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

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.

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.

Through the research and practice of computer basic course at medical colleges, the paper summarizes the experience of using modern technical means, to reform the traditional teaching ideas, teaching methods, teaching means and teaching management, to diversify teaching resources sharing. It also analyzes the shortcomings and makes recommendations to further strengthen the course development.

ObjectiveTo discuss the relationship between patella location and chondromalacia patella,explore its mechanism and clinical significance.Methods Knee joint MRI was performed in 1052 patients (506 men and 546 female).Among them,there were 299 patients( 100 men and 199 female)with chondromalacia patella.They were divide into the group of 1-19,the group of 20-39,the group of 40-59 years old and the group of older than 60 years to compute the positive rate respectively.Insall-Salvati method was used to measure the length of chondromalacia ligaments(L) and the length of chondromalacia path(P).The relationship between patella location and chondromalacia was tested by using t test and x2 test.ResultsThe total positive rate of chondromalacia patella was 28.4％ (299/1052).In female it was 36.4％ (199/546) and in men was 19.8％ (100/506).The group of 1-19 years old had 16 patients ( 16.8％,16/95).The group of 20-39 years old had 71 patients( 17.9％,71/396).The group of 40-59 years old had 116 patients ( 33.2％,116/349 ).The group of older than 60 years had 96 patients (45.3％,96/212).The positive rate of chondromalacia patella increased with age.The L/P value of normal group and chondromalacia patella group were 1.15 ±0.15 and 1.24 ±0.17 respectively.The L/P value of normal group of men and women were 1.13 ± 0.15 and 1.17 ± 0.14 respectively.The L/P value of chondromalacia patella group of men and women were 1.20 ±0.17 and 1.26 ±0.16 respectively.The InsallSalvati index of age groups showed significant differences.The L/P value of pathological changes group and normal group of 1-19 years old were 1.38 ± 0.25 and 1.24 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 20-39 years old were 1.24 ± 0.17 and 1.15 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 40-59 years old were 1.24 ±0.16 and 1.12 ±0.12 respectively.The L/p value of pathological changes group and normal group of older than 60 years were 1.21 ±0.16 and 1.12 ±0.12 respectively.All of them had significant differences (P ＜ 0.01 ).ConclusionsThe positive rate of chondromalacia patella for female is higher than that for men,which also increases with age.High patella location is relevant to chondromalacia patella.

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 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.

Objective To explore the abnormal inflammatory cytokine profile of salpingitic infertility by means of cytometric bead assay(CBA). Methods To assay representative inflammatory cytokines of 40 patients of salpingitic infertility(PSI) and 40 healthy control by CBA, and compared 30 samples of serum with peritoneal fluid collected from identical subject. Results Experiment data displayed that in PSI the Th lymphocytes were decreased significantly (t =2. 1236,P <0. 05), Ts lymphocytes increased markedly, and the ratio of Th/Ts markedly decreased ( t = 2. 8392, P < 0. 01 ), compared with those of healthy control.(Pre-)inflammatory eytokines (IL-8, IL-1β, IL-6 and TNF-α) were all significantly higher than those of healthy controls ( t = 4. 9302,5. 5449,3. 4975,5. 6623, respectively, all P < 0. 01 ) ; while anti-inflammatory cytokines ( IL-10, IL-12 ), also increased markedly ( t = 5. 3428,5.9847, respectively, all P < 0. 01 ).Beside IL-10, all other cytokine concentrations presented in serum were higher than that of peritoneal fluid;IL-8(t =2.2113,P <0.05),IL-llS(t =2.9756,P <0.01), IL-6(t =2.3298,P <0.05), TNF-α (t =3. 2895, P < 0. 05 ), IL-12 ( t = 3. 3281, P < 0. 05 ), implying more sensitive of serum samples. Conclusion PSI displayed extensive disorders of the inflammatory cytokine network, CBA can be used to probe the disharmony condition at high through-out and high sensitivity.