Objective To evaluate the effectiveness and safety of open tension-free hernioplasty and two kind of laparoscopic hernia repair for the treatment of primary unilateral inguinal hernia. Methods Patients suffering from primary unilateral inguinal hernia were randomly divided into 3 groups to undergoopen operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty (TAPP) or totally extraperitoneal hernioplasty (ZEP). Results From February 2006 to February 2009, a total of 164patients were divided into 3 groups, with 62 undergoing open tension-free mesh-plug hernia repair, 50receiving TAPP and 52 receiving TEP. Postoperative patients were then followed up for a period of(16±8)months. The average operating time for the patients in the open mesh repair group was significantly shorter compared to the other two groups (P＜0.01 ). The cost in the open mesh repair group was also significantly lower than the other two groups (P＜0.01). The pain scores in open mesh group were significantly higher than those in the other two groups (P＜0.01). The hospital stay and the recovery time were both significantly longer in the open mesh repair group (P＜0.01) compared to the other two groups. No major complications and recurrence was found in neither groups. Conclusions Open tension-free mesh-plug hernia repair, TAPP and TEP are all safe and effective for the treatment for patients with primary unilateral inguinal hernia. TAPP and TEP are superior to open tension-free mesh-plug hernia repair as these two procedures involve less postoperative pain and fast recovery.

AIM: To investigate the expression of tissue factor(TF) induced by oxidized high density lipoprotein(oxHDL) in human umbilical vein cell line,ECV304,and the related mechanisms.METHODS: Four main groups were designed: the negative,the positive(ECV304 with histamine),the HDL group and the oxHDL group.Quantitative real-time polymerase chain reaction(RQ-PCR) and Western blotting were used to detect the expression level of TF.The specific inhibitors of MAPKs,SP600125(c-jun terminal NH2 kinase,JNK),SB203580(p38 MAP kinase,p38 MAPK),PD98059(extracellular signal-regulated kinase,ERK1/2) were used to investigate the underlying mechanisms.RESULTS: The TF expression in normal ECV304 cell line was not detected.Histamine administration resulted in a significant expression of TF in ECV304 cell line,with strongest effect after 1 h co-incubation at concentration of 1?10-5 mol/L histamine(about 4.8-fold higher expression of TF compared with that of 1?10-9 mol/L histamine).Expression level of TF was detected after stimulated with oxHDL in dose-and time-dependent manners.The highest expression of TF mRNA was found at 20 mg/L oxHDL and 6 h co-incubation,with 1.8-fold and 5.3-fold increase in TF expression,respectively,compared with that at 10 mg/L oxHDL and 2 h co-incubation.20 mg/L oxHDL also caused an apparent augmentation of TF protein expression,about 1.5-fold higher compared with that stimulated by 40 mg/L oxHDL.HDL co-incubation did not cause a detectable expression of TF protein.The mRNA levels of TF in ECV304 cell line induced by oxHDL were decreased by 95.0%,81.0%,87.0%,respectively(all P