Objective To compare the efficacy and complications of early transabdominal preperitoneal patch (TAPP) implantation and open tension-free repair in the treatment of adult inguinal hernia .Methods 84 adult patients with inguinal hernia were divided into two groups by random number table ,and 42 cases in each group .The control group was given Lichtenstein technique ,while the observation group underwent TAPP .The surgery situation, postoperative visual analogue scale (VAS) scores,postoperative morbidity and recurrence rate were compared between the two groups.Results The operative time,ambulation time,average length staying hospital and postoperative VAS scores of the observation group were (42.21 ±3.13) min,(1.13 ±0.21) d,(4.28 ±0.62) d and (2.28 ±0.22) points,which were significantly less than (65.72 ±3.62)min,(2.03 ±0.30)d,(7.87 ±0.83)d and (4.56 ±0.31) points of the control group(t=7.29,8.02,8.32,9.29,all P<0.05).The incidence rate of postoperative complica-tions and recurrence rate of the observation group were 11.90% and 2.38%,which were significantly lower than 26.19%and 16.66%of the control group(χ2 =12.52,14.39,all P<0.05).Conclusion The effect of TAPP in the treatment of adult inguinal hernia is remarkable ,and it is safe and minimally invasive ,which is easy to operate ,it has low recurrence rate ,rapid postoperative recovery and has better clinical value .

OBJECTIVE To survey the distribution and diversity of bacteria among COPD patients in our hospital′s comprehensive intensive care unit(ICU).METHODS All 166 strains of bacteria were divided into three groups:from noninvasive positive pressure ventilation,from mechanical ventilation and from standard medical treatment and compared their difference.RESULTS The most common pathogens were Candida albicans(38.8%),Klebsiella pneumoniae(10.2%) and Escherichia coli(8.2%) in the standard medical treatment group;C.albicans(45.5%),Pseudomonas aeruginosa(9.1%) and K.pneumoniae(9.1%) in the noninvasive positive pressure ventilation group;however,P.aeruginosa(23.2%),C.albicans(17.9%)and Acinetobacter baumannii(12.6%) in the mechanical ventilation group,respectively.Accompanying with the mechanical ventilation,the resistant-drug rates were observably increased.CONCLUSIONS The percentage of Gram-negative bacilli and fungal infection in the COPD patients of comprehensive ICU is very high.So we should supervise and control the results of antibiotics susceptibility.

Objective To study on the changes of the DNT cells and T lymphocyte subtype in children with infectious mononucleosis (IM) and its clinical significance.Methods The flow cytometry (FCM) was used to detected the DNT cells and other T lymphocyte subtype in 48 cases of IM.Results The study showed that DNT cells( 9.39 ± 4.89 )% were greatly increased in comparison with normal controls (NC) (4.26 ± 1.68)% ( P ＜0.01 ).CD4 cells(21.45 ±9.87)% were decreased ( P ＜0.01 ) and CD8 cells increased in comparison with NC (32.43 ± 5.07) % ( P ＜ 0.01 ).Conclusion DNT cells and T lymphocyte subtype can be used to evaluate the immune function of children with infectious mononucleosis (IM) and provide guidance for adoptive immunotherapy.

Objective To study of percutaneous laser disc decompression(PLDD)in the patients of lumbar disc herniations.Methods 66 patients were treated with PLDD.The mean age of the 48 male and 18 female patients was 39.3 years old.Results 58 patients of all,or 87.9% showed excellent or good result.15 patients(78.9%)showed excellent and 2 patients(10.5%) were good,2 patients(10.6%) were fair or poor under 30 year old.15 patients(44.1%)showed excellent and 17(50.5%)patients were good,2(5.9%)patients were fair in 31~50 years old.2(15.4%) patients showed excellent and 7(53.8%)patients were good,4(29.8%)patients were fair or poor over 51 years old.Conclusion PLDD is safe and convenient method of treating lumbar disc herniations.

OBJECTIVETo study the relationship between allergic rhinitis and fractional exhaled nitric oxide (FeNO).METHODS FeNO was measured in 66 allergic rhinitis patients before and after treatment. Visual analogue scale (VAS) score was used to describe the patient's symptoms. RESULTSFeNO and VAS score were significantly decreased after treatment (t=4.25,P=0.0000;t=3.34, P=0.0008), and the decrease proportion were (14.56±27.23)% and (8.68±53.17)% respectively. Correlation analysis showed FeNO and VAS score was significantly correlated before (r=0.43,P=0.0003) and after (r=0.45,P=0.0002) treatment. After treatment, the decreased proportion of FeNO and VAS score were significantly correlated (r=0.25,P=0.0437). CONCLUSIONFeNO can provide objective evidence for the treatment efficacy of allergic rhinitis.

Objective To define basic medical service items in Shanghai community health centers.Methods Two rounds of Delphi expert consultation were carried out with 36 experts specialized in general practice,general practitioner training,internal practice,public health and health management,then the scope of medical service system was set up based on experts' opinions.Results The newly-defined system consisted of three first-grade items:outpatient medical service,hospital medical service and medical service for home beds and temporary home visits.The first-grade items contained 22 second-grade items and the second-grade items consisted of 26 detailed items,including 17 baseline items,8 optional items and 1 restrained item.In two rounds of Delphi consultation the activity coefficient of experts was all 100％,authority coefficients of experts was 0.825,and harmonious coefficient of the importance of the evaluation was 0.361 and 0.488 (all P ＜ 0.01),respectively.Conclusion The preliminarily developed system of basic medical service items in Shanghai community health service can provide a reference frame for government policy-making.

Objective To observe the protein expressions of PI3Kp110, pAkt, pGSK3β of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) signaling pathway in the whole blood of patients with Kashin-Beck disease and analyze the status of PI3K/Akt signaling pathway. Methods Patients with Kashin-Beck disease ( KBD group ) were from six counties ( Xunyi , Linyou , Yongshou , Qianyang , Changwu and Long County) of Shannxi Province in Kashin-Beck disease areas , and the healthy controls (control group) were matched by age and sex. Venous blood was collected from patients and healthy controls. Trizol method was applied to extract the whole blood protein; protein expression levels of PI3K/Akt signaling pathway in whole blood were detected by Western blotting; the gray values were observed and recorded by the sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS-PAGE) and GDS-8000 gel imaging analysis system. Differences between the two groups were assessed by Student’s t-test. Results Compared age and sex between KBD group and control group, differences were not statistically significant(t=0.701, P>0.05;χ2=0.400, P>0.05). The protein expression levels of PI3Kp110, pAkt and p-GSK3β in KBD group were higher than that in control group(156.1 ± 92.1 vs. 79.5 ± 21.5, 113.7 ± 15.2 vs. 43.3 ± 10.7 and 105.9 ± 17.5 vs. 37.3 ± 12.0, respectively) and the differences were statistically significant (t=2.563, 6.567, 7.916; all P < 0.05 or < 0.01). Conclusion The PI3Kp110, pAkt and p-GSK3β expressions of signaling pathway proteins in the whole blood of patiens with Kashin-Beck disease are up-regulated significantly and the status of PI3K/Akt signaling pathway is activated.

Objective　To define the range of the normal values of MRI signals of hippocampal formation(HPF) for the diagnosis of early stage Alzheimer's disease and hippocampal sclerosis.Methods　MRI signals of 254 normal adults were measured on the transverse section.Results　HPF signal intensities were:T1 relaxation times,629±73 ms;T2 relaxation times,83±5.5 ms;and proton density value,5978±651.The T2 value range(χ±2S)was 72～94 ms,and mean 83 ms.T2 value greater than 104 ms will be associated with evidence of hippocampal pathologic changes.The mixed signal intensity of T2WI(30,60,120)were:3907±407,2657±347,1288±174.The signal intensity ratios of T2WI were:1.02,1.07,1.13.Conclusion　As for the histological features of temporal lobe cortex and HPF,T1relaxation times and proton density values are matched but T2 relaxation times of HPF are relatively longer.

Objective To evaluate the clinical efficacy of transpedicular intracorporeal bone graft with allogenic bone in treatment of thoracolumbar osteoporotic compression fracture. Methods A total of 45 patients with thoracolumbar osteoporotic compression fractures were treated with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone. Anteroposte-rior and lateral X-ray photographs were taken before and after operation and at follow up period to determine the ratio of anterior and middle compressed body height to the normal height, the vertebral angle and the superior-inferior endplate angle. The extent of local pain was measured by VAS score. The implant failure was also recorded during follow-up. Results The operative reduction and interbody bone grafting exerted a satisfactory effect on the ratio of anterior and middle body height to the normal height, the vertebral angle and the superior-inferior endplate angle. Local back pain disappeared immediately after surgery in 34 patients out of 38 patients followed up for more than two years. No implant failure was found during follow-up. Conclusions Early treatment with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone can effectively correct local deformity, prevent late vertebral collapse and implant failure and is an ideal treatment method for thoracolumbar osteoporotic compression fracture.