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.

Objective To analyze nursing intervention and digoxin treatment of elderly heart failure patients taking digoxin drug compliance reasons. Methods Select Red Cross Hospital of Hangzhou on March 21, 2015 to March 21, 2016, 110 cases of senile heart failure patients as the research object, take the envelope random grouping scheme, divided into normal group and experimental group two groups, each group are occupying 55 cases. Among them to digoxin therapy on conventional therapy alone, in the experimental group were markedly drug treatment and corresponding nursing intervention, compared two groups of patients' medication compliance and quality of life score. Results the patients in the experimental group were 98.18% and 81.82% respectively, and the comparison groups were significantly different(P<0.05). The experimental group after treatment the patient's quality of life score of each dimension (physical function, psychological state, the doctor-patient relationship, independence, social relations, the personal faith and the general quality of life) were significantly better than the conventional group(P<0.05). Conclusion For elderly patients with heart failure to take scientific and reasonable method for nursing to improve the adherence of digoxin drugs, improve the quality of life, is worth popularizing practice.

Objective To study the expressions and prognostic significance of high mobility group protein A1 (HMGA1) and high mobility group protein A.2 (HMGA2) in pancreatic carcinoma.Methods The expressions of HMGA1 and HMGA2 were examined by immunohistochemical SP method in 60 cases of pancreatic carcinoma and 30 cases of normal pancreatic tissues.The relationship between the expression and prognosis was also analyzed.Results The expressions of HMGA1 and HMGA2 in pancreatic carcinoma were significantly higher than those in normal tissues,and the positive expression rates were 70.0％ vs.6.7％ (x2 =32.105,P =0.000) and 73.3％ vs.3.3％ (x2 =39.200,P =0.000).The expression of HMGA1 in pancreatic carcinoma was correlated with histological grade (x2 =6.774,P =0.034),TNM stage (x2 =4.776,P =0.029) and lymphatic metastasis (x2 =12.614,P =0.000).The expression of HMGA2 in pancreatic carcinoma was correlated with histological grade (x2 =8.200,P =0.017) and TNM stage (x2 =7.253,P =0.007).The expression of HMGA1 was positively associated with HMGA2 expression (r =0.393,P =0.001).Kaplan-Meier analysis showed that the median survival time of HMGA1 and HMGA2 positive patients were shorter than those patients with HMGA1 negative and HMGA2 negative (14.0 months vs.24.0 months,x2 =14.568,P =0.000;15.0 months vs.21.0 months,x2 =7.270,P =0.007).Conclusion HMGA1 and HMGA2 are highly expressed in pancreatic carcinoma,and play synergistic roles in the generation and progress of pancreatic carcinoma.There is certain value of combined detection of HMGA1 and HMGA2 to predict the prognosis of pancreatic carcinoma.

The author proposed detailed introduction of handling of complications in the Australian AR-DRGs program,introduced considerations of complications by AR-DRGs from two aspect-the level of disease complications and the complexity of clinical treatments.The authors specifically described CCL and PCCL evaluations.This paper provides reference for the localization of DRGs program design.

ObjectiveTo investigate the causes, operation time, and microscopic repairing procedures of contusive iridodialysis. Methods23cases(23 eyes) who had partial iridodialysis due to contusions of the eyeballs underwent the microscopic repair during 7 to 18 days after injury. Viscoelastic agent and other auxiliary devices were used in the operation. ResultsAll eyes were fully corrected with approximate round-shaped pupils and their visual function improved. 1 eye with raised intraocular pressure was performed with trabeculectomy. ConclusionTimely repair of partial iridodialysis performed under microscope was safe and effective.

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.

Objective To explore the changes of the levels of CA-125 antigen(CA125) and vascular endothelial growth factor (VEGF) in serum and peritoneal fluid in patients with endometriosis (EMT), and the relationship with EMT. Methods One hundred and twenty patients with EMT (EMT group)and 98 patients with uterine fibroids (control group) were enrolled in this study. The levels of CA125 and VEGF in serum and peritoneal fluid were detected by enzyme linked immunosorbent assay (ELISA), and the results were compared. Results The levels of serum CA125,VEGF in EMT group were significantly higher than those in control group:(40.31±11.14) kU/L vs.(24.71±9.19) kU/L,(59.75±6.87) ng/L vs. (36.38±8.12) ng/L, there were significant differences(P<0.05). The levels of serum CA125,VEGF inⅠ-Ⅱphase andⅢ-Ⅳphase in EMT group had no significant differences ( P>0.05). The levels of peritoneal fluid CA125,VEGF in EMT group were significantly higher than those in control group:(311.46± 107.29) kU/L vs.(158.17± 55.42) kU/L,(73.28 ±10.40) ng/L vs. (40.21 ±9.84) ng/L, there were significant differences (P<0.05). The levels of peritoneal fluid CA125,VEGF in Ⅲ-Ⅳ phase were significantly higher than those in Ⅰ-Ⅱ phase in EMT group:(387.41±70.91) kU/L vs. (308.42±81.21) kU/L, (69.22±7.13) ng/L vs. (55.44±8.23) ng/L, there were significant differences (P<0.05). In EMT group, the levels of CA125 and VEGF in serum were significantly lower those in peritoneal fluid:(40.31±11.14) kU/L vs. (311.46±107.29) kU/L, (59.75±6.87) ng/L vs. (73.28 ±10.40) ng/L, there were significant differences (P<0.05). Conclusions The levels of CA125 and VEGF in serum and peritoneal fluid are closely related to EMT. Peritoneal fluid in monitoring of EMT may be more sensitive and reliable than serum.

Objective To systematically analyze therapeutic effects of extracorporeal photopheresis (ECP) on refractory steroid-resistant,-dependent or-intolerant graft-versus-host disease (GVHD),to compare remission rates of skin GVHD in detail.Methods Databases were searched for studies concerning remission rates of GVHD after the treatment with ECP,and relevant data were extracted and pooled by using meta-analysis with STATA 12.0 software.Results A total of 22 literatures were reviewed,including 787 patients with refractory GVHD.Meta-analysis showed that the pooled complete remission (CR) rate and overall remission (OR) rate were 57％ (95％ CI:47％-66％) and 79％ (71％-86％) respectively in patients with acute GVHD,27％ (21％-33％) and 63％ (58％-69％) respectively in patients with chronic GVHD,77％ (71％-82％) and 87％ (82％-91％) in patients with acute skin GVHD,as well as 39％ (30％-48％) and 70％ (63％-77％) in patients with chronic skin GVHD.Conclusion ECP is an effective therapy for refractory GVHD,especially for skin GVHD.