Objective To retrospectively analyze the risk factors of recurrent groin hernia. Methods Data came from all hernia repairs recorded in our hospital between 1991 and 2001. A total of 1 082 cases of groin hernia was analyzed through Cox proportional hazard model to determine the relative risks between recurrence and mode of admission, types of groin hernia, repair methods (traditional/tension free hernioplasty), and post operative complications.Results From 1991 to 2001,1 082 groin hernia operations were performed in our hospital, 88.9% for primary hernia and 11.2% for recurrent hernia. As compared with traditional hernia repair methods, Lichtenstein’s tension free hernioplasty technique had less relative risk for recurrent hernia repair than that for primary hernia repair. Postoperative complications and indirect hernia were linked to an increased relative risk for recurrence. Conclusion There are many factors affecting the recurrence of inguinal hernia, but the use of tension free hernia repair may decrease re recurrence of recurrent hernia.

Objective To review experimental study and clinical application of materials to bile duct repair and reconstruction.Methods Comparison of different materials was made between advantages and disadvantages.Results Synthetic grafts such as vitallium,teflon are easy to handle,but have no flexion,and have foreign body reaction.Although autogenous free tissues such as venous patch and peritonium are resistant to infection,they are likley to lead to bile duct stricture because of lacking adeuqate blood supply.Vascularized neibouring tissues for repearing bile duct defect have satisfactory results.Conclusions To avoid bile duct striccture,vary measures should be taken to repair bile duct defecs;for segmental loss of bile duct,end to end anastomosis or Roux-en-Y biliary jejunal reconstruction should be applied.

ObjectiveTo review the treatment of 132 patients with vascular injuries admitted to our hospital from Jun,1985 to May,2001.Methods Clinical data were analyzed according to the cause, site, type, and surgical modality of vascular injuries. ResultsThe mortality rate in this group was 6.8%, amputation rate 8.3%, and patency rate of primary surgical treatment was 91.9%.ConclusionsSurgical exploration is the mainstay of diagnostic approaches for acute vascular injury; flexible measures should be taken to ensure high patent rate of the injuried blood vessel,lower mortality and high salvage of limbs.

Objective To evaluate catheter-directed thrombolysis through popliteal vein for the treatment of lower extremity deep venous thrombosis (DVT). Method A total of 62 patients with single symptomatic lower limb DVT were analyzed. The popliteal vein of symptomatic limb was punctured, under Doppler guidance a 5-F sheath was advanced into the deep vein. A catheter was advanced beyond the thrombus. After a bolus of 200 000 IU urokinase, 100 000 IU/h urokinase was infused for up to three days, meanwhile 400 IU heparin was administered subcutaneously every 12h. Clinical efficacy grade was evaluated by measuring the perimeter of legs and lysis grade was calculated based on venographic results. Results In addition to total or partial removal of the thrombus collateral circulation increased, the limbs edema reduction rate was 78% and the thrombolysis rate was 67%. Thrombolysis rate in acute, and relapsing cases was significantly higher than in chronic group (75%,and 71% vs. 49%,P

Objective To evaluate the value of lymphoscintigraphy in diagnosis of chylous ascites in children.Methods Lymphoscintigraphy was done in 6 cases,computed tomography(CT) was done in 4 cases,X-ray exam was done 42 times.And their video repore were compared.Results Lymphoscintigraphy was done in 6 cases,5 cases′ results were positive which diagnosed chylous ascites,and their leaking positions were also found.Conclusion Lymphoscintigraphy has the qualitative and orientational effect on diagnosis of children with chylous ascites.

Objective To investigate the effects of in situ venous arterialization on extensive artery obliterans occlusion of the lower extremity. Methods Lumbar sympathetic ganglionectomy and one stage in situ arterialization of the great saphemous vein were performed in 104 ischemic limbs of 88 patients with extensive arterial occlusion. Results Eighty-two of 104 limbs were followed-up from 6 months to over 6 years. The intermittent claudication, night pain improved in all cases, with satisfactory wound healing and no swelling of the lower limbs. Conclusions Arterial blood flow through venous conduit improves and reconstructs the blood circulation of the ischemic limbs.

OBJECTIVETo analyze the relationship of K-ras mutation with the development of liver metastasis in colorectal cancer patients and the survival outcomes.

METHODSFrom 2003 to 2008, 300 patients who underwent colorectal cancer surgery in the Department of General Surgery of Zhongshan Hospital, Fudan University were assigned to different groups, according to the diagnosis and follow-up results. The mutation of exon 2 of K-ras was detected in primary paraffin-embedded lesions by PCR and Pyrosequencing. The association of gene mutation with the development of liver metastasis and its prognosis was studied.

RESULTSAmong 300 cases, the mutations of exon 2 were present in 120 cases(40%). The G13D mutation was more common in metachronous metastasis group than that in synchronous group(17.0% vs. 8.0%, P=0.041). Multivariable regression analysis showed that G13D mutation was an independent risk factor(HR=1.108, 95%CI:1.032-5.062, P=0.048) for metachronous metastasis. Patients with mutated K-ras had a poorer overall survival compared to those without mutated K-ras for patients without liver metastasis(median overall, 65 vs. 72 months, P=0.039), and for patients who received metastasis resection(median disease-free survival 18 vs. 24 months, P=0.048). Multivariable analysis showed that K-ras mutation was an independent risk factors of overall survival(HR=1.561, 95%CI:1.022-6.422, P=0.045) in patients without liver metastasis.

CONCLUSIONDetection of K-ras mutation may predict the development of liver metastasis and prognosis.

Aged ; Colorectal Neoplasms ; genetics ; pathology ; Female ; Genes, ras ; genetics ; Humans ; Liver Neoplasms ; genetics ; secondary ; Male ; Mutation ; Prognosis

OBJECTIVETo investigate the effect of small interfering RNA (siRNA) targeting C-erbb-2 oncogene on the radiosensitivity of C-erbb-2-overexpressing lung adenocarcinoma cell line.

METHODSFour pairs of siRNA targeting the coding sequence of C-erbb-2 mRNA were synthesized and their interference effects were evaluated using quantitative real-time fluorescence PCR. The siRNA with the best interference effects was transfected into Calu-3 cells, which were then exposed to 2 or 5 Gy irradiation, with the cells with transfection or irradiation alone as the control groups. The cell apoptosis after the treatment was detected using annexin V-FITC Kit.

RESULTSThe apoptosis rate of the Calu cells was 7.767-/+0.551 in the blank group, 14.400-/+1.114 in the interference group, 11.867-/+0.737 in 2 Gy irradition group, 23.000-/+1.664 in 2 Gy irradiation + interference group, 16.100-/+0.624 in 5 Gy irradiation group, and 27.900-/+1.709 in 5 Gy irradiation+interference group.

CONCLUSIONThe siRNA targeting C-erbb-2 gene can enhance the radiosensitivity of Calu-3 cells to gamma-ray and increase their apoptosis rate following gamma-ray exposure in vitro.

Adenocarcinoma ; genetics ; pathology ; Apoptosis ; drug effects ; radiation effects ; Cell Line, Tumor ; Genes, erbB-2 ; genetics ; Humans ; Lung Neoplasms ; genetics ; pathology ; RNA Interference ; RNA, Small Interfering ; genetics ; Radiation Dosage ; Radiation Tolerance ; genetics

The discussion centered primarily on background, basis and research ways of the study on producing area suitability of genuine traditional Chinese drugs in this paper. The authors expounded application and development of the used modem techniques. The direction and strategy of producing area suitability of genuine traditional Chinese drugs for the future were proposed and prospected aiming to provide with scientific thoughtway and guiding later production and practice.
Climate ; Drugs, Chinese Herbal ; Ecosystem ; Geographic Information Systems ; Pharmacognosy ; Plants, Medicinal ; genetics ; growth & development ; Random Amplified Polymorphic DNA Technique ; Soil ; Technology, Pharmaceutical ; methods

OBJECTIVETo investigate relationship between glucose metabolic disorders and expression of insulin receptor (IR) and tyrosine protein kinase (TPK) in posthepatitic cirrhosis hepatocyte and HBV DNA expression in pancreatic cells.

METHODSTo detect HBV DNA in paraffin-embedded pancreatic and hepatic tissues from 12 posthepatitic cirrhosis patients with positive serum HBV markers by using in situ hybridization (ISH) with a digoxigenin labelled probe. The amount of IR and TPK have been evaluated by immunohistochemical quantitative analysis using image analyzer in hepatocyte of 12 patients positive for HBV markers with posthepatitic cirrhosis in serum. Immunofluorescent histochemical double staining technique was used. HBsAg and IR were observed under confocal laser scanning microscope.

RESULTSEleven of 12 cirrhosis patients? hepatocytes were HBV DNA positive, including 7 patients (7/7) with impaired glucose tolerance (IGT) and 4 patients (4/5) with normal glucose tolerance (NGT). Eight of 12 pancreatic cells were HBV DNA positive, including 7 patients (7/7) with IGT, but only one patient (1/5) with NGT-HBV DNA was found positive in pancreatic cells in significantly more subjects in IGT group than in NGT group (P less than 0.01).IR and TPK amount in hepatocyte of IGT was significantly less than that of NGT patients with posthepatitic cirrhosis (P less than 0.01). IR amount was closely related to the TPK in cirrhosis hepatocyte r=0.82597(P less than 0.01). HBV DNA was mainly localized in the nuclei of hepatocyte and pancreatic acinar and islet cells. Immunofluorescent histochemical double-staining showed that HBsAg was partly localized in the IR positive areas of hepatocytes and pancreatic islet cells.

CONCLUSIONHBV can invade acinar cells of pancreas and islet cells, which might be a direct cause of insulin-dependent diabetes mellitus-like the disorder and insulin absence after HBV infection. Decrease of IR and TPK might be main cause of noninsulin-dependent diabetes mellitus-like disorder after having hepatitis or posthepatitic cirrhosis.

DNA, Viral ; analysis ; Female ; Glucose Metabolism Disorders ; complications ; metabolism ; virology ; Hepatitis B virus ; genetics ; Hepatocytes ; metabolism ; virology ; Humans ; In Situ Hybridization ; Liver Cirrhosis ; complications ; metabolism ; virology ; Male ; Middle Aged ; Pancreas ; cytology ; virology ; Protein-Tyrosine Kinases ; metabolism ; Receptor, Insulin ; metabolism