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.

Objective To investigate the prevalence and genotype distribution of human papilloma virus (HPV) infection among patients with cervical carcinoma or precancerous lesions in Xuzhou region. Methods 688 patients with cervical lesions confirmed by colposcopic biopsy were assigned to three groups:low-grade squamous intraepithelial lesion (LSIL) (187 cases), high-grade squamous intraepithelial lesion (HSIL) (359 cases) and cervical carcinoma (142 cases). The genotypes of HPV were determined by nucleic acid hybridization technique. The prevalence and genotype distribution of HPV were further analyzed. Results The infection rates of HPV in LSIL , HSIL and ICC group were 68.98 % (129/187), 94.99 % (341/359), 95.78 % (136/142), respectively. These rates were statistically significant different (P< 0.05). With the aggravation of cervical lesions, HR-HPV infection rate was gradually increased and LR-HPV infection rate was gradually decreased. The most common HPV types were listed below in order of decreasing prevalence. LSIL:HPV16, 52, 58, 18, 31; HSIL: HPV16, 58, 33, 31, 52; cervical carcinoma: HPV16, 31, 58, 18, 33. Based on the cumulative logistic regression model, confidence intervals of the relevance between the overall HPV prevalence and occurrence of cervical lesions were calculated: HPV16 (OR= 7.215, P< 0.05), HPV31 (OR=2.768, P<0.05), HPV33 (OR=1.846, P<0.05), HPV58 (OR=1.726, P<0.05) Conclusions The prevalence of HR-HPV infections increased with the aggravation of cervical carcinoma in Xuzhou region. In order of decreasing prevalence, the most prevalent of HPV types are HPV16, 31, 33, 58. The results indicate that HPV18 have strong tumorigenicity, but is not popular in Xuzhou region. By contrast HPV52 is more common in LSIL than that in cervical carcinoma.

ObjectiveTo review the treatment of 132 patients with vascular injuries admitted to our hospital from Jun,1985 to May,2001.Methods Clinical data were analyzed according to the cause, site, type, and surgical modality of vascular injuries. ResultsThe mortality rate in this group was 6.8%, amputation rate 8.3%, and patency rate of primary surgical treatment was 91.9%.ConclusionsSurgical exploration is the mainstay of diagnostic approaches for acute vascular injury; flexible measures should be taken to ensure high patent rate of the injuried blood vessel,lower mortality and high salvage of limbs.

Objective To investigate the peripheral blood Th17 and CD4 + CD25 + regulatory T cell levels and their correlations in patients with primary hepatocellular carcinoma (PHC).Methods Peripheral blood samples were collected from 30 PHC patients and 25 healthy controls in the First Affiliated Hospital of Zhejiang University from June 2008 to May 2009.Mononuclear cells were isolated and the Th17 and CD4 + CD25 + regulatory T cells were detected by flow cytometry and compared between patients and controls by t test.Spearman test was performed to analyze the correlation of Th17 with CD4 + CD25 +regulatory T cell concentrations.Results The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood in healthy controls were (2.10 ± 0.87) ％ and (7.10 ± 2.32) ％ ; while those in PHC patients were (3.38±1.68)％ and (11.78±5.62)％ (t=3.640 and 4.162,P＜0.01).The level of Th17 cells was positively associated with that of CD4 + CD25 + regulatory T cells in PHC patients (r =0.821,P ＜0.01).Conclusion The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood are high in PHC patients and positively correlated with each other,which indicates that CD4 + CD25 + regulatory T cells may contribute to the disease progression and pathogenesis of carcinoma through inducing Th17 cells differentiation.

Objective To compare the biological characteristics of adipose-derived mesenchymal stem cells (ADAS) and bone marrow derived mesenchymal stem cells (BMSCs).Methods The adipose and bone marrow-derived sources of mesenchymal stem cells were separated,and their phenotype,cell doubling time and the secretion of factors were compared.They were also used to detect T-cell cycle,activation,and proliferation inhibition.Results BMSCs and ADAS were similar on the cell phenotype and the differences only existed in the expression of only CD106.For the proliferation rate,ADAS grew faster than BMSCs (doubling time 28 h vs.39 h,P＜0.05); ADAS and BMSCs also had the same ability to inhibit T cell proliferation,and dose-dependent effects existed in mitogen-stimulated Tcell proliferation and MLR: there was a strong inhibitory effect in 1:2,but this effect disappeared at 1: 100.Both ADAS and BMSCs could arrest most T cells in the G0/G1 phase,but the role of ADAS was weaker than that of the BMSCs.ADAS could not inhibit apoptosis of T cells.ADAS and BMSCs played the same roles in inhibiting the differentiation of TH0 to TH1 or TH2: mainly inhibiting differentiation of TH 0 to TH1 cells (IL-2-and IFN-γ-producing cells),but having no significant effect on TH2 cells (IL-4-and IL 10-producing cells).Conclusion ADAS and BMSC have a similar role in immune regulation.In the same volume,fat tissue has the number of more than 10 times of stem cell precursor cells than that of bone marrow,so adipose tissue is a more promising stem cells transplant source.

Objective To establish a technical route for the efficient expression and purification of PprI protein from Deinococcus radiodurans R1 by using eukaryotic Pichia pastoris.Methods The encoding sequence of the Deinococcus radiodurans pprI gene was modified according to the preference of Pichia pastoris' codon.Modified pprI gene was fully synthesized with PCR and a 6 × His tag was added at its Nterminal.The PCR products were purified and then cloned into Pichia pastoris expression vector pHBM-905A.After utilizing Cop I and Not I double enzyme digestion and retrievering linear objective fragment,new pprI gene was transformed to the GS115 strain of Pichia pastoris.The obtained Pichia pastoris transformants were induced to express.Culture supernatants were detected by SDS-PAGE,Western blot,and mass spectrometry.A Ni-NTA column was uesd to purify the target protein and the BCA method was used to determine protein concentration.Results The coding sequence of new synthetic Deinococcus radiodurans pprI gene was correct.The purpose protein band of a molecular weight of 43 000 was detected in the culture supernatant of transformed Pichia pastoris strains by SDS-PAGE and Western blot.The mass spectrometry confirmed that it was the Deinococcus radiodurans PprI protein.When the concentration of imidazole was 250 mmol/L,the elution rate of PprI protein was the highest.The purified protein concentration was 0.35 mg/ml measured by BCA method.Conclusions This study has successfully constructed a new pprI gene and the recombinant strain of Pichia pastoris secreting PprI protein,and established a technical route for the efficient expression and purification of PprI protein.

Objective As there are difficult problems in surgical puncture needle cleaning and cleaning effect monitoring,we are aiming at finding some reliable solutions through relevant comparative tests. Methods Lumbar puncture needle,bone puncture needle and anesthe-sia spinal needle after clinical use,80 of each kind,were randomly collected and equally divided into the experimental group and the control group. The control group was given traditional lumen surgical instruments cleaning procedure,and the experimental group was given newly cre-ated small lumen instruments manual cleaning procedures. Magnifying glass,self-made instruments monitoring and ATP bioluminescence mo-nitoring were respectively used to verify the cleaning effect. Results All needles were monitored with magnifying glass,self-made instruments monitoring and ATP bioluminescence monitoring after cleaning,and the qualified rate were 98. 33%,97. 00% and 93. 33% respectively in the experimental group while 95. 00%,83. 33% and 78. 33% respectively in the control group. Results of self-made instruments monitoring and ATP bioluminescence monitoring showed that there was no difference between the two kinds of detection methods. Conclusion Newly created small lumen instruments manual cleaning procedures and self-made instruments monitoring were of reliable effect and strong operabili-ty in terms of puncture needle cleaning and cleaning effect monitoring,and they were worthy of further research and application.

One hundred and five patients with non-ST segment elevation acute coronary syndrome were followed up for 1 year.They were assigned to the event group or non-event group according to the presence of endpoint events(cardiac death and nonfatM myocardial infarction).B-type natriuretic peptide level was measured at 30 days and 1 year and compared between the two groups.The results showed that the level of B-type natriuretic peptide was higher in the event group[(235±107)μg/L vs(154±49)μg/L at 30 days;(259±100)μg/L vs(143±57)μg/L at 1 year].Thus,B-type natriuretic peptide is an important prognostic factor for patients with non-ST segment elevation acute coronary syndrome.

Objective To compare the impact of propofol and sevoflurane on thermoregulation in children undergoing orheopaedic surgery.Methods Sixty-eight children scheduled to undergo ortho-paedic surgery were randomly allocated to receive propofol (group P)and sevoflurane(group S)anes-thesia,34 cases in each group.Tympanic temperature was recorded 5 minutes before (T0 )and 5 min (T1 ),1 5 min (T2 ),30 min (T3 ),45 min (T4 ),60 min (T5 ),75 min (T6 ),90 min (T7 ),105 min (T8 )and 120 min (T9 )after anesthesia.Total fluid intake,duration of surgery,duration of anesthe-sia,the incidence of hypothermia,and the incidence of shivering were also recorded.Results Com-pared with T0 ,in both groups body temperature declined at T1-T8 .There was no difference between the two groups in total fluid intake,duration of surgery,duration of anesthesia and the incidence of shivering.Compared with group P,children in group S had a higher incidence of hypothermia(8 vs 1). Children in group S had lower temperature,which had statistical significance at T7 and T8 (P <0.05). Conclusion The core temperature of children undergoing orthopaedic surgery showed a trend of in-crease after the first fall in the surgery.Compared with propofol,sevoflurane anesthesia is more likely to lead to the incidence of hypothermia in children undergoing orthopaedic surgery in 90 min after in-duction of anesthesia.