Objective To analyze reasons of postoperat iv e relapse of inguinal hernia and to explore the clinical significance of laparos copic transabdominal preperitoneal (TAPP) repair for recurrent hernia. Methods We retrospectively analyzed clinical data of 24 cases of recurr ent inguinal hernia treated by laparoscopic TAPP repair from June 1998 to Octobe r 2003 in this hospital. There were 11 cases of direct hernia and 13 cases of in direct hernia. Results Operations were completed successfully in all the 24 cases without conversions to open surgery. The operation time was 47~128 min (mean, 69 min), and the postoperative hospital stay, 2~5 days (mean, 3 days). Urinary retention happened in 6 cases after the operation, in which a F oley urethral catheter was indwelled for 1~3 days. There were no complications s uch as wound infection, scrotal hematoma or pneumatosis. Follow-up checkups were made for 2~66 months (mean, 27 months) in all the 24 cases. No recurrence was o bserved. Conclusions Laparoscopic TAPP repair for recurrent in guinal hernia has advantages of minimal invasion and few complications, being a safe and feasible option for treating recurrent inguinal hernia.

We presented a new method for vessel segmentation and vascular structure recognition for coronary angiographic images. During vessel segmentation, a new vessel function was proposed to attain vessel feature map. Then the region growing algorithm was implemented with an automatic selection of seed point, extraction of main vessel branch, and vessel detail repairing. In the algorithm of vascular structure recognition, a fuzzy operator was used, which can detect the structures of vascular segments, bifurcations, crosses, and tips. The experimental results indicated that there was about 5 percent larger vessel region which was extracted by the proposed segmentation method than that by the simple region growing algorithm, and several thinner vessels were resumed from the lower gray region. The results also indicated that the fuzzy operator could correctly infer the simulative and real vessel structure with 100% and 90.59% correctness rate on the average, respectively.
Algorithms ; Coronary Angiography ; Humans ; Radiographic Image Enhancement ; methods ; X-Rays

Objective: To explore the relationship between gastrointestinal heat retention syndrome and the inci-dence of pneumonia and recurrent respiratory tract infections (RRTIs) in children. Methods: A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital. Children without respiratory tract infections (RTIs) were consecutively recruited according to the selection criteria. A semi-structured questionnaire was used to record traditional Chi-nese medicine (TCM) symptoms and demographic and physiological characteristics. Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity. The participants were followed up for 12 months. Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months. Episodes of pneumonia and RTIs were recorded in detail. Results: A total of 420 children were included. Of participants, 370 (88.10％) were followed up for 12 months. The mean number of RTI episodes per participant was 5.37 (95％ CI: 5.14 to 5.60). In total, 186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the non-gastrointestinal heat retention syndrome group completed the 12-month follow-up period. The base-line of both groups was comparable. The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27 (95％ CI: 1.01 to 1.59) times that in children without gastrointestinal heat retention syndrome. Logistic regression analysis revealed that abnormally increased appetite with frequent hunger, foul breath, dry stools, and dark red or purple fingerprints were positively correlated with the incidence of pneumonia. Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI. Conclusions: Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children. Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.