Objective To summarize the experience of laparoscopic appendectomy(LA).Methods A retrospective analysis was carried out on clinical data of 162 cases of laparoscopic appendectomy in this hospital from August 2002 to April 2005.Results Laparoscopic operation was completed in all the cases but 1 case of intestinal tuberculosis.The operative time was 30~90 min(mean,42 min) and the intraoperative blood loss was 5~10 ml.No complications were noted.Conclusions Laparoscopic appendectomy has advantages of little invasion,less blood loss,rapid recovery,and fewer complications,being a safe and ideal surgical alternative.

Objective To analyze the effect of combined detection of serum tumor markers, Ki-67 and P-glycoprotein (PGP) in lymph node metastasis and postoperative recurrence of colorectal cancerpatients. Methods The clinical data of 517 colorectal cancer patients who had underwent surgicaltreatment were retrospectively analyzed. Among them, lymph node metastasis was found in 165 cases(lymph metastasis group), and 352 cases did not have lymph node metastasis (non lymphoid metastasis);postoperative recurrence was found in 224 cases (postoperative recurrence group), and 293 cases did havepostoperative recurrence (non postoperative recurrence group). The serum tumor markers levels of cancerantigen 19- 9 (CA19- 9), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and theexpressions of Ki-67, PGP were compared. The correlation between the serum tumor markers levels andthe expressions of Ki-67, PGP was analyzed. Results The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in lymph metastasis group were significantly higher than those in non lymph metastasis group:(21.39 ± 3.15)μg/L vs. (10.12 ± 2.48)μg/L, (68.48 ± 5.82) U/L vs. (35.26 ± 3.51) U/L, (82.16 ± 7.53) U/L vs. (32.46 ± 6.24) U/L, 69.70% (115/165) vs. 13.64% (48/352) and 72.73%(120/165) vs. 14.77%(52/352), and there were statistical differences (P<0.01). The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in postoperative recurrence group were significantly higher than those in non postoperative recurrence group:(18.26 ± 2.34)μg/L vs. (9.18 ± 1.26)μg/L, (47.52 ± 4.85) U/L vs. (21.43 ± 2.18) U/L, (59.16 ± 4.25) U/L vs. (33.17 ± 3.46) U/L, 60.27% (135/224) vs. 9.56% (28/293) and 6.70% (15/224) vs. 7.51% (22/293), and there were statistical differences (P<0.01). The correlation analysis results showed that the positive expression rates of Ki-67 and PGP were positive correlated with the serum levels of CEA, CA19-9 and CA125 (P<0.05). Conclusions The levels of serum tumor markers and the positive expression rates of PGP and Ki-67 in colorectal cancer patients with lymph metastasis and postoperative recurrence are high. The levels of tumor markers are closely related to the positive expression rates of Ki-67 and PGP, which indicates that the combined detection of these indexes has a good effect on evaluating lymph metastasis and postoperative recurrence of colorectal cancer patients.

A reverse phase HPLC-ELSD method for the determination of ginsenoside Rg1 in the rootof Panaa pseudo-ginseng var. notoginseng (Burkill) Hoo et Tseng was reported. Chromatographic condi-tions: Shim-pack CLC-ODS column (6.0 mm×150 mm)； acetonitrile-water (30: 70) as the mobilephase； Shimadzu LC-6A with SEDEX-55 ELSD detector. The method was found to be simple and accuratewith recovery rate of 100. 50％ and RSD= 1.82 %. The established UV spectrophotometric determinationof total saponins in P. pseudo-ginseng var. notoginseng was also tried and gave an accurate result coinci-dental with that of the HPLC results. The recovery rate was 101.50%， and RSD=1. 44%. It seemed thatboth methods can be used reliably for the quality control of P. pseudo-ginseng var. notoginseng.

Objective To explore the application and analysis of E-PASS scoring system for orthopaedic senile hip surgery risk assessment. Methods Retrospectively analyzed the data of 188 cases of elderly hip fracture patients with anesthesia and surgery, postoperative complications. Useing E-PASS scoring system to evaluate the mortality of patients with surgical risk. Results Postoperative complications mainly was respiratory system diseases, the rate of complication was 25.88%(22/85), accounting for total cases rate was 11.70% (22/188). Secondly for cardiovascular diseased and urinary system diseases. E-PASS scoring system showed that the scores of surgery risk assessment in patients with complication was significantly higher than that without complication:(0.27±0.23) scores vs. (0.17±0.16) scores, t=3.728, P<0.05. Ninety-one patients were evaluated to occur complications by E-PASS grading system, 85 patients occurred practically,the rate of actual value/forecast was 0.93.Six patients were evaluated to die, 2 patients occurred practically, the rate of actual value/forecast was 0.33, there were no significant differences ( P=0.056,0.124). Conclusion E-PASS scoring system for orthopaedic senile hip surgery risk assessment can predict the risk of complication and death effectively,it is value of interventing the preoperative risk factors and has great clinical application value.

Objective To investigate early diagnosis,treatment and prev ention of tibia fatigue fracture. Methods From August 1988 to July 1999, 66 case s of tibia fatigue fracture were treated with exposure to the irradiation of Zho u Lin Spectrum Treatment Device, plaster splintage, according to their different clinic characteristics and results of X-gram.Results The 66 cases were followe d up for an average of 6 months. The result was excellent in 50 cases, good in 1 6, with the excellent and good rates of 100%. Conclusions As a result of a chro nic course of accumulative injury, the tibia fatigue fracture develops from quan titative changes to qualitative changes. It is essential for medical workers to have a good knowledge of the classification and features of the condition. It is also important for the army to make scientific and reasonable training plans fo r the soldiers.

Objective To determine whether there is any difference in rocuronium-induced muscle relaxation between patients of Buyi and Han nationality.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 20-55 yr,with body mass index of 20-25 kg/m2,undergoing laparoscopic or arthroscopic surgery under general anesthesia,were divided into 2 groups ( n =30 each):Han group (group H) and Buyi group (group B).Anesthesia was induced with midazolam,fentanyl and TCI of propofol (Cp=2-3 μg/ml).Tracheal intubation was facilitated with rocuronium 0.6 mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 30-35 mm Hg.Neuro-muscular (N-M) function was monitored by accelerography.N-M block was assessed by single stimulation of ulna nerve after loss of consciousness.The onset time,maximal N-M block time,clinical muscle relaxation time (from injection d rocuronium to 25％ recovery),75％ recovery time (from injection of rocuronium to 75％ recovery) and recovery index were recorded.The plasma concentration of albumin and α1-acid glycoprotein were measured by ELISA and biochemical analysis respectively.Results The onset time was significantly longer and plasma α1-acid glycoprotein concentration lower in group B than in group H.There was no significant difference in maximal N-M block time,clinical muscle relaxation time,75％ recovery time,recovery index and plasma albumin concentration between the 2 groups.Conclusion The onset time of rocuronium-induced N-M block is longer in patients of Buyi nationality as compared with patients of Han nationality.Lower plasma α1 -acid.glycoprotein concentration may be involved in the underlying mechanism.

Objective To investigate the relationship between the polymorphisms of both aldose reductase (AR) and endothelial nitric oxide synthase (eNOS) genes in chromosome 7q35 and the susceptibility to diabetic nephropathy (DN) in type 2 diabetes of Han nationality in North China. Methods The C(-106)T in the promoter region of AR gene as well as the G894T in exon 7 and the 27 bp repeat polymorphism in intron 4 of the eNOS gene were investigated in 85 healthy controls and 134 type 2 diabetics with or without DN. The C(-106)T as well as the G894T genotype were determined by PCR RFLP method and sequencing the PCR products. The 27 bp repeat polymorphism alleles were determined by PCR combined with agarose gel electrophoresis and sequencing the PCR products. Results The frequencies of the C allele and C/C genotype in AR gene as well as T allele and T/G genotype in exon 7 and the 4a allele and 4a/4b genotype in intron 4 of eNOS gene were significantly higher in DN+ group than those in DN-group (all P

Objective To study the proliferation and apoptosis of endothelia cells in cavernous hemangioma of liver(CHL),and to find their relation with the occurrence and development of CHL.Methods Twenty two CHL speciments of resection or biopsy in our hospital were collected.Another 10 speciments of small blood vessel in portal area of normal liver tissues and 10 speciments of strawberry hemangioma were collected as contrasts .The expression of proliferating cell nuclear antigen(PCNA) was assessed with monoclonal antibody of PCNA by immunohistochemical ABC method.The apoptosis of cells was assessed by end labeling method(TUNEL).Results Proliferation index(PI) of endothelia cells in CHL was 13.27?5.79.There wasn't significant difference from PI of endothelia cells of small blood vessels in portal aera of normal liver(10.85?4.79),while significant difference did exist compared with PI of tumor cells in strawberry hemangioma ( 29.31 ?8.55). Apoptosis index(AI) of endothelia cells in CHL was (3.49?1.36).There wasn't significant difference from AI of endothelia cells of small blood vessels in portal aera of normal liver(2.65?1.06),while significant difference did exist compared with AI of tumor cells in strawberry hemangioma ( 11.38 ?2.66,t=11.18,P

Objective :To observe correlation among serum levels of cardiac troponin I (cTnI ) ,N terminal pro brain natri—uretic peptide (NT—proBNP) and cardiac function in pregnant patients with chronic heart failure (CHD) and its signifi—cance.Methods : A total of 82 pregnant patients with CHF treated in our hospital from Jun 2012 to Oct 2017 were enrolled as pregnancy + CHF group.Another 42 non—pregnant CHF patients (non—pregnant CHF control group ) and 42 normal pregnant women (normal pregnancy control group) were selected simultaneously .According to NYHA classification ,preg—nancy + CHF group was further divided into class II group (n＝36) and class III～IV group (n＝46).Serum levels of cTnI and NT—proBNP were measured and compared among above groups .The correlation among serum cTnI ,NT—proBNP levels and cardiac function class were analyzed in pregnant patients with CHF .Results : Compared with CHF control group and normal pregnancy control group ,there were significant rise in serum levels of cTnI [ (1.32 ± 0.46) ng／ml ,(0.08 ± 0.03) ng／ml vs.(2.39 ± 0.54) ng／ml] and NT—proBNP [ (4351.63 ± 374.82) pg／ml ,(204.92 ± 35.16) pg／ml vs.(6142.75 ± 415.06) pg／ml] in pregnancy + CHF group , P＝0.001 all ;those of CHF control group were significantly higher than those of normal pregnancy control group , P＝0.001 both .In pregnancy + CHF group ,compared with class II patients , there were significant rise in serum levels of cTnI [ (1.26 ± 0.37) ng／ml vs.(2.29 ± 0.52) ng／ml] and NT—proBNP [ (4103.51 ± 276.20) pg／ml vs.(6049.55 ± 427.06) pg／ml] in class III～IV patients , P＝0.001 all.Spearman correla— tion analysis indicated that serum levels of cTnI and NT—proBNP were significant positively correlated with cardiac function class in pregnant patients with CHF ( r＝0.732 ,0.884 ,P＜0.01 both).Conclusion :Serum levels of cTnI and NT—proBNP are significant positively correlated with cardiac function class in pregnant patients with CHD .Their detection can provide powerful evidence for early diagnosis and cardiac function assessment .

Objective To investigate the flora distribution and drug resistance status in the Affiliated Hospital of Academy of Military Medical Sciences so as to provide experimental data for clinical doctors to use antibiotics more efficiently.Methods The clinical data of pathogenic bacterial infections over nearly one year in our hospital were retro -spectively analyzed .Results There were 3815 strains of pathogenic bacteria isolated from the sample .The percentage of Gram-positive strains was 36.4%while that of Gram-negative bacteria was 63.6%.The most common bacteria were Esche-richia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus epidermidis.In terms of drug tolerance , Enterobacteriaceae remained highily sensitive to carbapenems .The total resistance rate was 2%-5%.The resistance rate of A.baumannii to meropenem and imipenem was 60%.There were still a few pan-drug resistant strains among K.pneumoniae,A.baumannii and P.aeruginosa,but there were no drug resistant strains to vancomycin , tige-cycline and linezolid in Staphylococcus.The resistance rate of Enterococcus faecium to vancomycin was 9%.The bacteria were distributed predominantly in ICU ,Department of Hematology and Department of Oncology .The samples were mainly composed of phlegm specimens .Conclusion The high distribution in the three departments mentioned above is largely re-lated to the diseases being treated .The specimens from the lower respiratory tract show more types of bacteria that are mostly drug-resistant, and the isolating rate of vancomycin resistant Enterococcus and carbapenems resistant K.pneumoniat is com-paratively high .