Inguinal hernia is a common surgical disease, and most patients need surgical treatment. In recent years, minimally invasive surgery based on laparoscopy has been popularized in hernia surgery. With the release of clinical guidelines, the progress of instruments and materials, the update of treatment concepts and anatomical knowledge, laparoscopic inguinal hernia repair, especially laparoscopic total extraperitoneal hernia repair (TEP), is developing towards a more accurate and minimally invasive direction. Based on literatures in recent years and combined with clinical practice, the authors explore the advances in clinical application of laparoscopic TEP.

Objective: To investigate the associations between behavioral risk factors and overweight or obesity among schoolage children and adolescents in Shanghai, and to provide a reference for making targeted prervention and control measures for overweight and obesity. Methods: A total of 11 913 children and adolescents aged 9-18 years old were selected according to 2014 Shanghai Physical Fitness and Health Surveillance. Questionnaire survey and physical examination including height, weight and other physical index were performed. Logistic regression was used to analyze the association between overweight or obesity and sleep time, diet, physical exercise and sedentary behavior Results: The prevalence of overweight or obesity was higher among boys who slept longer than or equal to 10 hours(36.7%), compared with those with less than 8 hours of sleep(31.3%)(P<0.01). The rates of overweight or obesity in girls was higher among breakfast skippers(36.4%) than breakfast nonskippers(17.6%)(P<0.05). The prevalence of overweight or obesity was higher among pupils who did not like physical education(38.2%) than those who preferred(30.8%)(P<0.01). The prevalence of overweight or obesity among junior middle school students playing video games and computer over 2 hours(28.1%) was higher than those playing less than 1 hours(23.0%)(P<0.05). Unwilling to participate in longdistance running exercise, watching TV more than 1h per day were risk factors for overweight or obesity(OR=1.16, 95%CI:1.05-1.27; OR=1.22, 95%CI:1.05-1.43, respectively).Girls who were breakfast nonskippers had a lower risk of overweight or obesity (OR=0.33, 95%CI:0.16-0.67). Students in urban areas who watch TV more than 1h per day was risk factor for overweight or obesity(OR=1.36, 95%CI:1.07-1.74). Students in rural areas who slept longer than 10 hours had an increased risk of being overweight or obese (OR=2.0, 95%CI:1.23-3.25). Pupils who played video games and computers for more than 2 hours had an increased risk of being overweight or obese(OR=1.45, 95%CI:1.01-2.08). Conclusion In 2014, overweight or obesity among Shanghai’s primary and middle school students was highly interconnected with bad dietary behavior, static life style, and the distribution of factors shows obvious population characteristics.

Objective To investigate the application significance of 3.0T MR three dimensional double-echo steady state(3D-DESS) and three dimensional-true fast imaging with steady-state procession(3D-True FISP) sequences in diagnosis of wrist cartilage of rheumatoid arthritis (RA).Methods 26 patients who were clinically diagnosed with RA underwent wrist MR scans with 3D-DESS and 3D-True FISP sequences, while both sequences' scanning were achieved on 20 of them.340 articular-surface morphological conditions' were observed,which were divided into level 0, level 1 and level 2 damages according to morphological performance,and recorded on 3D-DESS and 3D-True FISP sequence respectively.The diagnostic differences in the number of lesions were compared for two sequences.Results The numbers were 79 and 50 for level 1 damage and 23 and 33 for level 2 damage on 3D-DESS and 3D-True FISP sequence respectively (P<0.05).The artifacts were showed in 14 patients on 3D-True FISP,and only two patients on 3D-DESS.Conclusion 3D-DESS sequence does better than 3D-True FISP in displaying RA wrist cartilage,which is able to provide certain help for treatment and prognosis evaluation of RA.

Objective:To discuss the implementation and experience of the quality control circle ( QCC) activi-ty in shortening the interval time of consecutive operation and speeding up the turnover of operating table. Method:We formed a QCC team and explored the influential factors of the interval time of consecutive operation using quali-ty control technique. We found out the real reason, put forward corresponding countermeasures, and organized the implementation. Results: Before the implementation of QCC, the average interval time of consecutive operation was 24. 6 minutes, whereas it decreased to 16. 2 minutes after the implementation of QCC with the progress rate of 64. 87%. Through the QCC activities, the problem-solving ability, responsibility, communication and coordina-tion ability, motivation, confidence, team cohesion, and the use of quality control technique of the QCC members has improved significantly. Conclusion:Through the quality management tools of QCC, the interval time of con-secutive operation has greatly shorten, the turnover of operation table has improved, and doctors′ and operating room nurses′satisfaction has improved significantly.

Objective To compare the egicacy and security of intracoronary administration of tirofiban combined high-dose adenosine during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (STEMI).Methods Eighty-eight cases with STEMI were randomly divided into observation group(44 cases) who were accepted 2 times intracoronary adenosine(2 mg,10 ml 0.9％ NaCl),and control group(44 cases) who were afforded only 10 ml 0.9％ NaCl by prospective,double-blind,and random study.The two groups were received10 g/kg tirofiban after aspiration catheter in the culprit lesion distal bolus injection of 3 rain,at the same time,continuous infusion of 0.15 g/(kg · min) for 24 h.The postoperative coronary arteriography and electrocardiogram were evaluated.Meanwhile,the postoperative myocardial blush grade(MBG),thrombolysis in myocardial infarction (TIMI),corrected TIMI frame counts (CTFC),ST-segment elevation resolution (STR) major adverse cardiac events (MACE),and adverse reactions of adenosine were recorded.Results There was no significant difference in terms of postoperative TIMI and STR between two groups (P ＞ 0.05).The CTFC of observation group was (24.4 ± 4.9) frames,significant better than that of control group((21.9 ±3.7) frames;t =2.701,P ＜0.01).The ratio of MBG in observation group was 24/44,higher than that of control group(14/44 ; x2 =4.632,P ＜ 0.05).There were no significant difference regarding of the ratio of death,MACE,target vessel revascularization,grade of NYHA between observation and control group at followed up for 1 and 12 month (P ＞ 0.05).The ratio of patients with blood pressure decrease ≥ 10 mm Hg,new second degree atrioventricular block in observation group were 15.9％ and 20.5％,higher than that in control group (2.3％ and 15.9％ ; x2 =4.950,7.221 ; P =0.026,0.007).The adverse reaction was transient.Conclusion The intracoronary administration of tirofiban combined high-dose adenosine during PCI in patients with STEMI plays an effective role on improvement of myocardial perfusion.

Objective To investigate the optimal method for synthesizing thiolated doxorubicin .Methods Thiolated doxorubi-cin was synthesized through two different methods .Doxorubicin was reacted with 2-iminothiolane (2-IT) and S-acetylthioglycolic acid N-hydroxysuccinimide ester (SATA),respectively.The synthesized thiolated doxorubicin was further characterized by HPLC and MS -ESI techniques .Several factors including molar ratios as well as reaction time were evaluated .Results The results showed that thiolat-ed doxorubicin could be synthesized via both of the two methods successfully .Thiolated doxorubicin could be stable when doxorubicin was reacted with SATA .But the crude thiolated doxorubicin could be cyclized easily when doxorubicin was reacted with 2-IT.Conclu-sion Thiolated doxorubicin prepared with SATA is more feasible than that with 2-IT.

Objective To investigate the effect and safety of rotational power-driven thrombectomy therapy through intrapulmonary for acute massive pulmonary thromboembolism.Methods Sixteen patients of acute massive pulmonary thromboembolism diagnosed by CT and pulmonary angiography were treated with Straub Rotarex system.The successful rate,release of clinical manifestations and the blood hemodynamic changes were observed and analyzed.Results The clinical manifestations were improved remarkably in all the 16 patients,arterial partial pressure of oxygen,saturation of arterial blood oxygen,shock index,Miller score and mPAP were (56.7± 13.4) mm Hg,84.1 ± 10.4)％,(1.27 ±-0.39),(22.7±11.4) and (36.3 ±9.4) mm Hg respectively before treatment,and (92.2 ± 8.6) mm Hg,(96.6 ± 12.7) ％,(0.57 ± 0.42),(12.1 ± 7.8)points and (21.9 ± 7.3) mm Hg respectively after treatment,which were all improved significantly (t =-2.794,2.601,-2.592,-2.638,-2.617,P ＜ 0.01).Conclusion Rotational power-driven thrombectomy therapy through intrapulmonary is an effective and safe technique for the treatment of acute massive pulmonary embolism.

Objective To develop specific targeted magnetic biomarkers which can selectively mark the senile plaques in Alzheimer' s disease (AD) and verify its feasibility and validity.Methods Aβ1-40 peptide and Tat-PTD ( Tat-protein transduction domain) was binded with dextran-coated ultrasmall superparamagnetic iron oxide ( USPIO) particles.Visualization of plaques in vivo in Alzheimer transgenic mice was investigated at 7.0 Tesla using T2 sequences after intravenous administration of the targeted nanoiron contrast agent and verified by histological staining.Results The targeted nano-iron contrast agent could enter the cultured neural stem cells,and was able to accelerate T2 relaxation rates of water protons in the cells and negatively reinforce the T2 signal intensity in the labeled cells.Plaques were specifically detected in vivo by magnetic resonance imaging ( MRI) and correlated well with histological staining after injection of nano-iron contrast agent into the APP/PS1 mice.Conclusion The targeted nano-iron contrast agent has the ability of selectively labeling the senile plaques in AD brain tissues in vivo,which might enable the early detection of plaques by MRI and can be further applied in the studies of early diagnosis of AD.

【Objective】To investigate the role of mycophenolate mofetil (MMF) in the prevention of acute rejection in renal transplantation.【Methods】A total of 106 patients were randomized into two groups.One group received MMF (n=56),the other received azathioprine (Aza) (n=50).The time of the following study was within the first 6 months after transplantation.【Results】The rate of acute rejection of group receiving MMF was 20%,it′s lower than that of the group receiving Aza 44% (P<0.01).The recovery rate of acute rejection treated by methylprednisolone (MP),in MMF group 82% was higher than Aza group 55%.(P<0.05).Meanwhile the hepatotoxicity as well as cytomegalovirus (CMV) infection were lower in MMF group than those in Aza group.【Conclusion】MMF as a new anti-rejection drug could more effectively prevent acute rejection than Aza after renal transplantation,and has lower toxicity and side effect.

[Objectivej To establish a gas chromatography (GC) method for the determination of the content of camphor, isoborneol and borneol in Anmo Ointment. [ Methods ] The determination was performed by programmed temperature GC, in which a 100% concentration of dimethylpolysiloxane was used as stationary liquid phase and the GC was equipped with FID detector at 300℃. [Results] The isolation and the linearity were fine with the rate of recovery of camphor 100.5% (RSD being 1.4%), isoborneol 99.1% (RSD being 1.8%) and borneol 100.8% (RSD being 1.3%). [Conclusion] This method is sensitive, rapid and accurate. It can be used to control the quality of Anmo Ointment.