Objective To explore the clinical effects of Kugel surgical treatment for inguinal hernia.Methods Operative time,chornic pain,complications and charges of 355 patients with inguinal hernias were analyzed retrospectively.Results Recurrences occurred in 1 patient,during a mean followl-up of 36 months (range:7-85).The average operation time was 35.4 min (range:20-130),average surgical charges were 6 253 yuan.Postoperaive chronic pain appeared in 6 patients.There are 3 cases of sermoa,1 case of haematoma and 2 case of wound infection.Conclusion The Kugel inguinal hernia repair is safe and effective,with the advantage of mild pain and prompt recovery after operation,and a low risk of complications and recurrence.

AIM:To investigate changes of retinal nerve fiber layer ( RNFL) thickness and macular retinal thickness in patients with early diabetic retinopathy ( DR ) and disclose the changing trends of RNFL thickness and macular retinal thickness in different stages of early DR.
METHODS:It was a clinical case control study. Through selecting 60 patients ( 120 eyes ) with early DR diagnosed with type 2 diabetes were divided into non - diabetic retinopathy (NDR) group (20 cases, 40 eyes) and mild non-proliferative diabetic retinopathy (NPDR) group (20 cases, 40eyes), moderate NPDR group (20 cases, 40 eyes) . Twenty normal patients ( 40 eyes ) were enrolled as control group. The RNFL thickness of optical nerve ( with circle scan round optic nerve head, scan diameter of 3. 45mm) and the retinal thickness of macular ( around center point with 1000μm diameter ) were measured by optical coherence tomography ( OCT ) , to compare the RNFL thickness changes of the control and early DR patients.
RESULTS:Compared with the control group, the RNFL thickness of optical disc in the inferior quadrant was descended obviously in NDR group ( P < 0. 05 ), with statistically significant difference,; there were no statistically significant difference in other quadrants ( P>0.05). In mild NPDR group, the RNFL thickness of optical disc in the mean and inferior quadrant was significantly descended than that in the NDR group. In moderate NPDR group, the RNFL thickness of optical disc in the mean, superior and inferior quadrant was statistical significance descended than that in the NDR group ( P < 0. 05 ). Compared with the NPDR group, NDR group and control group, the RNFL thickness of optical disc in each quadrant were descended significantly. There was statistically significant difference in macular retinal thickness among the NDR group, mild NPDR and moderate NPDR group ( P<0. 05), the retinal thickness was increased gradually in mild NPDR and moderate NPDR group.
CONCLUSION:With the development in the degree of early DR, RNFL thickness is gradually decreased and retinal thickness is increased, OCT can be observed qualitatively and quantitatively in DR.

ObjectiveTo observe the therapeutic effect of standing bed on orthostatic hypotension with cervical spinal cord injury. Methods36 patients with cervical spinal cord injury were divided randomly into the standing bed group and routine treatment group. The blood pressure of all patients were measured every day during rehabilitation treatment. The function of spinal cord was assessed before and after treatment.ResultsThe function of sensory and motor in the two groups were all improved, but there was no statistical difference between the two groups in the grades of spinal cord function. There were 27 patients who had orthostatic hypotension in the study. All the patients with complete spinal cord injury suffered the orthostatic hypotension. There was no improvement in blood pressure of complete spinal cord injury after treatment. In incomplete spinal cord injury patients, there was a significant improvement and the difference of blood presure between lying and standing was decreased in standing bed group after treatment (P<0.05). Compared with routine treatment group, the blood pressure in standing bed group was improved (P<0.05). Conclusions Cervical spinal cord injury could have orthostatic hypotension. Complete spinal cord injury would suffer orthostatic hypotension in different degree. The standing bed treatment could improve the orthostatic hypotension in incomplete spinal cord injury.

Objective To evaluate the methods and effect of balloon catheter dilation of esophageal caustic ingestion stenosis in children. Methods We analysed 18 cases, including 10 cases of esophageal stenosis due to ingestion of sulphuric acid, 7 cases of esophageal stenosis caused by ingestion of sodium carbonate and the last one through ingestion of chemical materials include zinc sulphate. Barium esophagogram was taken before dilation for every patient and the balloon size varied from 4 mm?40 mm to 16 mm?40 mm or 20 mm?40 mm in diameter was selected for the procedure. Results 18 cases were all successful in dilation by balloon catheter, without esophageal perforation and other complications. The satisfactory results maintained from six months to thirty months with remarkable improvement clinicoly. Conclusions Balloon catheter dilation is a simple, safe and reliable method for the treatment of esophageal caustic ingestion stenosis in children, and should be recommended as the first choice.

BACKGROUND: Pathogenesy of immunoglobulin A nephropathy (IgAN) is not clear up to now. Present research has verified that the key pathogenetic pathway is abnormalities of IgA1 molecular O-glycosylation induced by decrease of β1, 3-galactosyltranferase activity in IgA1 hinge region of IgAN patients. Prophase study by the authors supposed that the key of IgAN O-glycosylation abnormality might be due to the decrease of β1, 3-galactosyltranferase specific molecular protein chaperone Cosmc in B lymphocyte of peripheral blood in IgAN patients.OBJECTIVE: To measure DNA sequence of β1, 3-galactosyltranferase specific molecular chaperone in coding region of Cosmc gene in IgAN patients, and compared with the sequence of Gene Bank.DESIGN: Case-controlled observation.SETTING: Department of Nephrology, West China Hospital, Sichuan University.PARTICIPANTS: Totally 27 IgAN patients and 10 non-IgAN patients were recruited in Department of Nephrology of West China Hospital of Sichuan University from November 2005 to August 2006, and five normal controls were included in this study. All the subjects knew the fact and agreed to participate in the experiment.METHODS: The experiment was performed at the State Key Laboratory of Biotherapy of Sichuan University. 2 mL peripheral venous blood of all the samples were taken into heparin sodium anticoagulated tubes, from which total genomic DNA were extracted by phenol/chloroform precipitation method. Concentration of DNA was determined by ultraviolet spectrophotometer. The polymerase chain reaction (PCR) was used to amplify the coding region of β1, 3-galactosyltranferase specific molecular chaperone Cosmc gene in all the subjects and direct sequencing was done in PCR products of each subjects. The results of all the sequencing were compared with Gene Bank one by one.MAIN OUTCOME MEASURES: Amplification findings and sequencing of coding region of β1, 3-galactosyltranferase specific molecular chaperone Cosmc gene by PCR.RESULTS: ①Coding region of Cosmc gene located at 257-1 213, and amplified Cosmc gene was 1 247 bp. ②The sequence of Cosmc gene coding region was similar in IgAN patients, non-IgAN patients and normal controls, and no difference of gene sequence was noticed in all the result sequences as compared with the Gene Bank registered sequence.CONCLUSION: No abnormal sequence is found in coding region of Cosmc gene in IgAN patients, suggesting that this coding region probably is not associated with the abnormalities of IgA1 O-glycosylation in IgAN.

Objective To evaluate the methods and effect of balloon catheter dilation of benign esophageal stenosis in children. Methods 9 cases had an anastomotic stenosis after surgical correction of esophageal atresia; 11 cases of esophageal stenosis due to ingestion of caustics; one case had an lower esophageal stenosis after Nissen surgery and one case after gastroesophagoplasty. Age ranged from 17 days to 7 years. Each case had a barium esophagram before balloon dilation. The balloon size varied from 3 to 10 mm in diameter. Results 21 cases were successful after dilation of balloon catheter. There were no esophageal perforation and complications. The satisfactory results maintained from six months to thirty months. Conclusions Balloon catheter dilation is a simple、safe and reliable method for the treatment of benign esophageal strictures in children as the first choice.

Objective To study the pathogenesis of nonalcoholic steatohepatitis(NASH) in rat model. Methods Male SD rats were fed with a high fat diet for 12 weeks. Non alcoholic ateatohepatitis serum lipid, aminotransferase values and free fatty acid (FFA) levels were tested, the malondialdehyde (MDA) and superoxide dismutase (SOD) activity of hepatic tissue were also detected. Hepatic cytochrome P450ⅡE 1 (CYPⅡE 1) were detected in liver section by immunohistochemistry using CYPⅡE 1 specific antibodies and also with an immunohistochemical procedure for detecting the number of Kupffer cells. Results FFA concentrations of the serum and hepatic tissue were markedly increased, which was accompanied by an increase of MDA in hepatic tissue, whereas SOD activity of hepatic tissue was decreased. CYPⅡE 1 immunostaining was markedly increased, especially in the perivenous region. The number of Kupffer cells in NASH was significantly increased compared with control livers. Correlation analysis revealed that the increases in the levels of FFA correlated positively with the hepatic CYPⅡE 1 expression, the lipid peroxidation, and the pathological scores in the liver of NASH rats. Conclusion The increased FFA, highly expressed CYPⅡE 1, activated kupffer cells and increased lipid oxidate were all contributed to NASH.

Objective To express the immunodominant epitopes of the branched chain 2 oxo acid dehydrogenase complex (BCOADC), the pyruvate dehydrogenase complex (PDC), the 2 oxo glutarate dehydrogenase complex (OGDC) and a triple hybrid clone (designated as BPO), and use BPO as a tool for the detection of M2 specific for primary biliary cirrhosis (PBC). Methods The cDNA fragments encoding the M2 reactive epitopes of BCOADC, PDC and OGDC were amplified using PCR with total RNA extracted from human peripheral mononuclear blood cell. The fragments were cloned into pQE 30 and then transformed into plasmid E.coli M15. Its products were induced by isopropylthio ? D galactoside and confirmed with SDS PAGE and Western blot. Results Four specific proteins induced from the transformants containing the fused plasmid were shown to have antigenic reactivity with PBC sera, but not with normal control sera. Conclusions We succeeded in expressing three immunodominant epitopes and a hybrid clone which can be used as a powerful and specific method for the diagnosis of PBC.

Objective: To explore whether abnormal brain activity exists in schizophrenics during resting state by fMRI technique and regional homogeneity(ReHo)approach. Methods: fMRI images were obtained in resting state from 18 patients with schizophrenia diagnosed with the DSM-Ⅳ criteria and 18 control subjects. The newly published ReHo approach was applied for fMRI data analysis. Results: Patients with schizophrenia showed decreased ReHo of BOLD signal in resting brain compared with control subjects(P

After the functions and requirements of medical information officers and the distribution of enterprises were described, the problems in domestic education of medical informatics ( such as insufficient class hours for medical course and unclear orientation of subjects) were analyzed according to the status quo in training of medical informatics students, and some suggestions were put forward for the orientation of medical informatics education in China.