Objective To study the technique of totally extraperitoneal laparoscopic hernioplasty(TEP). Methods 16 patients with inguinal hernia were treated with TEP.There were 14 indirect inguinal hernia and 2 direct inguinal hernia.All patients were treated by laperoscopic herhisplasty through extraperitoneal route. Results All cases were operated on successfully.Operation time was 65.5(40～120)min.The average postoperative hospital stay was 3.7(3～7)days.No complication occurred.There was no recurrence. Conclusionss TEP is a satisfactory technique with a low recurrence rate and a low major complication rate.

Objective To investigate the effects and advantages of laparoscopic hernioplasty for hernia.Methods From June 1995 to June 2005,222 patients with hernia were treated with laparoscopy.Transabdominal preperitoneal hernia repair(TAPP) were performed in 166 patients.Totally extraperitoneal hernia repair(TEP) were performed in 25 patients.Closure of the internal orifice of hernia was performed in 21 patients.Furthermore,incisional hernia in 2 patients, diaphragmatic hernia in 1 patient and mesenteric hernia in 1 patient were performed by laparoscopic hernioplasty and 6 patients with hernia of oesophagus finestra performed hernioplasty combined collapse gastric fundus with laparoscopy.In this series 45 patients associated with other abdominal disease were simultaneously treated with laparoscopy.Results All cases were operated successfully.The span of operation reduration was 42.5 min((10～180 min)).The average length of postoperative hospital stay were 4.6 days.There was one early failure owing to the use of too small a piece of mesh.Conclusion The results indicate that mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate.

Objective To make etiological and epidemiological investigation on the infection of Angiostrongylus canto-nensis in 8 pupils in Changle City. Methods (1) CSF of patients was examined with the conventional method to detect pathogens and eosinophiles. (2) The fecal samples of wild rodents were collected from the spot and examined microscopically to discover the first stage larvae of A. cantonensis. (3) Snails (Pila gigas) were collected in the spot. The smashed head tissue was examined for the third stage larvae of A. cantonensis. (4) The patient's clinical symptoms and physical signs were recorded with an emphasis on central nervous system. Results (1) Two larvae of the third stage of A. cantonensis were found in CSF of one patient. Eosinophiles occupied 68% of the cell number in average (ranged from 47% to 83%) in CSF of the 8 patients. (2) The infection rate of the first stage larvae of A. cantonensis was 39.3% (44/112) in feces of the rodents. (3) The infection rate of the third stage larvae of A. cantonensis was 40. 0% (82/205) in the snails. (4) Major clinical manifestations in the 8 patients included: severe headache(8/8), dizziness(8/8), nausea(8/8), vomiting(8/8), lethargy(7/8), lower limb hypody-namia(7/8). Conclusion The confirmation of severe infection of A. cantonensis in 8 child patients demonstrated that a natural nidus of angiostrongyliasis is present in Chengle City.

Objective To provide the basis for the differentiation with similar species of intestinal flukes through observing the figure of Haplorchis pumilio. Methods Adults of H. pumilio were collected from the intestine of the cat which was infected with the encysted cercariae of H.pumilio for 45 days. The worms were observed after staining. Eggs and metacercariae of H.pumilio were collected and examined for their shape, size and morphological characteristics. Pseudorasbora parva, the fish host, was examined for the parasitized sites of metacercariae. Results The principal characteristics of the adults is the acetabulum degradation. There are only the genital sucker with 44-48 hamuli. The average measurement of eggs is 31.2?16.7 ?m with a smooth shell. Its aceromion is not evident. The average diameter of metacercariae is 168.5 ?m. There are squamous spines on metacercaria. The metacercariae only parasitize in the muscle between the basis of the fin and the fish body. The average measurement of metacercaria cyst is 445?95?m, with squamous spines on the body surface. Hamuli are found on the genital sucker of metacercaria cyst. Conclusion The morphological figures and parasitic sites of metacercaria, the genital sucker of the adult, and the number and form of the hamulus on the genital sucker provide basis for distinguishing H. pumilio from other intestinal flukes.

Objective]To prove that Fujian Province is also a natural focus of Pagumogonimus veocularis(Pv).[Methods]The adult worms were obtained from a cat fed with Pv metacercariae.[Results]Pv were found in Jianou,Fujian Province.All 1 873 Semisulcospira libertina showed negative.The positive rate of Tricula fujianensis and Erhaia jianouenensis were 0.10%(1/695) and 0.25%(5/2 038), respectively. The main crab host was S.fujianensis.Ps alone and mixed infection with Pv were found in the Sinopotamon ,the infection rates were 36.8%(43/117)and 20.5%(24/117), respectively. The numbers of the metacercariae were 806 and 40, respectively. A cat was infected with 12 metacercariae of Pv , eggs were found in the stool 56 days after infection,and 6 worms were found in the lungs 68 days after infection. [Conclusion]Fujian is one of the natural focus of Pv, cat is the adequate host. The fluke was identified as Pv according to the characteristics of the metacercariae.

In order to understand the situation of schistosomiasis in Fujian Province, the surveillance and field survey data of 16 counties (cities or districts) were statistically analyzed from 2003 to 2008 according to the national and provincial surveillance protocols. The snail areas were 69 400 m~2 in 2003, and 506 700 m~2 in 2004, then decreased to 57 700 m~2 in 2008 after the snail control in 2005 and 2006. Serological examinations were conducted in 18 000 people, among which 5 412 people were the mobile population from schistosome-endemic areas, and 110 persons were positive, among which 8 persons had eggs and miracidia in their stools, among 7 885 appendix samples, Schistosoma japonicum eggs were found in 8 samples of the patients who came from the o-riginal endemic areas. By the stool examination, 2 709 head of farm cattle in the region with snails were not found infected with Schistosoma japonicum. It is suggested that the areas of residual snails are large and widespread, and the imported patients are found frequently, so the danger of schistosomisis transmission still remains.

The aim of the study was to investigate the population ecology of medical shellfish and the infection of An-giostrongylus cantonensis in Longhai ,Fujian Province ,China .Aquatic and terrestrial shellfish were collected in survey points according to different types of breeding grounds .Then ,lung-microscopy method was involved in the detection of the lung tis-sue in Ampullaria gigas .Other shellfishes were mashed to detect the third-stage larvae of Angiostrongylus cantonensis .Hom-ogenization and lung microscopy were compared in the detection of the larvae of A .cantonensis in Achatina snails .Factors re-lated to the environment and influence of shellfish hosts were also included .Results showed that 8 species of molluscans were found ,including Pila gigas ,Bellamya aeruginosa ,Bellamya lithophaga ,Melanoides tuberculata ,Achatina fulica ,Vag-inulus alte ,Philomycus bilineatus ,and Bradybaenasimilaris with 1 673 specimens in 27 survey points from 9 townships .The infectionratewas19.78% inaverage.TheinfectionrateinV.altewas56.63% (47/83);theinfectionratesforA.fulicaand P .gigas were 39 .32% (92/234) and 27 .14% (130/234) ,respectively .The infection rate of each survey point was closely re-lated to the distances from the residents living area .Morever ,A .cantonensis larvae were detected in M .tuberculata .Lung mi-croscopy and homogenization method detection rate was 87 .1%and 100 .0% ,respectively .The difference was statistically sig-nificant .In conclusion ,V .alte ,A . fulica and P .gigas were A . cantonensist infection dominant population . The infection rate was closely related to micro-ecological environment for all kinds of shellfish .M .tuberculata was the new host of A .can-tonensis .Lung microscopy method should not be used in the qualitative screening detection of A . f ulica infected with A .can-tonensist .

Objective To investigate the clinical effect of treat severe brain trauma combine hernia with standard hemi-craniectomy and canopy incision surgery. Methods Selected 76 cases of severe brain trauma combine hernia patients as research subjects, which were randomly divided into study group and control group, 38 cases in each group, the con-trol group received standard hemicraniectomy treatment,study group received standard hemicraniectomy and atrium in-cision treatment. The clinical effects were compared for the two groups. Results The rates of severe disability or long-term coma, mortality in the study group were lower than the control group, the differences was statistically significant(P<0.05). The scores of GCS of the study group were better than the control group after operation for 4 weeks and 6 months (P<0.05). Conclusion Patients with severe brain trauma associated with hernia use standard hemicraniectomy and canopy incision treatment can effectively improve the patient's brainstem around the pool,and help to improve the survival rate of patients who received treatment.