Objective To sum up the experience of diagnosis and treatment of paraduodenal hernia. Methods The clinical data of 18 cases of paraduodenal hernia treated by surgery were analyzed retrospectively. Results The average age of the patients was 34 years old.There were 15 cases with left paraduodenal hernia and 3 cases with right paraduodenal hernia.Ten patients usually had no clinical symptoms,while acute abdominal pain occurred after full food in 7 cases,and after vigorous movement in 10 cases respectively.Abdominal X-ray revealed complete or incomplete intestinal obstruction in 16 cases,while abdominal CT revealed abnormal cystic loops of small intestine between the pancreas and the stomach in 10 cases.All 18 cases underwent surgical operation,recovered 10-15 days after operation.After 2-8 years follow-up,there was no hernia recurrence.Conclusion Paraduodenal her-nia is difficult to diagnosis before operation,and the key to correct diagnosis and treatment is to explore the positive exploratory laparotomy.

The design of portable and low power consumption 12-lead ECG is based on the digital signal processor TMS320C5515 and the analog front end ADS1298. The ADS1298 collects the ECG signals and deliver them to TMS320C5515. The preprocessed ECG signals are displayed real-time on a LCD and can be stored without compression for a long time. The ECG signals can also be sent to an up computer by a USB connector so that ECG data can be analyzed offline. The system has small volume, high precision and low power consumption.
Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Signal Processing, Computer-Assisted ; instrumentation ; Software Design

Objective To explore the airway management strategy of patients with double-lumen tracheal intubation during anesthesia recovery period.MethodsA retrospective analysis of clinical data of 60 patients who underwent double-lumen tracheal intubation were enrolled from december 2014 to december 2016 in oue hospital was conducted.The mean arterial pressure (MAP), blood oxygen saturation (SpO2), heart rate (HR) and respiration (R) of all patients were measured at different time points,before and after operation, before and after extubation.ResultsThere was no significant difference in MAP and SpO2 between before and after operation,the levels of MAP and SpO2 before extubation and in extubation were significantly higher than those before operation (P<0.05), and five to ten minutes after extubation returned to the preoperative level.There was no significant difference in HR and R indexes between before and after operation, and the HR and R indexes in extubation and before extubation were significantly higher than those before operation, the difference was statistically significant(P<0.05), which was returned to preoperative level ten minutes after extubation.ConclusionIn the patients with double-lumen tracheal intubation, the observation and scientific care of the airway in the recovery period of anesthesia can not only ensure the stability of the vital signs, but also improve the safety of the patients.It is worthy of clinical application.

Biomacromolecules play an important role in the treatment of many diseases, but as a result of cell membrane serving as the natural barriers, only the small molecular compounds whose molecular weights are smaller than 600 Da can get through cell membrane and enter the cell. In recent years, some short peptides (the length less than 30 amino acids) are found to have the cell-penetrating function, called cell-penetrating peptides (CPPs). They are able to effectively translocate segments of protein, polypeptides, nucleic acid into the cells of many mammal animals with many methods. They have high transduction efficiency and will not lead to cell damage. So, the discovery of CPPs has a very good applicable prospect in such research fields as cell-biology, gene-therapy, drug transduction in vivo, evaluation of clinical medicine and medical immunology. This paper reviews the types and characteristics of CPPs, internalization mechanisms, applications, and their existing problems.

BACKGROUND: The changes in trabecular bone microarchitecture in osteoporosis have aroused much attention. The decrease in the number of trabecular nodes and increase in the number of free ends are found in osteoporosis, but the mechanism is still unclear.OBJECTIVE: To observe the trabecular remodeling process in ovariectomized rats as the osteoporosis models electron microscopically, and to explore the reasons for the decrease in the number of trabecular nodes and increase in the number of free ends.DESIGN: Randomized and controlled animal trial.SETTING: Department of Orthopedics, Third Hospital of Peking University.MATERIALS: The experiment was conducted in the Animal Laboratory, Third Hospital of Peking University from September 1999 to February 2000. Thirty-six female Wistar rats of 3 months old and 240-280 g were selected and randomly divided into ovariectomized group and control group with 18 rats in each group. The rats were observed at 4,8, and 12 weeks postoperatively with 6 rats at each time point.METHODS: The rats of ovariectomized group were subjected to ovariectomy 1 week after feeding, but the control group was not. The changes of proximal tibia trabecular microarchitecture was observed under scanning electron microscope at 4, 8 and 12 weeks, respectively, and the osteoclast, osteoblast, and structure of cell organs were observed under transmission electron microscope.MAIN OUTCOME MEASURES: [1]The re modeling process after ovariectomy by electron microscope; ②morphological changes of trabecular bone.RESULTS: [1]Scanning electron microscope observation showed that trabecular bone remodeling was distributed in every region of trabecular microarchitecture, especially St and Nd-St region. After ovariectomy, the transverse trabecular was easier to be perforated and broken; the trabecular network was almost intact at 4 weeks, but gradually damaged at weeks 8 and 12; moreover, the collagen fibers on the surface of trabecular bone were scrappy, disorder and thinner. ②By the transmission electron microscopic study, the tibial osteoclast were found active at 12 weeks. When absorbing cancellous bone, osteoclast closely adhered to its surface, and digitations stretched into the cancellous bone. The shape and size of digitations were significantly different, and around them, lucent area was observed. Osteoclast was polynucleation with abundant kytoplasm, and there were plenty of Golgi complex, smooth endoplasmic reticulum and mitochondrium. Lysosome inclusion compounds with different sizes and electron density were found in cells. Osteoblast was rarely found, and cell edge was rough, with bone lacuna.CONCLUSION: Bone remodeling is significantly active in St and Nd-St region of trabecular bone in ovariectomized rats.This may be the reason for the decrease in the number of trabecular nodes and increase in the number of free ends.

Biomacromolecules play an important role in the treatment of many diseases, but as a result of cell membrane serving as the natural barriers, only the small molecular compounds whose molecular weights are smaller than 600 Da can get through cell membrane and enter the cell. In recent years, some short peptides (the length less than 30 amino acids) are found to have the cell-penetrating function, called cell-penetrating peptides (CPPs). They are able to effectively translocate segments of protein, polypeptides, nucleic acid into the cells of many mammal animals with many methods. They have high transduction efficiency and will not lead to cell damage. So, the discovery of CPPs has a very good applicable prospect in such research fields as cell-biology, gene-therapy, drug transduction in vivo, evaluation of clinical medicine and medical immunology. This paper reviews the types and characteristics of CPPs, internalization mechanisms, applications, and their existing problems.

Objective:To investigate the clinical efficacy of gabapentin capsules( GBP)combined with amitriptyline and tramadol in the treatment of patients with postherpetic neuralgia( PHü)and anxiety. Methods:Totally 106 PHü patients with anxiety symptoms at different degree were selected and divided into group A(n=53)and group B(n=53). Group A was given GBP,amitriptyline and tramadol,while group was given GBP only. The anxiety,depression,quality of life and pain-relieving intensity( by VAS)of the pa-tients were determined before the medication( T1 )and in the first week( T2 )and the fourth week( T3 )after the medication. Follow-up was carried out regularly according to the requirements to evaluate the clinical efficacy. Results:The anxiety,depression and VAS scores in the two groups on T2 were statistically significant lower than the corresponding results on T1(P<0.05). On T3,however, there were statistically significant differences between the two groups(P<0. 05). The total adverse reaction rate of group A was signif-icantly lower than that of group B(P<0. 05). The total effective rate of group A was significantly higher than that of group B(P<0. 05). Conclusion:GBP combined with tramadol and amitriptyline in the treatment of PHü patients with anxiety can effectively con-trol the pain of the patients,significantly reduce the scores of VAS and improve the quality of life of the patients.

Objective To observe the efficacy of endoscopic resection with thyroid benign tumor. Methods 60 cases of thyroid benign tumor were randomly divided into the endoscopic group and the traditional group, 30 cases in each group. The operation time, blood loss ,drainage volume, postoperative hospital stay, postoperative complications and hospitalization expenses in two groups were compared. Results There was no significant difference ( P >0. 05) between the two groups of postoperative hospital stay; endoscopic group blood loss (25.3 ± 15.6) ml significantly less than the traditional group (57. 2 ± 33. 8) ml, the difference was statistically significant ( P < 0. 05); endoscopic postoperative drainage volume ( 85.6 ± 53.2) ml significantly more than the traditional group ( 23. 5 ±37.2) ml (P < 0. 05); endoscopic operative time of ( 105.3 ± 23. 5) min, while the traditional group ( 80. 4 ±25. 3 ) min, the difference was significant ( P < 0. 05 ); hospitalization costs were significantly higher than conventional endoscopy group ( P < 0. 05). Both groups were not have obvious complications postoperation. Conclusion Compared with traditional open surgery, endoscopic surgery for benign thyroid tumors has advantages of superior cosmetic results and less bleeding,it is a good choice for the treatment of the disease.

Objective:To investigate the analgesic effect of ultrasound-guided quadratus lumborum block at the lateral supra arcuate ligament (LSQLB) and subcostal transversus abdominis plane block (TAPB) for open liver surgery.Methods:Forty-two patients who underwent elective open liver surgery in Lishui Central Hospital from February 2021 to October 2021 were randomly divided into two groups: LSQLB group (L group, n=21) and TAPB group (T group, n=21). Both groups underwent preoperative ultrasound-guided nerve block, and then LSQLB in group L and subcostal TAPB under the right costal margin in group T. The surgery was subsequently completed under general anesthesia. Patient controlled intravenous analgesia (PCIA) was performed in both groups. The mean arterial pressure (MAP) and heart rate (HR) before skin cutting (T 0), immediately after skin cutting (T 1), at the time of liver exploration (T 2), and at the time of suturing (T 3) were compared between the two groups; the intraoperative sufentanil and remifentanil consumption was recorded; the visual analogue score (VAS) of pain at 2, 8, 16, 24, and 48 h postoperatively and the number of analgesic pump presses and remedial analgesia at 48 h postoperatively were recorded. The incidence of adverse effects such as postoperative hypotonia (lower limb muscle strength ≤grade 4 on the blocked side), hypotension, nausea and vomiting were recorded. Results:The MAP and HR at T 1, T 2 and T 3, the dosage of sufentanil and remifentanil during operation of group L were lower than those of group T(all P<0.05); the VAS score at 2, 8, 16 and 24 hours after operation in group L were lower than those of group T (all P<0.05). The number of analgesic pump presses and remedial analgesia at 48 hours postoperatively in group L were less than those in group T after operation (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions such as postoperative hypokinesia, hypotension, nausea and vomiting in the two groups (all P>0.05). Conclusions:LSQLB for open liver surgery is more hemodynamically stable and has a more definite analgesic effect.