Objective To evaluate the laparoscopic repair for indirect inguinal hernia in children. Methods A total of 72 children with unilateral and 25 children with bilateral indirect inguinal hernia underwent laparoscopic high ligation of the sac. In operation a self-made needle introduced subperitoneally was used to pass a ligature circumferentially around the internal ring. Results All the operations were successfully completed. The average operating time was 10 min in unilateral hernias and 16 min in bilateral hernias. The postoperative hospital stay was 1 day. No surgical complications occurred. Follow-up for 2~60 months (mean, 31 months) in 70 children found no recurrence. Conclusions Laparoscopic repair for indirect inguinal hernia in children is safe, feasible and minimally invasive, offering a low complication and recurrence rate and a quick postoperative recovery.

BACKGROUND:There are many kinds of ways to obtain osteoblasts at present, but how to get high-purity osteoblasts in a easy and fast way has become a hot research.
OBJECTIVE:To explore a method to get massive and high purified osteoblasts effectively by comparing three common primary osteoblast culture methods, and to observe the biological characteristics of the osteoblasts from the skul of neonatal rabbit.
METHODCalvarias were dissected from newborn New Zealand white rabbits within 24 hours, and osteoblasts were isolated with bone tissue method, col agenase digestion method and modified tryptase and col agenase sequential digestion method respectively, then the cells were subcultured in vitro. Osteoblast proliferation and osteogenic activity were identified by inverted microscope for morphology observation. The rate of living osteobalsts was counted with trypan blue staining. The growth curve of the cells was drawn with MTT method. Alizarin red staining was applied to detect alkaline phosphatase and osteocalcin protein in the cellculture supernatants. Col agen I and col agen III immunohistochemical staining was also performed. RT-PCR was used to determine the expression of osteocalcin and col agen I mRNA expression.
RESULTS AND CONCLUSION:The cultured cells showed highly homogeneous appearance with active proliferation, and they had the typical features of osteoblasts. Alizarin red staining and col agen I immunohistochemical staining were both positive, while col agen III immunohistochemical staining was negative. Alkaline phosphatase and osteocalcin protein expression in the cellculture supernatants can be detected. The expression of osteocalcin and col agen I mRNA was positive in the RT-PCR test. Compared with col agenase digestion method, the modified tryptase and col agenase I sequential digestion method cost less time, presented higher production of osteoblasts and higher cellsurvival rate (P<0.05). Bone tissue method was the easiest method and did the least damage to osteoblasts, but it presented lowest production of osteoblasts and cost the maximum time among the three methods. So it cannot be used in large-scale osteoblast culture. A large quantity of high purity osteoblasts were obtained by modified trypsase and col agenase I sequential digestion method, which can be used as a reliable and efficient way to obtain the original generation osteoblasts in vitro.

Objective To study the value of sequential duodenoscopic-laparoscopic treatment in patients with cholelithiasis. Methods Clinical data of 2 248 cases of cholelithiasis treated with sequential duodenoscopic-laparoscopic plan from January 2000 to December 2004 were retrospectively reviewed. Results Duodenoscopy indicated the confirmative diagnosis of gallbladder stones in 1 817 cases and gallbladder stones with associated common bile duct stones in 431 cases. Among 2 021 cases diagnosed as having gallbladder stones by B-ultrasonography: endoscopic retrograde cholangiopancreatography (ERCP) was performed in 690 cases, 213 of which were found having associated common bile duct stones; intraoperative cholangiography (IOC) was conducted in 85 cases, 10 of which were found presenting common bile duct stones; residual stones in the common bile duct after laparoscopic cholecystectomy (LC) were noted in 6 cases which were cured by endoscopic sphincterotomy (EST). Among 227 cases diagnosed as having gallbladder stones combined with common bile duct stones by B-ultrasonography, the diagnosis of common bile duct stones were confirmed by ERCP in 202 cases. Out of the 2 248 cases, 1 817 cases underwent the LC, 395 cases received EST and LC, and 36 cases were given the laparoscopic bile duct exploration (LBDE) (the bile duct was closed by primary suture in 26 cases and a T-tube was left in the bile duct in 10 cases). The 6 cases of residual stones in the bile duct were cured with EST postoperatively. A total of 28 cases required a conversion to open surgery (1.2%), and complications occurred in 52 cases (2.3%). Conclusions Sequential duodenoscopic- laparoscopic treatment for cholelithiasis offers a low residual stone rate and a high success rate.

Objective To study the clinical application of laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOEST) with the antegrade guidewire technique in the treatment of cholecystocholedocholithiasis.Methods This is a prospective controlled study comparing LC combined with preoperative endoscopic sphincterotomy (POEST) versus LC combined with IOEST in the treatment of cholecystocholedocholithiasis.Patients who were diagnosed to have cholecystocholedocholithiasis from June 2012 to February 2013 in our hospital were divided into the POEST group and the IOEST group.There were 50 patients in each group.The operation time,successful stone-extraction rate,residual stones rate,complication rate,postoperative stay and hospitalization cost between the groups were compared.Results The sex,age,stone size,number of stones and diameter of the common bile duct showed no significant difference between the two groups (P ＞ 0.05).There were no differences between the two groups in surgical time of EST,surgical time of LC combined with EST,successful stone-extraction rate and hospitalization cost (P ＞ 0.05).There were significant differences between the two groups in the residual stones rate,postoperative hyperamylasemia rate,postoperative acute pancreatitis rate and postoperative stay (P ＜0.05).LC combined with IOEST using the antegrade insertion of guidewire technique significantly reduced the residual stones rate (0 vs 8％),postoperative hyperamylasemia rate (4％ vs 18％),postoperative acute pancreatitis rate (0 vs 8％) and postoperative stay.Conclusions LC combined with IOEST using the antegrade guidewire technique could be performed safely when compared with the traditional sequential technique,LC combined with IOEST using the antegrade guidewire technique significantly reduced the postoperative acute pancreatitis rate and the residual stones rate.LC combined with IOEST using the antegrade guidewire technique should be the recommended technique to treat patients with cholecystocholedocholithiasis.

Four phthalocyanines (iron tetracarboxylphthalocyanine, copper tetracarboxylphthalocyanine, manganese tetracarboxylphthalocyanine, cobalt tetracarboxylphthalocyanine) were used as dual functional mimic enzymes of superoxide dismutase (SOD) and catalase (CAT). The first function, eliminating O2－, was proved by using riboflavine-methionine photoreduction method in the concentration range of 10－5 to 10－6 mol/L. The second function, clearing out H2O2, was demonstrated by means of spectrophotometry with the decomposing percentage being increased with the increase of the concentration of the imitating compounds. Measurements of metal phthalocyanines, SOD and CAT by the liver homogenate technique of mice showed that they had obvious action of decreasing the lipid peroxidation.

Four phthalocyanines (iron tetracarboxylphthalocyanine, copper tetracarboxylphthalocyanine, manganese tetracarboxylphthalocyanine, cobalt tetracarboxylphthalocyanine) were used as dual functional mimic enzymes of superoxide dismutase (SOD) and catalase (CAT). The first function, eliminating O2－, was proved by using riboflavine-methionine photoreduction method in the concentration range of 10－5 to 10－6 mol/L. The second function, clearing out H2O2, was demonstrated by means of spectrophotometry with the decomposing percentage being increased with the increase of the concentration of the imitating compounds. Measurements of metal phthalocyanines, SOD and CAT by the liver homogenate technique of mice showed that they had obvious action of decreasing the lipid peroxidation.

Objective To summarize the complications and their incidences following Anterior Subcutaneous Internal Pelvic Fixation(ASIPF).Methods A comprehensive search was conducted of PubMed Library,Cochrane Library,Web of Science,SinoMed,Wanfang Data and China National Knowledge Internet for all articles addressing the postoperative complications of ASIPF published in English and Chinese from January 2009 to November 2018.A proportion Meta-analysis across the studies was performed for the complications after ASIPF (lateral femoral cutaneous nerve irritation,femoral nerve palsy,heterotopic ossification,infection and implant failure) using R software.Results This meta-analysis included 29 clinical studies involving a total of 825 patients.The complications following ASIPF were lateral femoral cutaneous nerve irritation,femoral nerve palsy,heterotopic ossification,infection and implant failure;their incidences were respectively 12％ (95％ CI:from 7％ to 19％),3％ (95％ CI:from 2％ to 4％),30％ (95％ CI:from 22％ to 39％),4％ (95％ CI:from 3％ to 6％) and 4％ (95％ CI:from 3％ to 6％).Conclusions Lateral femoral cutaneous nerve irritation and heterotopic ossification are common complications following minimally invasive internal fixation for anterior pelvic ring injury.High-quality clinical research is needed into the factors leading to the complications and into their preventive countermeasures.

The use of antibiotics in dental implantology is very common and the abuse of antibiotics is increasingly obvious. The rational use of antibiotics in the process of oral implantology needs the support of evidence based medicine. The prophylactic use of antibiotics in dental implantology is reviewed in this article, including the summary of different infection risks, such as peri-implantitis and maxillary sinusitis after maxillary sinus floor lifting.

Objective: To analyze the clinicopathological features of type 2 diabetes mellitus complicated with colorectal cancer (DCRC). Methods: A case-control study was conducted. Inclusion criteria: (1) hospitalized patients receiving fibrocolonoscopy; (2) adenocarcinoma and mucinous adenocarcinoma diagnosed by pathology; (3) with preoperative cTNM clinical staging; (4) colorectal cancer patients undergoing surgical treatment; (5) with postoperative pTNM staging; (6) no smoking or drinking habits. Exclusion criteria: (1) familial adenomatous polyposis (FAP); (2) Lynch syndrome; (3) carcinoma of anal canal and perianal carcinoma; (4) multiple primary cancer; (5) with serious cardiocerebrovascular diseases or multiple organ failure. Clinicopathlogical data of 32 DCRC patients who were diagnosed and treated in Peking University Shougang Hospital from December 2017 to December 2018 were retrospectively collected and analyzed. Forty nondiabetic colorectal cancer (CRC) patients during the same period were selected as control group according to the sex ratio and the age difference less than 5 years. Student′s t test and χ² test were used to compare the difference between the two groups in baseline clinicopathological data, clinical test results, tumor markers and infiltration status of T cells in tumor immune microenvironment. Results: Among 32 DCRC patients, 24 were males and 8 were females with a mean age of (63.0±1.7) years; among 40 CRC patients, 30 were males and 10 were females with a mean age of (60.5±1.6) years. The duration of diabetes mellitus in DCRC patients (from the diagnosis of diabetes mellitus to the diagnosis of colorectal cancer) was (9.2±1.3) years. The body mass index (BMI) of DCRC group was significantly higher than that of CRC group [(24.8±0.6) kg/m² vs. (23.2±0.4) kg/m², t=2.372, P=0.020]. There were no significant differences in other baseline data (sex, age, primary site of tumor, R0 resection rate, pathological stage, pathological type, differentiation degree of tumor, preoperative intestinal obstruction) between the two groups (all P>0.05). Serum triglyceride level in DCRC group was higher than that in CRC group [(2.1±0.2) mmol/L vs. (1.5±0.1) mmol/L, t=3.085, P=0.003], while hemoglobin [(120.3±5.2) g/L vs. (132.7±2.8) g/L, t=-2.224, P=0.029], anti- thrombin III [(94.2±3.7)% vs. (103.5±2.4)%, t=-2.197, P=0.031], and red blood cell count [(4.2±0.1)×10¹²/L vs. (4.5±0.1)×10¹²L, t=-2.055, P=0.044] were all lower than those in CRC group. The preoperative carcinoembryonic antigen (CEA) level in DCRC group was higher than that in CRC group [(50.3±21.8) μg/L vs. (5.6±1.0) μg/L, t=2.339, P=0.022]. There were no significant differences in preoperative levels of other four tumor molecular markers (CA199, CA242, CA724 and CA125) between the two groups (all P>0.05). The expression of Foxp3 [specific markers of CD4+, CD25+ regulatory T cells (Treg)] in DCRC group was higher than that in CRC group [(82.7±6.2) cell/HPF vs. (62.6±4.9) cell/HPF, t=2.586, P=0.012]. There were no significant differences in the infiltration of CD4, CD8, PD-1 and PD-L1 positive cells between two groups (all P>0.05). Conclusions The average diabetic history of DCRC patients is nearly 10 years. They have higher BMI and serum CEA level, and more Treg cell infiltration in the tumor. Close attention should be paid to these patients in clinical practice.