Objective To explore surgical technique and clinical outcome of transabdominal preperitoneal hernia repair(TAPP)and totally extraperitoneal hernia repair(TEP)in inguinal hernia repair.MethodsThe clinical data of 23 patients underwent laparoscopic herniorrhaphy were retrospectively analyzed.Nine patients were underwent TAPP,and 14 patients underwent TEP.ResultsNone of patients was changed to open operation.Only one patient of TEP was changed to TAPP.Average operative time was(82.1?40.6)min.Blood loss was(5.7?3.0)ml.Disruption of peritoneum happened to 2 patients underwent TEP.The rate of postoperative complications was 21.7%(5/23),which included serum swelling(1 case),scrotal emphysema(2 cases),transient neurapraxia in the area of repair(1 case)and urinary retention(1 case).No chronic pain,foreign body sensation and infection were found.Average hospitalization after operation was(4.3?0.9)d.No recurrence was observed during a follow-up period of 1-15 months.ConclusionLaparoscope herniorrhaphy is safe due to lower recurrence and complications.It also has the advantages of slight pain and rapid recovery.

Objective To investigate the effect of hypertonic sodium chloride hydroxyethyl 40 injection (HSH)on craniocerebral injury accompanied with hypovolemic shock and ICP.Method Sixty patients suffering from craniecerebral injury accompanied with the hypovolemic shock and admitted to ICU and Neurosurgical Department of Guang dong General Hospital from September 2007 to June 2008,were chosen into the study prospectively.Those who was younger than 18years or older than 70 years,and those who were pregnant or meustruous women,or serious hepatic and renal insufficiency,hypertension,coronaxy artery disease,diabets mellitue,uncontrolled bleeding,brain death,erc were excluded.The patients were randomly divided into 3 groups.Each group included 20 patients and they were resuscitated with LR(500 ml),HIS(4 ml/kg)and HSH(4 ml/kg)respectively.The changos of blood pressure,laboratory examination indices and ICP Were detected before and at 30,60,120 minutes after resuscitation.Results MAP raised over 60 mmHg and ICP declined 10%within 30 min in HIS and HSH groups.The effect of HSH on the improving of blood pressure and the reduction of ICP wag more obvious than that of LR and HIS at 120 minutes(F=18.43,8.99,P<0.05)after resuscitation.There were no obvious oboes of the laboratory examination indices after resuscitation.Conclusions The themputic effect of HSH on ICP and MAP in craniocerebral injury accompanied with hypovolemic shock is obvious and lasting,which would be beneficial to the protection of cerebral function.

Objective To evaluate the indications of temporary cardiac pacing during perioperative period of non-cardiac operations.Methods Temporary cardiac pacemakers were installed preoperatively in 102 patients with bradyarrhythmia.The patients were divided into paced and no-paced groups according to the ECG monitoring during perioperative period.Clinical data were compared between the two groups.Results Totally 37 patients needed pacing during perioperative period.They were older than the no-paced patients [(61?17)y vs(52?14)y,t=2.885,P=0.005].In the paced group,more patients had history of myocardial infarction [54%(20/37)vs 14%(9/65),?2=18.733,P=0.000],cardiomyopathy [8%(3/37)vs 0%(0/65),P=0.045],and syncope [11%(4/37)vs 0%(0/65),P=0.030],abnormal findings in Holter [97%(36/37)vs 48%(31/65),?2=25.741,P=0.000] and UCG [97%(36/37)vs 45%(29/65),?2=26.076,P=0.000].Conclusions Temporary cardiac pacemaker can enhance the perioperative safety and reduce the incidence of cardiovascular complications in patients with bradyarrhythmia.Overall assessments of clinical setting were needed before implantation.The indications for temporary cardiac pacing include bradyarrhythmia with myocardium disorder,which is confirmed by UCG,advanced age,as well as history of syncope.Positive result of atropine test is not one of the significant indications.

Objective To observe different effects of cyclic and continuous nutrition infusion on serum nutritional indicators, peripheral white blood cell counts (WBC), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ ) score in patients with mechanical ventilated respiratory failure (MVRF).Methods A cross-over and self-controlled trial was conducted in 48 patients with MVRF treated in a medical intensive care unit during December 2006 to June 2009, and continuous nutrition (group A) and cyclic nutrition (group B) were infused respectively for patients of the two groups.Serum levels of albumin (ALB), pre-albumin (PA), transferrin (TR), PaO2, PaCO2, WBC and APACHE Ⅲ score were measured for the patients with 24-hour continuous nutrition (group A) and 16-hour cyclic nutrition (group B)infusion.Effects of the two nutritional therapies were compared.Results After nutrition infusion, serum levels of ALB, PA and TR were (34±3)g/L, (196±28)mg/L and (2.1±0.3 ) g/L in group A, and (35 ±4) g/L, (198 ±25) mg/L and (2.0 ±0.4) g/L in group B, respectively; and PaO2 and PaCO2levels were (92 ± 12) mm Hg ( 1 mm Hg =0.133 kPa) and (42 ± 10) mm Hg in group A, and (91 ±9)mm Hg and (42 ± 10) mm Hg in group B, respectively.WBC and APACHE Ⅲ score were ( 11.8 ± 1.7) ×109/L and 38 ±7 in group A, and ( 12.6 ± 1.2) × 109/L and 40 ±6 in group B, respectively.Significant difference in serum levels of PA and TR was found between the two groups (PPA =0.019 and PTR =0.013),while there was no significant difference in other indictors between the two groups.Conclusions 24-hour continuous nutrition infusion for patients with MVRF can obviously improve their serum levels of PA and TR,but has no effect on serum level of ALB, PaO2, WBC and APACHE Ⅲ score in critical ill patients, as compared to those with 16-hour cyclic nutrition infusion.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; physiopathology ; psychology ; Quality of Life ; psychology ; Survivors ; psychology

Objective To study the relation between phlegm-damp retention type of metabolism syndrome and microcosmic indices in order to find out the objective evidence for TCM syndrome differentiation.Methods Totally 49 cases of metabolism syndrome were observed,25 of them were phlegm-damp retention type in differentiation and 24 were non-phlegm-damp retention type.The height, body weight,waistline and blood pressure of two groups were measured,the serum leptin,insulin and blood lipid were determined, and the insulin resistance index(IRI)and body mass index(BMI)were calculated.Results The leptin,BMI,systolic pressure,FINS and IRI of the phlegm-damp retention group were all higher than those of the non-phlegm-damp retention group.Conclusion BMI, leptin,insulin,and IRI may be taken as the the index of syndrome differentiation in metabolism syndrome.

The biobank for medical researchers is a resource of significant utility , which also causes a series of ethical issues. For example, the question of what kind of informed consent should be adopted for the biobanking tissue residue, whether related study can be conducted without the donors' consent and how to accomplish the biobank research. Based on ethical principles of donation, individual rights of donor and common interest of the society, this study suggested the informed consent that to which extent can be accepted for biobank and which type should be adopted in different scenes with two feasible choices. One is the irreversible, and the other is the reversible anonymization process for samples. The necessity and rationality of informed consent for biobank con-struction were also evaluated in order to provide references for the ethical practice of biobank research.

Animals ; Bites and Stings ; virology ; Cats ; Child ; Epstein-Barr Virus Infections ; diagnosis ; Herpesvirus 4, Human ; Humans ; Lymphadenitis ; diagnosis ; virology ; Male

Anti-Infective Agents ; therapeutic use ; Burkholderia pseudomallei ; drug effects ; isolation & purification ; Humans ; Male ; Melioidosis ; drug therapy ; microbiology ; pathology ; Middle Aged ; Skin Diseases, Bacterial ; drug therapy ; microbiology ; pathology ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Isocitrate Dehydrogenase ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Male ; Mutation ; Nuclear Proteins ; genetics ; Prognosis ; Treatment Outcome