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.
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.
【 Abstract 】 Objective Overexpressions of epidermal growth factor (EGF) and EGF receptor have been associated with progression and invasive phenotype of pancreatic cancer. However, the underlying molecular mechanism by which EGF worked in pancreatic cancer cells has not been completely understood. In this study, effect of EGF on the invasion and metastasis of pancreatic cancer cells and its regulatory mechanism were investigated. Methods The effects of EGF on the proliferation, adhesion and invasion of pancreatic cancer cells were detected by WST-1 proliferation assay, adhesion assay and invasive assay, respectively. The activity and expression of MMP-2 and MMP-9 were examined by zymography, Western blot and RT-PCR, respectively. The activity of NF- κ B was examined by EMSA. Results EGF could significantly promote the invasiveness of pancreatic cancer cells but did not affect cell proliferation or adhesion. The expressions of NF- κ B and MMP-9 were significantly increased by EGF, but EGF did not affect the activity and expression of MMP-2. Furthermore, EGF stimulated the NF- κ B binding activity. Pretreatment with NF- κ B inhibitors, pyrrolidine dithiocarbamate (PDTC), could significantly inhibit the activity of NF- κ B induced by EGF. Meanwhile, the EGF-induced expression and activity of MMP-9, as well as cell invasiveness were also inhibited by NF- κ B inhibitor. Conclusion EGF could increase the expression and promote the invasiveness of MMP-9 via the activation of NF- κ B in pancreatic cancer cells, which implies that NF- κ B inhibitant, such as PDTC, may diminish the invasiveness of pancreatic cancer cells.
【Abstract】 Objective To explore the features of Ki-ras mutations at codon 12 in Chinese patients of pancreatic cancer and to compare these features with those in Western countries. Methods Fifty-nine samples were collected during operations for pancreatic adenocarcinoma in our hospital from December 1989 to November 1997. The patients, age ranged from 30 to 73 years 〔(55.5±10.4) years〕,with 38 males and 21 female. TNM staging of the patients: stage Ⅰ(n=4); stage Ⅱ(n=8), stage Ⅲ(n=42),stage Ⅳ(n=5). PCR was used to amplify target gene and Dot blot hybridization for detecting Ki-ras mutations at codon 12 was performed in fifty-nine specimens of Chinese pancreatic cancer. The data of Ki-ras mutations at codon 12 from Western countries were gotten by Medline system. Results Ki-ras mutation at codon 12 was detected in 76.3% of the patients in this group. The frequency of double mutation of Ki-ras at codon 12 in this group (15.6%) was highest than that in western countries. Our results were compared with those reported in Western countries. The results suggested that there were the significant differences in the substitution of Ki-ras mutations at codon 12 and in the ratio of transition to transversion in pancreatic cancer among various countries. Conclusion Ki-ras mutations at codon 12 is frequent in Chinese pancreatic cancer, and a gene component to pancreatic cancer may be different among various countries. In addition, the effect of Ki-ras mutations at codon 12 on prognosis of patients with pancreatic cancer is different in various countries.
In order to overcome the influence of stray light and impurity on the image of video laryngoscope, we designed an optical structure by using TracePro, a simulation software, to imitate optical path status. Images are captured by CMOS sensor which has the size of 4.5 mm×18 mm and the pixel size is 1.75 μm×1.75 μm. The sensor is placed in the elbow of the laryngoscope, and the elbow has the size of 9 mm×10 mm. As a result, the video laryngoscope could meet the requirements, including wide viewing angle (80°), short focal length (2.8 mm), long working distance (10 cm), and least impurity. In the test, the image was clear and there was no facula or impurity in the condition of required illumination, and thus stray light and image impurity were eliminated and the image quality was improved.