Objective To investigate the value of Kugel patch for elderly patients with recurrent inguinal hernia.Methods From February 2004 to February 2007,37 elderly patients with recurrent inguinal hernia received surgical treatment in our hospital.The patients were divided into two groups according to the surgical methods.Twenty-one patients,including 17 cases of unilateral indirect inguinal hernia,1 bilateral indirect hernia,1 direct hernia,1 indirect hernia complicated with femoral hernia,and 1 indirect hernia complicated with direct hernia,received hernia repair with Kugel patch via the posterior approach.The other 16 patients,including 15 cases of unilateral indirect hernia and 1 case of direct hernia,were treated with TAPP.Results The operation time in the Kugel group was significantly shorter than that in the TAPP group [(23.2?5.8) min vs(40.5?5.2) min,t=-9.392,P=0.000].In the TAPP group,2 patients complained of surgical-site pain or tension,while no patient in the Kugel group had the symptoms(?2=0.869,P=0.351).The mean hospital stay in the Kugel group was shorter than that in the TAPP group [(5.7?0.7)d vs(6.3?0.8) d;t=-2.429,P=0.020].The patients were followed up for 3-36 months,none of them had recurrence.Conclusions As an new,non-tension,safe,and minimally invasive method,hernia repair using Kugel patch through the posterior approach is of great advantage to elderly patients.The method is worth being used widely.

Objective To explore and evaluate the feasibility and accuracy of applying decision tree methods to predict the risk of hospital-acquired pressure ulcers (HAPUs) in intensive care upit (ICU) patients,and provide a theoretical basis for the prevention of HAPUs in clinical practice.Methods A retrospective design was used to collect 468 patients' records,and all of the patients were hospitalized in ICUs including medical intensive care unit and coronary care unit between October 2011 and October 2013 in a 3 A grade hospital in Guangzhou.The CART algorithm was used to construct the decision tree risk prediction model.The area under the receiver operating curve (AUC),sensitivity and specificity were used to evaluate the predictive validity of the decision tree model compared with the Braden Scale.Results The decision tree model had four stratums and eleven nodes.Six classification rules and three styles of high-risk populations were screened out:(1)age ＞81;(2)age ≤81 combined with fecal incontinence;(3)age ≤81 combined with total Braden score ≤ 13 and diastolic blood pressure ＜ 60mmHg (1 mmHg=0.133 kPa).The AUC of the decision tree model was significantly higher than the Braden Score (Z=2.31,P ＜ 0.05).The sensitivity and specificity of the decision tree model (0.809 and 0.703) were higher than the Braden Score (0.777 and 0.587).Conclusions The decision tree model is an easy and feasible tool to predict the risk of HAPUs in ICU patients,and it can be used to screen high-risk populations.

Sugarcane molasses containing large amounts of sucrose is an economical substrate for succinic acid production. However, Escherichia coli AFP111 cannot metabolize sucrose although it is a promising candidate for succinic acid production. To achieve sucrose utilizing ability, we cloned and expressed cscBKA genes encoding sucrose permease, fructokinase and invertase of non-PTS sucrose-utilization system from E. coli W in E. coli AFP111 to generate a recombinant strain AFP111/pMD19T-cscBKA. After 72 h of anaerobic fermentation of the recombinant in serum bottles, 20 g/L sucrose was consumed and 12 g/L succinic acid was produced. During dual-phase fermentation comprised of initial aerobic growth phase followed by anaerobic fermentation phase, the concentration of succinic acid from sucrose and sugarcane molasses was 34 g/L and 30 g/L, respectively, at 30 h of anaerobic phase in a 3 L fermentor. The results show that the introduction of non-PTS sucrose-utilization system has sucrose-metabolizing capability for cell growth and succinic acid production, and can use cheap sugarcane molasses to produce succinic acid.
Bioreactors ; Escherichia coli ; genetics ; metabolism ; Escherichia coli Proteins ; genetics ; Fermentation ; Membrane Transport Proteins ; genetics ; Metabolic Engineering ; Molasses ; Saccharum ; chemistry ; Succinic Acid ; chemistry ; Sucrose ; chemistry

Objective To explore the risk factors of ulcerative colitis-associated colorectal cancer (UC-CRC).Methods The retrospective case-control study was conducted.The clinicopathological data of 536 patients with ulcerative colitis (UC) who were admitted to the Henan Tumor Hospital from March 2004 to June 2015 were collected.Observation indicators:(1) follow-up results:cases with follow-up,follow-up time,cases of UC-CRC,age of onset,pathological type of UC-CRC;(2) risk factors analysis affecting occurrence of UC-CRC:gender,age of onset,course of disease,severity of disease,disease classification,extent of lesion,smoking history,family history of colorectal cancer,anemia,hypoproteinemia,body weight loss,extraintestinal manifestations,colonic polyps,backwash ileitis,atypical hyperplasia,anxiety or depression,treatment method and regular endoscopy reexamination.Follow-up using outpatient examination and telephone interview was performed to detect prognosis of patients up to April 2017.Patients underwent colonoscopy once every 6 months within 3 years after diagnosis and once every 1 year after 3 years.Measurement data with skewed distribution were described as M (range).The univariate analysis was done using the chi-square test and Fisher exact probability.The multivariate analysis was done using the Logistic regression model.Results (1) Follow-up results:of 536 patients,450 were followed up for 26.0-120.0 months,with a median time of 76.4 months.During the follow-up,16 patients were complicated with UC-CRC,including 9 males and 7 females.Age of onset of colorectal cancer was 14-78 years,with an average age of onset of 44 years.Pathological type:high-differentiated right colon adenocarcinoma was detected in 5 patients,high-and moderate-differentiated left colon adenocarcinoma in 3 patients,left colon signetring cell carcinoma in 2 patients,moderate-differentiated rectal tubular adenocarcinoma in 3 patients,highdifferentiated rectal papillary adenocarcinoma in 2 patients and malignant lymphoma in 1 patient.(2) Risk factors analysis affecting occurrence of UC-CRC:the results of univariate analysis showed that course of disease,extent of lesion,colonic polyps and atypical hyperplasia were risk factors affecting occurrence of UC-CRC (x2 =14.848,18.885,10.554,P＜0.05).The results of multivariate analysis showed that course of disease ＞ 10 years,lesion involving the whole colon,colonic polyps and atypical hyperplasia were independent risk factors affecting occurrence of UC-CRC (OR=12.893,17.847,7.326,19.742,95％ confidence interval:1.726-74.337,1.445-89.793,1.263-43.128,3.625-96.524,P＜0.05).Conclusion The course of disease ＞ 10 years,lesion involving the whole colon,atypical hyperplasia and colonic polyps are independent risk factors affecting occurrence of UC-CRC.

Objective To test the Footscan system for guiding the postoperative rehabilitation of calcaneus fractures.Methods Sixty patients with unilateral calcaneus fracture were divided randomly into a rehabilitation group and a control group.Patients in both groups began a routine of functional rehabilitation training 24 h after a reduction and fixation operation.The patients in the rehabilitation group received individualized rehabilitation protocols based on regular dynamic evaluation of their plantar pressure using the Footscan system.Those in the control group were administered routine rehabilitation training without the personal modifications.At the 2nd and 7th month postoperation,the dynamic plantar pressure of both groups was evaluated and the functioning of their feet Was scored.Results At the 2nd month post-operation,there was no significant difference between the two groups in terms of subtalar ioint range of motion,the lateral deviation of pressure center,the time of heel touch with the ground,the maximum pressure at the lateral aspect of the calcaneus and impulsive force during walking.The functional evaluation scores were also not significantly different.At the 7th month post-operation,all the indices in both groups had improved significantly over the 2nd month,bulthe improvement in the rehabilitation group Was greater(except the time of heel touch with the ground).Conclusion The Footscan system can be a valuable tool for evaluating patients with calcaneus fracture and serve as a reference for planning rehabilitation interventions for such patients.

Objective To evaluate a novel lymph node (LN) sorting method on surgical resected sample guided by nanometer carbon staining and principle following the supplying artery tributory in rightsided colon carcinoma.Methods From May 2015 to June 2016,51 patients were randomly divided into two groups adopting traditional LN sorting method and that of a combination of nanometer carbon and artery guided.The final LN status were compared between the 2 groups.Results The total LN number and the positive LN in novel method group were higher than control group (437 vs.349,70 vs.54).The dissection time used,the number of harvested positive LN that was ＜ 5 mm were significantly different [(13.1 ± 3.2) minvs.(17.8 ±3.8)min,t=4.75,P=0.000;1.0±l.0vs.0.2 ±0.6,t=3.51,P=0.000].The number of patients with harvested LN less than 12,the rate of positive lymph nodes,the rate of metastasis were not significantly different (all P ＞ 0.05) between the two groups.Conclusions Use of nanometer carbon development combined with artery approach facilitates LN sorting,yielding more positive LNs,and increating the accuracy of pathological staging in right-sided colon cancer.

Objective To develop a human Tim-3 specific monoclonal antibody and evaluate its biological activity and possible use in clinical diseases associated with dysregulated Tim-3 expression .Methods The BALB/c mice were immu-nized by conventional method, and positive clones were used to develop anti-human Tim-3 antibody, the binding and neutralization activities of which in vitro and in vivo were investigated.Results ①A monoclonal antibody (clone L3D) which could specifically bind to human Tim-3 protein in ELISA assay was obtained and the subtype of the monoclonal antibody was IgG2a .②Flow cytometry indicated that the monoclonal antibody could bind to Tim-3 expressed in human U937 cells.This antibody also showed a cross activity to mice′Tim-3.③The monoclonal antibody inhibited the apoptosis of THP1 cells induced by Gal-9, the ligand of Tim-3.④Injection of Tim-3 antibody exacerbated sepsis in mice as marked by the decreased survival rate and increased expression of pro-inflammatory cytokines .Conclusion An anti-human Tim-3 monoclonal antibody is successfully obtained.The excellent binding and neutralization activities of this antibody enable it to be widely used in clinical diseases associated with deregulated Tim-3 expression .

OBJECTIVETo explore the application of three-stitch preventive transverse colostomy in anterior resection of low rectal cancer.

METHODFrom May 2015 to March 2016, 70 consecutive low rectal cancer patients undergoing anterior resection and preventive transverse colostomy in our department were recruited in this prospective study. According to the random number table method, 70 patients were divided into three-stitch transverse colostomy group(observation group, n=35) and traditional transverse colostomy group(control group, n=35). Procedure of three-stitch preventive transverse colostomy was as follows: firstly, at the upper 1/3 incision 0.5-1.0 cm distance from the skin, 7# silk was used to suture from outside to inside, then the needle belt line went through the transverse edge of the mesangial avascular zone. At the lower 1/3 incision 0.5-1.0 cm distance from the skin, 7# silk was used to suture from inside to outside, then silk went through the transverse edge of the mesangial avascular zone again and was ligatured. Finally, in the upper and lower ends of the stoma, 7# silk was used to suture and fix transverse seromuscular layer and the skin. The operation time and morbidity of postoperative complications associated with colostomy were compared between two groups.

RESULTSThere were no significant differences in baseline data between the two groups(all P>0.05). The operative time of observation group was shorter than that of control group [(3.2±1.3) min vs. (15.5±3.4) min, P<0.05]. Incidences of colostomy skin-mucous separation, dermatitis, stoma rebound were significantly lower in observation group [5.7%(2/35) vs. 34.3%(12/35), P=0.007; 8.6%(3/35) vs. 31.4%(11/35), P=0.036; 0 vs. 17.1%(6/35), P=0.025, respectively], while incidences of parastomal hernia and stoma prolapse in two groups were similar (both P>0.05).

CONCLUSIONCompared with traditional transverse colostomy method, the three-stitch preventive transverse colostomy has more operating advantages and can reduce postoperative complications associated with colostomy.

Colostomy ; adverse effects ; methods ; Comparative Effectiveness Research ; Humans ; Operative Time ; Postoperative Complications ; epidemiology ; Prospective Studies ; Rectal Neoplasms ; surgery ; Surgical Stomas ; adverse effects ; Suture Techniques ; adverse effects ; instrumentation ; Sutures ; Treatment Outcome

This research work was aimed to improve the performance of magnetic induction tomography (MIT) system by designing a high-performance excitation source and the optimal excitation coil. A new type excitation source with adjustable output was designed, and then the power circuit was simulated by the software ICPA. Focused and solenoid coils were designed in accordance with the design principle of coil, then the optimal excitation coil was proved by measuring the magnetic field distribution and the experimentation of phase detection using neuron cell models. At the stated excitation frequency, the parameters of the excitation source are output power 0.035 W-31.4 W, steady output peak current over 1 A, frequency stability 10(-9), and THD amplitude less than -51dB. When compared with other coils, the focused discal excitation coil is most effective for phase detection with the use of neuron cell models. The excitation source can produce the stated frequency sine wave with higher frequency stability, lower THD and wider adjustable output power. The phase difference between normal cell model and edema cell model was more significant by measurement using focused discal coil.
Brain ; physiology ; Electronics, Medical ; instrumentation ; Equipment Design ; Humans ; Image Processing, Computer-Assisted ; Magnetics ; instrumentation ; Tomography ; methods

OBJECTIVETo explore the technical advantages of nano carbon development combined with artery approach in lymph node sorting of rectal cancer.

METHODSFrom December 2015 to June 2016, 70 patients with of rectal cancer in General Surgery Department of Henan Cancer Hospital were randomly divided into nano carbon development combined with artery approach group(artery approach group) and conventional group. Specimen of artery approach group was placed on the sorting table. Anatomy was performed from the root of inferior mesenteric artery to left colonic artery, sigmoid artery and superior rectal artery. Along the arterial vessel shape, the black-stained lymph nodes and non-stained lymph nodes (perhaps pink, pale yellow, white or pale brown) were examined carefully using visual and haptic combination method for identification of lymph node. From the root of inferior mesenteric artery, central lymph nodes were sorted. Along the vessel shape, vascular lymph nodes were sorted. Intestinal lymph nodes around the rectum were examined as well. Then, specimen was reversed on the sorting table and underwent sorting as above after the examination of obverse. The conventional group received routine method. The total number, the average harvested number, the number of positive lymph nodes and the number of patients with lymph nodes less than 12 were compared between two groups.

RESULTSAmong 70 cases, 37 were male and 33 were female with the median age of 57(32-88) years old. Dixon resection was performed in 46 cases, and Miles resection in 24 cases. Total sorting lymph node was 1 105, including 641 of artery approach group and 464 of control group with significant difference (t=20.717, P=0.000). Lymph node sorting time of artery approach group was (12.6±3.9) minutes, which was shorter than (18.2±4.1) minutes of control group (t=12.464, P=0.000). In artery approach group, number of lymph node with diameter less than 5 mm was 142, sorting rate was 22.2%(142/641), of which 29 were positive(20.4%). In conventional group, 37 lymph nodes with diameter less than 5 mm were found, and sorting rate was 8.0%(37/464), of which 6 were positive(16.2%). Number of the first station of lymph node sorting in artery approach group and conventional group was 282(44%) and 169(36.4%); number of the second station lymph node sorting was 230(35.9%) and 180(38.8%); number of the third station lymph node sorting was 129(20.1%) and 115(24.8%).

CONCLUSIONThe method of nano carbon development combined with artery approach in lymph node sorting of rectal cancer has some advantages, such as simple operation, more harvested lymph nodes, and more accurate pathological staging.