Objective To investigate the clinical effect of laparoscopic inguinal hernia repair in the treatment of elderly patients with inguinal hernia.Methods The clinical data of 80 elderly patients with inguinal hernia in the Second People＇s Hospital of Yuyao from November 2011 to October 2014 were analyzed retrospectively and divided into two groups according to the different operative methods.The laparoscopic group(47 cases) was treated with laparoscopic inguinal hernia repair,33 cases of the traditional group were treated with traditional inguinal hernia repair.The complication rate and recurrence rate were compared between the two groups.Results The intraoperative bleeding of the laparoscopic group[(42.27 ± 8.77) mL] was less than that of the traditional group[(54.24 ± 10.61) mL],the operative time [(44.78 ± 12.45)min],hospitalization time[(7.39 ± 2.52)d] in the laparoscopic group were shorter than those in the traditional group[(55.27 ± 20.61) min,(10.27 ± 3.67) d],the differences were statistically significant(t =5.508, 2.833,4.164,all P<0.05).At 1 d,2 d,5 d after operation,the pain scores of the laparoscopic group were lower than those of the traditional group(all P<0.05).The incidence rate of complications and recurrence rate in the laparoscopic group were 4.26% ,2.13% ,respectively,which were lower than those in the traditional group(33.33% ,18.18% ) (χ2 =12.045,6.258,all P<0.05).Conclusion For elderly patients with inguinal hernia,laparoscopic inguinal hernia repair treatment is significantly better than traditional inguinal hernia repair,the recurrence rate is lower.

Objective To investigate the clinical effect of laparoscopic inguinal hernia repair in the treatment of elderly patients with inguinal hernia. Methods The clinical data of 80 elderly patients with inguinal hernia in the Second People's Hospital of Yuyao from November 2011 to October 2014 were analyzed retrospectively and divided into two groups according to the different operative methods. The laparoscopic group(47 cases) was treated with laparoscopic inguinal hernia repair,33 cases of the traditional group were treated with traditional inguinal hernia repair. The complication rate and recurrence rate were compared between the two groups. Results The intraoperative bleeding of the laparoscopic group[(42. 27 ± 8. 77) mL] was less than that of the traditional group[(54. 24 ± 10. 61) mL],the operative time [(44. 78 ± 12. 45)min],hospitalization time[(7. 39 ± 2. 52)d] in the laparoscopic group were shorter than those in the traditional group[(55. 27 ± 20. 61)min,(10. 27 ± 3. 67)d],the differences were statistically significant(t = 5. 508, 2. 833,4. 164,all P < 0. 05). At 1 d,2 d,5 d after operation,the pain scores of the laparoscopic group were lower than those of the traditional group(all P < 0. 05). The incidence rate of complications and recurrence rate in the laparoscopic group were 4. 26％ ,2. 13％ ,respectively,which were lower than those in the traditional group(33. 33％ ,18. 18％ ) (χ2 = 12. 045,6. 258,all P < 0. 05). Conclusion For elderly patients with inguinal hernia,laparoscopic inguinal hernia repair treatment is significantly better than traditional inguinal hernia repair,the recurrence rate is lower.

Objective To observe the influence of Shenmai injection for the postoperative infection and related serum indexes of patients with breast cancer,in order to provide evidence for the prevention of patients'postoperative infection.Methods 90 patients with breast cancerwere selected as the study object,and all the patients were randomly divided into control group(conventional postoperative treatment group)45 cases and observation group (conventional treatment and Shenmai injection group)45 cases,then the postoperative infection rates,inflammatory indexes and immune indexes before the treatment and after the treatment at different time were compared .Results The total postoperative infection rate of observation group was one case (2.22%),and it had no obviously difference compared with four cases (8.89%) of control group,the inflammatory indexes including PCT, TNF-α, IL-6 and hs-CRP at first,third and seventh day after the treatment were all lower than those of control group ,the immune indexes including CD3 +、CD4 +、CD8 +及 CD3 +CD4 +were all better than those of control group ( all P<0.05 ) .Conclusion The Shenmai injection can effectively control the postoperative infection rate of patients with breast cancer,and it also plays active improvement role for the infection related indexes.

Objective To investigate the significance of glomerular deposition of C4d in accessing the severity and prognosis of IgA nephropathy. Methods A total of 131 patients were recruited for the study. Immunofluorescence was used to detect the deposition of C4d in renal tissue of pa?tients with IgA nephropathy,and the relationship between C4d deposition and clinical and pathological parameters and renal remission was ana?lyzed. Results Totally 30 patients had glomerular deposition of C4d. Compared with the patients without C4d deposition,the patients with C4d deposition had significantly higher levels of serum creatinine,urinary protein excretion and C4d and higher prevalence of hypertension,but had sig?nificantly decreased levels of glomerular filtration rates. With the histopathological phenotypes segregated by Lee 's classification,the ratios of C4d deposition presented an increase(P=0.005). The patients with C4d deposition had more severe mesangial proliferation,endocapillary hypercellu?larity,segmental glomerulosclerosis and tubular?interstitial injury. The rates of renal remission were significantly lower in IgA nephropathy patients with C4d deposition than those without C4d deposition(P<0.001). Conclusion IgA nephropathy patients with C4d deposition have more se?vere clinical and pathological manifestations and lower rate of renal remission. Glomerular C4d deposition is expected to be an important pathologi?cal prognostic factor for predicting the prognosis of IgA nephropathy.

Objective To investigate the prevalence of hyperuricemia in health check-up population of Beijing suburb.Methods Total 1 336 rural residents in Nankou Township of Beijing received health check-up from July to Aug 2014,including 686 subjects aged 20-59 years (young/middle-aged group) and 650 subjects aged 60-96 years (elderly group).The blood pressure and body mass index (BMI) were measured;serum uric acid (SUA),fasting blood glucose (FBG) and blood lipids (TG,TC,HDL-C,LDL-C) were determined.The SUA levels ＞ 420 μmol/L for male and ＞ 360 μmol/L for female were defined as hyperuricemia.Results The four quartiles of SUA levels were 27.00-254.59 μmol/L (Q1),254.60-302.35 μmol/L (Q2),302.36-359.78 μmol/L(Q3) and 359.79-702.0 μmol/L (Q4).The prevalence of hyperuricemia was significantly higher in young/middle-aged group than that in elderly group [20.41％ (140/686) vs.13.85％ (90/650),x2 =10.08,P =0.001 5],the systolic blood pressure [SBP,(126.8±15.7) vs.(116.7±12.0)mmHg(1 mmHg=0.133 kPa),t=2.76,P=0.008],FBG [(7.40±4.10) vs.(6.11 ±2.03)mmol/L,t=2.12,P=0.036],TC [(5.52±1.10) vs.(5.23±1.00)mmol/L,t =2.04,P =0.045],LDL-C [(3.5 ±0.7) vs.(2.4 ±0.9)mmol/L,t =2.21,P =0.029]in young/middle-aged group were significantly higher than those in elderly group.BMI,FBG were significantly higher in Q4 than those in other quartiles [BMI:(26.44 ± 3.88) vs.(24.19 ± 3.37),(25.49±3.42) and (25.61 ±3.49)kg/m2,t =2.78,P=0.008;FBG:(8.19 ±1.52) vs.(6.34±1.34),(6.09 ± 1.51) and (6.40 ± 1.98) mmol/L,t =2.80,P =0.007].The triglyceride (TG) levels in group Q3 and Q4 [(1.85 ± 0.90) and (1.92 ± 0.44) mmol/L] were higher than those in Q1 and Q2 [(1.37 ±0.76) and (1.70 ±0.84) mmol/L,t =2.1,P =0.035].Only 9.57％ subjects (22/230)with hyperuricemia was not combined with metabolic disorder;subjects combined with one and two metabolic disorders accounted for 20.87％ (48/230) and 69.57％ (160/230),respectively.Conclusion Screening for hyperuricemia is important for comprehensiye treatment and management of hyperuricemia in rural residents,especially in the young and middle-aged population.

Objective To investigate Paragonimus westermani infection in the intermediate hosts and animal reservoivs in Jiangxi Province. \ Methods\ Two forest farms in Jingan and Wanzai Counties and one town in Yushan County of Jiangxi Province were selected as pilots for epidemiological and retrospective survey. The intermediate hosts (snails, crabs) and reservoir hosts(cat, dog, civet cat, wildcat, etc.) were collected and examined. Data on the changes of ecological environment and people's behaviors were also collected. \ Results \ The average infection rate in Semisulcospira libertina and Sinopotamon spp. was 0\^21% and 54\^3% respectively, and that of reservoir hosts was 5\^6%. Compared with those in 20 years ago, the infection rate in Sinopotamon spp. decreased considerably. \{Conclusion\}\ The three areas are still endemic for P.westermani with lower prevalence than before possibly due to the change of ecological environment.

Local medical college is the mainstream of altitude medical college education in our country.Facing furious competition,we must make a reasonable orientation,construct the characteristics of running school,establish scientific concept,construct specific subject and specialty and make an all-around development in order to walk up to national stage by depending on powerful unity,serve the regional economy and social development,and form a new situation of two patterns by converting single medical colleges to all-around college and remaining the existing single medical college.

Although immunoglobulin A (IgA) nephropathy (IgAN) is considered as an immune-mediated inflammatory disease,the pathogenesis and mechanisms associated with its progression have not been completely understood.To date,the potential pathogenesis of IgAN is thought to be a possible increase of galactose-deficient IgA1,followed by binding to antiglycan antibodies to form immune complexes,which are deposited in the glomerular mesangium and lead to the activation of complement pathways and initiation of immune-mediated inflammation.Activation of alternative and lectin complement pathways,complement components,and complement regulatory proteins play important roles in the pathogenesis and progression of IgAN.Complement components and complement regulatory factors in the renal tissue,urine,and serum samples are considered to be useful predictive biomarkers to evaluate the activation of the complement system and determine the prognosis of IgAN.The application of novel techniques such as the genome-wide association study would promote further research to determine the role and mechanisms of action of the complement system,whereby it could be used as a new therapeutic target for the management of IgAN.

OBJECTIVETo explore the correlation of the position and height of the examination couch with the accuracy of image registration in an exact effective field of vision (FOV) of single photon emission computed tomography/computed tomography (SPECT/CT) and determine the optimal position of the examination couch for best image registration.

METHODSThe tests were performed on a SPECT/CT with 6 radioactive (153)Gd sources in 3 groups (two in each group with energy peak of 40.9 Kev, 41.54 Kev, and 103.18 Kev) in an assorted standard pattern. Thirteen groups of slice data were obtained by changing the position and height of the bed but keeping the tomograpy slice constant. The bias of the accuracy of image registration was acquired using ALIGNMENT software and compared for different examination couch positions and heights.

RESULTSThe position of the examination couch at 0 cm in the Z axis and -4 cm in the Y axis showed the least error of image registration.

CONCLUSIONTo achieve optimal SPECT and CT image fusion, quality control must be implemented and calibration of image registration accuracy should be done when necessary.

Objective:To examine the expression of human leukocyte antigen G (HLA-G) in the peripheral blood and cancerous tissues of patients with papillary thyroid carcinoma (PTC) .Methods:The expression of soluble HLA-G (sHLA-G) in the peripheral blood of 50 individuals with PTC (PTC group) , 25 patients with benign thyroid tumors (BTT group) from Department of Thyroid and Breast Surgery, Beilun branch of the First Affiliated Hospital of Zhejiang University and 20 healthy controls (healthy control group) from physical examination center was assessed by ELISA. Immunohistochemical examination of HLA-G levels was also performed on tissue specimens from patients in the PTC and BTT groups, and their correlation with clinicopathological features of thyroid cancer was analyzed. SPSS 19.0 was used for statistical analysis. The measurement data of normal distribution were tested by two independent samples t test. Chi square test was used to compare the rates between the two groups. Results:The sHLA-G expression in peripheral blood was 21.33 (±5.54) , 22.73 (±4.99) , and 18.29 (±4.43) ng/mL in the preoperative PTC, BTT, and healthy control groups, respectively. Compared to the healthy group, sHLA-G levels were considerably higher in the PTC and BTT groups, with statistically significant differences (totally P < 0.05) . There was no significant difference in statistically sHLA-G levels between the BTT and PTC groups ( P > 0.05) . The positive HLA-G expression rate in PTC tissues was 78% (39/50) . There was no evidence of HLA-G expression in common tissues adjacent to PTC. HLA-G was not expressed in benign tumors. HLA-G was linked with the PTC tumor diameter, and the rate of positive expression was considerably greater with tumor diameters >1 cm than with those ≤1 cm ( P<0.05) . The rate of HLA-G positive expression was not significantly correlated with sex, age, multiple foci, extra-glandular invasion, metastasis of lymph nodes, or the TNM stage in PTC individuals ( P > 0.05) . Conclusions:HLA-G is significantly expressed at high levels in PTC tissues, is correlated with the tumor diameter, and may probably have a significant role in this disease. Peripheral blood sHLA-G may be associated with thyroid tumorigenesis, and its value in PTC requires further verification.