Tension-free repair for inguinal hernias has been led into China since 1997 and being promoted quick development of hernia and abdominal wall surgery in China,meanwhile,there are still many problems in the recurrence,chronic pain and patch infection due to irregular operations.In order to solve these problems and improve the diagnosis,treatment and research levels of hernia and abdominal wall surgery,surgeons must pay attention to the basic and clinical technologies,quality control and so on.The studies on etiology of hernia will bring innovative therapy,registration system will contribute to summarize the clinical experiences,and establishment and implementation of quality control of hernia could ensure the effects of diagnosis and treatment.However,there is still a controversy about whether laparoscopic technology on inguinal hernias is minimally invasive surgery or not,though it is safe and effective.

AIM: To establish a method of RP-HPLC for determination of calycosin and formononetin in Zhengqifuzheng Preparation(Radix Astragali, Fructus Ligustri Lucidi, etc.). METHODS: Kromasil ODS column(5?m,4.6mm?250mm) was used to determine two isoflavoniods with water-methanol gradient elution, at column temperature of 25℃, flow-rate of 1.0mL?min -1 and detection wavelength at 254nm. RESULTS: The average recoveries of formononetin and calycosin in Zhengqifuzheng Capsules were 96.53% and 98.34% and RSD were 2.25% and 4.01%, respectively, the average recoveries of formonoenetin and calycosin in Zhengqifuzheng Granules were 97.20% and 95.65% and RSD were 2.66% and 2.32%, respectively. CONCLUSION: The method is sample, reliable, accurate, practical, and can provid a new idea to study the quality standard of this preparation.

Objective To observe the influence of spine kyphotic deformity on postmenopausal osteoporosis patients' pulmonary function and physical activity,and then provide a guide for the rehabilitation training of patients with osteoporosis and a kyphotic spine.Methods Sixty postmenopausal women with osteoporosis were recruited from the osteoporosis outpatients of the Third Hospital of Peking University.Half of them suffered from spine kyphosis (the spine kyphosis group) and the other half did not (the non-spine kyphosis group).There was no significant difference in the average ages and body mass indexes of the two groups.The research applied Cobb's angle and wall-occiput distance (WOD) to assess kyphosis severity,a visual analogue scale (VAS) to evaluate the patient's pain level,plus pulmonary function assessments and thoracic expansion assessments in both groups simultaneously,and the 6-minute walking test (6-MWT) to assess the patients' physical activity.Results The spine kyphosis group said they experienced significantly more pain than the non-kyphosis group,and they had worse pulmonary function and poorer physical activity.These differences were statistically significant.Pulmonary function was significantly correlated with the severity of spine kyphosis,back ache,thoracic expansion as well as physical activity.Conclusion Spine kyphosis deformity can aggravate back ache among postmenopausal osteoporosis patients,and affect their pulmonary function and physical activity.When planning clinical exercise training for such patients,physicians should pay attention to respiratory function training so as to improve the patients' pulmonary function,physical activity and endurance as much as possible,and thus improve their quality of life.

AIM To establish chromatography fingerprint of Radix Codonopsis. METHODS HPLC was applyed on a Hypersil ODS column with water-methanol gradient elution, flow-rate of 0.8 ml?min -1 . Determination of content of atractylenodie Ⅲ adopted ELSD and PAD with methanol-water(67∶ 33), flow-rate of 1.0 ml?min -1 , column temperature at 30?C , ELSD:carried-gas flow-rate of 2.2 L?min -1 , drift-tuber temperature was 80?C ;PAD:wavelength was 220 nm. RESULTS 25 common peaks were picked up, their similarity among 10 batchs of samples was more than 98.12 % based on marker composition(Atractylenolide Ⅲ). CONCLUSION The chromatography fingerprint of Baitiao Radix Codonopsis could be used as their characteristic chromatography fingerprint of hydrophobic fraction.

This article introduced the peritoneal dialysis nursing model of Home Dialysis Unit in the affiliated hospital of Colorado University,including:overall status,setting and distribution,responsibilities of staff,work model of PD (pre-dialysis education,catheter insertion,CAPD/CCPD training,clinic visit model,home visit model,etc),and explored the enlightenment of this model on PD nursing in our country.This model provided references for dialysis center distribution,staff arrangement,pre-dialysis education,home visit,increase of social support and so on.

Objective To investigate the prevalence status of overweight and obesity among the middle‐aged and elderly pop‐ulations in southwest area and their influence factors .Methods By adopting the stratified cluster sampling method ,the mode of the questionnaire investigation combined with the physical examination was adopted to collect the effective data in 7 205 permanent resi‐dents aged 40-79 years old in cities and countries of Chongqing and Chengdu ,including the contents of age ,waistline ,hipline ,dias‐tolic blood pressure ,heart rate ,postprandial blood sugar ,triglyceride ,exercise frequency ,uric acid ,etc .The prevalence rates of over‐weight and obesity among the middle‐aged and elderly populations in southwest area and their distribution characteristics in cities and countries ,and in male and female populations were described .The related influence factors of overweight and obesity were in‐vestigatedResults The prevalence rate of overweight was 35 .91% among the middle‐aged and elderly populations in southwest area (37 .02% for cities ,32 .92% for countries ,33 .84% for males and 37 .41% for females);the prevalence rate of obesity was 11 .40%(11 .13% for cities ,11 .40% for countries ,8 .94% for males and 12 .84% for females);among them ,the overweight rate in cities was higher than that in countries ,the overweight rate in females was higher than that in males .The obesity rate in females was higher than that in males(P<0 .01) ,the obesity rate had no difference between cities and countries(P>0 .05) .The multivariate re‐gression analysis showed that lack of exercise ,overweight or obesity family history were the risk factors of male overweight and o‐besity ,while the difference between cities and countries ,lack of exercise were the risk factors of female overweight and obesity .Con‐clusion The overweight and obesity rates among the middle‐aged and elderly populations in southwest area are high ,the body mass in nearly half of people exceeds the normal standard .Strengthening the overweight and obesity related health education in communi‐ties and restraining the serious trend of overweight in the population of this area have an important significance for the prevention and treatment of cardiovascular diseases .

Objective To investigate the safety , feasibility , and clinical application value of digital sub-traction angiography ( DSA) -guided insertion of totally implantable venous access port ( TIVAP) in patients with digestive system cancer .Methods We retrospectively analyzed the data of 15 digestive system cancer patients who were inserted with TIVAP under DSA guidance between April 2013 and January 2016, recorded the TIVAP-related complications and indwelling time, and investigated the patients’satisfaction about TIVAP.Paired rank sum test was used for the differences in patients’quality of life before and after the insertion of TIVAP.Results Of the 15 digestive system cancer patients , operation success rate of TIVAP insertion was 100%, with the success rate of venipuncture on first attempt being 100%.The incidence of complication was 6.67% ( 1/15 ) , which was manifested as pull feeling at the neck occurring in the eighth month after insertion .The indwelling time of TIVAP was from 2 to 28 months, with a median value of 9 months.Patients’satisfaction rate of TIVAP was 86.67%(13/15).The proportion of patients with a good quality of life was 100%(15/15), statically signifi-cantly higher than that before the insertion [46.67%(7/15), Z=-3.416, P=0.000).Conclusions TIVAP insertion under DSA guidance in digestive system cancer patients is safe and feasible , with few complications and fair patient satisfaction .It may improve the patient ’s quality of life , worthy of clinical application .

Objective: To analyze the prevalence and risk factor of co-exiting pre-hypertension and pre-diabetes condition in middle to elder adults, and to provide the theoretical basis for preventing cardiovascular disease in relevant population in Chengdu area.
Methods: A total of 5240 middle to elder adults from (40-79) years of age in Chengdu area were enrolled for a stratiifed cluster sampling study. The blood pressure, glucose and other clinical information were collected by more than 30 medical professionals with uniifed training to investigate the prevalence of co-exiting pre-hypertension and pre-diabetes condition with the risk factors.
Results: The overall prevalence rate of coexisting pre-hypertension and pre-diabetes condition was at 12.5% in Chengdu area and the standardized prevalence was at 11.5%. The prevalence rate in urban area was 12.4% and in rural was 13.2%, P=0.47, the prevalence in male gender was 12.7% and in female was 12.4%,P=0.81. With the increased age, the prevalence trend was elevated accordingly. Multi-regression analysis indicated that the elder age, overweight or obesity (female with abdominal obesity), sibling history of hypertension, hyper-triglyceridemia, multiple childbirth and menopause had the higher risk of coexisting pre-hypertension and pre-diabetes condition, allP<0.05; the higher educational level could decrease the risk of prevalence in male gender,P<0.05 and the proper exercise could decrease the risk in female gender,P<0.05.
Conclusion: There is a high prevalence rate of coexisting pre-hypertension and pre-diabetes condition in middle to elder population in Chengdu area and the prevalence is closely related to age. It is important to prevent such condition by elevating educational level nationwide, controlling waist and body weight, adjusting diet structure with proper exercise.

Objective To investigate the feasibility of a noval anterior cubital approach for the coronoid via flexor?prona?tor teres interval and assess the clinical result. Methods Five formalin?fixed adult cadaver elbows were used. Through a single universal anteromedial longitudinal skin incision, the coronoid tip was exposed via pronator and flexor carpiradialis interval, and coronoid anteromedial facet and base via palm longus and flexor carpi ulnaris interval. The distances from the entry point to the muscles or branching point of the nerves to the line passing through medial and lateral epicondyles, as well as the length were mea?sured with regard to the motor nerve branches arising from median nerve to pronator teres, flexor carpiradialis, palm longus and flexor digiti superficialis, as well as the most proximal two motor branches to flexor carpi ulnaris arising from ulnar nerve. From September 2013 to August 2014, 4 male patients with ulnar coronoid fracture were treated operatively through the above anterior cubital approach in our hospital. They were all left side involved, with an average age of 32 years (range, 16-42 years). According to O’Driscoll classification, there were two cases of type Ib and two cases IIb respectively. They were all treated by open reduction and internal fixation through flexor?pronator teres interval. Results At cubital fossa, there were 2-3 branches to the pronator teres mostly, 1 branch to flexor carpiradialis and palm longus arising from median nerve. The branch to the flexor digiti superficia?lis usually was long and thick, and divided into 2-5 short twigs near muscle. The branch to palm longus had the same trunk with that to flexor digiti superficialis. The branch to flexor digiti superficialis was the most proximal among those passed through the in?terval of pronator teres and flexor carpiradialis, and its entry point to the muscle had an averaged distance of 37.22 mm to the line passing through medial and lateral humeral epicondyles. It was optimal to expose coronoid tip through the interval of pronator teres and flexor carpiradialis. It was safe to expose coronoid proximal to the branch to flexor digiti superficialis. While, it was better to expose the anteromedial facet and base of corocoid through the interval of palm longus and flexor carpiulnaris via median and ul?nar nerve interface. All of the four patients were followed up for an average period of 9 months. They all achieved bone union from 6 weeks to 3months (mean, 9 weeks). All the patients obtained excellent result according to the modified An&Morrey elbow per?formance index with scores from 94 to 100. Conclusion The novel anteromedial cubital approach via flexor?pronator teres is opti?mal for exposure of coronoid.

As the descending genicular artery supplies multiple perforating branches around the knee joint,it can be used in corticocancellous,osteomusculocutaneous and other composite tissue flaps to repair composite tissue defects at one stage.Consequently it plays a very important role in the field of reconstruction surgery.At present,however,there has been no systematic review of its clinical applications.Having reviewed all the recent reports available on the free tissue perforator flaps with descending genicular artery,we classified them into five major forms.In this paper,we comment on their anatomical mechanisms,variations and clinical applications.Additionally,we predict that digital technology will be used in the future clinical application of the perforator tissue flaps with descending genicular artery.