Objective To investigate the preoperative management and the clinical effeciency of Lichtenstein tension-free hernioplasty in adult patients with inguinal incarcerated hernia.Methods Clinical data of 86 patients with inguinal incarcerated hernia were analyzed retrospectively.Hernia was repaired with Lichtenstein tension free after reposition.Results There were 59 male patients and 27 female patients with median age of (63 ± 18) years.There were 8 patients with liver cirrhosis.The operation was performed successfully in all patients.Segmental bowel resection with end-to-end anastomosis was performed in 38 emergency cases.Operative time was 20-120 min,with an average time of 54 min.The postoperative hospitalization was 5-17 d,with an average of 8 d.There were 7 cases of skin ecchymosis at the scrotum,there were no intestinal perforation,hepatic encephalopathy and upper gastrointestinal hemorrhage after operation.In early series of 24 cases without drainage tube left in place,there were 10 cases of fat liquefaction,10 cases of hydrops of hernial sac,6 cases of seroma and 3 cases of wound infection after operation.After 12 to 48 months of follow-up,there was no mortality after 2 years,no hernia recurrence.Conclusions Tension free repair in the treatment of incarcerated inguinal hernia is safe and feasible.

Objective To investigate the long-term effects of propofol postconditioning on cerebral ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four healthy male SD rats,aged 7-8 weeks,weighing 250-280 g,were equally and randomly divided into 4 groups:sham operation group (group S),I/R group,propofol postconditioning group (group P) and intralipid group (group I).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Focal cerebral ischemia was induced by occlusion of middle cerebral artery for 60 min using a nylon thread with a rounded tip which was inserted into internal carotid artery in groups I/R,P and I.Two hour infusion of propofol was started at 20 mg· kg- 1· h- 1 immediately after the onset of reperfusion in group P,while the equal volume of normal saline was given instead in S and I/R groups,and 10％ intralipid was given instead in group I.Five rats in each group were chosen on day 1,14 and 28 after operation for assessment of neurological behavior and detection of cerebral infarct volume.Six rats in each group were chosen to perform Morris water maze test at day 9 and 23 after operation for 6 consecutive days.Five rats in each group were sacrificed on day 1,14 and 28 after operation and the hippocampal tissues were isolated for determination of the expression of GluR1-containing AMPA (GluR1-AMPA) receptor and GluR1-AMPA receptor in cell membrane.The ratio of GluR1-AMPA receptor in cell membrane/GluR1-AMPA receptor was calculated.Results Compared with group S,neurological behavior scores and the number of animals' swimming across the platform were significantly decreased,cerebral infarct volume was significantly enlarged,escape latency was significantly prolonged,and ratio of GluR1-AMPA receptor in cell membrane/GluR1-AMPA receptor was significantly increased ( P ＜ 0.05),while no significant change in the expression of GluR1-AMPA receptor was found in I/R group ( P ＞0.05).Propofol postconditioning inhibited cerebral I/R-induced changes mentioned above ( P ＜ 0.05).Conclusion The brain protection against focal I/R injury by propofol postconditioning can last for 28 days after operation and the inhibition of trafficking of GluR1-AMPA receptor from cytoplasm to cell membrane may contribute to this long-term brain protection.

Objective To investigate the serum level of NT-pro-BNP in patients with acute ischemic stroke and to determine whether NT-pro-BNP levels were associated with the death within 15 days of stroke onset. Methods Two hundard twenty-six consecutive patients with acute ischemic stroke within 48 hours of onset were enrolled in this study. We measured plasma NT-pro-BNP within 72 h and recorded the NIHSS score on admission. Patients were divided into two groups: the deceased group, who died within 15 days, and the survival group. The factors associated with the death within 15 d of stroke onset were investigated by using multivariate logistic regression analysis. Results Twenty-four (10.6%) patients died with 15 days of stroke onset. The incidence of atrial fibrillation, cardioembolism and large infarc?tion, the mean ± SD of NIHSS score, age, glucose level and creatinine were significantly higher in the deceased group than in the survival group (P<0.001). On the other hand, the mean ± SD of LVEF, albumin, LDL-C, and total-cholester?ol were significantly lower in the deceased group than in the survival group(P<0.05 ). The median of the plasma NT-pro-BNP level was significantly higher in the deceased group than in the survival group (2598.5 vs. 190.4 pg/mL, P<0.001). The optimal cut-off level, sensitivity, specificity and ROC area of NT-pro-BNP levels to distinguish the de?ceased group from the survival group were 955.2 pg/mL, 83.3%and 82.2%, 0.906, respectively. Binary logistic regression analysis demonstrated that NIHSS score of ≥13 (OR=56.18, 95% CI=9.06 to 348.40, P =0.000) , plasma Lg NT-Pro-BNP level (OR=38.79, 95%CI=6.52 to 230.95, P=0.000) , and the size of infarction (OR=8.73, 95%CI=1.11~68.88, P=0.040) were independent factors associated with the death within acute phase of stroke. Conclusions The plas?ma NT-pro-BNP level can predict the death of stroke patients within 15 days of stroke onset.

Background:The prognosis of systemic lupus erythematosus complicated with lupus enteropathy is poor. At present, studies on pathogenesis of lupus enteropathy are rare. Aims:To investigate the expressions of intercellular adhesion molecule-1 (ICAM-1),vascular cell adhesion molecule-1 (VCAM-1)and intestinal fatty acid binding protein (I-FABP) in lupus enteropathy in mice. Methods:Twenty MRL/ lpr lupus mice were randomly divided into two groups:lupus enteropathy group and control group. Lupus enteropathy model was established by administration with TNBS enema. Histological score was assessed,expressions of ICAM-1,VCAM-1 and I-FABP were determined by immunohistochemistry, and correlations with histological score were analyzed. Results:Compared with control group,histological score was significantly increased (8. 1 ± 5. 8 vs. 0. 8 ± 0. 5,P = 0. 000),expressions of ICAM-1 (9. 4% ± 2. 1% vs. 6. 2% ± 1. 1%),VCAM-1 (15. 1% ± 2. 1% vs. 12. 2% ± 1. 9%)and I-FABP (17. 5% ± 2. 5% vs. 6. 1% ± 0. 9%)were significantly increased (P < 0. 05)in lupus enteropathy group. Expressions of ICAM-1,VCAM-1 and I-FABP in colon tissue in lupus enteropathy group were positively correlated with histological score (r = 0. 870,P = 0. 010;r = 0. 881,P =0. 010;r = 1. 000,P = 0. 000). Conclusions:ICAM-1,VCAM-1 and I-FABP may be associated with pathogenesis of lupus enteropathy.

Wnt signals widely exist in live creatures,involved in many physical or pathological processes,including the cell prolif-eration, differentiation and apoptosis. Recent studies show that Wnt/β-catenin signaling pathway may play an important regula-tory role in the protective effects of neurovascular unit in ische-mic stroke. Some chemicals,such as sulindac and estradiol,and some compound traditional Chinese medicine which contains gly-coside( e. g. rhodiola rosea ) , volatile oil ( e. g. turmeric ) and compound prescription ( e. g. Dan Long Xing Nao Fang ) can protect the neurovascular unit by regulating the pathway. This aims to review the research progress of the protective effects of Wnt/β-catenin signaling pathway on the neurovascular unit in is-chemic stroke,with combination of chemicals and traditional Chi-nese medicine which can protect the neurovascular unit via Wnt/β-catenin signaling pathway. It aims to provide the methodology basis for elucidating the mechanism of drugs,and also provide a new idea for researching the new drug which can reduce the dis-ability rate caused by sequela of stroke.

Objective:To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening.Method:802 infants(1179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE).However, they failed in the first or & and second hearing screening. Auditory brainstem response (ABR) , distortion product otoacoustic emissions(DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests.Result:Among 802 cases(1179 ears),the ratio of single-ear(53.2%) is higher than both-ears(39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation ;25.8% infants once suffered from hypercholesterolenia failed in the hearing screening,which was higer than the other known risk factors.P＜0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk fators group(10.8%);56.9% of the infance who did not pass the hearing screening were found none risk factors, 42.3% of the infances who had high risk factors was normal hearing level;96 cases(138 ears) undergone twice assesement, in morderat disorder group, more cases(74.3%) changed better , and less disorder group(40.9%), severe disorder group (33.3%).Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases(12 ears) diagnosised auditory neuropathy.Conclusion:The important factors make the follow-up decision incluing perinatal history,hearing level and age.Maybe some high-factors we did not realized. Gene screening should be paied more attention in the future work.

Objective To design the family support scale for adolescent patients with nephritic syndrome. Methods 192 adolescent patients with nephritic syndrome were selected in the pilot investigation, and then formed the first questionnaire. The reliability and the validity of the questionnaire were evaluated by the experts. Results The questionnaire involved 15 items and its reliability and the validity were satisfied. There was a positive correlation between the family support and the self-nursing degree. Conclusion The reliability and the validity of this questionnaire are both up to the demands, it can used to study the condition of family support for adolescent patients with nephrotic syndrome.

Objective To investigate the relationship between social support and subjective well-be-ing in only-child-lost ( OCL ) people, and the mediating effect of self-efficacy in this relationship. Methods By stratified cluster sampling,206 only-child loss people were investigated with Social Support Rating Scale ( SSRS) ,General Self-Efficacy Scale ( GSES) and Index of Well-Being ( IWB) ,and data were analyzed with SPSS19.0 software and Amos17.0 software. Results ①Scores of SSRS,GSES and IWB in only-child-lost people were(31.78±8.18),(24.12±0.67) and (8.38±3.05). ②Correlation analysis showed that scores of GSES,SSRS and 3 dimensions of SSRS were positively correlated with scores of IWB ( r=0. 542,0.332,0.214,0.332,0.216;P<0.05) . ③Self-efficacy partially mediates the relationship between social support and subjective well-being through mediating effect test(χ2/ df=1.986,GFI=0.985,AGFI=0.942, RMSEA=0.069),mediating effect accounted for 16.08%.Conclusion Social support is an important factor which plays a direct or indirect role in subject well-being. Self-efficacy is the intermediate link between social support and subject well-being.

A series of tacrine-methoxybenzene hybrids (5a-5i) were designed, synthesized and evaluated as inhibitors of cholinesterases (ChEs). All the compounds had better ChEs inhibitory activities than tacrine with IC50 values at the nanomolar range. Compound 5h exhibited the strongest inhibition on acetylcholinesterase (AChE) with an IC50 value of 6.74 nmol x L(-1) and compound 5f showed the most potent inhibition on butyrylcholinesterase with IC50 value of 3.83 nmol x L(-1). Kinetic and molecular modeling studies showed that these hybrids targeted both the catalytic active site and the peripheral anionic site of AChE.

A series of quinoline-polyamine conjugates (8a-8n) were designed, synthesized and evaluated as inhibitors of cholinesterases (ChEs). Some of these compounds had potent ChEs inhibitory activity with IC50 values at micromolar range. Compound 8n exhibited the strongest inhibition on acetylcholinesterase (AChE) with an IC50 value of 8.78 micromol x L(-1), and compound 8i showed the most potent inhibition on butyrylcholinesterase (BChE) with IC50 value of 1.60 micromol x L(-1) which was slightly better than rivastigmine. The structure-activity relationship revealed that the chain length of polyamine and linker played important roles for inhibitory activity. Molecular modeling studies showed that 8i targeted both the catalytic active site (CAS) and the peripheral anionic site (PAS) of cholinesterases.