ObjectiveTo explore the clinical effect of the different surgical treatment for patients with inguinal hernia.Methods98 patients with inguinal hernia were randomly divided into two groups and 49 cases in each group.The observation group was given filling tension-free hernia repair,the control group using traditional hernia repair.The postoperative follow-up were compared in clinical efficacy and recurrence.ResultsIn the observation group and control group,the duration of postoperative pain,surgical time and patient recovery time was 93.9％ (46/49) vs 81.6％ (40/49) (x2 =2.645,P＜0.01),(45.2 ±7.2)min vs (51.4 ±6.4)min(P ＜0.05),(60.8±5.4) min vs (71.4 ± 6.7) min ( P ＜ 0.05 ),( 2.0 ± 2.1 ) d vs (4.9 ± 1.8) d ( P ＜ 0.05 ).Postoperative follow-up found that both groups of patients relapse rate was statistically significant( x2 =3.279,P ＜0.01 ).ConclusionTwo different surgical treatment of inguinal hernia,the tension-free hernia repair compared with the traditional hernia repair was more suitable for the body,surgery time and recovery time was short,reducing the relapse rate in patients with inguinal hernia,was an effective means of treatment.

Objective To explore the psychological characteristics of cancer long-term survivors.Methods One hundred and fifty one cancer long-term survivors(survival time ≥5 years) were chosen for participation from Guangzhou and Shenzhen by the coin method in this study.The qualitative data of the patients'psychological characteristics were collected by individual interviews,and the patients'behavioral and psychological characteristics were measured by the Tumor Psychological Scale(TPS),the Cancer Coping Modes Questionnaire(CCMQ) and the Psychological Adjustment Scale for Cancer Patients(PASCP).The psychological characteristics of the 151 cancer long-term survivors were compared with the average level of cancer patients (over 557 patients).Quantitive data were analyzed by two independent samples't-test.Results (1) Most cancer long-term survivors knew their diagnosis in two weeks after they were diagnosed.The cancer long-term survivors were better in mentality and got more social supports.Most long-time survivors attributed their success to good psychological well-being and positive treatments.(2) The TPS scores of cancer long-term survivors group(1.99 ± 0.45,1.68 ± 0.51,1.33 ± 0.32,1.87 ± 0.44,1.78 ± 0.41 respectively) were lower than the scores of the average level of cancer patients (3.06 ±2.12,3.08 ± 2.03,2.86 ± 2.08,3.02 ± 2.06,2.98 ± 1.75 respectively) in the dimensions of personality,emotion,unconscious,cognition and the total average score.The differences were significant statistically(P ＜ 0.01).The CCMQ scores of cancer long-term survivors group were higher than the scores of the average level of cancer patients in the dimension of confrontation and catharses.In the dimensions of avoidance and suppression,resignation and fantasy,the scores of cancer long-term survivors group were lower than the scores of the average level of cancer patients.All the differences were significant statistically (P ＜ 0.05).The PASCP scores of cancer long-term survivors group were higher than the scores of the average level of cancer patients in the dimension of emotion/self-esteem,subjective feeling,interpersonal relationship/social life,the daily life and the other.The differences was significant statistically(P＜ 0.001).Conclusion There are common characteristics of cancer long-term survivors such as good mental health state,lower tumor psychological level,positive coping styles,getting better psychological adjustment.

Objective To analyze the skeletal characteristics of temporomandibular joint in patients with unilateral posterior scis-sors bite by using the cone-beam computed tomography(CBCT) .Methods Thirty-five patients of Angle class Ⅰ were scanned by CBCT (19 cases with unilateral scissors bite as the experimental group and 16 cases without scissors bite as the control group ) The CT images were reconstructed into 3D computer models by using the Dental Volume Reformat Function of the Ondemand 3D pack-age .9 anatomical landmarks were located and all data of 11 measured value were statistically analyzed .Results There were statisti-cal differences in the skeletal characteristics of temporomandibular joint in the scissors-bite side of the experimental group compared with those in the non-scissors-bite side (P<0 .01) .The side-to-side differences of the skeletal characteristics of temporomandibular in the controlled group were not statistically significant (P>0 .05) .There were statistical significances in the skeletal characteris-tics of temporomandibular joint of the controlled group compared with those in the scissors-bite side of the experimental group ,and the same with those in the non-scissors-bite side (P<0 .01) .Conclusion The CBCT is an effective tool to analyze the skeletal char-acteristics of temporomandibular joint characteristics .There were differences in the morphology of the condyle and the glenoid fossa of patients with unilateral posterior scissors bite .

Objective To investigate the distribution and antimicrobial resistance of gram-negative bacilli isolated from wound specimens of orthopedic patients,and provide reference for the rational use of antimicrobial agents. Methods 682 isolates of gram-negative bacilli were collected from orthopedic department in a comprehensive hospi-tal between January 2011 and December 2013, antimicrobial susceptibility testing results were analyzed. Results The main gram-negative bacilli isolated from wound specimens of orthopedic patients were Pseudomonas aeruginosa (P .aeruginosa)(16.72%),Escherichia coli (E.coli)(15.40%),and Enterobacter cloacae (E.cloa-cae)(12.76%).The detection rates of extended-spectrum beta-lactamase-producing E.coli and Klebsialla pneu-moniae (K .pneumoniae)were 54.29%(57/105)and 31 .43% (22/70)respectively,and mainly distributed in the trauma orthopedic department,accounting for 49.12% and 45.45% respectively.The susceptibility rates of E.coli, K .pneumoniae ,and E.cloacae to meropenem and imipenem were all 100.00%.The susceptibility rates of E.coli and K .pneumoniae to amikacin,piperacillin-tazobactam and amoxicillin/clavulanic acid were all >80%.Suscepti-bility rate of E.cloacae to most antimicrobial agents were 71 .26% -100.00% except for piperacillin(64.37%). Susceptibility rates of P .aeruginosa to most antimicrobial agents were >85% except for cefepime (78.95%)and aztreonam (65.79%).Conclusion Gram-negative bacilli are the most common pathogens in wound infection of or-thopedics patients.In order to use antimicrobial agents rationally and improve clinical treatment effect,it is impor-tant to realize the distribution of pathogens and antimicrobial resistance.

Purpose To investigate the application value of diffusion weighted imaging (DWI) in differential diagnosis of common liver lipid-containing tumors.Materials and Methods Sixty patients with pathologically confirmed liver lipid-containing tumors from January 2011 to August 2015 were retrospectively analyzed,including 25 cases ofhepatocellular carcinoma (HCC),20 cases of hepatic adenoma (HA) and 15 cases of hepatic angiomyolipoma (HAML).Apparent diffusion coefficient (ADC) value and ratio of ADCtumor/ADCliver (rADC) of tumors were respectively measured.Routine MRI findings were analyzed.Results The MRI findings of these three common liver lipid-containing tumors were with their own characteristics.For HCC,HA and HAML,the average ADC value was (1.225±0.221)×10-3 mm2/s,(1.318±0.212)×10-3 mm2/s and (1.317±0.297)×103 mm2/s,respectively,(b=800 s/mm2);the average rADC value was 1.004± 0.151,0.984 ± 0.146 and 1.027±0.223,respectively.There was no significant difference in ADC and rADC among these three tumors (P＞0.05).Conclusion ADC and rADC had no differential diagnosis value in common liver lipid-containing tumors.Routine MRI signals and enhanced imaging features are the main diagnostic basis.

Objective To establish a rapid and sensitive method for detection of urinary protein.Methods In B-R buffer solution with pH 4.2,the signals of resonance light scattering by Poncesu S (PS) combined with protein in ?ex=?em=306nm were detected.Results There was a linear relation between the scattering signals of resonance light,and the protein concentration ranged from 0 to-1500 mg/l. The regression equation was ?I=2.24c-0.41,r=0.999 and the detection limit was 1.48 mg/l. The average recovery was 102.8% and the between-and within-subject coefficients of variation were 2.09% and 5.40% respectively.No significant difference was found compared with the method of PS.Conclusion The established method in this study is a simple,rapid and high sensitive method for determination of urinary protein.

Objective To understand the status of infection with multidrug-resistant organisms (MDROs) in intensive care units(ICUs),and evaluate the intervention efficacy of targeted monitoring.Methods Prospective study was adopted,patients who were admitted to ICUs in 2014-2015 were selected (January-December 2014 was as preintervention stage,January-December 2015 was as intervention stage),trend of MDRO infection before and after intervention were compared and analyzed.Results Before and after intervention,297 and 217 strains of MDROs were isolated respectively,except carbapenem-resistant Pseudomonasaeruginosa (CRPA),the isolated strains of carbapenem-resistant Acinetobacterbaunannii (CRAB),carbapenem-resistant Enterobacteriaceae (CRE),methicillin-resistant Staphylococcus aureus(MRSA),and vancomycin-resistant Enterococcus (VRE) declined after intervention.MDRO infection rate declined from 7.17 ％ before intervention to 3.88％ after intervention,infection rate of CRAB and CRE after intervention were both lower than before intervention (both P＜0.05);MDRO infection rates in general ICU and internal medicine ICU increased from 8.75％ and 7.84‰ before intervention to 4.39‰ and 2.28％ after intervention,respectively (both P＜0.05).After taking comprehensive intervention measures,compliance to prevention and control measures,such as ordering rate of doctor's advice on contact isolation for 24 hours,hand hygiene,health care workers' awareness all enhanced significantly(all P＜0.05).Conclusion Targeted monitoring and intervention measures can reduce isolation rate of MDROs in ICUs.

This study was aimed to find the relationship between lung function injured characteristic of ulcerative colitis (UC) and endoscopic index. It will verify and enrich Chinese medicine theory to guide clinical diagnosis and treatment. UC patients without respiratory system diseases were selected between September 2009 and March 2011 from several triple-A hospitals in China. Furthermore, disease history, lung function, colonoscopy and histopathology were taken. The results showed that among 171 enrolled cases, there were statistical differences in endoscopic index of residual-function and diffusion-function between the abnormal group and the normal group (P< 0.05). The resid-ual-function group was r = 0.003. There were no statistical differences in ventilatory-function and small-airway-function in the abnormal group. It was concluded that there were different types of injured lung function in UC. A-mong them, the abnormalities of residual-function and diffusion-function had strong correlation with the intestinal damage degree. The change on residual-function was more obvious.

Objective To explore the effect of aldosterone on renal epithelialmesenchymal transition in streptozocin(STZ)-induced diabetic nephropathy rats. Methods Wistar rats were intraperitoneally injected with STZ(60 mg/kg)for the preparation of diabetic model.After 4 weeks,the rats with urinary protein＞30 mg/d were regarded as successful diabetic nephropathy(n=16),and were randomly divided into diabetic nephropathy(DN group,n=8)and spironolactone group(SP group,n=8).Then eight healthy rats were selected randomly as control group(N group,n=8).SP group rats were treated with spironolactone 40 mg·kg-1·d-1,and N group and DN group rats were given equal water.After 8 weeks,rats were sacrificed to collect urine,blood plasma,kidney tissue for detection of 24 h urinary protein,creatinine and renal pathological changes.Aldosterone concentration in plasma and kidney tissue was detected by mdioimmunoassay;E-cadherin,α-SMA protein expression by immunohistochemistry,Western blotting; E-cadherin,α-SMA mRNA expression by RT-PCR. Results Compared with N group,serum creatinine, urinary protein excretion in the DN rats were significantly higher (P＜0.01,respectively), E-cadhefin protein and mRNA were significantly reduced (P＜0.01, respectively),α-SMA protein and mRNA expression was up-regulated (P＜0.01, respectively). Aldosterone level of kidney tissue in DN rats was increased obviously [(24.71±5.30) ng/g vs (16.38±2.85) ng/g, P＜0.01], which was positively correlated with urinary protein excretion, serum creatinine and α-SMA protein (r=0.737, 0.574, 0.688, P＜0.01, respectively), and negatively correlated with E-cadherin protein (r=-0.659, P＜0.O1). While no significant difference was found in serum aldosterone among three groups. Compared with DN rats, urinary protein excretion, serum creatinine were reduced (P＜0.01, respectively), E-cadherin protein and mRNA were increased (P＜0.01, respectively), α-SMA protein and mRNA expression were decreased (P ＜0.01, respectively) in SP group rats.Conclusions Local aldosterone involves in renal epithelial-mesenchymal transition in diabetic nephropathy rat. Spironolactone can block the effect of aldosterone and play a role in renal protection.

OBJECTIVE To drew the map of distribution of concealed sites in epistaxis and optimize the mode of diagnosis and treatment. METHODS We have searched 117 references on intractable/refractory/latent epistaxis treated under nasal endoscopy in the last decade, including 11 708 cases with epistaxis. There were total 11 860 cases in this study plus 152 cases in our hospital. We summed up the experiences of the optimized treatment mode performed on concealed epistaxis, which was searching the accurate bleeding areas by nasal endoscopy and performing minimally invasive radiofrequency treatment without nasal packing. RESULTS We had found that the offending arteries about epistaxis are mainly sphenopalatine artery and anterior or posterior ethmoid artery. The frequency of bleeding areas came as follows: the vault of inferior nasal meatus in 3783 cases(31.90%), the olfactory sulcus of middle turbinate in 3522 cases(29.70%), the posterior regions of middle meatus in 1349 cases(11.37%), the regions of deviation of nasal septum in 1065 cases(8.98%), the foremost regions of nasal cavity in 738 cases(6.22%), and the others or uncertain in 1403 cases(11.83%). Finally, we drew a concise map of distribution about epistaxis on the basis of the concealed bleeding areas and offending vessels. 151 of 152 patients(99.34%) could find out the bleeding sites accurately and stop the bleeding through minimally invasive radiofrequency ablation. CONCLUSION We drew a map of distribution about epistaxis in concealed areas so that it is convenient for us to seek out the bleeding sites. Rational use of nasal endoscopy to explore the sites of intractable epistaxis and minimally invasive radiofrequency are optimized mode of treatment.