Objective To evaluate the laparoscopic repair for indirect inguinal hernia in children. Methods A total of 72 children with unilateral and 25 children with bilateral indirect inguinal hernia underwent laparoscopic high ligation of the sac. In operation a self-made needle introduced subperitoneally was used to pass a ligature circumferentially around the internal ring. Results All the operations were successfully completed. The average operating time was 10 min in unilateral hernias and 16 min in bilateral hernias. The postoperative hospital stay was 1 day. No surgical complications occurred. Follow-up for 2~60 months (mean, 31 months) in 70 children found no recurrence. Conclusions Laparoscopic repair for indirect inguinal hernia in children is safe, feasible and minimally invasive, offering a low complication and recurrence rate and a quick postoperative recovery.

Objective To study the value of sequential duodenoscopic-laparoscopic treatment in patients with cholelithiasis. Methods Clinical data of 2 248 cases of cholelithiasis treated with sequential duodenoscopic-laparoscopic plan from January 2000 to December 2004 were retrospectively reviewed. Results Duodenoscopy indicated the confirmative diagnosis of gallbladder stones in 1 817 cases and gallbladder stones with associated common bile duct stones in 431 cases. Among 2 021 cases diagnosed as having gallbladder stones by B-ultrasonography: endoscopic retrograde cholangiopancreatography (ERCP) was performed in 690 cases, 213 of which were found having associated common bile duct stones; intraoperative cholangiography (IOC) was conducted in 85 cases, 10 of which were found presenting common bile duct stones; residual stones in the common bile duct after laparoscopic cholecystectomy (LC) were noted in 6 cases which were cured by endoscopic sphincterotomy (EST). Among 227 cases diagnosed as having gallbladder stones combined with common bile duct stones by B-ultrasonography, the diagnosis of common bile duct stones were confirmed by ERCP in 202 cases. Out of the 2 248 cases, 1 817 cases underwent the LC, 395 cases received EST and LC, and 36 cases were given the laparoscopic bile duct exploration (LBDE) (the bile duct was closed by primary suture in 26 cases and a T-tube was left in the bile duct in 10 cases). The 6 cases of residual stones in the bile duct were cured with EST postoperatively. A total of 28 cases required a conversion to open surgery (1.2%), and complications occurred in 52 cases (2.3%). Conclusions Sequential duodenoscopic- laparoscopic treatment for cholelithiasis offers a low residual stone rate and a high success rate.

Objective To discuss the clinical features and treatment methods of chronic hydrocephalus after traumatic subarachnoid hemorrhage.Methods A total of 40 cases of chronic hydrocephalus after traumatic subarachnoid hemorrhage were analyzed retrospectively.Results Eight cases improved after treatment of non-operation,the lateral ventricle external drainage was done in 32 cases of chronic hydrocephalus.Shunt tube obstruction occurred in 3 patients,with abdominal,subcutaneous and intracranial infection.The shunting operation device was pulled out and the 3 patients received operation for the second time.Two cases appeared intracranial hemorrhage,and the hemorrhage was absorbed after conservative treatment.Total Glasgow prognosis score was good in 32 cases,with mild disability in 5 cases,moderate disability in 2 cases and severe disability in 1 case.Conclusions Traumatic subarachnoid hemorrhage after chronic hydrocephalus should be early diagnosed and early treated,CT and MRI scan is the effective means to the diagnosis and differentiaion.The lateral ventricle external drainage is good method in treatment.

BACKGROUND: Lentivirus can infect divided and undivided cells. It remains uncertain whether the lentivirus can successful y infect primary ovarian granulosa cells. OBJECTIVE: To investigate infecting ratio and cel apoptosis of lentivirus carrying bcl-2 gene in primary human ovarian granulose cells cultured in vitro. METHODS: The lentiviral vector carrying bcl-2 gene was constructed using molecular biology, and packaged into lentivirus with high titer. The resulting recombinant lentivirus carrying bcl-2 genes were then used to infect primary human ovarian granulosa cells in vitro at different multiplicity of infection, 10, 50, 100, 200, and 400. Infection efficiency and cel proliferation were observed at 24, 48, 72, and 96 hours fol owing infection. Cel apoptosis was detected by flow cytometry, and bcl-2 gene transcription was assessed using reverse transcription PCR. RESULTS AND CONCLUSION: Primary human ovarian granulosa cells adhered at 24 hours, and exhibited polygon- or fusiform-shape and colony-like growth. When multiplicity of infection was 100, cel appearance and growth remained unchanged, and infection efficiency was high, which reached the peak up to 72 hours. Moreover, the positive rate was up to 60% in granulosa cells. Lentivirus carrying bcl-2 gene could increase expression of Bcl-2 protein and inhibit apoptosis of primary ovarian granulosa cells.

The geo-herbalism of Cangzhu, Atractylodes lancea (Thunb.) DC. , was studied for itsstrict quality control. Samples of typical and representative populations of geo-herbal and non-geo herbalorigin were collected, examined and cultivated through field work. Volatile oils from samples of varioushabitats were determined by GC/MS, and their respective bacteriostatic minimum inhibitory concentration(MIC)determined. Results of the study showed that both the size of capitulum and cleft on the leaves var-ied greatly even in species of the same population. The main components in their volatile oil also variedgreatly with Maocangzhu (MCZ) contains atractylone (29.54%) and atractylodin (17.82%); that of Nan-cangzhu (NCZ) contains hinesol (61.86%) and β-eudesmol (19.79%), and Baicangzhu (BCZ) cantains βeudesmol or mixture of β-eudesmol and atractylone (over 30%). Volatile oils of speciaes from Luotina,Taibai, and Huanglong showed potent bacteriostatic activity against Streptococcus hemolyticus (SH), com-parable to penicillin or streptomycin. In conclusion, A. lancea is a polymorphic complex greatly influencedby geographic environment and a reasonable proposal is to name them by geo-herbal names such as: MCZas A. lancea var. maoshanensis Hu et Feng; NCZ as A. lancea subsp. luotianensis Hu et Feng; and BCZ asA. lancea var. chinensis (Bunge) Kitam other than independent species as A. chinensis Bunge. It was in-correct to say that MCZ has no atractylone in its volatile oil and therefore differs from A. macrocephalaKoidz. (Baizhu). Inhibitory activity of the volatile oils against SH and Pseudomonas aeruginosa (PA) arealso quite different due to the habitats and imply that the rhizome from Luotian may be used to cure infec-tion diseases caused by SH and PA besides their traditional uses.

ObjectiveTo evaluate the value of inferior petrosal sinus sampling (IPSS) in the diagnosis of adreno-corticotropic hormone ( ACTH ) dependent Cushing syndrome ( CS ) with unknown origin. MethodsIPSS was carried out for the diagnosis of 16 cases with ACTH dependent CS who had not been identified after a series of dexamethasone suppression tests and radiological examinations. The ratio of inferior petrosal sinus/peripheral ACTH was assayed.The sensitivity and specificity of diagnosis of the Cushing disease were estimated. ResultsThe inferior petrosal sinus/peripheral ACTH ratio was over 2. 0 in 13 cases. Twelve cases underwent surgery with pathological diagnosis of pituitary ACTH adenoma, 1 patient relieved after γ knife treatment. The ratio was ＜ 2.0 in 3 cases including 2 pulmonary carcinoid and one pituitary ACTH adenoma. The sensitivity and specify of IPSS for the diagnosis of Cushing disease were 13/14and 2/2 respectively.ConclusionIPSS was a safe technique with high sensitivity, specify and infrequent complications in the diagnosis of ACTH dependent Cushing disease.It had great clinical value in the differential diagnosis of ACTH dependent Cushing disease with unknown origin.

Objective:To summarize the clinical results of the artificial iris diaphragm (AID)implantation for eyes with silicone oil longstanding tamponade.Methods: In this study,the operation indications,results and complications of 11 consecutive cases of artificial iris diaphragm implantation for eyes with silicone oil longstanding tamponade were studied. Results: In all of the 11 primary ocular disorder cases , 7 cases (7/11) were serious ocular trauma, 2(2/11)cases were diabetic retinopathy with traction retinal detachment , 1 case (1/11) was recurrent retinal detachment with complicated PVR, and 1 case (1/11) was Coats disease; The silicone oil was retained completely behind the surface of artificial iris diaphragm in 7(7/11) of all the 11 cases,in which no visual acuity was affected The complications were low intraocular pressure (IOP)and heavy fibrosis on the surface of artificial iris diaphragm. Conclusion: Open type artificial iris diaphragm implantation in eyes with longstanding silicone oil tamponade can effectively prevent the silicone oil from cotacting the cornea causing complication by spontaneously blocking and rescuing anterior chamber fluid circulation.

The electroencephalography (EEG) has a wide range of content, complex graphics and abstract theory. Meanwhile, there are differences in professional level, learning ability and subjective initia-tive among refresher doctors. In order to improve the quality of teaching, and to better serve the refresher doctors, the following strategies have been applied in the teaching process. We not only make the training target according to the actual condition of every refresher doctors, but also make them take a correct atti-tude towards study and follow the teaching arrangement. Besides, we not only orient at the operational skills training, including electrode installation, EEG evoked test, Point-of-Care test to eliminate the interference, but also promote the refresher doctors to seek the law of the diagram in the actual interpretation process with longitudinal development view and horizontal comparison perspective. Furthermore, we not only stan-dardize their report, but also broaden their view.

Objective To investigate the clinical effects of vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy (PDR V-VI stage).Methods A total of 80 patients with proliferative diabetic retinopathy from January 2012 to January 2014 were divided into the single group and the combined group according to the surgical method.Patients of the single group were treated by vitrectomy while patients of the combined group were treated by vitrectomy combined with cataract surgery.The incidence of retinal reattachment,postoperative vision and surgical complications between the two groups were compared.Results Compared with the single group,the incidence of retinal reattachment was higher in combined group (P ＜ 0.05).The postoperative vision improvement was better than that in single group,the difference was significant (P ＜ 0.05).And the surgical complications in combined group was less than that in single group,the difference was significant (P ＜ 0.05).Conclusion Vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy has a better clinical effect which is safe and reliable,and it can improve the rate of retinal reattachment and reduce surgical complications.

BACKGROUND:Single fracture or colapse of the posterolateral tibial plateau fractures is relatively rare in the clinical work. Rational choice of surgical approach and internal fixation for posterolateral plateau fracture is significant to restore the lower limb force line, maintain the joint stability and obtain good biocompatibility.
OBJECTIVE:To compare the stability and biocompatibility of Carlson posterolateral and posterior midline approaches for the treatment of posterolateral tibial plateau fractures with “T” shaped locking plate.
METHODS:From July 2011 to July 2014, 43 patients with posterolateral tibial plateau fractures, who were treated in the Affiliated Hospital of Jining Medical University, were retrospectively analyzed. Al patients were assigned to two groups according to approaches. In the Carlson posterolateral approach group, 22 cases received “T”-shaped plate insertion by Carlson posterolateral approach. In the posterior midline approach group, 21 cases received “T”-shaped plate insertion by posterior midline approach. After repair, perioperative data, fixation effects and knee function score were compared and analyzed between both groups.
RESULTS AND CONCLUSION:(1) 43 cases (43 knees) of posterolateral tibial plateau fractures were folowed up strictly. (2) No significant difference in operation time, fracture healing time, total load time, Hospital for Special Surgery score at 12 months postoperatively, tibial plateau angle and posterior slope angle immediately and 12 months postoperatively was detected between both groups (P > 0.05). (3) Significant differences in fracture exposure, blood loss, and excelent and good rate of Rasmussen at 12 months postoperatively were identified in both groups. Moreover, above indexes were better in the Carlson posterolateral approach group than in the posterior midline approach group (P< 0.05). (4) These findings confirmed that for a single fracture or colapse of the posterolateral tibial plateau fractures, two kinds of surgical approaches can achieve ful and direct exposure. Carlson posterolateral approach has good repair effect, fixation effect and biocompatibility.