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.

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.

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.

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.

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 investigate the characteristics of the breakthrough cases of mumps in Ningbo City, Zhejiang Province from 2018 to 2023, so as to provide insights into improving prevention and control measures for mumps. Methods: Data of mumps cases and mumps containing vaccine (MuCV) vaccination in Ningbo City from 2018 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System and Zhejiang Immunization Planning Information System. The population distribution characteristics and MuCV immunization history of mumps breakthrough cases were described. The impacts of the final immunization age and immunization interval on the age of onset were analyzed. Results: A total of 6 643 mumps cases were reported in Ningbo City from 2018 to 2023, with an average incidence rate of 11.72/105. There were 5 142 breakthrough cases (77.40%), including 3 173 males (61.71%) and 1 969 females (38.29%). The median age of onset was 6.00 (interquartile range, 4.00) years. There were 2 487 cases in preschool children (48.37%) and 2 232 cases in students (43.41%). There were 4 736 one-dose breakthrough cases (92.10%) and 406 two-dose breakthrough cases (7.90%). The proportion of two-dose breakthrough cases among all mumps cases increased from 1.00% in 2018 to 25.32% in 2023. Among individuals born after December 2018, the median age of onset of two-dose breakthrough cases was 3.00 (interquartile range, 1.00) years, which was older than that of one-dose breakthrough cases at 1.00 (interquartile range, 2.00) year (P<0.05). The ages of onset of mumps breakthrough cases differed significantly with varying final immunization ages and immunization intervals (both P<0.05). Conclusions The breakthrough cases of mumps in Ningbo City from 2018 to 2023 were mainly males, preschool children and students. The proportion of two-dose breakthrough cases increased, and the age of onset delayed.

Diabetic rat model was established by peritoneal injection of streptozocin.At the end of 2 weeks,oxidized low-density lipoprotein (oxLDL) level in diabetic rats was raised [ ( 2.87 ± 0.40 vs 2.27 ± 0.36 ) μg/dl,P＜0.05 ] and endothelium-dependent relaxation was sluggish compared with normal rats.At the end of 6 weeks,oxLDL level continued to increase [ 4.32 ±0.66 ) μg/dl,P＜0.01] and endothelium-dependent maximum relaxation ( Rmax ) was decreased obviously ( P ＜0.01 ).Meanwhile,the protein and mRNA expressions of lectin-like oxidized lowdensity lipoprotein receptor-1 ( LOX-1 ),NF-kB,and ICAM-1 on vessel wall of diabetic rats were higher than those in normal rats,and LOX-1 mRNA was positively correlated with the levels of oxLDL,NF-kB,and ICAM-1 mRNA,while negatively correlated with Rmax,indicating that OxLDL/LOX-1 system may cause early endothelial dysfunction in diabetes via activating NF-kB and up-regulating ICAM-1 expression.

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 evaluate the characteristics of quantitative monitoring of brain function during the perioperative period in elderly patients and its relationship with postoperative cognitive dysfunction (POCD).Methods Seventy ASA physical status Ⅰ or Ⅱ patients,aged ≥ 60 yr,scheduled for elective lumbar spine decompression and fusion surgery under general anesthesia,having an expected postoperative length of hospital stay ≥ 7 days,were enrolled in the study.The cognitive function was assessed by using Mini-Mental State Examination before operation and the results were normal.Fifty healthy elderly volunteers were chosen and served as control group.Cognitive function was assessed at l day before operation (D0) and 3 (D3) and 7 days after operation (D7).Z score was used to identify POCD.All the patients were then divided into POCD group or control group (group C) according to the results of diagnosis.Quantitative monitoring of brain function was carried out using a traction system,and the wavelet index (WLI),i_22 and i_20 were recorded.Results A total of 67 patients completed the study and were enrolled in the analysis,there were 9 cases in group C,and 58 cases in group POCD.The WLI was significantly decreased at D7,and no significant change was found in WLI at D3 as compared with the value at D0.The WLI was significantly lower at D7 than at D3.There was no significant difference in i_22 and i_20 between the three time points.Compared with group C,i_22 was significantly decreased at D0,and no significant change was found in i_22 at the other time points and in WLI at each time point in POCD group.Conclusion During quantitative monitoring of brain function during the perioperative period in the elderly patients,WLI is significantly decreased on 7th day postoperatively,and no significant change is found in i_20 and i_22,however,the pre-operative low i_22 value can predict the development of POCD.

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.