BACKGROUND:It has been generally accepted that polypropylene mesh tension-free hernia repair may repair the inguinal hernia,but the clinical application is not wide.OBJECTIVE:To analyze retrospectively the effect of polypropylene mesh plug tension-free hernia repair versus the traditional herniorrhaphy for inguinal hernia.DESIGN,TIME AND SETTING:Case analysis was performed among 115 cases who underwent inguinal hernia in Department of General Surgery,Affiliated Xinhua Hospital of Hainan Medical College from March 2003 to October 2007.PARTICIPANTS:The involved patients were 76 males and 39 females,aged 26-81 years with a mean of 61.3.There were 78 cases with lateral indirect hernia,11 direct hernia,2 femoral hernia,and 12 bilateral indirect hernia.35 of 115 patients were operated with polypropylene mesh tension-free hernia repair and 80 patients were provided at traditional repair method.Mesh cone hernia ring and patches were offered from Bard Company(USA).RESULTS:The size of hernia ring was selected based on the pattern number and amount of mesh plug.Transfixing suture was performed along the center and tip of hernial sac.Subsequent to the mesh plug implantation,the flap was processed into interrupted suture with hernia ring at a interval of 0.5-0.8 cm.Traditional herniorrhaphy was chiefly consisted of Bassini,McWay and Shouldice operative types.MAIN OUTCOME MEASURES:Operative duration,out of bed activity time and average hospitalization time were observed.Utility of anodyne,uroschesis and scrotal swelling were detected after operation.RESULTS:All patients were cured.There were 35 patients operated with mesh tension-free repair of inguinal hernia.The operation mean time was 42 minutes.The mean time of getting out of bed was 8 hours after operation.The mean hospitalization time was 6.2 days.There were 2 patients with uroschesis,3 patients utilizing the anodyne,and 1 patient with scrotal swelling after operation,without complications about wound infection and scrotal hydrocele.No recurrence occurred by follow-up visit of 6-36 months after operation.Eighty patients operated with the traditional herniorrhaphy.The operation mean time was 56 minutes.The mean time of getting out of bed was 68 hours after operation.The mean hospitalization time was 11.6 days.There were 9 patients with uroschesis,37 patients utilizing the anodyne and 1 patient with scrotal swelling after operation,without complications about wound infection and scrotal hydrocele.Nine patients were recurrent by follow-up visit of 6-36 months after operation.CONCLUSION:Polypropylene mesh plug tension-free repair for inguinal hernia is suitable to repair and enhance the pectineus porose area,with great histocompatibility.Thus,it is obviously ascendant to the traditional herniorrhaphy.

Objective To analyse the clinical effects on colon cancer with acute intestinal obstruction.Methods 56 patients with acute intestinal obstruction caused by colon cancer were studied retrospectively.The experience of diagnosis was summarized.Results 47 patients with acute intestinal obstruction caused by colon cancer received Stage Ⅰ tumor resection and the other 9 patients received different stages.54 patients healed (96.4％) and 1perioperative deaths (1.8 ％).Postoperative complications occurred in 18 cases (32.1％) including incision infection,intraperitoneal infection and intestinal fistula.Conclusion Stage Ⅰ tumor resection is feasible and safe surgical procedures for acute intestinal obstruction caused by colon cancer.

Objective To clone and express the valuable Clonorchis sinensis antigen molecules which can be applied to the diagnosis of clonorchiasis. Methods Based on the sequences (Genbank) No. AF271091 (CysA) and No.AF093242 (CysB), primers were designed to amplify the two C. sinensis cysteine proteinase genes and expressed in E.cloi. The expressed proteins were purified by affinity chromatography and then tested for their immunological characters.Results The two genes were successfully cloned and expressed. Western blot showed that CysB had strong reaction with clonorchiasis sera and very weak reaction with schistosomiasis sera, while CysA showed no reactivity with the probed sera. Immunohistochemistry showed that both proteins were mainly located in adult worm intestines and the intrauterine eggs.Conclusions The results suggested that, of the two expressed C. sinensis proteins, CysB had good antigenic reactivity against sera from patients. It is a potential candidate of diagnostic antigens for clonorchiasis.

Objective To analyze the epidemic status of principal human parasites, so as to provide scientific evidence for making prevention countermeasures for Guangdong Province in the future. Methods In 2015, a survey was performed according to the scheme of "The 3rd National Survey of Principal Human Parasites"as well as the incidence of parasites disease in Guangdong Province,the residents at 48 investiation sites in counties were surveyed. The survey of the soil-transmitted nematodes (Ascariasis, Ancylostoma, Trichuris trichiura and Enterobius vermicularis) and intestinal protozoa were performed based on the ecological regions and stratified by economic and geographic situation.The survey of food borne Clonorchis sinensis was performed along with the soil-transmitted nematodes in rural areas, and it was performed by the sample method of random cluster in cities and towns.The residents in each investigation site as the object, the ovum of the soil-transmitted nematodes, Clonorchis sinensis and other helminths were examed by the modified Kato-Katz method, test tube filter paper was used to identify Hookwormspecies, and the intestinal protozoa was checked by direct smear method. The transparent tape anal swabs method for children aged 3 - 6 years to check Enterobius vermicularis. Results Totally 12 401 residents of 48 survey sites from 22 counties were surveyed, and the total infection rate of intestinal parasites was 8.29%(1 028/12 401). The infection rate of soil-transmitted nematodes was 3.39% (420/12 401),in which the infection rate of Ascariasis, Ancylostoma, Trichuris trichiura and Enterobius vermicularis were 0.52% (64/12 401), 1.89%(234/12 401),0.46%(57/12 401),and 0.52%(65/12 401),respectively.The infection rate of Clonorchis sinensis was 4.90%(608/12 401). Nine hundred and sixty-seven children were tested for eggs of Enterobius vermicularis with the infection rate of 12.41% (120/967). The number of hook larva culture was 153, among them, 140 were hookworm larvae of America and no duodenal hookworm larvae and other nematode species were found.Totally 9 309 residents were tested for intestinal protozoa infection,and the infection rate was 0.31%(29/9 309). Conclusion In Guangdong Province, the infection rate of soil-transmitted nematodes is decreasing while the infection rate of Clonorchis sinensis is still high, and the control work of parasites still should be strengthened especially for food borne parasitic diseases.

Objective:To study the feasibility of using pelvic iterative cone beam CT images for dose calculation of radiation therapy planning, so as to provide support for adaptive radiotherapy.Methods:The CIRS 062 M phantom was scanned by Varian Halcyon v2.0 o-ring accelerator, and the average CT number under different scattering conditions was calculated, and then the ICBCT-ED conversion curve was established. CT images of CIRS 002PRA pelvic IMRT phantom and ICBCT images at different positions were collected. Treatment plan using VMAT technique based on CT image was designed and transplanted into ICBCT image with dose recalculated. The differences of gamma passing rate among target volume, organs at risk and 3-dimensional dose were compared. Based on the actual treatment plan of patients, the differences of 3-dimensional dose gamma passing rate in 10 pelvic patients were analyzed retrospectively.Results:There was a large CT value deviation at central position between the isolated no-scattering condition and the full-scattering condition, and the maximum deviation was 144 HU. The CT values of other positions in full-scattering condition were similar to those of the central position, and the maximum deviation was less than 50 HU. Based on the calculated result of ICBCT images at different positions of the pelvic phantom, the dose deviation of the target volume or organs at risk was less than 1 Gy. Compared with the plan based on CT images, the average 3-dimensional dose gamma passing rate under the criteria of 1% dose difference (DD)/1 mm distance-to-agreement (DTA) and 2% DD/2 mm DTA in plan based on ICBCT images were (88.86 ±1.18)% and (98.38±0.89)%, respectively. The ranges of average 3-dimensional dose gamma passing rate under the criteria of 2% DD/2 mm DTA and 3% DD/3 mm DTA in 10 patients with pelvic tumors were 90.03%-95.43% and 93.58%-97.78%, respectively, and the worst result was only 85.90% and 92.90%, respectively. The main reason of the worst result was the dose difference caused by large variation of bladder contour due to over-filling.Conclusions:Under comprehensive scattering conditions, the ICBCT-ED conversion curve is reconstructed and the treatment plan can be designed by using the ICBCT image of Halcyon v2.0 linear accelerator. The accuracy meets the standards of clinical application, which provides assurance for adaptive radiotherapy in the future.

Gegen Qinlian Decoction (GQD), a traditional Chinese medicine (TCM) formula, has long been used for the treatment of common metabolic diseases, including type 2 diabetes mellitus. However, the main limitation of its wider application is ingredient complexity of this formula. Thus, it is critically important to identify the major active ingredients of GQD and to illustrate mecha-nisms underlying its action. Here, we compared the effects of GQD and berberine, a hypothetical key active pharmaceutical ingredient of GQD, on a diabetic rat model by comprehensive analyses of gut microbiota, short-chain fatty acids, proinflammatory cytokines, and ileum transcriptomics. Our results show that berberine and GQD had similar effects on lowering blood glucose levels, modulating gut microbiota, inducing ileal gene expression, as well as relieving systemic and local inflammation. As expected, both berberine and GQD treatment significantly altered the overall gut microbiota structure and enriched many butyrate-producing bacteria, including Faecalibacterium and Roseburia, thereby attenuating intestinal inflammation and lowering glucose. Levels of short-chain fatty acids in rat feces were also significantly elevated after treatment with ber-berine or GQD. Moreover, concentration of serum proinflammatory cytokines and expression of immune-related genes, including Nfkb1, Stat1, and Ifnrg1, in pancreatic islets were significantly reduced after treatment. Our study demonstrates that the main effects of GQD can be attributed to berberine via modulating gut microbiota. The strategy employed would facilitate further stan-dardization and widespread application of TCM in many diseases.