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.

Female ; Hernia, Inguinal ; etiology ; pathology ; surgery ; Humans ; Male ; Risk Factors

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

Adult ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; Male ; Middle Aged ; Occupational Health ; Young Adult

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).

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 observe the clinical efficacy of Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine in treatment of chronic urticaria (CU). Methods Totally 108 CU patients were randomly divided into treatment group and control group, 54 cases in each group. The treatment group was given Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine (10 mg, 1 time per day) according to symptom controlling situation, and control group with the decreasing amount of loratadine only. Both groups were treated for 4 treatment courses (2 weeks as a treatment course). Symptom score reduce index was used to calculate the effective rate after 8 weeks of treatment. And the taking antihistamine medicine score was recorded 4, 6, 8 weeks of treatment. The follow-up visits were made to observe long-term efficacy of the cured patients 1 month, 3 months and 6 months after discontinuing the medication. Results Totally 27 cases from the treatment group were cured, with a total short-term effective rate of 96.30%;13 cases from the control group were cured, with a total short-term effective rate of 65.38%, with statistical significance (P<0.05). The taking antihistamine medicine score in treatment group (0.553 ± 0.239) was lower than that in control group (0.721 ± 0.245), namely the symptom improvement in treatment group was better than that in control group by taking less antihistamine medicine. Long-term clinical efficacy showed that the treatment group was also distinctively better than the control group. Conclusion Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine is more effective for CU, and with better short-term and long-term clinical efficacy than the control group.

Objective To investigate the therapeutic measures of unresectable primary liver cancer (PLC) with transcatheter arterial chemoembolization(TACE).Methods The clinical data,treatment measures and followed up data of 312 patients with unresectable primary liver cancer from January 1991 to March 2010 were analyzed retrospectively.Of these 312 patients, different dosages, measures of transcatheter arterial chemoembolization together with immunotherapy and nutritional support treatments were given to the patients according to their own statements, including the patency of portal vein (evaluated by portography), the range, blood supply and lipiodol concentration of the lesions (evaluated by hepatic arteriography), and the systemic conditions.Some of these patients also accepted cryotherapy, radio frequency ablation (RFA), percutaneous ethanol injection therapy.Results Two hundred and eighty-seven patients were followed up (92％).Forty-two cases accepted the two-stage operation as the lesions were localized or reduced.In these 42 patients, 34 cases accepted the hepatectomy, 8 cases accepted the cryotherapy.The 1,3 and 5 year survival rate of all patients were 87.6％, 33.1％ and 13.2％.Conclusion TACE for unresectable primary liver cancer should be used individually and comprehensivly.Surgical treatment should be taken once the lesions can be resected.

von Willebrand factor (vWF) and factor Ⅷ (FⅧ) exist in a complex form in blood.After being activated,they mediated platelet adhesion and aggregation,and play an important role in the course of thrombosis.The levels in blood of both of them were affected by a variety of factors.vWF and FⅧ are closely associated with the risk,etiological type,severity and outcome of acute ischemic stroke.Studies on the corresponding antagonistic drugs have made a breakthrough,and these drugs may become more advantageous antithrombotic s.

Objective To study the efficacy and toxicity of standard CEOP regimen in elderly patients with non-Hodgkin's lymphoma (NHL).Methods The study included 34 previously untreated patients,age 60 to 80 years old,with NHL,through July 2009 to December 2011.The patients with T-cell lyphoma received four to eight cycles of CEOP (cyclophosphamide 750 mg/m2 d1,epirubicin hydrochloride 60-75 mg/m2 d1,vincristine 2mg d1,and dexamethasone 10-15 mg d1-5) every 3-4 weeks.Otherwise,the patient with B-cell lymphoma received R-CEOP,rituximab (375 mg/m2) was administered one day before CEOP.All the patients' clinical materials were collected and used to annalyze the efficacy and toxicity of the CEOP±R regimen.Results Among these 34 NHL patients,17 cases reached CR,9 cases reached PR,3 cases remained SD,and 5 cases appeared PD.The total response rate was 76.5 ％(26/34).The major toxicity was bone marrow restraint.The rate of leukocyte decline with Ⅲ-Ⅳ degree was 71.4 ％ (24/34).Conclusion Using the standard regimen of CEOP leads to satisfied efficacy of elderly patients with NHL,and the toxcity is tolerant.