The impact of groin pressure on post-TAPP enhanced recovery / 中华普通外科杂志

Objective To investigate the influence of postoperative groin pressure on transabdominal preperitoneal hernioplasty (TAPP).Methods From Mar 2015 to Jul 2016 113 TAPP cases were prospectively divided into two groups,with observation group not taking any measures and intervention group using salt bag of 500 g to compress inguinal region for 12 hours.Postoperative recovery was compared between the two groups.Results After 48 hours,there was no significant difference between the two groups in pain,local complications,scrotum or labia majora swelling remission rate and urinary retention (P ＞ 0.05).However,the observation group had a less foreign body sensation (P =0.038).After 1 month,the two groups had no significant difference in terms of pain,foreign body sensation,sexual life and scrotum or labia majora swelling residual rate (P ＞ 0.05).Conclusions Groin region compression after TAPP does not help alleviate the pain,or reduce the incidence of local complications,and it does increase the foreign body sensation.

Effect of extracellular histones on intestinal mucosa barrier function in mice and role of extracellular histones in development of sepsis / 中华创伤杂志

Objective To investigate the effect of extracellular histones (EH) on intestinal mucosal barrier function in mice and the correlation of EH with the pathogenesis of sepsis.Methods Twenty male C57BL/6 mice were assigned into experiment group (n =10) and control group (n =10) according to the random number table.Same dose (50 mg/kg) of EH and saline were administered through the caudal vein of mice in experiment and control groups respectively.Blood and intestinal samples in each group were collected 3 h after the administration.Morphology of intestinal mucosal tissue was detected by light scope and transmission electron microscope.Expressions of tight junction related proteins (ZO-1,Occludin and Claudin-1) were detected by western blot.Plasma levels of diamine oxidase (DAO) and intestinal fatty acid binding protein (I-FABP) were determined by ELISA method.Plasma level of endotoxin (ET) was determined by limulus test.Results Under transmission electron microscope,experiment group showed disorganized microvilli of intestinal epithelial cells with partially twisted,broken and lost,unclear tight junctions,and widened cellular space.Under light scope,experiment group showed substantial inflammatory cell infiltration in the intestinal wall,disorganized intestinal villi,edema and hemorrhage of mucosa and submucosa,and edematous goblet cells.Experimental versus control group showed significant reduction in levels of Claudin-1 (0.587 7 ±0.060 6 vs.0.677 2 ±0.038 3),Occludin (0.1277±0.0857vs.0.4306±0.0869) and ZO-1 (0.393 3±0.080 8 vs.0.812 8± 0.096 3) (P ＜ 0.05).Experimental versus control group showed significantly up-regulated plasma levels of DAO [(1.61 ±0.20) U/ml vs.(0.69 ± 0.15) U/ml],I-FABP [(548.5 ± 36.8) EU/ml vs.(178.8±26.9) EU/ml] andET [(0.182±0.076) EU/mlvs.(0.091 ±0.029) EU/ml](P＜0.05).Conclusion EH can obviously impair the integrity of intestinal mucosal barrier in mice and hence induce endotoxin translocation.

Effect of Pinch-3 gene interference of glomerular podocytes on cell morphology and cell traction force / 生物医学工程学杂志

Pinch-3 protein is an important constituent of cell membranes, which directly affects the cell morphology and mechanical properties. We observed and compared the change of morphology and cell traction force of glomerular podocytes before and after Pinch-3 gene inhibition by gene interference technology in this experiment. We found that a number of pores appeared on the cell surface, and the cell projected area were increased at the same time, with an approximate average about an increase of 40% after Pinch-3 gene inhibition. The results showed that the cell traction force of glomerular podocytes was significantly reduced, with an approximate average decrease of 40%, the maximum value of the cell traction force was reduced and the distribution of cell traction force became dispersive. All this suggested that after Pinch-3 gene inhibition, some pores created on the cell surface influenced the physical properties of glomerular podocytes and then affected the cell projected area and influenced the formation and distribution of cell traction force of the glomerular podocytes as well.

The clinical value of " Push-pull traction-relax homing-Repeatedly confirmed" in the prevention of bile duct injury in LC / 中华肝胆外科杂志

Objective To study the value of the technique of "Push-pull traction-relax homingrepeatedly confirmed" in the prevention of bile duct injury in LC. Methods From March 2001-August 2009, we applied this technique in 4800 cases of LC. The technique of "Push-pull traction" showed the structures of in the Calot's triangle. The technique of "relax homing" was to restore the cystic duct,hepatic duct and common bile duct to their original anatomical positions. The technique of "repeatedly confirmed" repeatedly identified the positions of the cystic duct, the common hepatic duct and the common bile duct. Results There was no bile duct injury. Conversion to open surgery happened in 118patients due to difficulties in identifying the Calot's triangle structures, bile duct stones, gallbladder cancer, and gallbladder-duodenal fistula. Conclusions The "Push-pull traction-relax homing-repeatedly confirmed" technique could effectively prevent bile duct injury in LC. The method is simple, easy to master and worthy of promotion.

Open ventral hernia repairs with Kugel patch

To describe the initial results of open ventral hernia repair by sublay placement of the self-expanding ring polypropylene patch [Kugel patch]. Twenty-four patients with ventral/incisional hernias were operated upon with this technique between December 2004 and August 2008 in the Department of General Surgery, Affiliated Zhong-Da Hospital, Southeast University, Nanjing, JiangSu Province, China. Hernia defect sizes, operative technique, operative times, postoperative complications, and recurrence were recorded. The age range of the operated patients was 37-81 years with a mean of 67.1 +/- 10.3. The operation includes hernia of linea alba, spigelian hernia, umbilical hernia, and incisional hernia, and with defect sizes ranging from 1-18 cm [mean: 6.7 +/- 4.5 cm]. Postoperative complications were seroma, upper respiratory infection, and mild pain. The mean operation time [estimated for hernia repair] was 118.5 +/- 42.2 minutes, and the mean postoperative hospital stay was 8.1 +/- 3 days [3-16 days]. There was no recurrence during the follow-up time [8-54 months, median: 26 months]. Open repair of ventral or incisional hernias with Kugel, or modified Kugel patch by sublay technique is safe, simple, and effective with low postoperative complication rate

Minimally invasive surgery for gallbladder polyps / 中国现代普通外科进展

Objective: Gallbladder polyps are frequently discovered in the past decade. Ifthe polyps are oenign,without concomitant stone and the gallbladder has a good function, it is not an absolutely indication for cholecystectomy. For this reason percutaneous endoscopio polypectomy of the gallbladden polyps were developed and applied. Methods: Among those who underwent peroutaneous endosoopic polypectomy of the gallbladder, 85 patients with gallblaeder polyps were studied. Under the epidural anesthesia, cholecystoscope was introduced into the gallbladder. The polyps were coagulated by self-made miorowave ceagulator and then resected for histopathelogical evaluation. The preserved gallbladders were followed up to evaluate the effioacy of this minimally invasive therapy. Results: All precedures were eventful with mean operation time of 1h to 1. 5h. Sixty seven patients were followed-up for a mean of 5.5 yeah (2～9 years) and showed all patients to be symptom free and in 64 cases the gallbladder function was found to be well preserved without recurrence of polyps and occurrenca of gallstones on ultraSound. Conclusion: The procedure reposed is a reliable, simple,effective and minimally invasive technique to remove gallbledder polyps and to preserve gallbladder function for the patients who have the benign gallbladder polyps.

Combined General and Gynecological Laparoscopy:Report of 160 cases / 中国微创外科杂志

Objective To investigate the clinical value of combined general and gynecological laparoscopy.Methods From March 2003 to December 2006,160 patients with abdominal and gynecological diseases were treated with laparoscopy,including laparoscopic cholecystectomy(LC)+ salpingostomy in 20,LC + ovarian cystectomy in 24 cases,LC + hysteromyomectomy in 12,LC + hysteromyomectomy and uterine artery blockage in 7,LC + subtotal hysterectomy in 19,LC + total hysterectomy in 11,LC + treatment of endometriosis in 6,laparoscopic appendectomy(LA)+ salpingostomy in 16,LA + ovarian cystectomy in 22,LA + subtotal hysterectomy and total hysterectomy in 18,decortication of liver cysts + ovarian cystectomy in 4,and laparoscopic hepatectomy + adnexectomy in 1.Results Laparoscopic procedures were completed in all the 160 cases without conversion to open surgery.The operation time ranged from 40 to 220 min(mean,120 min),and postoperative hospital stay ranged from 1 to 6 days(mean,3.4 days).No patient had perioperative complications.Among the 160 cases,143 were followed up for 3 to 24 months(mean,19.5),during which 1 developed vaginal stump hemorrhage 10 days after the operation and was cured by conservative therapy,1 experienced vaginal polypi at the stump 2 months postoperation and underwent polyp resection.Conclusions Combined general and gynecological laparoscopy is a promising method for patients with abdominal diseases complicated with gynecological diseases.It is important for surgeons from different departments to deeply understand the indications of laparoscopy,prepare well before operation,and cooperate closely.

Enhanced gallbladder bile coagulation associated with cholesterol gallstone formation / 中国病理生理杂志

AIM: To elucidate the mechanism of fibrin in cholesterol gallstone disease. METHODS: Hemostatic indices were systemically examined in the gallbladder bile obtained from 26 patients with gallstones and 17 without gallstones. RESULTS: Significant increases were found in tissue factor (TF) concentration( P