Objective To explore the causes and managements of peritoneal laceration in the laparoscopic totally extraperitoneal (TEP) hernia repair during learning curve.Methods The retrospective cross-sectional study was conducted.The clinical data of 120 patients with inguinal hernia who underwent laparoscopic TEP hernia repair in the Third Affiliated Hospital of Anhui Medical University (98 patients) and Anhui Provincial Hospital (22 patients) during surgeons' learning curve between February 2012 and January 2017 were collected.Patients underwent laparoscopic TEP hernia repair,meshes were intraoperatively placed and then fixed by medical glue.Observation indicators:(1) intraoperative situations:surgical procedure,operation time,using of mesh,intraoperative peritoneal laceration;(2) postoperative situations:time to anal exsufflation,time for fluid diet intake,occurrence of complications,duration of hospital stay;(3) follow-up:number of patients receiving follow-up,follow-up time,recurrence of hernia during follow-up,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain,incisional infection.Follow-up using outpatient examination and telephone interview within 10 days postoperatively and using telephone interview at 10 days postoperatively was performed to detect the recurrence of inguinal hernia,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain and incisional infection up to May 2017.Measurement data with normal distribution were represented as （x）±s.Results (1) Intraoperative situations:of 120 patients,112 underwent laparoscopic TEP hernia repair,5 converted to laparoscopic transabdominal preperitoneal hernia repair and 3 converted to open surgery due to adhesion between hernial sac and surrounding tissues induced bleeding of separation.Total operation time of 120 patients was (71 ± 13) minutes,including (63± 7) minutes in 106 patients with unilateral hernia and (79 ± 11)minutes in 14 patients with bilateral hernia.All the patients used intraoperatively meshes of 10.0 cm×15.0 cm and 16.0 cm× 10.8 cm.Forty-eight patients had intraoperative peritoneal laceration,peritoneal laceration occurred for reconstruction of preperitoneal space in 10 patients,separation of anterolateral preperitoneal space in 11 patients and improperly operating equipment or hernial sac in 27 patients.Of 48 patients with peritoneal laceration,40 continued to finish operation through acupuncturing into the abdominal cavity for exsufflation and then received peritoneal suture and repair,including 5 with recurrence of indirect inguinal hernia (receiving tissue repair) undergoing peritoneal repair through opening hernial sac,and 8 intraoperatively converted to other or open surgery.(2) Postoperative situations:time to anal exsufflation and time for fluid diet intake in 120 patients were (18± 4) hours and (15±6) hours.Of 120 patients,14 had postoperative complications,scrotal emphysema of 6 patients disappeared in 24 hours anti inguinal and scrotal seroma of 8 patients disappeared after puncture treatment.All the patients were discharged from hospital in 2 days postoperatively.(3) Follow-up:112 of 120 patients were followed up for 3-65 months,with a median time of 31 months.During follow-up,there was no occurrence of recurrence of hernia,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain and incisional infection.Conclusion During surgeons' learning curve,identifying anatomy of the groin clearly,a right way to treat the hernia sac and broken peritoneum in the operation can ensure the smooth completion of the laparoscopic TEP hernia repair.

AIM: To compare the chemical compositions in the expressed oil from euphorbia before and after processing.METHODS: GC-MS was used to compare the chemical compositions in the expressed oil before and after processed euphorbia.RESULTS : Tirty-four chemical compounds were detected in the expressed oil of the raw and 30 of the processed.CONCLUSION: Processing has the major effect on the chemical compositions in the expressed oil of euphorbia.

AIM:To compare the chemical compositions in the expressed oil from euphorbia before and after processing.METHODS:GC-MS was used to compare the chemical compositions in the expressed oil before and after processed euphorbia.RESULTS:Tirty-four chemical compounds were detected in the expressed oil of the raw and 30 of the processed.CONCLUSION:Processing has the major effect on the chemical compositions in the expressed oil of euphorbia.

Objective To investigate the relationship between the expression of BRCA1 in breast cancer tissues and the sensitivity to docetaxel chemotherapy.Methods The expression of BRCA1 was detected by immunohistochemical method and the new adjuvant chemotherapy containing docetaxel chemotherapy regimen (TEC)was given.The relationship between BRCA1 expression and efficacy of neoadjuvant chemotherapy with docetaxel was studied.Results The rate of complete response,partial response,stable disease and progress disease was 22.6％,71.7％,5.7％,and 0％ respectively in breast cancer patients with positive BRCA1 expression and 11.8％,58.9％,27.4％,and 2.0％ in breast cancer patients with negative BRCA1 expression.The difference between the 2 groups had statistical significance.Conclusion BRCA1 expression has a positive relationship with sensitivity to chemotherapy regimen containing docetaxel chemotherapy regimens (TEC),and can be used as a good marker for predicting efficacy of chemotherapy and screening agents.

Objective To evalhate the protective effect of oral raloxifene on lung function after acute lung injury (ALI) in rats. Methods Thirty male adult Sprague-Dawley rats were used and divided into three groups: LPS raloxifene hydrochloric acid. group before secondary impact ( Group A, n = 10 ), LPS raloxifene hydrochloric acid group after secondary impact ( Group B, n = 10) and control group ( n = 10). All the rats were injected intraperitoneally with 5 mg/kg LPS. Raloxifene (30 mg/kg) was orally administered one hour before LPS injection and 14 hours after LPS injection in Groups A and B. The con-trol group remained free. All the animals were anesthetized by intraperitoneal injection of pentobarbital so-dium at 40 mg/kg and the femoral artery was cannulated 16 hours after LPS injection to measure the mean arterial pressure (MAP). All the rats received a direct intratracheal injection of hydrochloric acid ( pH = 1.2, 0.5 ml/kg). Before injection of hydrochloric acid and at 0. 5,1.5 and 4 hours after injection of hy-drochloric acid, the blood gas was measured. Fifteen rats ( five from each group) underwent a micro posi-tron emission tomography ( [18F] FDG microPET) scan of the thorax four hours after hydrochloric acid in-stillation. Then, the lung tissue was collected for histopathological examination. Results The Group B showed better pulmonary gas exchange and more stable MAP compared to the control group. The [18F] fluorodeoxyglueose uptake and histological lung injury score were 9. 01 ± 1.58 and 12.6 ± 0.97 respec-tively in Group B, which were higher than 4. 67 ± 1.33 and 9. 01 ± 1.58 respectively in control group (P < 0. 01 ). Conclusions Raloxifene exerts significant protective effect on lung function after ALI. [18F] FDG microPET is a useful method to evaluate the inflammatory reaction during ALI.

Objective To evaluate the effect of acute hypervolemic hemodilution (AHH) on myocardial damage in severely burned rabbits.Methods Eighteen healthy adult rabbits,weighing 2.0-2.5 kg,were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),burn group (B group) and AHH group.Rabbits were subjected to 3rd degree burn covering 40％ of the total body surface area.After the model was established,6％ hydroxyethyl starch 130/0.4 was infused intravenously,and the target Hct was 25％ in AHH group.Before AHH (To) and at 2,4 and 8 h after AHH (T1-3),left ventricular systolic pressure (LVSP),left ventricular end-diastolic pressure (LVEDP),+dp/dtmax and-dp/dtmax were recorded,and blood samples from femoral veins were taken to determine the concentration of serum cardiac troponin I (cTnI) by ELISA.The rabbits were sacrificed at T3,and myocardial specimens were removed for microscopic examination of pathological changes with light microscope.Results Compared with group C,the serum cTnI concentration and LVEDP were significantly increased,LVSP and +dp/dtmaxwere decreased at T1-3 in B and AHH groups,and-dp/dtmax at T1-3 in group B and-dp/dtmax at T3 in group AHH were decreased.Compared with group B,LVSP,+dp/dtmax and-dp/dtm,x were significantly increased at T1-3,and no significant change was found in serum cTnI concentration and LVEDP in group AHH.There was no significant difference in the pathological changes between group B and group AHH.Conclusion AHH can not aggravate the early myocardial damage in severely burned rabbits.

ObjectiveTo investigate the effects of sevoflurane anesthesia on aquaporin-9 (AQP-9) expression in brain tissue after focal cerebral ischemia-reperfusion (I/R) in rats.MethodsSeventy-five male SD rats weighing 230-270 g were randomly divided into 3 groups ( n =25 each):group sham operation (group S) ; group I/R and group sevoflurane anesthesia (group SE).All the animals were tracheally intubated under 2.0％ sevoflurane and mechanically ventilated.Anesthesia was maintained with fentanyl infusion at 25 μg· kg-1 · h-1 after a bolus of fentanyl 10 μg/kg and inhalation of 65％ N2O in O2 in groups S and I/R and with inhalation of 2％ sevoflurane in 35％ O2 in group SE.Focal cerebral ischemin was induced by occlusion of middle cerebral artery for 2 h using a nylon thread with rounded tip which was inserted into the right internal carotid artery and advanced cranially until resistance was met.The neurologic function was assessed and scored (0=no deficit,4 =unable to move,unconscious) and brain edema rate (volume of ischemic hemisphere-volume of contralateral hemisphere ÷volume of contralateral hemisphere × 100％ ) and expression of AQP-9 were determined at 6 h,1,2,3 and 5 d of reperfusion.ResultsFocal cerebral I/R significantly increased neurologic deficit scores,brain edema rate and AQP-9 expression in brain tissue in group I/R as compared with group S.Sevoflurane anesthesia significantly attenuated the I/R-induced increase in neurologic deficit scores and brain edema rate and further increased I/R-induced increase in AQP-9 expression in brain tissue.ConclusionSevoflurane anesthesia can reduce focal cerebral I/R injury by up-regulating the expression of AQP-9 in brain tissue.

Objective To investigate the effect and the mechanism of the GITR-antibody(glucocorticoid-induced tumor necrosis factor receptor-ligand antibody) on the mouse leukemia model induced by L615.Methods The mouse leukemia models induced by L615 cells were divided into 4 groups: negative controls(peritoneal injection of normal saline,0.2 ml/d),GITR group(GITR,100,infused through caudal vein 2 d before leukemic lymphocytes inoculation,again at dose of 50 ?g/each mouse after inoculation),Cyclophosphamide group(200 mg?kg~(-1)?d~(-1),intraperitoneal injection from the 3~(rd) day after inoculation for 3 d),GITR+ Cyclophosphamide group(100 mg?kg~(-1)?d~(-1) Cyclophosphamide instead).The survival time,leukocyte counting in the peripheal blood,liver and spleen index were calculated and the pathological examination of liver,spleen were performed.Results GITR-ligand could prolong the survival time of mouse leukemia model,lead the necrosis and apoptosis of leukemic cells in bone marrow,decrease the liver and spleen index,decrease and relieve the leukocyte increase of peripheal blood and the irregular swelling of liver and spleen.Conclusion Through immunoregulation,GITR-antibody can inhibit the L615 leukemic cells effectively,therefore inhibit the progress of leukemia to some extent.