Objective To retrospectively analyze the risk factors of recurrent groin hernia. Methods Data came from all hernia repairs recorded in our hospital between 1991 and 2001. A total of 1 082 cases of groin hernia was analyzed through Cox proportional hazard model to determine the relative risks between recurrence and mode of admission, types of groin hernia, repair methods (traditional/tension free hernioplasty), and post operative complications.Results From 1991 to 2001,1 082 groin hernia operations were performed in our hospital, 88.9% for primary hernia and 11.2% for recurrent hernia. As compared with traditional hernia repair methods, Lichtenstein’s tension free hernioplasty technique had less relative risk for recurrent hernia repair than that for primary hernia repair. Postoperative complications and indirect hernia were linked to an increased relative risk for recurrence. Conclusion There are many factors affecting the recurrence of inguinal hernia, but the use of tension free hernia repair may decrease re recurrence of recurrent hernia.

Objective To review experimental study and clinical application of materials to bile duct repair and reconstruction.Methods Comparison of different materials was made between advantages and disadvantages.Results Synthetic grafts such as vitallium,teflon are easy to handle,but have no flexion,and have foreign body reaction.Although autogenous free tissues such as venous patch and peritonium are resistant to infection,they are likley to lead to bile duct stricture because of lacking adeuqate blood supply.Vascularized neibouring tissues for repearing bile duct defect have satisfactory results.Conclusions To avoid bile duct striccture,vary measures should be taken to repair bile duct defecs;for segmental loss of bile duct,end to end anastomosis or Roux-en-Y biliary jejunal reconstruction should be applied.

Leptin,the product of the obese gene,is a 16kDa secreted protein produced by white adipocytes.Because of its dual nature as a hormone and cytokine,leptin plays a role in regulating energy metabolism,inflam-marion,immune response,neuroendocrine and angiogenesis,and so on.The review focuses on the research and controversy of leptin's effect in osteoarthritis.

Objective To evaluate the expression of ? opioid receptor of the knee joint synovium tissue in patients with chronic inflammation. Methods The patients were divided into inflammatory group and control group(n=25 for both). Those who were allocated to the inflammatory group were diagnosed as osteoarthritis by arthroscopy, and in the control group, the patients were having dislocation of patella and took internal fixation with arthroscopy. The synovium tissues were harvested from suprapateller bursa, articulation vestibule, intercondylar fossa and articulation metacele. The synovium were taken to measure ? opioid receptor by immunohistochemistry and RT-PCR in both groups. Results Immunohistochemical and RT-PCR results revealed that the expression of mRNA and the optical density (OD) of immunoreaction of ?-opioid receptor in the knee synovium tissue in the chronic inflammation group were significantly higher than those in the control group (P0.05). Conclusion The expression of ? opioid receptor of the knee joint synovium tissue in chronic inflammation was significantly up-regulated. It may play a partial role in the peripheral mechanism of morphine.

There are twenty-one gene-associated sites of hereditary spastic paraplegia (HSP) that have been reported, including eleve gene-associated sites of autosomal dominant inheritance, seven gene-associated sites of autosomal recessive and three gene-associated sites of X2 linked recessive. Nine genes of HSP have been cloned as followed, atlastin, spastin, paraplegin, L1CAM, PLP, Hsp60, maspardin, TRAK1 and so on.

Achievement ; Otolaryngology ; Otorhinolaryngologic Surgical Procedures ; Periodicals as Topic

Head ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Periodicals as Topic

Acupuncture ; history ; Acupuncture Points ; China ; History, Ancient ; Humans ; Medicine in Literature ; Terminology as Topic

OBJECTIVETo explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA).

METHODSFrom June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function.

RESULTSAll incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score.

CONCLUSIONPFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure stable fixation and earlier get out of bed.

Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies