Objective To investigate the feasibility of tension-free inguinal hernia repair whether use of antibiotics prophylaxis.Methods A total of 204 cases of adult inguinal hernia were selected and they were divided into treatment group(51 cases)and control group(153 cases)under a hospital order by 1 ∶ 3 randomly.The patients in treatment group were treated by first-generation cephalosporin antibiotics once preoperatively,while the patients in control group received no antibiotics treatment.The incidence of early postoperative infection between two groups was compared.Results Among of 204 cases,5 cases developed surgical site infection,1 case from treatment group,infection rate was 2.0％ (1/51),while 4 cases from control group,infection rate was 2.6％(4/153).There was no significant difference in the infection rate between two groups(x2 =0.000,P =1.000).No significant difference was found in the results of complete white blood cell count,neutrophilic granulocyte ratio,hospital stays and hospital expenses between two groups(P ＞ 0.05).Conclusion There is no real need to apply regular antibiotics prophylaxis treatment for adult tension-free inguinal hernia repair without high risk factors.

OBJECTIVE:To observe the occurrence of severe myelosuppression after chemotherapy and to improve its therapeutic effects. METHODS:A total of 288 cases of 268 patients with grade Ⅳ bone marrow suppression induced by chemotherapy treatment were analyzed. RESULTS:Of the 288 cases,The median day when absolute neutrophil coun(tANC)

Aromatase inhibitors(AIs) are standard therpy for postmenopausal women with estrogen responsive breast cancers.By inhibiting the aromatase enzyme,causing decreases in endogenous estrogens,the treatment of Als is responsible for lower bone mineral density(BMD) and increased fractures.Therefore,early recognition, prevention,and/or treatment of AI-induced bone loss is needed.Zoledronic acid is specific inhibitors of osteoclasts and extensively used in bone metastasis patients.Recently, there are several trials evaluating the use of in- travenous zoledronic acid as prevention and treatment of AI-induced bone loss in postmenopausal women with breast cancer.In this article, we aim to review the use of zoledronic acid in this population including the response and safety.

Objective To evaluate the effect of recombinant human erythropoietin(rhEPO)on pressure induced retinal ischemic injury in rats.Methods The fluorogold(FG)tracing technique was used to observe the survival rate of the retinal ganglion cells(RGCs).Retinal ischemia was induced by increasing the intraocular pressure to 102 mmHg for 60 min in 20 Long Evans rats,then 5 ml rhEPO was injected into the right vitreous chamber immediately and normal saline into the left vitreous chamber as vehicle controls.Another 5 rats without any treatment served as normal controls.All animals were sacrificed at 1,4,7 or 14 d after reperfusion and RGCs were counted to assess the effect of rhEPO.Results The RGCs in eyes treated with intravitreal rhEPO were significantly higher than those in vehicle controls(P

Objective To observe the correlationship of serum leptin,adiponectin,Th1/Th2 cytokine and symptom severity in obese adult asthma patients,and investigate the pathogenesis of obese adult asthma.Methods From July to December in 2016,100 patients with asthma in the People's Hospital of Zhuhai,and 50 cases of healthy physical examination in the same period were studied.According to body mass,50 cases were divided into obese asthma group (A group),normal body mass asthma group(B group),obesity physical examination group (C group) and normal body mass physical examination group (D group),with 25 cases in each group.The serum leptin,adiponectin,INF-γand IL-4 were detected using ELISA,as well as did the concurrent pulmonary function and ACT.The correlationship of serum leptin and adiponectin,INF-γ,IL-4,pulmonary function and ACT were evaluated.Results The serum leptin,adiponectin,IFN-γ,IL-4 and IFN-γ/IL-4 in A group were (9.67 ±2.86) μg/L,(8.03 ± 3.69) mg/L,(83.69 ± 25.11) ng/L,(22.40 ± 10.92) ng/L,(4.67 ± 2.63),respectively,which in B group were (5.98 ± 3.03) μg/L,(12.30 ± 5.41) mg/L,(41.88 ± 24.25) ng/L,(7.10 ± 7.83) ng/L,(1.20 ± 0.83),respectively,which in C group were (7.02 ± 3.36) μμg/L,(11.52 ± 4.52) mg/L,(37.49 ±25.33) ng/L,(21.25 ± 9.65) ng/L,(2.00 ± 1.13),respectively,which in D group were (4.55 ± 2.33) μg/L,(15.13 ± 5.28) mg/L,(34.37 ± 12.46) ng/L,(21.25 ± 9.65) ng/L,(1.87 ± 1.21),respectively,the differences among the four group were statistically significant(F =19.435,13.114,33.252,23.250,31.750,all P ＜ 0.05);The leptin levels showed a negative correlation with ACT and FEV1 ％ Pred(r =-0.501,-0.384,all P ＜ 0.05),but a positive correlation with IFN-γand IFN-γ/IL-4(r =0.446,0.423,all P ＜ 0.05),and no correlation with IL-4 (r =-0.189,P ＞ 0.05).The serum adiponectin in A group was lower than that in B group,C group and D group (Z =3.207,t =3.532,5.520,all P ＜ 0.05),and showed a positive correlation with ACT and FEV1 ％ Pred (r =0.361,0.466,all P ＜ 0.05);and showed no correlation with INF-γ,IL-4 and IFN-γ/IL-4 (r =-0.155,0.108,-0.161,all P ＞ 0.05).Conclusion The serum leptin in obese asthma patients has a higher levels and a positive correlation with clinical severity,and probably play a role in airway hyperresponsiveness by Th1 cytokine mediating.The serum adiponectin has a negative correlation with clinical severity,but no correlation with Th1/Th2 cytokine.

Objective:To investigate the value of histogram analysis of ultrasound gray scale in differential diagnosis of triple negative breast invasive ductal carcinoma (TN-IDC) and non-triple-negative breast invasive ductal carcinoma (NTN-IDC).Methods:Totally 195 patients with invasive ductal carcinoma confirmed by pathology in Hubei Cancer Hospital from September 2017 to July 2020 were retrospectively analyzed.According to immunohistochemical results after surgery, 195 patients were divided into TN-IDC group ( n=44) and NTN-IDC group ( n=151). All cases were retrospectively analyzed to observe the ultrasonoscopy histogram features of tumors and obtain the histogram parameters, including mean, variance, skewness, kurtosis and percentile gray-scale values. The histogram parameters of TN-IDC were compared with those of NTN-IDC. The ROC curves were constructed to observe the efficiency of differential diagnosis. Results:The values of variance, 90th and 99th percentiles in TN-IDC group were much lower than those in NTN-IDC group (all P<0.05). The values of mean, skewness, kurtosis and other percentile (1st, 10th, and 50th) values between the two groups were not significantly different(all P>0.05). The optimal cutoff value for the accurate identification of TN-IDC and NTN-IDC groups was 552.85 for variance[sensitivity 75.0%, specificity 79.5%, positive predictive value(PPV) 51.6%, negative predictive value(NPV) 91.6%, accuracy 78.5%, and area under curve 0.829, respectively]. The optimal cutoff value for the accurate identification of TN-IDC and NTN-IDC groups was 74 for 90th percentile (sensitivity 68.2%, specificity 57.6%, PPV 31.9%, NPV 86.1%, accuracy 60.0%, and area under curve 0.648, respectively). The optimal cutoff value for the accurate identification of the two groups was 107 for 99th percentile (sensitivity 75.0%, specificity 77.5%, PPV 49.3%, NPV 91.4%, accuracy 76.9%, and area under curve 0.772, respectively). Conclusions:Histogram analysis of ultrasound gray scale can provide certain value for the differential diagnosis of TN-IDC and NTN-IDC, the variance and 99th percentile values could perform better.

Effect of interleukin-6 receptor (IL-6R) antibody on polymethyl methacrylate (PMMA) bone cement-mediated expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-kappaB ligand (RANKL) in synovial fibroblasts was investigated. Synovial tissue obtained from total knee arthroplasty was digested and cultured. Inverted microscope was employed to observe the synovial cells and immunocytochemistry (SABC method) staining was used to identify synovial fibroblasts. This experiment was divided into three groups according to different culture media: PMMA group (75 μg/mL PMMA bone cement particles), IL-6R antibody group (10 ng/mL IL-6R antibody+75 μg/mL PMMA bone cement particles), and control group (no IL-6R antibody or PMMA bone cement particles). Influence of IL-6R antibody and PMMA on proliferation of synovial fibroblasts was measured by cell counting kit-8 (CCK-8). ELISA method was used to measure OPG and RANKL levels in culture solution. Fluorescence quantitative real-time PCR (FQ-PCR) was used to detect the expression of OPG and RANKL mRNA. After three consecutive passages, more than 95% of the primary synovial cells became long spindle fibroblast-like cells. SABC staining results showed that the fibroblast-like cells were negative for anti-CD68 antibody and positive for anti-vimentin antibody, with brown madder stained. CCK-8 test demonstrated that the absorbance (A) value at 450 nm was significantly lower in IL-6R antibody group than in PMMA group and control group (P<0.01), but there was no statistically significant difference in A value at 450 nm between the control group and PMMA group (P>0.05). Results of ELISA indicated that the expression of OPG was significantly higher in IL-6R antibody group than in PMMA group and control group (P<0.01). The expression of RANKL was inhibited (P<0.05), and the ratio of OPG/RANKL was significantly increased in IL-6R antibody group as compared with PMMA group and control group. There was no significant difference in the expression of OPG between control group and PMMA group (P>0.05), but the expression of RANKL was higher in PMMA group than in control group (P<0.05), and there was a significant difference in the ratio of OPG/RANKL between them (P<0.05). Results of FQ-PCR revealed the expression of RANKL mRNA was significantly inhibited (P<0.01) and the expression of OPG mRNA was significantly increased (P<0.01) in IL-6R antibody group as compared with PMMA group and control group. The expression of RANKL mRNA was higher in PMMA group than in control group (P<0.05), but the expression of OPG mRNA had no significant difference between them (P>0.05). IL-6R antibody could significantly increase the expression of OPG, but inhibit the expression of RANKL, which might provide a theoretical basis of molecular biology for the prevention and treatment of aseptic loosening of prosthesis.

There are great differences in the education and working system of certain professionals between Chinese mainland and Taiwan region due to the differeuces in the political system.In this essay,we try to compare the differences in the education level,objective and course offering of the medical imaging technique major and the differences in the professional qualification examination system and the working system between Chinese Mainland and Taiwan Region.We also probe into the possible fields for both sides to learn from each other and to provide references for cooperative school - running,professionals' interchange and working system of medical imaging technique majors of both sides.

Objective To develop a small-diameter tissue-engineered blood vessels which possesses normal blood vessels physiological structure, good biocompatibility, and mechanical properties. And it was evaluated by mechanical and biological of national standard of medi-cal transfusion material. Methods The bio-derived material were regarded as the ground substance, and it was evaluated by mechanical and biological of national standard after composite modification. Results The axial and radial tensile stress of the blood vessel was 23. 14 N and 36. 79 N respectively, and it was greater than the standard 7. 5N. The tensile rate of the axial and radial was 95. 19% and 80. 24% respec-tively, which were higher than the standard value 20%. The suture strength of the blood vessel was 13. 71 N, which was conform to the me-chanical requirement. Mainly used blood vessels or its extracts to detect the pH of the blood vessels is in the scope of control deionized water pH (7. 5 ± 1. 5);the hemolysis rate was 1. 3972% which was less than 5%;the whole blood coagulation time was 50% longer than the con-trol level, and there was no stimulation after intradermal injection. Conclusion With bio-derived material as the ground substance and com-positely modified, this kind od blood vessels is conform to the mechanical and biological of national standard, and it has the potential of clini-cal application which could play an important role in the replacement therapy of small-diameter vascular xenografts.

A 17-year-old young man with a history of swollen leg and intermittent jaundice was presented to Peking Union Medical College Hospital with acute fever and mental disturbance.He developed deep venous thrombosis,acute myocardial infarction and plantar skin necrosis during the past four years,and was presented with an acute episode of fever,thrombocytopenia,acute kidney injury,acute myocardial infarction,mental disturbance,and obstructive jaundice.Laboratory tests showed schistocytes on peripheral blood smear.High titer of antiphospholipid antibodies was detected.Strikingly,the activity of a disintegrin and metalloprotease with a thrombospondin type 1 motif,member 13 (ADAMTS13)was significantly decreased without the production of inhibitors.Images indicated stenosis of the common bile duct,common hepatic duct,and cystic duct,which caused dilation of bile ducts and the gall bladder.Corticosteroids and anticoagulation therapy were effective at first,but the disease relapsedonce the corticosteroids tapered down.Plasma exchange was administrated for 17 times,which was effective temporarily during this episode.Methylprednisolone pulse therapy,intravenous immunoglobulin,rituximab,anticoagulation therapy,and bile drainage,were all tried but still could not control the disease.The patient's family agreed to withdraw treatment after he developed septic shock.