BACKGROUND:It has been generally accepted that polypropylene mesh tension-free hernia repair may repair the inguinal hernia,but the clinical application is not wide.OBJECTIVE:To analyze retrospectively the effect of polypropylene mesh plug tension-free hernia repair versus the traditional herniorrhaphy for inguinal hernia.DESIGN,TIME AND SETTING:Case analysis was performed among 115 cases who underwent inguinal hernia in Department of General Surgery,Affiliated Xinhua Hospital of Hainan Medical College from March 2003 to October 2007.PARTICIPANTS:The involved patients were 76 males and 39 females,aged 26-81 years with a mean of 61.3.There were 78 cases with lateral indirect hernia,11 direct hernia,2 femoral hernia,and 12 bilateral indirect hernia.35 of 115 patients were operated with polypropylene mesh tension-free hernia repair and 80 patients were provided at traditional repair method.Mesh cone hernia ring and patches were offered from Bard Company(USA).RESULTS:The size of hernia ring was selected based on the pattern number and amount of mesh plug.Transfixing suture was performed along the center and tip of hernial sac.Subsequent to the mesh plug implantation,the flap was processed into interrupted suture with hernia ring at a interval of 0.5-0.8 cm.Traditional herniorrhaphy was chiefly consisted of Bassini,McWay and Shouldice operative types.MAIN OUTCOME MEASURES:Operative duration,out of bed activity time and average hospitalization time were observed.Utility of anodyne,uroschesis and scrotal swelling were detected after operation.RESULTS:All patients were cured.There were 35 patients operated with mesh tension-free repair of inguinal hernia.The operation mean time was 42 minutes.The mean time of getting out of bed was 8 hours after operation.The mean hospitalization time was 6.2 days.There were 2 patients with uroschesis,3 patients utilizing the anodyne,and 1 patient with scrotal swelling after operation,without complications about wound infection and scrotal hydrocele.No recurrence occurred by follow-up visit of 6-36 months after operation.Eighty patients operated with the traditional herniorrhaphy.The operation mean time was 56 minutes.The mean time of getting out of bed was 68 hours after operation.The mean hospitalization time was 11.6 days.There were 9 patients with uroschesis,37 patients utilizing the anodyne and 1 patient with scrotal swelling after operation,without complications about wound infection and scrotal hydrocele.Nine patients were recurrent by follow-up visit of 6-36 months after operation.CONCLUSION:Polypropylene mesh plug tension-free repair for inguinal hernia is suitable to repair and enhance the pectineus porose area,with great histocompatibility.Thus,it is obviously ascendant to the traditional herniorrhaphy.

Objective To explore the feasibility and clinical value of metallic stent in the management of unresectable hepatic portal cholangiocarcinoma. Methods A study was investigated in 17 patients with unresectable hepatic portal cholangiocarcinoma from January 1998 to January 2006. A memory alloy biliary stent was placed into the obstructive bile duct for internal biliary drainage. Results Patients’ jaundice disappeared within 2 weeks after the stent placement. Cholangiography via the drainage tube showed patent bile ducts. Follow-up surveys in 16 patients for 4~30 months (mean, 11.5 months) revealed a survival time of 4~20 months (mean, 11 months) in 13 fatal patients. The remaining 3 patients had survived 10, 12.5, and 30 months, respectively. Conclusions Placement of memory metallic biliary stent for patients with unresectable hepatic portal cholangiocarcinoma is an ideal palliative therapy, which is simple and effective for reducing jaundice.

BACKGROUND: Many experiments have proved that heavy-load movement training causes the acute increase of free radicals. The increase of endogenous free radicals and caused cellular and subcellular lipid peroxidation strengthening injure the structure and function of tissue cells, thereby, decrease motor ability. Sleep deprivation also causes the increase of oxygen free radicals.OBJECTIVE: To observe the changes in malondialdehyde (MDA) and glutathione (GSH) levels as well as superoxide dismutase (SOD) activity in serum of acute exhaustive exercise rats following different time periods of sleep deprivation.DESIGN: A randomized controlled animal experiment.SETTING: Laboratory of Exercise Sciences & Sports Medicine, Physical College, Hunan Normal University.MATERIALS: Thirty healthy male SD rats of clean grade, weighing about (220±13)g, provided by Experimental Animal Center of Hunan Agricultural University, were involved in this study.METHODS: This experiment was carried out in the Laboratory of Exercise Sciences & Sports Medicine, Physical College,Hunan Normal University from April 2006 to May 2006. Thirty rats were randomized into 5 groups: blank control group,simple exercise group, sleep deprivation 24 hours group, sleep deprivation 48 hours group and sleep deprivation 72 hours group, with 6 rats in each group; Rats in the blank control group were allowed to sleep normally, but not do exercise; Rats in the simple exercise group were allowed to sleep normally and executed after acute exhaustive exercise; Rats in the sleep deprivation 24, 48 and 72 hours groups were deprived their sleep for 24, 48 and 72 hours,respectively, then they were executed after acute exhaustive exercise. Method of gentle handling was used in creating rat models of sleep deprivation; Rats in the simple exercise group and sleep deprivation groups were forced to do exercise according to the rat exercise model project established by Bedford: treadmill gradient 10°, speed 19.3 m/min, all the exercise rats were exhaustive (Exhaustion criteria: At the end of exercise, rats reached 1/3 of runway over 3 times;Various stimulations for expelling were invalid. After running, rats presented with breathlessness, expression lassitude,ventral decubitus, slow stimulus response, weaker escape response in being captured). After experiment, rats in each group were executed under the anesthetic state, and their blood was taken out, and centrifuged after natural clotting.Supernatant fluid was taken for detecting MDA and GSH levels as well as SOD activity.MAIN OUTCOME MEASURES: Changes in MDA and GSH levels, and SOD activity in rat serum.RESULTS: Thirty rats were involved in the final analysis. ① MDA level in the simple exercise group was higher than that in the blank control group (P＜ 0.01). MDA level in the sleep deprivation 24 hours, 48 hours and 72 hours was higher than that in the simple exercise group, respectively (P ＜ 0.01). MDA level in the sleep deprivation 72 hours was statistically higher than that in the other sleep deprivation groups, respectively (P ＜ 0.01). ②GSH level in the simple exercise group was lower than that in the blank control group (P ＜ 0.01). GSH level in the sleep deprivation 24 hours group was higher than that in the simple exercise group [(P ＜ 0.01). GSH level in the sleep deprivation 24 hours and 48 hours groups was lower than that in the simple exercise group, respectively (P ＜ 0.05, 0.01). There were statistical differences in GSH level among sleep deprivation groups (all P＜ 0.01). ③ SOD activity in the simple exercise group was lower than that in the blank control group (P ＜ 0.01); SOD activity in the sleep deprivation 24, 48 and 72 hours groups was lower than that in the simple exercise group, respectively (P ＜ 0.01); SOD activity in the sleep deprivation 48 and 72 hours groups was significantly lower than that in the blank control group, respectively (P ＜ 0.01); There were statistical differences in SOD activity among sleep deprivation groups (P ＜ 0.01).CONCLUSION: Sleep deprivation can cause serumal oxidative stress injury of rats; With elongation of time of sleep deprivation and exhaustive exercise, oxygen free radical production in serum of rats accumulates more and more, ability to get rid of oxygen free radical becomes weaker and weaker, and injury to body is more and more obvious.Serumal oxidative stress status of acute exhaustive exercise rats following sleep deprivation

Objective To analyse the clinical effects on colon cancer with acute intestinal obstruction.Methods 56 patients with acute intestinal obstruction caused by colon cancer were studied retrospectively.The experience of diagnosis was summarized.Results 47 patients with acute intestinal obstruction caused by colon cancer received Stage Ⅰ tumor resection and the other 9 patients received different stages.54 patients healed (96.4％) and 1perioperative deaths (1.8 ％).Postoperative complications occurred in 18 cases (32.1％) including incision infection,intraperitoneal infection and intestinal fistula.Conclusion Stage Ⅰ tumor resection is feasible and safe surgical procedures for acute intestinal obstruction caused by colon cancer.

BACKGROUND:After arthroscopic knee surgery, deep vein thrombosis easily occurs. Currently, there were no specific clinical manifestations in deep vein thrombosis, so a fast, convenient and reliable risk assessment tool was needed to evaluate the clinical high-risk groups for prevention and intervention. The effectiveness of Caprini Risk Assessment Scale used in thrombosis risk assessment has been confirmed by a large number of researches, but the current domestic research is less.
OBJECTIVE:To verify the validity of Caprini risk assessment scale in evaluations of high deep venous thrombosis risk patients among knee arthroscopy patients, and to explore effective strategies for prevention of deep vein thrombosis in patients undergoing knee arthroscopic surgery.
METHODS: A case-control study design was used to colect 49 deep vein thrombosis patients admitted to the Department of Orthopedics, Renhe Hospital of Three Gorges University from January 2008 to June 2015 as case group, and randomly selected 98 patients admitted during the same period of non-deep vein thrombosis patients as control group. Caprini risk assessment scale was used to assess risk assessment and risk grading of deep venous thrombosis, and to explore the correlation between risk classification and risk of deep vein thrombosis.
RESULTS AND CONCLUSION: (1) Basic conditions comparison: application time of tourniquet, the proportion of smoking patients, and proportion of deep venous thrombosis and (or) the history of pulmonary thromboembolism were higher in the case group than in the control group (P < 0.05). (2) Caprini score was significantly higher in the case group than in the control group (P < 0.001). In the case group, the proportion of very high risk patients (53%) was highest, folowed by high risk (25%), totaly 78%. In the control group, the proportion of high risk patients (32%) was highest, folowed by low risk (29%). Significant differences in above risk degree analysis were identified between the two groups (P< 0.001). (3) Deep venous thrombosis and (or) the history of pulmonary thromboembolism was positively correlated with Caprini score in the case and control groups (P < 0.05). Caprini score was positively associated with application time of tourniquet in the case group (P< 0.05). (4) Logistic regression analysis of Caprini risk classification and the risk of deep vein thrombosis: with increased caprini risk classification, the risk of deep vein thrombosis increased significantly. The risk of deep venous thrombosis in patients with high risk and very high risk was 2.130 and 11.786 times of patients with low risk, respectively. (5) These results indicate that Caprini risk assessment model can effectively assess the risk of deep vein thrombosis among patients receiving knee arthroscopy.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.