Objective To evaluate the efficacy and safety of antibacterial drugs conservative therapy versus appendectomy for treating simple acute appendicitis(AA).Methods Randomized controlled trials (RCT) on antibacterial drugs conservative therapy versus appendectomy for treating simple AA were retrieved from CBM (1978 June 2015),CNKI (1979-June 2015),Medline (1950-June 2015),Pubmed (1950-June 2015),Embase (1970-June 2015) and Cochrane library (issue 2,2015) by computer.The included RCTs were performed the data extraction according to the criteria of the Cochrane handbook by two researchers.Then the included d/literatures were performed the quality assessment and the extracted effective data were performed the meta analysis.Results Six RCTs were included involving 1510 patients with AA,among them,767 cases were treated with antibacterial drugs and 743 cases were treated with appendectomy.Compared with surgical treatment,the effect rate of antibacterial medication conservative therapy was decreased by 25.00％ (RD=-0.25,95％ CI:-0.35--0.14),the recurrence rate was increased by 48.43 times (OR=48.43,95％CI:16.94-138.44),the loss time of labor force was shortened by 1.52 d (MD=-1.52,95％ CI:-3.02 0.02),but the occurrence rate of complications(RD=-0.06,95％CI:-0.15 0.03),pain time(MD=-0.76,95％CI:-3.31 1.79),hospital stay time (MD=4.60,95％CI:-0.89 10.09) and sick leave time(MD=-2.39,95％CI:-5.62-0.84) had no statistical differences between the two kinds of treatment method(P＞0.05).Conclusion Appendectomy may be the gold standard method for treaung simple AA.

Background:Esophageal cancer is a common gastrointestinal cancer with poor prognosis,and effective chemotherapy is lacking currently. Studies have shown that cardiac glycosides can inhibit tumor cells growth,but its mechanism has not been fully clarified. Aims:To investigate the effect and mechanism of ouabain in regulating proliferation of human esophageal carcinoma cells. Methods:OE19 human esophageal carcinoma cells were treated with ouabain,and cells in control group were treated with DMSO. Cell proliferation was assessed by cell counting method. mRNA expressions of Sox2,Sox4,Sox7,Sox9 and Sox10 were determined by real-time PCR. Protein expression of Sox4 was determined by Western blotting. Gene expressions of phospho-histone3( ph3),a cell proliferation marker and Sox4 were detected by immunofluorescence staining. Results:Ouabain( ≥ 40 nmol/ L)could significantly inhibit OE19 cells proliferation. mRNA and protein expressions of Sox4 were significantly decreased in OE19 cells in ouabain(40 nmol/ L)group than those in control group(P < 0. 05). No significant differences in mRNA expressions of Sox2,Sox7,Sox9 and Sox10 were found between the two groups(P > 0. 05). Gene expressions of ph3 and Sox4 in nucleus of OE19 cells were decreased in ouabain (40 nmol/ L)group than those in control group. Conclusions:Ouabain is effective in inhibiting human esophageal carcinoma cells proliferation,the underlying mechanism might be related with down-regulation of Sox4 expression and the subsequent cell cycle modulation.

Objective To examine the availability of emergency medical services(EMS) for patients with acute stroke and to investigate influential factors affecting the preference of patients'to EMS.Methods Consecutive information of patients with acute stroke who presented to the emergency department of Zhongnan Hospital of Wuhan University from June 1, 2014 to December 31, 2015 were analyzed.Gender, age of patients, transport modality, risk factors in cerebrovascular diseases, initial symptoms, stroke types, onset and admission time were included to make analysis in retrospective study.The participants were divided into two groups based on the preference of patients, namely EMS group and self-transport group.Wilcoxon rank sum test or Chi-squared test was used to statistical analysis as appropriate.A multiple binary logistic regression was used to determine the relationship between various patient-related factors with probability whether patients chose EMS or not.Results Among the 240 patients, only 29.2%of them asked for the EMS at the onset of symptoms (EMS group, n=70), and the rest patients called for other services(self-transport group, n=170).Logistic regression analysis revealed that the patients with the symptom of altered consciousness or convulsion (95%CI:0.107-0.403,OR=0.208,P<0.01) were more likely to use EMS.The time consumed from onset to visit of patients with acute stroke to emergency physician was significantly shorter in EMS group (M, 60 min vs.180 min,P<0.01).Conclusion The symptom of altered consciousness or convulsion was the independent factor to determine whether patients with acute stroke preferred EMS or not.

BACKGROUND:Numerous studies have shown that air wave pressure therapy plays an important role in prevention of deep venous thrombosis of lower limb after a major operation on the hip.
OBJECTIVE:To explore the efficacy of air wave pressure therapy on deep vein thrombosis of the lower extremity in patients with total knee arthroplasty.
METHODS:A total of 80 patients with total knee arthroplasty were randomly divided into experimental group and control group. Patients in the control group were treated only with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise;patients in the experimental group were treated with air wave pressure therapy at 2 days postoperatively, and were also treated with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise. Swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were recorded in both groups.
RESULTS AND CONCLUSION:At 2 weeks after treatment, swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were significantly reduced in the experimental group, and its effects were significantly better than those in the control group (P<0.05). Early use of air wave pressure therapy after total knee arthroplasty can al eviate limb swel ing effectively and have obvious advantages in improving coagulation index and blood coagulation condition and in preventing deep vein thrombosis of the lower extremity after total knee arthroplasty.

Objective To investigate the effect of prosthetic replacement for senior patients with unstable intertrochanteric fractures of the femur.Methods Fifty-three senior patients with comminuted intertrochanteric fracture of the femur were subjected to total hip arthroplasty (n =23) and bipolar artificial femoral head replacement (n =30).Uncemented long-stem prostheses were used in 50 patients and cemented long-stem prostheses in 3.Time interval between admission and surgery was 3-13 days (mean 6 days).Results The total hip arthroplasty had the operation time for mean 90 minutes (range,80-110 minutes) and blood loss for mean 350 ml (range,260-410 ml).While the hemiarthroplasty had operation time for mean 65 minutes (range,50-90 minutes) and blood loss for mean 230 ml (range,180-290 ml).Fifty-one patients were available to mean 49.6-month follow-up (range,13-65 months).Four patients presented with frequent hip pain at a tolerable level after hemiarthroplasty and the symptom was relieved after oral non-steroidal anti-inflammatory drug therapy.One patient with postoperative infection was cured by timely debridement.Seven patients were died of heart and brain disorders in 5 years,with no relation to surgical complications.The period for fracture healing was mean 10 months,with excellence rate of 96％ for hip function but with no acetabulum abrasion,implant loosening or submersion.Conclusion Early prosthetic replacement is an effective treatment for unstable intertrochanteric femoral fractures in the elderly.

The formative assessment system has been applied to the internship education for the clinical anesthesia with the aim to improve students' initiative and to evaluate their outcomes more compre-hensively. The students' performance in the shift exchange, case discussion, raising question, solving question at the time points of after the preclinical train, one month and 3 months into the anesthesia internship, and after the completion of internship, and their capability in preoperative patient assessment, condition report, clinical practice, review writing have been evaluated to determine the educational quality and to instruct the improvement of educational approach. Assess process takes into account both the individuality and the gen-eral character of the students and feedbacks the evaluation result to improve the practice teaching The im-plementation of the evaluation can promote students' autonomous learning and comprehensively evaluate students' practice process.

Humans ; Accidents, Traffic ; Cause of Death ; Technology

OBJECTIVETo explore the effects of testis murine cytomegalovirus (MCMV) infection on mature sperm viability in mice.

METHODSBALB/c mice without MCMV infection, screened by ELISA, were randomly divided into two groups: an experimental group (n = 64) and a control group (n = 40). The former were directly inoculated with MCMV into the testis, while the latter treated by inoculation of DMEM without MCMV. The mice in both of the groups were sacrificed respectively at 1, 2, 4, 6, 9, 14, 21, 38 d postinoculation (D1, 2, 4, 6, 9, 14, 21, 38 PI), the testis was examined histopathologically, and meanwhile the viability of mature sperms in the epididymis cauda was measured.

RESULTSMCMV basophil inclusion bodies were found in the Leydig cells in the experimental group, and spermatogenic cells were vacuolated and arranged disorderly. Compared with the control group, the sperm viability in the experimental group was decreased significantly by 71.42% to 56.04% (P < 0.05) on D1 PI.

CONCLUSIONThe sperm viability in mice might be descended significantly by MCMV infection in the early period, but restored to normal with time. This shows that MCMV infection might influence procreation transiently.

Animals ; Cell Line ; Cell Survival ; physiology ; Cytomegalovirus Infections ; pathology ; physiopathology ; Male ; Mice ; Mice, Inbred BALB C ; Random Allocation ; Spermatozoa ; physiology ; Testicular Diseases ; pathology ; physiopathology ; virology ; Testis ; pathology

Objective To analyze the local control rate and the desimetric patterns of local recurrence in nasopharyngeal carcinoma(NPC)patients having been treated with standardized conventional radiotherapy and to evaluate the delineation of rational target volume.Methods From Jan.2000 to Dec.2000,476 patients with untreated NPC were treated by standardized conventional radiotherapy alone at the Sun Yat-sen University Cancer Center.The radiation ports were designed on a X-ray simulator.The nasopharyngeal lesion demonstrated by CT scan and the subclinical spread regions adjacent to the nasopharynx were defined as the target volume.Kaplan- Meier method was used to calculate the cumulative local recurrence rate.For patients with locad recurrence,the primary and recurrent local tumor volumes(V_(nx),V_(recur))were delineated with three-dimensional treatment planning system(3DTPS),and the dataset of radiation ports and delivered prescription dose to the 3DTPS were transferred according to the first treatment.The dose of radiation received by V_(recur)was calculated and analyzed with dose- volume histogram(DVH).Local recurrence was classified as:1.“in-port”with 95% or mere of the recurrence volume((recur)_V_(95))was within the 95% isedase;2.“marginal”with 20% to95% of _(recur)V_(95)within the 95% isedese; 3.“outside”with only less than 20% of _(recur)_V_(95)within the 95% isodose curve.Results With the median follow- up of 42.5 months(range 8～54 months),52 patients developed local recurrence.The 1-,2-,3 and 4-year cumulative local failure rate was 0.6%,3.9%,8.7% and 11.5%,respectively.Among the 42 local recurrent patients who could be analyzed by 3DTPS,52% were in-port,40% were marginal and 7% were outside.For most of the marginal recurrence and all the outside recurrence patients,the main reason of recurrence were related to the unreasonable design of the radiation port and inaccuracy in the interpretation image findings.Conclusions The outcome of better local control rate and the dosimetric pattern of local recurrence show that the target volume is reasonable for NPC in Sun Yat-sen University Cancer Center.Enhancing the capability of correct interpretation of images,accurate design of the radiation pouts and making most useful molecular or functional imaging techniques to escalate the local radiation dose are promising ways to improve the local control further and better.

OBJECTIVETo observe the effects of water decoction of the root of Crataegus cuneata on infertility induced by multi-glucoside of Tripterygium wilfordii (GTW) in rats.

METHODMale adult rats were randomly divided into five groups, which were treated via gastric gavage of distilled water (1 mL x kg(-1)) , solution of GTW (10 mg x kg(-1)) and three doses of water decoction of root of C. cuneata (1.8, 5.4, 18 g x kg(-1)) + GTW (10 mg x kg(-1)), respectively. 8 weeks later, GTW was stopped and the decoction and water continued for another 4 weeks. And then, all the male rats were copulated with adult female rats. The rates of pregnancy, average numbers of embryos and luteum of female rats, relative weights of reproductive organs, sperm counts, sperm motility and viability were compared among all the groups. The histology and ultrastructure of testis and epididymis were observed, while the concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testostorone (T) in serum and T in testicular homogenate were detected by radioimmunoassay.

RESULTCompared with those in GTW model group, the embryo numbers, the relative weight of testis and epididymis and sperm counts and motility in C. cuneata groups were increased obviously (P < 0.05). After treatment, the morphological damages of seminiferous tubules and sperms were recovered, while concentrations of T in testicular homogenate were also significantly increased (P < 0.01).

CONCLUSIONC. cuneata could relieve the reproductive lesions induced by GTW, and hence improve the uberty of the male infertile model rats.

Animals ; Crataegus ; chemistry ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Glucosides ; antagonists & inhibitors ; isolation & purification ; Infertility, Male ; chemically induced ; metabolism ; pathology ; Male ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Sperm Motility ; drug effects ; Spermatogenesis ; drug effects ; Testis ; drug effects ; metabolism ; Testosterone ; blood ; metabolism ; Tripterygium ; chemistry