Objective To assess the feasibility and safety of modified laparoscopic totally extraperitoneal(TEP)hernia repair.Methods From January to August 2007,a total of 31 patients with hernia were treated with modified TEP hernia repair under general anesthesia in our hospital.During the operation,the anterior peritoneal space was separated,and then a domestic single balloon catheter was inserted into the extraperitoneal space to expand the latter.The mesh was not fixed during the operation.Results All the operations were successfully completed with a mean operation time of(69.8?21.8)minutes,mean blood loss of(7.6?4.2)ml,and mean postoperative hospital stay of(2.6?1.3)d.Five cases developed laceration of the peritoneum during the operation,and 2 had scrotal hydrocele after the operation.The patients were followed up for 1-7 months [mean,(4.2?2.4)months],no recurrence or chronic pain at operative area were found during this period.Conclusions Modified TEP is feasible for hernia repair.The method is a safe and tension-free technique with a low rate of postoperative chronic pain at the operation region.

Objective To evaluate the efficacy of oral etopside (VP16) and oral cyclophosphamide (CPM) combination in the treatment of hormone-refractory prostate cancer (HRPC). Methods Between June 2000 and July 2003,9 patients with HRPC were treated with oral etopside (50 mg/d) and oral cyclophosphamide (100 mg/d) for 21 days with every 28 days as a cycle.Inclusion criteria were previous complete androgen blockade,anti-androgen (flutamide) withdrawal evaluation,and clinical or biochemical disease progression.The therapy was continued until there was evidence of disease progression or the patients could not tolerate the adverse effects of the medications. Results All the 9 patients had a mean follow-up of 7.5 months.PSA levels decreased by at least 50%,from pre-treatment of (90.5?43.6)ng/ml to post-treatment of (24.8?22.2)ng/ml,in 4 patients. The mean duration of response was 6.8 months (range,2-15 months).An objective response was obtained in 2 patients (1 of CR and 1 of PR).Toxic and adverse effects were minimal. Conclusions The combination of oral VP16 and CPM may be an efficacious and well-tolerated regimen in patients with HRPC.

50% for more than 1 month as effective,and the efficacy for soft tissue metastases were classified as complete,partial remission,stabilization and progression.Results All patients were followed up for 6-24 months(mean,12 months) with the evaluation of efficacy and toxicity.PSA levels decreased by at least 50% in 6 of 12 cases(50%);it decreased from(63.9?47.3)ng/ml before treatment to(14.4?8.8)ng/ml after treatment,with a mean duration of response being 7.5 months(range,5-12 months).Partial remission of soft tissue metastases was obtained in 2 cases;the metastatic lesions were reduced from 4.0 cm?5.0 cm,(3.0cm?)(3.5) cm to 2.0 cm?2.0 cm,1.0 cm?1.5 cm,respectively,by the treatment,with response duration being 3 and 8 months,respectively.Toxicities were minimal with leukopenia at grade Ⅰ in 1 case,anemia at grade Ⅰ in 1,baldness at grade Ⅰ in 1,nausea at grade Ⅰ in 2 and impaired liver function at grade Ⅱ in 1.Conclusions The combination of oral estramustine phosphate and oral etoposide may be an effective and well-tolerated regimen in patients with HRPC.

Objective To explore the value of procalcitonin (PCT)and lipopolysaccharide (LPS)in identifying pathogens and evaluating therapeutic efficacy of hospital-acquired pneumonia (HAP).Methods A total of 110 HAP patients were enrolled in a prospective study,patients were divided into gram-negative bacterial infected HAP group (G- infected group,n=50),gram-positive bacterial infected HAP group (G+ infected group,n=30),and control group (nontypical pathogen or virus infected group,n =30).Serum levels of PCT,LPS and C-reactive protein (CRP)of patients were dynamically detected,receiver operating characteristic (ROC)curve and area under the curve (AUC)were adopted to assess the value of PCT and LPS in predicting pathogenic bacteria causing HAP. Results PCT and LPS levels of G - infected group were (3.43 ±1 .15)ng/mL and (0.20 ±0.08)EU/mL respec-tively,which were higher than G+ infected group ([0.42±0.12]ng/mL and [0.05±0.02]EU/mL respectively)and control group([0.14±0.08]ng/mL and [0.02 ±0.01 ]EU/mL respectively)(all P <0.05 ).Levels of PCT and CRP of G- infected group before and after therapy were both significantly different ([3.43±1 .15]ng/mL vs [0.63 ±0.22]ng/mL,[47.26±30.35]mg/L vs [9.21 ±6.54]mg/L,respectively)(both P <0.01).The levels of PCT, LPS,and CRP in moderate and severe patients were all significantly higher than mild patients ([5.43±1 .05]ng/mL vs [0.72±0.32]ng/mL,[0.33±0.07]EU/mL vs [0.09 ±0.04]EU/mL,[57.46 ±20.15 ]mg/L vs [8.25 ± 5.24]mg/L,respectively)(all P <0.05).Sensitivity and specificity of combined detection of PCT and LPS in dif-ferentiating gram-negative bacteria infected VAP from gram-positive bacteria infected VAP were 95.83% and 96.15% respectively,AUC was 0.95.Conclusion PCT and LPS have certain value in identifying pathogens of HAP,combined detection of PCT and LPS can increase specificity in identifying HAP type,and assess the efficacy of antimicrobial therapy in accordance with the dynamic change.

Objective:To investigate the clinical manifestations and causative factors of adverse drug reactions following cinepazide mahate injection and provide reference for the safe use of drugs.Method:503 cases treated with cine- pazide maleate in our hospital were retrospectively studied and the results were statistically analyzed by SPSS(versionl 1.0).Result:Of 503 patients,27 cases presented some adverse events with an incidence of 5.4%,and adverse drug reac- tions were found in 11 cases with an incidence of 2.2%.The main adverse drug reactions were nervous,gastrointestinal and dermal reactions.The adverse drug reactions had no relation with sex,but with age of patients and combination use of drugs(P

Objective For preventing the recurrence of superficial transitional cell carcinoma of bladder. Methods Recombinant interferon-alpha and mitomycin C have been used combindly in cl inical study.42 patients were divided into two groups: recombinant interferon-a lpha plus mitomycin group and mitomycin C group.The protocol of chemoimmunoprop hylaxis include 6 weekly and 6 two weekly instillation of 3?10 7 IU recombinan t interferon-alpha plus 40mg mitomycin C in 40ml normal saline via catheter.Che moimmunotherapy was given once monthly for at least two years. Resul ts Follow-up(from 6 to 30 months with a median of 18 months)consist ed of cystoscopy and cytology with cold cup biopsies carried out every 3 months for 2 years. Recurrence after instillation of recombinant interferon-alpha plus mitomycin C was observed in only 2 (10%). Recombinant interferon-alpha plus mi tomycin C yielded better effect ive rate(P

Purpose:To improve the surgical technique in the treatment of renal pelvic and ureteral malignancy.Methods:From May. 1998 to December. 2000 intravesical ureterectomy has been carried out for 9 cases of renal pelvic malignancy . the distal ureter was intussuscepted into the bladder by traction of a ureteral catheter that had been attached to the cephalad end of the ureter after the kidney was removed. Patients have been followed up for 6 to 30 months with a mean of 18.6 months.Results:No surgical complication has been observed. On cystoscopy, no tumor occurrence has been found at the site of the removed ureteral orifice and other part of the bladder.Conclusions:The surgical technique is characterized by good results,few complication and simplicity.

An introduction to the telemedicine service of the hospital in its web-based hospitalprogram which covers theweb-based healthcare center,and thehealthcare cabin to interact with the center remotely.The center operates on the telehealth management platform based on cloud computing, offering remote monitoring,health assessment,health management,follow-up,online consultation,pre-registration and mobile payment.Theweb-based hospitalcan simplify the medical service flow,alleviate the complaints incurred by concentrated quality medical resources,influx of patients and limited physical space of tertiary hospitals,and the tense doctor-patient relationship as well.

Objective To investigate two single nucleotide polymorphism sites of IRF5 and to de-tect their relationship with SLE in a population from Shandong province. Methods The polymorphisms (rs2004640 G/T,rs10954213 G/A) were detected with PCR-RFLP in 92 eases of SLE and 88 healthy con-trols. The genotype and allele frequencies were calculated and analyzed. Results The genotype frequencies Of GG, GT and TT in rs2004640 site in SLE were 0. 198, 0.521 and 0.281, respectively. The difference was significant between SLE and centrol (X2 = 8.73, P < 0.05). The genotype frequencies of GG, GA and AA in rs10954213 site in SLE were 0. 318, 0. 409 and 0.273, respectively. The differenee was significant between SLE and control (X2 = 6. 36, P < 0. 05). Conclusion The polymorphism of rs2004640, rs10954213 in IRF5 may be associated with SLE in the population of Han nationality from Shandong province of China.