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Objective:To investigate the clinical efficacy of femoral hernia repair.Methods:The retrospective and descriptive study was conducted. The clinical data of 102 patients with femoral hernia who were admitted to People′s Hospital of Xinjiang Uygur Autonomous Region from January 2012 to January 2019 were collected. There were 13 males and 89 females, aged (65±9)years, with a range from 31 to 91 years. Patients underwent emergency or selective surgery according to Guideline for diagnosis and treatment of adult inguinal hernia (2018 edition), including laparoscopic transabdominal preperitoneal hernia repair (TAPP), McVay repair or open preperitoneal mesh hernioplasty. Observation indicators: (1) intraoperative and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect complications and hernia recurrence up to February 2019. Measurement data with normal distribution were represented as Mean± SD, and count data were represented as absolute numbers. Results:(1) Intraoperative and postoperative situations: 102 patients had unilateral femoral hernia, including 57 of left hernia and 45 of right hernia. There were 79 patients with incanceration or strangulation, and 23 without incanceration or strangulation. The 79 patients with incancerated or strangulated hernia underwent emergency surgery, including 35 undergoing open McVay repair (5 had conversion from laparoscopic surgery) and 44 undergoing laparoscopic TAPP. The 23 patients without incanceration or strangulation underwent selective surgery, including 3 undergoing open preperitoneal mesh hernioplasty and 20 undergoing laparoscopic TAPP. Meshes were used on 87 of the 102 patients. The operation time, time to postoperative drainage tube removal, and duration of postoperative hospital stay were (62±3)minutes, (2.2±0.3)days, and (3.5±1.3)days, respectively. (2) Follow-up: 102 patients were followed up for (7±3)months, with a range from 1 to 12 months. During the follow-up, pulmonary infection, deep venous thrombosis, incisional infection, intestinal obstruction, seroma, intestinal fistula, and affected hernia recurrence were observed in 5, 4, 3, 3, 1, 1, and 1 of the 79 patients undergoing emergency surgery, respectively. There were 3 patients dead. One patient with intestinal obstruction underwent secondary enterostomy and then closure at postoperative 3 months. The other patients with complications were improved after symptomatic and supportive treatment. During the follow-up, seroma, intestinal fistula, and affected hernia recurrence were observed in 1, 1, and 1 of the 23 patients with selective surgery. The above patients with complications were improved after symptomatic and supportive treatment.Conclusion:Early and correct diagnosis, selection of appropriate surgical methods, and immediate surgery can effectively treat femoral hernia.
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Objective To explore the application value of epidural analgesia childbirth association a care in the puerpera childbirth.Methods According to the digital table,368 cases of childbirth puerperal were divided into observation group and control group,184 cases in each group.The control group was given analgesia childbirth,the observation group was given complex nursing intervention.The maternal birth outcomes of the two groups were observed.Results In the observation group,the maternal first labor time,labor time for 2 h,the total labor time, bleeding in 2h after delivery were (5.41 ±1.21 )h,(0.89 ±0.17)h,(6.32 ±1.57)h,(232.75 ±21.87)mL respectively,which in the control group were (5.32 ±1.22)h,(0.91 ±0.18)h,(6.24 ±1.55)h,(230.96 ±21.68)mL respectively,the differences between the two groups were not statistically significant(t =0.710,1.095,0.491,0.788, all P >0.05).In the observation group,the maternal cesarean delivery rate,postpartum maternal pain score,uterine recovery time were 10.33%,(1.43 ±0.67)points,(22.18 ±2.63)d respectively,which in the control group were 19.02%,(2.89 ±1.54)points,(29.79 ±5.41)d respectively,the differences between the two groups were statistically significant(χ2 =5.556,t =11.792,17.160,all P <0.05).In the observation group,the neonatal Apgar score,incidence of fetal distress,neonatal asphyxia rate were (9.27 ±0.88)points,1.09%,0.00% respectively,which in the control group were (8.03 ±0.31)points,5.43%,2.17% respectively,the differences between the two groups were statistically significant(t =3.526,χ2 =5.513 1,4.044,all P <0.05 ).Conclusion Adopt a consortium epidural analgesia application in maternity nursing intervention can improve the success rate of vaginal delivery,does not interfere with the labor progress,ensure the safety of the maternal and infant is worth popularization and application in clinic.
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Objective To compare the effect of different concentrations of ropivacaine in epidural analgesia of childbirth.Methods According to the digital table,300 cases of our hospital childbirth puerpera were randomly divided into A,B,C three groups.A group was given 0.125％ ropivacaine compound fentanyl analgesia,B group was given 0.1％ ropivacaine compound fentanyl analgesia,group C was not required analgesia childbirth.The childbirth of three groups was observed.Results In group A,the labor time was (261.38 ± 19.87) min,postpartum 2h blood loss was (241.03 ± 34.57) mL.In group B,the labor time was (260.09 ± 19.69) mnin,postpartum 2h blood loss was (238.66 ± 35.01) mL.In group C,the labor time was (270.46 ± 20.86) min,postpartum 2h blood loss was (251.75 ± 36.79) mL.Statistical analysis showed that there was no significant difference (t =0.472,1.035 ; all P ＞ 0.05).In group A,the fetal heart rate was (142.34 ±21.57)times/min,neonatal Apgar score was (9.77 ± 0.21),and umbilical artery blood pH value was (7.27 ± 0.06).In group B,fetal heart rate was (145.21 ± 21.49) times/min,neonatal Apgar score was (9.79 ± 0.20),and umbilical artery blood pH value was (7.26 ± 0.08) ; Fetal heart rate of group C was (143.78 ±22.01)times/min,neonatal Apgar score was (9.64 ±0.24),and umbilical artery blood pH value was (7.28 ± 0.07).The differences among three groups were not statistically significant (t =0.763,0.360,0.114,all P＞ 0.05).Analgesic effect time of group A was (12.13 ± 1.76) min,pain score was (1.03 ±0.46) points,analgesic harem duration was (22.39 ± 3.21) s,analgesic harem time interval was (3.26 ± 1.49) min,the cesareandelivery rate was 8.00％.In group B,the analgesic effect time was (12.04 ± 1.69mnin),pain score was (1.01 ± 0.52) points,analgesic harem duration was (21.04 ± 3.18) s,analgesic harem time interval was (3.4.9 ±1.51)min,the cesarean delivery rate was 9.00％ ; Duration of the analgesic effect of group C was (16.77 ±16.77) min,pain score was (3.76 ± 1.23) points,analgesic harem duration was (26.98 ± 5.87) s,analgesic harem time interval was (2.65 ± 0.75) min,the cesarean delivery rate was 48.00％.The differences between groups were statistically significant (chi square or t =6.148,8.522,5.749,4.095,61.316 ;P ＜ 0.05).Conclusion Application of 0.1％ ropivacaine compound fentanyl anesthesia can effectively relieve patients'pain,shorten labor and reduce postpartum 2h blood loss,impact less on contractions at the same time,reduce the incidence of cesarean delivery,has no influence on the neonate,which is worth popularization and application in clinic.
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Objective To explore the expression profiles and their clinical significance of microRNA (miRNA) molecules in different stages of chronic hepatitis B virus (HBV) infection.Methods The miRNA molecule expressions of 12 patients with chronic hepatitis B,12 chronic HBV carriers,12 inactive hepatitis B surface antigen (HBsAg) carriers,and 9 healthy controls were screened using miRNA microarray.The miRNA profiles were validated by the real time fluorescence quantitative polymerase chain reaction (PCR).The t-test was used for comparison between twogroups,whereas one-way ANOVA and SNK-q tests were used for multiple comparisons.Mann-Whitney and Kruskal Wallis H tests were used for comparison of two or more groups of data with skewed distribution.The receiver operation characteristic (ROC) curve was constructed to evaluate the diagnostic significance of miRNA molecules.Results Compared with the healthy controls,significant differences in the expression profiles of miRNA molecules were found in peripheral blood mononuclear cells of chronic HBV carriers (2 molecules up-regulated,and 18 down regulated) and chronic hepatitis B patients (33 molecules up-regulated and 19 down-regulated).No significant difference was found between inactive HBsAg carriers (2 molecules up regulated,and 3 down-regulated) and controls.The results of six miRNA molecules detected by real-time fluorescence quantitative PCR were basically consistent with the results detected by microarray.The area under ROC curve of the six miRNA molecules of hsa miR-4711-3p,hsa-miR-3191 5p,hsa-miR-5704-5p,hsa-miR 548ah-5p,hsa-miR-146a-5p and hsa-miR-29b-3p in distinguishing immune tolerance and clearance of chronic HBV infection were 0.994,0.984,0.967,1.000,1.000 and 0.996,respectively.Conclusions The different expression profiles of miRNA molecules could be used to distinguish the different stages of chronic HBV infection,and are closely related with the immune tolerance and activation in chronic HBV infection.
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Objective miRNA-122 levels may correlate with liver cancer prognosis,and therefore understanding its expression is crucial for future treatment.This study investigates the effect of DNA methylation on the expression of liver specific miRNA-122 and its effects on proliferation and apoptosis of hepatocellular carcinoma cells.Methods Methylation sequencing detected the methylation of the miRNA-122 promoter region,and the level of miRNA-122 expression was measured by using real-time quantitative PCR.The proliferation and apoptosis of hepatocellular cell lines were detected by flow cytometry and CCK8.Results Compared with human primary hepatocytes [(21.9 ± 11.4)％],the level of miRNA-122 promoter methylation in Huh7,HepG2,and QSG-7701 cell lines were (87.6±9.3) ％,(89.0 ± 14.3)％,and (69.5 ±11.5)％,respectively.This represents a significant increase (P=0.000),especially in Huh7 and HepG2 cell lines.Compared with human primary hepatocytes (2.83× 104 ±3746),the levels of miR-122 expression in the above three cell lines were significantly decreased,especially in Huh7 and HepG2 cell lines (P=0.007).After treatment with 5-Aza-dc,the degree of methylation in Huh7 and HepG2 cell lines were significantly lower than that of the blank group (P=0.038,P=0.025),and the levels of miRNA-122 expression were significantly elevated (P=0.008,P=0.003).Also,compared with the control groups,the apoptosis of Huh7 cells and HepG2 cells were significantly increased (P=0.001,0.027).Conclusion The expression of miRNA-122 is regulated by DNA methylation and correlated with the apoptosis of liver cancer cells.Therfore,the methylation regulation of miRNA-122 expression might be involved in the occurrence and development of hepatocellular carcinoma.
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Objective To analyze the clinicopathological characteris tics of systemic lupus erythematosus (SLE) with secondary antiphospholid syndrome (APS) . Methods Data of 11 cases of SLE with secondary APS (SLE with APS) admitted to Peking Union Medical College Hospital from January 2000 to March 2010 were retrospectively analyzed. Kidney biopsy was performed on all of these patients. Differences of clinicopathology and outcomes between SLE with and without APS were compared. Results Renal involvement was found in all the SLE with APS patients. The prominent clinical manifestations included hypertension (54.5%), nephrotic level of proteinuria (24 h proteinuria ≥3.5 g)(72.7%) and renal insufficiency (45.5%). Diastolic blood pressure, mean arterial pressure and glomerular filtration rate in SLE with APS were significantly higher than those in SLE without APS (all P＜0.05). In 8 out of 11 cases (72.7%), APS nephropathy (APSN) in kidney biopsy was found, characterized by small vessel vaso-occlusive lesions. These included thrombotic microangiopathy (TMA), fibrous intimal hyperplasia (FIH), focal cortical atrophy (FCA) and tubular thyroidization. Among those, 5 cases (45.5%) had chronic APSN and 4 (36.4%) had acute APSN (one case had acute and chronic APSN at the same time). The incidences of APSN and acute APSN in the SLE with APS group were significantly higher than those in SLE without APS group (P＜0.05). Conclusions The major renal manifestations of SLE with APS are hypertension, nephrotic level of proteinuria and renal insufficiency. Other than lupus nephritis, also a high incidence of APSN is found in SLE with APS patients.
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Objectives:To study the postoperative nutritional support in patients with pancreatic disease. Methods:Based on the kind of pancreatic disease,twenty two patients were randomly divided into PN+EN group and TPN group during 20 days after operation.Body weight,the restoring time of intestinal movement,the complications,the blood amylase,the serum glutamic pyruvic transaminase,the blood urea nitrogen,the blood sugar,the serum albumin(Alb),transferritin(TFN) and prealbumin(PAB) were compared on the first,fifth,tenth and twentieth day after operation. Results:Body weight of two groups reduced lightly.The blood amylase decreased remarkably.The functions of liver and kidney were recovered gradually.The blood sugar tended to restore normal.Alb,TFN,PAB of two groups increased remarkably( P