For treatment of pediatric inguinal hernia, we fabricated a device, i.e. so called "filling type pediatric hernia sac", which treats the problem from the abdominal cavity, through the abdominal and is a self-adaptive closer, using synthetic material. The device includes filling rack, self-adaptive umbrella support bar, bottom piece, outside pulling line and device fixing lines. The filling rack is composed of 2 concentric circles of 3.0 cm diameter with peripherally fixed together and can be pulled into the shapes of a ball or an olive. The supporting bar is structured of 3 pieces with 0.5 cm wide, 4.0 cm long, cross-fixed on top of the filling rack. The bottom piece is in a circular structure with a diameter of 3.0 cm, and it is connected to the filling rack bottom. Adjust positioning stay outside the fixed on the top of the device are connected at one end, and the other end free through filling the top frame connected with the bottom slice of central fixation. By using this device, we treated 37 pediatric inguinal hernia cases with 38 side-inguinal hernia successfully. The mean duration of post-operation follow-ups was 14.6 ± 5.89 months, without hernia recurrence, obvious scar and hard sections of inguinal region. This device could provide a convenient, safe and effective plugging technology for children's pediatric hernia.
Child ; Hernia ; therapy ; Herniorrhaphy ; instrumentation ; Humans

Objective To study the relationship between spiral CT features and histological differentiation of gastric carcinoma.Methods Triphasic spiral CT scans with water filling method and administration of hypotonic agent were performed in 55 patients with advanced gastric carcinoma.Spiral CT findings were compared with postoperative pathology and histological differentiation.Results(1)The size and enhanced features of the lesions were significantly correlated with tumor histological differentiation(P

Objective To analyze the imaging features of ovarian thecoma-fibroma in multi-slice CT (MSCT )and improve the di-agnostic level.Methods CT features of 26 patients with 28 pathologically confirmed lesions were analyzed retrospectively.Correla-tion between tumor length and ascites and menopause was analyzed.Results Of 26 patients (28 lesions),24 patients were unilateral, 2 patients were bilateral.Of 28 lesions,there were 18 ovarian thecoma,6 fibrothecoma and 4 fibroma.The longest diameter of tumor ranged from 34.74 mm to 227.64 mm (mean value 101.06 mm±42.25 mm).The longest diameter of tumor in the group of ascites (n=1 7)was larger than that of without ascites.All the tumors had well-defined border,with 24 of them round or oval in shape,4 lobulated;with 22 of them solid in composition,4 mixed,2 cystic;with 20 of them inhomogeneous in density.The tumors showed no or mild enhancement,0-5 HU added CT value in 1 1,5-10 HU in 1 1,10 -20 HU in 6,with 4 cases showing multiple slim blood vessels during the arterial phase.Conclusion The typical imaging features of ovarian thecoma-fibroma were unilateral,oval,solid mass with well-defined border,no or mild enhancement (less than 20 HU)and accompanied by ascites.These characteristics will be helpful in the diagnosis and differential diagnosis of ovarian thecoma-fibroma.

Objective To observe the effects of TLR9 on the nude mouse transplanted tumor growth of human pancreanc cancer and its drug resistance.Methods The nude mouse transplated tumor of human pancreatic cancer PANC-1 was established and randomly divided into 6 groups for conducting the experiment:sterile normal saline group,TLR9 agonist,TLR9 inhibitor group,gemcitabine group,TLR9 inhibitor plus gemcitabine Bin group,TLR9 agonist plus gemcitabine.The tumor size and growth situation were recorded by the vernier caliper.The immunohistochemical method was used to detect tumor TLR9 receptor expression.The tumor growth,metastasis and paracancerous nssue invasion situation were observed by the magnetic resonance imaging (MRI).Results The volume and growth speed of resected tumor mass in the gemcitabine group,TLR9 agonist + gemcitabine group,TLR9 inhibitor plus gemcitabine group was significantly smaller than those in other groups (P＜0.05),which in the TLR9 agonist + gemcitabine group were significantly greater than those in the TLR9 inhibitor plus gemcitabine group and gemcitabine group (P＜0.05),the difference between the TLR9 inhibitor plus gemcitabine group and gemcitabine group had statistical significance (P＜0.05),while the difference among the TLR9 agonist group,TLR9 inhibitor group and normal saline group had no stastistical significance (P＞0.05).The tumor in mice at 7 weeks after planting showed oval shape with clear boundary by MRI observation,no obvious metastais and paracancerous invasion were seen in paracancerous nssues no statistically significant,5 weeks,6 weeks after planting,seven weeks mice observed in MRI,the tumor into an,state clearly that the transfer of the surrounding tissue,no significant vascular invasion,heart,liver,kidney disease.The TLR9 expression on the surface of tumor tissue was detected and identified.Conclusion Pancreatic cancer nude mouse transplated tumor has definitely positive expression of TLR9,TLR9 activation can significantly decrease the sensitivity of pancreatic cancer to chemotherapy,increases the drug resistance of tumor,on contrary promotes the tumor growth.

Objective To investigate the CT spectral imaging features of benign and malignant ovarian tumors and to assess the value of spectral CT in differentiating between benign and malignant ovarian tumors.Methods This study was granted by the institutional review board with a waiver for informed consent.34 patients with ovarian tumor(11 benign tumors and 23 malignant tumors)underwent preoperative CT scanning that included arterial phase (AP)and venous phase (VP)with GSI mode.Measurements were performed on the GSI viewer.The iodine concentration (IC,100 ug/cm3)was saved,and the normalized iodine concentration (NIC)and the spectral curve(spectral Hounsfield unit curve)were recorded.The slope of the curve was calculated as the formula:(CT attenuation (40 keV)-CT attenuation(100 keV))/60.The CT value was measured at 70 keV in Mono image.CT values,the slope of the spectral curve,the iodine concentration and NIC were compared between the two groups by using independent sample t-test with software SPSS 2 1.0.Receiver operating characteristic (ROC)was used to determine the threshold of slope of the spectral curve,the iodine concentration and NIC for differentiating benign and malignant ovarian tumors in VP.Results The slope of the spectral curve,the iodine concentration and NIC of malignant ovarian tumors in VP were 1.72±0.77,14.50±6.44 (100 μg/cm3),and 0.33±0.12.The slope of the spectral curve,the iodine concentration and NIC of benign ovarian tumors in VP were 1.05±0.48,8.86±4.04 (100 μg/cm3),and 0.22±0.13.Significant differences were found between the slope of spectral curve,the iodine concentration and NIC of the malignant ovarian tumors and those of the benign ovarian tumors in VP (P=0.01).CT values in double phases revealed no difference between these two groups (P>0.05).Conclusion There is a significant difference between the solid component of benign ovarian tumors and that of malignant ovarian tumors in spectral CT.GSI scan mode can provide more information for the differential diagnosis of benign and malignant ovarian tumors.

Objective: To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy. Methods: The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5.3 software. Results: A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle’s maneuver alone (MD=-314.59, 95%CI: -362.37~-266.81, P<0.05). Bleeding during hepatectomy was significantly lower (MD=-217.79, 95% CI: -284.57~-151.00, P<0.05); so was the intraoperative blood transfusion rate (OR=0.48, 95% CI: 0.36~0.62, P<0.05). The incidence of complications was significantly lower (OR=0.74, 95% CI: 0.57~0.95, P<0.05). However, there were no significant differences in operation time, length of hospital stay, intraoperative monitoring index and postoperative liver and kidney function recovery (P>0.05). Conclusions Infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver in hepatectomy was safe and reliable. Compared with the Pringle’s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.

Objective To investigate the opportunity and skill of surgery for pancreatic sinistral portal hypertension.Methods Clinical data were retrospectively analyzed on 15 cases of pancreatic sinistral portal hypertension admired from Dec 2015 to Dec 2017.Results All fiften cases underwent surgical treatment,among them three cases were initially treated conservatively in the early stage and treated surgically for gastrointestinal bleeding,12 cases with definite pancreatic disease and pancreatic sinistral portal hypertension treated in the first stage.Three patients underwent second surgery for recurrent gastrointestinal bleeding.The patients were followed up for 6 to 18 months with symptoms significantly impioved without deaths.Conclusions Splenectomy combined with esophagogastric devascularization is the basic surgical treatment for pancreatic sinistral portal hypertension.

Objective:To elucidate the change of whole genome expression profile for the effect of melatonin on radiation-induced intestinal injury in mice.Methods:C57BL/6J male mice were administrated with melatonin at 10 mg/kg body weight by intraperitoneal injection once a day for five consecutive days before abdominal irradiation with 14 Gy of γ-rays. Small intestines were harvested 3 d after radiation. GO annotation and KEGG pathway of the differential genes involved in small intestine were explored by DNA microarray analysis.Results:Compared with the control group, 584 differential genes were up-regulated and 538 differential genes were down-regulated for administration group pre-irradiation. The overlapping differential genes were selected from the irradiated mice and the administrated mice pre-irradiation. There were 324 up-regulated genes and 246 down-regulated genes unique to the administrated mice pre-irradiation. GO annotation analysis of the differential genes indicated that the top 15 significantly enriched biological processes for the administrated mice pre-irradiation mainly included autophagosome assembly (GO: 0000045), autophagosome organization (GO: 1905037) and regulation of acute inflammatory response (GO: 0002673). The genes ATG12, ATG16L2 and AMBRA1 were involved in autophagosome assembly and autophagosome organization. The genes C3, CPN1, CD55, CFP, CNR1, C1QA, C2 and CREB3L3 were involved in the regulation of acute inflammation response. KEGG pathway analysis of the differential genes involved indicated that the top 15 significantly enriched pathways for the administrated mice pre-irradiation mainly included O-glycan biosynthesis (hsa00512), glycosphingolipid biosynthesis (hsa00603), ECM-receptor interaction (hsa04512) and biosynthesis of unsaturated fatty acids (hsa01040). qRT-PCR verification showed that the expressions of ATG12 and ATG16L2 genes involved in autophagy for the administrated mice pre-irradiation increased significantly compared with the irradiated mice ( t=2.40, 4.35, P<0.05). Conclusions:The differential genes related with the biological process of autophagy, acute inflammatory response and the pathway of unsaturated fatty acid biosynthesis might be involved in the effect of melatonin on radiation-induced intestinal injury.