Analysis of recurrent factors and therapeutic effect after laparoscopic inguinal hernia repair / 中华外科杂志

Objective: To analyze the recurrence factors and reoperation effect of laparoscopic inguinal hernia repair. Methods: A total of 41 patients with recurrence after laparoscopic repair of the inguinal hernia admitted to the Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2017 to December 2021 were retrospectively analyzed. All patients were males, aging (62±7) years (range: 51 to 75 years). The recurrence intervals were 3 days to 7 years postoperatively. The surgical methods, causes of recurrence, and treatment outcomes of the patients were analyzed. Fisher exact probability method is used to compare the rates. Results: Among all cases, the primary surgical procedures included transabdominal preperitoneal herniorrhaphy (TAPP) in 31 cases and total extraperitoneal herniorrhaphy in 10 cases. The reoperative procedures included the TAPP of 11 cases and the Lichtenstein procedure of 30 cases. The factors of recurrent cases in all patients could be divided into 4 categories, including insufficient mesh coverage in 23 cases, mesh curling in 9 cases, mesh contractuture in 7 cases, and improper mesh fixation in 2 cases. Recurrence, infection, chronic pain, foreign body sensation didn't occur in the followed period of(M(IQR)) 18(24) months(range: 12 to 50 months). There was no statistical difference in the incidence of postoperative seroma between the TAPP and Lichtenstein procedure (3/11 vs. 20.0% (6/30), P=0.68). Conclusions: Postoperative recurrence of laparoscopic inguinal hernia is mostly caused by the lack of mesh coverage. Due to the emphasis on standardized surgical operation, a good outcome could be achieved through reoperation by the TAPP or Lichtenstein procedure.

Investigation of prevalence for perioperative venous thromboembolism and risk factors of the present situation in Chinese adults patient with inguinal hernia(CHAT-1) / 中国实用外科杂志

OBJECTIVE: To investigate and analyze the current situation of inguinal hernia treatment and postoperative venous thromboembolism(VTE)events in Chinese adults. METHODS: From January 1, 2017 to December 31, 2017, the patients who were hospitalized with inguinal hernia in 58 large hospitals in mainland China were retrospectively analyzed by means of questionnaire. After data cleaning, all patients were stratified and statistically analyzed using Caprini score.RESULTS: A total of 14 322 questionnaires were received from 58 different hospitals. After data patching and data cleaning, a total of 13 886 questionnaires(97.0%) were retained in accordance with the standard. The ratio of laparoscopic surgery and open surgery was 51.2% and 48.8% respectively. A total of 16 VTE events were observed,accounting for 0.1%(95% CI 0.11-0.13). The incidence of VTE was 0.2%(95%CI 0.18-0.20) in the high-risk group and 0.02%(95%CI 0.01-0.03) in the middle-risk group. The incidence of VTE in the high-risk group was significantly higher than that in the middle-risk group(P=0.000). No VTE event was found in the low-risk group. Of all patients, only 3250(23.4%) underwent Caprini risk assessment,with 13.2% receiving any prevention, whether appropriate or not, and only 1.2% receiving appropriate prevention. CONCLUSION: The incidence of VTE event after operation of inguinal hernia in Chinese adults is severely underestimated, and has not been paid enough attention by surgeons at present.

Pulsed electromagnetic fields stimulating osteogenic differentiation and maturation involves primary cilia-PI3K/AKT pathway / 北京大学学报(医学版)

OBJECTIVE@#To study whether the pulsed electromagnetic fields (PEMF) promoting rat osteoblasts differentiation and maturation is related to the primary cilia and PI3K/AKT pathway, and to explore the mechanism of PEMF in promoting bone differentiation.@*METHODS@#Enzyme solution was used to obtain newborn SD rats calvarial osteoblasts (ROB), which were processed by 50 Hz 0.6 mT PEMF for 0, 0.5, 1, 1.5 and 2 h, detecting PI3K and AKT protein expression and changes in primary cilia length and incidence; with LY294002 blocking PI3K/AKT signaling pathways we observed whether PEMF promoted osteogenic differentiation of ROB was affected; by interfering IFT88 gene expression by RNAi to inhibit primary cilia we observed whether PI3K/AKT signaling pathway and osteogenic differentiation of ROB was affected. Osteogenic differentiation indexes included alkaline phosphatase (ALP) activity, Real-time PCR and Western blot detection of osteogenic related genes of BMP-2, COL-1 and OSX and calcified nodules number, etc..@*RESULTS@#After exposure to PEMF for 0, 0.5, 1, 1.5, and 2 h, the protein expression of PI3K and AKT in ROB were increased significantly (P<0.01) and the primary cilia became longer; and the protein expression of PI3K reached the highest level at 0.5 h, as the treatment time of PEMF increased, the PI3K protein expression decreased. AKT showed higher protein expression at 0.5 h and 1.5 h. After blocking the PI3K/AKT signaling pathway with the PI3K blocker LY294002, PEMF could no longer increase ALP activity and the gene expressions of BMP-2, COL-1, OSX which were osteogenically related. However, PEMF could increase the ALP activity and the osteogenically related gene expression in ROB before blocking. After RNAi interfered the primary cilia, PEMF could no longer increase the protein expression of PI3K, which indicated that PEMF could not activate the PI3K/AKT signaling pathway after primary cilia interfering; secondly, the effect of PEMF on enhancing ALP activity disappeared, it also decrease the gene expressions of BMP-2, COL-1, and OSX, and the ability of increasing the calcification nodule formation also disappeared, indicating that the ability of PEMF to promote osteoblast maturation and mineralization disappeared after primary cilia interference.@*CONCLUSION@#PEMF activated the PI3K/AKT signaling pathway through primary cilia on the surface of osteoblasts, then promoted bone formation activity and differentiation.

Exploration of Multidimensional Regulation of Dahuang Ling Xian Capsules on Bile Duct Cells at Inflammatory State Based on miRNA Chip Technology / 广州中医药大学学报

Objective To investigate the effect of Dahuang Ling Xian Capsules(DLXC) on miRNAs in bile duct cells at inflammatory state. Methods The cultured well-grown bile duct cells at logarithmic phase were chosen for the experiment. Lipopolysaccharide (LPS , 5 μg/mL) was used to induce the model of bile duct cells at inflammatory state, and then DLXC (1 mg/mL) was added. After co-culturing for 72 h, the total RNA of bile duct cells was collected for miRNA chip detection and bioinformatics analysis. Results DLXC showed regulatory effect on the expression of 30 miRNAs in bile duct cells at inflammatory state, through which to affect biological processes involving with bile duct cell signal transduction, organic compound reaction and hypoxia stress, cell components such as cytoplasm , endoplasmic reticulum and membrane rafts , molecular biological functions of signal transduction activity , DNA binding in transcription regulation region and voltage-gated potassium channel activity , and multiple pathways of hypoxia-inducible factor-1(HIF-1) signaling pathway , uanosine 3 ' , 5 '-cyclic monophosphate-protein kinase C (cGMP-PKG) signaling pathway , tumor necrosis factor alpha (TNF-α) signaling pathway, chemokine signaling pathway, apoptosis signaling pathway, phosphatidylinositol-3-kinase (PI3K)-Akt signaling pathway and Toll-like signaling pathway. Conclusion DLXC exert the multidimensional regulation of bile duct cells at inflammatory state with miRNAs as targets.

Icariin enhances differentiation and maturation of rat calvarial osteoblasts in collagen hydrogel three-dimensional culture / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of icariin on the differentiation and maturation of rat calvarial osteoblasts(ROB) in collagen hydrogel three-dimensional culture.</p><p><b>METHODS</b>ROB were obtained by enzyme digestion from the segregated neonatal SD rats skull and were embedded in 2 mg/mL rat tail collagen for three-dimensional culture. The growth state of ROB was observed by FDA/PI staining, HE staining and scanning electron microscopy. ROB were treated with icariin at the concentration of 1 × 10⁻⁴, 1 × 10⁻⁵, 1 × 10⁻⁶ and 1 × 10⁻⁷ mol/L respectively. The activity of alkaline phosphatase(ALP) was detected after 3, 6, 9 d of icariin treatment. Three-dimensional cultured ROB were treated with optimal concentration icariin for 12, 24, 36, 48 h and total RNA was extracted and the mRNA expressions of bone morphogenetic protein-2 (BMP-2), Runt-related transcription factor 2 (RUNX-2) and Osterix were detected by real time RT-PCR. The protein expression of BMP-2, RUNX-2 and Osterix were examined by Western-blotting.</p><p><b>RESULTS</b>ROB were cultured in collagen hydrogel successfully. FDA/PI staining, HE staining, and scanning electron microscopy showed that ROB adhered with collagen tightly and distributed homogeneously. Icariin at final concentration of 1 × 10⁻⁵, 1 × 10⁻⁶ and 1×10⁻⁷ mol/L all enhanced the activity of ALP of collagen hydrogel three-dimensional cultured ROB, and 1 × 10⁻⁶ mol/L was the optimal concentration. Besides, icariin (1 × 10⁻⁶ mol/L) increased mRNA and protein expression of BMP-2、RUNX-2 and Osterix compared to control group.</p><p><b>CONCLUSION</b>Icariin can enhance the expression of osteogenic markers of ROB in collagen hydrogel three-dimensional culture significantly.</p>

Effect of osthol on apoptosis and bone resorption of osteoclasts cultured in vitro / 药学学报

This study is to investigate the effect of osthol on osteoclasts' activity, bone resorption as well as apoptosis in vitro, and explore the mechanism of osthol in preventing osteoporosis. Osteoclasts were separated from long-limb bones of new born rabbits, cultured in 24-well plate with glass slices and bone slices, and treated by 1 x 10(-5) mol x L(-1) osthol. Osteoclasts were identified by observing live cells with phase contrast microscope, HE staining, TRAP staining and toluidine blue staining of bone resorption pits. The numbers of bone resorption pits were counted as well as the surface area of bone resorption on bone slice. Osteoclasts were stained with acridine orange to detect the cell apoptosis. The ratio of apoptotic osteoclasts was observed under fluorescence microscope. The gene expression of RANKL, OPG, TRAP and p-JNK1/2 protein expression were examined using real time PCR and Western blotting, respectively. Comparing with the control group without osthol, the rates of apoptotic osteoclasts increased obviously and the number and area of bone resorption pits decreased evidently with 1 x 10(-5) mol x L(-1) osthol. There is significant difference between control group and experiment group treated by 1 x 10(-5) mol x L(-1) osthol. Therefore, the osthol through RANK+RANKL/TRAF6/Mkk/JNK signal pathway inhibits the osteoclasts activity, enhances osteoclasts apoptotic and inhibits the bone resorption.

Inguinal hernia repair with acellular tissue matrix patch for pediatric patients aged 6 to 18 years / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of hernioplasty using acellular tissue matrix patch to repair inguinal hernia of pediatric patients aged 6 to 18 years.</p><p><b>METHODS</b>Sixty eligible patients aged 6 to 18 years with primary unilateral inguinal hernia were randomly assigned to experimental or control group from June to December 2009. In the experimental group, acellular tissue matrix patch was used during Lichtenstein herniorrhaphy while traditional high ligation of hernial sac was used in the control group. Preoperative and postoperative parameters such as clinical informations of patients, postoperative complications and recurrence rate were recorded and analyzed.</p><p><b>RESULTS</b>There were no significant differences between the 2 groups in postoperative length of stay [(31 ± 8) h vs. (34 ± 11) h] and postoperative Visual Analogue Scale Pain Score (2.8 ± 0.9 vs. 2.6 ± 1.0) (P > 0.05), but the operation time in the experimental group were longer than that in the control group significantly [(39 ± 4) min vs. (36 ± 4) min, t = 3.357, P = 0.001]. The duration of follow-up ranged from 14 to 20 months. There were no postoperative incisional infection, chronic postoperative pain and local foreign body sensation in two groups. In the experimental group, 3 patients suffered scrotal hydrocele as compared 2 patients in the control group. There was no recurrence in the experimental group as compared 2 patients (6.7%) in the control group, which was no significant difference (P > 0.05).</p><p><b>CONCLUSION</b>Lichtenstein repair for pediatric patients aged 6 to 18 years with acellular tissue matrix patch has good results and with limited postoperative complications.</p>

Cutis verticis gyrata / 中华整形外科杂志

<p><b>OBJECTIVE</b>To improve the recognition and treatment of Chinese cutis verticis gyrata.</p><p><b>METHODS</b>Based on the review of the etiopathology, clinical features, diagnosis, classification and treatment of the disease in the literatures, six patients with the cutis verticis gyrata were treated with the skin graft or the expanded scalp flap.</p><p><b>RESULTS</b>The operative effects were satisfactory during 6 months to 5 years of the follow-ups. No recurrence was found in all cases. Two patients treated with skin graft had lead to baldness, four patients treated with the expanded scalp flap had been good appearance.</p><p><b>CONCLUSIONS</b>The method of the expanded scalp flap is good and effective treatment for the cutis verticis gyrate.</p>

Gene knockout and knockin on the Escherichia coli lac operon loci using pBR322-red system / 生物工程学报

pBR322-Red is a newly constructed recombineering plasmid, which contains a part of the pBR322 vector, a series of regulatory elements of lambda-prophage and Red recombination genes. In the beginning, we studied the best working conditions of pBR322-Red, and then modified lac operon in E. coli W3110 chromosome using the plasmid as follow: Firstly, we knockout the lacI gene using Red-mediated recombineering with overlapping single stranded DNA oligonucleotides. Secondly, we substituded the lacA and lacY genes with lacZ, a report gene, by Red-mediated linearized double strands DNA homologous recombination. Finally, we detected the expression of lacZ on these loci for the first time. The results suggested that pBR322-Red system is suitable for modifying W3110 chromosome with various recombination strategies.

Early diagnostic and prognostic value of procalcitonin in critical ill patients with sepsis / 中华全科医师杂志

Objective To investigate the diagnostic value of procalcitonin(PCT)as an early indicator for sepsis.Methods Serum levels of PCT and C-creative protein(CRP)and white blood cell (WBC)count were measured in 30 patients in critical condition hospitalized at an intensive care unit(ICU) with diagnosis of systemic inflammatory response syndrome(SIRS).They were divided into two groups, sepsis and non-sepsis,based on their clinical manifestations and results of lab tests.Blood specimen was collected from each patient for measurement of PCT,CRP and WBC count on the 1~(st),3~(rd)and 7~(th)day after hospitalization and bacteriological culture for blood and sputum,and chest X-ray was performed,as well. Acute physiology,age and chronic health evaluation(APACHE Ⅱ)was made on the 1~(st),3~(rd)and 7~(th)day after hospitalization to assess their ill condition.Their prognosis were judged on the 28~(th)day of the follow-up. Results Serum level of PCT increased significantly in the sepsis group(with the highest of 10.13 ng/ml), as compared with that in the non-sepsis group.Sensitivity,specificity and predictive value of a positive test for a cut-off value of serum level of PCT at 0.5 ng/ml were 97.0%,91.7% and 82.1%,respectively, which were all better than those of serum level of CRP and WBC count.Serum level of PCT in the patients was significantly associated with their prognosis,and PCT in those died was significantly higher than that in those survived.Whereas,serum level of CRP and WBC count elevated in both groups,but the difference between the two groups did not reach a level of statistical significance.Conclusion Serum level of PCT can be used as an early indicator for judgment of sepsis for a patient with infection and reflection of severity of illness.