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Traditional Chinese Medicine (TCM) is the gem of Chinese culture,while TCM culture the root and driving force for its development.Higher learning institutes,one of whose main missions is innovating and inheriting culture,are playing the unique roles in promoting world-wide recognition of TCM culture through international cooperation due to the abundant resources in TCM academy,talent,clinical study and international education.Taking Jiangxi University of Traditional Chinese Medicine as an example,this paper has made constructive exploration and study on how to promote the international communication of TCM culture to allow the international community for better understanding and the application of TCM based on the analysis of current situation and experience summarization with literature investigation and case study.Effective measures that have been put forward include establishing TCM experiencing center,promoting the construction of Confucius Institute,proactively building TCM library,improving the standardization of TCM translation,optimizing approaches of TCM international communication,and speeding up the cultivation of TCM international communication talents.
ABSTRACT
Objective To explore the clinical efficacy of laparoscopic inguinal hernia repair (LIHR) in elderly patients.Methods The retrospective cohort study was adopted.The clinical data of 3 203 patients with inguinal hernias (3 847 sides) who were adnitted to the Ruijin Hospital of Shanghai Jiaotong University School of Medicine between January 2001 and December 2013 were collected.Of 3 203 patients,979 (1 107 sides) with age ＜ 60 years and 2 224 (2 740 sides) with age ≥ 60 years were respectively allocated into the under 60 years group and 60 years or older group.The surgical procedures including transabdominal preperitoneal (TAPP) approach,total extraperitoneal (TEP) approach and intraperitoneal onlay mesh (IPOM) approach were selected and performed by doctors in the same team.There were light-weight and heavy-weight patches.Observation indicators included (1) overall operation situations,(2) surgical comparison between the 2 groups,(3)comparison of postoperative indicators between the 2 groups,(4) follow-up.Follow-up using telephone interview and outpatient examination was performed to detect the recovery time of non-restricted activity,recurrence of hernia and complications.Measurement data with normal distribution were represented as ~ ± s and comparison between groups was done by the t test.Comparisons of count data were analyzed using the chi-square test or Fisher exact probability.Ranked data were compared by the nonparametric rank sum test.Results (1) Overall operation situations:3 203 patients with inguinal hernias (3 847 sides) underwent LIHR,including 1 475 (1 677 sides) using TAPP approach,1 718 (2 154 sides) using TEP approach and 10 (16 sides) using IPOM approach (6 using TAPP and IOPM approaches in each side).The light-weight patch was used in 2 206 sides and heavy-weight patch was used in 1 641 sides.Operation time was (31 ± 12) minutes in all 3 203 patients,(27 ±9)minutes in 2 559 patients with unilateral hernia and (44 ± 12)minutes in 644 patients with bilateral hernia,respectively.Duration of postoperative hospital stay was (1.5 ± 1.2) days.(2) Surgical comparison between the 2 groups:TAPP approach,TEP approach,IPOM approach,light-weight patch and heavy-weight patch were performed to 567,538,2,751,356 sides in the under 60 years group and 1 110,1 616,14,1 455,1 285 sides in the 60 years or older group,respectively,with statistically significant differences in above indicators between the 2 groups (X2 =37.976,70.022,P ＜ 0.05).Operation time in unilateral hernia and bilateral hernia and total operation time were (27 ± 9)minutes,(42 ± 10)minutes,(29 ± 10)minutes in the under 60 years group and (27 ± 10)minutes,(44 ± 12)minutes,(3 1 ± 13)minutes in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (t =-0.106,-1.768,-4.445,P ＞ 0.05).(3) Comparison of postoperative indicators between the 2 groups:the pain score at postoperative day 1 and duration of postoperative hospital stay were 2.4 ± 1.1,(1.5 ± 1.1) days in the under 60 years group and 2.3 ± 1.0,(1.5 ± 1.3) days in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (t =1.419,-0.126,P ＞0.05).(4) Follow-up:all the patients were followed up for 23-60 months,with a median time of 43 months.Cases with non-restricted activity recovery at postoperative week 2 and 4 were 973,978 in the under 60 years group and 2 208,2 222 in the 60 years or older group,respectively,showing no statistically significant difference between the 2 groups (X2=0.113,P ＞0.05).The recurrence of hernia,severe complications,serum tumescence,paresthesia and enteroparalysis were detected in 1,0,49,5,1 sides in the under 60 years group and 11,3,132,16,2 sides in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (x2=1.556,0.269,0.254,P ＞ 0.05).The urinary retention in the under 60 years group and 60 years or older group was respectively detected in 6 and 44 sides,showing a statistically significant difference between 2 groups (x2=6.956,P ＜ 0.05).Conclusion LIHR is safe and effective in elderly patients,and it can achieve good clinical efficacy under selecting reasonable operation procedures and patches.
ABSTRACT
Objective To investigate human cell division control protein 4(hCDC4) expression and its correlation with the clini‐copathological features in oral squamous cell carcinoma(OSCC) .Methods We freshly collected 52 samples of surgically resected OSCC tissues and 12 samples of normal tissues .hCDC4 expression in the samples was detected by immunohistochemical staining . The correlation between hCDC4 protein expression and clinicopathological feature was analysed .OSCC cells and Tca8113 were transfected with hCDC4‐siRNA ,cell proliferation and c‐Myc and Cyclin E protein expression were determined by using M TT and Western blot .Results The hCDC4 protein expression in normal tissues was significantly up‐regulated compared to those in OSCC tissues (83 .3% vs .25 .0% ,P < 0 .05) .Clinicopathological analysis revealed that reduced hCDC4 expression was associated with large tumor size ( ≥ 4 cm) and high clinic stage ( Ⅲ + Ⅳ ) (P< 0 .05) .hCDC4 knockdown by siRNA led to increased cell prolifera‐tion and c‐Myc and Cyclin E protein accumulation in Tca8113 cells .Conclusion Loss of hCDC4 may promote tumor progression by resulting in c‐Myc and Cyclin E protein accumulation in OSCC .