Objective To discuss the feasibility and safety of tension-free mesh plug hernioplasty under local anesthesia in out-patient clinic.Methods Tension-free mesh plug hernioplasty under local anesthesia was performed in 65 cases of unilateral inguinal hernia in out-patient clinic from April 2003 to May 2005.There were 56 cases of indirect inguinal hernia(including 1 case of recurrent hernia) and 9 cases of direct hernia.Results The hernioplasty was successfully completed in all the 65 cases,with good anesthetic results registered.The operation time was 20~65 min(mean,32 min),and the length of clinic stay,3~20 h(mean,(4.8 h)).Incisional fat liquefaction occurred in 1 case.Follow-up visits for 2~24 months(mean,9.5 months) found no recurrence or testicular atrophy.Conclusions Tension-free mesh plug hernioplasty under local anesthesia is a safe,reliable,and cost-effective out-patient procedure for patients with type Ⅱ~Ⅲ unilateral inguinal hernia.

Epilepsy, Benign Neonatal ; genetics ; Humans

The all-in-one femtosecond laser corneal refractive surgery,especially small incision lenticule extraction (SMILE),has gained more and more attention in clinic,because of its small incision,“no flap” and corneal biomechanical stability advantages.However,like any other kind of corneal refractive surgery,the all-in-one femtosecond laser refractive surgery not only exists its clinical advantages,but also has its limitations.It is very important to put into perspective clinical advantages and limitations of all-in-one femtosecond laser corneal refractive surgery.

Epileptic encephalopathies are an epileptic condition characterized by epileptiform abnormalities associated with progressive cerebral dysfunction.These syndromes include early myoclonic encephalopathy and Ohtahara syndrome in the neonatal period,West syndrome and Dravet syndrome in infancy,myoclonic status in nonprogressive encephalopathies,and Lennox-Gastaut syndrome,Landau-Kleffner syndrome,and epilepsy with continuous spike waves during slow wave sleep in childhood and adolescences.Other epileptic syndromes such as migrating partial seizures in infancy and severe epilepsy with multiple independent spike foci may be reasonably added.In this paper,an overview of epileptic encephalopathies including clinical features,etiology,electroencephalogram characteristics,treatment and prognosis are provided.

Epilepsy is a common disorder of neurological system in children.Inborn errors of metabolism (IEMs) is one of an important etiology of epilepsy.Seizures may be the first and the major presenting feature of IEMs.IEMs are a relatively rare cause of epilepsy,but their recognition and diagnosis is very important because several disorders are treatable.This review will concentrate on diseases where epilepsy is the predominant clinical manifestation and especially where the disease course can be positively influenced by specific metabolic therapies.

Six hours after inhalation pulmonary injury,the pulmonary microvascular permeability (PMVP),pulmonary malondialdehyde (MDA) level,superoxide dismu-tase activity (SOD),the contents of protein and leucocytes in broncho-alveolar lavage fluid(BALF),and serum MDA level were determined in rats pretreated with allopurinol.In addition,the pathological changes of the lung tissues were also studied.It was found that early administration of allopurinol resulted in marked reduction of PMVP,and the protein content and leucocyte count in BALF.His-topathological examinations revealed that allopurinol could reduce the leucocyte accumulation in pulmonary vessels,interstitial leucocyte infiltration,interstitial and alveolar edema and hemorrhage,and vascular congestion.The serum and pulmonary levels of MDA also markedly decreased.The changes of pulmonary level of MDA were parallel to those of PMVP,and the protein content and leucocyte count in BALF in time course and in degree.The results listed here imply that the mechanism of the therapeutic effects of allopurinol on inhalation pulmonary injury is to reduce the production of superoxide anions through the inhibition of xanthine oxidase,in turn to inhibit the peroxidation of pulmonary lipids to alleviate pulmonary damage.

Generalized epilepsy with febrile seizures plus(GEFS+)is a familial in herited epileptic syndrome characterized by phenotypic heterogeneity from the mi lder febrile seizures to the severest epileptic encephalopathy such as severe my oclonic epilepsy in infancy(SMEI).GEFS+ is a disorder with a genetic heterogen eity.Molecular genetics have revealed that four genes are associated with the p athogenesis of GEFS+.These include mutations in genes encoding subunits of neur onal voltage-gated sodium channels(SCN1A,SCN1B,SCN2A)and ?2 subunit of the gamma amino-butyric acid(GABA)A receptor(GABRG2).These genes have be en confir med as having a role in autosomal dominant GEFS+ families.In addition,the phen otypes of the affected members may depend on the types and locations of these ge ne mutations.This review states the molecular genetic progress of GEFS+ in brie f.

Objective To clone human survivin gene and express survivin-an inhibitor of apoptosis proteins in Pichia pastoris eukaryotic expression system. Methods Full length survivin gene was amplified by PCR using survivin specific primers. The verified survivin gene by sequencing was subcloned into pPic9k. The recombinant plasmid was linearized by restriction enzyme cutting. The linear survivin gene was introduced into GS115/ His-cells by electroporation. The transformants were transferred onto YPD plates that contained different concentrations of G418 for screening the positive clones. The integrated survivin gene in positive clones was confirmed by PCR. Selected transformants were cultured in BMMY medium with 1 % methanol for inducing the expression of survivin protein. The expressed survivin protein was analyzed by ELISA. Results The cloned human survivin sequence was the same as that in the GeneBank. The recombinant pPic9k-survivin was constructed in Picha pastoris eukaryotic expression vector. After the linear digestion, the recombinant vector was introduced into GS115/ His-cells, the 6 positive clones against G418(4 mg/mL) were obtained and confirmed by PCR; the highest survivin protein was expressed when expressed for two days in 1 % methanol BMMY medium. Conclusions Improved survivin protein yield may be reached by modifying the experimental conditions. This will help to further study the biological functions of survivin and its roles in tumor developments.

Objective To discuss the diagnostic value of combined utilization of urinary cystatin C (CysC) and β‐N‐acetyl‐glu‐cosaminidase (NAG) in renal tubules injury .Methods Urine samples were collected from 130 cases of patients with renal tubular damage (case group) and 100 cases of health individuals (normal control group) ,respectively .The concentration of CysC and the activity of NAG in urine were detected .Results The sensitivity ,specificity ,and positive predictive value of combined utilization of CysC and NAG in diagnosis of renal tubules damage were 85 .4% ,89 .6% and 82 .1% ,respectively .The concentration of CysC and the activity of NAG in case group after treatment were both significantly different from those before treatment (P<0 .05) .Conclu‐sion Combined utilization of urinary CysC and NAG has a significant value for the diagnosis and the therapeutic monitoring in re‐nal tubules injury .

Objective To study and analyze the clinical observation and nursing measures of prednisone acetate combined leflunomide in the treatment of IgA nephropathy.Methods 100 patients with IgA nephropathy treated in our hospital from February 2015 to September 2016 were randomly divided into the control group and the experimental group,with 50 patients in each group.Patients in the control group were treated with prednisone and dropped to 0.5 mg/kg after 12 weeks.The patients in the experimental group were treated with leflunomide and dropped to 20 mg after 3 days.The patients in the experimental group and the control group were treated for 3 months.The two groups of patients were given reasonable nursing measures, and compared the treatment effect.Results The effective rate of treatment in the experimental group was 94.0％, significantly higher than that in the control group (64.0％),with statistical difference(P<0.05).After treatment,the level of 24 hours proteinuria in the experimental group was (0.541±0.322)g/L, significantly lower than that of the control group (1.516±0.568)g/L,with statistical difference (P<0.05) .The adverse reaction rate of the experimental group was 0％, and that of the control group was 8％,with statistical difference(P<0.05).Conclusion Prednisone acetate combined leflunomide was effective in the treatment of IgA nephropathy, and can significantly improve the efficiency of treatment, and has clinical significance.