Objective To analyze the clinical effect of small incision operation and traditional operation in treatment of pediatric hernia,and to provide a theoretical basis for the clinical treatment of pediatric hernia.Methods 68 children with pediatric hernia were treated as the research subjects,they were randomly divided into control group and observation group,34 children in each group.The control group adopted the traditional operation treatment,while the observation group was taken small incision.The clinical efficacy and complications of both two groups were compared. Results The operation time,bleeding volume,hospitalization time and incision length of the observation group were (10.45 ±1.35)min,(5.21 ±0.78)mL,(1.98 ±0.76)d,and (1.04 ±0.23)cm,which were better than those of the control group [(15.67 ±3.24)min,(8.56 ±1.87)mL,(3.78 ±1.12)d,and (2.54 ±0.65)cm,respectively],the differences were significant (t =5.760 0,5.747 7,4.171 7,7.986 8,all P <0.05).The incidence rate of complica-tions of the observation group was 2.94%,which was significantly lower than that of the control group (11.76%),the difference was significant (χ2 =5.7118,P <0.05).Conclusion The clinical curative effect of using small incision in the treatment of pediatric hernia is significant,this method has the advantages of small operation wound,less pain, faster postoperative recovery,less complications and other advantages,it is worthy of clinical application.

Objective To investigate the features of clinical pathology,phenotye and differential diagnosis of thyroid follicular carcinoma-like renal tumor.Methods A 25-year-old female patient was hospitalized in February 28,2011 because of hypertension for 20 months.Physical examination revealed a right renal space-occupying lesions without percussion pain.Blood pressure was 200/130 mm Hg (1 mm Hg =0.133 kPa).Thyroid,heart,lung,and abdominal examination showed no abnormalities.Blood,urine routine,biochemical examination,blood catecholamines,and thyroid function test results were normal.CT examination showed that a visible circular nodules with clear boundary was in the upper pole of the right kidney,and the maximum section about 2.2 cm × 3.0 cm withuneven density andrenal artery was pressed down.Clinical diagnosis was right renal tumor,and right renal tumor was removed under general anesthesia.Intraoperative tumor was located in the right renal hilumwithclear boundary,and the surrounding mild adhesions.Postoperative blood pressure wasnormal.Results General inspection of the specimen:a 2.5 cm diametermasswith intact capsule.The color of the section of the mass is gray red and gray.Multiple small cysts are seen in the section and the cysts contain jelly material.Microscope inspection:the tumor tissue is arranged like thyroid follicular and the follicular contains much acidophil colloid.Immunohistochemistry:the tumor cell is EMA (+),Vimtin (+),CK7 (+),CK20 (+),CD117 (-),TTF-1 (-),TG (-),CgA (-),Syn (-).Conclusions Thyroid follicular carcinoma-like renal tumors is a very rare kidney epithelial cell tumor,which is attributable to any known subtypes of renal cell carcinoma.To improve the understanding of it can avoid misdiagnosis and prevent inappropriate treatment.

Objective To observe the changes of the multifocal electroretinograph (mf-ERG) in commotio retinae. Methods The affected eyes (traumatic group) and the fellow eyes (control group) of 31 patients with unilateral commotio retinae were examined by RETI scan 3.15 system. The responses of 61 retinal regions were recorded, and the average amplitude densities of the N 1 (the first negative) wave and P 1 (the first positive) wave in different regions of retinal were analyzed. Results The average amplitude densities of 1-4 rings in N 1 wave and 1-5 rings in P 1 wave were much lower in traumatic group than those in the control. Conclusions The average amplitude densities of N 1 wave and P 1 wave of mf-ERG in retinal affected regions decreases markedly in eyes with commotio retina; mf-ERG may provide the quantificational and orientational detection for the visual ability of the eyes with commotio retinae.

ObjectiveTo evaluate the retinal function with central serous chorioretinopathy (CSC) and the fellow eyes (mf-ERG).MethodsTwenty patients (40 eyes) with unilateral CSC, diagnosed by fluorescein angiography, were examined on each eye of the patients by mf-ERG multifocal electroretinography. The patients aged from 31 to 53 (13 men, 7 women; mean age, 41 years), and the CSC eyes had visual acuities of 0.2 to 0.8. None of the patients had significant abnormality in the fellow eyes with visual acuities of 0.8 to 1.5. Twenty-four healthy people (29 normal eyes with visual acuities of 1.0 and more and without any retinal diseases) were studied simultaneously as the normal control. The stimulus matrix of 61 hexagonal elements were grouped into 5 concentric rings from the fovea outward to 30? of the degree of visual field. The first-order responses of mf-ERG were recorded. The first negative wave (N 1-wave) and positive wave (P-wave) of the mf-ERG were measured. Amplitude intensities and latechies for the two configurations were calculated and compared.ResultsCompared with the control eyes, the responses were not only depressed severely in P 1- and N 1-wave amplitude intensities in the ring 1~3 in the CSC eyes with CSC (P0.05). There were no significant differences in N 1- and P 1-wave latencies in 5 concentric rings among the control eyes, the fellow eyes or the CSC eyes.ConclusionsCSC is a kind of macular disease involving both eyes. It may cause the decrease of retinal function in macular area of CSC eyes and also influence the retinal function in macular area of the fellow eyes. mf-ERG is a sensitive way in examining visual function.

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective To explore the protection and mechanism of hydrogen sulfide (H2S) preconditioning against injury induced by cisplatin in human marrow mesenchymal stem cells (HMMSCs).Methods HMMSCs were treated by cisplatin at 0,5,10,20,40,60,80 mg/L concentrations for 24 h respectively and were exposed to cisplatin at 20 mg/L concentrations for 0,6,12,24,36,48 h respectively.HMMSCs were pretreated with NaHS at 0,0.4,0.6,0.8,1.0 mmol/L respectively for 30 min before exposed to cisplatin at 20 mg/L concentrations for 24 h.HMMSCs were treated by U0126 or combined with human epidermal growth factor (HEGF) together for 30 min before they were preconditioned with NaHS for 30 min.The cell survival rate,cell apoptosis rate,the expression of p-ERK1/2 and t-ERK1/2 were recorded.Results The cell survival rate decreased to 71.72％±2.72％,59.41％±5.44％,50.37％±4.55％,38.97％±2.92％,30.11％±4.64％ and 21.71％±5.35％ respectively after cells were treated with cisplatin at 5,10,20,40,60,80 mg/L concentrations respectively,and the differences were statistically significant compared with 0 mg/L group.The cell viability fell to 70.30％±6.20％,61.63％±2.70％,51.29％±3.13％,38.72％±3.66％ and 27.57％±2.32％ after HMMSCs were treated with cisplatin at 20 mg/L for 6,12,24,36,48 h respectively,and the differences were statistically significant compared with 0 h group.The cell viability increased to 65.99％±2.67％,72.93％±5.44％,75.10％±4.71％ and 76.56％± 5.25％ when HMMSCs got pretreatment of NaHS,and the differences had statistical significance compared with cisplatin group.The cell apoptotic rate decreased from 35.29％±2.77％ to 18.62％±0.97％ when HMMSCs were pretreated with NaHS at 0.6 mmo/L.Treatment of HMMSCs with cisplatin at 20 mg/L for 24 h reduced p-ERK1/2 expression.The pretreatment of NaHS could inhibit the inhibitory action to the expression of p-ERK1/2 induced by cisplatin.Pretreatment with U0126 or HEGF inhibited or promoted the protection and the upregulated expression ofp-ERK1/2 caused by NaHS pretreatment.Conclusion The preconditioning of H2S can protect cell damage caused by cisplatin via activating the ERK1/2 pathway of HMMSCs.

Objective To investigate the molecular regulatory mechanism of glucagon like peptide 1 (GLP-1) on proliferation, differentiation and apoptosis of human umbilical cord blood endothelial progenitor cells (EPCs). Methods EPCs were isolated from the umbilical cord blood of healthy pregnant women and cultured in 6-hole cell plate at 2×105 density in vitro, transfected with empty vector plasmid (control group), pcDNA3-GLP-1 plasmid (GLP-1 group), pcDNA3-GLP-1plasmid+AMD3100 (GLP-1+AMD3100 group) and simple AMD3100 (AMD3100 group). The pcDNA3-GLP-1 was transfected into EPCs. The 25μmol/L AMD3100 was used to block the SDF-1/CXCR4 signal pathway of EPCs for 1 h. The cell proliferation was determined by MTT method. The mRNA expressions of differentiation and apoptosis related genes PPARγ, C/EBPα and Caspase-3 were investigated by RT-PCR, and Caspase-3 activity was determined by Caspase-3 activity assay kit. Results Compared to control group, AMD3100 inhibitor showed no effects on cell proliferation, differentiation and apoptosis, while over-expression of GLP-1 in EPCs obviously promoted cell proliferation, and differentiation related genes PPARγand C/EBPαmRNA expression, but down-regulated mRNA expression and the activity of Caspase-3 significantly (P＜0.05), indicating that GLP-1 increased proliferation and differentiation of EPCs while decreased cell apoptosis. When the SDF-1/CXCR4 signaling pathway was blocked by AMD3100, over-expression of GLP-1 induced promotion of cell proliferation, and the differentiation was decreased significantly and the apoptosis was significantly increased (P＜0.05). Conclusion These data confirm that GLP-1 might promote EPCs proliferation and differentiation, and inhibit cell apoptosis through the regulation of the SDF-1/CXCR4 signaling pathway.

Objective To develop a CAD system for breast augmentation in order to improve the effect and raise patients' satisfaction.Methods 3D data of breast were collected by computer-aided projecting fringe measurement,and a CAD software system for breast surface 3D reconstruction and breast augmentation was developed under AutoCAD.Results A CAD system for breast augmentation was developed.Conclusion The system,which can provide a visual direction for the design of breast augmentation,has many advantages such as non-contact,speediness,accuracy,direct-view,etc.

Objective To identify the epidemiological changes in invasive fungal infection (IFI) in a neonatal intensive care unit (NICU) to provide information for prevention and treatment of IFI.Methods A total of 102 cases who were diagnosed with IFI among 42 187 neonates hospitalized in the NICU of Affiliated BaYi Children's Hospital,Chinese People's Liberation Army General Hospital from January 1,2009 to December 31,2014 were enrolled in this study.Since January 1,2012,the divisions of our NICU were more specific and intravenous fluconazole was administered as a routine preventive measure for high-risk infants.Clinical information of the IFI cases including general features,incidence,distribution of pathogens and drug (Amphotericin B,Fluconazole,Flucytosin,Itraconazole and Voriconazole) sensitivity were analyzed between former period (January 1,2009 to December 31,2011) and latter period (January 1,2012 to December 31,2014) by Chi-square test.Results The total incidence of IFI was 2.42‰ (102/42 187),and among the 102 IFI cases,73.5％ (75/102) were preterm infants and 75.5％ (77/102) were low birth weight infants.The incidence ofIFI in the latter period was lower than that in the former period [1.8‰ (48/26 046) vs 3.3‰ (54/16 141),x2=9.329,P＜0.01].The incidences of IFI in neonates with gestation age ＜28,≥ 28-＜32 and ≥ 32-＜37 weeks in latter period were decreased as compared with those in former period [10.6 ‰ (3/284) vs 76.9 ‰ (9/117),x2=12.569;6.1‰ (13/2 134) vs 21.9‰ (28/1 277),x2=16.868;1.4‰ (12/8 706) vs 1.9‰ (10/5 256),x2=7.165] (all P＜0.01).Altogether 103 pathogen strains were identified from 102 IFI cases as one Candida parapsilosis strain and one Laurent cryptococcus strain were both isolated from one patient.The most prevalent three pathogens were Candida albicans [51.5％ (53/103)],Candidaparapsilosis [24.3％ (25/103)] and Candida glabrata [8.7％ (9/103)].The isolated rates of Candida albicans and Candida glabrata strains in the latter period were higher than those in the former period [63.3％ (31/49) vs 40.7％ (22/54),x2=5.218;18.4％ (9/49) vs 0.0％ (0/54),x2=10.868],while the isolated rate of Candida parapsilosis strain was lower in the latter period than that in the former period [12.2％(6/49) vs 35.2％(19/54),x2=7.355] (all P＜0.05).All pathogen strains were sensitive strains except one Candida krusei strain which was isolated in the former period and was resistant to Fluconazole.Conclusions Premature infants born at lower gestational ages or with low birth weights are still at high-risk of IFI,but the incidence of IFI has declined in recent years.Routine administration of fluconazole in high-risk infants in NICU could prevente IFI without increasing drug resistance.Candida albicans is the predominant pathogen ofIFI.

Objective To investigate the effect of mesenchymal stem cells (MSCs) on subcutaneous xenograft tumors in mice with Lewis lung cancer. Methods MSCs isolated from bone marrow of C57BL/6 mice were made into single cell suspension and were cultured in vitro. The cells of the 4th to 5th passage were used for the subsequent experiments. Fifty six C57BL/6 mice were inoculated subcutaneously with Lewis lung cancer cells, and were grouped into Group D0 (MSCs were given simultaneously with inoculation)and Group D10(MSCs were given 10 d after inoculation). Group D0 included three subgroups (n=8): Group 1 with inoculation of tumor cells, Group 2 with inoculation of tumor cells and MSCs, and Group 3 with inoculation of tumor cells and tail intravenous injection of MSCs. Group D10 included four groups: Group 4 with inoculation of tumor cells and injection of MSCs in tumors, Group 5 with equivalent PBS (the control of Group 4), Group 6 with inoculation of tumor cells and tail intravenous injection of MSCs, and Group 7 with equivalent PBS (the control of Group 6). The time of tumor formation and the volume of tumor were observed and compared among the groups. ResultsIn Group D0, earlier onset of tumor development was observed in Group 2 as compared to Group 1 and Group 3 (P<0.05), while there was no significant difference on the volume of tumor in the three groups (P>0.05). In Group D10, the volume of tumors were larger in Group 4 compared to the control (P<0.05), while there was no significant difference on the volume of tumors between Group 6 and the control (P>0.05). Conclusion Inoculating mixture of MSCs and Lewis lung cancer cells accelerates tumor formation,and injection of MSCs in tumors stimulates the growth of tumors.