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Objective:To compare the application value of different polypropylene mesh in inguinal hernia repair of adults.Methods:The prospective cohort study was conducted. The clinical data of 120 adult patients with inguinal hernia who were admitted to two medical centers (60 in Huadong Hospital affiliated to Fudan University and 60 in Shanghai Ninth People′s Hospital affiliated to Shanghai Jiaotong University from March 2012 to Match 2014 were collected. Patients were randomly divided into study group and control group using the random number table. Patients in the study group underwent repair of inguinal hernia using the SMP95958X mesh, and patients in the control group underwent repair of inguinal hernia using the modified Kugel mesh. All patients underwent preperitoneal repair by senior hernia surgery specialists. Observation indicators: (1) postoperative pain; (2) complications and follow-up. Patients were followed up at postoperative 3 months and 6 months using outpatient examination to detect the short-term complications by physical or color doppler ultrasonography examination, and at postoperative 5 years using telephone interview or outpatient examination to detect long-term complications including infection, foreign body sensation and recurrence of hernia. The follow-up was up to March 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), comparison between groups was analyzed using the nonparametric rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square, continuous correction chi-square test or Fisher exact probability. Comparison of ranked data were analyzed using the nonparametric rank sum test. Results:A total of 118 patients with inguinal hernia were selected for eligibility, including 116 males and 2 females, aged (64±12)years, with a range from 29 to 84 years. Of the 118 patients, 59 were in the study group and 59 were in the control group, respectively. (1) Postoperative pain: of the 59 patients in the control group, 34 took painkiller and 1 case lost the data of taking painkiller at postoperative 2 days. Of the 59 patients in the study group, 29 cases took painkiller. There was no significant difference in taking painkiller between the two groups ( χ2=1.055, P>0.05). The pain score at postoperative 2 days and 3 months were 3.26(range, 0.70-6.90) and 0.87(range, 0.00-4.10) of the control group, respectively, and 3.03(range, 0.00-8.80) and 0.83(range, 0.00-3.10) of the study group, respectively, showing no significant difference between the two groups ( Z=0.782, 0.729, P>0.05). (2) Complications and follow-up: the incidence of postoperative complications at perioperative period (within postoperative 2 days) was 1.7%(1/59) and 1.7%(1/59) in the control group and study group, respectively, showing no significant difference between the two groups ( P>0.05). Both of 59 patients in the control group and study group were followed up for 6 months after operation, respectively. The incidence of postoperative complications at 3 months and 6 months after operation was 1.7%(1/59) and 1.7%(1/59) in the control group, respectively, and 5.1%(3/59) and 5.1%(3/59) in the study group, showing no significant difference between the two groups ( P>0.05). Fifty-five patients of the control group and 52 patients of the study group were followed up for 5 years after operation, respectively. There was 1 case of infection in the control group, with the incidence of postoperative long-term ( within 5 years after operation) complication of 1.8%(1/55), and there were 2 cases of infection and 1 case of foreign body sensation in the study group with the incidence of postoperative long-term (within 5 years after operation) complication of 5.8%(3/52), showing no significant difference between the two group ( P>0.05). There was no recurrence of hernia in either group. Conclusion:Both of the SMP95958X mesh and the modified Kugel mesh can be used in preperitoneal repair of inguinal hernia, showing no significant difference in the efficacy between them.
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Objective:To investigate the clinical features of encephalocraniocutaneous lipomatosis (ECCL).Methods:The clinical characteristics, imaging manifestations and electroencephalogram changes of five patients with ECCL from Guangdong 999 Brain Hospital between December 2016 and February 2019 were collected and analyzed.Results:All five cases showed ocular, skin and central nervous system anomalies. Corneal anomalies were found in five cases, eyelid coloboma in three cases, calcification of the globe in two cases, and choristoma in one case. All five cases presented with naevus psiloliparis, three cases with small nodular skin tags on eyelids, and three cases with café-au-lait spots on the trunk. Dysplasia of the right cerebral hemisphere was observed in all five cases, four cases with enlargement of the right ventricle, three cases with arachnoid cysts, and one case with dysplasia of the corpus callosum. The onset of the seizures of five cases was found within one year old. Spasms were observed in five cases, partial seizure in three cases, and tonic seizure in one case. Five cases were drug-resistant epilepsy. Seizures decreased significantly after adrenocorticotropic hormone treatment in one case and seizures free after surgery in one case. One case had seizure free by corpus callosotomy, but had a relapse after four months. Three cases used ketogenic diet, including one case with epileptic seizure reduction, one case with development progress. All five cases had developmental delays. The exon gene sequencing of four cases was found normal. KRAS gene mutation was found in brain tissue of one patient.Conclusions:ECCL is a rare clinical disease that often involves the nervous system, skin and eyes. The seizures of the patients are often difficult to control and have development delays. Surgery may be necessary to control the seizures. ECCL is thought to be somatic mutations, which are hard to detect in the blood and can be found in affected tissues.
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Aim To investigate the anti-proliferating effect of tetrandrine ( Tet ) on colon cancer cells and its possible molecular mechanism. Methods We intro-duced crystal violet staining and flow cytometry to ana-lyze the effect of Tet on proliferation in LoVo cells. Flow cytometry was used to detect the effect of Tet on apoptosis in LoVo cells. Western blot assay was taken to analyze the effect of Tet on the expression of insulin-like growth factor binding protein 5 ( IGFBP5 ) . Final-ly, luciferase reporter assay, recombinant adenovirus mediated over-expression or silence of IGFBP5 were used to analyze the possible role of IGFBP5 in the anti-proliferating effect of Tet on colon cancer cells. Re-sults Crystal violet staining and flow cytometery anal-ysis results showed that Tet could exert an anti-prolifer-ating effect and induce apoptosis in LoVo cells. Tet de-creased the expression of IGFBP5 in a concentration-dependent manner. Tet inhibited the transcriptional ac-tivity of pTOP-luc reporter, which could be reversed by exogenous expression of IGFBP5 mostly. Similar results were found in the expression of c-Myc, but IGFPB5 knockdown couldn’ t reverse this effect. Conclusion Tet can inhibit the proliferation of colon cancer cells, and this effect may be mediated by down-regulating the expression of IGFBP5 to inhibit Wnt/β-catenin signa-ling transduction partly.
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Objective To compare the clinical effect of minimally puncture aspiration therapy with cranial awl hole aspiration thereapy for hypertension cerebral hemorrhage.Methods Sixty-two people were divided into two groups at random:minimally puncture aspiration therapy was used to treat 31 patients with hypertensive cerebral hemorrhage,minimally puncture aspiration therapy was guided by CT with YL-1 minimally puncture needle.Cranial awl hole aspiration thereapy was used to 31 patients and was guided by CT.Results The intracranial hemorrage secondary rate was 12.9％,hematoma removal rate was 81.0％.After 3 months of treatment,light defect with neural function was 16 cases(51.6％),severe neurological deficits was 3 cases(9.6％)and moderate defect was 8 cases(25.8％).The intracranial hemorrage secondary rate was 16.1％,hematoma remowal rate was 82.6％,After 3 months of treatment,light defect with neural function was 15 cases(48.4％),severe neurological deficits was 4 cases(12.9％)and moderate defect was 8 cases (25.8％).The hematoma removal rate of minimally puncture aspiration thereapy was similar to cranial awl hole aspiration thereapy,while the intracranial hemorrage secondary rate was lower (x2 =0.412,P =0.324).Conclusion The neural function defence score showed no significant differences.And it' s suitful for patients with poor tolerance.