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 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.

BACKGROUND: Transplantation of bone marrow mesenchymal stem cells (MSCs) improves functional recovery after spinal cord injury (SCl), but the mechanisms involved remain unclear.OBJECTIVE: To observe the effects of MSCs transplantation on the expression of brain-derived neurotrophic factors (BDNF) in rats after SCl.DESIGN, TIME AND SETTING: Randomized, controlled, animal experiment. The study was performed at the Laboratory of Neuroanatomy, China Medical University from April to July 2003.MATERIALS: A total of 64 SD rats, aged 3 months, of either gender, weighing 250-300 g, were used. Of them, 4 were randomly selected to isolate and culture MSCs, and the remaining were used to establish SCl models.METHODS: The 60 rats were randomly divided into 3 groups. Seven days after SCl, MSCs group (n=24) was transplanted with 5 μL culture solution containing 1×109/L MSCs to the injury site using micro-injection; PBS group (n=24) was transplanted with 5μ L PBS, and the blank control group (n=12) with 5μ L normal saline.MAIN OUTCOME MEASURES: The rats were sacrificed at 7, 14, and 28 days post-surgery. MSCs morphology was observed and the expression of BDNF at the lesion areas was examined by immunohistochemistry,RESULTS: All 60 rats were included in the final analysis. After ten subcultures, the cell proliferative capacity was reduced, and cell body turned to flat; the MSCs protiferation and morphous could be maintained by adding basic fibroblast growth factor.Transplantation of MSCs enhanced the expression of BDNF compared with PBS and blank control groups at 7, 14, and 28 days post-surgery (P ＜ 0.05); white no significant difference was found between PBS and blank control groups (P ＞ 0.05).

Streptolysin S (SLS),one of the important virulence factors of Streptococcus,exist in several kinds of human and animal pathogenic bacterial,including Streptococcus pyogenes,Strepstococcus iniae and Streptococcus anginosus.SLS is a peptide toxin encoded by nine consecutive genes (sagA-sagⅠ).The functions of SLS include contributing pathogenic bacterium to pass through epithelial barrier,causing tissue damage,resisting to phagocytic clearance of host immune cells and interacting with other virulence factors.In addition,SLS as a signaling molecule of cell quorum sensing is involved in regulating the expression with other virulence factors.This paper summarized the structures and the biological functions of SLS in Streptococcus infection.

Objective To compare direct magnetic resonance(MR)arthrography with arthroscopy of the wrist for evaluation of injury in the triangular fibrocartilage complex(TFCC).Methods Fourteen cases with suspicion of injury of triangular fibrocartilage complex were performed with conventional MR and direct MR arthrography,10 cases were done by arthroscopy.In the direct MR arthrography,needle placement was obtained using clinical landmark under sterile technique and fluoroscopy,intra-articular injection was performed at the radius-scaphoid space with 5-7 ml 0.3%mixture of Gadolinium (0.1 mmol/L)and saline(0.3 ml Gd-DTPA+100 ml saline).The findings of MRI and MR arthrography were analyzed with results of arthroscopy.Resuits (1)Among 14 cases with injury of TFCC,there were ulnar tear in 5cases,radius tear in 4 cases,complete tear in 5 cases(included 2 cases with long term rheumatoid).(2)High signal intensity and isointensity signal of injury of TFCC were revealed on STIR or T2 WI and T1 WIrespectively,normal hypointensity signal of the TFCC was partially or completely absent.Contrast media at the ulnar insertion(5 cases with ulnar tear)or radius attachment of the TFCC(4 cases with radius tear)were seen in the MR arthrography with difierent extent,5 cases with complete tear showed contrast media at the both ulnar insertion and radius attachment of the TFCC.The findings of MR arthrography were well corresponded with results of arthroscopy on the lesion site,including ulnar tear in 3 cases,radius tear in 4cases and complete tear in 3 cases.(3)Among 14 cases with TFCC,8 cases had dislocation of radius-ulnar joint,6 cases had bone contusion of radius or ulnar,synovial reaction was also clearly depicted on conventional MRI and direct MR arthrography in all cases.Conclusion Compared with results of arthroscopy,direct MR arthrography can adequately reveal the injury of the triangular fibrocartilage complex,synovial reaction and edema changes are depicted on conventional MRI.

Objective To evaluate the value and limitation of MRI in the diagnosis of meningovascular neurosyphilis. Methods Five cases of neurosyphilis confirmed by clinical history/laboratory were examined with MRI (3 plain MRI, 2 enhanced MRI). The results of blood and CSF TPPA/RPR were positive and HIV was negative. Results Abnormal signals were demonstrated in the temporal lobe in 3 cases, and infarction was revealed in the basal ganglion and periventricular white matter in another 2 cases. There was no marked contrast enhancement in the 2 cases. Conclusion Meningovascular neurosyphilis has no characteristic features on MRI, but MRI is an effective method in delineating the size, range, and characters of neurosyphilis, and it is also an useful modality to follow-up after antibiotic therapy.

Objective To explore the role of CGRP and progesterone along with it on the etiopathology of PIH. Methods 8 specimens of umbilical vein endothelial cells from women with PIH were cultured. Four groups were divided when cultured cells were confluent: the sera of normal pregnancy women (group 1), the sera of women with PIH (group2), the mixture of the sera of women with PIH and the injection of progesterone (group3), and the same amount of media (group 4). The cultured cell were added respectively into the four different kinds of media. After 24h of incubation, the concentration of endothelin (ET) and CGRP in media were measured by radioimmunoassay. Results 1. Comparing with group1, the concentration of CGRP in group 2 decreased and ET increased significantly. Statistic difference of ET/CGRP was found between the two groups. 2. Comparing with group 1, the concentration of CGRP in group 3 was unchanged and ET increased obviously. No difference of ET/CGRP was shown between them. 3. Comparing with group 3, in group 2, the concentration of CGRP decreased obviously and that of ET unchanged. Significant difference of ET/CGRP was found. Conclusions Progesterone, along with CGRP, might delay the onset and progressing of PIH.

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.