OBJECTIVE: To explore the application of biological patches in tension-free inguinal hernia repair. METHODS: Totally 29 Chinese references and 1 English article regarding tension-free repair for inguinal hernia with biological patches were retrieved from 1999 to 2008. Then the retrieved information was summarized from clinical data, surgical results, complication, and recurrence rate to report the biological patches in tension-free inguinal hernia repair. RESULTS: The biological patch in tension-free inguinal hernia repair was characterized by little trauma, simple operation, rapid recovery and less complication with lower recurrence rate, especially obtained an excellent result in treating recurrent hernia. CONCLUSION: Tension-free repair for inguinal hernia with biological patches is an ideal operative method.

Objective To test the level of follicular helper T cells (Tfh) and interleukin (IL)-21,CXCL13 in the peripheral blood of patients with ankylosing spondylitis (AS),and to analyze the relationship between Tfh and clinic features and explore the possible immunological pathogenesis of AS.Methods The Tfh cells were obtained from patients and normal controls and detected by flow cytometry.While the levels of IL-21,CXCL13 in patients and normal controls were measured by enzyme-linked immunosorbent assay (ELISA) tests.Data analysis were performed by Student's t-test,Rank-sum test,Spearman's correlation test.Results The expression of CD4+CXCR5 qCOS + cells (Tfh) (mean rank 33.71) and IL-21 [(299±27) ng/L],CXCL13 [(5.8±1.0) μg/L] in the peripheral blood of AS was significantly higher than normal controls [mean rank 23.54,(176±26) ng/L,(4.2±0.8) μg/L] (Z=-2.258,t=17.221,t=6.464,all P＜0.05).It was similar in AS with peripheral joint involvement compared with AS of non-peripheral joint involvement,and there was no difference between AS patients with positive HLA-B27 and those without HLA-B27.Mean -while,no correlation was found between the expression of Tfh,IL-21,CXCL13 and level of ESR,CRP,BASDAI.And there was no significant correlation between the expression of Tfh and IL-21,CXCL13 (P＞0.05).Conclusion The expression of Tfh and the levels of IL-21,CXCL13 are increased significantly,but are not closely relatedto disease activity.These results indicate that the abnormality of Tfh may play an important role in the pathogenesis of AS.

BACKGROUND: Trabecular metal has been reported to provide enough physiologic support for new bone formation, to induce bone ingrowth and osseointegration so as to achieve the biological synosteosis; therefore, it is available for improving the initial and second stability of the dental implant.OBJECTIVE: To explore the stress distributional differences between porous tantalum trabecular metal (PTTM) dental implant and conventional titanium (TI) dental implant in the zone of mandibular premolar using three-dimensional finite element analysis.METHODS: Three-dimensional finite element models emulating PTTM and TI dental implants were established using Mimics16.0 and CATIA in the zone of mandibular premolar with three types of bone (II, III, IV). Then 100 N force was applied on the abutment at a 45° angle to the vertical axis of the implants in software of MSC Patran2010 and Nastran2010, then the representative von Mises stress nodes were calculated and sampled randomly, and finally the von Mises stress distributional differences between two types of implants were analyzed using SPSS 20.0 statistical software.RESULTS AND CONCLUSION: (1) The Von Mises stresses around the two types of implants both focused on the interface of the cortical bone-abutment-implant region, and the stress was relatively less for the corresponding trabecular bone. (2) If the bone quality was similar, the average von Mises stress of PTTM was higher than that of TI dental implants, but there was no significant difference (P > 0.05). As the bone density lowered (II-IV), the average Von Mises stresses were both increased, and the increasing rate of PTTM was higher than that of TI in bone of II-III, and was lower than that of TI in bone of III-IV. In this experiment, there were no significant stress distributional differences between PTTM and TI dental implant. However, with the bone density reduction, the increasing rate of average Von Mises stress for PTTM was lowered than that for TI dental implants in bone of III-IV, which suggests that PTTM dental implant may be more beneficial for the primary and secondary stability in osteoporosis patients undergoing dental implantation.

Objective To evaluate the influence of different cannulation technique in endoscopic retrograde cholangiopanereatography (ERCP) on success rate, risk of post-ERCP complication and operation time of the procedure. Methods The data of 120 patients who underwent ERCP from June 2000 to June 2008 because of biliary duct disorders were retrospectively studied. Conventional carmulation technique was applied in 60 patients and guide-wire eannulation was used in other 60. The success rate, total time of ERCP operation and the incidence of post-ERCP complications including acute pancreatitis and biliary system infec-tion within 7 days were assessed. Results Compared with conventional carmulation technique, selective can-nulation with a standard ERCP catheter under the assistance of guide-wire proved a higher success rate and a shorter operation time (P<0.05). Incidences of postoperative pancreatitis and infection with conventional cannulation were 10.0% (6/60) and 23.3% (14/60), respectively, while with guide-wire assisted cannu-lation were 3.3% (2/60) and 10.0% (6/60), respectively. No complication of bleeding was observed in either group. Conclusion Guide-wire assisted cannulation in ERCP can shorten operation time, improve success rate and reduce post-ERCP complications. Further evaluations are warranted.

To explore novel scopoletin derivatives with more potent antiproliferative activity, a series of compounds were designed and synthesized(10a-10i)by linking benzamide to scopoletin′s framework. Their structures were determined by ESI-MS, IR and 1H NMR. The antiproliferative activity of the synthetic derivatives against human cancer cells MCF-7, A549 and HCT-116 was evaluated by MTT assay. Preliminary experimental results showed that compound 10g was the most potent one, whose antiproliferative activity was stronger than that of the positive control scopoletin and sunitinib.

OBJECTIVETo analyze the genetic susceptibility of HLA-DQA1 allele to anaphylactoid purpura(AP)and its association with the clinical features in juvenile Hans residing in Inner Mongolia.

METHODSSeventy children with AP and ninety normal controls of Hans in Inner Mongolia were subjected to HLA-DQA1 genotyping with the use of polymerase chain reaction-sequence specific primer (PCR-SSP) technique.

RESULTS(1) The gene frequency of HLA-DQA1*0301 of AP group (33.4%) was significantly higher than that (10.6%) of control group (chi square=21.899, P<0.01). On the other hand, the gene frequencies of HLA-DQA1*0302 were 6.7% and 19% in the AP group and the control group respectively; a significant difference between them was seen (chi square=9.786, P<0.01); (2)The gene frequencies of both DQA1*0301 and DQA1*0302 in the cutaneous purpura simplex cases and the controls were not significantly different (P>0.05). The gene frequencies of DQA1*0301 of the cutaneous purpura cases associated with gastrointestinal, joint and renal impairment were 26.7%, 28.5% and 29.3% respectively, which were higher than that of the control group (10.6%); the differences were statistically significant (P<0.01, 0.01, 0.01; respectively). The gene frequencies of HLA-DQA1*0302(3.9%, 5.7% and 9.6%) for the cutaneous purpura cases associated with gastrointestinal, joint and renal impairment were significantly lower than that (19%) of the controls except renal impairment(P<0.01, 0.01, respectively).

CONCLUSIONThe allele of HLA-DQA1*0301 was probably a susceptible gene while HLA-DQA1*0302 was the protective one in AP of the children who were Han inhabitants in Inner Mongolia. The results of this study also revealed that patients with the allele of HLA-DQA1*0301 tended to involve gastrointestinal, joint and renal impairment.

Adolescent ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; Female ; Gastrointestinal Diseases ; complications ; genetics ; Gene Frequency ; Genetic Predisposition to Disease ; HLA-DQ Antigens ; genetics ; HLA-DQ alpha-Chains ; Humans ; Joint Diseases ; complications ; genetics ; Male ; Purpura, Schoenlein-Henoch ; complications ; genetics ; Renal Insufficiency ; complications ; genetics

Objective:To analyze the correlation between serum claudin-1(Cla-1) level and the risk of papillary thyroid carcinoma(PTC) in patients with thyroid nodules.Methods:The clinical data of 345 patients with thyroid nodules were retrospectively analyzed. According to the pathological results, they were divided into PTC group and benign thyroid nodule(BTN) group. The difference of serum Cla-1 level between 2 groups and its correlation with the risk of PTC were analyzed.Results:In groups of PTC( n=225) and BTN( n=120), the median value of serum Cla-1 level was 14.03(10.30, 20.40) ng/mL. The differences in the median value[17.90(14.00, 22.93)ng/mL vs 9.40(8.15, 11.20) ng/mL] of serum Cla-1 level in the PTC and BTN were statistically significant by Wilcoxon signed-rank test. The prevalence of PTC in thyroid nodules increased gradually with increasing of serum Cla-1 level. Receiver operated characteristic curve analysis showed that the best diagnostic cut-off value of the PTC was 13.02 ng/ml of which the sensitivity was 81.8%, the specificity was 89.2%, and the area under curve(AUC) was the largest(AUC=0.944, P<0.01, 95% CI 0.922-0.965). Logistic regression analysis showed that elevated serum Cla-1 level increased the risk of PTC, and it was statistically significant( OR=4.334, 95% CI 1.662-11.303, P=0.003). There was a significant correlation among the serum Cla-1 level and gender, age, location of involvement, number and diameter of cancer nodules, extracapsular invasion of thyroid, lymph node metastasis, tumor stage and combined with Hashimoto′s thyroiditis( P<0.01). Conclusion:The serum level of Cla-1 may be one of risk factors to predict PTC, and it is related to the total amount of PTC tumor cells in vivo, but it was not related to the aggressive behavior of tumor.

Objcetive: To explore the treatment of long segment defect of tibia by using tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap. Methods: From February 2012 to August 2017, The People′s Hospital of Zun Yi City Bo Zhou District treated 16 patients who had long segment defect of tibia.There were 11 males and 5 females, age from 22 to 58 years old, the average age was 42 years old. Iliac flap grafting with tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle was used to treat the defect of long segment of tibia. There were 4 cases with simple tibial defect and 12 cases with skin defect. The longest tibial defect was 5-8 cm. Results: In this study, four patients used iliac flaps with deep circumflex iliac pedicle, the area of flaps ranged from 2.5 cm×5.0 cm to 5.0 cm×10.0 cm, while the area of iliac flaps ranged from 5.0 cm×2.5 cm to 8.0 cm×4.0 cm. Twelve patients used grafting with tensor fascia lata combined with iliac flap, the area of flaps ranged from 5.0 cm×12.0 cm to 12.0 cm×23.0 cm, while the area of iliac flaps ranged from 7.0 cm×2.0 cm to 8.0 cm×4.0 cm. All 16 cases of bone flap were survived, fracture healing, without surgical complications. The average follow-up period was 1.5 years, the flaps had good appearance in 10 cases and was slightly bloated in 6 cases; the ankle had normal motion in 14 cases and had poor dorsal extension in 2 cases. X-ray films showed that the bone flap repaired the bone defects and reached bone healing. Conclusions Vascularized tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap grafts increase local blood supply and accelerate the process of fracture healing.