Objective To study clinical effect after laparoscopic abdominal preperitoneal inguinal hernia repair methodwithout stapler. Methods 80 cases of inguinal hernia(hospitalized from February 2015 to January 2017)were divided into two groups according to the random number table method ,with 40 patients in each group. Traditional laparoscopic peritoneal inguinal hernia repair method was applied in the control group. Free stapler group received free stapler laparoscopic preperitoneal inguinal hernia repair treatment method. Operation time , amount of bleeding during surgery , the average hospitalization time after operation , the total cost of hospitalization,postoperative pain score,postoperative recovery activities time,patients′satisfaction,operation effusion after operation occurred scrotal hematoma and other complications were comparedbetween the two groups of patients. Results In free stapler group,patients′ satisfaction rate was significantly higher than the control group (P < 0.05). Area of effusion,scrotal hematoma and other complications infree stapler group after surgery were significantly lower than the control group (P < 0.05). Total cost of hospitalization,postoperative pain score, postoperative recovery time activities in free stapler group were significantly better than those in the control group (P<0.05). Operation time,bleeding amount during the operation,average hospitalization time difference between the two groups were not statistically significant(P > 0.05). Conclusion Operation time and amount of bleeding were similar between traditional laparoscopic transabdominal preperitoneal inguinal hernia repair method and free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair.Clinical effect of free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair proves to be effective with less complications ,less pain, faster postoperative recovery, and can reduce the cost of treatment.Free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair has satisfactory cosmetic results and was well received by patients,worthy of promotion.

Objective To examine the epidemiology of kidney stone in Pudong New Area ofShanghai and analyze its risk factors. Methods 12 565 residents with the age above 16 years weresurveyed. All subjects needed to answer a questionnaire concerning their sex,age,geographic loca tions,occupation,education status and family history of renal calculi,etc. Ultrasound examinationwas used to diagnose the kidney stone. Results The average prevalence of kidney stone was 3.15%(396/12565),4. 05%(247/6096)in the men and 2.30%(149/6469) in the women,respectively (P<0. 05). The prevalence increased significantly with age of men,whereas the prevalence was highest forwomen aged 50-59. The prevalence between city and rural was not significantly different before age60 (2.58% vs 2. 62%,P>0. 05),whereas the prevalence were significantly different after age 60(6.28% vs 3.36%,P<0.05). The prevalence of subjects with a family history of renal calculi washigher than that without family history (32.02% vs 2.06%,P<0. 01). The prevalence in manage ment staff and vehicle drivers were the highest. Conclusions The prevalence of kidney stone in Pud ong New Area of Shanghai was lower than that in south of China. The relative risk increased in sub jects of aged men,women aged 50 59,with family history of renal calculi,management staff and ve hicle drivers. An understanding of the epidemiology particularly the interactions among different fac tors,may help lead to approach that reduce the risk of stone formation.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism (PHPT) with urolithiasis.Methods The clinical data of 9 PHPT patients who were evaluated with simple metabolic evaluation in 881 urolithiasis from 2000 to 2005 were summarized and the references were reviewed.Results The level of serum calcium was (2.96±0.48)mmol/L before operation, (1.94±0.42) mmol/L after operation.The level of parathyroid hormone(PTH) was(1133.53±788.21)pmol/L before op-eration,(74.52±49.17)pmol/L after operation.The level of serum calcium and PTH changed significantly after the parathyroidectomy (P<0.01).Follow-up for 14 months to 6 years.the ureteral stones fragments with lithotripsy were clear after 3 months and followed without recurrence,although the renal stones without lithotripsy were followed with no significant change.Conclusions Increase of serum calcium or increase of PTH above double with normal serum calcium may be helpful for diagnosis of PHPT with urolithiasis.Ureteral stone with PHPT should be treated together.Renal stone with PHPT may be followed up after the parathv-roidectomy,and be treated until the complications were occurred.It suggests that the maidend diagnosed pa-tient with urolithiasis should be added with simple metabolic evaluation,including serum calcium, phospho-nium and PTH.

BACKGROUND:Stem cel transplantation has achieved good results in the treatment of cerebral ischemia, and how to reduce apoptosis of transplanted cel s has become the focus of the therapy.
OBJECTIVE:To investigate the injured effect of tumor necrosis factor alpha (TNF-α) on bone marrow mesenchymal stem cel s and its mechanism.
METHODS:Primary cultured bone marrow mesenchymal stem cel s from Sprague-Dawley rats were treated with 200μg/L TNF-αfor 6 hours. Cel vitality was assayed by MTT, and cel apoptosis was observed by Hoechst33342 staining. Apoptotic rate was detected by Annexin-V/PI double staining. Level of oxidative stress was evaluated by determination of malondialdehyde and superoxide dismutase levels. The protein expressions of phosphorylated-Akt, Akt, phosphorylated-FoxO1, FoxO1 were detected by western blot analysis.
RESULTS AND CONCLUSION:After treatment with TNF-α, the cel vitality of bone marrow mesenchymal stem cel s decreased, the apoptotic rate increased, and the cel s were arrested in the S phase. Moreover, the oxidative stress level was elevated, and the protein expression of phosphorylated-Akt and phosphorylated-FoxO1 was significantly reduced compared with the control group (P<0.05). These results suggest that TNF-αat high level contributes to the S-stage arrest, responsible for the apoptosis processes of bone marrow mesenchymal stem cel s via the Akt-FoxO1 pathway.

Objective To create a whole process management database of urolithiasis and to discuss the application value of the database.Methods According to the 2014 guidelines for urolithiasis of CUA and the needs of follow up and research, a clinical management database of urolithiasis was established using ASP.NET and Microsoft SQL Server 2008, collected the data from hospital information system (HIS), laboratory information management system (LIS), picture archiving and communication systems (PACS), clinical information system(CIS), radiology information system(RIS), electronic medical record(EMR) and follow-up system.Results The database system was user-visually, stable, data communication automatically and query securely.This database was based on the general information of urolithiasis included clinical pathway, diagnosis, treatment, prevention, follow up and charge.It supplied strong foundation and platform for statistics analysis, improving efficiency and quality of urolithiasis scientific research.Conclusions The database of urolithiasis can be established by computerized information management system, which could be beneficial not only to information management of case record but also to clinical, and research works.

Objective The objectives of this study were to investigate the expression of Aurora-A pro-tein in cervical cancer and precancerous lesions,and its relationship with human papilloma virus( HPV) infection, and to analyze the role of Aurora-A in the pathogenesis of cervical cancer. Methods One hundred cases of cer-vical biopsy or surgical resection specimens were collected from high-risk HPV( HR-HPV) test. There were 20 cases of normal cervical tissues,20 cases of CIN grade 1 ( CIN1 ) ,20 cases of CIN grade 2 ( CIN2 ) ,20 cases of CIN grade 3(CIN3),and 20 cases of cervical squamous cell carcinoma. The expression of Aurora-A protein was detected by immunohistochemistry and the correlation between Aurora-A expression and HR -HPV infection was analyzed. Results Aurora-A was highly expressed in cervical intraepithelial neoplasia and cervical cancer (P<0. 05),and its positive expression rate increased with the degree of cervical lesions. There was a positive correlation between Aurora-A expression and cervical cancer(r=0. 475,P<0. 001). There was a positive cor-relation between Aurora-A expression and HR-HPV infection in CIN2 and CIN3(V=0. 591,P<0. 05). Con-clusion Aurora-A may be associated with the development of cervical cancer. Aurora-A can be used as an important biomarker for the early diagnosis of cervical intraepithelial neoplasia or cervical cancer. It is also a po-tential therapeutic target for cervical cancer.