Objective To evaluate the feasibility,safety,and cosmetic results of single-incision laparoscopic appendectomy by using conventional instruments. Methods From January 2013 to May 2014,clinical data of 52 patients undergoing single-incision laparoscopic appendectomy in our hospital were retrospectively analyzed. The appendectomy was performed by using conventional instruments through three 5-mm trocars via a 2-cm curved incision above the umbilical margin. Results The single-incision laparoscopic appendectomy was successfully completed in all the 52 cases without conversion to conventional laparoscopic or open surgery.The mean operative time was 43 ±7 min (range,30 -90 min).The average postoperative hospital stay was 2.5 ±0.5 days (range,1 -7 days).During follow-up visits for 1 -3 months,there were no postoperative complications.The scars were not obvious in all the patients. Conclusion Laparoscopic appendectomy can be achieved through a single incision by using conventional instruments.This approach is feasible,safe,and concealing.

Objective To explore the application and significance of multiple clinical pathway training oriented teaching model in clinical teaching of laboratory diagnostic. Methods Totally 50 medical students enrolled in the Second Military Medical University from September to December in 2015 were divided into experimental group and control group. The course consists of theoretical teaching and experi-mental operation. The pathway group (n=25) were introduced into multiple clinical pathway training oriented teaching method. The theoretical teaching was carried out bysimulation examination application, simulation interpretation and simulation diagnosis and treatment, while the experimental course was carried out by using video teaching combined with actual operation. The control group was taught by traditional teaching method using slide teaching and operation display. The theoretical test including case study and operational skill tests were performed among students in both groups after 10 class hours training . The satisfaction questionnaires were conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. Differences were compared with independent sample t testing using GraphPad Prism 5.0 statistical software. Results The medical records about professional theoretical test including case study and opera-tional skill test in the pathway group were superior to those in the control group with significant statistical difference (both P<0.05). The records of medical students were (81.84±7.21), (42.00±2.79) in the pathway group and (76.24 ±6.98), (37.00 ±3.71) in the control group. The questionnaire result showed that the pathway group's satisfaction was high, especially with the theoretical knowledge andsceneteaching (higher than 80％). The pathway group believed that multiple clinical pathway training helped to improve learning interest and clinical thinking ability . Conclusions Multiple clinical pathway training oriented teaching model is helpful for the medical students to achieve the basic idea of clinical pathway, improve the profes-sional ability, enhance the interest of learning and the quality of teaching, standardize teaching and promote teaching and learning.

Objective To study the relationship between serum tumor marker level and the apoptosis regulation gene of tumor tissue in the patients with primary hepatocarcinoma .Methods 40 cases of primary hepatocarcinoma and 40 healthy people were in‐cluded into the observation group and control group .Then the levels of tumor marker GP73 ,TK1 ,DKK1 in serum and the expres‐sion of apoptosis regulation gene in tumor tissue were detected in the two groups .Results The serum GP73 ,TK1 and DKK1 levels of the observation group were significantly higher than those of the control group ,the difference was statistically significant (P<0 .05) .The apoptosis inhibiting gene Plk1 ,Livin and Xiap levels in the hepatocellular carcinoma tissue were higher than those in the adjacent normal tissues ,while the pro‐apoptotic gene M TS1 ,Caspase‐3 and Caspase‐8 levels were lower than those in the adjacent normal tissues ,the difference had statistical significance (P< 0 .05) ;serum GP73 ,TK1 and DKK1 levels were positively correlated with Plk1 ,Livin and Xiap levels and negatively correlated with M TS1 ,Caspase‐3 and Caspase‐8 levels .Conclusion The levels of se‐rum GP73 ,TK1 and DKK1 in the patients with primary hepatocarcinoma are abnormally increased ,moreover which are closely cor‐related with the apoptosis regulating gene expression and the ideal indexes to evaluate the disease condition of primary hepatocarci ‐noma .

Objective To compare the anthelmintic effect of albendazole with that of triclabendazole against Fasciola giganti-ca. Methods Two patients infected with Fasciola gigantica were investigated,and one was administered with albendazole orally (200 mg,twice per day for 5 days)and another was administered with triclabendazole[10 mg/(kg?d)for 2 days]. Their total fe-ces were collected daily during the period of whole therapy,and the eggs of the parasite were collected by using the nylon bag method,and incubated at 28℃. Results The parasite eggs were detected from the first patient’s dejecta on the 1st,2nd and 5th day after the end of the treatment,and no miracidiums hatched out as well as no eggs developed during the period of 25 days of the incubation. Meanwhile,her body temperature fluctuated between 37.4℃and 38.3℃,and she still complained bellyache. For the other invalid,the eggs were not detected on the 2nd and 5th day after the end of the treatment. However,the eggs before and dur-ing the treatment developed the miracidiums of Fasciola gigantica on the 13th day after the incubation,but the eggs collected from the 1st day after the termination of the therapy did not develop and no miracidiums hatched out. At the same time,the signs and symptoms of the patient vanished after the 4th day of the end of the therapy. Conclusions Albendazole has no obvious insecticid-al activity on adult Fasciola gigantica in the short term,but may affect the development of eggs. Triclabendazole has the anthelmin-tic effect on the adults as well as eggs of Fasciola gigantica. In addition,triclabendazole has the characteristics of well curative ef-fect,short course of treatment,and no obvious side effects.

Objective To investigate the assessment of multi-detector spiral CT on the cardiac function after bioprosthetic valve replacement with mitral valve preservation.Methods Thirty-five patients suitable for undergoing bioprosthetic mitral valve replacement in our hospital from May 2012 to February 2014 were randomly divided into 2 groups:group A(experimental group,intraoperative preservation of mitral valve and subvalvular structure during,n=16) and group B (control group,without intraoperative preservation of subvalvular structure of mitral valve,n=19).MDCT before operation and on postoperative 10 d was performed for evaluating the left ventricular function.Results In the comparison of preoperative MDCT,the end diastolic velocity(EDV),end systolic velocity(ESV),ejection fraction(EF) and stroke volume(SV) had no statistical difference between the group A and B.In MDCT results on postoperative 10 d,EDV,ESV and EF in the group A were 113.42±9.22)mL,(38.63±3.40)mL and (51.63±4.71) ％,which in the group B were(113.42 ± 9.22) mL,(38.63 ± 3.40) mL and (51.63 ± 4.71) ％ respectively,the difference was statistically significant(P＜0.05),but SV had no statistical difference between the two groups(P＞0.05).Conclusion The bioprosthetic valve replacement with mitral valve preservation is safe and feasible in technology,moreover effectively protects the postoperative left ventricular function.

Objective To evaluate therapeutic results of radiofrequency endovenous obliteration (RFO) for the treatment of varicose veins of the lower limbs. Methods Fifty six cases (56 limbs) of primary greater saphenous vein tributary varicose veins were randomly assigned to RFO group (n=28) and conventional stripping operation group (n=28). In RFO group, the wall of the greater saphenous vein was treated at 85℃ with the catheter to occlude the whole length of the vein. The other 28 cases underwent stripping procedure. The scattered superficial varicose veins in calf in both groups were managed by phlebectomy. The number of surgical incision, postoperative pain, average hospital days and the short-term results were compared. Results Patients in RFO group have less surgical incisions and less postoperative pain, without subcutaneous hematoma. The average hospital stay was 2.5?1.00 days in RFO group compared to 4.14?0.85 days in stripping operation group. Conclusions RFO effectively obliterates the whole length of the great saphenous vein and is of less trauma,faster recovery, and less scars.

Objective To summarize our preliminary experience on diagnosis and treatment of aorta pseudoaneurysms due to deceleration injury. Methods Retrospective analysis was made on 8 cases of aorta pseudoaneurysms due to deceleration injury regarding its clinical findings, imagines and surgical operations or endografting treatment. Results Diagnosis was confirmed by imaging examinations. Among two cases who refused a surgery one died and the other lost follow-up after discharge. Surgery was successful in the remaining six cases including two cases treated by open surgery and four cases by intervensive endografting. Conclusions Aorta pseudoaneurysms due to deceleration injury can be correctly diagnosed by imaging examinations. Aorta pseudoaneurysms should be treated timely since spontaneous cure is almost impossible. Traditional surgical operations is effective, however, endografting is a relatively safe, less traumatic procedure.

Objective To investigate whether emodin combined with 5AzA-cdR can enhance the demethylation of tumor suppressor genes p16,RASSF1A and ppENK in nude mice with subcutaneously transplanted pancreatic cancer.Methods Pancreatic cancer cells Panc1 burdened subcutaneous xenograft nude mice model was established,which were randomly divided into control group,emodin group,5AzA-cdR group and emodin combined 5AzA-cdR group (combined group).The growth of transplanted tumors wasobserved in each group.Methylation specific PCR (MSP) was used to detect the methylation levels of p16,RASSF1A and ppENK in the xenograft tumor tissue among three groups.The mRNA and protein expression of three tumor suppressor genes were detected by FQ-PCR and Western blotting,respectively.Results The weight of xenografts in the control group,emodin group,5AzA-cdR group,and combination group were (0.28 ±0.01),(0.17 ± 0.01),(0.12 ± 0.02),(0.08 ± 0.01)g,respectively.The tumor volume was (517 ±0.02),(382 ± 0.01),(232 ± 0.03),(169 ± 0.01) mm3.The methylation levels of p16 were 1.00 ± 0.00,0.89 ± 0.02,0.63 ± 0.02,and 0.19 ± 0.01;the methylation levels of RASSF1A were 1.00 ± 0.00,0.88 ± 0.02,0.51 ± 0.01,and 0.32 ± 0.01;the methylation degree of ppENK was 1.00 ± 0.00,0.92 ± 0.02,0.77 ± 0.02 and 0.31 ± 0.01,respectively.The expression of p16 mRNA was 1.00 ± 0.00,1.71 ±0.02,2.67 ± 0.02,3.81 ± 0.01.The expression of RASSF1A mRNA was 1.00 ± 0.00,1.92 ±0.02,2.73 ± 0.03,3.77 ± 0.01.The expression of ppENK mRNA was 1.00 ± 0.00,1.69 ± 0.03,2.17 ± 0.02 and 4.28 ± 0.01.The expression of p16 protein was 1.00 ± 0.00,1.71 ± 0.02,2.67 ± 0.02,3.81 ± 0.01;the expression of RASSF1A protein was 1.00 ± 0.00,1.92 ± 0.02,2.73 ± 0.03.3.77 ± 0.01;ppENK protein expression levels were 1.00 ±0.00,1.69 ±0.03,2.17 ±0.02,4.28 ±0.01.The weight and volume of xenografts in the three treatment groups were significantly smaller than those in the control group.The methylation of three tumor suppressor genes was lower than that of the control group,and the expression of tumor suppressor mRNA and protein was all significantly higher than the control group,which the combination drug group was also significantly stronger than that in emodin group and 5AzA-cdR group,and the differences were statistically significant (P ＜ 0.05 or ＜ 0.01).Conclusions The combination of emodin and 5AzA-cdR can enhance the demethylation effect of 5A6A-cdR on the tumor suppressor genes p16,RASSF1A and ppENK in the tumor tissue of pancreatic cancer xenograft model.

Objective To explore the clinical value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma (PTC).Methods A total of 1 408 PTC patients who met the inclusion criteria and received initial thyroidectomy at our department from January 2006 to December 2011 were enrolled in this study.Results After a median follow-up time of 7.8 years,distant metastases developed in 46 patients.Patients with lateral neck lymph node metastasis ≥7,individual size of lateral neck lymph node metastasis ≥ 1.15 cm and the total number of cervical lymph node metastasis ≥9 were prone to higher risk of distant metastasis;the high risk group had a lower 10-year distant metastasisfree survival (78.7％ vs.98％,x2 =122.941,P ＜0.01) and a shorter distant metastasis-free survival time (99.2 M vs.122.5 M,x2 =122.941,P ＜ 0.01).Conclusions Lateral lymph node metastasis is an independent risk factor for distant metastasis in PTC patients.

Traumatic intracranial hematoma progresses rapidly and may cause quick increase of intracranial pressure and even brain hernia, ultimately leading to coma or death. Therefore, traumatic intracranial hematoma needs prompt treatment, but the prerequisite of treatment is early examination and diagnosis. Due to the limited transportation and other reasons, the existing large-scale detection devices such as CT and MRI cannot be deployed on the rescue site or during patient transportation. Instead, the portable diagnosis devices have the characteristics of miniaturization and high flexibility, which is conducive to promoting early detection, assisting diagnosis and further guiding the formulation of treatment plans. At present, more and more attention has been paid to the portable diagnosis devices in the diagnosis of intracranial hematoma. The authors summarized the conventional diagnosis methods and application of portable diagnosis devices for traumatic intracranial hematoma, aiming to provide a reference for the diagnosis of traumatic intracranial hematoma.