Objective To explore the causes and managements of peritoneal laceration in the laparoscopic totally extraperitoneal (TEP) hernia repair during learning curve.Methods The retrospective cross-sectional study was conducted.The clinical data of 120 patients with inguinal hernia who underwent laparoscopic TEP hernia repair in the Third Affiliated Hospital of Anhui Medical University (98 patients) and Anhui Provincial Hospital (22 patients) during surgeons' learning curve between February 2012 and January 2017 were collected.Patients underwent laparoscopic TEP hernia repair,meshes were intraoperatively placed and then fixed by medical glue.Observation indicators:(1) intraoperative situations:surgical procedure,operation time,using of mesh,intraoperative peritoneal laceration;(2) postoperative situations:time to anal exsufflation,time for fluid diet intake,occurrence of complications,duration of hospital stay;(3) follow-up:number of patients receiving follow-up,follow-up time,recurrence of hernia during follow-up,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain,incisional infection.Follow-up using outpatient examination and telephone interview within 10 days postoperatively and using telephone interview at 10 days postoperatively was performed to detect the recurrence of inguinal hernia,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain and incisional infection up to May 2017.Measurement data with normal distribution were represented as （x）±s.Results (1) Intraoperative situations:of 120 patients,112 underwent laparoscopic TEP hernia repair,5 converted to laparoscopic transabdominal preperitoneal hernia repair and 3 converted to open surgery due to adhesion between hernial sac and surrounding tissues induced bleeding of separation.Total operation time of 120 patients was (71 ± 13) minutes,including (63± 7) minutes in 106 patients with unilateral hernia and (79 ± 11)minutes in 14 patients with bilateral hernia.All the patients used intraoperatively meshes of 10.0 cm×15.0 cm and 16.0 cm× 10.8 cm.Forty-eight patients had intraoperative peritoneal laceration,peritoneal laceration occurred for reconstruction of preperitoneal space in 10 patients,separation of anterolateral preperitoneal space in 11 patients and improperly operating equipment or hernial sac in 27 patients.Of 48 patients with peritoneal laceration,40 continued to finish operation through acupuncturing into the abdominal cavity for exsufflation and then received peritoneal suture and repair,including 5 with recurrence of indirect inguinal hernia (receiving tissue repair) undergoing peritoneal repair through opening hernial sac,and 8 intraoperatively converted to other or open surgery.(2) Postoperative situations:time to anal exsufflation and time for fluid diet intake in 120 patients were (18± 4) hours and (15±6) hours.Of 120 patients,14 had postoperative complications,scrotal emphysema of 6 patients disappeared in 24 hours anti inguinal and scrotal seroma of 8 patients disappeared after puncture treatment.All the patients were discharged from hospital in 2 days postoperatively.(3) Follow-up:112 of 120 patients were followed up for 3-65 months,with a median time of 31 months.During follow-up,there was no occurrence of recurrence of hernia,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain and incisional infection.Conclusion During surgeons' learning curve,identifying anatomy of the groin clearly,a right way to treat the hernia sac and broken peritoneum in the operation can ensure the smooth completion of the laparoscopic TEP hernia repair.

Objective To evaluate the efficacy and safety of tiotropium bromide in treating stable mild and moderate chronic obstructive pulmonary diseases. Methods A randomized,double-blind,parallel comparison clinical trial was conducted in 40 patients with COPD. Twenty patients in tiotropium bromide group were treated by tiotropium bromide powder,and another twenty patients in controll group were given ipratropium,in contrast. The spirometry of both groups was conducted. 4 weeks after treatment. Results The forced expiratory volume in one second ( FEV1 ) and forced vital capacity(FVC) in two groups were significantly increased after treatment( P<0.01 ). The increase of FEV1 in tiotropium bromide group was higher than that in controll group after 4-week. There was no significant differ-ence in rescue medication consumptions. The incidence of adverse effects has no statistical difference between two groups. Conclusion Tiotropium bromide is an effective and safe bronchodilator in treating patients with COPD.

AIM To investigate the effects of Tea Po lyp henols on induction of apoptosis in human liver cancer cell etc. Telomerase acti vity of BEL-7404 cells was dramatically declined during the cell incuba tion with Tea Polyphenols. METHODS MTT colorimetric assay and trypan b lue exclusion method were used to examine the growth inhibition ofTea Polyphenols on BEL-7404 cells. Telomerase activity in cell was determined by PCR-ELISA method. Cell morphology and DNA gel electrophoresis were used to observe the apoptosis. RESULTS The solution of Tea Polyphenols showed dose-dependent and time-dependent inh ibitory effects on the proliferation on BEL-7404 cell line. After treatment wit h 0 2 and 0 1 g?L -1 tea polyphenols for 48 hours, cells displayed DNA ladder bands and typical morphological change of apoptosis included: ce ll shrinkage, membrane blebbing, chromatin condensation, nuclear fragmentation etc. Telomerase activit y of BEL-7404 cells was dramatically declined during the cell incubation with Tea Polyphenols. CONCLUSION Tea Polyphenols has growth inhibiti ng effect and may induce apoptosis in BEL-7404 in a certain dose range. The ant icancer mechanism of Tea Polyphenols might be related to the inhibition of telom erase activity.

Object To study the chemical constituents from the whole plant of Swertia przewalskii Pissjauk Methods The constituents were isolated on silica gel column chromatography and their structures were identified by spectral and chemical analysis Results Fifteen compounds were isolated and identified as 1, 7 dihydroxyl 3, 8 dimethoxyxanthone (Ⅰ), 1, 8 dihydroxyl 3, 7 dimethoxyxanthone (Ⅱ), 1, 7, 8 trihydroxyl 3 methoxyxanthone (Ⅲ), 1, 3, 7, 8 tetrahydroxyxanthone (Ⅳ), 1 O ? D glucopyranosyl 7 hydroxyl 3, 8 dimethoxyxanthone (Ⅴ), 1 O ? D glucopyranosyl 8 hydroxyl 3, 7 dime thoxyxanthone (Ⅵ), 7 O ? D glucopyranosyl 1, 8 dihydroxyl 3 methoxyxanthone (Ⅶ), 1 O D xylo pyranosyl (1→6) ? D glucopranosyl] 7 hydroxyl 3, 8 dimethoxyxanthone (Ⅷ), 1 7 hydroxyl 3, 8 dimethoxyxanthone (Ⅷ), 1 O D xylopyranos yl (1→6) ? D glucopytanosyl] 8 hydroxyl 3, 7 dimethoxyxanthone (Ⅸ), 8 8 hydroxyl 3, 7 dimethoxyxanthone (Ⅸ), 8 O D xylopyanosyl (1→6) ? D glucopyranosyl] 1, 7 dihydroxyl 3 methoxyxanthone (Ⅹ), luteolin (Ⅺ),? sitosterol ( Ⅹ 1, 7 dihydroxyl 3 methoxyxanthone (Ⅹ), luteolin (Ⅺ),? sitosterol ( ⅩⅡ ), oleanolic acid ( ⅩⅢ ), ursolic acid ( ⅩⅣ ) and getiopicroside ( ⅩⅤ ), respectively Conclusion Compounds Ⅳ～Ⅷ, Ⅺ, ⅩⅡ , ⅩⅣ and ⅩⅤ were obtained from this plant for the first time

OBJECTIVE To investigate the relationship among hepatitis B virus(HBV) basic core promoter(BCP) mutation,serum HBV DNA contents and HBV markers as well as liver function of chronic hepatitis B patients.METHODS The A to T mutation at nucleotide 1762 and G to A mutation at nucleotide 1764 were determined by the method of polymerase chain reaction(PCR) microplate hybridization ELISA in 176 patients with chronic hepatitis B virus infection.RESULTS The rate of HBV BCP mutants in negative and positive groups of HBeAg was 49.4% and 33.3%,respectively(P

Objective To develop a suit of rapidly-fixed evacuation stretcher for safe and convenient transportation of the wounded. Methods By making use of the expansion-shaping property of a bubble-shaped material produced by the chemical reaction of two kinds of Macromolecule materials, and the restrictive effect of body shape matching cotton fabric fixation-bag, a new type of stretcher was developed. Results It was proved by the maneuver and all kinds of traffic accidents that the field stretcher could provide dependable safeguard for the wounded, and the effect was very well. It was suitable to carry out the second or the third treatment and other transportation schemes. Conclusion This new type of field stretcher is light, portable and easily-operated, and besides, it can be used repeatedly.

The development of orthopedic fixing materials is a most basic and active aspect in orthopedic injury treatment.Their invention and application of early manual splints,gypsum bangs,hot-shaped splints,polymeric bangs and so on,greatly promoted orthopedic fixing performance and varied the strategies of orthopedic injury treatment.By repeated experiments and clinical trials,we developed a new orthopedic fixing material using polymeric materials.Convenient to operate,easy to remove,auto-shaped,X ray transmittable,water proof and durable,it not only satisfies the needs of fixing different parts of the body,but also remedies the defects of earlier fixing materials,and therefore has gained an extensive application as the best fixing material for the treatment of clinical and battle-field bone fractures.Further studies on it will surely better its properties,reduce its cost and lead it to a wider application.

ObjectiveTo investigate the prevalence of 15 skin diseases in adolescents from Liangshan prefecture in Sichuan Province.Methods A stratified cluster random sampling method was used to select subjects.Adolescents from 2 urban and 3 rural middle schools were investigated,who were required to fulfill self-report questionnaires and received physical examinations by doctors.ResultsA total of 7747 adolescents aged from 12 to 20(15.86 ± 1.86) years were included in the investigation,and skin diseases were present in 6379 adolescents,with a total incidence of 82.34％.In average,each subject suffered from 1.3372 ± 0.96861 skin diseases.Of the adolescents,4698(60.64％) had acne,2219(28.64％) freckle,966(12.47％) lichen pilaris,792(10.22％) eczema or dermatitis,511(6.60％) urticaria,195(2.52％) papular urticaria,37 (0.48％) vitiligo,55 (0.71％) psoriasis,166 (2.14％) verruca vulgaris,168 (2.17％) flat wart,317 (4.09％) tinea manus and pedis,142 (1.83％) tinea corporis,62 (0.80％) chloasma,26 (0.34％) nevus flammeus,15 (0.19％) nevus of ota.Male adolescents showed a higher incidence of acne(63.91％ vs.58.50％),but a lower incidence of eczema,lichen pilaris,freckle,chloasma and psoriasis compared with female adolescents.The incidence of acne,vitiligo,psoriasis and melasma were higher,while that of freckele was lower(25.93％ vs.29.58％ ) in Yi adolescents than in Han adolescents.Increased incidence of acne and papular urticaria and decreased prevalence of urticaria,freckle,melasma and lichen pilaris were observed in urban adolescents compared with rural adolescents.ConclusionsThe prevalence of skin diseases is high in adolescents from Liangshan prefecture.Of these 15 skin diseases,acne,freckle,lichen pilaris,eczema and urticaria are the 5 most common diseases in the area.Differences exist in the incidence of skin diseases between male and female,Han and Yi,urban and rural,adolescents.

Objective To study the characteristics of neonatal sepsis caused by gram positive (G +) bacteria,gram negative (G+) bacteria and fungi.Method Clinical data of 202 neonates with sepsis hospitalized from Jan.2012 to May.2015 were studied.According to the different pathogens,202 neonates were divided into gram positive bacteria group,gram negative bacteria group and fungi group.The general information,clinical manifestation,laboratory examination and treatment outcome of the three groups were analysed with Chi square analysis,LSD,Fisher exact probability tests.Result A total of 202 cases of neonatal sepsis were recruited.The detection rate of gram positive bacteria,gram negative bacteria and fungi was 35.2％ (71 cases),56.4％ (114 cases) and 8.4％ (17 cases),respectively.Comparing with gram negative group and fungi group,gram positive group had older gestational age (36.0 ± 3.8 w,compared with gram negative 33.0 ± 3.9 w,fungi group 31.2 ± 3.2 w,P ＜ 0.05),larger birth weight (2 620 ± 925 g compared with gram negative group 1 999 ± 849 g,fungi group 1 595 ± 666 g,P ＜ 0.05),lower nosocomial infection rate (29.6％ compared with gram negative group 70.2％,fungi group 94.1％,P ＜0.05),lower rate of shock,blood glucose disturbance and thrombocytopenia (P ＜ 0.05).There was no statistics difference between the gram negative group and fungi group.Comparing with the other two groups,fungi group was older [20.0 (11.5,39.5) d compared with gram positive group 7.0 (2.0,17.0) d,and gram negative 10.0 (6.0,18.2) d,P ＜ 0.05].The rate of deep venous catheterization in fungi group was higher than that in gram positive group and gram negative group (88.2％ compared with gram positive group 25.4％,gram negative group 40.4％,P ＜0.05).The treatment course of fungi group was longer than that of the gram positive group and gram negative group [22.0 (12.0,37.5) d compared with the gram positive group 14.0 (10.0,17.0) d,gram negative group 14.0 (11.0,18.0) d,P ＜0.05].The incidence of apnea in the gram negative group was higher than that in gram positive group and fungi group (P ＜ 0.05).The rate of leukocytosis,leukocytopenia and elevated CRP were higher in gram negative and gram positive group (P ＜ 0.05).Conclusion The clinical manifestations and laboratory examinations in neonatal sepsis caused by different pathogens were different,which can help to early identification of different pathogenic infections.However,there is no specific indicators to differentiate neonatal sepsis caused by different pathogens.Early identification of the pathogen needs clinical acumen.