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 estimate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) level for early diagnosis of acute kidney injury (AKI) in patients with sepsis.Methods One hundred and twenty-six sepsis patients admitted to intensive care unit (ICU) in Baoshan Branch Hospital of Shuguang Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine from June 2014 to December 2015 were enrolled, and they were divided into two groups according to whether complication of AKI was present. The levels of urinary NGAL in the two groups of septic patients were evaluated immediately and at 12, 24 and 48 hours after the definite diagnosis, and the levels were compared between the two groups; the receiver operating characteristic curve (ROC curve) was performed and the value of urinary NGAL level in early diagnosis of sepsis AKI was evaluated.Results There were 60 septic cases complicated with AKI (AKI group), with the prolongation of time after definite diagnosis, the urinary NGAL (g/L) levels were gradually increased at 12, 24 and 48 hours, the levels were significantly higher than those at the corresponding time points in the group without AKI [non AKI group (66 cases), 12 hours: 178.2±32.8 vs. 53.8±10.4, 24 hours: 228.4±24.6 vs. 54.1±9.0, 48 hours: 186.1±43.6 vs. 52.5±9.4, allP < 0.05]. The area under ROC curve (AUC) of urinary NGAL level at 24 hours after definite diagnosis and 95% confidence interval (CI) were 0.863 (0.766-0.929) and 0.686 (0.466-0.696), respectively, when the cutoff value of urinary NGAL was 65.9μg/L, the sensitivity was 81.9% and specificity 76.1%; when the cutoff value of urinary NGAL was 57.9μg/L, the sensitivity was 70.2% and the specificity 57.2%.Conclusion Urinary NGAL level can be used as a reference marker for the early diagnosis of sepsis concomitant AKI.

Objective To construct the recombinant plasmid of PA-ⅠL and express in E.coli BL 21 (DE3), and evaluate the biological activity of recombinant protein.Methods PA-ⅠL gene was amplified by PCR using primers designed according to Pseudomonas aeruginosa genome sequences and then cloned to the vector pET -28a ( +).The recombinant plasmid was transformed into E.coli BL21(DE3) and induced to express by IPTG.The recombinant protein was purified by nickel affinity chromatography.The binding activity of recombinant PA-ⅠL with Gb3/CD77 was evaluated by flow cytometry.The function of recombinant PA-ⅠL on the binding of bacteria with host cells was evaluated by colony plate counting.Results and Conclusion The recombinant PA-ⅠL protein was highly expressed in E.coli BL21(DE3) and protein purity by SDS-PAGE analysis was high after nickel affinity chromatography .Besides, the recombinant PA-ⅠL had binding activity to Gb3/CD77 and inhibited the binding of PAO1 to host cells in a dose-dependent manner.

Objective To discuss the effect of quick freezer equipment and quick freezing time on the preparation of cryoprecipitate.Methods The cryoprecipitate,already prepared,was placed into the MBF21 freezer and minus 30℃ SANYO refrigerator for 30-minute and 50-minute storage.The activity of coagulation factor VⅧ,and the content of fibrinogen in different equipment were detected by automatic coagulation analyzer,in order to make sure whether it met the quality requirements.Results The content of fibrinogen in the cryoprecipitates from both of the equipment after 30-minute storage met the requirement,with the qualification rate of 100％.As to the activity determination of coagulation FⅧ,low temperature refrigerator showed a qualification rate of 62.5％,which was significantly lower than that of quick freezer with a qualification rate of 97.5％ (P＜0.01).The cryoprecipitates from both of the equipment after 50-minute storage,with part of fibrin precipitation,had a qualification rate of fibrinogen content lower than 50％ (P＞0.05).The qualification rate of quick freezer and low temperature refrigerator was 35％ and 12.5％,respectively,with significant difference.Conclusion Quick freezer can make the cryoprecipitate quick-frozen,which can ensure the quality.The coagulation factor VⅧ is unstable,whose activity decreased with the increase of temperature.We should try our best to shorten the time off the cold chain.

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.