Objective To summarize the experiences of tension-free method in inguinal hernia recurrence.Methods Using the PHS Ethicon Ine,42 patients with recurrent hernia were performed tension-free hemioptasty.Results The operation time was from 40 to 150 minutes.The patients could walk up within 1 d after the procedure.No incision infection was found.The eomplicatiom included 4 retention of urine.3 large serotal hematoma requiring surgical drainage.The follow-up period ranged from 6 months to 3 years,no recurrence and foreign body sensation in inguinal region were observed.Conclusion PHS call be anatomically adapted to repairing and augmenting the myopectineal orifice.It is suitable to the patients with recurrent inguinal hernia.

In recent years, the treatment and prevention of lumbar disc herniation has advanced greatly. This paper reviewed the researches of Taichi Quan therapy for lumbar disc herniation in terms of three model stability, pose stability, adaptability, contraindications and follow-up, etc. Since the patients underwent different courses, the Taichi Quan therapy need to be selected to meet the patients status. The mechanism of the effects need further study.

Objective: [WT5”,6BZ]To investigate the anti tumor effects of melittin in vitro . Methods: Melittin was isolated and purified from bee venom by gel filtration. The cytotoxicity of melittin against established cell lines(SMMC 7721,BEL 7402 and Hep 3B cell) was determined using by MTT assays. Mitomycin, vincristine and cinobu facini were used as control. The time effect relationship of melittin against SMMC 7721 cell line was studied. Results: Melittin showed the anti tumor effect in a dose dependent matter for tumor cells in vitro ,but there was no time effect relationship. The anti tumor effect of melittin was better than the control. Conclusion: Melittin has marked and quick anti tumor activity in vitro against established cell lines. [

OBJECTIVE:To investigate the influences of Schwann cells-alginic acid sodium hydrogel transplantation on cellular apoptosis,Bcl-2 expression,and lower limb locomotor function in a rat model of spinal cord injury.METHODS:SD rats of clean grade were randomly divided into 4 groups:normal control,simple injury,Schwann cells,and Schwann cells-alginic acid sodium hydrogel.Spinal cord transaction model was established in the latter 3 groups.Gelatin sponge blocks containing Schwann cells suspension were transplanted into the Schwann cells group.Schwann cells-alginic acid sodium hydrogel was transplanted into Schwann cells-alginic acid sodium hydrogel group.No treatments were performed in the normal control and simple injury groups.At 12 hours,1,3,7,and 21 days after surgery,animals were assessed using Basso,Beattie and Bresnahan (BBB) locomotor rating scale and were sacrificed.The spinal cord-transected segments were taken to prepare paraffin sections for TUNEL and Bcl-2 staining to quantitate apoptotic cells and Bcl-2 cells in the injured spinal cord and to investigate their distributions.RESULTS:A small number of slightly stained Bcl-2 positive cells were observed in the normal control group.In the simple injury group,Bcl-2 immunoreactive cells peaked at 3 days after surgery,and the expression level was close to normal level at 14 days.Following Schwann cells-alginic acid sodium hydrogel transplantation,Bcl-2 immunoreactive cells in the spinal cord-transected segments were significantly increased till 7 days (P＜0.05) and remained this level for more than 14 days.In the simple injury group,apoptotic cells were most as compared with the remaining 3 groups,and peaked at 1 and 7 days following spinal cord injury,and they were mostly distributed in the white matter.BBB scores were significantly higher in the Schwann cells-alginic acid sodium hydrogel transplantation group than in the simple injury and Schwann cells groups (P＜0.05).CONCLUSION:Schwann cells-alginic acid sodium hydrogel transplantation could inhibit cellular apoptosis and enhance Bcl-2 expression in the spinal cord-transected segments,and thereby promote the recovery of locomotor function after spinal cord injury but did not reach normal levels.

Objective To study the expression of hepatic growth factor(HGF) and C-met in reserved liver tissue after partial hepatectomy of rats with hepatic fibrosis. Methods Totally 130 SD rats were randomly divided into four groups: normal group (n=7), group of normal rats with partial hepatectomy(n=50),hepatic fibrotic group(n=7), and group of hepatic fibrotic rats with partial hepatectomy(n=66). Rats were killed after operation 12 hours, 1 day, 3 days, 5 days, 7 days and 14 days separately, then HGF and C-met of reserved liver tissues were detected with immunohistochemistry staining and Western blotting. Results In the group of normal rats with partial hepatectomy, immunohistochemistry staining indicated that the expression of HGF and C-met increased to get the peak point after partialhepatectomy 12 hours and 3 days respectively, and HGF maintained at the high level to the 7th day, then decreased gradually, finaly approched to the level of pro-operation at 14th day, but C-met fell sharply,and declined to the the level of pro-operation at the 14th day. In the group of hepatic fibrotic rats with partial hepatectomy, the expression of HGF and C-met decreased sharply after operation 12 hours, next HGF increased to get the peak point at the 1st day, and then declined speedily, and decreased to the bottom at the 14th day, but C-met declined to the bottom at the 3rd day, then increased slightly till the 7th day, affter that increased sharply to the summit at the 14th day. Western blotting analysis showed the results of HGF and C-met coincided with that of immunohistochemistry. Conclusion The high isochronous expression of HGF and C-met in hepatic tissue is propitious to hepatocellular division, Which indicates that the expresson out of step of HGF and C-met might be the key reason of hard regeneration of fibrosis liver after operation.

Chronic low back pain is a common type of pain which is related to the dysfunction of low back muscles. In recent years, the pressure biofeedback has been widely used for the assessment and treatment of chronic low back pain. This paper reviewed the reliability and validity of pressure biofeedback unit in the evaluation of lumbar and abdominal muscles activity, as well as its application on the rehabil-itation of chronic low back pain, which mainly related to the assessment and treatment of lumbar muscle activity and lumbar spine stability.

Objective To study the relationship of expression of angiopoietin gene and angiogenesis in the in-situ implanted hepatoma in rats. Methods Forty Wistar rats were used to establish the in-situ implanted hepatoma model by implanting Walker256 hepatoma cell line. The number of microvessel density(MVD) in hepatoma was calculated . The expression of angiopoietin mRNA was observed by in-situ hybridization method. Results The MDV in the implanted hepatoma in the first day of 1, 2 and 3 week postimplantatively were (15?4.3)/Hp,(17?3.6)/Hp,(45?7.8)/Hp respectively. The amount of MDV and expression of Ang-1 mRNA were increased significantly and correlated with MDV in the hepatoma tissues and non-hepatoma tissues,and no significant difference between the two types of tissues. Expression of Ang-2 mRNA was not seen in non-hepatoma tissues,but in hepatoma tissues,the expression of Ang-2 was obvious. Conclusions Angiopoietin-2 mRNA may play a role in the angiogenesis of the in-situ implanted hepatoma.

Firstly, this article introduced the definition of medical dispute and public remedy. Thereafter, it analyzed the causes of public remedysilence in medical disputes from four perspectives including the self-defect of public remedy, inadequacy of legal construction, lack of trust in public remedy, and the popularity of private remedy. Finally, it pointed out the countermeasures of enhanced legal construction, unimpeded public remedy and striking private remedy to solve the problem of public remedy silence in medical disputes.

Objective To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access.Methods Twenty-seven cases (male 17,female 10; age range 32-89 years ) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans,7 with diabetic foot and 2 with thromboangiitis obliterans.According to the Fontaine staging,6 cases were classified as Fontaine Ⅱ,11were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ.All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment,but in vain.So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery,peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting.Results The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms.Hematoma at the puncture site occurred in 3 patients,and paresthesia of toes occurred in 1after dorsalis pedis arteriotomy.No severe perioperative complication occurred.The average ankle brachial index increased from 0.37 ± 0.11preoperatively to 0.85 ± 0.12 postoperatively.Conclusions Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access.

Objective To analyze complications of carotid artery stenting (CAS) and preventions.Methods Clinical data and treatment outcomes of 72 consecutive patients ( 80 stents ) from July 2006 to January 2012 with carotid stenosis were analyzed.Asprin 100 mg and clopedigrel 75 mg were given orally 5 days before CAS.Distal embolic protection device were implanted in all patients,pre-dilatation was done for those with carotid stenosis ＞ 90％ and post-dilatation was done for those of residual stenesis ＞ 30％.Severe complications of CAS mean death,myocardial infarction (MI) and stroke.Other minom included transient ischemic attack ( TIA ),hyperperfusion and intracranial hemorrhage ( ICH ),bradycardia and/or hypotension,hypertension,access hematoma or bleeding.Results In 72 patients a total of 80 self-expandable bare stents were successfully implanted.Distal embolic protection devices were used in all cases.Combined procedure was taken in 5 cases including OPCABG in 2 cases,left subclavain artery stenting in 2 cases and renal artery stenting in 1 case.The overall in-hospital complications was 37.5％ (27 of 72).Of these events,1 case had minor strokes defined as a modified Rankin Scale score less than 3 at 1-year follow-up,2 patients (2.78％ ) experienced a hemispheric TIA (neurological symptoms that resolved within 24 hours),1 patient experienced hyperperfusion syndrome.The overall mortality rate was 0,21 cases (29.2％ ) experienced hemodynamic instability (hypotension in 15 cases,bradycardia in 5 cases and hypertension in 1 case) and 2 others had access hematoms.The 30-day death/stroke/myocardial infarction risk was 1.39％ (1 minor stroke).Conclusions Hemedynamic instability (hypotension and bredycardia) is main complications of carotid artery stenting in patients with carotid artery stenosis,severe complications are rare.