Objective To compare the surgical outcome of Lichtenstein,open preperitoneal technique and double-laver mesh technique in tension free repair of incarcerated inguinal hernia.Methods Totally 438 cases of indirect inguinal hernia in our hospital were retrospectively analyzed from January 2008 to January 2012,io which 154 patients received Lichtenstein,186 patients received open preperitoneal technique and 98 patients received double-layer mesh technique.Results The recurrence rates of these three groups were low,0.65％,0.54％,0,respectively,and there was no significant difference in the recurrence rate between these 3 groups (P ＞0.05),but significant difference in the foreign body sensation and postoperative pain between the open preperitoneal technique group and the other two groups(P ＜ 0.05),and the cost of the double-layer mesh technique group was ahout 2000 yuan higher than the other two groups.Conclusion The open preperitoneal technique can reduce the postoperative pain and foreign body sensation after surgery with low cost,and it is a good choice for inguinal hernia repair.

Objective To approach the effect of prosthetic valve at preventing reflux esophagitis.Methods After the total gastrectomy and esophagojejunostomy,interrupted suture was apphed to form a prosthetic valve at output and input beyond Braun's stoma.Results Only one got light reflux esophagitis in 15 patients.Conclusion Prosthetic valve can prevent reflux esophagitis,and the operation is convenient and safe,which is deserved to be in generalization and approach the latest method.

Alcohol Drinking ; Carcinoma in Situ ; pathology ; Epithelium ; pathology ; Gastroesophageal Reflux ; complications ; Humans ; Hyperplasia ; Laryngeal Neoplasms ; classification ; etiology ; pathology ; therapy ; Larynx ; pathology ; Papillomavirus Infections ; Precancerous Conditions ; classification ; etiology ; pathology ; therapy ; Prognosis ; Smoking

Objective To observe the changes of osteoblasts and vascularization during osteogenesis by tissue engineering technique under the electron microscope and study the feasibility of improving vascularization of the tissue engineering bone by using the small intestine submucosa(SIS) as the scaffold. Methods The bone mesenchymal stem cells(BMSCs) were isolated by using the gradient centrifuge method.BMSCs were seeded in the SIS.The scaffold-cell constructs were cultured in vitro for two weeks.There were no cells on the SIS as control.They were implanted subcutaneously in the dorsa of the athymic mice.The implants were harvested after(in vivo) incubation for 4,8 and 12 weeks.The changes of osteoblasts and vascularization were observed under the transmission electron microscope and the scanning electron microscope. Results The BMSCs grew quite well.BMSCs differentiated on the surface of the SIS and secreted a great deal of extracellular matrices.The scaffold-cell constructs formed a lot of bone and vessels in vivo.The scaffold degraded after 12 weeks.No osteoblasts but vascularization and fibroblasts were observed as control. Conclusion SIS can be used as the scaffold for constructing tissue engineering bone as it can improve the formation of bone and vessels in vivo.

Objective To investigate the diagnosis/misdiagnosis reason/treatment of residual gallbladder stone with choledocholithiasis.Methods The clinical data of 34 patients with residual gallbladder,16 cases of them suffered from choledocholithiasis additionally were retrospective analyzed.Results 14 cases were treated by residual cholecystectomy +choledochotomy +T -tube drainage,2 cases were were treated by choledochotomy + T -tube drainage.Preoperative misdiagnosis of residual gallstones rate was 56.3% (9 /16 ),7 cases were found residual gallstones during operation.The other 2 cases were misdiagnosed residual gallstones.The rate of intraoperative and postoperative misdiagnosis was 12.5% (2 /16 ).18 cases with residual gallstones,16 cases underwent residual cholecystectomy,2 cases who were suspected with choledocholithiasis underwent residual cholecystectomy +choledo-chotomy,T -tube drainage.18 cases had no preoperative and postoperative misdiagnosis.Conclusion The clinical symptom of residual gallbladder stone with choledocholithiasis was similar to residual gallstones,often characterized by upper abdominal pain,fever,chills,jaundice,abdominal distension and other symptoms.It is difficult for preoperative imageological diagnosis that less than 3 cm residual gallbladder and small stones.When choledocholithiasis at the same time,needing more intraoperative careful dissect cystic duct and common bile duct,completes the cystic duct and common bile duct exploration,reducing misdiagnose residual gallstones.

g this model, trainees could improve their basic techniques, such as resection and vaporization technique.

Objective To investigate the application of improving prolene hernia system(PHS) tensionfree repair for inguinal hernia under ultrasound-guided local nerve block anesthesia.Methods Retrospective analysis the clinical data of 40 patients with improving prolene hernia system(PHS) tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia from January 2013 to January 2014 in Gulou Hospital of Nanjing University.Results In group of ultrasound-guided local nerve block anesthesia , the average anesthesia time was (8.9 ± 1.5) min, the time to get out of bed was (5.6 ± 1.1) h, the length of stay was (2.9 ± 0.7) d,There were (12.4 4± 2.2) min, (10.2 ± 1.6) h and (3.7 ±± 0.7) d in general anesthesia group, and significant difference(P ＜0.05), the average operation time of two groups were (22.6 ± 2.0) min, (22.1 ± 2.4) min,the average duration of postoperative analgesia was (6.4 ± 1.6) h, (6.1 4± 1.5) h, and no significant difference (P ＞ 0.05).Conclusions Improving prolene hernia system(PHS) tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia is simple , easy and safe to be performed with mild pain, faster recovery and less bleeding.It is worthy of popularization and application.

Flammulin, an anti-tumor protein, was purified from the aqueous extract of basidiomes of Flammulina Velutipes. Purified flammulin emulsified with Freund's adjuvant was injected subcutaneously into New Zealand white rabbits. After several immune enhancements, these animals were bled and sera were separated. Antiserum against flammulin in Western blots were applied to determine if flammulin be present in the liquid state culture or fruiting body. The result showed that anti-flammulin serum could recognize the aqueous extract of fruiting body in SDS-PAGE gels under the reducing conditions, no flammulin was detected in mycelia of Flammulina Velutipes.

Objective To investigate the clinical characteristics of acute inhalational metallic nickel poisoning and its treatment effect.Methods Data including epidemiology,clinical features,laboratory tests,imaging examinations,therapy protocol as well as prognosis were collected and analyzed.Results Thoracic CT scan of all patients demonstrated as bilateral diffuse infiltration.Nickel concentration in both blood and urine were high in all patients and the concentration was positively associated with poisoning severity.All 4 patients received glucocorticoid treatment,2 of whom with acute respiratory distress syndrome were admitted to ICU to initiate mechanical ventilation and were given sodium dimercaptopropanesulfonate.All patients survived to hospital discharge.Conclusions Acute inhalational metallic nickel poisoning is uncommon and early symptoms are inconclusive.The blood and urine nickel concentration is helpful to judge the severity of the disease.Pulmonary diffuse infiltration is the main clinical feature.Glucocorticoid,chelation therapy as well as symptomatic treatment are effective therapies to relief disease severity.

Objective:To investigate the effect and mechanisms of Phloroglucinol ( PG) on renal ische-mia and reperfusion injury (IRI).Methods:Forty-eight male Wistar rats were divided into 3 groups (16 rats per group):sham operated, saline-treated I/R (I/R), and PG-treated I/R (PG).I/R model:Af-ter removing the right kidney , renal I/R injury was induced by clamping the left renal artery for 45 min followed by reperfusion.The rats were administered with PG (30 mg/kg, intraperitoneally) or saline 15 min before renal ischemia .The blood and kidneys were harvested 6 and 24 h after reperfusion .Renal function and histologic changes of serum creatinine (SCr) and blood urea nitrogen(BUN)were assessed. Malondialdehyde (MDA),catalase (CAT),superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) were measured.Nuclear factor-kapa B ( NF-κB) and caspase-3 in the kidneys were also measured.Results:SCr and BUN were (103.9 ±10.4) μmol/L and (15.2 ±1.0) mmol/L in I/R group, and (81.8 ±13.4) μmol/L and (11.5 ±1.2) mmol/L in PG group 6 h after reperfusion .SCr and BUN were (154.9 ±12.1) μmol/L and (28.1 ±1.4) mmol/L in I/R group, and (103.8 ±5.9)μmol/L和(16.0 ±1.0) mmol/L in PG group 24 h after reperfusion.PG treatment significantly attenua-ted renal dysfunction and histologic damage caused by I /R injury(P<0.05).The I/R-induced elevation in kidney MDA level decreased , where as reduced kidney SOD ,CAT and GSH-Px were increased .What is more , the apoptotic tubular cells , the levels of active caspase-3 ,and active nuclear factor kappa B dra-matically decreased after PG treatment .Conclusion:PG protects murine kidney I/R injury by suppres-sing oxidative stress , inflammation , and cell apoptosis .