Objective To discuss the feasibility of laparoscopic closure of the internal ring and high ligation of the hernial sac in children with indirect inguinal hernia.Methods Laparoscopic closure of the internal ring and high ligation of the hernial sac was conducted in 21 children with indirect inguinal from January 2003 to December 2004 in this hospital.A 5-mm 30? laparoscope was introduced through the umbilicus.The internal ring and the posterior crus(PC) on the side of hernia were identified.A 3-mm dissection forceps was placed on the midline between the umbilicus and pubic symphysis.At the skin projection of the internal ring on the side of hernia,a round-tip needle with 3-0 Prolene suture grasped by a regular needle holder was passed directly into the abdominal cavity to suture the posterior crus and then penetrate out of the abdomen via the roof of the internal ring through the musculoaponeurotic arch of the transversus abdominis.Then the Prolene suture was cut off,and passed by using the Endoclose device into the extraperitoneal cavity at the skin projection of the internal ring.The dissection was continued from without outward around the sac to encircle the neck and an extracorporeal high circumferential ligation of the sac was finished.Results The operation was successfully completed in all the 21 cases.The operating time was 16~50 min(mean,32.9 min),the postoperative duration in hospital was 1~2 d,and the time to normal activity,1~4 d(mean,1.4 d),respectively.No postoperative bleeding,hematoma of scrotum,or incisional infection occurred.Follow-up checkups in the 21 cases for 1~24 months(mean,15 months) showed no recurrence.Conclusions Laparoscopic closure of the internal ring and high ligation of the hernial sac is a novel,feasible,reliable and effective herniorrhaphy for the treatment of pediatric indirect inguinal hernia.

Objective To observe the interaction between the extreme stress and mild traumatic brain injury in the patients surviving Wenchuan earthquake.Methods Forty survivors in Wenchuan earthquake were selected for the psychological status survey 2-30 days after the disaster,among them 20 survivors were suffering from mild traumatic brain injury,and the remainders were in normal physical conditions.The Symptom Checklist-90(SCL-90),which consisted of 90 items with 5 grades for each item(0-4 grade,grade zero as none and grade 4 as severe),including 9 symptom factors,was adopted to perform the evaluation for all the subjects in both groups,and the subscales were compared.Results Five subscales of SCL-90,including somatization,depression,anxiety,hostility and fear,which averaged 2.12?0.50,1.83?0.60,1.99?0.40,1.80?0.70 and 2.20?0.8,respectively,were significantly increased in mild traumatic brain injury group than that in control group(P0.05).Conclusions Mild traumatic brain injury occurred among survivors of severe earthquakes is strongly associated with psychological problems.A higher incidence of psychological disorder in survivors of earthquake with mild traumatic brain injury indicates that one must be cautious when attributing a health problem to mild traumatic brain injury,since the post-traumatic stress disorder and depression may be the primary problem.The high-risk population with psychological obstacle consists of the survivors with mild traumatic brain injury,and the interactions of both psychological stress and traumatic brain injury may lead to more complex clinical symptoms,so psychotherapy should be emphasized in the treatment of patients with mild traumatic brain injury.

Diabetic nephropathy is one of the most serious complications of diabetes mellitus and it seriously endangers people's health.Some previous studies indicate that the occurrence and development of diabetic nephropathy is not positively associated with control of blood glucose and course of disease,Its development has family aggregation and ethnic differences.In addition to environmental factors,genetic factors play an important role in the process of occurrence and development of diabetic nephropathy,Many genetic mutations can lead to a high degree of susceptibility to diabetic nephropathy.Discovery of some related genes of diabetic nephropathy and elucidation of these genes function provide an effective means in the early diagnosis,gene therapy and individualized drug therapy of diabetic nephropathy.In this review the action and function of discovered related genes of diabetic nephropathy are summarized.

To explore innovative training model for young teachers in university,literature and practical data in university were analyzed.A new concept of research tutor system was put forward in which young teachers and tutors were linked with scientific research project and common interests.Tutors in one subject trained the young teachers from another subject.In this model,a new relationship with equality and free-talk between tutors and students was established and the advantage of talent group effect was ascended.Discipline crossing,multiple communication and interactive learning may be promoted and the number of innovative young teachers and scientific research achievements may increase.

Objective To study the Ile796Val polymorphism in human SCAP gene in Hubei area, and analyze its correlation with coronary heart disease (CHP) and hypertension and the relationship between polymorphism and lipid metabolism. Methods Using PCR RFLP, we detected genotypes of Ile796Val polymorphism in human SCAP gene. Results The allele A frequencies of Ile796Val in human SCAP gene for controls, CHD patients and the hypertension patients were 0.32, 0.45 and 0.42 respectively. The allele G frequencies were 0 68, 0.55 and 0.58 respectively. There were significant differences in frequencies of genotype and alleles between controls and hypertension group. And there was significant difference in the level of TC, LDL C and ApoB. In CHD group, there was significant difference in the TC level between different genotypes. In hypertension patients, although a difference was noted in genotype, there was no significant difference in allele frequencies and lipid level exceps a significant difference in the levels of TC, LDL C and ApoB in hypertension patients. Conclusion Ile796Val polymorphism in human SCAP gene may be a great agent to cause disorder in the lipid level of blood and lipid metabolism of tissue. It is of great significance in disorder in lipid metabolism of inter cellular and genetic investigation of hyperlipidemia.

Purpose: To explore the relationship between the amount of lymphocyte containing adhesion molecules(CD_(44)) and the development and postoperative metastasis of bone tumors. Method: The percentage of peripheral blood CD_(44) positive lymphocyte's(PB CD_(44) + L) in 45 patients with bone tumor and the tissue CD_(44) content in 7 malignant bone tumors were determined with the flow cytomentric immunological method. Results: The PB CD_(44) + L in benign tumor group(BG) and malignant tumor group(MG) were much higher than that of the control, and the PB CD_(44) + L in MG was higher than that in BG. No difference was found in the content of PB CD_(44) + L between the mahgnant non-metastatic group (MNG) and the malignant metastatic group(MMG). The postoperative PB CD_(44) + L in the BG and MNG was decreased, but CD_(44) was unchanged pre-and postoperatively in the MMG. The patients with high CD_(44) content in the tumor tissues were liable to postoperative lung metastasis. Conclusions: The determination of CD_(44) in PBL and tumor tissue can be helpful to determine the nature of the neoplasm and to predict its prognosis.

Objective Use the automatic microbiological analysis system which for the streptococci (ATB rapid 32 Strep) to identify streptococci, and compare the examination speed and accuracy with the internationally recognized bacterium identification golden method API 20 Strep (streptococci identification biochemistry system) to enable the clinical microorganism room use ATB rapid 32 Strep identification system correctly, and provide the etiology basis to clinical promptly.Methods Isolate the bacterium from patient blood, cerebrospinal fluid, pig heart, pork and so on, then separate the streptococci in form to the blood plate, lay them in carbon dioxide incubator, after 35 ℃ 24 hours. Use ATB rapid 32 Strep,API 20 Strep and the traditional manual method to identify 18 strains of bacterias and carry on the medicine sensitive experiment.Results ATB rapid 32 Strep identified 16 strains as streptococcus suis II, 2 strains as streptococcus bovis II; API 20 Strep identified 17 strains as streptococcus suis II, 1 strain can not be identified; the tradition manually method identified all of the 18 strains as streptococcus group D . These 18 strains all sensitive to the Chloramphenicol , clindamycin, erythromycin, levofloxacin, penicillin, quinupristin/dalfopristin, cefotaxime, vancomycin and sulfafurazole , and resistant to the tetracyclin.Conclusion ATB rapid 32 Strep can identify the streptococcus suis in 4 hours , and the coincidence rate with API 20 Strep is 94.4%.So ATB rapid 32 Strep is one kind of system which could identify bacterium simply,quickly,accurately,and provide infectious disease etiology information for clinical immediately, satisfy the requirement of clinician and the microorganism examines.

Objective:To explore the pharmaceutical care points in advanced lung cancer patients with brain metastases. Meth-ods:Clinical pharmacists participated in the drug treatment process of one case of small cell cancer patient with brain metastases. Pharmaceutical care was carried out from various aspects, including brain metastases treatment, chemotherapy, antiviral therapy and patient education. Results:Cerebral transfer symptoms and quality of life of the patient were effectively improved and adverse reactions were reduced by the pharmaceutical care. Conclusion:By the implementation of pharmaceutical care on the patient, clinical pharma-cists can not only improve their own knowledge base and exploit professional advantage, but also provide suggestions on rational drug use for health care professionals.

Objective To explore the effect of comprehensively-designed experiment teaching methodology in the teaching of geriatric nursing. Methods Sixty-three nursing students in the grade of 2010 were assigned into the experiment group, where the comprehensively-designed experiment teaching methodology were adopted. And the fifty-eight nursing students in the grade of 2009 were assigned as the control group, where the traditional experiment teaching methods were adopted. The two groups were compared in terms of theory test scores and evaluations to the two teaching methods. Result The theory examination score and students'evaluation in the experiment were higher than those of the control group (P<0.05). Conclusion Comprehensively-designed experiment teaching method used in the teaching of geriatric nursing is beneficial for the students to improve their interest in learning, cultivate their comprehensive quality, shorten the gap between the experimental teaching and clinical practice and improve the teaching effect of geriatric nursing.

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