Objective To investigate the clinical effects of laparoscopic repair of esophageal hiatal hernia using Bard CruraSoft PTFE/ePTFE Mesh combined with Toupet partial fundoplication.Methods From August 2006 to April 2007,13 patients with esophageal hiatal hernia(typeⅠin 6 and type Ⅲ in 7)were treated by laparoscopy in our hospital.Under a laparoscope,esophageal hiatal hernia was separated by ultrasonic scalpel,and then repaired using Bard CruraSoft PTFE/ePTFE Mesh with Ethicon Endopath Multifieed Stapler.Afterwards,Toupet partial fundoplication was performed.Results The operation was completed in all the cases without converting to open surgery.The mean operation time was 142 min(115-185 min);mean intraoperative blood loss was 75 ml(25-120 ml);mean time to the first flatus and oral feeding was 32 h(26-37 h);and mean postoperative hospital stay was 4 d(3-6 d).The patients were followed up for 4-11 mon(mean 6.5 mon).The symptoms disappeared in 1 month.Three months after the operation,barium examination found no recurrence of the hernia in the 13 cases.Conclusions Laparoscopic repair of esophageal hiatal hernia with mesh combined with Toupet partial fundoplication is a safe and minimally invasive operation.The method is worth being widely used.

Objective To investigate effects of laparoscopic repair of abdominal wall incisional hernia using polypropylene and expanded polytetrafluoroethylene(e-PTFE) composite mesh. Methods Forty-one patients with abdominal wall incisional hernia(4~25 cm in length and 3~18 cm in width) were treated in this hospital from October 2004 to August 2005. The patients received laparoscopic mesh herniorrhaphy after complete dissection of adhesion using an ultrasonic scalpel.A polypropylene and(e-PTFE) composite mesh(Bard Composite Mesh) was used and fixed using the Ethicon Endopath Multifeed Stapler(EMS).Results The laparoscopic mesh herniorrhaphy was successfully completed in all the 41 patients without conversions to open surgery.The operative time was 60~182 min(mean,85 min).Postoperatively,the patients felt slight pain and began to take food on the second day.The time to first passing flatus was 25~41 hours(mean,32 hours).The postoperative hospital stay was 5~7 days(mean,6 days).No recurrence occurred during a follow-up period of 6~16 months(mean,9 months) in the 41 patients. Conclusions The laparoscopic incisional hernia repair using the Bard Composite Mesh is a safe and effective method.

Gene Library ; Humans ; Nucleic Acid Hybridization ; methods ; Pulmonary Fibrosis ; diagnosis

This study was to appraise safety and feasibility of laparoscopic approach and investigate the clinical effects of laparoscopic tension-free repair of esophageal hiatal hernia using mesh. From August 2006 to July 2009, 24 patients with esophageal hiatal hernia underwent laparoscopic repair. Twenty-three patients received laparoscopic tension-free repair using mesh, at the same time, Toupet or Dor partial fundoplication was performed. One patient was converted to open surgery. The average operating time was 90 min (70-210 min) and the blood loss was between 10-110 mL. There was no death. The mean postoperative hospital stay was 5 days (3-30 days). During a follow-up period of 12-20 months (mean 15 months), there was no recurrence of the hernia, and no complication with use of mesh. The present study suggested that laparoscopic approach was secure and minimally invasive operation for esophageal hiatal hernia and the use of mesh could reduce recurrence rate.

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.

Objective In order to master the current situation of Keshan disease in Yunnan province and to provide scientific basis for Keshan disease control and prevention. Methods Eighteen villages were selected as the investigation sites in 6 counties across all the Keshan disease wards in Yunnan province,where the residents were investigated. Then,the villages census data was collected,clinical examination aiming mainly on cardiovascular system was carried out,including electrocardiography and X-ray to the suspected patients. Correct diagnose of Keshan disease was made by the Diagnostic Standard of Keshan Disease(GB 17021-1997). At the same time,10 food samples and 10 hair samples for detecting selenium content in every investigation site. Results There were 9818 residents investigated in the 18 investigation sites in 6 counties,and 34 eases of Keshan disease were found,the total incidence rate was 0.35%(34/9818). Among the 34 Keshan disease eases,32 cases were latent Keshan disease,the incidence rate was 0.33%(32/9818); 2 cases were chronic Keshan disease,the incidence rate was 0.02%(2/9818). There was no any acute and sub acute cases be found. Most Keshan disease cases aged from 5 to 14,67.65% (23/34). Abnormal ECG rate was 6.90% (677/9818). Among 56 X-ray films,47 cases had a cardiothoracic ratio less than or equal to 0.50,83.93%(47/56),5 cases from 0.51 to 0.55,8.93%(5/56),4 cases from 0.56 to 0.60,7.14%(4/56). Selenium content was detected in 180 food samples and 180 hair samples. The average food selenium content (mg/kg) was 0.013±0.010,the lowest content in Yongsheng county (0.006± 0.001),the highest content in Tonghai county(0.027±0.009). The average hair selenium eontentwas(0.252± 0.078)mg/kg,with the lowest(0.145±0.043)mg/kg in Yoagsbeng county,the highest (0.297±0.062)mg/kg in Tonghai county. Conclusions The detected ratio of Keshan disease is low in Yunnan province. Most of Keshan disease patients age from 5 to 14. It was presented that the Keshan disease infectious agents were still strong and active. The foodstuffs and hair Selenium content is low in food and hair sample,and varies in different investigation site. It is necessary to supply selenium for prevent Keshan disease in the severe areas.

Objective To evaluate laparoscopic local resection for the treatment of gastric tumors. Methods The clinical data of 78 patients who received laparoscopic local resection at the PLA General Hospital from February 2006 to January 2010 were retrospectively analyzed. According to the tumor site and free range, total laparoscopic gastrectomy was applied to 45 patients, laparoscopic local resection was applied to 22 patients, laparoscopic and endoscopic tumor resection was applied to 11 patients. The efficacies of the surgical approaches were investigated. Results Laparoscopic local resection was successfully performed on the 78 patients without conversion to open surgery. The mean operation time and operative blood loss were 75 minutes (range, 45-120 minutes) and 60 ml (range, 35-90 ml), respectively. The mean diameter of the tumor was (2.5±1.3)cm (range, 0.7-4.8 cm). No mortality or morbidity occurred postoperatively. The bowel function recovery time and the duration of hospital stay were 35 hours (range, 25-42 hours) and 7.5 days (range, 6-9 days), respectively. The results of postoperative pathological examination verified that 63 patients were with gastric stromal tumor, 11 patients were with benign gastric diseases, including 5 with gastric heterotopic pancreas, 2 with inflammatory pseudotumor, 2 with hyperplastic polyp, 1 with schwannomas and one with angioma. Four patients were with carcinoid, 3 carcinoids were located in mucous layer and 1 invaded into muscular layer. The median time of follow-up was 26 months, and no anastomotic stenosis or port-site metastasis was observed. Of the 63 patients with gastric stromal tumor, 2 were treated with imatinib mesylate, 1 had tumor recurrence and received reoperation. Conclusion Laparoscopic local resection is safe and feasible for the treatment of benign gastric neoplasms, stromal tumor and early gastric tumors.

A two-step method for the purification of blocking-type anti-human CD80 monoclonal antibody 4E5 from mouse ascites was developed using anion exchange and gel filtration in combination. The ascites was first purified by anion exchange after centrifugation and filtration. The experimental parameters of sample loading and elution were optimized. The optimized loading condition was pH 8.0,50 mmol/L Tris-HCl and satisfactory results were obtained using a 0~0.5mol/L NaCl step elution. The fraction containing the protein of interest was directly loaded on gel filtration column and eluted using a 20 mmol/L phosphate buffer at pH 7.2. The purity of the obtained monoclonal antibody was up to 95% with a recovery of 61%. The purity of mAb could efficiently inhibit the growth of Daudi cells. The amplification of the method was also studied using a Bio-Scale Q5 column and the result was satisfied.

Chemotherapeutic drugs play an important role in the treatment of cancer, but the individual differences of patients' sensitivity to chemotherapeutic drugs and the drug resistance of chemotherapeutic drugs have always been a thorny problem in clinical treatment. Recent studies have shown that gut microbiota plays a key role in regulating the efficacy of chemotherapeutic drugs. Gut microbiota can regulate host response to chemotherapy through a variety of mechanisms, including immune interaction, heterogeneous metabolism and changes in community structure. This paper introduces the effects of traditional chemotherapeutic drugs and new immunotherapeutic drugs, such as anti-CTLA-4 and anti-PD-1 antibodies, on gut microbiota, as well as their effects on chemotherapeutic efficacy and mechanism, in order to provide evidences and clues for cancer treatments targeting gut microbiota.

By summarizing the recent literatures on brain mechanisms with acupuncture intervention based on blood oxygenation level-dependent (BOLD)-functional magnetic resonance imaging (fMRI), the BOLD-fMRI examination and analysis methods, the points to be acupunctured, the corresponding meridian activation regions, the specific intensity range, functions and indications of the acupoints, the manifestation of 'bi-directional regulation' characteristics, fMRI performance of chronergy, laterality and needling qi of acupuncture were reviewed to provide the ideas for future research in this area.