腹股沟疝Kugel补片修补术的临床应用及疗效分析

目的 探讨Kugel补片在腹股沟疝无张力修补术中的疗效.方法 回顾性分析了我院2008年～2010年我院152例腹股沟疝患者应用Kugel补片修补术的患者的临床资料.结果 152例患者中有6例术后切口疼痛,切口出现红肿3例,阴囊水肿28例,尿潴留1例,经1～12个月的随访,2例复发.结论 Kugel补片无张力疝修补术具有微创、疼痛轻、全腹股沟修补、复发率低的优点、是老年腹股沟疝及无张力疝修补术后复发疝的首选治疗方法.     

Kugel补片在腹股沟疝无张力修补术后复发疝中的应用

目的：评价Kugel补片在腹股沟疝无张力修补术后复发疝手术中的疗效。方法：对20例腹股沟疝无张力修补术后的复发疝,其中疝环充填式无张力疝修补术后15例,平片无张力疝修补术（Lichtenstein）后5例。采用美国Bard公司生产Kuge补片再进行无张力修补。结果：20例患者无1例切口感染、术后疼痛轻、恢复快、经1～24个月随访无复发。结论：Kuge补片无张力疝修补术具有微创、全腹股沟修补、并发症少、复发率低的优点、是腹股沟疝无张力修补术后复发疝的首选治疗方法。     

开放Kugel补片腹膜前间隙腹股沟疝无张力修补术的临床体会

目的:探讨开放Kugel补片腹膜前间隙腹股沟疝无张力修补术的临床治疗体会。方法:选取我院40例腹股沟疝患者,所有患者均采用开放Kugel无张力疝修补术治疗。记录所有患者的手术时间,术后恢复情况及并发症的发生情况。结果:手术时间为50分钟-2小时;术后恢复情况好,24小时下地为36例;并发有慢性疼痛者1例(2.5%),阴囊积液1例(2.5%),切口液化3例(7.5%)。结论:应用开放性Kugel补片经前入路腹膜前修补腹股沟疝术,其手术时间短、创伤小、术后病人恢复快,易于掌握,近期疗效满意,复发率低,在临床上值得且易于推广。     

无张力疝修补术后复发23例分析

目的：探讨无张力疝修补术后的复发原因及手术治疗方法。方法：术后复发疝23例,选取Plug充填式补片19例,Kugel补片4例。补片卷曲移位者重新置入网塞补片;横筋膜薄弱内环较大者采用Kugel补片置入腹膜前间隙展平后再闭合疝环。结果：无张力疝修补术后复发23例中,斜疝18例,直疝4例,股疝1例。术后随访0.5~4年,再次复发2例均为采用Plug充填式无张力修补术式者,再次手术采用Kugel补片后均未复发。术后腹股沟血肿5例,对症处理后2月内消失。结论：无张力疝修补术后腹股沟疝复发与手术操作不当,补片材料选择及高腹内压等因素相关。     

内存记忆弹力环补片无张力修补腹股沟疝：附68例分析

目的总结内存记忆弹力环补片（Kugel）在腹股沟疝无张力修补术中的经验。方法回顾性分析68例74侧腹股沟疝，采用美国巴德公司生产的Kugel进行无张力修补。结果手术时间40-90min，手术后6h能下床活动，术后疼痛轻。无伤口感染，阴囊积液和阴囊血肿，随访3-6个月无复发。结论 利用Kugel行痛修补术可做到全腹股沟区覆盖，安全可靠，创伤小，并发症少，术后恢复快。     

Kugel腹股沟疝修补术临床分析

目的评价Kugel无张力腹股沟疝修补术的安全可靠性。方法采用美国巴德公司Kugel补片（8cm×12cm）为58例腹股沟疝患者施行无张力修补术。观察手术效果。结果平均手术时间45分钟,术后6小时能下床活动,切口疼痛轻微。随访3年,复发2例。结论Kugel疝修补术是一种安全可靠、微创、无张力、全面修补整个腹股沟区所有潜在缺陷的腹膜前修补术式,具有术后恢复快、并发症少、复发率低的优点,值得推广运用。     

Kugle补片治疗腹股沟疝探讨

目的目的探讨Kugel补片在腹股沟疝修补术中的特点及优势。方法对52例利用Kugel补片腹股沟疝修补术进行分析讨论。结果全组患者均治愈,手术时间50~70分钟,术后24小时下床活动,平均住院天数6.8天。阴囊血肿1例,阴囊积液2例,尿潴留3例,8例患者腹股沟区疼痛,按VRS分级1级5例;2级3例,服用止痛剂效果良好。术后随访6月~2年无复发。结论Kugel补片有效地治疗腹股沟疝,并复发症少。精细操作是手术成功的关键。     

改良Kugel微创腹股沟疝修补术

目的 总结改良Kugel微创腹股沟疝修补术的近期临床效果.方法 采用Kugel补片对158例178侧腹股沟疝患者行无张力疝修补术.结果 每例侧手术时间20～35 min,平均28min;术后6～18 h,平均9 h下床活动;术后4～9 d,平均7 d恢复正常日常活动.无伤口感染、阴囊血肿;阴囊积液5例（3.2%）;术后随访1～36个月,1例复发（0.6%）;无髂腹股沟神经综合征.结论 改良Kugel微创腹股沟疝修补术容易掌握,是微创、无张力、全腹股沟修补术,具有创伤小、患者恢复正常活动早等特点.     

开放式Kugel补片腹膜前微创修补腹股沟疝

目的总结内存记忆弹力环补片(Kugel补片)腹膜前修补腹股沟疝体会。方法应用Kugel补片,开放式后入路腹膜前置入治疗40例41侧腹股沟疝。结果手术时间(40.5±10.3)min(25~70 min);术后4~24 h下床活动;术后(3.9±1.4)d(2~7 d)出院。切口均甲级愈合,无感染、皮下血肿、阴囊积液。早期复发1例。结论Kugel疝修补术具有微创、无张力、免缝合、术后恢复快等特点。     

76例复发性疝行Kugel腹股沟疝无张力修补术诊治体会

目的总结Kugel腹股沟疝无张力修补术的经验。方法采用美国巴德公司生产的Kugel补片为76例腹股沟复发性疝患者施行无张力修补术。观察手术时间、伤口疼痛、术后自主能力恢复、并发症和复发率。结果全部患者治愈无并发症,随访患者术后恢复良好,随访1～2年无复发。结论Kugel疝修补术是一种微创、无张力、几乎不需缝合,全面修补整个腹股沟区域的腹膜前修补术式,具有术后恢复快,并发症少的优点。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.