Objective To evaluate the efficacy of ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing inguinal hernia repair.Methods Forty ASA Ⅰ or Ⅱ patients,aged 18-79 yr,with body mass index ＜ 30 kg/m2,scheduled for elective unilateral inguinal hernia repair combined spinal-epidural anesthesia,were randomly divided into 2 groups (n =20 each):control group (group C) and ultrasound-guided TAP block group (group B).The ultrasound-guided TAP block was performed at the end of surgery and 20 ml of 0.375 ％ ropivacaine was injected in group B,while the equal volume of normal saline was given in group C.Tramadol was injected intravenously when VAS score ≥ 4 after surgery.VAS scores at rest and during activity were recorded at 4,6,24 and 48 h after surgery.The warm block plane on the blocked side was measured at 24 and 48 h after surgery.The overall satisfaction on analgesia was scored and the time when the patients passed the flatus was recorded.TAP block-related side effects were recorded.Results Four patients required tramadol in group C,while no patients required rescue analgesic in group B.Compared with group C,VAS scores were significantly decreased,the overall satisfaction scores were increased (P ＜ 0.05 or 0.01),and no significant change was found in the time when the patients passed the flatus in group B (P ＞ 0.05).The rate of warm plane block on the blocked side was 80％ at 24 h after surgery and there was not warm block plane in patients at 48 h after surgery in group B.There was not warm block plane in patients at 24 and 48 h after surgery in group C.TAP block-related side effects were not found in group B.Conclusion The efficacy of ultrasound-guided TAP block for postoperative analgesia is better in patients undergoing inguinal hernia repair and the safety is higher.

Objective To evaluate the correlation between low choledochal joint and common bile duct stones(CBDS)by magnetic resonance cholangiopancreatography(MRCP).Methods The clinical data of 129 patients without intrahepatic calculus after cholecystectomy receiving MRCP from March 2008 to August 2009 were retrospectively analyzed.MRCP images and T2WIs were analyzed independently by 2 doctors to classify anatomic variants of cystic duct and calculus.Results CBDS was found in 49 and low insertion of the cystic duct in 31 of the 129 patients(38% vs.24%).For the latter 31 patients, low insertion of the cystic duct with CBDS was found in 17.The analysis showed that low choledochal joint were associated with CBDS(x2 =4.921, P=0.027).Conclusion There is a certain correlation between low insertion of the cystic duct and CBDS.The low insertion of the cystic duct is one of the risk factors for calculus of the common bile duct.

Objective To evaluate the feasibility and clinical significance of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of anatomic variants of the extrahepatic biliary tract. Methods The MRCP images of 535 patients who were admitted to The Second Affiliated Hospital of Suzhou University from March 2008 to March 2009 were retrospectively analyzed by two reviewers independently. The anatomic variants of the extrahepatic biliary tract were evaluated by studying the T2-weighted magnetic resonance images. Results The consistency between the two reviewers in the diagnosis of low choledochal joint, medial cystic duct insertion, aberrant hepatic duct, accessory hepatic duct and other anatomic variants was 98% , 99% , 89% , 90% and 100%, respectively (K = 0.86, 0.93, 0.81, 0.82, 1.00). The extrahepatic biliary system was clearly displayed by MRCP in 500 patients, and anatomic variants were observed in 240 patients, including low choledochal joint in 85, parallel cystic duct in 37, medial cystic duct insertion in 82, aberrant hepatic duct in nine, accessory hepatic duct in 10, choledochal cyst in three and high cystic duct in seven. A total of 259 patients underwent operation, and 168 patients had anatomic variants of the extrahepatic biliary tract. Conclusion MRCP imaging enables the accurate assessment of anatomic variants of the extrahepatic biliary system and avoids bile duct injury.

ObjectiveTo observe the clinical efficacy of acupuncture-moxibustion in treating tinnitus.MethodNinety-eight patients with tinnitus were divided into a warm-needling group (n=32), an acupuncture group (n=34), and a medication group (n=32), to observe thetherapeuticefficacies.ResultThe total effective rate was 83.3% in the warm-needling group, versus 78.8% in the acupuncture group and 60.0% in the medication group.ConclusionWarm needling and acupuncture plus TDP are both superior to the medication treatment in comparing the therapeutic efficacy.

ObjectiveTo explore the characteristic and difference of the executive function of the premeditated group and attack group of male juvenile delinquents by the Stroop test.Methods 123 male juvenile delinquents and 128 normal controls were examined by a general information questionnaire,the Stroop test of the Chinese version and impulsive premeditated aggression scale (IPAS).SPSS17.0 statistical software used to analysis the survey results.Results ( 1 ) By Stroop test the premeditated group and impulsive group of juvenile delinquents was found that correct number of test 3( 109.97 ± 1.87),errors number of test 4(4.45 ±4.84),amend number of test 1 and test 4 ( 1.18 ± 1.50 ; 1.50 ± 1.59 ),and completion time of test 4 ( 143.74 ± 28.36) had statistically significant (P ＜ 0.05 ),the others had no significant difference between the two groups.(2) The premeditated group of juvenile delinquents and normal adolescents in Stroop test comparison was statistically significant in completion time of test 1,test 2 (56.49 ± 14.90 ;88.31 ± 20.02)(P ＜ 0.05 ).The impulse group of the juvenile delinquents and normal adolescents was statistically significant in the correct number of test 2 to test 4( 107.20 ± 3.39 ; 109.97± 1.87 ; 102.47 ± 5.62 ),errors number of test 2 ( 1.86 ± 2.27 ),amends number of test 3 ( 1.50 ± 1.59 ),and completion time of test 1 to test 4 (59.96 ± 11.08 ;92.03 ± 20.87 ;62.77 ± 12.31 ; 143.74 ± 28.36) (P ＜ 0.05 ).The others of two groups were no significant difference.ConclusionIt is found that juvenile delinquents exist defects of executive function,and perform functional defects in the attack group of juvenile delinquents is more obviously.

Objective To define the mutation spectra of deafness gene in 318 Chinese Han population with nonsyndromic hearing loss (NSHL). Methods From October, 2015 to April, 2016, anticoagulant venous whole blood of 318 patients with NSHL were collected. The genes including GJB2, SLC26A4, GJB3 and 12Sr RNA were detected with polymerase chain reaction (PCR) and Matrix Assisted Laser De-sorption/Ionization Time-Of-Fight Mass Spectrometry (MALDI-TOF MS). Results Among these patient, 111 cases (34.9%) had GJB2 muta-tions, in which the mutation carrying rate of 235delC was the highest (25.47%), 43 cases (13.5%) had SLC26A4 mutations, 3 cases (0.94%) had GJB3 mutations, and 12 cases (3.77%) had mitochondria 12Sr RNA mutations. Conclusion Definition of mutation spectrum among dif-ferent populations with NSHL is important for development of optimal genetic screening services for congenital hearing impairment.

Objective To investigate the percentage of CD5-positive B cells in peripheral blood mononuclear cells(PBMC) of patients with chronic HCV infection and its clinical significance.Methods The expression of CD5 molecule on B cell surface was detected by flow cytometry and HCV RNA copies were detected by real-time PCR.Results The percentage of CD5+-B cells significantly increased in the patients with chronic HCV infection(58.4%?9.8%) compared with healthy controls(22.5%?5.9%)(P

The readjustment of the army establishments has resulted in the mergence of some sanatoriums into hospitals,which has given rise to a novel mode of management and offered a new opportunity for the development of sanatoriums.In the past four years since the mergence of our sanatorium into Nanjing General Hospital in 2004,we explored the mode of integrating recuperation with treatment and combined the resource advantages of ours with the technical superiority of the hospital,which led to an improvement of our competitive ability and comprehensive service and accordingly promoted the overall development of the sanatorium.

AIM: To develop an HPLC method for determining narigin,hesperidin and neohesperidin in Weili Tablet(Rhizoma Pinelliae,Radix et Rhizoma Gentianae,Fructus Aurantii immaturus etc. ). METHODS: The analysis was carried out with a Diamonsil C18(4. 6 mm ? 250 mm,5 ?m)column and the mobile phase of acetoni-trile-1% glacical acetic acid solution(19:81,v/v). The flow rate was 1. 0 mL/min and column temperature was 30 ℃. The detection wavelength was set at 283 nm. RESULTS: The calibration curve was linear within the range of 6. 0-60. 0 ?g/mL,2. 24-22. 4 ?g/mL and 10. 2-102. 0 ?g/mL for narigin,hesperidin and neohesperidin,respec-tively. The average recoveries were 100. 2% ,98. 8% and 97. 1% for narigin,hesperidine and neohesperidine,re-spectively. CONCLUSION: The method is reproducible,sensitive and accurate for determination of narigin,hes-peridin and neohesperidin in Weili Tablet.

Objective Previous studies of peripheral nerves activation during magnetic stimulation have focused almost exclusively on the cause of high external parallel electric field along the nerves, whereas the effect of the transverse component has been ignored. In the present paper, the classical cable function is modified to represent the excitation of peripheral nerves stimulated by a transverse electric field during magnetic stimulation. Methods Responses of the Ranvier nodes to a transverse-field are thoroughly investigated by mathematic simulation. Results The simulation demonstrates that the excitation results from the net inward current driven by an external field. Based on a two-stage process, a novel model is introduced to describe peripheral nerves stimulated by a transverse-field. Based on the new model, the classical cable function is modified. Conclusion Using this modified cable equation, the excitation threshold of peripheral nerves in a transverse field during MS is obtained. The modified cable equation can be used to represent the response of peripheral nerves by an arbitrary electric field.