Objective To compare the efficacy of Lichtenstein and transabdominal preperitoneal patch repair(TAPP) in the treatment of primary inguinal hernia in adults. Methods The clinical data of 223 patients who received Lichtenste and 121 patients who underwent TAPP in our hospital between January 2002 and January 2006,were analyzed retrospectively.The efficacy and complications of the two methods were compared.Results The rate of intraoperative injury of the inner organs in the TAPP group was significantly higher than that in the Lichtenstein group [5.8%(7/121) vs 0.4%(1/223),?2=7.626,P=0.006],while no significant difference was detected in the rate of abdominal organ injury between the two groups [0.8%(1/121) vs 3.1%(7/223),?2=0.969,P=0.325].The rate of postoperative complications in the TAPP group was significantly lower than that in the Lichtenstein group [14.0%(17/121) vs 36.3%(81/223),?2=18.881,P=0.000].In the TAPP group,during a follow-up of(14?7) months,one case of recurrence was found(0.8%).Whereas in the Lichtenstein group,the patients were followed up for(16?8) months,two of them had recurrence(0.9%).No significant difference existed in the recurrence rate between the two groups(?2=0.000,P=1.000).Conclusions Both the Lichtenstein and TAPP have benefits and drawbacks.Individulized therapy is recommended for the patients with inguinal hernia.It is important for surgeons to know the indications of the operations.

This paper presents the preliminary design of data acquisition system of a portable uroflowmeter. The system uses double-hole cantilever pressure sensor. The signal is transferred to ATmega644PA microprogrammed control unit (MCU), converted by A/D (analog to digital) convertor. Then the further data are processed and get the corresponding relationship of weight-time and two curves of urine flow and urinary flow rate. In the measurement accuracy of the device about urine flow, two factors about the placement and height of the data acquisition are analyzed to show the accuracy of the equipment through the Origin 8.0 data analysis software. The design is characterized by low cost and high speed of data collection, real-time, high accuracy.
Data Collection ; Flowmeters ; Humans ; Monitoring, Ambulatory ; instrumentation ; Software ; Urination ; physiology ; Urodynamics ; physiology

Objective To investigate the effectiveness of organ dose modulation (ODM) technology with respect to dose reduction and image quality of the sensitive organs during CTA of craniocervical arteries. Methods Ninety one patients suspected of arterial vascular disease and evaluated by CTA of craniocervical arterires were enrolled in this study. Patients were divided into group A (n=46) and group B (n=45) according to the order of examination. All patients hadCTA examination of craniocervical arteries. The ODM technique was used only in plain phase in group A and was used both in the plain phase and enhanced phase in group B. The tube current in the four direction (anterior,posterior,left,right) of thyroid and orbital area and radiation dose were recorded. The image quality of group A and group B was evaluated by objective indicators [CT attenuation values and contrast-to-noise ratio (CNR) of vessels in the thyroid area and orbital region ]and the subjective score. The independent samples t test was used for the statistical analysis of the objective indicators and nonparametric rank sum Mann-Whitney U test were used for subjective score. Results For A group, There were significant differences for the tube current at all directions of the thyroid gland and orbital area between the plain phase and the enhanced phase except the current at the posterior of the thyroid gland area(P value all<0.05),and the current in plain phase lower than that in enhanced phase. The mean current of thyroid gland and the orbital area were (604±43) mA and (656± 22) mA in the plain phase and (341±54) mA and (409±63) mA in enhanced phase. The differences were significant (t values were -10.909 and -38.454,P<0.01).CTDIvol and ED were (15.6±1.4) mGy and (1.44± 0.17) mSv in the plain phase and (17.4 ± 1.4) mGy and (1.60 ± 0.18) mSv in the enhanced phase, the differences were significant (t values were - 42.008 and - 32.130, P<0.01) . There was no significant differences for the objective indicators and the subjective score between group A and group B(P>0.05). Conclusion ODM technique can provide protective effect on the sensitive organs during craniocervical CTA examination without compromising the image quality.

Objective:To investigate the effects of mucosal strengthening treatment on preventing recurrence of closedvarices. Methods: In 264 patients with esophageal varices obliteration by banding ligation and sclerotherapy, of 136 patientswere gone on to treat with strengthening mucosa, and 128 patients without strengthening treatment. All patients had beenobserved out of hospital for 1-13 years. Results: There were no recurrence and rebleeding of esophageal varices in the groupwith strengthening treament. But in the group without strengthening treatment, 25 patients (19. 5%) had isolated or strip-like varices with red colour signI small veins grew thick and part of mucosa appeared clear hyperaemia in 21 patients(16.4% ); 6 patients (4.7% ) rebleeded. There were significant differences between two groups (P

Objective To explore the role of miR-20a on pulmonary surfactant synthesis of alveolar epithelial cells A549 and its potential mechanism.Methods Lentivirus miR-20a overexpression vector(miR-20a group) or lentivirus no-load vector(no-load group) was transfected into A549 cells,and the expression of green fluorescent protein(GFP) was observed to determinate the transfection effficiency;cell proliferation was detected by using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT);the bioinformatics software and database were applied to predict and analyze the target genes of miR-20a about lung development;expressions of miR-20a,pulmonary surfactant-associated protein A(SP-A),pulmonary surfactant-associated protein B(SP-B),pulmonary surfactant-associated protein C(SP-C) and pulmonary surfactant-associated protein D(SP-D) mRNA were detected by using quantitative real-time PCR(qPCR);the expressions of SP-A protein,SP-B protein,SP-C protein,SP-D protein and protein signal transducers and activators of transcription 3 (STAT3) were detected by using Western blot.Results Observation of GFP expression under a fluorescent microscope indicated similar transfection efficiency,and real time-PCR showed that the expression of miR-20a increased after being transfected with lentivirus miR-20a overexpression vector(3.85 ± 0.18)compared with the normal group (0.99 ± 0.04)and the no-load group (1.21 ± 0.12),and the differences were significant(t =10.85,9.64,all P ＜0.001).As a result,lentivirus miR-20a overexpression vector was constructed successfully.Online software predicted that STAT3 gene was likely to be the target gene of miR-20a.Compared with the normal group (24 h,48 h,72 h:0.23 ± 0.01,0.39 ± 0.01,0.56 ± 0.03) and the no-load group (24 h,48 h,72 h:0.25 ± 0.01,0.44 ± 0.05,0.59 ± 0.01),miR-20a did not change the cell proliferation at different time points(24 h,48 h,72 h:0.26 ± 0.01,0.41 ± 0.02,0.58 ± 0.02) (all P ＞ 0.05).Compared with the normal group (1.00 ± 0.05,1.24 ± 0.20,1.31 ± 0.09,0.89 ± 0.12) and the no-load group (0.76 ± 0.10,1.31 ± 0.13,1.50 ± 0.11,1.01 ± 0.11),miR-20a up-regulated the mRNA expressions of SP-A,SP-B,SP-C and SP-D (2.05 ± 0.17,2.14 ± 0.10,2.84 ± 0.09,1.66 ± 0.08),and the differences were significant (all P ＜ 0.05).Compared with the normal group (0.46 ± 0.01,0.27 ± 0.03,0.69 ± 0.01,0.43 ± 0.01) and no-load group (0.43 ± 0.01,0.21 ± 0.01,0.79 ± 0.02,0.44 ± 0.02),miR-20a also increased the protein expressions of SP-A,SP-B,SP-C and SP-D (0.55 ±0.01,0.47 ±0.05,0.96 ±0.02,0.59 ±0.03),the diffe-rences were statistically significant (all P ＜0.05).The expression of STAT3 in miR-20a group(0.37 ±0.05) was significantly lower than that in the normal group(0.60 ±0.04) and the no-load group (0.68 ±0.06),and the differences were statstically significant (all P ＜ 0.05) in A549.Conclusions STAT3 is a downstream target gene of miR-20a.miR-20a can promote pulmonary surfactant synthesis of alveolar epithelial cells A549 by inhibiting STAT3.

Objective To explore the effect of psychological nursing intervention on the pain, sleep quality and life quality of patients with gastric cancer. Methods A total of 84 cases of gastric cancer patients from January 2013 to January 2014 were randomly divided into intervention group and control group, 42 cases in each group, the control group was received conventional care, while the intervention group focused on the implementation of psychologicalnurs-ing intervention, SAS, SDS scores, VAS scores and PSQI scores before and after the intervention, and the general health, physiological function, physiological function, body pain, vitality, social function, emotional function, mental health quality of life scores were compared before and after intervention between two groups. Results After intervention, the SAS scores, SDS scores, VAS scores decreased significantly than before intervention and intervention group were lower than control group(P<0.05),the PSQI scores were significantly lower than before the intervention and intervention group were lower than the control group (P<0.05), after the intervention,the physical function, physical function, bodily pain, vitality, social functioning, role emotional, mental health scores were significantly higher than before intervention and intervention group were higher than the control group(P<0.05). Conclusion Positive psychological nursing interven-tion for gastric cancer helps to alleviate patients anxiety, depression and other negative psychological, reduce pain and improve sleep quality in patients, to further improve the quality of life of patients.

Objective To investigate the influence of low-tube current in combination with simultaneous iterative reconstruction algorithm on bone mineral density (BMD) of T12 and image quality with a chest phantom.Methods An adult male chest phantom was selected.CT scan of the chest was performed at tube voltage of 120 kV and five different tube currents (20,30,40,50,60 mAs) in combination with filtered back projection (FBP),iDose4 (Level 4) and iterative model reconstruction (IMR,Level 2),respectively.BMD of T12 in chest phantom and objective evaluation results on different tube currents and simultaneous iterative reconstruction techniques were compared.The subjective scoring of mediastinum and lung window imaging qualities at tube current of 20 mAs with IMR and tube current of 60 mAs with FBP were compared.The consistency between two observers was evaluated.Results There was no significant difference between BMD values nor CT values on different tube currents and simultaneous iterative reconstruction techniques of chest phantom (all P＞ 0.05),but the differences between SD values were statistically significant (P＜ 0.001).SD values obtained with IMR were lower than those of iDose4 and FBP at same tube currents (all P＜0.001).At tube current of 60 mAs with FBP,the consistency of two observers in mediastinum window was the best (Kappa=1,P＜0.001),while in lung window was medium (Kappa=0.64,P=0.002).At tube current of 20 mAs with IMR,the consistency of two observers in mediastinum window was medium (Kappa=0.64,P=0.002),while in lung window was the best (Kappa=1.00,P＜0.001).Conclusion Low-tube current in combination with simultaneous iterative reconstruction algorithm can reduce radiation dose without affecting the accuracy of BMD.

Objective To investigate the reproducibility and accuracy of spinal BMD (bone mineral density) by low mA using adaptive statistic iterative reconstruction based on phantom model.Methods European spine phantom (ESP) was scanned with 5 different tube currents (40,60,80,100 and 120 mA) on the GE Revolution prototype.All data were transferred to the quantitative CT (QCT) PRO workstation for measuring the bone mineral density (BMD).And all data were reconstructed using different adaptive statistical iterative reconstruction veo (ASiR-V) weighting percentages from ASiR-V 0 filtered back projection(FBP) to ASiR-V 100％,at interval of 20％.Quantitative measurements of CT value,noise,and contrast noise ratio (CNR) of L1,L2 and L3 were measured in each group.The singlefactor analysis of variance (ANOVA) was used to compare the bone mineral density values of different mA and ASiR-V weighting percentages.Results Volume CT dose index(CTDIvol) and dose length product (DLP) were positively correlated with tube current(r =1).The BMD of ESP phantoms had no statistically significant differences among the multi-center lumbar spines L1,L2 and L3 at different doses under the same ASiR-V weighting percentages (P ＞ 0.05),as well as at the same dose under different ASiR-V weighting percentages(P ＞ 0.05).The error of bone density accuracy was within 6％.Conclusions Low dosage of 120 kV and 40 mA using ASiR-V without affecting the accuracy of BMD has the potential effect to reduce radiation dose without compromising image quality.

The establishment of an economic operating mechanisms for hospitals is a key factor in advancing the growth of public hospitals in the modern age.At present,the due value of key factors such as medical resources and labor value of medical personnel in public hospitals in China has not been fully reflected,which not only restricts the overall operation efficiency of hospitals,but also makes it difficult to realize the marginal value of hospital operation and management.The economic operating mechanisms of public hospitals is in urgent need of reform.Large public hospitals in Henan Province has established an economic operating mechanisms of public hospitals based on intelli-gent finance,comprehensive budget management as the core,and cost control and performance management as the major tools to realize the interconnection of various systems and promote the high-quality development of hospi-tals with the three major supports of industry and finance integration,financial integration and financial integration.

This paper takes the"departmental core group"of the logistics department of Beijing Tiantan Hospital as a practical case to explore the methods to improve the performance of the"departmental core group"of the logistics department of public hospitals and analyze the implementation effect.In 2021-2023,Tiantan Hospital adopted five measures:Heterogeneous membership structure,full division of responsibilities,institutionalized management norms,list of work objectives,risk control throughout the process and implemented the whole process of closed-loop management of"three major issues and one great is-sue".This paper compares the quality of management of"three major issues and one great issue"in the three years before and after the implementation of the five measures,and finds that after the adoption of the five measures,the management efficiency is improved,the number of topics increased fourfold compared with the previous three years,and the number of engineering,service and procurement projects completed on schedule doubled compared with the previous three years;the quality of decision-making is improved,decision-making management is legal and compliant,and there are no errors in work;the satisfaction of employees is improved,it was rated as advanced department and advanced grass-roots party organization.It was concluded that the five meas-ures are an effective way to improve the performance of the"departmental core group"in the logistics department,which can pro-vide a reference for the team building and departmental management of the"departmental core group"in public hospitals.