ObjectiveTo evaluate the application value of the emergency laparoscopic surgery in incarcerated inguinal hernia of children. MethodsManual reduction of incarcerated hernia was laparoscopic- assisted after anesthesia, high-ligation of hernia sac was done by one hole method of laparoscopic treatment.ResultsAll of 22 cases of pediatric incarcerated hernia were done, no complications occurred. Eighteen patients were followed up for 3 - 15 months, 9.3 months on average, without serious complications. ConclusionsThe emergency laparoscopic surgery in children of incarcerated inguinal hernia is safe and feasible,with smaller trauma, quicker recovery and smaller health risk.

Objective To analyze the effect of different procedures of alimentary reconstruction for the digestive and absorptive functions of patients after total gastrectomy. Methods From January 2012 to January 2013,there were 114 patients with gastric cancer,of which 58 patients received Roux-en-Y anastomosis were the control group,56 patients received P-type jejunal loop esophageal jejunal Roux-en-Y anas-tomosis were the observation group,the nutritional status and postoperative complications of two groups were compared. Results The level of RBC,HGB,TP and ALB of the observation group were significantly higher than that of the control group(P<0. 05),the incidence rate of in-traoperative complications,diarrhea and reflux esophagitis of the two groups had no significant differences (P>0. 05),but the incidence rate of postoperative dumping syndrome and abdominal distension of the observation group were significantly lower than that of the control group (P<0. 05). Conclusion The efficacy of P-type jejunal loop esophageal jejunal Roux-en-Y anastomosis for gastric surgery was superior to Roux-en-Y anastomosis.

Objective To explore the ultrasonic characteristics of cystic adventitial disease (CAD) and to evaluate the value of color Doppler ultrasound in diagnosis of CAD. Methods We retrospectively analyzed the ultrasonograms and other imaging methods of eight patients with CAD conformed by surgery in The first Hospital of China Medical University. Results Five of the eight CAD cases were confirmed by color Doppler ultrasound before surgery, and three were misdiagnosed. All the cases were single, with five in popliteal artery, two in iliofemoral artery, and one in external iliac vein. We divided the cysts into concentric cysts and eccentric cysts according to the cystic shape and the lumen stenosis. Six cases were eccentric cysts, in which two had septations;two cases were concentric cysts, and both had septations. The affected vessel expanded, but its shape did not change and the lumen was compressed. There were three layers of wall between the cyst and the lumen. The peak systolic velocity of the affected lumen increased and the distal end systolic peak velocity decreased when lesion occurred in artery. Distal end lumen reflux were slow when lesion occurred in distal veins. Angiography showed the stenosis of the affected lumen, which was described asscimitar sign. CT showed uniorlocular or multilocular cyst, and the compressed lumen. All of the eight patients underwent the diseased adventitia resected along with excision of the cyst. Conclusions The color Doppler ultrasound can display the location, shape, and internal echo of CAD, and thus it can accurately evaluate luminal stenosis and flow pattern. This is of important clinical significance for the diagnosis, treatment, and prognosis of CAD.

BACKGROUND:Posterior lumbar interbody fusion can thoroughly decompress the central canal, which is the common surgical technique for the central type of lumbar disc herniation with intervertebral instability at low lumbar segment. However, due to the regular traction on dural sac and nerve root in the operation, lower limb radicular pain in the early stage is inevitable. OBJECTIVE:To evaluate the effect of local use of gelatin sponge containing prednisolone acetate around the nerve roots after posterior lumbar interbody fusion on lower limb radicular pain. METHED:Sixty-three cases of lumbar disc herniation with degenerative instability were devided into treatment group (n=21) and control group (n=42) based on the type of implants. Gelatin sponge containing prednisolone acetate was implanted into patients in the treatment group after posterior lumbar interbody fusion, while pure gelatin sponge was implanted into patients in the control group. RESULTS AND CONCLUSION:Compared with the control group, radicular pain in the treatment group was significantly relieved within 1 week after surgery. The visual analog scale score and Oswestry disability index score were similar between the two groups. There were three cases of radicular pain recurrence in the control group, but no incision infection and epidural hematoma after surgery in both two groups. In conclusion, local use of gelatin sponge containing prednisolone acetate around the nerve roots can significantly relieve lower limb radicular pain in the early stage after posterior lumbar interbody fusion in lumbar disc herniation, contributing to early rehabilitation exercise and patient satisfaction outcomes.

Objective To study the cell killing effect on isolated sarcoma 180 cells by ultrasound activating Protoporphyrin IX and to explore its biological mechanism.Methods The sonodynamical effect was investigated on S180 tumor cells exposed to the combination of 120 mol/L protoporphyrin Ⅸ (PPⅨ) and focused ultrasound at the frequency of 2.2 MHz and an intensity of 3W/cm2. The livability of cells was evaluated by trypan blue staining. Scanning electron microscope (SEM) observation of the surface of cells was performed to evaluate the morphological changes induced by ultrasonic irradiation. The generation of oxygen free radicals in cell suspensions was immediately detected after treatment by the active oxygen detection kit. Oxidative stress was assessed by measuring the activities of key antioxidant enzymes (ie, Superoxide dismutase[SOD], Glutathione peroxidase [GSH-PX], Catalase [CAT]) in S180 cells after SDT.Results The cell damage rate of ultrasound combined with PPIX was significantly higher than that treated with ultrasound alone only, and PPIX alone had no killing effect on S180 cells. Enzymatic chemical methods showed the content of MDA significantly increased after treatment, while the activities of key antioxidant enzymes in tumor cells all decreased at different levels, and was associated to the generation of oxygen free radicals in cell suspension after treatment. Conclusion Oxygen free radical may play an important role inimproving the membrane lipid peroxidation, decreasing the activities of key antioxidant enzymes in cells, and the biological mechanism might be involved in mediating the killing effect of S180 cells in SDT.

Systemic lupus erythematosus (SLE) is an archetypical systemic, autoimmune inflammatory disease , of which the mechanism still not unveiled. Studies on epigenetics in SLE have long been the subject of investigation and as part of epigenetics. DNA methylation has been confirmed to play a role in the pathogenesis of SLE. The high autore-activity of CD4~+ T cell from SLE patients is associated with DNA hypomethylation. DNA hypomethylation is crucial to induce SLE - like autoimmune disease in SLE - non - susceptible mice. The reactivation of inactive X chromosome by hypomethylation may lead to high incidence of SLE in women. Drug - induced SLE is also connected with DNA hypomethylation. To understand the role of DNA methylation in the onset of SLE comprehensively, we review the findings reported in the literatures about DNA methylation and SLE.

【Objective】To observe the effect of acupuncture mainly on cleft points on chemical radiculitis rats and to explore the therapeutic mechanism of acupuncture on lumbar disc prolapse.【Methods】Twenty-four rats with chemical radiculitis were equally randomized into acupuncture group and model group,and another 12 normal rats were in the blank control group.Acupuncture group received acupuncture on acupoints of Jiaji(EX-B2)and Weizhong(BL40)and cleft points of Foot-Shaoyang Meridian and Foot-Taiyang Meridian for 28 days.After treatment,rat behavioral changes and morphological features of nerve cells were observed,the weight of inflammation filter paper was detected,and hemorheologic parameters,nitric oxide (NO) and interleukin 6(IL-6) were assayed.【Results】Acupuncture improved the motor function of affected limb,recovered the senses of pain and tough,improved hemorheologic parameters,reduced the inflammatory reaction,relieved degeneration of nerve root,and decreased the contents of inflammatory factors(P

Objective To retrospectively review the clinical characteristics and antimicrobial resistance profile of nosocomial bloodstream infections caused by Klebsiella pneumoniae in surgical patients for better use of antimicrobial agents.Methods The clinical data of the surgical patients who were diagnosed with K.pneumoniae-associated bloodstream infections in Tung Wah Hospital from January 2013 to June 2015 were reviewed and analyzed retrospectively.The diagnosis of bloodstream infections was based on national diagnostic criteria.The pathogens were routinely isolated and identified.Antimicrobial susceptibility testing was carried out by using Kirby-Bauer method.The data were analyzed by WHONET 5.6 software.Results A total of 78 surgical patients were identified with nosocomial bloodstream infections due to K.pneumoniae during this period,including primary bloodstream infections (12.8％,10/78) and secondary bloodstream infections (87.2％,68/78).These infections were mainly associated with surgical and invasive procedures.Nearly 40％ of the K.pneumoniae isolates were resistant to ceftriaxone,cefuroxime and piperacillin.ESBLs were produced in 43.6％ (34/78) of the K.pneumoniae isolates.The ESBLs-producing strains showed significantly higher resistance rates to various antibiotics than non-ESBLs-producing strains.Piperacillin-tazobactam,amikacin,imipenem,and meropenem still have good antibacterial activity against these K.pneumoniae isolates.However,imipenem-resistant strains are emerging.Conclusions Most of the bloodstream infections caused by K.pneumoniae were secondary to infections in other body sites in surgical patients.Hospital infection control measures should be strengthened.Meanwhile,the clinicians should take full advantages of microbiological laboratory to profile the pathogens and their susceptibility patterns,which is crucial for rational use of antibiotics.

Objective:To explore the way and feasibility of carrying out developmental-behavioral pediatrics(DBP) teaching for medical students on probation.Method :To divide 230 medical students on probation into experimental group(120 students) and control group(110 students).The former group spent four class hours in child developmental-behavioral outpatient department and another four hours in sensory integrative therapy room to assist doctors in their training work as volunteers,and their rest probation contents were the same as those of the latter group which had classes according to teaching outline of pediatrics.Test scores of pediatrics of the two groups were compared.Questionnaires filled in by students of experimental group were analyzed.Results of the two groups,scores of pediatrics were not different,which showed that scores weren't influenced by extra teaching contents.Results of questionnaires showed that teaching of DBP was welcome to students,and they had made advances in relative knowledge and their overall quality.Conclusion: It is necessary to carry out DBP teaching.The teaching way of this study has got good effect and is feasible.

Objective To study the percentage depth dose difference (PDD) between Monte Carlo method and the measurement method.Methods Based on the detail treatment head structure designing by the manufacture,the BEAMnrc Monte Carlo code was used to simulate the 6 MV photon beams of a Siemens Primus linear accelerator.DOSXYZnrc program generated 6 MV X-ray parameters such as PDD,and it was measured by MP3 three-dimensional water of PTW corporation phantom.The deviation of PDD was calculated using formulas ((measured value-simulation algorithm value)/measured value × 100％).Results Distance from the surface of the water was less than 1.2 cm,the deviation of PDD was ＞ 2％.Distance from the surface greater than 1.2 cm,the deviation of PDD was ＜ 2％.Conclusion In the built-up areas,PDD obtained by the Monte Carlo simulation algorithm is more accurate.