Objective:To study the feasibility of surgical techniques and clinical experience of the airbag-free separation of nail and the whole extraperitoneal laparoscopic hernia repair(TEP).Methods:Ninty-three cases of inguinal hernia.Patients were treatecl in our hospital from March 2005 to January 2009,with 39 cases of regular.Free air and non-stapling of mesh TEP and 54 cases of routine open tension-free hernioplasty.Results:The operation times were as follows:TEP Group,unilateral hernia(101.3?15.6 min),bilateral hernia(138.4?17.3 min);Open Group,unilateral hernia(81.6?7.6 min),bilateral hernia 175.8?22.0 min.The couplications in TEP Goup inclucled 3 cases of retroperitoheal rupture,3 cases of intra-operative vascular injury,and 2 cases of postoperative scrotal hematoma.Nine cases of sacrotal hematoma,4 cases of infective and 6 cases of long-term pain in the groin area happened in open Group.Conclusion:TEP of free balloon separator with no stapling patch is safe,reliable,less post-operative complications and especially suitable for bilateral hernia.

Objective To investigate the coordinate repression of angiostatin(AS)and Fas gene on human colon carcinoma LOVO.Methods Plasmid pcDNA3-AS and pcDNA3-Fas were constructed,and AS,Fas,AS and Fas gene were transfected to human colon carcinoma LOVO cells by liposome method.The expressions of target protein were detected by Western blot.The effects of transfection of AS and Fas gene on the growth of human colon carcinoma cells were detected by MTr methods.AS,Fas,AS and Fas gene were transfected to the human colon carcinoma subcutaneously implanted in nude mice by direct injection into the tumor.The tumor sizes were detected after 14 days of the first gene transfection.Results The effect of gene transfeetion in LOVO cell after twelve hours,24 h,48 h and 72 h were observed and compared with control group,co-transfection of Fas and AS gene group and Fas group significantly inhibited the growth of human colon carcinoma LOVO line cells(P＜0.01).Fourteen days after plasmid transfection,the tumor volume in group Fas and group co-transfection were signifieandy smaller than that of control,AS and Fas group(P＜0.05).The tumor volume in AS group and Fas group were significantly smaller than that of control(P＜0.05).Conclusion Angiostatin and Fas gene have coordinate repression effect on human colon carcinoma in vivo.

Objectives To evaluate accurately hepatocyte injury degree of severe hepatitis patients by quantifying plasma DNA of severe hepatitis patients and study its clinical application in diagnosis of severe hepatitis comparing with ALT.Methods Six milliliters of peripheral blood samples were collected from 185 patients with hepatitis B which are divided into four groups, severe hepatitis with 30 cases, acute hepatitis with 20 cases, chronic B hepatitis with 90 cases, and liver cirrhosis with 45 cases. 100 healthy controls were enrolled. Circulating DNA was extracted from plasma by the BILATEST virus DNA/RNA extraction kit and quantified with a novel duplex real-time PCR assay, respectively.Results Plasma DNA levels of hepatitis B patients were significantly higher than those of healthy controls (104.2 ng/ml vs. 23.4 ng/ml (median),P=0.0000).A significant difference of plasma DNA concentration was found between severe hepatitis and acute hepatitis (P=0.0018), and chronic B hepatitis (P=0.0000), and liver cirrhosis (P=0.0000).The median value of serum ALT of hepatitis B patients was 107.5 U/L, much higher than that of the healthy controls (24.1 U/L,P=0.0000).The levels of serum ALT were significantly different between severe hepatitis and acute hepatitis (P=0.0024), while there was no remarkable difference between severe hepatitis and chronic B hepatitis (P=0.0600), liver cirrhosis (P=1.0000). Moreover, for distinguishing severe hepatitis from liver cirrhosis and chronic B hepatitis, the plasma DNA assay was notably superior to ALT by the analysis of receive operating characteristic (ROC) curves (AUC, 0.95 vs. 0.51,P=0.0000; 0.86 vs. 0.34,P=0.0000).Conclusion The results by measuring plasma DNA of hepatitis B patients with the novel duplex real-time quantitative PCR showed that plasma DNA may be considered as a robust predictive marker for accurately evaluating hepatocyte injury degree of severe hepatitis patients.

Objective To study the willingness to home care needs of patients, in order to provide a basis for the further development of home care. Methods The self-designed questionnaire was used in the study. By using the convenience sampling method,500 patients with home care in 10 communities in Taiyuan city were surveyed. Results A total of 390 cases (78. 0%) had the demand of home care. The top 3 demands were that 208 cases ( 53. 3%) needed the disease prevention knowledge instruction, 205 cases ( 52. 6%) needed the measurement of blood pressure, and 202 cases (51. 8%) needed to set up the health records and the regular physical examination. 226 patients ( 57. 9%) required the home care services provided by hospital nurses. There was significant difference in the choices of home care providers in patients with different disease (χ2 =6. 786,P<0. 05). 221 cases (56. 7%) hoped that the cost of home care could be charged according to the service items. 234 cases (60. 0%)hoped that the home care costs could be covered by the health insurance. Conclusions Home care service is the development direction of future nursing. It should be responded to an appeal by the policy and become demand-oriented. We should set up home care service system, to meet people′s diversified needs.

Objective To understand the present situation of community nurse′s home care ability, in order to provide a reference for training community nurse′s home care ability in late general hospital. Methods All 7 community service center in Yingze District were selected by cluster sampling method including 43 community service stations and 183 nurses involved questionnaire investigation. Results A total of 179 community nurse′s organization ability was (3. 39 ± 0. 92) score, self development ability (3. 49 ± 0. 87) score, critical thinking ability (3. 57 ± 0. 68) score, practice ability of home care (3. 60 ± 0. 68) score and interpersonal interaction ability ( 3. 83 ± 0. 76 ) score; multiple liner regression analysis presented that the age, occupational title, community working length and continuing education were the influencing factors of community nurse′s home care ability score(P<0. 05). Conclusions Community nurse′s home care practice ability and communication skills are known well, but the overall level is low, so we should organize and analyze the previous nursing demand results to make out reasonable, effective, targeted training plan for community nurse′s training.

Objective:To measure the mesio-distal interradicular space of posterior teeth at different height by CBCT.Methods:60 subjects with skeletal Class Ⅰ,Ⅱ and Ⅲ patterns were included(n =20).From the distal of first premolar to the mesial of second molar,the mesiodistal width at the height of 2,4,6,8 and 10 mm from the alveolar crest were measured and analysed.Results:The interradicular distance was larger than 3 mm within 4-10 mm height in maxilla and in mandible.The maxillary mesiodistal width values measured between the first premolar and second premolar in skeletal Class Ⅰ and Class Ⅱ pattern was greater than that in Class Ⅲ(P ＜0.05) and there was no significant difference in other zones.In the mandible,the values of skeletal Class Ⅲ pattern were greater than those of skeletal Class Ⅰ and Class Ⅱ pattern(P ＜0.05).Conclusion:The suitable interradicular zone is within 4-8 mm to the alveolar crest between the second premolar and first molar for miniscrew implant placement in maxilla,and over 4 mm between the first molar and second molar in mandible.The difference of interradicular spaces in sagittal skeletal features is existed.

Objective:To explore the clinical value of modified upper urinary tract video urodynamics in evaluating the surgical effect and guiding the follow-up treatment after ureteral reconstruction.Methods:From December 2018 to November 2020, sixty-nine patients underwent upper urinary tract reconstruction and received modified video urodynamics at the time of nephrostomy removal 3 months after the surgery in the RECUTTER database (29 cases in Peking University First Hospital, 22 cases in Emergency General Hospital, and 18 cases in Beijing Jiangong Hospital). There were 39 males and 30 females, with an average age of (40.4±12.7)years. The stricture was located in left in 34 patients, right side in 27 patients, and bilateral sides in 8 patients. The upper, middle, and lower thirds of the ureter were affected in 26, 10, and 33 cases, respectively. The preoperative creatinine was (92.3±26.9)μmol/L, and the estimated glomerular filtration rate (eGFR) was (85.1±23.2)ml/(min·1.73m 2). The upper urinary tract reconstruction included ileal replacement of ureter in 25 cases (36.2%), pyeloplasty in 8 cases (11.6%), ureteroneocystostomy in 9 cases (13.0%), boari flap in 6 cases (8.7%), lingual mucosal graft ureteroplasty in 9 cases (13.0%), appendiceal onlay ureteroplasty in 3 cases (4.3%), ureteroureterostomy in 3 cases (4.3%), and balloon dilation in 6 cases (8.7%). Based on the pressure and imaging, the results could be divided into three types, type Ⅰ, the pressure difference remained stable near baseline, and the renal pelvis pressure was below 22 cmH 2O(1 cmH 2O=0.098 kPa), and the reconstructed ureter is well visualized during the whole perfusion process; type Ⅱ, the pressure difference increases with the perfusion, but it can decrease to a normal level with the ureteral peristalsis; type Ⅲ, the pressure difference exceeds 15 cmH 2O, and the ureteral peristalsis is weak or disappears at the same time. The management strategies and treatment effects of different subtypes were analyzed. Successful treatment was defined as no further treatment required, the absence of hydronephrosis-related symptoms, and the improved or stabilized degree of hydronephrosis. Results:All 69 patients successfully completed upper urinary tract video urodynamics. The pressure difference was higher than 15 cmH 2O in 8 patients, and the median pressure difference was 37(19-54)cmH 2O. The renal pelvis pressure exceeded 22 cmH 2O in 10 patients, and the median pressure was 63.5 (24-155) cmH 2O. Video urodynamic results of upper urinary tract were classified as type Ⅰ in 60 cases, type Ⅱ in 5 cases, and type Ⅲ in 4 cases. Patients in type Ⅰ do not require other treatment after nephrostomy tube removal. Patients in type Ⅱ should avoid holding urine after the removal of nephrostomy and D-J tubes. All patients in type Ⅲ received further treatment, of which 2 patients replaced D-J tube regularly, 1 patient underwent long-term metal ureteral stent replacement, and 1 patient underwent ureteroscopic balloon dilation. The median follow-up time was 24 (18-42) months. All patients in type Ⅰ met the criteria for surgical success, The pre-and postoperative creatinine in type Ⅰ patients were (88.71±23.09)μmol/L and (88.75±23.64)μmol/L ( P=0.984), and eGFR were (88.06±22.66)ml/(min· 1.73m 2)and (87.97±23.01)ml/(min·1.73m 2), respectively( P=0.969). For type Ⅱ patients, ultrasound showed that the degree of hydronephrosis improved in 3 cases and remained stable in 2 cases. The pre-and postoperative creatinine were (105.97±7.75)μmol/L and (97.63±7.56)μmol/L ( P=0.216), and eGFR were (69.08±14.74)ml/(min·1.73m 2)and (75.95±14.02)ml/(min·1.73m 2)( P=0.243), respectively. For type Ⅲ patients, ultrasound showed that the degree of hydronephrosis remained stable. The pre-and postoperative creatinine were (105.14±44.34)μmol/L and (101.49±57.02)μmol/L ( P=0.684), and eGFR were (65.32±19.85)ml/(min·1.73m 2) and (73.42±27.88) ml/(min·1.73m 2), respectively( P=0.316). Conclusions:The pressure and imaging results of modified upper urinary tract video urodynamics can assist in evaluating the surgical effect of ureteral reconstruction, and the classification has certain guiding significance for further treatment.