Objective To explore the value of tension-free hernioplasty in the treatment of adult inguinal hernia.Methods 70 cases patients with inguinal hernia were randomly divided into the observation group(52 cases, given tension-free hernioplasty) and control group(18 cases,given traditional hernioplasty) ,the operation time,active time,the hospitalization time and postoperative pain of the two groups in perioperative period were observed and recor-ded,and the results were statistically analyzed.Results The observation group patients in the operation time, bed time,postoperative hospitalization time was (42.4 ±13.1) min,(1.5 ±1.1) d,(4.1 ±1.6) d,the control group (65.6 ±14.8) min,(2.4 ±1.2) d,(6.3 ±2.9) d,two the three indexes were significantly different ( t=6.263, 2.923,4.011,all P<0.01);the score of pain patients in the observation group[(2.3 ±0.8)points]was significantly lower than that of the control group[(3.4 ±0.6)points] (t=5.461,P<0.01).Conclusion tension-free hernio-plasty has a significant effects on treating patients with inguinal hernia,the operation time is short,the postoperative recovery is quickly,which is worthy of clinical widely.

Objective:To explore the effect of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis.Methods:Totally 40 patients with cholecystolithiasis complicated with choledocholithiasis in the Second People's Hospital of Anqing from January 2016 to December 2019 were divided into double mirror combined group (20 cases) and open surgery group (20 cases) according to the operation mode.The patients in the double mirror combined group were treated by laparoscope combined with choledochoscope, and patients in the control group were treated by cholecystectomy and common bile duct exploration.The operation time, amount of bleeding, time to first flatus, postoperative complications and blood indicators were compared between the two groups.Results:The amount of bleeding[(32.50±14.82)mL], the length of hospital stay[(17.30±3.34)d], and the incidence of complication[ 5%(1/20)] in the double mirror combined group were lower than those in the open surgery group[(68.50±30.82)mL, (21.15±5.18)d, 40%(8/20)], the operation time[(162.50±56.39)min] in the double mirror combined group was longer than that in open surgery group[(102.25±21.18)min], there were statistically significant differences ( t=4.707, 2.792, 4.473, χ 2=2.692, all P<0.05). The levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and albumin (ALB) in the two groups after operation were lower than those pre-operation, which in the double mirror combined group were better than those in the open surgery group[double mirror combined group (preoperation and postoperation): ALT(215.35±272.00)U/L, (44.60±44.63)U/L, TBIL(38.80±43.23)μmol/L, (16.68±11.93)μmol/L, ALB(42.65±3.25)g/L, (39.58±3.78)g/L; open surgery group(preoperation and postoperation): ALT(201.78±61.14)U/L, (61.14±48.35)U/L, TBIL(80.89±91.16)μmol/L, (40.24±53.61)μmol/L, ALB(39.37±6.81)g/L, (34.11±4.78)g/L], there were statistically significant differences ( t1=2.86, 2.72, 4.02; t2=3.54, 3.89, 4.34, t3=3.56, 4, 12, 4.01, all P<0.05). There was no statistically significant difference in white blood cell count ( P>0.05). Conclusion:The clinical efficacy of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis is better than open surgery.

Objective: To explore the short and mid-term efficacy of device closure of patent foramen ovale (PFO) for treating the patients with PFO combining cryptogenic stroke (CS) and transient ischemic attack (TIA). Methods: A total of 56 PFO patients with CS and TIA receiving device closure in our hospital from 2009-05 to 2015-12 were retrospectively studied. Transthoracic echocardiography (TTE), electrocardiogram (ECG), chest X-ray were examined at 24h, 1 month, 3 and 6 months after theoperation; telephone visit was conducted every 6 months thereafter. Results: There were 54/56 PFO patients combining CS and 2 combining TIA; 53 (94.6%)patients received PFO occluder from Starway medical technology. Aspirin was used for 6 months after the operation. The patients were followed-up for the average of (34.67±23.24) months. No body suffered from post-operative stroke and TIA; no residual shunt was observed. Conclusion: The short and mid-term efficacy of device closure has been satisfactory for treating the patients with PFO combining CS and TIA; its overall clinical value should be further investigated in large population and long-term study.

Objective    To assess the feasibility and safety of percutaneous transcatheter closure of atrial septal defect (ASD) guided by transthoracic echocardiography (TTE) in outpatients. Methods    From December 2016 to June 2018, 50 simple ASD patients underwent TTE-guided transcatheter closure in the outpatient operating room of our hospital (a TTE group) including 22 males and 28 females at the age of 16-48 (27.40±6.95) years. Fifty patients with simple ASD treated with the guidance of conventional fluoroscopy during the same period were treated as a control group, including 22 males and 28 females at the age of 15-48 (28.58±6.96) years. Both groups were re-examined by TTE during follow-up at 1 month, 3 months, 6 months and 1 year. Results    The mean age, body weight, the size of ASD and occluder and success rate had no statistical difference between the two groups (P>0.05). Compared with the control group, the TTE group had significantly lower mean operation time (P<0.01) and less cost (P<0.01) since patients need not to be hospitalized. No related complications were found in the TTE group during follow-up. Conclusion    Percutaneous transcatheter closure of ASD guided by TTE appears safe and effective for outpatients, and can significantly reduce the cost.