Role of Long Non-Coding RNA (LncRNA) LINC-PINT Downregulation in Cardiomyopathy and Retinopathy Progression Among Patients with Type 2 Diabetes.

BACKGROUND Despite the acknowledgement that LncRNA LINC-PINT may inhibit tumor cell invasion in human cancers, it is not yet determined when it comes to diabetes and its related complications. MATERIAL AND METHODS There were 244 patients with T2D and 126 healthy volunteers were admitted to People's Hospital of Xinjiang Uygur Autonomous Region Hospital. Fasting blood (5 mL) was obtained from the patients and controls a day after admission. The diabetes patients' fasting blood was extracted once every 6 months during follow-up. The total RNA was extracted and then used for detecting the expression of LINC-PINT. RESULTS A comparison was made in this study, where LINC-PINT did not experience significant downregulation level in the majority of those suffering diabetes complications when in contrast to healthy controls, while LINC-PINT expression was found in diabetics. The follow-up study showed that LINC-PINT was downregulated in patients who developed cardiomyopathy and retinopathy or both but not in patients who developed other complications. Treatment with high glucose limited the extent of LINC-PINT expression in the ARPE-19 and AC16 cells. While the overexpression of LINC-PINT increased the viability of ARPE-19 and AC16 cells, siRNA-mediated silencing of LINC-PINT elicited the opposite effect. CONCLUSIONS Hence, we concluded that the overexpression of LINC-PINT may exhibit inhibitory effects on the progression of cardiomyopathy and retinopathy among patients with type 2 diabetes.

[Efficacy comparison of the laparoscopic total extraperitoneal prosthetic and the Lichtenstein herniorrhaphy for inguinal hernia].

OBJECTIVE: To compare the efficacy and safety between laparoscopic total extraperitoneal prosthetic (TEP) and Lichtenstein herniorrhaphy in the treatment of inguinal hernia (IH). METHODS: Clinical data of 158 IH patients at our hospital from October 2015 to October 2016 were retrospectively analyzed. Among 158 patients, 85 patients underwent TEP (TEP group), and 73 underwent Lichtenstein herniorrhaphy(Lichtenstein group). Patients of TEP group received general anesthesia. The space between suprapubic space and iliac fossa was separated with attention to protect the spermatic cord during the operation so as to avoid excessive separation. When the patch was placed, the internal margin exceeded the contralateral pubic tubercle, the lateral margin reached the anterior superior iliac spine, there was at least 2 cm overlap between the superior margin and the joint tendon, the lower margin was inserted into the suprapubic bladder space(Retzius space), and the lateral lower margin was at least 6 cm to internal ring. Lichtenstein group received local anesthesia or continuous epidural anesthesia and all underwent routine Lichtenstein herniorrhaphy. Operative time, postoperative conditions and recurrence were compared between two groups. RESULTS: Among these 158 patients, 129 were male and 29 were female, with an age ranging from 26 to 75 years (median 42 years). Baseline data were not significantly different between two groups(all P>0.05). There was no perioperative death and serious complications in two groups. The difference was not statistically significant in operative time[(47.6±5.4) minutes vs. (48.9±6.3) minutes, t=0.238, P=1.024]. But TEP group was better than Lichtenstein group in terms of intraoperative blood loss [(7.53±2.31) ml vs. (11.41±4.49) ml, t=5.783, P=0.032], postoperative bedtime [(1.25±0.32) days vs. (2.83±0.52) days, t=5.294, P=0.041], postoperative hospital stay [(2.38±1.14) days vs. (3.46±1.81) days, t=5.482, P=0.037], and postoperative pain score (1.27±0.47 vs. 3.42±1.93, t=5.639, P=0.034). Follow-up was 12-16 months (median 10 months). In TEP and Lichtenstein group after operation, incision infection occurred in both 1 case, edema of the scrotum or labia minora developed in 2 patients and 3 cases respectively, chronic pain was found in one and 2 cases respectively. The patients were followed up for 5 to 16 months(median 10 months), and recurrences was observed in 1 case both in TEP group and Lichtenstein group respectively. CONCLUSION: Laparoscopic total extraperitoneal prosthetic is safe and effective in the treatment of inguinal hernia, which is better than Lichtenstein herniorrhaphy in fast recovery, less trauma and more comfort, and worthy of clinical promotion.

[Efficacy comparison of laparoscopic Nissen, Toupet and Dor fundoplication in the treatment of hiatal hernia complicated with gastroesophageal reflux disease].

OBJECTIVE: To compare the efficacy and safety among laparoscopic Nissen, Toupet and Dor fundoplication in the treatment of hiatal hernia complicated with gastroesophageal reflux disease (GERD). METHODS: Clinical data of 276 patients of hiatal hernia complicated with GERD undergoing operation in our hospital from December 2012 to January 2015 were retrospectively analyzed, including 149 patients of laparoscopic Nissen fundoplication (Nissen group), 41 of laparoscopic Toupet fundoplication (Toupet group), and 86 patients of laparoscopic Dor fundoplication (Dor group). Esophageal reflux status, esophageal manometry, GERD Q rating scale, and postoperative recovery were compare among the three groups. RESULTS: Reflux status was improved significantly in the three groups after operation(all P<0.05),except that the efficacy in reducing reflux episodes and reflux longest time was not obvious in Toupet group(P>0.05). There were no significant differences in postoperative reflux time, acid reflux time ratio, reflux longest time ratio, DeMeester score among the three groups (all P>0.05). Pairwise comparison showed that Dor group was significantly better than Toupet group in reducing the number of reflux episode(14.36±10.58 vs. 29.83±19.71) and long-reflux (0.64±0.21 vs. 6.20±3.48)(both P<0.05), but Nissen group was better than these two groups in reducing the number of long-reflux (0.38±0.16, P<0.05). As compared to pre-operation, the postoperative esophageal sphincter pressure and residual pressure increased significantly, and the relaxation rate reduced significantly (all P<0.05), while the episode of ineffective swallowing increased significantly in Toupet group (11.25±2.04 vs. 6.36±3.26, P<0.05). The contrast in esophageal manometry between Toupet and Dor group showed that Dor group was better than Toupet group in the recovery of lower esophageal sphincter pressure (mean resting breathing) [(20.69±13.95) mmHg vs.(12.91±6.89) mmHg] and the decrease of ineffective swallowing [9.15±6.44 vs. 11.25±2.04](both P<0.05), while such results of Dor group were similar to Nissen group[(19.87±10.40) mmHg, 6.15±2.95, all P>0.05]. The GERD Q scores were significantly decreased after operation in 3 groups(Nissen group:10.94±2.20 vs.7.41±1.43, t=11.667, P=0.001; Toupet group: 10.91±2.02 vs.7.18±1.33, t=5.109, P=0.005; Dor group: 10.69±1.69 vs. 7.10±1.30, t=7.610, P=0.002). There was no significant difference in GERD Q scores among three groups (F=1.465, P=0.207). The operative time, blood loss, hospital stay and complications were not significantly different among 3 groups (all P>0.05). Follow-up period was 12-51 months (median 19 months), and no significant difference in recurrence was found [Nissen group: 2 cases (1.3%), Toupet group: 1 case (2.4%), Dor group: 1 case (1.2%), χ2=0.363, P=0.834]. CONCLUSIONS: It is safe and feasible for these three laparoscopic fundoplications to the treatment of hiatal hernia complicated with GERD. But laparoscopic Nissen and Dor fundoplication are better than Toupet fundoplication in reducing the number of reflux episodes, suppressing long reflux, increasing lower esophageal sphincter pressure (mean resting respiration) and decreasing the incidence of postoperative dysphagia.

[Clinical study of argon plasma coagulation combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia with Barrett esophagus].

OBJECTIVE: To investigate the clinical efficacy of argon plasma coagulation (APC) combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia associated with Barrett esophagus. METHODS: A total of 61 cases of hiatal hernias with Barrett esophagus from June 2010 to January 2014 in the Department of Minimal Invasive Surgery, Hernia and Abdominal wall Surgery, People's Hospital of Xinjiang Uyhur Autonomous Region were prospectively enrolled and were randomly allocated into two groups by computer system. Twenty-nine patients received esomeprazole 40 mg/d after APC treatment for 8 weeks (APC with medicine group). Thirty-two patients underwent laparoscopic hiatal hernia repair and Nissen fundoplication after APC treatment (APC with surgery group). All the patients were reviewed by gastroscope and pathologic examination at half a year and one year after operation respectively. Differences of disease improvement and recurrence between the two groups were evaluated. RESULTS: In APC with medicine group, the Barrett's esophagus was relieved after one or two times of APC treatment, however, gastroscope and pathology revealed recurrence of Barrett's esophagus in 7 cases at half a year, and cumulative 16 cases of recurrences were detected after one year follow-up(16/29, 55.2%). In APC with surgery group, only one patient had recurrent Barrett's esophagus at half a year, and a total of two at one year follow-up by gastroscope examination(2/32, 6.3%). Significantly low recurrence rate of Barrett's esophagus was observed in APC with surgery group compared to APC with medicine group(P<0.01). Furthermore, recurrent hiatal hernia was detected in only one case in APC with surgery group. No esophageal cancer was found in both groups during follow-up. CONCLUSION: APC combined with laparoscopic hiatal hernia repair and fundoplication is an ideal method for patients with hiatal hernia and Barrett's esophagus.