ObjectiveTo summarize the recent therapeutic effects of mesh-plug tension-free hernioplasty in elderly inguinal hernia. MethodsAll cases were performed with mesh-plug case-hardened products, which are manufactured by American Bard Company. ResultsAll the operative procedures were performed smoothly. Postoperative complications were:6 cases of urinary retention,4 scrotal hydroceles,2 persistent wound pain,2 local lightly projections with foreign body sensation,2 hypoincisional haematoma. 1～24 months of follow-up were taken,2 recent recurrences were reported. ConclusionMesh-plug tension-free hernioplasty is a perfect surgical operation. Its main characteristics are:simple performance, less trauma, tension-free, time-saving, good recent therapeutic effect, and fewer recent recurrence. It is especially suitable to the elderly patients and/or Patients with other diseases.

Objective To observe the therapeutic effect of ultrasonic microbubble combined with bevacizumab (Avastin) on choroidal neovascularization induced by photocoagulation in rabbits.Methods CNV was induced by photocoagulation with argon laser in 30 rabbits (60 eyes).All of the rabbits underwent fundus fluorecein angiography (FFA) 21 days after photocoagulation;6-8 hours later,3 rabbits were randomly chosen to be executed to having the immunohistochemical examination.Twenty-one days after photocoagulation,27 rabbits were divided randomly into 3 groups:bevacizumb,ultrasonic microbubble+bevacizumb,and control group;each group has 9 rabbits (18 eyes).The rabbits in control group had no interference treatment;while the rats in bevacizumb and ultrasonic microbubble+bevacizumb group underwent injection with bevacizumb or ultrasonic microbubble+bevacizumb respectively.FFA was performed on all of the rabbits 7,14,and 28 days after photocoagulation to observe the inhibition of CNV;immunofluorecence and Western blot were used to detect the expression of VEGF in retina and choroid.Twenty-eight days is the time point to determine the therapeutic efficacy.The expression of VEGF and the results of FFA were the sdandards of the judgement of therapeutic efficacy.Results Proliferaion of CNV to the retinal inner layer and the obvious leakage of fluoresein in the photocoagulation area indicated that the model of CNV was set up successfully.Twenty-eight days after injection,obvious fluorescent leakage was found in the control group,and the average fluorescent leakage in bevacizumab group differed much from the control group(t=16.2952,P<0.05);while the difference between ultrasonic microbubble+bevacizumb group and bevacizumab group was also significant (t=4.7955,P<0.05).At the same time point,the expression of VEGF in bevacizumab group detected by immunofluorecent assay and Western blot differed much from the control group (t=7.0327,9.2596;P<0.05),and the difference of VEGF between ultrasonic microbubble+bevacizumb group and bevacizumab group was significant (t=2.9724,17.1937;P<0.05).this experiment show that ultrasound combined bevacizumab intravitreal injection of the therapeutic effect of CNV superior to other groups(P<0.01).Conclusion Ultrasound microbubble combined with bevacizumab injection may improve the therapeutic effect on CNV by inhibiting the expression of VEGF.

Objective To establish a method of TRFIA with high sensitivity and broad detecting range for serum HBV large surface protein (HBV-LP).Methods The monoclonal antibody of HBV-LP was covered on the microwell plate and incubated with HBV-LP in blood sample,then Eu3+ labeled antibody of HBs was added.HBV-LP in standard substance,blood samples of 66 chronic hepatitis B patients and 30 healthy controls was detected by the TRFIA and ELISA.x2 test and linear correlation analysis were used for data analysis.Results The dose-response curve of standard substance with TRFIA had good linear correlation (r=0.999).Normal reference range was established at 0-1.36 mg/L based on the ELISA results of 30 healthy controls.The sensitivity was 0.10 mg/L.The specificity was 100％ (30/30).Correlation coefficient between the TRFIA and the ELISA was 0.800 9 (P＜0.001).The positive detecting rates of the 2 methods were significantly different (89.4％(59/66) vs 77.3％(51/66),x2 =6.13,P＜0.01).The recovery rate for HBV-LP was between 95.93％-107.62％.The effective detecting range(CV＜10％) of TRFIA was 1.35-2 764.00 mg/L,and that of ELISA was 10.8-691.0 mg/L.Conclusion The TRFIA was established for HBV-LP detection with higher sensitivity and wider detecting range compared to ELISA.It has potential value for HBV screening and monitoring of antiviral therapy.

Objective To research the diagnostic value and the relative factors of abnormal hepatic perfusion in hepatic abscess. Methods During February 1998~ October 2003, spiral scan was perfomed in 34 patients with hepatic abscess, of which 34 patients with hepatocellular carcinoma without portal carcinomatous embolus were randomly selected. Following plain spiral CT scan of the liver, arterial phase scanning was started at 20 s after contrast injection. CT findings were observed and the relative factors of abnormal hepatic perfusion of hepatic abscess were analyzed. Results Abnormal hepatic perfusion in arterial phase was seen in 26 cases, of which 18 cases in hepatic abscess and 8 cases in hepatocellular carcinoma, presenting as irregular patchy high density. CT demonstrated that formation of abnormal hepatic perfusion was related to the course of diseases, but not related to the location of the lesions. Conclusion Abnormal hepatic perfusion is another important enhanced CT sign and is valuable in the diagnosis of hepatic abscess.

Objective To investigate the safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney.Methods Between May 2014 and June 2016,Clinical records of 17 cases of stones in a solitary kidney who underwent flexible ureteroscopy and holmium laser lithotripsy were reviewed.10 of these cases were male and the others female;mean age of these cases was 45.8 (32-67) years.9 were on the left side while 8 were on the right.6 cases were with functional solitary kidney (with the GFR of the contralateral kidney less than 10ml/min),while 11 others were with anatomical solitary kidney (6 due to tumor,2 due to tuberculosis,3 being congenital).All cases underwent BUS,KUB as well as CTU to confirm diagnosis before surgery,with 8 diagnosed with renal pelvis calculi,5 were with upper or middle calyx calculi,and 4 were with subrenal calyx calculi.The mean ± SD size of the stones was 1.2 ± 0.3 cm.Clinical m anifestations were asymptomatic in 10cases,backache in 5 cases and fever in 2 cases.All patients underwent exams of CBC,urinalysis,liver and kidney function,coagulation function,ECG,chest X-ray as well as cleaning midstream urine cultivation after admission.Results Mean ± SD operation time among all cases was (74.2 ± 23.6) min,the amount of bleeding during surgery was 5-15 (mean:8) ml,duration of hospitalization was 3-12 (mean:4.5)days,ureteral stents are kept for an average time of 4 weeks after surgery.3 patients developed fever after operation,1 developed urosepsis;all these patients recovered after active anti-infection treatment.No post-operative complications such as fever,renal colic,hematuresis,ureteral perforation,active bleeding as well as sepsis were found among the other patients.The preoperative and postoperative serum creatinine had statistical difference (P ＜0.05).14 patients were proved to be stone-free by KUB or CTU.The stone-free rate after a single operation was 82.3％ (14/17).Residual stone were found in the 3 patients,who subsequently underwent a second flexible ureteroscopy and holmium laser lithotripsy.The stone-free rate after a second operation was 94.1％.Conclusions Flexible ureteroscopy and holmium laser lithotripsy is a safe and effective method for the treatment of nephrolithiasis in patients with a solitary kidney with a lower procedure-related injury rate,smaller amount of bleeding,a lower complication rate and a shorter time required to recover after surgery.

Objective To investigate the diagnostic and predictive value of measuring peritoneal inflammatory cytokines in predicting biliary fistulas in patients undergoing biliary surgery.Methods Peritoneal samples and serum samples of 3227 biliary surgery patients were collected on the first,third,fifth postoperative day,and IL-6,IL-8,IL-10,TNF-? and CRP of the samples were measured.Patients were divided into two groups:those with clinical evidence of biliary fistulas and those without any evidence of biliary fistulas.The age,sex,operative method and operative time between the two groups were compared.Results There was a negative correlation between biliary fistulas and age,sex and operation mode;but blood loss,operation time and common bile duct diameter had positive correlation with biliary fistulas.Peritoneal cytokine levels were significantly higher in patients with biliary fistulas as compared to those without biliary fistulas.Conclusions The peritoneal cytokine level is a sensitive parameter of peritoneal inflammation and can be as an additional diagnostic tool for the early prediction of biliary fistulas after biliary surgery.

Objective: To expatiate the application of int er ventional treatment in emergency management of life-threatening bleeding follow ing maxillofacial and jugular trauma. Method : Three cases of ma xillofacial and jugular serious injury with life threatening bleeding were treat ed by external carotid arteriography and embolization at branch of external car otid artery. Result:External carotid arteriography and emboliza tion could effectively stop life-threatening bleeding of maxillofacial and jugu lar serious injury. Preoperation arteriography could define diagnosis and direc t the treatment. 2 cases survived after treatment and 1 died of blood lose durin g treatment. Conclusion:External carotid arteriography and embo lization is effective in the treatment of maxillofacial and jugular serious inj ury with life-threatening bleeding.

Nutrition support is an important part of comprehensive treatment strategy for critically ill patients. After long-term scientific research and practice, great progress has been made in theoretical cognition and clinical application. The authors summarize the metabolic charac-teristics and nutritional support strategies of critically ill patients based on their pathophysiological changes, in order to provide rational and theoretical basis for reasonable and effective nutrition support strategy in critically ill patients.

Clinical Information System(CIS)is a new period of hospital information system(HIS).The construction of CIS can improve doctors and nurses' work.The traditional CIS includes doctor-workstation,PACS,LIS,RIS,etc.By establishing clinical coding system,PASS,online information gathering system and PDA,the information quality and application level of CIS can be elevated.

Objective To obtain the dynamic characteristics of the stretcher bed without absorber, and to optimize the absorber. Methods Pro/E and ADAMS were used to build the dynamic model of the stretcher bed on ambulance. The principle of random sine wave superposition and Visual Basic language were used to produce time-domain pavement roughness which could stimulate the model. The system was analyzed. Results The curve of vertical acceleration in time and frequency domain and the RMS of vertical acceleration without absorber were obtained by simulation., and a reasonably suited pair of stiffness and damping coefficient was found to reduce the vibration intensity. Conclusion The inherent frequency of the stretcher bed is 2.7Hz, which is out of the sympathetic vibration area of decubital body. Through adjusting and optimizing the stiffness and damping of vibration reduction equipment, the stretcher bed is more comfortable.