10.3969/j.issn.2095-4344.2013.24.019

Objective To summarize our experience on laparoscopic appendectomy combined with high ligation of the vaginal process in children.Methods From January 2004 to May 2007,totally 326 patients with appendicitis underwent laparoscopic appendectomy in our hospital.During the operation,by inguinal exploration,83 cases of vaginal process deformity (17 bilateral and 69 unilateral lesions) were confirmed.High ligation of the vaginal process was performed on these patients.Results The operation was successfully done in all of the 83 cases,none of them showed postoperative complications.The cases were followed up for 6 to 12 months,during which only one patient had recurrent inguinal hernia.Three patients developed latent hernia but receined no treatment. Conclusions Laparoscopic appendectomy combined with high ligation of the vaginal process is an safe,effective,and low-cost procedure,leading to quick recovery and less pain for children with appendicitis complicated with vaginal process deformity.

Objective To evaluate the value of laparoscopic surgery application in treating intussusception.Methods Between January 2004 and December 2007,12 children with refractory (8 cases,failed air enema) or recurrent (for over 3 times) intussusception received laparoscopic surgery in our hospital.Three trocars were used during the surgery.Under a laparoscope,by interrupted suture,the terminal ileum was joined to the ascending colon (3 stitches),and the ileocecal junction was fixed to the right posterior abdominal wall (2 to 3 stitches,only for children that failed air enema).Results The intraoperative blood loss ranged from 20 to 60 ml,and the operation lasted for 45 to 90 minutes.No patient developed anastomotic leakage or abnormal gastrointestinal function.The patients were followed up for 1 to 5 years (mean,2 years and 9 months),during which none of them had recurrence. The children had normal intake and excretion,and developed well.Conclusions Children with intussusception recover quickly after laparoscopic treatment with a few postoperative complications.

0.05).Conclusion Semiconductor laser can induce apoptosis of MG-63 cells by mitochondrion pathway,and the process may be associated with the increasing of ROS.

Objective To explore the feasibility of laparoscopic surgery in the treatment of pediatric periappendicural abscess.Methods A total of 22 cases of pediatric periappendicural abscess were treated with laparoscopic surgery from April 2013 to May 2016.In the operation, we performed the separation from the side of the abdominal wall and abscess adhesion, and then lifted the abscess for blunt separation into the abscess cavity.After the management of appendix stump, the abdominal cavity was washed and a peritoneal drainage tube was placed.Results Laparoscopic appendectomy was performed successfully in all the cases.No conversion to open laparotomy was needed.The operation time was (65.3±8.2) min, the intraoperative blood loss was (10.5±4.2) ml, and the postoperative hospitalization was (6.5±1.4) days.Follow-ups for 6-24 months (mean, 12 months) in the 22 cases found no complications, such as abdominal abscess, stump fistula, stump appendicitis or adhesive ileus.Conclusion The application of laparoscopic surgery in the treatment of pediatric periappendicural abscess is feasible and safe.

Objective To investigate the diagnostic value of serum TPSA, the ratio of free PSA(FPSA)and TPSA(F/T) and PSAD in prostate cancer(PCa).Methods The serum TPSA and PSAD levels and the ratio of F/T of 467 patients with BPH,116 patients with PCa and 50 healthy men as normal control were determined, analyzed and compared. Results Serum TPSA of PCa (53.26±33.10) were significantly higher than that of BPH (8.12±9.70) (P ＜0.01), and normal control (1.51 ±1.17) (P ＜0.01); Serum PSAD of PCa[(1.59±1.46) ng·ml-1·cm-3] were significantly higher than that of BPH [(0.14±0.17) ng·ml-1·cm-3] (P ＜0.01),and normal control [(0.08±0.07) ng·ml-1·cm-3] (P ＜0.01); F/T of PCa (0.22±0.16) was significantly lower than that of BPH (0.27±0.15) and normal control (0.36±0.14) (P ＜0.01). When TPSA was limited specificity at 4 ～10 ng/ml, F/T of PCa (0.18±0.13) were significantly lower than that of BPH (0.27±0.14), (P ＜0.05), PSAD of Pca [(0.21 ±0.07) ng· ml -1· cm -3] were significantly higher than that of BPH [(0.11 ±0.06) ng· ml-1· cm-3], (P ＜0.001). When F/T was 0.16, PSAD used 0.15 as the critical value, the sensitivity, specificity of diagnostic value and positive prediction value were 81.6 ％, 78.2 ％, 96.1％ and 53.8 ％, 76.9 ％, 97.9 ％, respectively;And the diagnostic efficiency was the highest. ConclusionF/T and PSAD have valuable role as the diagnose marker of PCa. When PSA level between 4 ng/ml and 10 ng/ml, F/T ratio and PSAD are of significant value to differentiate PCa from BPH patients.

OBJECTIVE; To review the molecule mechanism of multidrug resistant osteosarcoma cell apoptosis induced by laser. DATA SOURCES; An online search of Pubmed database and CNKI database was undertaken to identify the articles published from 1996 to 2006 by using the keywords of “laser, osteosarcoma and apoptosis”, and language was limited to both Chinese and English. STUDY SELECTION; The articles were primarily screened and then the full-texts were searched. Included criteria: relevant to the mechanism of tumor cell apoptosis induced by laser. Articles were excluded because of repetition and obsolescence. DATA EXTRACTION; Totally 74 articles were found and 31 of them were selected according to the inclusive criteria as described above. Of the 31 articles, 5 articles were related to reactive oxygen species, 5 were associated with intracellular calcium concentration, 6 were involved in protein kinase C and 5 in Bcl-2 respectively. The last 8 were about P53 in the tumor apoptosis induced by laser. DATA SYNTHESIS; The mechanisms that laser induces osteosarcoma cell apoptosis include mainly reactive oxygen species, intracellular calcium concentration, protein kinase C, Bcl-2, p 53 and so on. The recent reports focus on the proliferation improvement of low-intensity laser on normal cells, but few reviews the biologic effect of tumor cells, especially multidrug resistant osteosarcoma and animal models. It is presumed to be correlated with the mechanism involved above. CONCLUSION; The mechanism that laser induces osteosarcoma cell apoptosis is still unclear, and is mainly related to reactive oxygen species, intracellular calcium concentration, protein kinase C, bcl-2, p 53 and so on.

Objective To evaluate the clinical effect of single-site umbilical laparoscopy in the treatment for inguinal incarcerated hernia in children. Methods Retrospective reviews were conducted for the clinical data of the 105 children with inguinal incarcerated hernia during January 2010 to August 2014. According to different surgical approaches, data were divided into single-site laparoscopic surgery group (SLS, n=56) and open surgery group (OS,n=49). The follow-up period was 6-36 months. Results Two groups of patients were successfully completed surgery. The average operative duration was significantly longer in OS group (33.73±4.41)min than that of SLS group (26.14±5.17) min (P<0.01). The average operative blood loss was (3.18 ± 2.90) mL for OS group versus (1.73 ± 0.88) mL for SLS group (P<0.01). The hospitalization duration was (4.22±1.16) d for OS group versus (3.50±0.97) d for SLS group (P<0.01). The postoperative complications were 24.5%(12/49) for OS group and 8.9%(5/56) for SLS group. There was no recurrence of hernia in two groups. Conclusion Single-site umbilical laparoscopy is safe and efficacious for treatment of inguinal incarcerated hernia in children, which offers a new choice of treatment for occult inguinal hernia.

Objective To analyze the cosmetic effects and postoperative complications of patients with early breast cancer who underwent oncoplastic breast-conserving reconstruction and traditional breast-conserving surgery.Methods From January 201 2 to October 201 5,we collected a total of 67 patients with early-stage breast cancer who underwent breast-conserving surgery in Affiliated Mindong Hospital of Fujian Medical Univer-sity.Thirty patients who underwent oncoplastic breast-conserving reconstruction were in observation group,and 37 patients who underwent traditional breast-conserving surgery were in the control group.The postoperative complications,cosmetic effects and survival situations in the two groups were compared.Results In the aes-thetic effects evaluation,22 patients (73.33%)and 1 6 patients (43.24%)had good or excellent cosmetic effects,6 patients (20.00%)and 1 4 patients (37.84%)had general cosmetic effects,2 patients (6.67%) and 7 patients (1 8.92%)had poor cosmetic effects in the observation group and control group,with a signifi-cant difference (Z =-2.51 3,P =0.01 2).Four patients (1 3.33%)in the observation group had postopera-tive complications,including that 1 patients had incisional dehiscence followed by incisional wound infection and skin necrosis,and 3 patients had subcutaneous exudates.However,2 patients (5.41 %)in the control group had postoperative complications,including 1 patients with incisional dehiscence,and 1 patients with inci-sional wound infection.There were no significant difference in the occurrence rates of postoperative complica-tions in the two groups (χ2 =0.490,P =0.484).The mean follow-up period was 28 months.We found 1 patients of local recurrence,and 2 patients of metastases in the control group.However,all patients were free of recurrence and metastases in the observation group,with no significant difference (P =0.1 40).Conclusion Oncoplastic surgical technique in the breast-conserving surgery for patients with early-stage breast cancer is a safe and effective procedure,with highly satisfactory cosmetic effects for the majority of patients,which is worth to recommend.

Objective To establish a paraspinal neural pathway of quadriceps femoris by end-to-end anastomoses between the spinal ventral root after spinal cord injury(SCI) in rats. Methods Twenty-fourweek old SD rats, with the weight of 120 g to 150 g, were included. The left side was the experimental side, while the right side served as a control. Electrostimulating of L1-L5 ventral root was done respectively to decide the predominant nerve of quadriceps femoris. The lumbar 1 ventral root was reveal to little innervation of quadriceps femoris, and the lumbar 3 ventral root was predominant innervation. End-to-end anastomosis between the left L1 and L3 ventral root was done. After axona regeneration, the new paraspinal neural pathway of quadriceps femoris was established. At 6 months postoperatively, the early function of the new pathway was observed by electrophysiological examinations, hindlimb locomotion and BBB (basso, beattie and bresnahan)scale at 1,3,7, 14,21,28 d after SCI. Results Sixteen rats survived for 6 months after operation and only ten rats got good results because of tissue adhesion postoperatively. Single stimuli (2.5 mA,0.2 ms, 1 Hz) of the left anastomoses nerve resulted in action potential recorded from the left quadriceps femoris before and after the spinal cord hemisection horizontally between L2 segmental levels. The amplitudes of the action potentials were (7.63 ± 1.86) mV and (6.00 ± 1.92)mV, respectively, and there was no significant difference (P ＞ 0.05). The left quadriceps femoris contraction was initiated by single stimuli (2.5mA, 0.2 ms, 1 Hz) of the left anastomoses nerve. After paraplegia, when the right L3 ventral root was stimulated, the amplitude of the action potential was (15.87 ± 1.16) mV. Locomotion of the left hindlimb was partially restored after spinal cord hemisection while creeping and climbing. According to BBB scale, there was significant difference at 1, 3, 7 d, and little difference at 14, 21, 28 d after SCI. Conclusion Spinal ventral roots cross-ananstomosis to reconstruct the paraspinal pathway of quadriceps femoris after SCI is efficient reinnervation of hindlamb muscles in a rat model and may have potential in clinical application.