The epidemiology of inguinal hernia,the mesh's side effects on the spermatic cord,the spermatic cord blood vessels,the was deferens and the testicular in inguinal hernia hemiorrhaphy of tension-free were reviewed.The effects of the inguinal hernia herniorrhaphy and the mesh in clinical and animal experiments which affected on the male reproductive function such as the location.extent and pathological changeswere summarized,and the mechanism of the tension-free inguinal herniorrhaphy affecting the male reproducrive function were discussed.Improvingthe operation skills and the more appropriate choice of the mesh may protect the male reproductive function in tension-free inguinal hernia hemiorrhaphy.

Objective To investigate the clinical diagnosis and treatment strategies for retroperitoneal paragangliomas and to enhance the diag?nostic and therapeutic levels of retroperitoneal paragangliomas. Methods The clinical data of 49 patients having retroperitoneal paragangliomas were retrospectively analyzed. We studied 21 males and 28 females between an age range 17 and 72 years(mean 45.6 years). Hypertension was observed in 19 patients,9 patients suffered from lumbago or abdominal pain,and an abdominal mass was noted in 2 cases. Physical examination re?vealed paragangliomas in 17 patients. The positive rate of localization was 77.5%(31/40),96.0%(47/49),and 100%(10/10)using B?ultra?sound,computed tomography,and MRI respectively. Serum catecholamines were measured in 19 patients,of which 16 cases(84.2%)showed ele?vated levels. Results In our study,49 patients underwent open surgery,5 patients showed multiple tumors,and 56 tumors were found during sur?gery. The most common tumor location was periaortic and pericaval(71.4%,40/56). There were 51 cases of surgery in 49 patients. 54 tumors of 49 cases were totally resected. The tumors measured 1.5?20.0 cm in diameter with a mean diameter 6.7 cm. 75%tumors had integral pelos,14.2%(8/56)invaded the surrounding organs and vessels,and 10.7%(6/56)required resection of adjacent organs. We followed up 43 patients between 6 and 138 months after surgery. Postsurgical recurrence was noted in 4 patients,and 2 patients developed metastases. One patient died from metas?tasis during the follow?up period. Conclusion Surgical resection might be the most effective method for treatment of retroperitoneal paraganglio?mas. Sufficient preoperative and perioperative management might be the key point of successful surgery. Lifelong follow?up is important as recur?rent tumors need resection.

Objective To evaluate the clinical value of 64-slice spiral computed tomography combined with hs-CRP and MMP-9 to detect the vulnerable plaque of acute coronary syndrome.Methods Seventy-two patients with coronary heart disease were included and among them,43 patients were diagnosed as ACS and the other 29 patients diagnosed as stable angina group(SAP).All patients underwent 64-slice spiral computed tomography coronary artery imaging and examination of plasma hs-CRP and MMP-9 concentration.All patients underwent selective coronary angiography.Another 25 cases who underwent coronary angiography were included in the control group.Results The incidence of soft plaque was higher in the ACS group than in the SAP group(24 cases vs 4 cases,P=0.001).Compared with the control group,levels of hs-CRP and MMP-9 in the ACS group and the SAP group were both significantly higher(all P

Purpose: To observe the efficacy of combined chemotherapy of navelbine( NVB) and cisplatin ( DDP) plus concurrent palliative local radiotherapy in the treatment of stage M, nasopharngeal carcinoma( NPC). Methods: 21 cases of stage M, NPC received combined chemotherapy of NVB 25 mg/m2 on dl, d8 and DDP 30 mg/m2 on day 1-3. The therapy was repeated every 28 days. All patients were concurrenly treated with palliative radiotherapy for to the distant metastases areas. The radiotherapy dose varied from 15 to 60 Gy. Results: 1.The 1-, 2- and 3- year survival rates of the patients were 71.43%, 14.29% and 9.25% respectively. The median survival time ( MST) was 17 months. 2.The Cox Regression analysis showed that the effect of treatment and the liver invasion are significant prognostic factors. The survival rate is the highest in the patients with lung metastases. Conclusions: This scheme combined chemotherapy of NVB and DDP plus concurrent palliative local radiotherapy can improve the MST of the patients with stage M1 of NPC.

Objective To investigate the effect of Qingjing Capsule (QC) in treating advance menorrhea (AM) and to evaluate its safety. Methods Double- blind, double- imitating, parallel- controlled and randomized trial was performed in 63 cases of AM with deficiency- heat syndrome.Thirty- two cases was in QC group(Group A) and other 31 in Gujing pill group(Group B).The menstrual cycle, clinical symptoms and signs, basal body temperature (BBT), serum levels of estradiol (E2) and progesterone and endometrium biopsy were observed to evaluate the effects of QC. Results The short- term markedly- effective rate was 90.63% and 77.42% and the short- term effective rate was 96.88% and 93.55% in Group A and Group B respectively. The long- term markedly- effective rate was 83.87% and 67.74% and the long- term effective rate was 93.55% and 80.65% in Group A and Group B respectively. The long- term markedly- effective rate in QC group is superior to that in Gujing pill group, the differences being significant(P

Platelet play an important role in cerebral ischemial nerve injury. Aspirin (ASA) had been used to treat and prevent stroke in clinic. 30 rabbits were randomly divided into A, B and C groups. In group A ASA was given orally at a daily dosage of 15 mg/kg per rabbit for 5 days before cerebral ischemia; group B cerebral ischemia without giving ASA, and group C was normal rabbits as controls. The cerebral ischemial model was produced by occluding bilateral carotid arteries and bleeding from femoral artery. The results indicated that there was an obvious decrease of PAgT and TXA_2 and had no significance changes in free radicals increasing and Ca~(2+) rising from cerebral tissue in group A. The cerebral edema of group A was less severe than group B. It seemed that ASA had a protective effect on the nerve injury of cerebral ischemia. The derangement of ASA, platelet, free radicals and calcium ions interrelation and their significance on the nerve injury should be further studied.

Objective To compare the application of Goldman , CARPREG and ZAHARA in predicting cardiac outcomes in pregnant women with congenital heart disease. Methods A retrospective analysis of 144 pregnant women with CHD , enrolled in The Third Affiliated Hospital of Guangzhou Medical University between Jan 1992 and June 2015 was conducted. The mortality and the incidence of cardiac events were counted by three risk estimation methods. The sensitivity and calibration of three systems were compared by using Hosmer-Lemeshow goodness of-fit analysis and Aera Under Curve (AUC). Results In terms of mortality rates, the sensitivity of CARPREG was higher than that of Goldman (AUC:0.874 and 0.889 respectively;P = 0.568 >0.05);. In terms of the incidence of cardiac events, the sensitivity of ZAHARA was higher than that of Goldman (AUC:0.912 and 0.773 respectively;P = 0.063 > 0.05); Conclusions All 3 risk estimation methods have good performance in sensitivity of predicting the incidence of cardiac events and mortality in pregnant women with CHD. The ZAHARA has a better calibration in predicting the incidence of cardiac events , and we recommend ZAHARA as the first choice of evaluation system for this kind of patients.

Objective To observe the effect of ambroxol on the structure of Pseudomonas aeruginosa biofilm (BF) in an established biofilm model in vitro. Method Mature BF was formed after 7 days′ culture of Pseudomonas aeruginosa on plate. The BF structure was observed by scanning electron microscope (SEM). The parameters of BF structure were analyzed though pictures from confocal laser scanning microscopy (CLSM) with Image Structure Analyzer (ISA) software. Fluorescence intensity of the viable bacteria in BF treated by ambroxol alone and together with ciprofloxacin were determined with fluorescence microscopy. Results After the treatment of ambroxol, the BF was destroyed and the matrix outsides became thin and abnormal compared with the control by SEM, and small amount of bacteria dispersed. The results of ISA showed that with the treatment of 2 mg/ml ambroxol, BF was decreased in thickness, average diffusion distance (ADD) and textual entropy (TE) were decreased in comparison with the group without ambroxol treatment (P

Objective:To report the diagnosis and surgical treatment of a special type of Maisonneuve injury.Methods:A total of 4 patients were treated at Department of Orthopaedics, Beijing Chao Yang Hospital from January 2015 to July 2019 for Maisonneuve injury. They were 3 males and one female, aged from 34 to 61 years (average, 45.3 years). All injuries were closed, initially manifested as posterior dislocation of the ankle on X-ray films and X-ray and CT re-exams after manual reduction showed fine reduction with no obvious fracture of the ankle joint. Consequently the diagnosis of their Maisonneuve injury was missed in emergency visits, but re-exams in outpatient visits showed separation of distal tibiofibular syndesmosis. All the patients were treated by restoration of the fibular length, fixation of the distal tibiofibular syndesmosis and repair of the triangular ligament. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to evaluate functional recovery of the ankle joint at 12 months after operation.Results:All the 4 patients were followed up for 12 to 14 months (average, 12.7 months). The fractures united after 110 to 185 days (average, 149.3 days). No post-operative complications like infection, delayed union or nonunion were observed. The AOFAS score at 12 months ranged from 82 to 96 points (average, 90.5 points), giving 3 excellent and one good cases.Conclusions:The Maisonneuve injury which is clinically manifested as posterior dislocation of the ankle with no obvious fracture of the ankle joint is likely to be missed in clinical diagnosis. Therefore, X-ray exam of the full length tibia and fibula should be taken in physical examination after reduction for the patients with simple posterior dislocation of the ankle. Once the special type of Maisonneuve injury is diagnosed, surgical treatment is indicated. Satisfactory treatment efficacy can be achieved by fixation of the distal tibiofibular syndesmosis and repair of the triangular ligament.

Objective To evaluate the precision and uncertainty and comparison analysis of 6 items blood lipids index among 5 different Beckman AU biochemical testing systems ,such as triglyceride(TG) ,total cholesterol(TCHO) ,high density lipoprotein cholesterol(HDL‐C) ,low density lipoprotein cholesterol(LDL‐C) ,apolipoproteins A1(APOA1) ,apolipoproteins B(APOB) .Meth‐ods According to the document the EP15‐A2 of national Committee for Clinical Laboratory Standards ,6 items blood lipids index were respectively detected by 5 different Beckman AU biochemical testing systems to obtain precision and comparison .The intra‐and inter‐precision and results of comparability among different system were low than 1/4 or 1/3 or 1/2 CLIA′88 as evaluation standard ,respectively .The measurement uncertainty of these items were evaluated by the calibrator uncertainty and internal quality control and external quality control .Results The intra‐and inter‐or day‐to‐day precision and relative bias were accepted by clinical requirements .The expanded measurement uncertainty for TG was 0 .079 mmol/L and 0 .035mmol/L .The expanded measurement uncertainty for TCHO was 0 .248 mmol/L and 0 .157 mmol/L .The expanded measurement uncertainty for HDL‐C was 0 .144 mmol/L and 0 .018 mmol/L .The expanded measurement uncertainty for LDL‐C was 0 .140 mmol/L and 0 .186 mmol/L .The ex‐panded measurement uncertainty for APOA1 was 0 .148 mmol/L and 0 .090 mmol/L .The expanded measurement uncertainty for APOB was 0 .104 mmol/L and 0 .058 mmol/L .Conclusion The results of 6 items blood lipids index respectively show well preci‐sion and significantly correlation among 5 different Beckman AU biochemical testing systems and the results were comparable ,and the influence factor of detection results were expression directly by evaluating the measurement uncertainty of 6 items blood lipids index .This way of assessment is simple .