Objective To compare the clinical efficiency of tension-free repair(Lichtenstein) under local anesthesia and transabdominal preperitoneal (TAPP) for hernioplasty.Methods The clinical data of 120 patients with Lichtenstein for hernioplasty under local anesthesia (Lichtenstein group) and 98 patients with TAPP for hemioplasty (TAPP group) from January 2010 to July 2012 were analyzed.Results The operation time,blood loss and number of concurrent hernia found in the operation in Lichtenstein group was significantly lower than that in TAPP group [(40.1 ± 4.5) min vs.(45.7 ± 3.5) min,P ＜ 0.01 ; (6.7 ± 1.3) ml vs.(10.6 ± 2.3) ml,P ＜ 0.01 ; 10.2％ (10/98) vs.1.7％ (2/120),P =0.006].In Lichtenstein group,the frequency of analgesic drug used in 3 d after operation,time of return to regular activity were significant higher than those in TAPP group [(0.31 ± 0.03) times vs.(0.22 ± 0.09) times,(9.32 ± 1.38) d vs.(6.54 ±0.98) d],but the time to ambulation,hospital stay,and cost were lower[(5.34 ± 1.98) h vs.(10.24 ± 2.35)h,(2.98 ± 1.32) d vs.(6.43 ±0.93) d,(5032.15 ±372.18) yuan vs.(8325.76 ±438.23) yuan](P=0.010).The rate of complications had no significant difference between two groups (P =0.067).The rate of chronic pain in Lichtenstein group was significantly higher than that in TAPP group [10.0％(12/120) vs.0,P =0.001].The rate of real recurrent hernias in Lichtenstein group had no significant difference compared with TAPP group (P =0.199),but the rate of false recurrent hernias in Lichtenstein group was significantly higher than that in TAPP group [6.7％(8/120) vs.0,P =0.009].Conclusion Both of Lichtenstein under local anesthesia and TAPP for hemioplasty are safety and effective,and each has its advantages.

Objective To evaluate different laryngeal recurrent nerve dissections in thyroidectomy for benign and malignant thyroid diseases. Methods The chnical data of 572 patients undergoing thyroideetomy with at least one side nerve exposure were retrospectively analyzed.Results Among 572 cases,a total of 652 nerves were exposed,among those 451 were by lateral exposure,144 by inferior exposure,57 by superior exposure.Two non-recurrent laryngeal nerves were found in 572 cases.There were 6 cases referred to our department for postthyroidectomy hoarseness undergoing reexploration and it Was found that the laryngeal recurrent nerve were legated in 3 cases and severed in the other 3 cases.In this series,among those suffering from postoperative hoarseness at our own hospital,there were 3 cases in which the nerve was invaded by the tumor and it was unable to dissect the nerve intact from the tumor,while the other 4 were cases referred to our hospital for incomplete thyroidectomy and undergoing a difficult extensive second operation.Conclusions The use of lateral、inferior and superior exposure of laryngeal recurrent nerve dissection can ensure the safety and integrity of the nerve.

Percutaneous neprolithotomy (PCNL) is the preferred method for the treatment of the majority of urinary calculi, especially for the calculi lies in the renal and upper ureteral.Recently, a number of trials were applied into TPCNL, such as, decrease the nephrostomy and indwelling externally grooved ureteral stent, internal ureteral catheter and not aiming replace the preventive use of renal tube.TCNL has its advantages in postoperative pain, hospitalization time and postoperative recovery than standard percutaneous neprolithotomy.

Objective To evaluate the effect of ultrasonic speckle technique on cardiac function in patients with acute myocardial infarction (AMI).Methods 30 patients with AMI were selected as observation group,30 healthy people were selected as control group,and they were all detected by ultrasonic speckle technique.The differences of measurement indices of cardiac function with ultrasonic speckle technique were compared between the observation group and control group.The difference between ultrasonic speckle technique and its measured value was observed with single photon emission computed tomography(SPECT) as the gold standard.The correlation between the results of three-dimensional speckle ultrasound and SPECT in patients with AMI was analyzed.Results The parameters of LVEDV [(62.2 ± 6.4) mL vs.(80.3 ± 7.5) mL],LVESV [(21.7 ± 5.6) mL vs.(35.4 ± 7.2) mL] and LVEF [(62.6 ± 5.9)％ vs.(72.8 ± 5.6)％] in the observation group were significantly lower than those in the control group,the IVSTd [(1.1 ± 0.2) cm vs.(0.9 ± 0.2) cm] and LVPWd [(1.2 ± 0.2) cm vs.(0.8 ± 0.1) cm] were significantly higher than those in the control group,the differences were statistically significant(t =8.431,9.865,3.651,8.798,6.654,all P ＜ 0.05).In AMI patients,there were no significant differences in left ventricular parameters LVEDV,LVESV,LVEF measured between ultrasonic speckle technique and SPECT(all P ＞ 0.05).With SPECT as the gold standard,in AMI patients,the ultrasound parameters LVEDV,LVESV and LVEF were positively correlated with SPECT parameters(r =0.912,0.903,0.899,all P ＜ 0.05).Conclusion Ultrasound speckle technique can well evaluate myocardial function in patients with myocardial infarction.

Objective To explore the short-term efficacy and safety of edaravone combined with clopidogrel in treatment of acute cerebral infarction (ACI).Methods 120 cases of ACI were selected and they were randomly divided into the observation group(60 cases)and the control group according to the visiting order(60 cases).On the basis of routine treatment of ACI,the control group were treated with clopidogrel,and the observation group were added with edaravone combined with clopidogrel.All patients were treated continuously for 14 days.Patients' neural function,activities of daily living,and adverse reactions were evaluated before and after treatment.All patients were followed up for 1 year to record recurrence.Results After treatment,patients' limb movements,neural functions and language had varying degrees of recovery.Total efficiency was 93.33％ and 78.33％ respectively for the observation group and the control group.Grading of the neurologic impairment and life ability of the observation group were both better than the control group.The one-year recurrence rate was 5.77 ％ and 9.26％ for the observation group and the control group,and the difference had statistical significance (P ＜ 0.05).No obvious adverse reaction in the 2 groups was found.Conclusion The curative effect of edaravone combined with clopidogrel is remarkable in treating ACI,and it can remit patients' neurological deficit,improve their daily life ability,reduce the recurrence rate,and has high safety.

Purpose To study the expression of ERG in various vascular tumors, and to explore the value of ERG in the diagnosis of vascular tumor. Methods Immunohistochemical EnVision method was used to detect the expression of ERG and CD31 in 30 cases of vascular tumor and 20 cases of non-vascular tumor. Results All vascular tumors diffusely expressed ERG and CD31. Expression of ERG was unrelated to tumor histologic type and benign or malignant. Expression of ERG was consistent with CD31. Of 20 non-vascular tumors, all except for one cases of epithelial sarcoma did not express ERG. The sensitivity and specificity of ERG in the diagnosis of vascular tumor were 100% and 96. 7%. Conclusion ERG is a high sensitive and specific marker for vascular-derived tumor. The combinated detection of ERG and CD31 may useful for the diagnosis and differential diagnosis of vascular tumor.

Laser ablation of hard tissue allows very precise pre-programmed incisions with complete free geometry and it has advantage of leaving no tissue damages. Those disadvantages of thermal side effects and low cutting rates had been overcome by introducing ultra-short pulses and ultra-power laser systems. This review highlights the recent advances in the laser ablation of hard tissues.

groupL(P0.05). (3)Histopathologic changes in the liver:They were significantly milder in group H than in groups C and L, and the changes in group H were similar to group N. The changes in group L were the most severe. Conclusions(1)Prophylactic increase of hepatic glycogen storage could counteract the injury of hepatic functional reserve that occurs during warm ischemia and reperfusion. (2)The changes of hepatic functional reserve that occurs during warm ischemia reperfusion can be earlier and more sensitively reflected by ICGR_(15) and GLT than by the (routine) enzyme parameters of hepatic function.

Objective To investigate the calbindin D\|28K (CB) neurons that receive the visceral nociceptive information in the interstitial nucleus of the spinal trigeminal tract (INV) directly project to the nucleus of the solitary tract (NTS). Methods Triple\|labeled methods of fluorogold (FG) retrograde tracing combined with Fos and CB proteins immunofluorescence histochemistry after formalin stimulating upper alimentary tract. Results Most of FG\|retrograde labeled neurons distributed in the paratrigeminal nucleus (PaV) and the dorsal paramarginal nucleus (PaMd) of INV ipsilateral to the FG injection. About 71\^2% of FG\|retrograde labeled neurons contained CB and 31\^5% of FG/CB double\|labeled neurons exhibited positive Fos\|immunoreaction in INV.Conclusion The results suggested that a part of neurons containing CB in INV receive the visceral nociceptive information and directly project to NTS. CB neurons might play an important role in transmitting visceral nociceptive information from INV to NTS. [

Objective To evaluate radical resection for thyroid carcinoma in patients without lateral neck lymph node metastasis.Methods Clinical data of 132 thyroid carcinoma patients without lateral neck lymph node metastasis undergoing radical thyroidectomy were retrospectively analyzed.Results There were 35 male and 97 female patients.Age ranged from 18 to 62 years,median age was 34.2 years.All patients underwent ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection.The rate of recurrent laryngeal nerve injury was 4.5% (6/132).Taking into account of tumor invaded nerve,the rate of dissection procedure caused injury was 1.6% (2/128).Conclusion Combination of ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection constitutes radical thyroidectomy in papillocarcinoma of the thyroid gland without lateral neck lymph node metastasis,recurrent laryngeal nerve exposure is the key for this en bloc resection.