Objective To discuss curative effects of tension-free herniorrhaphy for phrase I and traditional herniorrhaphy on the treatment of incarcerated hernia.Methods 84 cases with incarcerated hernia were selected and divided into the observation group ( n=42 ) and control group ( n=42 ) by random number table, who were given tension-free herniorrhaphy for phrase I and traditional herniorrhaphy respectively.The operation time, amount of bleeding,out-of-bed activity time,analgesic rate and length of stay ( LOS) after the operation,and complication and reoccurrence rates during and after the medical treatment were observed and compared.Results The operation time, out-of-bed activity time,analgesic rate and length of stay ( LOS) after the operation of patients in the observation group[(45.7 ±10.3) min,(28.7 ±7.5) h,14.29%,(4.13 ±0.97) d] were all much shorter than those in the control group[(53.9 ±11.7)min,(41.5 ±10.3)h,35.71%,(6.07 ±1.04)d](t or χ2 =2.15,2.39,5.14,2.41, P<0.05 or P<0.01).After comparing the amount of bleeding of patients in the two groups during the operation,no obvious statistical differences appeared (P>0.05).3 and 10 cases of complication appeared in the observation group and control group after the operation respectively.The occurrence rate of complication in the observation group after the operation was much lower than that in the control group (χ2 =4.46,P<0.05).Following up for 6 to 67 months, no reoccurrence appeared in the observation group after the operation,while 6 cases of which appeared in the control group.And the postoperative reoccurrence rate of patients in the observation group was much lower than that in the control group (χ2 =4.49,P<0.05).Conclusion Tension-free herniorrhaphy for phrase I has confirmative curative effect on incarcerated hernia,with the following advantages like short operation time and out-of-bed activity time after the operation,low postoperative analgesic rate,short LOS,little complication,low reoccurrence rate and etc,which can gradually take the place of traditional herniorrhaphy and become the first operation method to treat incarcerated hernia with no intestinal necrosis.

Objective To compare the clinical conditions between the diabetics and non-diabetics at their initiation of peritoneal dialysis.Methods Sixty-seven patients aged over 50 years (27 type 2 diabetic and 40 non-diabetic patients) were included in the study.Patients’ residual renal function,nutritional status,comorbidities and physical activity were evaluated.Results Compared with nondiabetic patients,the serum creatinine,albumin and prealbumin levels,hand grip and physical activity were significantly lower and the nutritional status were significantly worse in diabetic patients,whereas the residual renal function and indices of comorbidity were significantly higher in diabetic patients as compared to nondiabetics.Conclusions The time choice for dialysis is combiningly determined by residual renal function,clinical status,comordity and nutritional status.And CAPP should be in time.

BACKGROUND: Mini-screw anchorage is an innovation technique applied in the orthodontic field, expanding the treatment ability of orthodontic appliance. Accurate of mini-screw insertion in the target position is a clinical problem which making orthodontist trouble in this technique application. OBJECTIVE: To introduce a kind of three dimensional guide of mini-screw used as anchorage in orthodontic treatment and to evaluate the positioning accuracy. DESIGN, TIME AND SE'I-rlNG: A contrast study was performed at the Department of Orthodontics, Capital Medical University from April to October 2005. PARTICIPANTS: Twenty cases (40 mini-screws) of maxillary critical anchorage requisition were considered as the experimental group, and 15 cases (30 mini-screws) who were not treated with surgical guide were considered as the control group. METHODS: Self-made stent was used as a positioning guide for implantation of mini-screw anchorage between the roots of upper second bicuspid and first molar. Thereafter, the position was measured. MAIN OUTCOME MEASURES: The vertical distance from measure points to the reference middle line were measured. RESULTS: In 40 mini-screws inserted with the aid of surgical guide, the average survival time of mini-screw as anchorage was 10.3 months, 2 were lost, and the success rate was 95%. The average survival time of 30 mini-screws in the control group was 9 months, 9 were loss, and the success rate was 70%. The positioning measurement showed that deviation of mini-screw was not found in the experimental group, but it was found in the control group. CONCLUSION: By aid of surgical guide splint, mini-scraw can be inserted correctly into the target region.

Objective To study the clinical effect of gonadotropin releasing hormone-analogue (GnRH-a) and marvelon in the treatment of ovarian endometriesis after laparoscopy.Method The postoperative women with ovarian endometriosis were divided into three groups:19 treated with GnRH-a and marvelon(greup A),20 treated with GnRH-a(group B),20 without endocrinal therapy(group C).The symptoms scores,the recurrence and side effects were compared.ResultsThree years after laparescopy,the recurrent rate and symptoms scores in group C was the highest (P＜0.05),the recurrent cyst size [(12 + 1)mm] and symptoms scores [(1.2 + 0.9)scores] in group A was the lowest among three groups.Conclusions Marvelon and GnRH-a can be used in the treatment of ovarian endometriesis after laparoseopy.The effect of marvelon combined with GnRH-a is prior to GnRH-a.

Objective To analyze MRI features and diagnostic value in adenomyosis.Methods Clinical and MRI data of 31 cases of adenomyosis confirmed by pathology were retrospectively analyzed.Turbo FSE T2WI,SE T1WI,and sagittal Turbo FSE T2WI examination were performed in all cases,10 of them were added to anatomic and sagittal fat-suppression(FS) T2WI scan.MR features of adenomyosis were analysed.Results In 19 cases of diffuse uterine adenomyosis,11 cases mainly showed diffusely thichened junctional zone of posterior wall.12 cases were focal uterine adenomyosis,the lesions located at posterior wall in 7 cases,front wall in 4 cases and bottom part in 1 case.28 cases displayed hypointensive masses like the intensity of junctional zone on T2WI and vesicular hyperintensive foci were found within the hypointensive lesions.The lesions in 21 cases were similar to that of myometrium on T1WI,9 of them displayed vesicular hyperintensive foci.Focal round-like junctional zone low signal intensity lesion in myometrial layer was found in 3 cases.Conclusion MRI can clearly determine the size and site of adenomyosis.FS is the valuable examination way.

Objective To explore the MRI findings of Wernicke encephalopathy so that to improve the knowledge of this disease.Methods MRI data of Wernicke encephalopathy in 7 cases were retrospectively analyzed.Results Symmetrical abnormal signal intensity was appeared in bilateral thalamus and the area around the third cerebral ventricle in 6 cases,in the area around aqueduct and pontine in 7 cases and in mammillary body,hypothalamus,fornix and the four cerebal ventricles in 2 cases.Above mentioned lesions showed long T1 and long T2 signal intensity and high signal intensity on fluid-attenuated inversion recovery(FLAIR),and high signal intensity on DWI in 2 cases.The lesions were enhanced in 2 cases and small vessels were radial enhancement around lateral ventricle in 1 case after administration of Gd-DTPA.Conclusion Wernicke encephalopathy has definite MR imaging findings,which is of important value in clinical diagnosis and treatment.

Objective To evaluate the elimination of melasma with nonablative Q-switched Nd : YAG1 064 nm laser. Methods 23 cases of melasma were treated with Q-switched Nd :YAG 1 064 nm laser using the following parameters: spot size, 6 mm; pulse duration, 5-7 ns; frequency, 10 Hz, and flu-ence, 1.8-2. 0 J/cm2. The procedure was repeated weekly. Results The treatment was well tolerated without the use of topical anesthetic. There was slight congestion, no blister and crust after treatment. Routine clean and make-up can be done after treatment. The melasmas were obviously lighten or fully eliminated after 8-10 treatments and 52. 17 % of patients showed excellent results. Only 5 cases experienced an episode of purpura on eyelid after treatment and disappeared spontaneously without post-inflammatory hyperpigmentation and scarring. Followed up over 6 months, there was recurrence in 7 patients who were effective by additional treatment. Conclusions Nonablative Q-switched Nd :YAG 1 064 nm laser is a more ideal method to eliminate melasma because of the credible effect, safe, simple operation, and no downtime, in despite of recurrence.

Objective To study the antithrombotic effect of polysaccharide extracted from Thallus Laminariae(PTP) on rats with endothelial injury.Methods Two kinds of endothelial injured rat models were established by injecting adrenaline and endotoxin.The wet weight of thrombus was evaluated by artery-vein loop method,the starting time of thrombus formation and the speed of blood flow were observed by mesentery microcirculation.Results In adrenaline-induced injury rats,the wet weight of thrombus was obviously decreased in high-dose PTP group and aspirin group compared with the model group.In endotoxin-induced injury rats,the starting time of thrombus formation was longer and the one-hour blood flow speed was faster in all TP groups and aspirin group than those in the model group.Conclusion PTP exerts the antithrombotic effect on rats with endothelial injury.

Objective To investigate the MRI features of supratentorial solid hemangioblastoma and to improve its diagnostic accuracy.Methods MRI image manifestations of 7 cases with supratentorial solid hemangioblastoma confirmed by operation and pathology were analyzed retrospectively.Results 7 cases of supratentorial solid hemangioblastoma were solitary.All tumors appeared as round or quasi-round masses with clear boundary, and showed equal or long T1 signal and slight long or long T2 signal,the obvious enhancement was seen in all tumors.There was mild to moderate edema around the tumors.The blood vessel was found within or around the tumors.Conclusion MRI manifestations of supratentorial solid hemangioblastoma have certain characteristics.

Objective To investigate the role of dynamic contrast-enhanced MRI (DCE-MRI) in the estimation of tumor angiogenesis and pathologic grading of extrahepatic cholangiocarcinoma.Methods Routine preoperative MRI and DCE-MRI scanning were performed on 57 patients with extrahepatic cholangiocarcinoma.The early signal enhancement ratio (eSER) and delayed signal enhancement ratio (dSER) of DCE-MRI were calculated.Microvessel density (MVD) and vascular endothelial growth factor (VEGF) expressions were detected in the extrahepatic cholangiocarcinoma tissue samples using immunohistochemical methods.The relations between the eSER or dSER and MVD,VEGF and the pathological grading of extrahepatic cholangiocarcinoma were analyzed.Results There was a positive correlation between the eSER or dSER and MVD of extrahepatic cholangiocarcinoma (r =0.62,P ＜ 0.05 ; r =0.45,P ＜ 0.05).The eSER of extrahepatic cholangiocarcinoma with a positive VEGF expression was higher than those with a negative VEGF expression (t =3.53,P ＜ 0.05).There was no significant difference in dSER between the positive VEGF expression group and the negative VEGF expression group (t =1.35,P ＞0.05).There was no significant difference in the eSER or dSER among the different differentiated extrahepatic cholangiocarcinoma (F =2.65,P ＞ 0.05 ; F =2.23,P ＞ 0.05).Conclusions The eSER and dSER reflected tumor angiogenesis of extrahepatic cholangiocarcinoma,and DCE-MRI contributed to the evaluation of biological features of extrahepatic cholangiocarcinoma in vivo.