Objective To discuss the value of tension-free hernia repair to recurrent inguinal hernia in elderly patients.Methods 38 eases with recurrent inguinal hernia in elderly patients were treated with shaped polyproplene tension-free hernioplasty.Results All eases were operated successfully.In the follow-up period ranged from 6 to 42 months.No Serious postoperation complications were found,no recurrent case recurred.This treatment is effective.Conclusion Tension-free hernia repair has many advantages,such as safety,easily manipulation,minimal invasion,rapid recovery,lower recurrence.It is a perfect and ideal surgical operation for the recurrent inguinal hernia in elderly patients.

In four patients with chronic pancreatitis from two hereditary pancreatitis (HP) families and 63 normal controls, five exons of cationic trypsinogen gene (PRSS1) were amplified by PCR and it's products were analyzed by sequencing, related clinical data were also collected. All the four patients were found mutations in the PRSS1 gene but their clinical feature is absolutely different. Six patients with diabetes mellitus were found in pedigree No. 1, it's members show pancreatitis symptom later, at about 29, the tumor markers (CA19-9, CA72-4) is obviously higher than the patients in pedigree No. 2, two patients with chronic pancreatitis in pedigree No. 2, show symptom earlier without diabetes mellitus, their clinical characterization are different too. The number of CD4+T cell/CD8+T is very low in Ⅲ 8, but Ⅲ 7 is normal, and the level of anti-HBs of Ⅲ 8 is variable in the course of pancreatitis, but the phenomenon was not found in Ⅲ 7. In their PRSS1 gene two guanosine (G) to adenosine (A) mutations were found in PRSS1 exon 3 of pedigree No. 1, one was detected at 336 basyl, the other mutation occurs at 361 basyl. The results of the mutations were Lys →Lys and Ala →Thr. While thymine (T) to adenosine (A) and (guanosine) G→(adenosine) A mutation in PRSS1 exon 3 was detected in the other patient of pedigree No. 2 (Ⅲ 8). One was 361 basyl, the other at 415 basyl. While c.415 T→A was not found in the proband of pedigree No. 2 PRSS1 gene (Ⅲ 7). All of the mutations were heterozygous mutation, that is to say all of the trypsinogen were wild type and mutant type concomitance, the normal and abnormal pathway of active trypsinogen exist partially. At the same time, the mutations of SPINK1 were not observed. Compared with the documents and registration of NCBI, it can be concluded that PRSS1 gene had many kinds of mutations in hereditary pancreatitis, the heterozygous mutations (c.336 G→A, c.415 T→A) were the novel mutations and related with clinical phenotype. What's more, it's the first time that the multisite heterozygous mutations of PRSS1 gene were reported. The presence of the mutations in four patients with chronic pancreatitis, it's absence in their relatives and the strong evolutionary conservation of the mutation, all indicate that the trypsinogen mutation is associated with hereditary pancreatitis and for the first time raises the question whether a gain or a loss of trypsin function participates in the onset of Chinese pancreatitis.

ObjectiveTo observe the influence of Danshen injection on the serum levels of TNF-α,IL-6 in patients with acute pancreatitis(AP).Methods70 patients with AP were randomly divided into the experimental and control group.The two groups were given conventional anti-inflammatory,antisecretory,antispasmodic,inhibition of pancreatic secretion treatment,and the experimental group were treated with Danshen injection.Before trealment and 1,2,4,6 days after treatment,the serum TNF-α,IL-6 levels were measured in both groups.The time of blood and urine amylase(AMS) returned to normal was observed in both groups.Results2,4,6d after treatment,the serum TNF-α,IL-6 of the observation group were lower than that of the control group( all P ＜ 0.05 ) ;The blood AMS recovery time of the observation group was ( 2.55 ± 0.71 ) d,which had no significant difference with that of the control group(2.46 +0.82)d(t =0.32,P ＞0.05 ),while urinary AMS recovery time of the observation group was (4.30 ±0.72 ) d,which was shorter than that of the control group ( 6.84 ± 0.88 ) d ( t =0.02,P ＜ 0.05 ).ConclusionDanshen injection could reduce the serum TNF-α,IL-6 levels in patients with AP,and had no effect on the serum amylase,with the trend of faster lower urinary amylase.