Objective To compare the cure rate,recurrence rate,complication and length of hospital stay in conservative treatment versus laparoscopic appendectomy for uncomplicated acute appendicitis in adults(>18 years-old),we designed this experiment.Methods Seventy-two patients in our department with uncomplicated acute appendicitis between May 2013 to May 2015 were included in our study,in which 43 cases as the experimental group accepted appendectomy,and the other 29 cases as the control group received conservative treatment,all of the patients were followed-up one year out of hospital.And there clinic data about cure rate,recurrence rate,complications and hospitalization time were redcorded.Results As a result,4 cases in the experimental group showed worsening of symptoms under conservative treatment and received laparoscopic appendectomy.2 cases in the experimental group showed recurrence after discharge.In the experimental group,cure rate was observed to be 86.2%,recurrence rate 8.0%(excluding the 4 cases that received laparoscopic appendectomy following aggravation).Conclusion In comparison,control group showed cure rate of 100% with 0% recurrence rate.In terms of complications,no apparent complications were observed in both groups.The mean length of hospital stay were 4.1 days and 5.1 days for experimental and control group,respectively.Our research showed that laparoscopic appendectomy remains to be the most effective treatment for uncomplicated acute appendicitis with a cure rate of 100%;and conservative treatment exhibited cure rate of 86.2%,resulted in less suffering of the patients,less occurrence of complications,and shorter duration of hospital stay.Although may recur,conservative treatment is still an effective treatment worth recommending.

Objective To explore the clinical outcome of self-designed composite external fixator in the treatment of severely comminuted or open proximal tibial fractures. Methods From July 2000 to January 2003, 22 cases of severely comminuted or open proximal tibial fractures were treated by self-designed composite external fixators, which involved 15 males and 7 females with an average age of 43 years (range, 20-80 years). This technique consisted of indirect reduction and limited open cannulated screw or K-wires fixation in case of necessity. Results All the patients had achieved fracture union at the 5th month averagely after operation. The period of follow-up was from 6-21 months(mean, 11 months). The mean duration of external fixation was 4.5 months. 4 cases received bone autograft from the iliac crest, primary union occurred in 20 cases, 2 cases with delayed union healed after bone-grafting. No infection occurred in 6 cases with open fracture. The other 16 cases also had no infection or skin necrosis. Only 4 cases with pin track infection healed by dressing change. 19 cases had knee flexion beyond 90?(containing 3 cases with second-stage knee release), 2 was 60? and 1 was 45?. 1 case took NSAIDs intermittently because of traumatic arthritis. According to Merchant grade, 14 were evaluated as excellent, 3 as good, 3 as fair and 2 as poor. The rate of excellent and good results was 77.3%. Conclusion The composite external fixator in treating the severely comminuted or open proximal tibial fracture has the following advantages, such as less-invasion, stable fixation, early-mobilization, high union rate and fewer complication.

Objective To investigate the results of comminuted or open tibi al Pilon fractures treated with a joint bridging movable external fixator. Methods From January 2000 to May 2002, fifteen patients with either severely comminuted or open Pilon fractures were treated with self-designed joint bridging movable external fixators. In some patients, the external fixation was combined with li mited open reduction and Kirschner wire internal fixation. Results All patients were followed up. The average period of following up was 10 months (range 6 to 2 2 months). The fractures were externally fixed for averagely 3 months. The inter val between fracture and bony union was averagely 4.5 months. There was no nonun ion occurred. Two delayed unions were further treated with bone grafting and one of them was stabilized with a plate. All the 9 open fractures were infection fr ee, so were the closed injuries. There was no skin sloughs found in all cases bu t minor pin tract infection was found in two cases. Range of motion at last foll ow-up examination was excellent in five patients, good in seven, fair in two, an d poor in one. One patient required ankle arthrodesis for posttraumatic arthriti s. Conclusion The results of the severely comminuted or open tibial Pilon fractu res treated with joint bridging movable external fixators were fairly satisfying . The fixator can firmly stabilize the fracture while ankle movement can be resu med early. The operation is less-invasive, and is with higher union rate and few er complications.

Objective Through the determination of the insulin receptor and its signal transducers,we tried to find the defects in the common pathway of insulin signal transduction in type 2 DM and to lay a foundation to discover the pathogenesis and effective drugs.Methods Using 32 P-labeling method to determine the activity of TPK and MAPK.Using Fluo 3-AM as fluorescent probe to determine intracellular calcium of patients with type 2 DM.Using photometry to determine the concentration of NO.Results The activities of TPK,MAPK remarkably descended and the concentration of NO also greatly descended compared with healthy people.The concentration of intracellular calcium increased compared with healthy people.Conclusion The defects of the related signal molecule in insulin signal transduction of type 2 DM existed.

Objective To create the effective community-based day-care model of mental disability with multiple approaches. Methods 30 subjects with schizophrenia in Taoranting community in Beijing were selected in control group (n=15) and intervention group (n=15). A day-care multiple rehabilitation model had been implemented in the intervention group. They were evaluated with Positive and Negative Syndrome Scale (PANSS) and WHO Disability Assessment Schedule 2.0 (WHO-DAS 2.0). Results The scores of PANSS negative symp-tom, general psychopathological symptom and WHO-DAS 2.0 significantly reduced continually in the intervention group 8 and 12 weeks af-ter intervention (P<0.01). Conclusion Community-based day-care model can improve the rehabilitation of mental disabled people and inte-grate the community resources for the schizophrenics.

Purpose To investigate clinicopathological features, immunohistochemical findings and differential diagnosis of papillary glioneuronal tumor ( PGNT) . Methods The clinical features, imaging, histological and immunohistochemical findings were analyzed in three cases of PGNT, along with review of the related literatures. Results Two patients were female adults, and the other was male adults. One presented with dizziness, and the other exhibited intractable seizures. Magnetic resonance imaging ( MRI) revealed a cyst-ic space-occupying mass in brain parenchyma of left temporal lobe or right parietal lobe. Microscopically, it was characterized by pseu-dopapillary structures composed of hyalinized vessels rimmed by cuboidal glial cells, oligodendrocyte-like cells and the proliferation of neuronal cells. On immunohistochemical staining, the perivascular cuboidal cells were GFAP-positive, the oligodendrocyte-like cells were Olig-2-positive, and the neuronal cells were synaptophysin-and nuclear protein-positive. Conclusion PGNT is a rare and new variant of mixed neuronal-glial neoplasm, the natural evolution of this tumor is one of low malignant potential and it has a good progno-sis. The distinctive pathologic features help to differentiate this entity from other neoplasm of the central nervous system which has pa-pillary structures.

Objective To observe and compare efficacy and safety of vinorelbine (NVB) plus ifosfamide (IFO) (NI regimen) and NVB plus cisplatin(DDP) (NP regimen) in treatment of metastatic breast cancer.Methods 82 cases of recurrent and metastatic breast cancer after the failure of treatment with anthracyclines and taxanes,40 cases were treated with NI regimen (NVB 25 mg/m2,day 1,day 8,IFO 1.2 g/m2,day 1,day 2,day 3),and the other 42 cases received NP regimen (NVB 25 mg/m2,day 1,day 8,DDP 25 mg/m2,day 1,day 2,day 3).Both groups were constituted of 21 days one cycle.After 2 cycles of chemotherapy,the response rate and side effects were evaluated.Results All 82 cases were evaluated for objective response.The total response rate of NI group and NP group were 52.50 ％ (21/40) and 57.14 ％ (24/42).There was no significiant difference (P ＞ 0.05).By analysis of the correlative factors,the total response rate in treatment of triple-negative breast cancer of NI group was 43.75 ％ (7/16),and that of NP group was 44.44 ％ (8/18).The two rates were also approximative (P ＞ 0.05).Main side effects were both bonemarrow suppression and gastrointestinal reaction.Bonemarrow suppression rate at grade Ⅲ-Ⅳ of NI group [57.5 ％ (23/40)] had no significant difference compared with that of NP group[57.14 ％ (24/42)] (P ＞ 0.05).But grade Ⅲ-Ⅳ gastrointestinal rate of NI group [7.50 ％ (3/40)] was significantly lower than that of NP group [26.19％(11/42)](P ＜ 0.05).Conclusion NI regimen in treatment of advanced breast cancer is effective,and it shows a similar response rate compared with NP regimen.Also it is effective for triple negeative breast cancers.The toxicity can be tolerated,and the gastrointestinal reaction rate of NI regimen is lower.NI regimen is a good choose in treatment of advanced breast cancer.

Objective To discuss the practicability of application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator.Methods The structure and principle of the electrical system were analyzed,the fault tree for the electrical system was built,and the qualitative analysis and quantitative analysis to the fault tree were made.The electrical system was innovated with effective redundant method,and the qualitative analysis and quantitative analysis were made after innovation.Theoretical analysis and the actual validation were made for the fault tree of electrical system after innovation.Finally,several notes were provided for the innovation to the similar medical equipments.Results The fault tree analysis method was applied to innovating the electrical system,and theoretical analysis indicated that the failure probability to total system reduced obviously.Actually,the actual effect after innovation also validated the correctness of the theoretical analysis.Conclusion Application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator is practical.But,the selection to the innovation event,the change to maintainence after innovation and the event to innovate carefully should be paid attention to.

Objective To investigate the clinical significance of the three iodide transporters in thyroid diseases. Methods Literatures about the Na+/I-symporter (NIS), pendrin and human apical iodide transporter (hAIT) in recent years were reviewed and their expressions in different thyroid diseases were also analyzed. Results NIS proteins express at the basolateral membrane of thyrocytes in normal thyroid tissue, while pendrin and hAIT proteins are limited to the apical membrane of thyrocytes lining in the follicular lumen. In the tissues of thyroid carcinomas, it was found that the NIS proteins expressed in the cytoplasm and their expressions decreased; The mutation of NIS gene may be one of the main causes of congenital hypothyroidism. The expression of prendrin protein may be related to the function of follicles: its expression level increased significantly both in Graves diseases and toxic adenomas, but significantly decreased in differentiated thyroid carcinoma. However, the correlation between the decrease and the degrees of differentiation of carcinoma cell line are still disputable. The expression of hAIT protein does not significantly altered in hyperfunctioning tissues. It only slightly decreased occasionally in hypofunctioning adenomas, but it decreased significantly in thyroid carcinomas. Conclusion The abnormal expressions of the three iodide transporters may be related closely with the type of thyroid diseases. However, their pathogenic mechanisms and the causes of their abnormal expression are still unknown, which need to be studied further.

liver cells.Repair test showed that liver cells had the strongest repair ability,spleen cells were the second and kidney cells had no repair ability nearly within 2 h incubation. Conclusion The tissue cells had a big difference to oxidative damage and repair ability and comet assay could be used as detection of DNA oxidative damage and repair ability in exo_chemicals.