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.

A new method for accurate determination of 15 rare earth elements including Y-Lu in tea samples by inductively coupled plasma-mass spectrometry( ICP-MS) was proposed. Sample preparation was based on the modified oxygen flask combustion technique. By using quartz cloth coated with glycerol instead of filter paper as the ignition agent, a total amount of 0. 1 g sample could be completely burned in a 500-mL flask. Key factors affecting the sample preparation effect were systematically investigated, and it was found that the extraction efficiencies of over 90% for all the analytes could be realized with 5 mL of 4% HNO3+1% HF ( V/V) as the extractant for the combustion residue and the total extraction process could be finished in one minute under sonication, which resulted in a very fast sample preparation procedure that could be completed in less than 3 minutes. The relative standard deviations ( RSD) of six parallel determination values were between 2. 7% and 5. 5%, and the detection limits ranged from 0. 001 mg/kg to 0. 006 mg/kg. Three tea standard reference materials were analyzed with the method and the detection results agreed well with the standard values. The method was successfully applied to three real samples analysis.

Xihuang pill,a famous anticancer traditional Chinese medicine formula,has curative effect in clinical application. It can inhibit the growth and invasion of tumor cells and cancer stem cells,prevent angiogenesis,and reverse the tumor immunosup-pressive microenvironment. This review summarizes the reported Xihuang pill' s anticancer mechanism and clinical application on colorectal cancer,breast cancer,liver cancer,so as to provide a reference for the further research and development on anticancer ap-plication of Xihuang pill.

Objective:To investigate the correlation between variations in mitochondrial DNA (mtDNA) control region (D-loop) and keloids.Methods:A total of 216 patients with keloids were collected from Department of Dermatology, the First Affiliated Hospital of Kunming Medical University from 2016 to 2019. Total DNA was extracted from peripheral blood samples of all the patients, as well as keloid tissues and perilesional normal skin tissues of 25 patients with keloids. Peripheral blood samples were collected from 299 health checkup examinees without keloids in Health Examination Center, the Affiliated Hospital of Yunnan University, who served as controls. PCR amplification and Sanger sequencing were performed on the mtDNA D-loop region, and mutation sites in each sample were analyzed by comparisons with the revised Cambridge Reference Sequence (rCRS) . Haplogroups were assigned in the 2 groups by using Phylotree-mtDNA tree Build 17. Mutations in the mtDNA D-loop region were compared among keloid tissues, perilesional normal skin tissues and peripheral blood samples. A median-joining network was constructed via network 5.0 software. Binary logistic regression analysis was performed to investigate the correlation between haplogroup frequencies and the occurrence of keloids, and chi-square, t and t′ tests were used to analyze clinical data. Results:Among the 216 patients with keloids, variations in mtDNA D-loop region were classified into 10 haplogroups, including A, B, D, R9, G, M*, M7, M8, M9 and N9, with the haplogroups R9 and M9 showing the highest (21.3%, 46/216) and lowest (0.9%, 2/216) frequencies respectively. The frequencies of haplogroups M7 ( P=0.040, OR=0.248, 95% CI: 0.066 - 0.937) and N9 ( P=0.048, OR=0.191, 95% CI: 0.037-0.986) were significantly lower in the patients with keloids than in the controls. The median-joining network plot showed that the distribution pattern of the haplogroup M7 differed between the patients with keloids and controls. Significantly less number of lesional sites and younger age of onset were observed in the patients with haplogroup M7 compared with those with non-M7 haplogroups ( P=0.000 1, 0.045, respectively) . Conclusion:The haplogroup M7 is correlated with the occurrence of keloids, and may be a potential protective factor for keloid formation.

Objective To investigate the application value of the preoperative progressive pneumoperitoneum (PPP) in parastomal hernia repair.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients who underwent parastomal hernia repair using PPP in the Sixth Affiliated Hospital of Sun Yat-sen University from December 2014 to February 2017 were collected.Patients received abdominal computed tomography (CT) scan after admission,and volumes of the hernia sac and abdominal cavity and (volume of the hernia sac / total volume of the abdominal cavity)× 100.0％ were respectively calculated.Open or laparoscopic parastomal hernia repair was selected based on the effects of artificial pneumoperitoneum.Observation indicators:(1) PPP situations:① completion;② changes of volumes of the hernia sac and abdominal cavity before and after PPP;③ adhesion and retraction of parastomal hernia contents after PPP;(2) surgical and postoperative recovery situations;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative long-term complications and recurrence of parastomal hernia up to May 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Repeated measurement data were evaluated with the repeated measures ANOVA.Results (1) PPP situations:① completion:28 patients received successful ultrasound-guided indwelling catcher.Twenty-four patients completed PPP,with a completion rate of 85.7％ (24/28) and an air injection volume of (3 995±531) mL,and 4 stopped PPP.Eighteen patients had varying degrees of abdominal pain,abdominal distension and scapular pain,including 17 with tolerance and 1 with disappearing of symptoms at day 6.Of 5 patients with shortness of breath,3 were improved or well tolerated through breathing exercises,and symptoms of 2 disappeared at day 7 and 9.Three patients had mild subcutaneous emphysema.The arterial CO2 tension of 1 patient was high and then returned to normal at day 7.Some patients had simultaneously multiple adverse reactions.② Changes of volumes of the hernia sac and abdominal cavity before and after PPP:volumes of the hernia sac before and after PPP were (699± 231) mL and (993 ± 332) mL,with a statistically significant difference (F=129.29,P＜0.05),and increasing volume of the hernia sac was (294± 167) mL,with an increasing rate of 43％±15％.Volumes of the abdominal cavity before and after PPP were (6 520±745)mL and (9 196± 909) mL,with a statistically significant difference (F=429.42,P＜0.05),and increasing volume of the abdominal cavity was (2 715±709)mL,with an increasing rate of 42％± 12％.(Volume of the hernia sac / total volume of the abdominal cavity) × 100.0％ before and after PPP were 9.6％ ± 2.7％ (less than or equal to 10.0％ in 20 patients,more than 10.0％ and less than or equal to 15.0％ in 6 patients,and more than 15.0％ in 2 patients) and 9.7％± 2.8％,with no statistically significant difference (F =0.44,P＞0.05).③ Adhesion and retraction of parastomal hernia contents after PPP:results of abdominal CT showed anterior abdominal bulging,abdominal contents prostrated at the base of the abdominal cavity due to gravity,and gas was full of gaps.Abdominal adhesion signs:adhesions of banded fibrous connective tissue established a connection between the base of the abdominal cavity and anterior abdominal wall,and intestinal canals were found inside the adhesions.Parastomal hernia contents of 28 patients had varying degrees of retraction to abdominal cavity,including 9 with complete retraction,13 with a great amount of retraction (retraction volume ＞50％) and 6 with a small amount of retraction (retraction volume ＜50％).Four patients were accompanied by incomplete stoma obstruction,and then obstruction disappeared or relieved after PPP.(2) Surgical and postoperative recovery situations:all the 28 patients underwent successful operations,without intestinal canal injury.Three patients received open parastomal hernia repair,including 2 receiving preperitoneal mesh repair using 8 layers Biodesign meshes (deep venous catheter for local drainage was placed and then removed at postoperative day 2 and 3) and 1 receiving Sugarbaker surgery using PCOPM mesh (peritoneal drainage-tube was placed and then removed at postoperative day 2).Other 25 patients received laparoscopic parastomal hernia repair and Sugarbaker surgery using PCOPM and Sepramesh meshes (no drainage-tube was placed).Bladder pressure of 28 patients at postoperative day 3 was (13±6)cmH2O (1 cmH2O =0.098 kPa),without an abnormal high pressure.Nine patients with postoperative complications were improved by conservative treatment,including 3 with seroma,3 with delayed stoma defecation or incomplete intestinal obstruction,2 with pulmonary infection and 1 with urinary tract infection.There were no occurrences of abdominal compartment syndrome,cardiac failure,lung failure,renal failure,other severe complications and perioperative death.Duration of postoperative hospital stay was (7.2± 1.5) days.(3) Follow-up situations:25 of 28 patients were followed up for 3-25 months,with a median time of 11 months.During follow-up,2 patients had chronic pain around the operation and a sense of discomfort and then were improved by symptomatic treatment,and 1 with parastomal hernia recurrence at postoperative month 6 after open preperitoneal mesh repair underwent again open preperitoneal mesh repair,without recurrence.There were no occurrence of tardive mesh infection and other longterm complications.Conclusion PPP in the treatment of parastomal hernia repair is safe and feasible.

Objective To explore the preparation of recombinant human cystatin C (Cys C ) and its polyclonal antibody . Methods The gene sequences encoding Cys C were designed according to characteristics of E .coli protein-coding ,and the target gene was artificially synthesized and expressed in E .coli .The target protein was purified by affinity chromatography and was used to immunize the New Zealand white rabbits .Western blot and enzyme-linked immunosorbent assay(ELISA) were adopted to detect the recombinant human Cys C and its polyclonal antibodies in the rabbits serum .Results Purity of prepared recombinant human Cys C was more than 90% .Anti-recombinant human Cys C antibody showed good binding activities and specificity .Conclusion Prepared recombinant human Cys C and its antibody can be used in further experimental research and clinical application .

Background:Zinc finger protein of cerebellum 2(ZIC2)is a transcriptional activator or repressor that is important for the organogenesis of the central nervous system.Previous studies have reported that ZIC2 is widely upregulated in a variety of tumors. Methods:Oncomine database was used to evaluate the expression levels of ZIC2 in hepatocellular car-cinoma(HCC)and normal liver tissues.Quantitative real-time polymerase chain reaction and immu-nohistochemistry were conducted to validate the results from the database.Cox regression analysis and survival curves were performed to assess the survival effect of ZIC2 in HCC. Results:Increased expression of ZIC2 was detected in HCC tissues compared with normal liver tissues.In addition,patients with high ZIC2 levels had a poor prognosis.Multivariate analysis showed that clinical stage(T or M classification)and ZIC2 levels were independent prognostic factors for overall survival.Moreover,a subgroup analysis revealed that patients with moderate or poor grade tumors,T1-2 tumors,N0 tumors,early American Joint Committee on Cancer(AJCC)stage,and old age were more likely to present with overexpression of ZIC2.To conclude,ZIC2 is upregulated in HCC and associated with the histology and survival of HCC patients. Conclusions:The expression status of ZIC2 may serve as an independent prognostic marker of HCC.

HBV A1762T/G1764A double nucleotide substitution (also called TA mutation) is relatively common in liver diseases. Hepatocyte nuclear factor 4 (HNF4) is one of liver-enriched transcription factors, and TA mutation is located in the binding region of HNF4 and HBV and plays an important regulatory role in HBV gene transcription and replication. Several studies have pointed out that TA mutation may aggravate liver diseases after HBV infection and increase the risk of chronic liver failure and liver cancer; however, it is still unclear how TA mutation can aggravate liver disease after HBV infection, and more studies are needed for clarification in the future. This article reviews the association between HBV A1762T/G1764A double nucleotide substitution and liver diseases.

Hepatitis B virus （HBV） infection can cause acute or chronic infection， while untreated patients can develop into liver cirrhosis or liver cancer， thereby leading to death. As one of the most important organelles of cells， the maintenance of the normal morphology and function of mitochondria is the basis for ensuring various physiological activities in cells， and physiological activities， such as mitochondrial dynamics， mitophagy， injury， and oxidative phosphorylation， can affect the maintenance of mitochondrial homeostasis. HBV infection can affect mitochondrial homeostasis. This article summarizes the research advances in mitochondrial homeostasis and HBV infection from the four aspects of mitochondrial dynamics， mitophagy， mitochondrial oxidative phosphorylation， and mitochondrial injury and discusses the association between the maintenance of mitochondrial homeostasis and HBV infection， in order to provide a theoretical basis for understanding the molecular mechanism of HBV infection and identifying the potential therapeutic targets for HBV.

Gastroesophageal reflux disease(GERD)is a common digestive disorder with a global prevalence of approximately 13%.The primary surgical options include the 360° Nissen fundoplication,270° Toupet fundoplication,and 180° Dor fundoplication.While the Nissen procedure demonstrates superior long-term outcomes compared to the other methods,it is associated with a higher incidence of postoperative dysphagia.Surgical decisions should be individualized based on esophageal motility and pH monitoring.The surgery not only aims to repair anatomical structures,but also to restore function,including the length of the abdominal esophagus and the angulation between the crura diaphragm and the spine.Reconstruction of the gastroesophageal valve and the phrenoesophageal fascia is crucial for optimizing surgical outcomes and preventing postoperative complications.Given the physiological and psychological changes associated with GERD,personalized treatment is essential for improving symptoms and enhancing quality of life.