at the same time point,the difference was statistically significant (P<0.05).The adverse reaction rate was 6.66% (2/30) in the observation group and 23.33% (7/30) in the control group, there was no significant difference between the two groups.The incidences of skin sag, pigmentation, incision delayed union and telangiectasia in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Compound betamethasone injection combined with radiation on the frontal facial keloid patients with significant effect,can significantly reduce the recurrence rate,improve the rate of improvement,reduce pain and complications in patients.

Objective: To study the effects of potentill on all systems of experimental animals to provide experimental evidence for the comprehensive safety evaluation of potentill.Methods: Mice and rats were given potentill orally to determine the influence on all systems, and the general pharmacological activities of potentill were recorded.Results: The general behavior of mice was normal after the adminisration of potentill , the test samples showed no synergetic hypnotic effect with nembutal at subthreshold dose, and had no influence on the spontaneous activity and body coordination ability of mice (P＞0.05).The test samples showed no obvious influence on the cardiovascular system and respiratory system of rats (P＞0.05).Conclusion: Potentill meets the general requirements of pharmacology at the prescribed dose.

Objective To evaluate the therapeutic effect of duodenoscopy in the early treatment of acute biliary pancreatitis (ABP).Methods Twenty ABP cases admitted from Oct.2000 to Mar.2004 received emergent endoscopic retrograde cholongiopancreatography (ERCP), sphincterotomy (EST) plus endoscopic lithotomy and endoscope naso-biliary drainage (ENBD).Other 16 cases were treated with conservative therapy or open surgery.Results Successful rate of endoscopic management was 95%.There were no severe complications nor mortality in this group.The duration of symptoms and hospitalization in endoscopy group were significantly shorter than control group ( P

Objective To investigate the effects of comprehensive geriatric assessment (CGA) and health intervention on outcome in discharged patients.Methods Discharged patients in geriatric ward from May to July 2012 were randomly assigned to control (n=36) and intervention (n=36) groups.Patients in the two groups were given comprehensive geriatric assessment (CGA) before discharging from hospital.Both groups were followed up for 3 months.Patients in intervention group received health intervention when leaving hospital,at 1 week,3 weeks and 3 months after discharge from hospital,while patients in control group were not given any intervention.The comprehensive illness condition (MCIRS-G),ability of daily life (ADL and IADL),rehospitalization and survival rate were compared between the two groups 3 months after the intervention.Results After 3 months,the scores of MCIRS-G,ADL and IADL were significantly better in intervention group than in control group[(29.06±4.51) vs.(33.09±4.34),(75.69±16.57)vs.(63.86±19.37),(11.72±3.20) vs.(9.77±2.52),respectively,t=3.84,2.77,2.85,all P=0.01].The total times ofreadmission and readmission length were less in intervention group than in control group [3 vs.17,x2 =8.79,P=0.02; (1.94±6.68) days vs.(8.81±14.09) days,t=2.64,P=0.01].There was no difference in survival rate between the two groups [100％ (36/36) vs.97.2％ (35/36),x2=1.01,P=0.30].Conclusions Comprehensive geriatric assessment and health intervention can alleviate symptoms and improve the ability of daily life.

Objective To investigate the effect of tannic acid on glomerular mesangial cells (GMC),and to clarify the mechanism of tannic acid in improving the pathological changes of diabetic nephropathy (DN)from the aspect of oxidative stress and micro-inflammation. Methods The glomerular mesangial cells were treated with glucose (30 mmol·L-1 )or advanced glycosylation end-products (AGEs)bovine serum albumin(BSA)(250 mg·L-1 )and then different concentrations of tannic acid (10,20,40 and 80μmol·L-1 )were added into the GMC.The cells cultured by normal glucose or treated with BSA were used as control groups and then the level of malonic dialdehyde (MDA), glutathione peroxidase (GSH-Px ), superoxide Dismutase (SOD ), CAT (Catalase ) activities and 8-hydroxy-2′-deoxyguanosine(8-OHdG)levels in the culture supernatant 48 h after culture were determined by colorimetry and ELISA method. The expressions of intercellular cell adhesion molecule-1 (ICAM-1 ) protein, monocyte chemotactic protein 1 (MCP-1 ) and ICAM-1 mRNA in GMC were detected by immunohistochemical staining and RT-PCR method.Results Compared with high glucose and AGEs groups,the MDA levels in tannic acid groups were reduced significantly(P<0.05);the activities of GSH-Px,SOD and CAT were increased significantly(P<0.05 or P<0.01);the 8-OHdG levels in annic acid groups were significantly reduced (P<0.05). Compared with high glucose and AGEs groups,the expressions levels of ICAM-1 protein in 40 and 80μmol· L-1 tannic acid groups were decreased (P<0.05 ). The mRNA expressions levels of MCP-1 and ICAM-1 were significantly lower than those in high glucose group (P<0.01 ).Conclusion Tannic acid could protect GMC against the damage of oxidative and inflammatory mediators,thereby delaying and improving the glomerular lesions of DN.

Objective To study on the relationship between plasminogen and brain-derived neurotrophic factor(BDNF),and explain the molecular mechanism of depression ,then provide new clew for diagnosis and treatment of depression .Methods The chronic unpredictable mild depression rat mode was established ,then depression symptoms including absence of delight ,the decline of actions and activities ,and weight reduction of rat were tested .The levels of individual plasminogen and BDNF in hippocampus were determined by Western blot .Results The expression of BDNF and plasminogen in depression rat mode and control group was significantly different(P<0 .01) ,and there was a positive correlation between BDNF and plasminogen(r=0 .65 ,P<0 .01) .Accord-ing to the linear-regression analysis ,there was a dependence relationship between them(r2 =0 .423) .The equation of regression was YBDNF=0 .750XPlasminogen +0 .201 .Conclusion Stress could affect the growth and survival of nerve cell ,which lead to the depression behavior of rats ,meanwhile ,the decline of plasminogen and BDNF levels ,the positive correlation between them illustrate that plas-minogen and BDNF take part in the mechanism of depression .

Objective To summarize the construction,upgrading process and clinical application of prostate cancer database (PC-Follow).Methods From September 2008 to December 2014,we designed two versions of off-line PC-Follow clinical databases based on Microsoft Access to support clinical follow-up and research in prostate cancer patients.Then,in order to achieve unified management of clinical data import and multi-center clinical research,we further upgraded PC-Follow to a browser/server (B/S) schema based web database.After upgrade,a simulated multi-center operation pattern was adopted to transfer all existed data-We then attempted to linkage our database with the hospital information system (HIS) and had eventually undertaken reality and stress testing on 3,124 cases'data migration in the hospital.The nationwide software testing and personnel training was conducted in 12 major medical centers.Results Twice of upgrade and alteration of schema of PC-Follow preserved the original user interface.Multiple functions,including data import,follow-up,research support,were obviously enhanced.Notably,the perfection in multi-user and hierarchical access control meet the future needs for multi-center clinical research.Via the import tool for PC-follow V3.0,we successfully migrated all data from the original one.After linking our database with the HIS software by one-way transmission protocol,the safety data extracting could be achieved.Specified administrators were appointed to process and analyze PC-Follow data in bulk,and data were voluntarily shared between attending centers,and showed stable performance on the 3,124 patients in our database.Feedback from nationwide multicenter training and testing indicated that our database was easy,readily accessible,with functionally stable modules,accurate website displays,and ideal response time.Conclusions The online PC-Follow database with hierarchical access provides support for multi-center clinical research in prostate cancer.The off-line PC-Follow database also grants certain degrees of data management for underdeveloped clinical centers,and it has its advantage to serve as prototypes for data migration to future online PC-Follow database once conditions are ripe.