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Objective:To investigate the long-term effects of porcine small intestinal submucosa (SIS) biologic mesh in open Lichtenstein tension-free hernia repair.Methods:The prospective randomized controlled study was conducted. The clinical data of 76 patients with unilateral inguinal hernia who underwent open Lichtenstein tension-free hernia repair in 2 medical centers (52 cases in Tianjin People′s Hospital and 24 cases in China-Japan Friendship Hospital) from August 2013 to March 2014 were selected. Based on random number method, patients were allocated into two groups. Patients undergoing Lichtenstein tension-free hernia repair using Biodesign Surgisis mesh were allocated into control group, and patients undergoing Lichtenstein tension-free hernia repair using SIS biologic mesh were allocated into experiment group. Observa-tion indicators: (1) grouping situations of the enrolled patients; (2) postoperative long-term effects. Follow-up was conducted using telephone interview, text message or mail to detect hernia recurrence or death due to other reasons as the end-point event of patients up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented by M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping situations of the enrolled patients: a total of 76 patients were selected for eligibility. There were 38 cases in the control group and the experiment group, respectively. The number of males and females, age, body mass index, cases with intraspinal anesthesia or local anesthesia (anesthesia method), cases with inguinal hernia on the left side or on the right side, cases classified as type Ⅰ, Ⅱ, Ⅲ, Ⅳ or Ⅴ of Gilbert classification, operation time of the control group were 35, 3, (56±15)years, (23.0±2.0)kg/m 2, 22, 16, 16, 22, 9, 16, 0, 11, 2 and (49±15)minutes, respectively. The above indicators of the experiment group were 34, 4, (54±13)years, (22.9±2.2)kg/m 2, 17, 21, 14, 24, 9, 21, 1, 7, 0, and (53±21)minutes, respectively. There was no significant difference in the above indicators between the two groups ( χ2=0.157, t=0.532, 0.367, χ2=1.317, 0.220, Z=-0.315, t=-0.765, P>0.05). (2) Post-operative long-term effects: 35 patients of the control group were followed up for (68.8±2.7)months, 4 cases of which died due to other reasons, 1 case had hernia recurrence, 1 case had chronic pain and no foreign body sensation and postoperative infection occurred. Thirty-one patients of the experiment group were followed up for (68.8±2.7)months, with no death or above complications. There was no significant difference in hernia recurrence or chronic pain between the two groups ( P>0.05). Conclusion:The long-term effects of biological mesh in open Lichtenstein tension-free hernia repair is satisfactory and there is no difference in the long-term effects between the domestic SIS biological mesh and Biodesign Surgisis mesh.
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Objective To observe the dynamic changes of aspartate transaminase(AST ) in gingival crevicular fluid on tooth movement in new bone area after distraction osteogenesis at different time .Methods The distraction osteogenesis surgical proce‐dure was performed in 8 beagle dogs without periodontal disease and normal teeth ,experimental teeth were transplanted into the bone regeneration area after 2 weeks and after 6 weeks .Comparative analysis AST of each time (1 ,2 ,3 ,7 ,14 ,28 d after distraction) dynamic changes in gingival crevicular fluid .Results The AST level of gingival crevicular fluid in experimental tooth was rising for the first three days ,and the group of two weeks were significantly higher than 6 weeks ;AST levels after 7 d showed a trend of de‐cline ,down to the lowest point at 21 d ,and gradually restored ,AST levels reached a higher level again in the 28 d .Conclusion The AST level of experimental teeth increased significantly after 2 weeks than after 6 weeks ,but over time the AST level change is not linear ,this change has certain guiding significance for the clinical research in the future .
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Objective:To review the application of aesthetic incision design in the treatment of maxillofacial bone fracture.Methods:53 cases of different types of maxillofacial fractures were treated by oral incision,outlet incision or outlet combined with oral incision and corresponding fix method.The patients were followed up for 6 -18 months.Results:X-ray examination showed that all fractures were well cured.Mouth opening and occlusion were recovered to normal in all cases without obvious scar on maxillofacial skin.Con-clusion:Well designed incision and the corresponding fixed method may guarantee good cosmetic results and bone healing in the treat-ment of maxillofacial bone fracture.
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Objective To construct the lentiviral vector Lenti-miR-210-Luciferase, and to detect angiogenic factors HIF-1α and VEGF expression in hPDLSCs transduced by Lenti-miR-210-Luciferase. Methods hPDLSCs were iso-lated and cultured, and according to human miR-210 gene sequence(NC_000011. 9), its primer was designed and amplified through PCR. The PCR products of the target gene were connected to the vector pLVX-EGFP-3FLAG-EF1-Luc. To identify the plasmid, target gene PCR product and the purpose vector were digested by EcoRⅠand XbaⅠ. Lenti-miR-210-Luciferase ( the control group was Lenti-LacZ-Luciferase) was constructed using the LR re-combination system. After hPDLSCs was transduced by Lenti-miR-210-Luciferase, the analysis of HIF-1α and VEGF expression was done with qPCR and the immunohistochemistry examination. Results The results of plasmid sequencing and digestion confirmed that the vector Lenti-miR-210-Luciferase was successfully constructed. After Lenti-miR-210-Luciferase was transduced to hPDLSCs on 0, 1, 4, 7 and 14 d, the results of qPCR showed that the over-expression of HIF-1αand VEGF was detected on 4 d, and continued until 21 d. Immunohistochemical results showed that after hPDLSCs were transduced by Lenti-miR-210-Luciferase, hPDLSCs were positive for HIF-1α and VEGF antibody, and the control group was negative. Conclusion The Lenti-miR-210-Luciferase is successfully constructed, and miR-210 can promote hPDLSCs the differentiation of angiogenesis.
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Objective To compare the clinical efficacies of polypropylene-polyglactic composite mesh, polyester mesh, polypropylene mesh in Lichtenstein repair for inguinal hernia.Methods The clinical data of 1 080 patients with primary unilateral inguinal hernia who were admitted to the Tianjin People's Hospital from February 2012 to May 2013 were prospectively analyzed.A randomized controlled study was performed based on a random numble table.All the patients were allocated into the ProGrip group (Parietex ProGripTM Self-Fixating Mesh), PET group (ParietexTM Lightweight Monofilament Polyester Mesh) and PP group (BardTM Soft Mesh).Patients received standard Lichtenstein tension-free repair under local anesthesia and were followed up by outpatient examination and telephone interview till May 2014.The indexs observed during the follow-up included occurrence of complications, post-operative pain and postoperative health-related quality of life.The following indexes were recorded : time of mesh fixation, operation time, hernia recurrence, pain degree at postoperative week 1 and month 1, 6, 12 by numerical rating scale (NRS), quality of life at postoperative month 1 by SF-36 questionnaire survey including physical function, role physical, body pain, general health, vitality, social function, role emotional,mental health.Measurement data with normal distribution were presented as x ± s.Comparisons among groups were analyzed by ANOVA and pairwise comparison by t test.Measurement data with skewed distribution were presented as M (range) and repeated measurement data were analyzed using the repeated measures ANOVA.Count data were evaluated by the chi-square test and Fisher exact probability.Postoperative moderate and severe pain rates were evaluated by the Kaplan-Meier method and analyzed by the Log-rank test.Results There were 1 022 patients screened for eligibility including 367 patients in the ProGrip group, 346 patients in the PET group and 309 patients in the PP group.The time of mesh fixation and operation time were (1.3 ± 0.5) minutes and (30 ± 5) minutes in the ProGrip group, (4.9 ± 0.9) minutes and (45 ± 7) minutes in the PET group, (5.0 ± 0.9) minutes and (44 ± 7)minutes in the PP group, respectively, showing significant differences among the 3 groups (F =6.21, 4.33,P ＜ 0.05).There were significant differences in the time of mesh fixation and operation time between the ProGrip group and the PET group (t =1.36, 4.39, P ＜ 0.05), and also between the ProGrip group and the PP group (t =2.67, 2.99, P ＜ 0.05).There was no significant difference in the time of mesh fixation and operation time between the PET group and the PP group (t =0.98, 0.63, P ＞ 0.05).Nine hundred and nine patients were followed up for a median time of 13 months (range, 12-26 months) , with a follow-up rate of 88.943％ (909/1 022).The number of recurred hernia in the ProGrip group, the PET group and the PP group was 1, 0, 0,showing no significant difference (P ＞ 0.05).The NRS scores of pain from postoperative week 1 to postoperative month 12 were ranged from 0 (0-2) to 0 (0-0) in the ProGrip group, from 2(0-5) to 0(0-0) in the PET group and from 1 (0-4) to 0 (0-0) in the PP group.The number of patients with moderate and severe pain was ranged from 52(14.17％) to 0(0) in the ProGrip group, from 87 (25.14％) to 0 (0) in the PET group and from 89 (28.80％) to 0(0) in the PP group.There were no significant differences in the changing trends of NRS scores of pain and number of patients with moderate and severe pain among the 3 groups (F =1.66, x2=1.52, P ＞ 0.05).The scores of physical function in the ProGrip group, PET group, PP group at postoperative month 1 were 52 ± 4,50 ± 6, 50 ± 6, the scores of role physical were 50 ± 6, 50 ± 6, 50 ± 5, the scores of body pain were 52 ± 7, 52 ± 7, 52 ± 7, the scores of general health were 63 ± 4, 57 ± 9, 58 ± 8, the scores of vitality were 63 ± 5, 62 ± 6,63 ± 6, the scores of social function were 58 ± 4, 58 ± 8, 57 ± 8, the scores of role emotional were 59 ± 4, 57 ± 8,58 ± 8, and the scores of mental health were 65 ± 4, 63 ± 5, 63 ± 6, respectively, showing no significant differences in above indexes among the 3 groups (F =2.36,3.65,1.98,2.41, 6.32, 2.33, 4.21, 3.52, P ＞ 0.05).Conclusion Patients undergoing Lichtenstein repair for inguinal hernia with polypropylene-polyglactic composite mesh, polyester mesh and polypropylene mesh have comparative of incidence of postoperative complications, postoperative pain, quality of life, and present postoperative long-term low recurrence, low incidence of pain and relatively high quality of life.
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ObjectiveTo evaluate results of the Lichtenstein tension-free mesh repair and summaraize the clinical experience in the treatment of the inguinal hernia. MethodsIn this retrospective study, 4011 tension-free inguinal hernia repairs were performed in 3631 patients, using a polypropylene mesh (Lichtenstein technique). Results The average hospitalization was 3.8 days, the overall complication rate was 2.4％, the recurrence rate was 0.1％. ConclusionThe Lichtenstein repair for the treatment of inguinal hernia has the advantage of less postoperative pain and low recurrence and is highly suitable for day case surgery.
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Objective: To compare the similarities and differences of teeth movement at different time points after distraction osteogenesis, and to explore the best time point of teeth movement after distraction osteogenesis. Methods: The experiment was carried out on 8 beagle dogs. Group I: started teeth movement at the second week after distraction osteogenesis. Group Ⅱ: started teeth movement at the sixth week after distraction osteogenesis. Analyzed the root, periodontal ligament and alveolar bone by physical measurement, X-rays and HE staining methods. Results: In the second and sixth week after distraction osteogenesis, the distance between the third and fourth premolar teeth reduced significantly(P<0.05), there was a remarkable difference between group I and group Ⅱ(P<0.05). Conclusion: Under the same force, the speed of tooth movement in the second week is faster than that in the sixth week, but periodontal absorption in the second week is more serious than that in the sixth week.
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Since the first description of tension-free herniorrhaphy and the developement of prosthetic ma-terial for inguinal hernia, many techniques have come and gone. We should deploy the idea of evidence-based medicine and clinical practice guideline, according to the pathogenetie condition and medical condi-tion, in order to make the best treatment perseription for patient under the condition of nomudization.