Objective To evaluate the diagnosis and surgical management of appandiceal mucoceles.Method The clinical data of 50 patients with appendiceal mucoceles surgically treated from January 2004 to January 2008 were reviewed retrospectively. Result The correct preoperative diagnosis rate was 8%.Eight patients were complicated with pseudomyxoma peritonei.The canceration rate was 4%.All the 50 patients recovered uneventfully after the surgery.There was no complications,no recurrence during the follow-up period,including the 2 patients with canceration. Conclusion It was difficult to make correct diagnosis of appendiceal mucoceles preoperatively.The diagnosis should always be in mind if the B-type ultrasonography indicated a cystoadenoma.Abdominal CT coupled with necessary digestive image examinations may improve the correct diagnosis rate.Some patients may be complicated with pseudomyxoma peritonei.Occasionally this abdominal mass was also associated with malignancy.Surgery is the management of choice,and the prognosis is good.

[Objective]To study the application and clinical results of the adjustable erternal fixation of ankle joint(AEFA) in orthopedic surgery.[Method]From January 1999 to May 2005,45 cases(55 feet)of equinovarus deformity were treated with orthopedic surgery.In order to preventent the deformity relapsion,the patients were assigned to two groups.The A group(26 cases,32 feet)patients were treated with the adjustable erternal fixation of ankle joint(AEFA).The B group(19 cases,23 feet)patients were treated with plaster immobilization.The orthopedic surgery effect and functions of ankle joint were studied and tested with independent sample t test and x~2 test.[Result]Thirty-eight cases were fellowed-up for 3 months to 9 years(averaged 19 months).There were significant difference between the two groups in the functions of ankle joint.[Conclusion]The new apparatus can effectively prevent the foot-drop deformity and enhance the function of ankle joint.

Objective:To investigate the effect of Operation Maps application on relieving anxiety of patients of the nurses of operation room preoperative visits. Methods:39 cases of operation were randomly divided into the application of operation maps 19 cases and routine visit group 20 cases, regular visiting group received routine preoperative interview content, and on the basis of content, the original application mapping group are visited by nurses carrying atlas album, and according to the related content the nurses explain to patients in the album when they introduce the patients the operating room environment surgery, surgical notes, position, etc. At the same time, the self rating anxiety scale measurement measures the anxiety of patients when they are admitted and after into operation room, and blood pressure, heart rate, pain intensity, the first time getting out of bed, exhaust time, clearing time, and they compare the difference. Results:The anxiety values of the original application mapping group mapping group, systolic blood pressure, heart rate are lower than regular visits group(t=2.28, t=4.756, t=10.28;P<0.05). Intensity of pain after operation in the two groups , get out of bed the first time, exhaust time showed no significant differences(t=3.04, t=3.06, t=2.56;P<0.01). Conclusion:Application of operation atlas of systematic, standardized preoperative visit is an important psychological guidance, and it can reduce the anxiety level of patients and effectively improve the quality of medical operation period.

Co-citation analysis, co-word analysis and strategic coordinates are combined to make known the subject theme evolu-tion. The research history of general surgery is described by eo-citation eluster analysis, citation strategic diagram is pictured by the theory of strategy coordinates to learn more about the novelty and attention of each hot topic. The present research focused on general surgery that would be found by co-words cluster analysis, and stages of development about each topic are discussed by strategic coordinates based of cluster results. It is helpful to provide a decision-making reference for professionals and managers.

Primary aldosteronism (PA) is a common form of secondary endocrine hypertension,which is characterized by hypertension,hypokelamia,myathenia,elevated serum aldosterone concentration and suppressed plasma renin activity.Besides,accumulating research evidences showed that parathyroid hormone (PTH) level was elevated in patients with primary aldosteronism,accompanied by secondary hyperparathyroidism.This review systemically introduces the interaction between aldosterone and PTH in PA patients.

Objective To assess the effectiveness of Chinese medicine treatment in endometriosis(EMT) by evidence-based medicine methods.Methods Retrieve articles mainly from Wanfang data,VIP information,CNKI and China TCM Database.Bring the articles report into research on the basis of strict quality evaluation.Consolidate cure rate and effective rate for meta-analysis.Results Based on 8 articles report,cure rate of Chinese medicine treatment is superior to western medicine treatment,and effective rate is equivalent to western medicine treatment.There is no side effect and other harmful consequence in evidence.Conclusions Chinese medicine treatment is superior to western medicine treatment in treating EMT.However,existence of some data methodological problems maybe directly affect the authenticity of the findings.So,more rigorous,randomized controlled trials should be designed in order to draw more reliable conclusions.

Lack of specific symptoms and signs makes clinical diagnosis of trichinellosis difficult. Epidemiological information is important, such as a history of ingesting raw or undercooked meat. An outbreak can be traced to a group of people dining together. Usual manifestations include abdominal pain or diarrhea with general discomfort in the enteric stage, and fever, eyelid or facial edema, muscle pain in acute stage. Complications, such as myocarditis, pneumonia, encephalitis, may develop in severe cases. Eosinophilia appears between 2 and 5 weeks after infection. Enzyme-linked immunosorbent assay(ELISA) using the excretory-secretory(ES) antigens of the muscle larvae or synthetic tyvelose as antigen is sensitive and specific, the serological method of choice as a screening test. Western blotting is needed to confirm the positive ELISA. Definitive diagnosis depends on the finding of larvae in a muscle biopsy specimen. Albendazole is the drug of choice for its treatment, 20-30 mg/(kg?d), two times daily for 5-7 days. Glucocorticosteroids are given only to severe cases and always be used in combination with albendazole, since they could prolong the intestinal phase of the infection and increase the muscle larval burdens.

Objective To establish a nested-real-time-PCR for the detection of IL-21R mRNA in peripheral blood mononuclear cells(PBMC)of patients with rheumatoid arthritis,and explore its clinical significance.Methods The outer primers of span intron and inner primers were designed for nested-real-time-PCR.To increase specific template,the concentration of primers and enzyme,cycle times were decreased in the first amplification,and the real-time fluorescent quantity assay was performed in the second amplification.The ?-actin gene was used as internal reference,and the results were presented as the ratios of IL-21R mRNA to ?-actin mRNA.Results IL-21R mRNA was detected in 60 patients with RA and 30 healthy controls.The expression of IL-21R mRNA gene in the patients with RA was increased,and the statistical analysis has significant differences(P0.05),but a significant difference was found in the patients of grade III compared with those of grade I and II(P

Objective To identify the clinical and neurophysiological features of multiple system atrophy (MSA) and explore diagnostic values using various techniques in electro neurophysiology Methods Forty four subjects diagnosed as multiple system atrophy (MSA) during 1983 to 2001 in PUMC Hospital were studied retrospectively about their clinical features, routine electromyography (EMG), nerve conductive velocity (NCV), somatosensory evoked potential (SEP), motor evoked potential (MEP), brainstem auditory evoked potential (BAEP) and visual evoked potential (VEP) The clinical features and the electroneurophysiologic results were analyzed in different subgroups (probable MSA and possible MSA, OPCA and non OPCA, classified MSA and unclassified MSA) Results Most patients were found to be suffered from autonomic failure (88 6%) and cerebella dysfunction (88 6%) The pyramidal sign was seen in 72 7% of patients No remarkable statistical differences were found in all of the above three domains The incidence of Parkinsonism was 36 4% of all the patients, which showed significant differences between probable and possible MSA (54 5% vs 18 2%), non OPCA and OPCA (50% vs 7 1%), unclassified MSA and classified MSA (52% vs 15 8%) EMG was abnormal in 7 patients (38 1%), all of them were neurogenic impairments The rates of abnormal EMG were varied differently between probable and possible MSA (54 5% vs 22 2%), non OPCA and OPCA (53 8% vs 14 3%), unclassified MSA and classified MSA (58 3% vs 12 5%), but without statistical differences The abnormal rates in BAEP,SEP, VEP and MEP were 56 7%, 28%, 23 1% and 20 0%, respectively, and there were no significant differences between subgroups Conclusions It should be hard to divide MSA into groups only by the clinical manifestations All EPs were abnormal in some extent The most sensitive test is BAEP in current study, but there were no differences among the subgroups in the rates of abnormal EPs The difference of EMG and NCV between the groups showed that the technique might be helpful in the diagnosis of MSA

Objective To evaluate the diagnostic value in pulmonary interstitial fibrosis by transbronchial lung biopsy(TBLB) and immunohistochemistry. Methods The lung tissue samples were obtained from 20 cases of pulmonary fibrosis due to different causes, including 9 cases of idiopathic pulmonary fibrosis(IPF) and 11 cases of pulmonary fibrosis caused by chronic obstructive pulmonary disease (PF COPD), by means of transbronchial lung biopsy. Hematoxylin and eosin staining, Masson trichrome staining and immunostaining with anti type Ⅲ collagen and anti type I collagen multiclonal antibodies were performed. Differences in clinical characteristics, pathological manifestations, levels, types and distribution of proliferation of collagen fibers between IPF and PF COPD were compared. Results The proliferation of collageneous fibers was significantly higher in IPF than in PF COPD( P