Objective To analyze the total cost and clinical effectiveness of internal fixation and hemiar-throplasty in the treatment of femoral neck fracture for the elderly. Methods From October 2013 to May 2015,85 patients above 60-year old who were diagnosed as displaced femoral neck fracture and received operation in our hospital. All the patients were divided into internal fixation(IF)group and hemiarthroplasty(HA)group respec-tively. There were 40 cases in the IF group and 45 cases in the HA group. The total cost associated with fracture in a year was collected by medical record ,telephone interview and standard methods. At the last follow-up ,we ap-plied Harris scores to evaluate the clinical outcome for each group. Results All the patients completed the operation successfully. During 1 year follow-up the total cost in the IF group was less than that in the HA group including higher primary hospitalization cost and less post-discharge cost. The total cost was 44,556.1 Yuan in the IF group and 72,198.0 Yuan in the HA group respectively. The data showed that the total cost of HA was 1.6 times higher than that of IF. At the last follow-up the mean Harris scores was 71.1 ± 12.1 in the IF group and 74.3 ± 10.3 in the HA group while the EQ-5D index was 0.74 ± 0.15 and 0.76 ± 0.13 respectively which showed no significant differ-ence(P > 0.05). Conclusions Both internal fixation and hemiarthroplasty have effective treatment for elderly pa-tients with femoral neck fracture. Compared to hemiarthroplasty IF can provide similar clinical effectiveness with less total cost. Therefore IF may contribute to decrease the economic burden for elderly patients in China.

Objective To observe the effect of the volatile oil of zanthoxylum bungeanum in killing demodex in vitro.Method The mites were collected with adhesive cellophane tape technique.The killing effect of the pure volatile oil with different concentrations volatile oils on human demodex was investigated by microscope.Results The pure volatile oil was highly powerful in killing D.f and D.b in vitro,and for the D.b,the killing effect was better.With the increase of dilutus multiple,the killing effect dareased.Conclusion The pure volatile oil of zanthoxylum bungeanum is an effective component in killing demodex in vitro.

Objective To explore the clinical efficacy and adverse reactions of children with acute promyelocytic leukemia (APL) by adopting Chinese children APL-2010-protocol in single center.Methods Forty-seven children with newly diagnosed APL in Soochow University Affiliated Children's Hospital from October 2010 to September 2015 were selected,including 30 boys and 17 girls with the median age of 7 years (1.2-14.0 years).The patients were divided into 3 groups,including 11 cases in the low-risk group,20 cases in the intermediate-risk group and 16 cases in the high-risk group.Their clinical features and therapeutic prognosis were analyzed retrospectively and the clinical efficacies were compared in low-risk group[white blood cell(WBC) ≤ 10 × 109/L,platelets (PLT) ＜ 40 × 109/L],intermediate-risk group (WBC ≤ 10 × 109/L,PLT ≤40 × 109/L) and high-risk group (WBC ＞ 10 × 109/L).Five-year event-free survival (EFS) rate and overall survival (OS) rate of each group were analyzed by using Kaplan-Meier curve method.Results The peak comparative difference of peripheral blood WBC among 3 groups was statisticallysignificant(x2 =7.618,P =0.002).The occurrence rate of disseminated intravascular coagulation (DIC) was 68.8％ and the occurrence rate in the high-risk group was higher compared with low-risk group and intermediate-risk group (x2 =8.217,P =0.016).Arsenic trioxide related side effects including abnormal liver tests,electrocardiogram and anaphylactic reaction were invertible after supportive therapy.Hematologic complete response (HCR) rate in the high-risk group was 93.7％,HCR time was (39.3 ± 2.7) days and molecular complete remission (MCR) time was(71.0 ± 9.7) days.HCR rate in the intermediate-risk group was 95.0％,HCR time was (44.6 ± 3.1) days and MCR time was (80.0 ± 8.2) days.HCR rate in the low-risk group was 100.0％,HCR time was (32.4 ±2.3) days and MCR's time was (71.5 ± 12.0) days.HCR time among 3 groups had statistical significance (F =3.652,P =0.034),but HCR rate and MCR time among 3 groups showed no statistical significance (F =0.318,P =0.729).In the high-risk group,EFS rate was (93.3 ± 6.4) ％,5-year OS rate was (86.7-± 8.8) ％.Meanwhile,5-year OS rate and EFS rate were 100.0％ in other 2 groups.Conclusions Treating patients with APL by using 2010 protocol according to the risk stratification in our center has achieved high long-time survival.The higher the risk,the higher the incidence of DIC in induction period,but eventually achieve a very high rate of 5-year EFS was achieved.No chronic arsenic toxicity or second malignancies were found during the follow-up time.

This paper presents the design and development of a set of microwave exposure system based on 1.8GHz mobile RF signal. This system can work on several modulation types to do microwave exposure experiment under different specific absorption rate (SAR) and prepare the way for researches in the effect exerted by the electromagnetic signal of mobile on human health. The hardware is made up of several RF instruments, waveguide and computer, and the software introduces the accomplishment of the control system and the algorithm of control.
Algorithms ; Cell Phone ; Computer Simulation ; Dose-Response Relationship, Radiation ; Electromagnetic Fields ; adverse effects ; Environmental Exposure ; Humans ; Microwaves ; adverse effects ; Neurons ; radiation effects

Objective: To study the pathology and its significance of early colorectal cancer and precancerous lesions treated by endoscopic submucosal dissection (ESD). Methods: A total of consecutive 113 cases were collected at the endoscopy center from August 2012 to June 2016, which were diagnosed as early colorectal cancer and precancerous lesions and undergone ESD. According to Japanese colorectal cancer treatment guidelines, specimens were processed and pathologically evaluated for histological type, tumor diameter, depth of invasion, budding grading, vessel invasion, and horizontal and vertical margin, as well as curative resection. Results: There were 63 cases of adenoma (55.75%), including 29(25.66%) tubular adenoma, 2(1.77%) villous adenoma, and 32(28.32%) villioustublar adenoma. Thirty-four cases of serrated lesion were found, which included 19(16.81%) traditional serrated adenoma, 11(9.73%) sessile serrated adenoma, and 4(3.54%) hyperplasic polyp. There were also 16(14.16%) cases of early colorectal cancer with 7 cases of well-differentiated adenocarcinoma, 7 cases of moderately-differentiated adenocarcinoma, 1 case of poorly-differentiated adenocarcinoma, and 1 case of mucinous adenocarcinoma. Vessel invasion were observed in 2 of 16 cases of early colorectal cancer which were both moderately-differentiated adenocarcinoma in sigmoid colon. The vertical margins were negative in 108(95.58%) of 113 cases. Positive vertical margin were found in only 1 case (moderately-differentiated adenocarcinoma, pT1b2) and another case was suspected as positive. The rest 3 cases could not be precisely diagnosed. The horizontal margins were negative in 80(70.80%) of 113 cases and positive horizontal margin were found in 20(17.7%) cases (19 adenoma and 1 moderately-differentiated adenocarcinoma). Thirteen cases cannot be precisely diagnosed. Histologically, complete resection rate was 82.30%. The complete resection rate of invasive adenocarcinoma was 93.75%. Among 16 cases of invasive adenocarcinoma, 5 cases (curative rate: 31.25%) were judged as curative resection whereas 11 cases were considered as non-curative resection. Seven non-curative resection cases were treated with further surgery and did not relapse after the follow-up. Conclusion The standardized processing and precise histopathological evaluation are key factors for colorectal ESD technique, which play an important role in the success of endoscopic therapy.

Objective:To explore the mechanism of extracorporeal shock wave combined with platelet rich plasma in the treatment of articular cartilage injury in knee osteoarthritis (KOA) rats based on the silent information regulator 1 (Sirt1)/forkhead transcription factor O1 (FoxO1) pathway.Methods:15 SD rats were used for platelet rich plasma extraction and 35 SD rats were randomly divided into blank control group, model group, extracorporeal shock wave group, platelet rich plasma group, and extracorporeal shock wave + platelet rich plasma group. Each group had 7 cases. After the intervention, HE staining of articular cartilage tissue was used to observe changes in articular cartilage morphology, Mankin score was used for pathological evaluation, CCK-8 method was used to detect chondrocyte vitality and proliferation, ELISA method was used to detect inflammatory factor levels in joint fluid, and Western Blot method was used to detect the expression levels of Sirt1 and acely-FoxO1/FoxO1 in five groups of articular cartilage tissue.Results:The HE staining of articular cartilage tissue showed that model group, extracorporeal shock wave group, platelet rich plasma group, and extracorporeal shock wave + platelet rich plasma group had varying degrees of pathological damage, with model group having the most severe pathological damage, while the other three experimental groups had no significant differences. The Mankin score and the level of acely-FoxO1/FoxO1 in articular cartilage tissue showed that blank control group < extracorporeal shock wave + platelet rich plasma group < platelet rich plasma group < extracorporeal shock wave group < model group (all P < 0.05). The results of Sirt1 level in articular cartilage tissue, activity, and proliferation ability of articular chondrocytes showed that model group < extracorporeal shock wave group < platelet rich plasma group < extracorporeal shock wave + platelet rich plasma group < blank control group (all P < 0.05). Comparison of inflammatory factor levels in joint fluid, blank control group < extracorporeal shock wave + platelet rich plasma group < extracorporeal shock wave group < platelet rich plasma group < model group (all P < 0.05). Conclusions:The combination of extracorporeal shock wave and platelet rich plasma can promote the proliferation of osteoarthritis chondrocytes and alleviate joint inflammation and cartilage damage in KOA rats by upregulating Sirt1 expression and downregulating FoxO1 acetylation levels.

Objective To investigate the value of depth of invasion (DOI) and pattern of invasion (POI) in predicting recurrence and evaluating prognosis of early oral squamous cell carcinoma (OSCC). Methods Data of 109 patients with primary OSCC were retrospectively collected. The chi-square test was used to compare categorical variables of clinical data. Univariate and multivariate Logistic regression analyses were used to analyze the correlation between clinical data and tumor recurrence. Cox regression analysis was used to analyze the correlation between clinical data and overall survival of patients. Results Univariate analysis showed that POI, DOI and pathological grade were correlated with recurrence and poor prognosis of early OSCC. Multivariate Logistic regression analysis indicated that DOI was an influencing factor for OSCC recurrence (OR=4.515, 95%CI, 1.283 to 15.894, P<0.05) and prognosis (HR=2.993, 95%CI, 1.225 to 7.317, P<0.05). There was a high correlation between POI and DOI of OSCC. Conclusion DOI ≥5 mm is considered as a relevant factor for recurrence and poor prognosis of early OSCC.

Objective:To evaluate whether additional radical surgery is necessary following non-curative endoscopic resection of early colorectal cancer.Method:Clinicopathological data in 104 patients following non-curative endoscopic resection of early colorectal coucer at the Department of General Surgery, Peking University First Hospital between Jan 2011 and Dec 2021.Results:Lymph node metastasis and/or residual cancer was found in 23 patients (22%), including 12 cases of lymph node metastasis, 7 cases of residual cancer and 4 patients with both residual cancer and lymph node metastasis. Univariate analysis indicated that vascular infiltration, positive vertical margin, and female gender were risk factors for lymph node metastasis. Risk factors for residual cancer were tumors ≥2 cm in size, negative lift sign, infiltration depth of ≥1 000 μm, and positive horizontal and vertical margins. Multivariate Logistic regression analysis revealed that vascular invasion, positive vertical margins, and being female were independent risk factors for lymph node metastasis, while positive vertical margins was independent risk factor for residual cancer. Salvage surgery lasted for a median of 184 (156-233) minutes, with an estimated blood loss of 50 (20-100) ml and an average postoperative hospital stay of 9 (8-11) days. Seven cases of Clavein-Dindo Ⅱ or higher complications were observed, including pulmonary embolism in 1 case , anastomotic leakage in one, lymphatic fistula in one, bowel obstruction in 2 cases and urinary tract infection in 2 cases.Conclusion:Salvage surgery is mandatory for early endoscopic non-curative resection of colorectal cancer.

Objective:By analyzing the clinical data of patients with primary duodenal adenocarcinoma (PDA), the risk factors affecting the postoperative prognosis of PDA patients were discussed.Methods:The clinical data of 191 patients diagnosed with PDA in Peking University First Hospital from Jan 2009 to Dec 2022 were collected. The survival rate was calculated and the survival curve was plotted by Kaplan-Meier method. Univariate analysis was performed by Log-Rank test, and multivariate analysis was performed by COX proportional hazards regression model to obtain independent risk factors.Results:The median age of onset in patients with PDA is 65 years old, and the most common symptoms are abdominal pain and abdominal distension. Prognostic analysis showed that the survival rates at 1, 3 and 5 years were 73.8%, 44.6%, and 23.0%. The analysis of Cox risk proportional regression model showed that preoperative CA19-9 level, depth of tumor invasion, degree of differentiation, TNM stage, and surgical mode were independent risk factors for the prognosis of PDA (all P<0.01). Conclusion:The overall incidence of PDA is low, but the prognosis is rather poor. Multvariable factors are associated with its prognosis and surgery is still the mainstay for hope of cure.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.