A variety of inert non Hodgkin' s lymphoma were converted into the risk of aggressive non Hodgkin' s lymphoma, especially in follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL).The histological transformation is not an event driven by a single factor, but is the clonal evolution process of a variety of mechanisms.This article reviews the biological behavior of the transformation from the high risk factors, the evolution mode of cloning and the molecular mechanism of the occurrence of the transformation.

Objective: To study the effects of Carisolv caries removal method on dentin bonding strength. Methods:Thirty extracted human third molars with moderate occlusal caries were used. Each molar was split into two parts, one part was prepared by Carisolv method and another was prepared by the low-speed burs. Then samples were randomly divided into three groups. Three adhesive systems were used: Prime&Bond NT +Dyract AP compomer、Uni-Etch +One-step plus+Renew resin composite and Prompt-L-Pop +Z100 resin composite. Microtensile bonding strength(MTBS) of the three adhesive systems were tested. Results:The MTBS of the three adhensive systems were (17.22?7.95) MPa, (25.40?8.44) MPa, (17.66?8.33) MPa in Carisolv group, and were (16.01?7.43) MPa, (23.45?7.55) MPa, (16.26?7.97) MPa in burs group. There was no significant difference between the two caries removal methods.Conclusion:Carisolv caries removal method has no side effects on dentin bonding strength of the three adhesive systems.

In recent years,high-temperature heat wave caused an increase in the number of deaths than other climate disasters,the study of the effects of heat waves on the health of urban residents health becomes a subject of concern.Sustained high-temperature heat waves will inevitably cause harm to human health,to understand the characteristics of heat waves is conducive to the prediction of high temperature heat waves and to the establishment of reasonable response measures.This paper mainly introduces the present status of heat wave occur,the impact of heat wave on human health,the influencing factors for excess mortality during heat waves as well as the research methods for heat wave which are commonly used to predict.

Objective To enhance the hospital′s competitiveness through evaluating hospital by its own staff.Methods The Servqual was used to investigate the hospital service quality.Results The hospital′s medical staff were good in personal appearance and professional knowledge.However, the hospital was week in equipment and fulfilling promises to patients.Conclusion The administrative should take corresponding measures to improve the quality of medical services for their existing management quality problems.

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.

To survey the time management disposition of the medical postgraduates,the Time Management Disposition Scale were used on 774 medical postgraduates for investigation in 2009. The difference of medical postgraduate from the countryside,towns and cities on time management disposition is not significant ( P＞0.05 ) ; Students of different gender have significant difference ( P＜0.05 ). The female postgraduates cultivation on time management disposition needs to be strengthened.

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.

Ultraviolet (UV) is a kind of important environmental factor that can cause dermatitis,photoaging and skin cancerization.The UV-induced production of inflammatory factors by epidermal keratinocytes has been deemed an important molecular event in occurrence of the above diseases.Various receptors,intracellular signal transduction-related regulatory molecules and nuclear transcription factors are involved in UV-induced inflammatory responses in keratinocytes,which mainly include epidermal growth factor receptor,aryl hydrocarbon receptor,peroxisome proliferatoractivated receptor,protein kinase C family,protein kinase B,mitogen-activated protein kinase family,nuclear factor-κB and transcription factor activator protein-l,etc,and constitute a complex inflammatory signal transduction network.

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.