Objective To study the standard operating methods and skills of Lichtenstein's tenaion-free her-nioplasty for treating groin hernia and the methods of reducing the postoperative complication and recrudescence. Methods Clinical data of treating greinhemia in 178 eases at Department of General Surgery, Luan People's Hospi-tal were reviewed and analyzed. Results On average, each operation needs 50 minutes and the patients spend 4 days in hospital. After 2～3 weeks,the patients can restore the daily activity and manual labour. There were 9 cases of uri-nary retention after operation,5 cases of scrotum haematoma's accumulating liquid,7 cases of the cut fat deliques-cing, 14 cases of various pain and numbness in groin area and 1 case of hernia recrudescence. Conclusion Lichten-stein's tension-free hemioplasty is a perfect surgical operation method which has many advantages, such as minimal trauma,rapid recovery, simple operation sequence, and less postoperative complication and recrudescence. It is in keeping with anatomy physiology.

OBJECTIVE To investigate the efficacy of rneropenem for the meatment of the patients with serious community-acquired pneumonia(SCAP).METHODS Sixty-four patients with SCAP were randomly divided into two groups.Group A(the treatment group,41 cases) was treated with meropenem(5-1.0 g iv q8-12 h?7 d) and group B(the control group,23 cases) treated with mezlocillin(5-1.0 g iv q8-12 h?7 d) in an open clinical study.RESULTS The efficacy rate of group A was 85.0%,with a bacteria elimination rate of 86.4% wheveas 57.0% and 64.3% in group B.There were significant difference between two groups(P

To prepare bio-degradable albumin microspheres containing carboplatin. METHODS: Bovin serum albumin microspheres containing carboplatin were prepared by using emulsion-direct heat cross linking techniques. RESULTS: The microsphere was yellow, powdery, with a mean diameter of 58.2 μm. The microphere loaded (11.26±0.48)% carboplatin. The trapping efficiency was (84.5±3.6)%. The pattern of drug releasing from the microspheres in vitro fitted to zero order release plot, with an initial burst in the first 2 hours. The releasing rate can be expressed by the follow equation: Q=21.90+8.50 t (d), r=0.995 8. t50=3 d. Stored at 4 ℃ and 37 ℃ respectively for 3 months, the microspheres did not alter much in shape, size and drug content. CONCLUSIONS: This method is simple, reproducible, having high drug trapping efficiency. The microsphere obtained is stable and release drug at a consistant rate in vitro, leading to a prosperity in clinical use.

Objective To investigate the clinical efficacy, the toxicity and side reactions of interventional chemoembolization with FOLFOX4 regimen through both hepatic artery and superior mesenteric artery, i.e. dual access technique, in treating primary hepatocellular carcinoma. Methods Between November 2010 and March 2013 at authors’ hospital, a total of 21 patients with advanced primary hepatocellular carcinoma (the study group) were treated with FOLFOX4 regimen by using dual access interventional technique. FOLFOX4 regimen included hepatic arterial infusion of 5-fluorouracil 400 mg/m2, hepatic arterial chemoembolization with iodipin and oxaliplatin 85 mg/m 2, intravenous administration of calcium folinate 200 mg/m2 IV on the first and second day, trans-superior mesenteric artery continuous infusion (lasting for 22 hours) of 5 -Fuorouracil 600 mg/m2 on the first and second day. During the same period other 21 patients with primary hepatocellular carcinoma were selected (used as the control group) to receive conventional hepatic arterial chemoembolization. In both groups, the treatment was repeated after 4-6 weeks. The therapeutic effect and the toxicity and side reactions were evaluated after the second treatment. Results The effective rate for the study group and the control group was 61.9% and 28.6% respectively, and the median survival time for the study group and the control group was 14.7 months and 9.4 months respectively. The differences in the effective rate and the median survival time between the two groups were statistically significant (P = 0.030 and P = 0.034). The occurrence of toxicity and side reactions, such as digestive tract reactions and the damage of liver function, in the study group were strikingly lower than those in the control group. Conclusion Through dual approach of hepatic artery and superior mesenteric artery catheterization, interventional chemoembolization with FOLFOX4 regimen is outstandingly effective for primary hepatocellular carcinoma, meanwhile, the side effects are very slight.

Hypoxia exists in a wide range of advanced solid tumors and is often associated with poor prognosis.Hypoxia can enhance tumor invasion, promote tumor angiogenesis, impact genomic stability and change the tumor microenvironment by activating expression of relevant genes through hypoxia-induced factors (HIFs).Hypoxia provides favorable conditions for tumor metastasis and relapse, and it is involved in all aspects of tumor development.The study of hypoxia in tumors may provide useful information for pre-clinical evaluation, individualized treatment and clinical prognosis.Positron emission tomography (PET) is a non-invasive imaging method, which can be used for assessing and quantifying tumor hypoxic microenvironment.This article reviews the mechanisms of hypoxia-induced tumor biological behavior changes and the research progress of the application of radiotracers for PET imaging of tumor hypoxia.

OBJECTIVE:To evaluate the curative effect and safety of dexamethasone for severe asthma and severe sepsis systematically. METHODS:Randomized controlled trials about dexamethasone for severe asthma and severe sepsis were retrieved from database,such as Cochrane library(1996～2007),PubMed(1966～2007),EMCC(1995～2007),CHKD(1994～2007)and pertinent literatures. The qualities of included studies were evaluated and extracted data were analyzed by Meta-analysis respectively. RESULTS:11 trials containing 1 435 cases were up to included standard. Therapy results of severe asthma:(1)in remission rate of the total symptom,difference between dexamethasone and prednisone was not statistically significant [OR 1.44,95%CI(0.75, 2.75);P=0.27];(2)In the incidence rate of ADR,dexamethasone was lower than prednisone [OR 0.13,95%CI(0.04,0.44);P= 0.001];(3)In the recurrence rate,no statistical significance was noted in difference between dexamethasone and prednisone [OR 0.58,95%CI(0.25,1.31);P=0.19]. Therapy results of severe sepsis:(1)In the mortality,difference between dexamethasone and placebo was not statistically significant [OR 0.85,95%CI(0.41,1.78);P=0.67];(2)In the incidence rate of ADR,no statistical significance was noted in difference between hydrocortisone and placebo [OR 1.05,95%CI(0.51,2.19);P=0.89]. CONCLUSION: Dexamethasone is similar to prednisone in the treatment of severe asthma but better than prednisone in drug safety. The safety of dexamethasone is similar to placebo in the treatment of severe sepsis.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To evaluate catheter-directed thrombolysis via the popliteal vein in the treatment of the lower limb acute deep venous thrombosis.Methods From July 2009 to October 2010,32patients of the lower limb acute deep venous thrombosis including 3 patients with concurrent pulmonary embolism underwent uhrasound-guided catheter-directed thrombolysis via the popliteal vein.The thrombolytic catheter was inserted into thrombus,through which urokinase was infused at a dosage of 100 × 104U/d.The venous patency score and the rate of patency improvement were observed by venograms before and after therapy.Results In every patient,the lower limb swell and pulomonary symptoms relieved.The circumferences between affected and normal thigh before and after the thrombolysis were(5.4 ± 1.4)cm and (1.7 ± 1.3)cm(t =9.92,P ＜0.01).The circumferences between affected and normal leg before and after the thrombolysis were(4.1 ± 1.5)cm and(1.5 ±0.7)cm(t =7.65,P ＜0.01).The venous patency score before and after the thrombolysis were(15 ± 4)and(4 ± 3)(t =7.12,P ＜ 0.01).The mean rate of venous patency was 88.21％.In the 3 patients with pulmonary embolism,thrombus was complete dissolved in 1 case and partial dissolved in 2 cases.No major complications occurred in all these patients.29 patients were followed up for 3-12 months.There were no thrombosis relapsed.Conclusions Catheter-directed thrombolysis via the popliteal vein with urokinase for acute lower limb deep venous thrombosis is safe and effective.

Objective To evaluate the clinical efficacy of Achillon,a novel guide for Achilles tendon suture produced by Newdeal Ltd in France,in the mini-invasive surgical treatment of acute Achilles tendon rupture. Methods Between December 2010 and March 2011,7 patients(7 feet) with acute Achilles tendon rupture were treated in our department.They were 5 males (5 feet) and 2 females (2 feet),with an average age of 34.2 years (range,21 to 53 years).The interval between injury and operation ranged from 1 to 11 days(3.8 days on average).A longitudinal incision approximately 2.0-3.5 cm in length was made around the ruptured Achilles tendon for minimally invasive repair after insertion of the Achillon.Postoperative rehabilitation was carried out. Results All the wounds healed at the first stage.All patients were followed up for 5 to 11 months, with an average of 7.2 months. All patients regained normal weight-bearing walking 3 months after operation without any re-rupture. According to the ankle-hindfoot scoring system of American Orthopaedic Foot and Ankle Society (AOFAS),they scored 93.2 points.By the visual analogue scale(VAS),they scored 1.2 points at the operation site. Conclusion The surgical treatment of acute Achilles tendon rupture with Achillon has advantages of mini-invasion,a low rate of incision problems and quick function recovery.

With the development of modern technology and clinical practice,the classic randomized controlled trial nowadays cannot meet the researchers' needs for evidence with more reliable external validity,especially in the field of TCM.Meanwhile,real-world study (RWS) has been attracting more attention and at the forefront of clinical research all over the world for providing evidence in conformity with the real world condition.In this paper,we firstly described the basic concept of RWS,and then found that it was characterized by large representative samples,loose inclusion or exclusion criteria,allocation of interventions according to patients conditions and willingness,long-term follow-up,and clinically relevant endpoints.By analyzing the existing examples of RWS,we noted and discussed the promising future of RWS in TCM clinical research.Finally,we hope this paper will provide some inspiration for TCM researchers.