Objective To explore the clinical effects of Kugel surgical treatment for inguinal hernia.Methods Operative time,chornic pain,complications and charges of 355 patients with inguinal hernias were analyzed retrospectively.Results Recurrences occurred in 1 patient,during a mean followl-up of 36 months (range:7-85).The average operation time was 35.4 min (range:20-130),average surgical charges were 6 253 yuan.Postoperaive chronic pain appeared in 6 patients.There are 3 cases of sermoa,1 case of haematoma and 2 case of wound infection.Conclusion The Kugel inguinal hernia repair is safe and effective,with the advantage of mild pain and prompt recovery after operation,and a low risk of complications and recurrence.

Objective To establish an artificial reflex arc to reinnervate the nerropathic bladder and restore bladder function after spinal cord injury. It involves a somatic reflex are with a modified efferent branch which passes the somatic motor impulses to the bladder and initiate autonomic bladder detrusor contraction. Methods This is achieved by intradural microanastomosis of the right L5 ventral root to S2 ventral root in canines. After a-conal regeneration,the pateller ligament-spinal cord center-bladder new artificial bladder reflex pathway was extablished. The early and final function of the reflex are was observed by electrophysiological experiments, bladder pressure tests and detrusor electromyograms (EMG)' Surgical operation of bilateral intradural microanastomosis of the L5 ventral roots to the S2 ventral roots was done in a 20 years old male patient with upper thoracispinal paraplegia. Results Single stmuli (115 mV, 1. 0 ms) of the right L, dorsal root resulted in evoked potentials recorded from the right S2 ventral root distal to the anastomosized site in all 6 canines. In 4 canines 6 months postoperation and 48 hours after spinal cord was transected, bladder contraction was very quickly initiated by trains of stimuli (l 000 mV, 10 Hz, 2 s) of the right L5 dorsal root and bladder pressures increased rapidly to average 65% of normal compared to controls' Bladder contraction induced by knocking the right pateller ligament increased to average 51 % of controls througt the new reflex arc. In 2 canines 18 months postoperation,bladder pressures increased by the same stimuli to average 84% of controls and to average 62% of controls by knocking the pateller ligament. Stimuli (3. 8 mA, 1' 0 Hz) of the right L5 dorsal root and femoral nerve resulted in EMG recorded from the detrusor in 2 canines 18 months postoperation. The patient achieved controllable micturition by calcaneus tendon-spinal cord center-bladder new artificial bladder reflex pathway at 14 months postoperation. Micturition was very quickly initiated by passive dorsalflexion of either lateral ankle joint,and the results of bladder function was excellent at postoperation. Conclusion The somatic motor a-cons can regenerate into the parasympathetic endoneurial tubes of autonomic nerve. Using the survived somatic reflex under the horizon of spinal cord injury to reconstruct the bladder autonomic reflex arc by intradural microanasto- mosis of ventral root is successful in the first patient and have a potential of clinical application.

To study the neural morphological basis of the "abdominal reflex spinal cord center bladder" artificial bladder reflex arc established by abdominal reflex. It is achieved by intradural microanastomosis of the right T 13 ventral root was anastomosed under microscope to S 2 ventral root by autogenous nerve grafting intraduraly, with the right T 13 dorsal root remaining intact and the right L 5 ～S 4 ventral roots severed. three to four months were allowed to achieve axonal regeneration, and new "abdominal reflex spinal cord center bladder" artificial bladder reflex pathway was established. Eight months after the operation, it was seen under light microscopy that regenerative nerve fibers of ventral root of T 12 had grown through the anastomotic site to distal nerve root. Under electron microscopy, nerve endings in the detrusor of the bladder were seen on the experimental side. The basic structure of the junction between parasympathetic nerve endings and bladder detrusor cells on the experimental side was similar to that on the control side. These features were not seen in the control group. The results suggested that the somatic motor axons above the lumbosacral paraplegia level could innervate bladder parasympathetic ganglion cells, and thereby transfersed somatic reflex activity to the bladder detrusor muscle, which was the morphological basis of the artificial bladder reflex arc leading to controllable micturition

Objective To explore the establishment of an new artificial bladder reflex arc for controlled micturition function in the conical spinal cord injury(SCI). Methods One conical SCI patients were included by lateral microanastomosis of the L6 ventral root to S2 ventral root. After several months of axonal regeneration, the function of bladder were examined clinically and urodynamically. Results Stimulation of the new artificial reflex are could inuduce controlled voiding, and could cause detrusor contraction when following 55 months of one patient. Conclusions Establishing of an new artificial reflex arc may effective for controlled micturition in conical SCI.

Purpose To explore the significance of three-dimensional reconstruction of fetus based on MRI scan data. Materials and Methods Three woman (more than 39 weeks' gestation) with a strong wish to have natural childbirth and voluntary to take the examination in Nanfang Hospital of Southern Medical University were recruited in the study. Mimics 10.01 software was used to do three-dimensional reconstruction. Results The fetal surface tissue showed low signal on the two-dimensional images, and amniotic fluid and lung, bladder, cerebrospinal fluid showed high signal. The placenta and uterine wall showed moderate to low signal. Those contributed to the clear boundary between fetal surface and other tissue surround. The three-dimensional fetus models were reconstructed successfully, which clearly demonstrated the main surface features and spatial position of the fetus. The fetal morphology and fetal position could be viewed in various directions. Conclusion Fetus surface can be reconstructed into three-dimensional model based on MRI data set, which has advantage of large visual field and can be observed at arbitrary angle. It provides a new method for morphological analysis and prenatal evaluation for fetal development and growth.

Objective To study the expression of β-catenin and cyclin-D1 in sporadic parathyroid adenomas and the clinical significance.Methods Immunohistochemistry and RT-PCR were used to examine the expression of β-catenin and cyclin-Dl in 20 cases of sporadic parathyroid adenomas,10 cases of parathyroid hyperplasia tissues and 8 cases of normal parathyroid tissues respectively.Results The results of immunohistochemistry showed that the expression of β-catenin was decreased on cell membrane of normal parathyroid tissues,parathyroid hyperplasia tissues and sporadic parathyroid adenomas,and was increased in the cytoplasm and the nucleus.The expression of cyclin-Dl was significantly higher in the adenoma group and hyperplasia group than in the normal group( P ＜ 0.05 ).The difference had no statistical significance in terms of cyclin-Dl expression between the adenoma group and the hyperplasia group( P ＞0.05 ).The abnormal expression of β-catenin was significantly correlated with the overexpression of cyclin-D1 in sporadic parathyroid adenomas( P ＜ 0.05 ).RT-PCR analysis showed that the expression of cyclin-D1 mRNA was 2.36 ± 1.12 vs 1.50 ± 1.03 ( P ＜ 0.05 ),and the expression of β-catenin mRNA was 1.02 ± 0.45 vs 0.88 ± 0.56( P ＞ 0.05 ) in adenomas and normal parathyroid tissues respectively.Conclusion The abnormal expression of β-catenin activates cyclin-Dl and thus leads to the uncontrolled cell proliferation and differentiation,which may be one of the mechanisms of the occurrence of sporadic parathyroid tumors.

Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury.Methods All transfusional cases underwent emergency craniotomy with trau-matic brain injury from January,2012 to June,201 6,1 61 males and 38 females,ASA physical statusⅠ-Ⅳ,were respectively analyzed and divided into autologous blood group (n = 108)and allogeneic blood group (n =91)based on whether or not using cell salvage.The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concen-tration at 70-100 g/L.The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS).Results The incidence of postoperative complications (33% vs.56%,P <0.01 )and adverse transfusion reaction (5% vs.14%,P <0.05)of the autologous blood group were lower than that in the allogeneic blood group,and the clinical outcome was better (P <0.01).Logistic regression analysis showed that allo-genetic transfusion (OR =1.953,95%CI 1.381-2.529)was an independent risk factor of postopera-tive complications.Conclusion The use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome.

Objective To explore the influence of lower concentration of cell free fetal fraction DNA in maternal plasma on non-invasive prenatal test(NIPT) .Methods A total of 3240 pregnant women accepted NIPT in Foshan Maternal and Children′s Hos-pital from April ,2015 to March ,2016 were analyzed retrospectively ,and 150 samples of which were male fetus judged by Z score of Y chromosome and the cell free fetal fraction DNA were lower than 8% were selected .The cell free fetal fraction DNA were in-creased by agarose gel electrophoresis ,then conducted NIPT ,compared with the results of aneuploidy screening .Results The cell free fetal fraction DNA were increased from 5% to 9 .2% by agarose gel electrophoresis .The result of NIPT after increasing fetal fraction was consistent with it before .Conclusion Concentration of cell free fetal fraction DNA has no influence on the result of NIPT when cell free fetal fraction DNA is above 5% .

Objective To explore the correlation between the incidence of abdominal and pelvic artery distortion and age using dig-ital three-dimensional reconstruction,in order to assess risk in uterine artery embolization surgical approach.Methods Collecting the CTA datasets of 475 patients,group A aged 11-27 (n=40),group B aged 28-44(n=218),group C aged 45-61(n=197), group D aged 62-78(n=20).The 3D model of pelvic arteries was reconstructed by mimics software,and the arterial distortion was recorded by rotating and observing the 3D model,which was further classified into three categories.One was the distortion of the aorta only,the second was the distortion of iliac artery,and the third being distortion of both sturctures.the number of cases appeared arterial distortion in every age group was calculated and the ratio of the total cases to each age group was counted.Results There were 128(26.9%)cases appeared arterial distortion,the last 347(73.1%)were not found distortion in any artery.Of the 128 cases,the occurrence rates of arterial distortion in each age group were 2.5%、11.9%、44.7%、65% for group A,B,C and D respec-tively.Pearson linear correlation analysis showed that the incidence of arterial distortion positively correlated with age (r=0.404,help of three-dimensional reconstruction.The occurrence rate of artery distortion is increased with age and the iliac artery distortion occurrence is higher than that of the aorta artery.

Objective To study the outcomes and influencing factors of the conversion from normal glucose tolerance -hyperinsulinemia (NCT-HINS) to diabetes in the population of a community in Beijing.Methods All the subjects investigated received 75 g oral glucose tolerance test (OGTT) for diabetes screening carried out in May, 2006 and May, 2008. Data were calculated to analyze the outcomes and influencing factors of the conversion. HINS was diagnosed if fasting serum insulin & 15 mIU/L and/or 2-hour serum insulin after glucose loading ≥ 80 mIU/L Results The prevalence of NGT-HINS in the community in 2006 and 2008 was 5.28% and 8.67% (P<0.01) respectively and that of diabetes mellitus (DM) and impaired glucose regulation (IGR) was 3.52% , 6.56% in 2006 and 4.42% ,6.47% in 2008.The probability of the conversion from NGT-HINS to IGR and DM was 18.6% and 2.3% , being much higher than that from normal glucose tolerance- normoinsulinemia (NGT-NINS) (5.4% and 0.7% , P <0.01). However, the probability of the conversion from NGT-HINS to DM was 2.3% , which was much lower than that from IGR (26.3% , P <0.01). The reason might be that individuals with NGT-HINS had a higher waist circumference, BMI, fasting plasma glucose, 2 h plasma glucose and TG but a lower HDL-C than individuals with NGT-NINS in 2006. The HOMA β-cell function index/HOMA insulin resistance index (HBCI/IR) of individuals with NGT-HINS was much lower than that of individuals with NGT-NINS, but much higher than that of individuals with IGR. Logistic regression analysis showed that age, TG and HBCI/IR were the major influencing factors of the conversion from NGT to glucose metabolic disorders.Conclusions The probability of conversion from NGT to DM was increased remarkably when HINS was diagnosed. The reason might be that individuals with NGT-HINS suffered more metabolic risk factors and had a decreased β-cell function. Therefore, individuals with NGT-HINS should be paid attention to in diabetes prevention study.