Female ; Hernia, Inguinal ; etiology ; pathology ; surgery ; Humans ; Male ; Risk Factors

Laparoscopic and robotic techniques change the view of groin anatomy from inside to outside.The amplification view of laparoscopy extends surgeons' visual field,with clear and precise anatomy,less bleeding and certain outcome.Robotic flexible joints increase angle of suture to abdominal wall.In this background,hernia surgeons pay close attention to closure of abdominal wall defect,choice and fix of mesh as well as status of robotic technique in hernia filed.

Many specific therapeutic antibody drugs have been developed for different indications. In drug development, it has been found that the antibody isotype framework can not only affect the physical and chemical properties of therapeutic antibodies, but also influence the activity and therapeutic effect. As a result, IgG isotype selection should be considered carefully in antibody drug development strategies. Because of the unique biological characteristics, IgG4 isotype has been used in some therapeutic antibodies for which effector functions are not desired. In order to provide new ideas for the development of antibody drugs, the research and application progress of IgG4 isotype in therapeutic antibody drug development has been reviewed.
Drug Design ; Humans ; Immunoglobulin G ; chemistry ; pharmacology

Objective To investigate the short-term treatment effectiveness of the auditory integrative training(AIT) on intelligence, language and gross motor function in children with spastic cerebral palsy (CP).Methods Sixty patients with spastic CP, aged 2 to 4 years old,who had been given all the routine conventional rehabilitation at the Rehabilitation Department of the People's Hospital of Guangxi Zhuang Autonomous Region from January 2011 to December 2013 were randomly divided into AIT treatment group (30 cases) and control group without AIT (30 cases), all patients were investigated by using Gesell Developmental Scales and the Gross Motor Function Measure (GMFM)-66 before and after 3-month therapy, and the changes in the regional cerebral blood flow of children (rCBF) were detected by single photon emission computed tomography (SPECT) before and after treatment.Results The scores of development quotient (DQ) of the treatment group after the AIT in areas of adaptive behavior, personal-social behavior,language(52.44 ± 13.43,52.07 ± 11.57,57.19 ± 6.18) were higher than those of the control group (45.09 ± 11.02,45.86 ± 9.66,53.44 ± 5.49), and the differences between the 2 groups were greatly significant statistically(t =-2.32,-2.26,-2.49, all P ＜ 0.05).There were no significant difference in DQ of gross motor, fine motor and scores on the GMFM-66 in the treatment group before and after treatment [40.40 ± 8.57,49.50 ± 14.20, (55.81 ±8.72) scores vs 44.03 ±11.90,46.34±9.78,(58.81 ±7.86) scores,t=-1.42,1.08,-0.52,all P＞ 0.05].SPECT detected abnormalities in all patients (100.00％) both in the 2 groups, compared with the control group,the rCBF was improved significantly after treatment in the treatment group (86.67％) (x2 =35.49 ,P ＜ 0.05).Conclusions The treatment of AIT can greatly improve the intelligence, language development and the brain function in children with spastic CP.It is an effective adjutant of rehabilitation method for children with spastic CP to improve intelligence and language development, and has less influence on motor function.

Objective To study the efficacy and toxicity of standard CEOP regimen in elderly patients with non-Hodgkin's lymphoma (NHL).Methods The study included 34 previously untreated patients,age 60 to 80 years old,with NHL,through July 2009 to December 2011.The patients with T-cell lyphoma received four to eight cycles of CEOP (cyclophosphamide 750 mg/m2 d1,epirubicin hydrochloride 60-75 mg/m2 d1,vincristine 2mg d1,and dexamethasone 10-15 mg d1-5) every 3-4 weeks.Otherwise,the patient with B-cell lymphoma received R-CEOP,rituximab (375 mg/m2) was administered one day before CEOP.All the patients' clinical materials were collected and used to annalyze the efficacy and toxicity of the CEOP±R regimen.Results Among these 34 NHL patients,17 cases reached CR,9 cases reached PR,3 cases remained SD,and 5 cases appeared PD.The total response rate was 76.5 ％(26/34).The major toxicity was bone marrow restraint.The rate of leukocyte decline with Ⅲ-Ⅳ degree was 71.4 ％ (24/34).Conclusion Using the standard regimen of CEOP leads to satisfied efficacy of elderly patients with NHL,and the toxcity is tolerant.

Objective To investigate the therapeutic measures of unresectable primary liver cancer (PLC) with transcatheter arterial chemoembolization(TACE).Methods The clinical data,treatment measures and followed up data of 312 patients with unresectable primary liver cancer from January 1991 to March 2010 were analyzed retrospectively.Of these 312 patients, different dosages, measures of transcatheter arterial chemoembolization together with immunotherapy and nutritional support treatments were given to the patients according to their own statements, including the patency of portal vein (evaluated by portography), the range, blood supply and lipiodol concentration of the lesions (evaluated by hepatic arteriography), and the systemic conditions.Some of these patients also accepted cryotherapy, radio frequency ablation (RFA), percutaneous ethanol injection therapy.Results Two hundred and eighty-seven patients were followed up (92％).Forty-two cases accepted the two-stage operation as the lesions were localized or reduced.In these 42 patients, 34 cases accepted the hepatectomy, 8 cases accepted the cryotherapy.The 1,3 and 5 year survival rate of all patients were 87.6％, 33.1％ and 13.2％.Conclusion TACE for unresectable primary liver cancer should be used individually and comprehensivly.Surgical treatment should be taken once the lesions can be resected.

von Willebrand factor (vWF) and factor Ⅷ (FⅧ) exist in a complex form in blood.After being activated,they mediated platelet adhesion and aggregation,and play an important role in the course of thrombosis.The levels in blood of both of them were affected by a variety of factors.vWF and FⅧ are closely associated with the risk,etiological type,severity and outcome of acute ischemic stroke.Studies on the corresponding antagonistic drugs have made a breakthrough,and these drugs may become more advantageous antithrombotic s.

Objective To observe the clinical efficacy of Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine in treatment of chronic urticaria (CU). Methods Totally 108 CU patients were randomly divided into treatment group and control group, 54 cases in each group. The treatment group was given Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine (10 mg, 1 time per day) according to symptom controlling situation, and control group with the decreasing amount of loratadine only. Both groups were treated for 4 treatment courses (2 weeks as a treatment course). Symptom score reduce index was used to calculate the effective rate after 8 weeks of treatment. And the taking antihistamine medicine score was recorded 4, 6, 8 weeks of treatment. The follow-up visits were made to observe long-term efficacy of the cured patients 1 month, 3 months and 6 months after discontinuing the medication. Results Totally 27 cases from the treatment group were cured, with a total short-term effective rate of 96.30%;13 cases from the control group were cured, with a total short-term effective rate of 65.38%, with statistical significance (P<0.05). The taking antihistamine medicine score in treatment group (0.553 ± 0.239) was lower than that in control group (0.721 ± 0.245), namely the symptom improvement in treatment group was better than that in control group by taking less antihistamine medicine. Long-term clinical efficacy showed that the treatment group was also distinctively better than the control group. Conclusion Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine is more effective for CU, and with better short-term and long-term clinical efficacy than the control group.

AIM: To study the expression and change of growth hormone receptors in experimental cirrhotic liver in rats. METHODS: Thioacetamide-induced liver cirrhosis was developed in Sprague-Dawley rats. The expression of growth hormone receptor and its mRNA was investigated by radio-ligand binding assay, revere transcript-polymerase chain reaction (RT-PCR) and digital image analysis in liver tissue or hepatocytes taken from normal control or cirrhotic rats with different stages of cirrhosis. RESULTS: Growth hormone-specific singular binding sties, namely growth hormone receptors, were detected in liver tissue or hepatocytes from rat samples with cirrhosis. The binding capacity of growth hormone receptors in rat cirrhotic live tissue was significant lower than that in normal control, and it decreased gradually along with the accumulation of collagen in the process of formation and development of liver cirrhosis. The binding sites of growth hormone receptors in rat cirrhotic liver cells were significantly lower than that in normal control. The expression of growth hormone receptor mRNA in rat cirrhotic liver tissue was also significant lower than that in normal control. CONCLUSIONS: The growth hormone receptor was expressed in cirrhotic livers at a reduced level in isolated hepatocytes or live tissue of cirrhotic rats, and lesser expression of growth hormone receptors was found in later stage of cirrhosis. The suppressed expression of growth hormone receptor was partly due to the reduced expression of its mRNA in cirrhotic liver tissue.

Objective To investigate whether emergency rooms in major general public hospitals are reasonably designed and convenient for patients. Methods 78 major public hospitals were selected from all over China, except Hong Kong, Macau and Taiwan, for emergency room convenience analysis. The standards in use were the "Standards of Hospitals" of Joint commission International Accreditation. Results The investigation found in such hospitals the following: poor road conditions outside the clinic and insufficient guides in the clinic; long-than-expected distance (normally over 50 meters) from ER to imaging departments (such as X-ray and CT scan service); ERs in provincial capital cities are significantly more convenient than those in non-capital cities; distance from ERs to CT service is significantly shorter in hospitals in eastern China than those middle and western China. Conclusions Parameters on ER's service quality from "Standards of Hospitals" could serve as a guideline to emergency medicine in China. ERs in China need to improve with conspicuous ER signs, unblocked passageways, and convenient access to inspection departments.