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Objective To compare the clinical effect of laparoscopic and open umbilical hernia repair for adult umbilicalhernia.Methods Eighty-threepatients with adult umbilical hernia admitted to People's Hospital of Beijing Daxing District from Feb.2008 to Jan.2017 were randomly divided into laparoscopic umbilical hernia repair group (n =38) and open umbilical hernia repair group (n =45).Patients in laparoscopic umbilical hernia repair group accepted laparoscopic umbilical hernia repair with intraperitoneal onlay mesh (n =38),while patients in open umbilical hernia repair group accepted traditional umbilical hernia repairtreatment.Operation time,hospital stay,blood loss,seroma/hematoma formation,wound infection,incomplete bowel obstruction and recurrence were compared between the two groups with the software of SPSS 22.0.The outpatient consultation was performed at 2 weeks,1 month,3 months,and 6 months after operation.The follow-up contents were wound condition,pain,and whether there were any masses in the umbilicus.After every 3 months of telephone follow-up or outpatient review,whether there were any masses in the umbilicus,the average follow-up time was 14 months.Results All operations were successfully completed.The operation time of laparoscopic umbilical hernia repair group was shorter than open umbilical hernia repair group [(31 ± 8) min vs (48 ± 10) min,P ＜ 0.01],and hospital stay were significantly shortened in laparoscopic umbilical hernia repair group (P ＜ 0.05).The amount of bleeding of the laparoscopic umbilical hernia repair group decreased significantly than open umbilical hernia repair group [(40 ± 18) ml vs (62 ± 25) ml,P ＜ 0.01].The postoperative painof the laparoscopic umbilical hernia repair group was mild than open umbilical hernia repair group (P ＜ 0.05).The postoperative complications include seroma,wound infection and incomplete bowel obstruction.There were no significant differences between the two groups of seroma,incision infection and recurrence (P ＞ 0.05).The difference of the incidence of incomplete bowel obstruction between the two groups was statistically significant (P =0.019) . The total postoperative complication rate was significantly lower in laparoscopic umbilical hernia repair group than in open umbilical hernia repair group(x2 =5.328,P =0.021).Conclusions Laparoscopic umbilical hernia repair has short operation time,less bleeding,and satisfactory postoperative pain.It is worthy of advocacy for umbilical hernia patients who can tolerate general anesthesia.
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Objective To compara the postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal (TAPP) and open transinguinal preperitoneal (TIPP).Methods Retrospective analysis of clinical data of 180 patients with inguinal hernia admitted to the Daxing District People's Hospital of Capital Medical University from January 2016 to January 2018,male 158 cases,female 22 cases,average age 56 years old,age range 23-80 years old.Including 110 patients in the TAPP group and 70 patients in the TIPP group,patients in the TAPP group were treated with laparoscopic TAPP,and patients in the TIPP group were treated with open TIPP.Pain degree was assessed with pain visual analogue scale (VAS) postoperatively at 3 weeks,3 months and 6 months.The incidence of chronic pain was measured at 3 weeks,3 months,and 6 months after surgery,and the incidence of foreign body sensation at 3 months was recorded.Measurement data were expressed as mean ± standard deviation (Mean ± SD),t test was used for comparison between groups;Chi-square test was used for compare the count data between groups.Results At 3 weeks,3 months,and 6 months after surgery,the mean value of pain VAS in the TAPP group was lowerthan in the TIPP group [(0.07 ± 0.40) scores vs (0.37 ± 0.94) scores,(0.03 ± 0.16) scores vs (0.24 ± 0.69) scores,(0.01 ± 0.10) scores vs (0.14 ± 046) scores],and the difference was statistically significant (P =0.004,0.002,0.004).The incidence of pain in the TAPP group was 3.6％,2.7％,and 0.9％ at 3 weeks,3 months,and 6 months after surgery,respectively.The incidence of pain in the TIPP group was 14.3％,11.4％,and 10.0％,respectively.The difference was statistically significant (P =0.021,0.040,0.012).At 3 months postoperatively,there were 2 cases (1.8％) in the TAPP group and 12 cases (17.1％) in the TIPP group with the foreign body sensation.The difference between the two groups was statistically significant (x2 =14.006,P =0.000).Conclusion Compared with the open TIPP,the laparoscopic TAPP is used to repair the inguinal hemia,The postoperative pain is milder,and the incidence of chronic pain and foreign body sensation was lower.
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Objective To explore the difference between laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open preperitoneal hernia repair for the treatment of inguinal hernia under local anesthesia.Methods A total of 64 cases with inguinal hernia underwent hernia repair in Beijing Daxing District Hospital of Capital Medical University from January 2014 to January 2015 were retrospectively analyzed.Thirty-four cases in test group were applied with TAPP and used D(9 * 13) mesh to repair for inguinal hernia,and 30 cases in traditional group with open preperitoneal hernia repair which used D10 mesh to repair for inguinal hernia.Results All operations were successfully completed.There was statistically significant difference in operation time(P =0.000),postoperative activity time(P =0.000),postoperative hospitalization time (P =0.003) and pass flatus time (P =0.000) between these two groups.There was no statistically significant difference in wound seroma(P =0.216),hematoma (P =1.000),analgesics (P =0.090) and recurrence rate of the first year (P =1.000).Conclusions Both TAPP and tension free repair of inguinal hernia under regional anesthesia are safe and effective methods for the treatment of inguinal hernia,which has its advantages.Surgeon should choose the suitable procedure according to patient's condition reasonably.
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By taking the course of laboratory hematology in Curtin University in Australia as an ex-ample, this paper introduced the characteristics of its teaching mode, teaching contents, teaching methods, assessment methods and laboratory practice. The advantages and disadvantages of education characteristics between Australia and China were compared and analyzed on the training methods and the training objec-tives, respectively. The education characteristics of laboratory hematology in Curtin University provided an important inspiration for our education reform in the field of medical laboratory in the future.
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Objective To discuss the protective effect of carbon nanoparticles lymphatic tracer on parathyroid glands in the operation of thyroid carcinoma. Methods Retrospectively analyzed the clinical data of 65 thyroid carcinoma patients from January 2014 to October 2014, and they were divided into 2 groups according to whether injected with carbon nanoparticles. The experimental group (30 cases) were injected with carbon nanoparticles in thyroidglands before major procedure, while the control group (35 cases) were not injected. In the experimental group, there were 22 cases accepted total thyroidectomy of the affected side gland + isthmus thyroidectomy + subtotal thyroidectomy of the offside gland, and 8 cases of total thyroidectomy. In the control group, there were 25 cases accepted total thyroidectomy of the affected side gland + isthmus thyroidectomy + subtotal thyroidectomy of the offside gland,and 10 cases of total thyroidectomy. And all the 65 cases ac-cepted centrallymph nodes dissection. Results After carbon nanoparticles injection, central lymph nodes became black while parathyroid glands did not become black. The experimental group showed (2. 6 ± 0. 8) parathyroids each patient, and no parathyroid was cut by mis-take;the control group showed (1. 9 ± 0. 7) parathyroids each patient, and 3 parathyroids were cut by mistake. and the difference between the two groups was statistical meaningful (P<0. 05). There was no permanent hypoparathyroidism in the two groups. There was 1 cases of temporary hypoparathyroidism occured in the experimental group, and 3 cases occured in the control group, and there was no statistical sig-nificance difference between the two groups. Conclusion Carbon nanoparticles is benefit to the identification of parathyroid in surgery, and it can reduce the incidence of inadvertent parathyroidectomy, but it cann’ t reduce the incidence of hypoparathyroidism after procedure.
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Objective To study the etiology,pathogenesis,diagnosis and treatment of non-traumatic splenic rupture.Method The clinical data of patients with atraumatic splenic rupture from our hospital were retrospectively analyzed,and the liferatures were reviewed.Results Most cases were male.The average age was high.The etiological factors were diverse,and the most common being blood diseases,virus infection,local inflammation and neoplasm.The pathogenesis is related to splenomegaly,increase in splenic fragility,altered haemostatic mechanisms,malposition of the spleen,and violent contraction of the diaphragm.It is more difficult to arrive at a diagnosis when compared with traumatic splenic rupture.Most patients required splenectomy,especially when the etiological factors were malignant blood diseases or splenic tumors.Some patients received non-operative treatment.The prognosis was related to the etiological factors and age.Conclusions The etiological factors of non-traumatic splenic rupture were diverse,and pathological splenic rupture was most common.A preoperative diagnosis was difficult,and splenectomy was the most common treatment.
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Background and purpose:The human oncogene B-cell-speciifc moloney murine leukemia virus integration site 1 (Bmi-1) is an important member of the polycomb group family, and it regulates cell proliferation and senescence via INK4a/ARF locus. This study investigated the effects of Bmi-1-siRNA on the proliferation of lung adenocarcinoma cell line SPC-A1 cells with INK4a/ARF locus and clarify the mechanism of Bmi-1-mediated effect on proliferation of lung adenocarcinoma cells. Methods:In this study, we chose the most efifcient siRNA chain the pGeneshl-2-Bmi-1 sense-1 and inserted into a pSUPER-retro-neo retroviral vector. The packaged si-Bmi-1 pSUPERret-ro-neo retroviral vector was stably transfected into lung adenocarcinoma SPC-A1 cell line. The stably transfected cells were cultured and passed. After transfection, the levels of Bmi-1 mRNA and protein expression of SPC-A1 cells were analyzed by RT-PCR and Western blot respectively. Trypan blue, MTT and plate colony forming assay were performed to observe the proliferation capibility of SPC-A1 cells and evaluate the cloning forming ability in vitro. The potency of tumorigenesis was observed in nude mouse through hypodermic inoculation of SPC-A1 cells. Cell cycle distribu-tion was analyzed by lfow cytometry (FCM) in SPC-A1 cells. The expression levels of proliferation proteins including p16INK4a, p53, Cyclin D1, PTEN, Akt and Ser473p-Akt were analyzed by Western blot. Results:The mRNA and protein expression levels of Bmi-1 were signiifcantly reduced in SPC-A1-Bmi-1-siRNA cells transfected with pSUPER-retro-neo retroviral vector. Knockdown of Bmi-1 could inhibit the growth, colony formation in vitro and tumorigenesis in vivo of SPC-A1 cells (P0.05), while Cyclin D1 and Ser473p-Akt were downregulated (P<0.01) and PTEN was up-regulated (P<0.01) in the SPC-A1-Bmi-1-siRNA cells. SPC-A1-Bmi-1-siRNA cells were treated with various concentrations of PTEN inhibitor to determine expression levels of PTEN, Bmi-1 and Ser473p-Akt protein. Ablation of PTEN rescued Bmi-1 and Ser473p-Akt expression in SPC-A1-Bmi-1-siRNA cells. Conclusion:Knockdown of Bmi-1 gene can arrest the proliferation of SPC-A1 cells through G0/G1 phase arrest by inhibiting Cyclin D1 expression indirectly, which may be not associated with p16INK4a signaling pathway.
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Background and purpose:The pro-oncogene Bmi-1 is a member of the polycomb-group family, can regulation of the proliferation and self-renewal of normal and tumor stem cells. In recent years, Bmi-1 has been found that it is overexpressed in varieties of human malignant tumors. The study aimed to observe the effects of Bmi-1-siRNA on the growth capacity of lung cancer cell line A549 in vivo and in vivo, and explore its mechanism. Methods:The most effective one as a target sequence was chosen from four Bmi-1 siRNA sequences which were designed by our lab, and one random sequence was chosen as a negative control. In short, the chemically synthesized siRNA and control sequences were connected to a retrovirus expressing vector, pSUPERretro-Neo plasmid, and then transfected into A549 cells. The stably transfected cells were cultured and passed. The level of mRNA and protein of Bmi-1 in A549 cells were assessed by RT-PCR and Western blot respectively. The proliferations of A549 cells in vivo was analyzed with MTT, trypan blue exclusion and plate colony forming methods. Flow cytometry was used for cell cycle analysis. The potency of tumorigenesis was observed in nude mouse through hypodermic inoculation of A549 cells. The expressions of cyclin D, p21/27, p-AKT and PTEN were analyzed by Western blot. Results:Compared to A549-ctr and A549-wt cells, Bmi-1 mRNA and protein levels all signiifcantly reduced in A549-Bmi-1-siRNA cells. Bmi-1-siRNA inhibited the growth, colony formation in vitro and tumorigenesis in vitro of A549 cells, and the interference cells cell cycle arrested in G1 phase. In A549-Bmi-1-siRNA cells, p-AKT and cyclinD1 expression were down-regulated while p21/p27 and PTEN were up-regulated. Conclusion:Silencing Bmi-1 gene inhibits the proliferation of A549 cells through G1 phase arrest, which involves the downregulation of cyclin D/p-AKT and upregulation of p21/p27/PTEN.
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Objective To investigate the diagnosis and treatment of idiopathicgranulomatous mastitis.MethodsThis study was to retrospectively review the clinical presentation,radiological investigation,histopathological features,treatment and outcome of idiopatbic granulomatoos mastitis of women presenting to Xuanwu Hospital between January 2002 and June 2010.ResultsTwenty-four patients with a mean age of 34.5 years presented with a diagnosis of idiopathic granulomatous mastitis.Patients presented with a palpable breast lump,breast abscess,fistula formation in different periods of the disease; the role of radiological imagings was found to be limited in differentiating idiopathic granulomatous mastitis from other inflammatory and maliguant conditions of the breast.All patients underwent a surgical procedure as the main treatment; in the form of excision or incision and drainage of the breast lesions. Mean follow-up was 47.38 ( range 6-96 ) months with recurrence in 3(12.5％) patients.ConclusionsIdiopathic granulomatous mastitis presents clinically with a palpable breast lump.The diagnosis is often only made histopathologically after surgical excision or core biopsy.Wide excision of the lesions or incision and drainage of the lesion are the main treatment modalities.
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Objective To investigate the role of endogenous histamine in Parkinson disease. Methods 6-OHDA-lesioned rats were prepared by the conventional mothod,and in the meantime a group of rats were administrated with ?-fluoromethylhistidine(?-FMH),an irreversible inhibitor of histidine decarboxylase(HDC),via intracerebroventricular injection(12.5 ?g or 25 ?g,i.c.v.) for seven days.On the 7 day,the apomorphine-induced turning behavior and were detected, and the immunoreactivity of dopaminergic neurons in the substantia nigra pars compact(SNc) and histaminergic neurons in the tuberomammillary nucleus(TMN) were evaluated by tyrosine hydroxylase(TH) and HDC immunohistochemistry,respectively.Additionally,the level of dopamine in striatum was determined with high performance liquid chromatography(HPLC). Results ?-FMH(25 ?g,i.c.v.) significantly reduced the turning behavior and prevented the loss of dopaminergic neurons in the SNc,and slightly increased dopamine level in the striatum.Whereas,the immunoreactivity of histaminergic neurons in the TMN of hypothalamus in both the 6-OHDA lesioned and the ?-FMH treated rats was not changed.Conclusion Endogeneous histamine may involve in the pathological processes of PD.However,the histaminergic neurons are not involved in PD.