Objective To evaluate total laparoscopic splenectomy combined with pericardial devascularization. Methods In this study,40 patients with portal hypertension and hypersplenism underwent total laparoscopic splenectomy combined with pericardial devascularization,in which 26 cases had a history of up-GI bleeding. Results Procedures were successful in 36 patients.There was four conversions to open surgery.The operations were completed in a mean time of (224 ± 54) min,with a mean estimated blood loss of (296 ± 209) ml and with no serious complication. Conclusion Total laparoscopic splenectomy combined with pericardial devascularization is a safe and effective available minimally invasive procedure in patients with portal hypertension and hypersplenism.

Objective To review our clinical experience on 12 patients with retroperitoneal infection who were treated with retroperitoneal laparoscopic debridement.Method This retrospective study included 12 patients with retroperitoneal infection who were treated with retroperitoneal laparoscopic dehridement and drainage.Results All the 12 patients recovered well and were finally discharged home.Conclusions Retroperitoneal laparoscopic debridement and drainage for retroperitoneal infection is a mini-invasive procedure.It was found to be safe,produced minimal bleeding and resulted in rapid postoperative recovery.It can be used as the first choice treatment in properly selected patients.

Objectives: To investigate the effects of adhesion and proliferation of bone mesenchymal stem cells (BMSCs) in the surface of lactic acid/glycolic acid/asparagic acid-co-polyethylene glycol PLGA-[ASP-PEG] tri-block polymer scaffolds, try to find a new biomaterial to induce seed cells in vitro for bone tissue engineering. Methods: Modified PLGA with polyethylene glycol (PEG) and asparagic acid (ASP) that has many ligands, and synthesis PLGA-[ASP-PEG] polymer material. BMSCs were cultured in PLGA-[ASP-PEG] polymer material and PLGA used as control group. Through precipitation method, MTT assay and total cellular protein detection to test the adhersion and proliferation of BMSCs. Scanning electron microscope is used to observe cells appearance. Results: BMSCs on the surface of PLGA-[ASP-PEG] polymer scaffolds are adherention to the culture flask, the number of cells is much higher than PLGA’s. The precipitation method suggest that adhesion and proliferation of BMSCs on the surface of PLGA-[ASP-PEG] is much higher than the control group(P

Abstract: Objective To investigate the prevalence and pathogenic characteristics of Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan, and to provide a basis for the prevention and treatment of infectious diarrhea in children. Methods Feces were collected from under five-year-old children with diarrhea in the First Affiliated Hospital of Dali University from 2020 to 2021. Clinical information of the cases was also collected. Yersinia enterocolitica was isolated from the samples after cold enrichment on selective culture plates, and the pathogenic characteristics of Yersinia enterocolitica were analyzed by biological type and serotype and virulence gene detection. Results A total of 397 feces were collected. Seven strains of Yersinia enterocolitica were isolated in three samples, and the prevalence of Yersinia enterocolitica infection was 0.76% (3/397). Among the three positive samples, two Yersinia frederiksenii or Yersinia intermedia were isolated in specimen No. 212 , and five Yersinia enterocolitica were detected in specimens No. 24 and 226. Two Yersinia enterocolitica isolated from one sample were biological type 1A, and the virulence gene test results were ail-/ystA-/ ystB+ /yadA-/virF-, which were non-pathogenic Yersinia enterocolitica. Three Yersinia enterocolitica isolated from the other sample were biological type 3, serotype O∶3 (rfbc+), and virulence gene detection results were ail+/ystA+/ystB-/yadA+ /virF+, which were pathogenic Yersinia enterocolitica. While pathogenic Yersinia enterocolitica was detected from feces of children with diarrhea at 11 months of age with a infection rate of 0.50%(2/397). Conclusion Sporadic infection of pathogenic Yersinia enterocolitica was found in under five-year-old children in western Yunnan Province. It is necessary to strengthen the monitoring and research of Yersinia enterocolitica.

Objective To evaluate the effect of obesity on the incidence of surgical site infection (SSI) in patients with inguinal hernia after tensionless repair and its treatment.Methods Clinical data of 628 cases with inguinal hernia undergoing tensionless repair from Sep.2008 to May.2016 were retrospectively analyzed.The 628 patients were divided into obesity group (n=150) and non-obesity group (n=478),or SSI group (n=9) and non-SSI group(n=619).The effect of obesity on SSI after inguinal hernia and its treatment was analyzed.Re sults Among the 628 patients,SSC happened to 9 patients and the incidence was 1.43％.The rate of SSI in obesity group and non-obesity group was 4.00％ (6/150) and 0.63％ (3/478),respectively (x=6.960,P=0.002).BMI was 30.92±3.03 and 26.24±3.79 respectively in SSI group and non-SSI group (t=3.686,P=0.000).The difference has statistical significance.Factors such as diabetes,age,sex,albumin levels,American society of anesthesiology (ASA),type of hernia,method and duration of operation had no significant difference between SSI group and non-SSI group (P＞0.05).Conclusion By analyzing the risk factors of SSI after tensionless hernia repair,we find that patients with obesity are more likely to have SSI.Strengthening prevention and early treatment is a key measure to prevent postoperative infection in these patients.

OBJECTIVETo observe the effect of electro-needling at acupoints of the yangming meridian on the expression of platelet associated complement-1 (PAC-1) and lower limb functions in acute cerebral infarction (ACI) patients.

METHODS58 ACI patients were randomly assigned to the treatment group and the control group. Conventional therapies were given to all patients. Additionally, the electro-needling at acupoints of the yangming meridian was given to patients in the treatment group. Changes of PAC-1 were detected using flow cytometry. Effect of lower limbs functions of ACI patients before and after electro-needling was assessed using Fugl-Meyer Index. Meanwhile, 20 healthy subjects were selected for reference value.

RESULTSIn the acute stage, the PAC-1 level in ACI patients were significantly higher than that in healthy subjects (P<0.05). The PAC-1 level in the electro-needling group was obviously lowered after treatment (P<0.01). There was no significant difference in the control group between before and after treatment. Significant difference was found in Fugl-Meyer index in the same group between before and after two-week treatment (P<0.05). It was higher in the electro-needling group than in the control group, showing significant difference (P<0.01).

CONCLUSIONSPlatelet activation exists in the acute stage of ACI. Electro-needling at acupoints of the yangming meridian showed obvious inhibition on PAC-1 levels, could improve lower limbs functions of ACI patients. It was inferred that electro-needling at acupoints of the yangming meridian promoted the recovery of paralyzed lower limbs at the early stage mainly by regulating PAC-1 levels, thus postponing the progress of ACI.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction ; metabolism ; rehabilitation ; therapy ; Electroacupuncture ; Female ; Humans ; Lower Extremity ; Male ; Middle Aged ; Platelet Membrane Glycoproteins ; metabolism ; Recovery of Function ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVETo evaluate the treatment outcomes of sacral nerve stimulation(SNS) for functional anorectal pain(FAP).

METHODSA total of 32 patients of FAP received SNS treatment through S3 from March 2011 to December 2011. Visual analogue scale(VAS), anal pressure measure, and health survey(SF-36) before and after treatment were used to evaluate the outcomes.

RESULTSAfter treatment, VAS score was significantly decreased, rectal anal reflex threshold volume elevated, and anal maximum contraction pressure (AMCP) and anal rest pressure significantly decreased compared with those before treatment(all P<0.01). Except for general health, the remaining dimension score of the SF-36 increased significantly after treatment, and the differences were statistically significant(P<0.05 or P<0.01). After SNS treatment, 19 cases were cured, 12 improved, 1 was refractory. The total effective rate was 96.9% during 3 months after treatment.

CONCLUSIONSNS is a safe and effective alternative for FAP and can alleviate the pain symptom and improve the quality of life.

Fecal Incontinence ; Humans ; Lumbosacral Plexus ; Pain ; Pain Management ; Quality of Life ; Rectum ; physiopathology ; Spinal Cord ; physiopathology ; Treatment Outcome

Objective To establish an extensively drug-resistant Acinetobacter baumannii (XDR-AB) infection model using Caenorhabditis elegans (C.elegans),and evaluate the effect of efflux pump inhibitors(EPIs) on reversal of ciprofloxacin resistance in XDR-AB.Methods XDR-AB infection model of C.elegans was established,six EPIs(CCCP,PAβN,NMP,omeprazole,reserpine,and verapamil)combined with ciprofloxacin were used to treat the infected model,the survival rate of C.elegans was recorded to evaluate the in vivo activities of drugs,toxicity test and in vitro drug susceptibility test were also performed.Results Lethal effect of different concentrations of XDR-AB on C.elegans was varied,5 × 106 CFU/mL of XDR-AB was selected to infect C.elegans.C.elegans survival test showed that survival curves of C.elegans infected with XDR-AB for 3 hours and curves of control group (polymixin B was added) were not significantly different (x2 =3.154,P＞0.05);compared with control group,survival curves of C.elegans infected with XDR-AB for 6 hours or 9 hours were significantly different (both P＜0.001),but 6 hours and 9 hours were not significantly different(x2 =0.669,P＞0.05),6 hours was chosen as the duration of infection,36 hours was appropriate for the duration of antimicrobial therapy.Ciprofloxacin with EPIs for infection model revealed that low concentration of PAβN,NMP,omeprazole,and reserpine could improve the survival rate of C.elegans by 30％-40％,15％-20％,20％-30％,and 20％ respectively,high concentration of verapamil could improve the survival rate of infected C.elegans by about 30％.In vitro susceptibility test and toxicity test results showed that ciprofloxacin combined respectively with CCCP,omeprazole,and verapamil could reduce minimum inhibitory concentration(MIC) to the original 1/4,combined respectively with PAβN,NMP,and reserpine could reduce MIC to the original 1/2,CCCP had the best bacterial inhibitory effect in vitro,but the toxicity was large,and was not suitable for the study of pharmacodynamics in vivo.Conelusion The infection model of C.elegans XDR-AB is initially and successfully established,which is used to evaluate the efficiency of six EPIs for reversing ciprofloxacin resistance.

BACKGROUNDInflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs). In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA.

METHODSBetween 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs. The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors. All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared.

RESULTSThe two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs. 42.4%, P = 0.001) and had larger aneurysms on admission ((7.4 +/- 0.7) cm vs. (6.3 +/- 0.9) cm, P = 0.006). In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5 +/- 9.1) mm/h vs. (11.4 +/- 5.4) mm/h, P < 0.05). Surgical morbidity and mortality rates did not differ between the two groups. The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308 +/- 36) minutes vs. (224 +/- 46) minutes, P < 0.05), but the cross-clamp time was similar in both groups ((41.5 +/- 6.2) minutes vs. (41.8 +/- 6.2) minutes, P = 0.92). A five-year survival rate analysis showed no significant difference between the two groups (P = 0.711).

CONCLUSIONSDespite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause low morbidity and mortality, similar to patients with aAAA. Long term outcome of IAAA patients is of no difference from aAAA patients.

Adult ; Aged ; Aortic Aneurysm, Abdominal ; mortality ; pathology ; surgery ; Atherosclerosis ; complications ; pathology ; Case-Control Studies ; Female ; Humans ; Inflammation ; complications ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective To study whether CETP TaqIB,KCNE1 S38G and eNOS T-786C genetic polymorphisms are associated with non-valvular atrial fibrillation in the Han population from Zhejiang province.Methods Polymerase chain reaction restriction fragment length polymorphism assay was used to detect the distribution of alleles and genotypes of CETP TaqIB,KCNE1 S38G and eNOS T-786C in 147 patients with non-valvular atrial fibrillation and in 147 subjects as controls in Han population of Zhejiang province.Results (1)The frequency of CETP B1 allele in NVAF patients was higher than that of the control group and showing a statistically significant difference(OR=1.763,95%CI:1.247-2.492.P=0.002). (2) Results from logistic regression analysis revealed that: after adjustment of confounding variables such as sex,age,smoking,hypertension and body mass index,data from the binary logistic analysis showed a statistically significant difference in CETP TaqIB genetic polymorphism between Patients and controls.(3)From multifactor dimensionality reduction analysis,results showed an interaction of CETP TaqIB,KCNE1 S38G and eNOS T-786C genetic polymorphisms.Odds ratio of the three simultaneously existing genetic polymorphisms was 1.849 times more than CETP TaqIB alone.Conclusion CETP BI allele was an independent risk factor for predisposition to non- valvular atrial fibrillation.These findings suggested that the simultaneous existence of CETP B1,KCNE1 S38G and eNOS T-786C allele might be elevated with the predisposition to non-valvular atrial fibrillation in the Han population of Zhejiang province.