Management of postoperative recurrence of inguinal hernia in adolescents: An analysis of 9 cases / 中国实用外科杂志

OBJECTIVE: To analyze the reoperation method and effect of recurrent inguinal hernia in adolescents after operation. METHODS: The data of 9 adolescent(13 to 18 years old) inguinal hernia patients with recurrence after surgical treatment admitted in the first people's hospital of Foshan from January 2006 to December 2018 were analyzed retrospectively. The methods of previous operation, reoperation, size of internal ring, major postoperative complications and recurrence rate were collected. RESULTS: Among the 170 adolescent patients who underwent inguinal hernia surgery,there were 9 cases of recurrent indirect inguinal hernia(the previous operation method was high ligation of the internal ring), including 2 cases of open surgery and 7 cases of laparoscopic surgery. Of the 9 patients, 3 had multiple recurrences and 6 had first recurrence. The sizes of internal ring were 0.3 to 3.0 cm in the operation. Surgical methods: 4 cases were performed with laparoscopic high ligation of internal ring, with the sizes of internal ring ranging from 0.3 cm to 2.0 cm. Laparoscopic inguinal hernia mesh repair was performed in 5 patients(3 patients with multiple recurrences)with the sizes of internal ring ranging from 1.5 cm to 3.0 cm. During the follow-up period of 6 months to 10 years, no wound or mesh infection, 3 patients showed discomfort in the inguinal area, 2 patients had mesh repair and 1 patient had high ligation. Seroma appeared in 1 patient which was repaired by mesh. One case of recurrence which was mesh repair.CONCLUSION: The choice of surgical method for recurrent inguinal hernia in adolescents should be based on the previous surgical method, recurrence frequency and the presence of large internal ring defect or transverse abdominal fascia defect. Laparoscopic high ligation is recommended for patients with primary recurrence of small internal ring defect. For patients with multiple recurrence or large internal ring defect, mesh repair is recommended.

Diagnosis and treatment of mature adrenal teratoma / 中南大学学报(医学版)

To discuss the pathology, clinical manifestation, diagnosis, therapy and prognosis of mature teratoma in adrenal gland. We reported 2 cases of mature adrenal teratoma and summarized their characters. No local recurrence or metastasis was found in the close follow-up of the 2 patients after the radical resection. Teratomas are rare germ tumors with potential malignant character which usually occur in the testes and ovaries. Adrenal teratomas are extremely rare and the diagnosis relies on radiological examinations. Early diagnosis and early surgical resection are the key in the treatment. Whether the postoperative chemotherapy is needed depends on the pathological result. Close lifelong follow-up is recommended and the prognosis is unclear at present.

Modified laparoscopic transabdominal preperitoneal repair of groin hernias / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the clinical value of modified transabdominal preperitoneal (TAPP) repair of groin hernias in adult patients.</p><p><b>METHOD</b>From May 2006 to April 2008, modified TAPP repair for hernia was performed in 403 adult patients with groin hernia and 22 with femoral hernia. Indirect hernia sac was treated by high ligation of the hernia sac in similar fashion with the management in children, while direct or femoral hernia was treated by dissecting the hernia sac. An incision was made on the lateral umbilical ligament, and the mesh was stapled and covered completely by the peritoneum of the lateral umbilical ligament, followed by fixation of the mesh with stapling and absorbable sutures.</p><p><b>RESULTS</b>All the operations were accomplished successfully with the operating time from 20 to 30 min for unilateral hemioplasty and the blood loss volume was 4-5 ml. Two patients developed scrotal edema and three showed scrotal seroma. No hernia recurrence was found in follow-up for 2-22 months. The patients complained of no intestinal obstruction symptoms including traction pain, abdominal pain, or nausea or urinary bladder stimulation symptoms.</p><p><b>CONCLUSIONS</b>Modified TAPP repair of groin hernias requires simple operation and produces reliable effect, and is therefore of clinical values for wide application.</p>

Treatment of bilateral hydronephrosis caused by prostate cancer / 中华泌尿外科杂志

Objective To evaluate the treatment of bilateral hydronephrosis caused by prostate cancer. Methods Twenty-four eases with mean age of 71 years old (ranging from 64--81 years old) were diagnosed with bilateral hydronephrosis caused by prostate cancer and treated with complete androgen deprivation. Surgical castration plus Bicalutamide 50 mg/d was offered to 18 eases and medical castration (Goserelin, 3. 6 mg/month) plus Bicalutamide 50 mg/d was offered to 6 cases. There were 19 cases developed severe lower urinary tract symptoms. Among these 19 cases, 13 cases had accepted Foley catheter and 6 cases accepted suprapubic tube drainage. Results Before and after the treatment, the prostate volume decreased from (70. 3±11.2)ml to (42.6±15.8)ml(P=0. 001). Total PSA decreased from (40. 3±27.2)ng/ml to (9.5±8.3)ng/ml(P=0.02). Of the 24 cases, hydrone phrosis improved in 18 cases, remained unchanged in 3 cases and deteriorated in 3 cases. There were 14 patients developed renal insufficiency. After the treatment, Serum urea nitrogen decreased from (12. 8±6. 5) mmol/L to (6. 3 ± 4. 2) mmol/L (P = 0. 004) and serum ereatinine decreased from (206.8±152.3)μmol/L to (85.3±43.6)μmol/L(P=0.03), respectively. For those 6 cases with hy dronephrosis unchanged or deteriorated during the treatment, 4 cases accepted percutaneous nephros tomy and 2 cases accepted chtaneous ureterostomy. Conclusion The combination of complete androgen deprivation and bladder drainage through Foley catheter or suprapubic tube is an effective option in the treatment of bilateral hydronephrosis caused by prostate cancer.

Experiences on Micro-laparoscopic Hernioplasty in Infants and Children: Report of 4500 Cases / 中国微创外科杂志

Objective To analyze the causes and preventions of the perioperative complications of micro-laparoscopic hernioplasty in infants and children with indirect inguinal hernia.Methods From January 1997 to January 2007,4500 infants or children with indirect inguinal hernia,including 702 cases who were complicated with hydrocele testis,were treated by micro-laparoscopic hernioplasty in our hospital.By laparoscopy,the endocycle was sutured circularly under the peritoneum using a self-designed needle.Then,only the peritoneum was ligated.Results No organ injury or complication occurred during the operation.The mean operation time was 9 min(5-13 min).Among the patients,4250 received a follow-up of 7-36 months(mean,25 months).Postoperative complications were found in 132 patients(3.1%),included scrotal gas in 10(0.24%),scrotal hydrocele in 16(0.38%),umbilical hernia in 27(0.64%),extraperitoneal emphysema in 20(0.47%),abdominal wall hematoma at the burr hole in 15(0.35%),foreign body sensation at the suture sites in 30(0.71%),scrotal hematoma in 8(0.19%),and iatrogenic cryptorchism in 6(0.14%).Thirty-five patients had recurrence(0.82%).Conclusions Micro-laparoscopic hernioplasty is a safe and reliable method for indirect inguinal hernia in infants and children.It is important to be familiar with the anatomy of the hernia under a laparoscope and to perform the operation carefully so that to avoid or decrease the perioperative complications.

Laparoscopy combined with radionuclide imaging in the diagnosis and treatment of gastrointestinal tract hemorrhage in children / 中国微创外科杂志

Objective To explore the clinical value of laparoscopy combined with radionuclide imaging in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, especially for Meckel’s diverticulum and double intestine. Methods ~ 99m Tc~-pertechnetate abdominal scintigraphy was performed in 22 children with a history of recurrent hemafecia or melena in this hospital from December 1998 to December 2005. All the children were given a laparoscopic exploration. Results Among the 22 patients, scintigraphy showed positive findings in 18 patients and negative, 4 patients. The positive patients were all confirmatively diagnosed by laparoscopic surgery and pathological examinations, including Meckel’s diverticulum in 14 patients and duplications of alimentary tract in 4 patients. In the other 4 patients with negative results, no organic pathologic changes was identified by laparoscopy in 3 patients and Meckel’s diverticulum was found after laparoscopic exploration in 1 patient. Conclusions Radionuclide imaging is an important method in the diagnosis of gastrointestinal tract hemorrhage in children and provides scientific basis for surgical intervention. The combination of laparoscopy and radionuclide imaging not only has values in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, but also minimizes the blindness and trauma of exploratory laparotomy.

Microlaparoscopic treatment of adhesive intestinal obstruction in children / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical significance of microlaparoscopic treatment for adhesive intestinal obstruction in children.</p><p><b>METHODS</b>Adhesion -lysis operation was performed in 18 patients with adhesive intestinal obstruct ion by microlaparoscope from March 2001 to January 2004. The clinical data were analyzed retrospectively.</p><p><b>RESULTS</b>Microlaparoscope assisted accretion-lysis operation was successfully performed in all patients. The operative time ranged from 15 min to 45 min (averaged 30 min), the aerofluxus time ranged from 12 hours to 28 hours (averaged 22 hours) after operation. All patients can take general activity at the first day and take in food at the second day after operation respectively. The hospital stay ranged from 3 to 5 days (averaged 4 days) without complications. All patients were followed-up from 3 months to 18 months (average d 6 months). All patients recovered well without occurrence of adhesive intestinal obstruction.</p><p><b>CONCLUSIONS</b>Micro-laparoscope assisted adhesion-lysis operation is a simple,safe,and feasible approach for adhesive intestinal obstruction in children.</p>

The treatment of hydrocele in children by mini-laparoscope / 中国微创外科杂志

Objective To study a new operative procedure for hydrocele in children under mini-lapascope.Methods 103 children with hydrocele aged from 1 to 9 years old were performed by suture around internal rings under mini-laparoscope from November 2000 to March 2002. Results The operative time was (5～8) minutes and hospital stay (4～5) days. The incision didn't need suture and there was no obvious scar after operation. All cases were followed up at 1st month, 6th month and 1st year postoperatively. All cases recovered except for 2 cases recurred at 1st month postoperatively. Conclusions Suture around internal rings under mini-laparoscope is a minimally invasive and simple method for the treatment of hydrocele in children. It can find and deal with hidden patent internal rings.

Laparoscopic hernioplasty combined with Mesh strenthening in the treatment ot hernia in adults / 中国微创外科杂志

Objective To evaluate the efficacy of mini-laparoscopic hernioplasty with Mesh strengthening in the treatment of hernia in adults. Methods We used mini-laparoscopic and self-decided needle-like instruments to perform 106 cases of Mesh replacement in addition to hernioplasty in treatment ot hernia in adults from January,1999 to Junuary,2001. Results Operation time ranged from 20min to 25min.Food-intake began in the operative day.No Complications occurred.The patient discharged 3d～4d after the operation.Following-up period lasting 5months to 2.5years showed no relapse occurred. Conclusions Mini-laparoscopic hernioplasty combined with Mesh strengthening is feasible in the treatment of hernia in adults.The method have the advantages ot mini-invasion,simple proccedures,shorter operation time and quicker recovery.

Experimental study of Dachuanxiong Decoction on injury induced by ischemia in nerve cells / 中成药

AIM: To study the protective effects of Dachuanxiong Decoction (Rhizoma Chuan Xiong, Rhizoma Gastrodiae, etc) on injury induced by ischemia in nerve cells. METHODS:The level variation of activity and calcium ions of nerve cell were observed, choosing nerve cell ischemia model with hypoxia device and adapting confocal laser scanning microscopy and MTT method.. RESULTS:Dachuanxiong Decoction adjusted the abnormal structure of ischemia nerve cell, inhanced the survival rate and nerve call's, activity and decreased the concentration of calcium ions of nerve cell. CONCLUSION: Dachuanxiong Decoction blocked the calcium ion channels, nourished and protected nerve cells from ischemic injury.

Toufeng Capsule's Influence on Concentration of Neurotransmitter and Blood Active Substance in Brain and Blood of Magraine Mice / 中成药

Objective:To research the influence and mechanism of Toufeng capsule (TFC) on the concentratioin of blood active substance and single amine neurotransmitter in the brain and blood of magraine mice.Methods: We chose animal disease model of migraine made by hypodermic nitroglycerin and measured the concentration of 5 HT. NE and DA in the rat's brain and blood by means of enzymeimmunoassay experimental methods.Results: TFC could obviously increase the concentration of 5 HT and NE in the bloold and of 5 HT, DA and NE in the brain.Conclusions: TFC might improve neurosystematic regulation functions and enhance the neurotransmitters' secretion and metabolism.

Extraction and purifiction process of total flavonoid compounds in Scutellaria baicalensis / 中成药

AIM: To determine the suitable condition and the optimal parameters for the extraction and purifiction process of total flavonoid compounds in Scutellaria baicalensis. METHODS: It was investigated by orthogonal experiment design of form L_9(3~4) with the extraction percentage of the total flavonoid compounds and baicalin from Scutellaria baicalensis as the standard. RESULTS: The optimal condition of extraction was with water as much as ten times of the medicine amount and was boiled for 2 h and three times,and the optimal condition of purifiction was as follows: solution concentration 0.25 g(crude medicinal materials) /mL,adjusting pH to 2,80 ℃ heat preservation up to 60 min, 50% alcohol as precipitant and the precipitated adjusted pH to 4.0. CONCLUSIONS: The optimal process is rational,practical and adapted to industry production.

Experimental study on anti-inflammatory,analgesic and antipyretic effects of Qinzhi Capsule / 中成药

AIM: To study the anti-inflammatory,analgesic and antipyretic effects of Qinzhi Capsule(Radix Scutellariae,Fructus Gardeniae,etc). METHODS: Qinzhi Capsule was taken orally.The experimental methods were as follow: abdomen capillary permeability in mouse induced by actetic acid,mouse ear swell induced by dimethylbenzene,mouse pain threshold induced by heat stimulation,animal fever induced by yeast to rat and endotoxin to rabbit,et al. RESULTS: Qinzhi Capsule could inhibit markedly the increase in abdomen capillary permeability in mouse induced by acetic acid(P

Experimental study on Qinzhi Capsule against virus and bacteria / 中成药

AIM: To study Qinzhi Capsule(Radix Scutellaniae,Fructus Gardeniae) against virus and bacteria. METHODS: The mice were infected separately by Ⅰ、Ⅱ type flu virus,staphylococcus aureus or pneumococcus in the experiment.The protective action of Qinzhi Capsule on them was observed in vivo.and detemined mininum inhibition concettation(MIC). RESULTS: Qinzhi Capsule could prolong markedly the survival periods of mice(P

Effect of Dachuanxiong Prescription on nerve cell injury of migraine rat / 中成药

Objective: To study the effects of Dachuanxiong Prescription(Rhizoma Gastrodiae, Rhizoma Chuanxiong, etc.) on nerve cell apoptosis of migraine model rat. Methods : To choose disease model of migraine with nitroglycerin by means of flow cytometry and transmission electron microscope. Results : Dachuanxing Prescription can adjust the abnormal ultra-structure of nerve cell of migraine model rats, decrease the incidence and the apoptosis percentage. Conclusion : Dachuanxing Prescription can block the nerve cell apoptosis of migraine model rat.