ObjectiveTo evaluate the application value of the emergency laparoscopic surgery in incarcerated inguinal hernia of children. MethodsManual reduction of incarcerated hernia was laparoscopic- assisted after anesthesia, high-ligation of hernia sac was done by one hole method of laparoscopic treatment.ResultsAll of 22 cases of pediatric incarcerated hernia were done, no complications occurred. Eighteen patients were followed up for 3 - 15 months, 9.3 months on average, without serious complications. ConclusionsThe emergency laparoscopic surgery in children of incarcerated inguinal hernia is safe and feasible,with smaller trauma, quicker recovery and smaller health risk.

Tetramethylpyrazine(TMP)is a main active alkaloid ingredient of Traditional Chinese Medicine Ligusticum chuanqiong Hort. The article reviews the protection of TMP against pathological damage and nervous retardation disease in central nervous and peripheral nervous system and summarizes the mechanisms in basic research,clinical practice and so on.

Objective Potassium channel is essential for excitability of neurons and is involved in the regulation of information transmission. The purpose of this study was to investigate the effect of propofol on the voltage-gated potassium channels in rat hippocampal pyramidal neurons. Methods SD rats of 5-15 days old were decapitated and brain was immediately removed. Hippocampal pyramidal neurons were freshly isolated. Whole-cell patch clamp recordings were made. Voltage-dependent sodium and calcium currents were inhibited by TTX 1?mol?L-1 and CdCl2 400 ?mol?L-1 added to the perfusate. The effects of propofol on transient outward potassium currents and delayed rectifier potassium currents were studied and also the kinetics of channels. Results All the channels studied were reversibly inhibited by propofol in a dose-dependent manner. EC50 of propofol on transient outward potassium channels and delayed rectifier potassium channels were (71?18) ?mol?L-1 and (37?18) ?mol?L-1 respectively. The maximum inhibition rates were 52%?3% and 32%?5% .Conclusion Propofol reversibly inhibits potassium currents in a does-dependent manner. It is inferred that propofol affects the excitability of hippocampal neurons.

[Objective] Systematic review was carried out in quality analysis of literature of Shuang Huanglian Injection (SHI) for acute respiratoiy infections ( ARI) . [Methods] Database was set up according to the principles of clinical epidemiology and evidence-based medicine and the evaluation scale for ARI. The data was managed by descriptive analysis and uniformity test. [Results] In 49 clinical reports, 42.16% adopted the randomized and controlled method but the quality was not so good; the criteria of inclusion and exclusion was absent or not standardized in most of the reports; blinded method was adopted scarcely; drop-out and missed cases were rarely mentioned while adverse effects were reported usually. [Conclusion] The design of clinical study of SHI for ARI has been improved in recent years but there is still a lot of inadequany.

Objective To explore the effects of electroacupuncture on the expression of glucose transporter 4 (GLUT4) and protein kinase Bβ (Akt2) in the skeletal muscles of insulin-resistant (IR) rats. Methods Twentyfour male Wistar rats were randomly divided into a normal control group, a model group and an electroacupuncture (EA) group. The rats of the model group and the EA group were fed with high fat diets to establish a model of insulin resistance. The rats in the EA group were then treated with electroacupuncture for 2 weeks, while those in the model group were not. Blood samples were collected to evaluate fasting insulin (FINS) and fasting blood glucose (FBG) to calculate the insulin sensitivity index (ISI). GLUT4 and Akt2 mRNA in the skeletal muscles were determined with reverse transcription-polymerase chain reactions (RT-PCRs) after 2 weeks of EA treatment. Results Compared with the control group, the FINS in the model group increased significantly, and ISI decreased significantly. Compared with the model group, the FINS in the EA group decreased significantly and ISI increased significantly. The expression of GLUT4 and Akt2 mRNA in the model group was significantly lower than in the control group or the EA group. Conclusion Electroacupuncture might improve the condition of IR rats, probably by enhancing the transposition of GLUT4 in the phosphatidylinositol 3-kinase/protein kinase signaling pathway.

Objective To establish the model of hyperlipidemie acute pancreatitis(AP)to explore the mechanism of hyperlipidemia in aggravating AP.Methods Sprague-Dawley rats were divided into four groups at radmon:1)control group(C);2)hyperlipidemic group(TG);3)acute pancreatitis group(AP);4)hyperlipidemic acute pancreatitis group(HAP).After 8 weeks,blood,pancreas and peripancreas tissue were collected from each rats for determination of various parameters.Results The levels of hyperilidemic index were elevated in HAP group compared with those of other groups.The ADP/ATP ratio was obviously increased in HAP group.Caspase-3 and caspase-8 of HAP group presented in zymogen forms,while in AP group they were in activity forms.After the pancreas issue were stained bv HE and further analyzed through TUNEL assay,we found that there were more pancreatic acinar cells undergoing necrosis in HAP group.Conclusion Hyperilidemia may promote the course of apoptosis to necrosis of pancreatic acinar cells,which may be the mechanism of deterioration in hyperlipidemic acute pancreatitis.

Objective To evaluate the treatment effects of the olecranon comminuted fracture by the angle stability prin-ciple combined with support under the articular surface. Methods From November 2008 to June 2012, 13 patients (7 male and 6 female, aged from 20 to 77 years) suffered from olecranon comminuted fracture were treated with Synthes anatomy locking com-pression plate and screws combined with Kirschner wires supporting under the articular surface through the posterior median ap-proach. Fractures occurred in the left elbow in 9 and in the right elbow in 4. According to the Mayo classification, 11 cases were classified as Mayo type IIB and 2 as IIIB. According to the Schatzker-Schmeling classification, 2 fractures were type A2, 9 type C, and 2 type D. One patient with type C fracture also had type I coronoid fracture according to Regan and Morrey classification. The Mayo elbow performance index (MEPI) and the shortened disabilities of the arm shoulder and hand (Quick-DASH) were employed to evaluate the functions. All patients took the satisfaction survey and X-ray during the follow-up. Results All patients were fol-lowed-up for 8 to 41 months. The mean ROM of the elbow joint was 112° (range, 65°-140° ), and the mean rotation angle of the forearm was 170° (range, 150°-180°). The mean score for the MEPI was 96 (range, 85-100), excellent 12, good 1. The mean score for the Quick-DASH was 6.2 (range, 0-16.7). In the satisfaction survey, 8 patients were very satisfied, 4 satisfied, 1 common level. All patients took the X-ray during the follow-up and all of them had achieved fracture union completely with the mean time period as 12.7 weeks (range, 11-24 weeks). No cubitus varus, valgus, and instability were found in all patients. No complication, such as infection, ulnar nerve injuries and etc. was found. Five patients complained about mild discomfort caused by internal fixation at 3 months after surgery. Three of them were diagnosed as joint stiffness because of ROM within 100° . One case in 3 elbow stiffness patients developed osteoarthritis after eight months, but no pain during joint activity. Internal fixation was removed in one case;an-other young patient took the operation for removal of internal fixation and release of medial ligament;the third patient refused oper-ation. Conclusion Angle stability principle (Synthes anatomy locking compression plate and screws) combined with supporting under the articular surface (Kirschner wires) can achieve stable fixation in treating olecranon comminuted fracture. It may realize the early exercise of the elbow joint with excellent clinical results. Therefore, it may be an optional choice in clinical practice.

Objective To retrospectively review the clinical characteristics and antimicrobial resistance profile of nosocomial bloodstream infections caused by Klebsiella pneumoniae in surgical patients for better use of antimicrobial agents.Methods The clinical data of the surgical patients who were diagnosed with K.pneumoniae-associated bloodstream infections in Tung Wah Hospital from January 2013 to June 2015 were reviewed and analyzed retrospectively.The diagnosis of bloodstream infections was based on national diagnostic criteria.The pathogens were routinely isolated and identified.Antimicrobial susceptibility testing was carried out by using Kirby-Bauer method.The data were analyzed by WHONET 5.6 software.Results A total of 78 surgical patients were identified with nosocomial bloodstream infections due to K.pneumoniae during this period,including primary bloodstream infections (12.8％,10/78) and secondary bloodstream infections (87.2％,68/78).These infections were mainly associated with surgical and invasive procedures.Nearly 40％ of the K.pneumoniae isolates were resistant to ceftriaxone,cefuroxime and piperacillin.ESBLs were produced in 43.6％ (34/78) of the K.pneumoniae isolates.The ESBLs-producing strains showed significantly higher resistance rates to various antibiotics than non-ESBLs-producing strains.Piperacillin-tazobactam,amikacin,imipenem,and meropenem still have good antibacterial activity against these K.pneumoniae isolates.However,imipenem-resistant strains are emerging.Conclusions Most of the bloodstream infections caused by K.pneumoniae were secondary to infections in other body sites in surgical patients.Hospital infection control measures should be strengthened.Meanwhile,the clinicians should take full advantages of microbiological laboratory to profile the pathogens and their susceptibility patterns,which is crucial for rational use of antibiotics.

Objective:To investigate and summarize the procedures of direct-covedng pancreaticojejunostomy with remaining jejunal mucosa in pancreaticoduodenectomy and to analyze the incidence of pancreatic fistula and other postoperative complications.Methods:A total of 21 patients were treated with pancreaticoduodenectomy between May 2005 and June 2009.During the surgery,we dissected 3cm long remnant of the pancreas out of ambient tissues.Near the 2.0-3.0cm of the pancreatic remnant.we fixed partial posterior wall with the full-thickness jejunum without mucosa destroyed by interrupted suture,and then pushed the remnant into the jejunum and fixed the anterior wall.Finally,at the 1.0cm of the panceratic remnant,we binded the iejunum to surround the pancreas through 7-silk sutures.Results:One case was treated with secondary surgery due to bleeding of the pancreatic remnant.The other patients recovered smoothly without pancreatic fistula or other complications.Conclusion:Postoperative pancreatic fistula is related to the texture of pancreas,method of pancreaticojejunostomy,surgical skills and perioperative treatment.Compared with other types of pancreaticojejunostomy,direct-covering pancreaticojejunostomy with remaining jejunal mucosa is simpler.

Objective To investigate diagnosis and surgical treatment of primary retroperitoneal malignarnt tumor.Methods Retrospectively analyzed the clinical data with primary retroperitoneal tumor.Results Twenty-eight eases with benign tumor and 47 cases with malignant tumor underwent total resection,only 17cases with malignant tumor underwent local resection.Conclusion The diagnosis B-ultrasonography,CT and MR of primary retroperitoneal tumor is very important for preparative of preoperation and to estimate of involved organ.Involved organ resection and repeated operation for recurred tumor improve cure rate.