Objective To investigate the advantages of treating pediatric indirect inguinal hernia by laparoscopic high ligation of hernia.Methods Two hundred and forty-four pediatric indirect inguinal hernia cases were admitted from August 2012 to May 2014,and were divided into conventional surgery group and laparoscopic surgery group according to the operation methods,with 122 cases in each group.The differences between the two groups regarding operation time,bleeding volume,postoperative pain,surgical scars,complications and recurrence were compared.Results Contralateral recessive hernia was observed in 52 cases (46.4％) of laparoscopic surgery group.The differences in operation time [unilateral hernia:(16.1 ± 5.3) min vs (14.3 ±4.4) min],[bilateral hernia:(29.2 ± 6.4) min vs (31.4 ± 5.2) min],bleeding volume [(2.2 ± 1.1) mL vs (2.9 ± 1.4) mL],surgical scars and recurrence between the two groups were not statistically significant,and no scrotal hematoma and latrogenic cryptorchidism were observed in both groups.But the differences regarding post-operative pain,time to ambulation,scrotal swelling were statistically significant (P ＜ 0.05).Conclusions Laparoscopic surgery showed advantages in small operation wound,rapid recover,less complications and possibility of exploration of contralateral processus vaginalis,so it is much more secure and reliable.

Objective To investigate the biotransformation of podophyllotoxin by cell suspension culture and root culture systems of Rheum palmatum.Methods Plant tissue culture technology was employed.The products were isolated by silica gel column chromatography and their structures were elucidated by spectral methods.Results Adding of podophyllotoxin had no obvious effects on the pH value of cell suspension culture and root culture systems of R.palmatum.In the case of present study,73.8% of podophyllotoxin was converted by cell suspension culture and 56.3% by root culture.The products were different between the two culture system.Podophyllotoxin was converted into picropodophyllin with cell suspension culture system and many other products besides epipodophyllotoxin with root culture system.Conclusion Both of cell suspension culture and root culture systems of R.palmatum are able to convert podophyllotoxin.

OBJECTIVE To investigate the clinical distribution and drug resistance of non-fermentative bacilli isolated from department of surgery so as to guide the rational use of antibiotics.METHODS VITEK-60 AMS system and Kirby-Bauer method were used to identify the pathogenic bacilli and examine the antibiotic resistance.RESULTS A total of 463 strains of nonfermentative bacteria were isolated from Jan 2002 to Dec 2004,the most common pathogen was Pseudomonas aeruginosa(55.07%),the next were Acinetobacter baumannii(20.52%) and Stenotrophomonas maltophilia(11.88%).The samples were mainly sputum(31.97%),drainage(13.39%),and wound secretion(12.31%).Isolation rate from SICU,departments of organ transplantation and burn were 28.08%,17.28% and 12.10%,respectively.P.aeruginosa,A.baumannii and S.maltophilia had high and multi-drug resistance.CONCLUSIONS Infections of respiratory tract and wound caused by non-fermentative bacilli are common in surgical department,and drug resistance is serious.The drugs should be chosen according to the results of the antimicrobial susceptibility tests.

Objective To evaluate the interventional management in emergency splanchnic bleeding and the application value.Methods 27 patients with emergency splanchnic bleeding underwent the interventional management in our hospital from May of 2003 to January of 2006 were reviewed.The sites and causes of the splanchnic hemorrhage were verified through selective DSA,using different methods and materials for percutaneous transarterial embolization.Results No bleedings recurred in all 27 patients within 18 months after the treatment.3 patients of advanced hepatic carcinoma died in 6 months because of non-splanchnic bleeding etiology.Conclusions Selective angiography is a veracious way to detect the location and cause of emergency splanchnic hemorrhage.The choice of different selective arterial embolizations and embolic materials can effectively and promptly cease the bleeding with rescuing the patients.

The accurate location of acupoints is the prerequisite for the efficacy of acupuncture-moxibustion. Bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement are commonly used in clinic for acupoints location. Based on the systematic review of the ancient literatures, this article discussed the meaning, evolution and relations of bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement. It’s concluded that the bone-length measurement should be a benchmark in ancient anthropometry and an important basis for acupoints location. Bone proportional measurement, used in different genders, ages and body sizes, was based on the relatively stable proportional relations of various body parts, though some of the standards were adjusted in accordance with the correlation between meridians and acupoints. Location of points by proportional unit of the body simplified the application of bone-length measurement and bone proportional measurement, based on the ratio between short and long bones or the ratio of same body parts in anthropometry. However, proportional unit of the body measurement should be applied for the specific body parts. Bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement are correspondingly the benchmark measurement, relative measurement, and simplified measurement.

Endemic dental fluorosis has been reported in some regions of the world. China seemed to have high prevalence of endemic dental fluorosis, especially in southwest China. It is now most likely that excessive fluoride intake during enamel development play a key role in the pathogenesis of dental fluorosis. However, excessive intake of fluoride-induced cellular and molecular mechanisms of dental fluorosis are not entirely conclusive. Scholars at home and abroad have made a lot of research on pathogenesis of enamel fluorosis by using various experimental techniques. More recent studies mainly suggest that endoplasmic reticulum stress and calcium overload-associated apoptotic pathway may participate in fluoride excess-evoked pathogenesis of dental fluorosis. Furthermore, the functional changes of enamel matrix protein and protease activity may be involved in the pathological event. This paper summarized the recent research progress on this topic.

Objective To explore the value of intravenous low dose furosemide on visualization of upper urinary tract during CTU. Methods 39 cases of normal upper urinary samples were examined by CTU with 5 minutes delayed,19 cases underwent intravenous injection of furosemide.The upper urinary tract was divided into 5 parts for scoring of images on a 5 score scales for opacification,the average value of ureter short axis of distention,and CT value by contrast material were measured.Results were analyzed by t test using SPSS.Results (1)30/38 segments of upper urinary tract were all or almost all opacification in furosemide group,the scores of upper urinary tract were higher than that of the control group,which had significant difference except the pelvis and left proximal ureter segments. (2)The disention of the ureter was significantly higher for all segments in furosemide group.(3)CT values in furosemide group decreased significantly for all upper urinary tract.Conclusion CTU excretory phase image acquisition with intravenous low dose furosemide is helpful on visualization of upper urinary tract.

BACKGROUND: The therapy of nonunion has been a difficult issue in orthopedics all the time. Part of nonunion can't heal even after many times of operations. The effects of non-surgical treatments are not satisfactory. Extracorporeal shock waves (ESW) is a new method that popular abroad in recent years.OBJECTIVE: To investigate the effect of ESW on nonunion, and preliminarily probe into its mechanism.DESIGN: Randomized group-division design, animal experiment.SETTING: Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: The experiment was conducted in the Medical Experimental Center of Animal, Wuhan University from September 1997 to March 1999. Forty healthy male rabbits were selected to establish model of nonunion. Thirty-two rabbits with hypertrophic nonunion were taken as materials and randomly divided into treatment group and control group with 16 rabbits in each group.METHODS: A multifunctional ESW apparatus of type HX902Ⅲ was adopted to treat the broken ends of nonunion in the treatment group with the energy, frequency, dose and focus range of 0.54 m J/mm2, 60 times/minute,2 000 times and 1.5 cm2 respectively. The second focus of shock wave was adjusted, aiming at corresponding parts in distal and proximal sites of nonunion, and acted 1 000 times. After that, rabbits were re-fixed with external apparatus and acted freely. Rabbits in the control group were fixed with external apparatus without any other treatments.MAIN OUTCOME MEASURES: Examination of the healing of nonunion with radiograph, transmission electron microscope (TEM) and in histology.RESULTS: A total of 32 enrolled animals were involved in the analysis of results.①X-ray photograph: During the treatment with ESW, the gaps of nonunion were more and more indistinct in X-rays, and the densities of two sclerotic ends were reduced, and the sclerotic marrow cavities became unobstructed. The X-rays of nonunion-gaps before ESW were significantly narrowed than those after the treatment. At 6 weeks after the treatment,nonunion in 6 rabbits of the treatment group (6/14) healed, and that in 12 animals (12/12) healed on the 12th week. However, only the nonunion in one rabbit (1/12) healed in the control group on the 12th week. Test of fourfold-table exact probability demonstrated that the healing status of nonunion in the treatment group was better than the control group, and the differences were remarkable (P＜0.001).②Examination under light microscope: large quantity of osteoblasts and mesenchymal cells assembled and were active in proliferation on the 2nd week of treatment in the treatment group, and plentiful bone trabeculae formed on the 6th week, and the nonunion healed on the 12th week of treatment. However, there were chronic inflammation and few trabeculae in the control group. ③TEM examination: the osteoblasts in the treatment group proliferated on the 2nd week of treatment, and there were abundant chondrosomes in the intracytoplasm,which could secrete collagen fibers with periodical transverse lines. On the 6th week, large amount of bone lacunas formed. However, little visible cells could be seen in the control group, and osteoclasts were found in act.CONCLUSION: The effect of ESW on hypertrophic nonunion is satisfactory, which may become a reliable and non-invasive treatment of nonunion.

Objective To investigate the change in body weight over time in rectal cancer patients receiving radiotherapy and the correlation between setup errors and weight loss,and to establish the image-guided radiotherapy regimens in different periods of treatment.Methods A total of 24 postoperative patients with rectal cancer admitted to our hospital in 2016 were selected.Before each fraction of radiotherapy,the body weight was recorded,and the patients underwent cone-beam computed tomography (CBCT) with different frequencies in every week.The planning CT was matched with CBCT to obtain setup errors.The paired t test was used for difference analysis;the Pearson method was used to analyze the correlation between setup errors and weight loss.Results Body weight was measured 456 times in the 24 patients,and these patients underwent CBCT scans and image registration 456 times.Two patients were excluded because of treatment discontinuance.In the first and second weeks,there was no significant change in body weight.In the third week,the mean weight loss was 1.53 kg.In the fourth week,the mean weight loss was 2.48 kg.In the fifth week,the mean weight loss was 3.24 kg.The setup errors obtained by CBCT image registration in the superior-inferior (SI),anterior-posterior (AP),and left-right (LR) directions were 0.19 cm,0.20 cm,and 0.18 cm,respectively,in the first week,0.18 cm,0.17 cm,and 0.15 cm,respectively,in the second week,0.20 cm,0.22 cm,and 0.21 cm,respectively,in the third week,0.19 cm,0.25 cm,0.24 cm,respectively,in the fourth week,and 0.34 cm,0.33 cm,and 0.31 cm,respectively,in the fifth week.The Pearson correlation analysis showed that weight loss increased the setup errors,with P values of 0.140,0.046,and 0.044 in the SI,AP,and LR directions,respectively.Conclusions For rectal cancer patients receiving radiotherapy,the body weight decreases significantly in the late period (especially in the fifth week),which influences the setup errors.Therefore,in the fourth and fifth weeks of radiotherapy for rectal cancer,the weight loss should be closely monitored,and the number of CBCT scans can be increased before the treatment fraction to ensure the accuracy and optimization of treatment.

Aim To evaluate the mucosal-protective effects of carboxymethylpachyman( CMP) on Fluorou-racil(5-Fu)-induced mice intestinal mucositis and ex-plore its mechanisms. Methods ICR mice were as-signed randomly to four groups:normal group( n=8;re-ceiving pure water orally for 14 d) ,CMP group( n=8;200 mg·kg-1 CMP for 14 d orally),5-Fu group(n=8;25 mg·kg-1 5-Fu for 7 d,intraperitoneally( i. p. ) , and CMP+5-Fu group( n=8;200 mg·kg-1 CMP for 14 d orally and 25 mg·kg-1 5-Fu for 7 d,i. p. ). At day 14the mice were sacrificed. The intestinal propel-ling rate and the colon length were measured. ROS, GSH and IL-1βcontents,and CAT,GSH-Px activities in homogenate supernatant of PPs were measured by kits for observing the effects of CMP on mice lipid peroxida-tion and intestinal mucosal inflammatory induced by 5-Fu. Colon tissues were used for hematoxylin and eosin ( HE ) staining for the determination of the effect of CMP on mice colon histopathology, immunohistochem-istry for the protein levels of NF-κB and p-p38 . Results CMP significantly extended colon lengths,accelerate the intestinal propelling rates, reduced colonic mucosa epithelium goblet cell loss, inflammatory cells infiltra-tion,and crypt depth shallow induced by 5-Fu. CMP obviously reduced ROS and IL-1β contents, and pre-vented reductions in homogenate supernatant of PPs GSH content, CATand GSH-Px activities by 5-Fu ad-ministration,and also reduced the expression of NF-κB and p-p38 in colon tissues. However, CMP alone had no effect on the colon of normal mice. Conclusion The current study demonstrates that CMP may have sig-nificant protective effects against 5-Fu-induced intesti-nal mucositis. Its mechanism may be related to enhan-cing the antioxidant activity,anti-inflammatory and an-ti-apoptotic effects.