Objective To explore surgical technique and clinical outcome of transabdominal preperitoneal hernia repair(TAPP)and totally extraperitoneal hernia repair(TEP)in inguinal hernia repair.MethodsThe clinical data of 23 patients underwent laparoscopic herniorrhaphy were retrospectively analyzed.Nine patients were underwent TAPP,and 14 patients underwent TEP.ResultsNone of patients was changed to open operation.Only one patient of TEP was changed to TAPP.Average operative time was(82.1?40.6)min.Blood loss was(5.7?3.0)ml.Disruption of peritoneum happened to 2 patients underwent TEP.The rate of postoperative complications was 21.7%(5/23),which included serum swelling(1 case),scrotal emphysema(2 cases),transient neurapraxia in the area of repair(1 case)and urinary retention(1 case).No chronic pain,foreign body sensation and infection were found.Average hospitalization after operation was(4.3?0.9)d.No recurrence was observed during a follow-up period of 1-15 months.ConclusionLaparoscope herniorrhaphy is safe due to lower recurrence and complications.It also has the advantages of slight pain and rapid recovery.

Objective To investigate the effect of hypertonic sodium chloride hydroxyethyl 40 injection (HSH)on craniocerebral injury accompanied with hypovolemic shock and ICP.Method Sixty patients suffering from craniecerebral injury accompanied with the hypovolemic shock and admitted to ICU and Neurosurgical Department of Guang dong General Hospital from September 2007 to June 2008,were chosen into the study prospectively.Those who was younger than 18years or older than 70 years,and those who were pregnant or meustruous women,or serious hepatic and renal insufficiency,hypertension,coronaxy artery disease,diabets mellitue,uncontrolled bleeding,brain death,erc were excluded.The patients were randomly divided into 3 groups.Each group included 20 patients and they were resuscitated with LR(500 ml),HIS(4 ml/kg)and HSH(4 ml/kg)respectively.The changos of blood pressure,laboratory examination indices and ICP Were detected before and at 30,60,120 minutes after resuscitation.Results MAP raised over 60 mmHg and ICP declined 10%within 30 min in HIS and HSH groups.The effect of HSH on the improving of blood pressure and the reduction of ICP wag more obvious than that of LR and HIS at 120 minutes(F=18.43,8.99,P<0.05)after resuscitation.There were no obvious oboes of the laboratory examination indices after resuscitation.Conclusions The themputic effect of HSH on ICP and MAP in craniocerebral injury accompanied with hypovolemic shock is obvious and lasting,which would be beneficial to the protection of cerebral function.

Objective To evaluate the indications of temporary cardiac pacing during perioperative period of non-cardiac operations.Methods Temporary cardiac pacemakers were installed preoperatively in 102 patients with bradyarrhythmia.The patients were divided into paced and no-paced groups according to the ECG monitoring during perioperative period.Clinical data were compared between the two groups.Results Totally 37 patients needed pacing during perioperative period.They were older than the no-paced patients [(61?17)y vs(52?14)y,t=2.885,P=0.005].In the paced group,more patients had history of myocardial infarction [54%(20/37)vs 14%(9/65),?2=18.733,P=0.000],cardiomyopathy [8%(3/37)vs 0%(0/65),P=0.045],and syncope [11%(4/37)vs 0%(0/65),P=0.030],abnormal findings in Holter [97%(36/37)vs 48%(31/65),?2=25.741,P=0.000] and UCG [97%(36/37)vs 45%(29/65),?2=26.076,P=0.000].Conclusions Temporary cardiac pacemaker can enhance the perioperative safety and reduce the incidence of cardiovascular complications in patients with bradyarrhythmia.Overall assessments of clinical setting were needed before implantation.The indications for temporary cardiac pacing include bradyarrhythmia with myocardium disorder,which is confirmed by UCG,advanced age,as well as history of syncope.Positive result of atropine test is not one of the significant indications.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; physiopathology ; psychology ; Quality of Life ; psychology ; Survivors ; psychology

Objective To observe different effects of cyclic and continuous nutrition infusion on serum nutritional indicators, peripheral white blood cell counts (WBC), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ ) score in patients with mechanical ventilated respiratory failure (MVRF).Methods A cross-over and self-controlled trial was conducted in 48 patients with MVRF treated in a medical intensive care unit during December 2006 to June 2009, and continuous nutrition (group A) and cyclic nutrition (group B) were infused respectively for patients of the two groups.Serum levels of albumin (ALB), pre-albumin (PA), transferrin (TR), PaO2, PaCO2, WBC and APACHE Ⅲ score were measured for the patients with 24-hour continuous nutrition (group A) and 16-hour cyclic nutrition (group B)infusion.Effects of the two nutritional therapies were compared.Results After nutrition infusion, serum levels of ALB, PA and TR were (34±3)g/L, (196±28)mg/L and (2.1±0.3 ) g/L in group A, and (35 ±4) g/L, (198 ±25) mg/L and (2.0 ±0.4) g/L in group B, respectively; and PaO2 and PaCO2levels were (92 ± 12) mm Hg ( 1 mm Hg =0.133 kPa) and (42 ± 10) mm Hg in group A, and (91 ±9)mm Hg and (42 ± 10) mm Hg in group B, respectively.WBC and APACHE Ⅲ score were ( 11.8 ± 1.7) ×109/L and 38 ±7 in group A, and ( 12.6 ± 1.2) × 109/L and 40 ±6 in group B, respectively.Significant difference in serum levels of PA and TR was found between the two groups (PPA =0.019 and PTR =0.013),while there was no significant difference in other indictors between the two groups.Conclusions 24-hour continuous nutrition infusion for patients with MVRF can obviously improve their serum levels of PA and TR,but has no effect on serum level of ALB, PaO2, WBC and APACHE Ⅲ score in critical ill patients, as compared to those with 16-hour cyclic nutrition infusion.

Objective To study the relation between phlegm-damp retention type of metabolism syndrome and microcosmic indices in order to find out the objective evidence for TCM syndrome differentiation.Methods Totally 49 cases of metabolism syndrome were observed,25 of them were phlegm-damp retention type in differentiation and 24 were non-phlegm-damp retention type.The height, body weight,waistline and blood pressure of two groups were measured,the serum leptin,insulin and blood lipid were determined, and the insulin resistance index(IRI)and body mass index(BMI)were calculated.Results The leptin,BMI,systolic pressure,FINS and IRI of the phlegm-damp retention group were all higher than those of the non-phlegm-damp retention group.Conclusion BMI, leptin,insulin,and IRI may be taken as the the index of syndrome differentiation in metabolism syndrome.

Objective To investigate the effect of DWI in diagnosing ovarian carcinoma .Methods MRI and DWI were performed in 33 patients with ovarian carcinoma and 23 patients with benign ovarian tumor proved by pathology ,respectively .ADC values of the cystic components and the solid components were respectively measured in ovarian carcinoma and benign ovarian tumor .Results The mean ADC value of solid component in ovarian carcinoma was (1 .68 ± 0 .37)× 10-3 mm2/s ,which was significantly lower than that of solid component in benign tumor [(3 .51 ± 0 .53) × 10-3 mm2/s] .There was no significant statistical difference between ovarian car‐cinoma and benign tumor in ADC value of cystic component [(5 .34 ± 0 .54)× 10-3 mm2/s vs (5 .89 ± 0 .37)× 10-3 mm2/s] .Conclu‐sion DWI is useful for diagnosis and differential diagnosis of ovarian carcinoma quantitatively .

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Isocitrate Dehydrogenase ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Male ; Mutation ; Nuclear Proteins ; genetics ; Prognosis ; Treatment Outcome

Objective:To observe the relationship between coronary heart disease(CHD)patterns and coronary lesion,and between the syndrome of spleen deficience with/or phlegm turbidity(SP)and coronary lesion.Methods:Traditional Chinese medicine(TCM)patterns and syndromes of 81 patients with CHD confirmed by coronary angiography(CAG)were differentiated.And the relationship between CHD patterns and coronary lesion,and between SP syndrome and coronary lesion were analyzed.The extent of coronary lesion was reflected by the affected branches and degree of arterial constriction based on CAG.Results:In 81 cases,the average affected branches amount in the group of blood stasis pattern was the most;arterial constriction degree in the group of cold-accumulation pattern was the most severe;the coronary lesion of cases in the qi-stagnation pattern group and yin-deficiency pattern group were slighter;but there was not significant difference among the CHD patterns groups.In 81 cases,there was significant difference between the SP syndrome group(38 cases)and the non-SP syndrome group(43 cases)in both affected branch distribution and arterial constriction degree.It manifested that the left circumflex artery(LCX)and right coronary artery(RCA)was easier to be affected and their constriction was more severe in the SP syndrome group.Conclusion:There was relationship between different CHD patterns and coronary lesion;coronary lesion and the clinical symptom of SP syndrome may exist the relationship of cause and effect.

【Objective】To observe the effect of Buzhong Yiqi Wan(BYW)on thyroid hormones in rat model of spleen-asthenia.【Methods】Thirty-four SD male rats were randomized into 3 groups:normal control group(N=10),spleen-asthenia model group(N=12),BYW group(N=12).Except the normal control group,the rats in other groups were given the decoction of Radix et Rhizoma Rhei(4 g?d-1 for each rat)to induce spleen asthenia,and meanwhile,BYW group reveived BYW(3.9 g?kg-1?d-1).The treatment lasted 20 days.Radioimmunoassay was used to detect serum levels of triiodothyronine(T3),thyroxine(T4),reverse triiodothyronine(rT3)and thyroid stimulating hormone(TSH).Meanwhile,the body weight,spleen and thymus weight as well as their ratio with the body weight were also observed.【Results】Serum T3 and T4 levels,spleen and thymus weight as well as their ratio with the body weight were decreased in the model group as compared with those in the normal control group(P