Objective To evaluate the effectiveness of inguinal hernia treated by tension-free hernioplasty in adult. Methods Electronic databases were searched including CNKI (1993 to 2003), MEDLINE (1993 to 2003) and OVID (1993 to 2003). Personal contact with experts in the field of tension-free hernioplasty was performed to identify potentially relevant trials. Randomized controlled trials of plug amp; Mesh versus Mesh only repair and laparoscopic versus open Mesh hernia repair in recurrence, peri-operative complication or long term postoperative complication were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan 4.2 software. Results Twenty one studies involving 4 154 patients met the inclusion criteria from 1993 to 2003. Compared with Mesh only repair, plug amp; Mesh repair had no significant difference in recurrence rate (OR 1.14, 95%CI 0.37 to 3.47, P=0.82), preoperative complication rate (OR 1.01, 95%CI 0.63 to 1.63, P=0.95) and long term postoperative complication rate (OR 0.46, 95%CI 0.18 to 1.16, P=0.1). Compared with open Mesh hernioplasty, transabdominal preperitoreal repair (TAPP) group had no significant difference in recurrence rate (OR1.24, 95%CI 0.65 to 2.36, P=0.52), preoperative complication rate (OR 0.89, 95%CI 0.65 to 1.22, P=0.46) and persistent pain (OR 0.76, 95%CI 0.48 to 1.19, P=0.22); totally extrapevitoreal repair (TEP) group had no significant difference in recurrence rate (OR1.07, 95%CI 0.51 to 2.24, P=0.70) or persistent pain (OR 0.95, 95%CI 0.55 to 1.65, P=0.86), and had lower tendency persistent pain (OR 0.50, 95%CI 0.34 to 0.73, P=0.000 4) with statistical significance. Conclusion Current evidence suggests that there is no significant difference between anterior approach plug amp; Mesh repair (Rutkow’s repair) and the Mesh only repair (Lichtenstein’s repair). TEP of Laparoscopic hernioplasty is superior to open Mesh hernia repair in preoperative complication. More researches are needed for recurrence rate, persistent pain.
【Abstract】Objective To investigate the effects of human growth hormone (GH) on colonic cancer cells to provide experimental evidence about the GH safety in colonic cancer therapy. Methods The nude mouse model of colonic carcinoma induced with SW480 cell line was established to observe the effects of GH on the transplanted carcinoma. GH and 5-FU were administered to SW480 cells cultured in vitro to observe the cell growth with MTT method. Results The volume, average diameter and weight of the transplanted carcinoma in GH group were significantly higher than those in control group（P＜0.05）. In vitro, the value of A in GH group was significantly higher than control group （P＜0.01), but the value of A in 5-FU+GH group was lower than control group（P＜0.01）. Conclusion GH can promote colonic cancer cell growth; GH combined with cell cycle specific chemotherapeutic drugs is safe in colonic cancer therapy and may be used as a promoter of chemotherapy.
ObjectiveTo detect the expression of microRNA-497(miR-497) in gastric cancer and its biological significance, and to find out its regulatory links with other genes and investigate the effect of miR-497 overexpression interference on chemotherapy sensitivity of gastric cancer cell line. MethodsNinety-four gastric cancer tissues and adjacent to cancer tissues from 2010 to 2013 in this hospital were collected. The expression of miR-497 in the gastric cancer tissue or adjacent to cancer tissue was detected by real-time PCR. SGC-7901 cell line was transfected by miR-497-negative control and miR-497-mimics, respectively. The BCL2L2 expression was measured by Western blot after upregulation of miR-497. The chemotherapy sensitivity of cell line was tested by MTT assay. Results①The expression of miR-497 was significantly downregulated in the gastric cancer tissues as compared with the adjacent to cancer tissues (P < 0.01). 2 BCL2L2 was predicted to target gene of miR-497. after miR-497 overexpression in cells, the expression of BCL2L2 protein was decreased in the miR-497-mimics cells as compared with negative control cells. The IC50 in the miR-497-mimics cells was significantly lower than that in the negative control cells(P=0.004 6). ConclusionsmiR-497 expression is frequently downregulated in gastric cancer tissue. Overexpression of miR-497 could inhibit the expression of target gene BCL2L2, and improve chemotherapy sensitivity of gastric cancer cell line, which implies that miR-497 may play an important role in carcinogenesis and therapy of gastric cancer.
目的 探讨十二指肠腺瘤并大出血的诊断和治疗。方法 对2例十二指肠腺瘤并大出血患者进行回顾性分析，并结合文献进行讨论。结果 2例术前均行X线气钡双重造影、胃镜及肿块活检，但未确诊。2例均行十二指肠切开、肿瘤切除术而痊愈。结论 十二指肠腺瘤早期多无临床症状，随着肿瘤的增大可并发肠梗阻或肿瘤溃疡出血而出现相应症状； X线钡餐和胃镜可发现肿瘤，但难于确诊，经内窥镜或十二指肠切开、肿瘤切除术是治疗本病的常用方法。
ObjectiveTo evaluate the clinical manifestation, diagnosis, and treatment of intrahepatic biliary cystadenoma (IBCA). MethodsThe clinical date of 12 patients with IBCA from January 2004 to December 2013 in our hospital were retrospectively analyzed. ResultsOf the total 10 patients were female and 2 were male. The average age was 49.0 years old (16-77 49.0 years old). The course of disease were 1 month-3years (average:7 months). The clinical symptoms were right upper abdominal fullness with a sense of pain in 6 patients, right upper abdominal mass in 1 case, jaundice in 1 case, and no symptoms in 4 cases. Enhanced CT examination showed that the tumor complete capsule and there were internal septations in 11 cases, the density of internal septations was different. There was mild enhancement of cyst wall and internal septations in 9 cases. All of 12 cases received surgical resection. Only 1 case showed recurrence in 2 years after operation, the remaining 11 patients had no recurrence. ConclusionsIBCA often occurs in middle-aged women. The main clinical symptoms are abdominal fullness with a sense of pain, right upper abdominal mass or jaundice. Enhanced CT is the main method of diagnosis before operation. Radical resection of IBCA is the best treatment, and can prevent recurrence effectively.
Objective To assess clinical outcomes of hand assisted laparoscopic right hemicolectomy (HALC) and standard laparoscopic right hemicolectomy (SLC). Methods The databases of Wanfang, CNKI, VIP, CBM, PubMed, Embase, and Cochrane Central Register of Controlled Trials were electronically searched. The relevant literatures were selected according to the inclusion and exclusion criteria. The Cochrane collaboration tool for assessing risk of bias was used to assess the quality of randomized controlled trials and the Newcastle-Ottawa Scale was used to assess non-randomized comparative studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 9 studies were included and involved 976 patients (480 patients in the HALC group and 496 patients in the SLC group). The results of meta-analysis showed that the HALC group was favor of shorter operative time as compared with the SLC group (P<0.05), but the length of incision and hospital stay were longer in the HALC group (P<0.05). There were no statistically significant differences between these two groups regarding as the conversion rate, time to return of bowel function, feeding time, reoperative rate during hospitalization, postoperative complications rate, and harvested lymph node number (P>0.05). As for the follow-up results, the 3-year survival rate was about 90%, and 5-year survival rate was about 80%, and there were no statistical differences in terms of recurrence rate and mortality between the HALC group and the SLC group (P>0.05). Conclusions Both HALC and SLC could achieve satisfactory minimal invasive outcomes and oncologic radical effects, and HALC has an advantage of shorter operative time, yet length of incision and hospital stay are longer than SLC. Therefore, HALC could be considered as an alternative to minimal invasive right hemicolectomy.
ObjectiveTo discuss the main auxiliary inspection methods and their guiding significance for inguinal hernia.MethodsBy searching literatures and international guidelines, to review the main auxiliary examination methods, such as ultrasound, CT, and MRI.ResultsClinical physical examination combined with ultrasound could increase diagnostic sensitivity. CT could provide surgeons with a better sense of wholeness and structural details, and could be used as a guide for specific types of inguinal hernia. The soft tissue recognition of MRI was good, and it had a good effect on the identification of hidden hernia, mesh conditions, and tissue inflammation.ConclusionEach examination has its own advantages, and should be selected based on clinical practice and medical center conditions.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
ObjectiveTo summarize the applications of Schwann cells (SCs), stem cells, and genetically modified cells (GMCs) in repair of peripheral nerve defects. MethodsThe literature of original experimental study and clinical research related with SCs, stem cells, and GMCs was reviewed and analyzed. ResultsSCs play a key role in repair of peripheral nerve defects; the stem cells can be induced to differentiate into SCs, which can be implanted into nerve conduits to promote the repair of peripheral nerve defect; genetically modified technology can enhance the function of SCs and different stem cells, which has been regarded as a new option for tissue engineered nerve. ConclusionAlthough great progress has been made in tissue engineered nerve recently, mostly limited to the experimental stage. The research of seed cells in application of tissue engineered nerve need be studied deeply.