Objective To summarize the clinical experiences and efficacy of laparoscopic total extraperitoneal repair(TEP) for inguinal hernia.Methods From April 2004 to August 2006,294 TEP operations was performed on 269 patients with inguinal hernia by using laparoscopy under epidural or general anesthesia.Among the patients,175 had indirect hernia,40 direct hernias,25 bilateral hernias,and 29 recurrent hernias.Results The operation was completed without converting to open surgeries in all the cases.The mean operation time was(63.1?37.5) min,blood loss(12.3 ?8.2) ml,and hospital stay(3.7 ?1.4) d.Of the patients,24 had peritoneal tearing(8.2%,24/269),4 had groin hematoma(2.4%,4/269),and 2 had foreign body sensation(0.7%,2/269).The patients were followed up for 6-12 months(median,9 months),the recurrence rate was 1.0%(3/294). Conclusion Laparoscopic TEP is safe and effective for patients with inguinal hernia.

Objective To summarize our experience on laparoscopic splenectomy with amputation of the secondary spleen pedicle. Methods From September 2006 to May 2007, laparoscopic splenectomy with amputation of the secondary spleen pedicle was performed on 13 patients, including 5 cases of traumatic spleen rupture, 2 idiopathic thrombocytopenic purpura, and 6 hypersplenism. Results All the operations were completed under a laparoscope without using hand-assisted procedures. The intraoperative blood loss was 50-800 ml (mean, 350 ml), and the operation time was 150-300 min (mean, 210 min). No complications occurred during and after the operation. The average postoperative hospital stay was 5-9 d (mean, 7.5 d). The patients were followed up for 1-6 months, during which all the patients had normal platelet count. Conclusions Laparoscopic splenectomy with amputation of the secondary spleen pedicle is a feasible, minimally invasive, safe and low-cost procedure.

Objective To investigate the effect of Xingnaojing injection solution in treating severe burn patients with sepsis. Methods 41 cases of burn patients with sepsis were randomly divided into experimental group and control group. The experimental group were intravenously injected 40ml/day Xingnaojing injection solution for 7 days. The control group received routine therapy. Bacteria counts in burn wound, the survival rate of the patients and the positive rate of blood culture in the both groups were determined and compared. Results The experimental group had significantly lower bacteria counts in burn wound compared with the control group, and the negative blood culture rate and patient's survival rate in the experimental group were also obviously higher than those in the control group (P

The paper introduces the ideas of designing hospital information system, including comprehensive cabling, network cover-age, ward calling system, ward monitoring system, queuing management, media teaching, multi -function hall, digital meeting and se-curity system, which would provide reference for the designing and implementation of hospital information system.

To systematically evaluate the importance of protein synthesis in ischemic preconditioning (PC)-induced ischemic tolerance (IT), temporary middle cerebral artery occlusion (MCAO) by Longa (20 min) was used for PC (ischemic precondioning). Twenty-four hours of reperfusion was allowed after PC and before permanent MCAO to establish ischemic tolerance (IT) to compare with non-PC (sham-operated) rats (n = 5 for each group). Infarct size and neurological deficits were measured 24 h after PMCAO. Samples of brain were taken for the determination of HSP70 expression by Western blot analysis. The effects of the protein synthesis inhibitor cycloheximide administered just before PC or administered long after PC but just before PMCAO on IT were also determined (n = 5 for each group). Our results showed that hemispheric infarct was significantly reduced (P < 0.01) only if PC was performed after 24 h, and PC significantly (P < 0.05) reduced neurological deficits (similar to reductions in infarct size). Cycloheximide eliminated ischemic PC-induced IT effects on bothbrain injury and neurological deficits if administered before PC but not if administered long after PC but before PMCAO. PC produced no brain injury but did increase HSP70 protein 24 h after PC. Cycloheximide eliminated that effect. The results suggest that PC is a powerful inducer of ischemic brain tolerance as reflected by the preservation of brain tissue and motor function. PC induces IT that is dependent on de novo protein synthesis.

Objective To explore the short-term and long-term effects ofapplication of Percutaneous Transhepatic Cholangioscopic Lithotripsy on the treatment of hepatolithiasis. Methods Eighty-threecases of hepatolithiasis were treated with the PTCSL and the other 87cases were treated with the Laparoscopic exploration lithotomy.The general clinical parameters , curative effect in the near future and long-term curative effect were anlyzed. Results No significant differences were found between the two groups in the general clinical parameters (P>0.05). The operation time,intraoperative blood transfusion volume and intraoperatve blood soss in group A were significantly shorter than those in group B(P<0.05, respectively). The original calculi residual rate was 2.4%, the eventually calculi residual rate was 4.8%and the recurrent cholangitis was4.8%in the model of PTCSL (Group A). The original calculi residual rate was 18.4%, the eventually calculi residual rate was 23.0% and the recurrent cholangitis was 23.0%in the model of Laparoscopic exploration lithotomy (Group B), with significant difference between these two groups (P<0.05). The calculi recurrence rate of group A was 12.0%,the calculi recurrence rate of group B was 22.9%,withno significant difference between these two group (P>0.05). No patients died in each group. The results of complications showed thatthe incidence of residual calculi of group A was significantly lower than that of group B (P<0.01). Conclusions Compared with the model of Laparoscopic exploration lithotomy, the PTCSL was more safe, minimally invasive and effective. The short-term efficacy of the model of PTCSL was better than that of the model of Laparoscopic exploration lithotomy.

Objective To investigate of the accuracy and feasibility of independent check for intensity-modulated radiotherapy (IMRT).Methods Inputing the linear accelerator Varian 600C/D physical data to IMsure ( a independent checking software) and constructing a calculation model.Use of IMsure to calculate the point dose and fluence of 25 cases IMRT treatment plans which have been calculated by Eclipse treatment planning system (TPS),and do a actual measurement of these plans by Matrixx at the same time.IMsure,TPS calculation results and measurement results of Matrixx were compared.Results Select Matrixx's center probe as a reference point,to TPS calculated results as the standard,then the average difference of the IMsure calculation and Matrixx measurement were ( -0.13 + 1.24)％ (t =0.20,P =0.840 ) and ( - 0.18 ± 1.45 ) ％ ( t =0.86,P =0.400 ),respectively.Compared IMsure with 3 mm/3 ％and 2 mm/2％ standard respectively,the average γ rate of TPS were (98.7 ±2.8)％ and (94.9 ±7.2)％ ;compared matrixx measurement results,the average γ rate of TPS were ( 99.0 + 2.0 ) ％ and ( 93.2 ±6.9) ％.The results show that the difference of the point dose and the γ rate of dose distribution by Matrixx measurement and IMsure calculation was no statistically significant difference ( t =1.54,P =0.126 ).Conclusions Independent checking software can be used in the treatment planning system to acceptance and initial clinical tests.In routine,a independent checking software as IMsure may do a pre-verificaton of IMRT treatment plan,or even partially replace of the actual measurement if the adequate conventional quality assurance do well,thus reducing the daily measurements.

Objective To explore the association of anti-mullerian hormone(AMH)in seminal plasma and serum with sperm counts and energy for male.Methods For 215 cases of healthy male selected from our reproductive clinic,with women′s reason for infertility,seminal plasma and serum AMH were detected,as semen parameters(sperm density,living rate,vitality and malformation rate),6 items of serum sex hormone.In seminal plasma and serum AMH respectively as the dependent variable,using multiple line-ar regression model to explore its quantitative relation with semen parameters and sex hormone levels.Results 215 cases were en-rolled,aged 34.28±5.70 years,while the median of the seminal plasma AMH was 0.47,quartile 0.05-3.09 pmol/ejaculation.The median of the serum AMH was 53.07,quartile 32.32 -72.20 pmol/L.Through multiple linear regression analysis,after adjusted by age and BMI,the seminal plasma of AMH and total number of sperm,sperm concentration,dynamic motility,total sperm activi-ty,serum inhibin B were positively correlated(P <0.05);The correlation between sperm morphology and other serum sex hormone had no statistical significance(P >0.05);Serum AMH negatively correlated with serum FSH,with serum inhibin B positively(P <0.05);Seminal plasma in various parameters and other related serum sex hormone had no statistical significance(P >0.05).Conclu-sion The seminal plasma of AMH were positively correlated with sperm concentration,sperm counts,sperm vitality,with the asso-ciation for serum AMH not yet found.

Objective To analyse CT signs of lumbar spinal degenerative diseases.Methods CT findings of lumbar spine in 1180 cases with degenerative disease lumbocrural pain were analysed.CT classification of degenerative disease of lumbar spine was carried out according to the lumbar structures in combination with clinical sign.Results Lumbar spinal degenerative disease could be classified into 6 types:intervertebral disc degeneration(degenerative rate 65.3%);lumbar vertebra degeneration(degenerative rate 48.1%);vertebra facet joint degeneration(degenerative rate 36.0%);ligment degeneration(degenerative rate 25.4%) ;degenerative stenosis of lumbar spinal canal(degenerative rate 44.0%);and degenerative lumbar spine unstability(degenerative rate 25.0%).The former 4 types were belonged to primary degeneration of lumbar spine,the latter 2 types were belonged to secondary degeneration of lumbar spine.Conclusion CT classification of lumbar spinal degenerative disease is helpful to clinic in diagnosis and therapy.

Objective To investigate the clinical value of medical image-three dimensional visible system (MI-3DVS) in percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) for the treatment of hepatolithiasis.Methods The clinical data of 66 patients with hepatolithiasis (55 were from the First People's Hospital of Shunde City and 11 were from the Zhujiang Hospital) were retrospectively analyzed.The images of computed tomography were three-dimensionally reconstructed with MI-3DVS.The location,number,size,shape of the stones were figured out,and the operation strategies of PTCSL were designed according to the types of the disease.The clinical value of MI-3DVS was evaluated according to the operation results and postoperative recovery of patients.All the patients were followed up via telephone or out-patient re-examination.Results Liver,biliary system,stones and blood vessels were three-dimensionally reconstructed with the MI-3 DVS,and the size,number,shape,location of the stones and location,degree,length of the biliary stricture and its anatomical relationship with adjacent blood vessels were clearly displayed.The coincidence rate of planned and actual operations was 95.5％ (63/66).The mean operation time,intraoperative blood loss,rate of stone clearance,complication rate and duration of hospital stay of 63 patients were (117 ± 9) minutes,(18 ± 1) ml,92.4％ (61/66),6.1％ (4/66) and (15 ± 4) days,respectively.All the patients were followed up till September 2012,the median survival time was 16 months (range,1-69 months),and the recurrence rate of hepatolithiasis was 9.1％ (6/66).One patient died of tumor metastasis and multi-organ dysfunction syndrome postoperatively.Conclusion MI-3DVS could effectively improve the safety and efficiency of PTCSL for patients with hepatolithiasis.