ABSTRACT
Ventral hernia is a very common surgical problem with its incidence gradually increasing due to aging population,and it has significantly threat to quality of life.Laparoscopic hernia repair is a kind of minimally invasive surgery based on tension-free hernia repair,which has become an effective way for treatment of ventral hernia after decades of development.Besides,the classic surgical approaches for adult inguinal hernia include intraperitoneal onlay mesh,transabdominal peritoneal and totally extraperitoneal repairs.However,some related complications including vascular injury and bleeding,postoperative pain,nerve damage,seroma,intestinal obstruction,infection and relapse have been increasingly reported with the extensive applications of laparoscopic ventral hernia repair.Surgeons still need to pay more attentions and take appropriate measures to prevent such events.Complications could be reduced by strictly following the indications of different laparoscopic hernia repair surgeries with a careful consideration of the advantages and disadvantages,understanding their pathogenesis,improving the laparoscopic operation techniques,getting familiar with the local anatomical structures and standardizing the surgical procedures.Establishing a correct and standard surgical training system will further shorten the learning curve of surgeons to promote the progression and development of hernia surgery in China.
ABSTRACT
Objective To study the diagnostic value of TREM-1,PCT and CD64 in children with sepsis disease and its effect on the application of low dose hormone.Methods 80 cases children with septic disease who received therapy from September 2014 to September 2016 in the third affiliated hospital of wenzhou medical university,28 cases of severe sepsis disease,52 cases of general sepsis disease,and selected 40 cases of healthy children in our hospital during the same period,the levels of TREM-1,PCT,CD64 of three groups were compared.And through the random number table method,those 80 cases children with sepsis disease were divided into the observation group(n=40) and the control group(n=40),the control group was treated with routine treatment,while the observation group was treated with hydroprednisone on the basis of the control group,after treatment for seven days,the levels of TREM-1,PCT,CD64 of two groups were compared.Results The levels of TREM-1, PCT and CD64 in the severe sepsis disease group and general sepsis disease group were higher than the healthy group(P<0.05),and the levels of TREM-1, PCT and CD64 in severe sepsis disease group were significantly higher than the general sepsis disease group(P<0.05).After treatment,the levels of TREM-1,PCT and CD64 were improved in two groups of patients with sepsis disease(P<0.05),after treatment of one day and seven days,the levels of TREM-1,PCT and CD64 in observation group were lower than in the control group(P<0.05).Conclusion TREM-1,PCT,CD64 levels can be used as early detection in children with sepsis disease,low dose glucocorticoid can effectively reduce the expression of TREM-1,PCT and CD64 levels in children with sepsis,it's conducive to the disease control.
ABSTRACT
Objective@#To investigate expression of nucleolar protein 14(NOP14) and CD31 in pancreatic cancer mouse model and its correlation with tumor progression.@*Methods@#Clinicopathological data of 5 patients with pathologically confirmed pancreatic ductal adenocarcinoma(PDAC) and hepatic metastasis between January 2013 and December 2015 was collected in Department of General Surgery, Peking Union Medical College Hospital. Immunohistochemistry staining was employed to detect the expression of NOP14 in matched primary PDAC and relevant metastasis.Pancreatic cancer cells with NOP14 stably knocked down were established by transfecting lentivirus with NOP14 targeted silencing RNA.The inhibition efficacy was detected by quantitative real time PCR and western blot.Microvascular density(MVD) in pancreatic cancer transplantation mouse model was determined by CD31 immunohistochemistry staining analysis and correlated with NOP14 expression and tumor progression.@*Results@#NOP14 had a significant higher expression in liver metastasis than primary pancreatic adenocarcinoma (2.09±0.45 vs. 1.31±0.27, P=0.028). NOP14 was knocked down 86 percent on mRNA level determined by qPCR and 78 percents on protein level detected by western blot. MVD was significantly decreased in NOP14-inhibited tumor from both pancreatic cancer cells subcutaneously and orthotopically grafted tumor mouse model with the value of 61.40±13.85 vs. 85.53±14.59 (P=0.041) and 38.33±10.91 vs. 59.33±15.37(P =0.037), respectively. Besides, MVD was positively associated with tumor volume(r=0.842, P<0.01) and metastasis (r=0.726, P=0.008).@*Conclusion@#NOP14 presents higher expression in hepatic metastasis of pancreatic adenocarcinoma and might promote tumor progression by increasing microvascular density.