Objective To explore the clinical efficacy of the new transumbilical laparoscopy and the conventional three-port method in the treatment of unilateral huge(≥15 mm)indirect inguinal hernia.Methods A retrospective analysis was conducted on the clinical data of 213 children with unilateral huge(≥15 mm)indirect inguinal hernia admitted to the hospital from July 2020 to August 2023.According to different surgical methods,the children were divided into the three-port group(107 cases,undergoing three-port laparoscopic high ligation of hernia sacs)and the new group(106 cases,undergoing new transumbilical laparoscopic surgery).The surgical indicators of the two groups of children,the face,legs,activity,cry,consolability(FLACC)score,parents'satisfaction with the appearance of the incision,testicular volume,postoperative complications and recurrence rate(within 1 year after surgery)were compared.Results The intraoperative blood loss and the number of incisions in the new group were less than those in the three-port group,while the incision length,operation time,postoperative incision healing time and hospital stay were shorter than those in the three-port group.The differences were statistically significant(P<0.05).At 6,12,24 and 48 hours after the operation,the FLACC score of the new group was lower than that of the three-port group,and the difference was statistically significant(P<0.05).The satisfaction rate of parents of children in the new group with the appearance of the incision was 100.00%,which was higher than 88.79%in the three-port group,and the difference was statistically significant(P<0.05).The volume of the affected testicle in both groups before the operation was smaller than that of the healthy side,and the volume of the affected testicle one year after the operation was larger than that before the operation.The differences were statistically significant(P<0.05).One year after the operation in the new group,there was no statistically significant difference in the testicular volume between the healthy side and the affected side(P>0.05).There was no statistically significant difference in the total incidence of complications and overall recurrence rate between the two groups(P>0.05).Conclusion Compared with the conventional three-port method,the new transumbilical laparoscopic surgery has the characteristics of convenient operation,less trauma,less pain,faster postoperative recovery and a beautiful incision.It has more advantages when applied in the treatment of unilateral huge indirect inguinal hernia≥15 mm.

Objective To explore the clinical efficacy of the new transumbilical laparoscopy and the conventional three-port method in the treatment of unilateral huge(≥15 mm)indirect inguinal hernia.Methods A retrospective analysis was conducted on the clinical data of 213 children with unilateral huge(≥15 mm)indirect inguinal hernia admitted to the hospital from July 2020 to August 2023.According to different surgical methods,the children were divided into the three-port group(107 cases,undergoing three-port laparoscopic high ligation of hernia sacs)and the new group(106 cases,undergoing new transumbilical laparoscopic surgery).The surgical indicators of the two groups of children,the face,legs,activity,cry,consolability(FLACC)score,parents'satisfaction with the appearance of the incision,testicular volume,postoperative complications and recurrence rate(within 1 year after surgery)were compared.Results The intraoperative blood loss and the number of incisions in the new group were less than those in the three-port group,while the incision length,operation time,postoperative incision healing time and hospital stay were shorter than those in the three-port group.The differences were statistically significant(P<0.05).At 6,12,24 and 48 hours after the operation,the FLACC score of the new group was lower than that of the three-port group,and the difference was statistically significant(P<0.05).The satisfaction rate of parents of children in the new group with the appearance of the incision was 100.00%,which was higher than 88.79%in the three-port group,and the difference was statistically significant(P<0.05).The volume of the affected testicle in both groups before the operation was smaller than that of the healthy side,and the volume of the affected testicle one year after the operation was larger than that before the operation.The differences were statistically significant(P<0.05).One year after the operation in the new group,there was no statistically significant difference in the testicular volume between the healthy side and the affected side(P>0.05).There was no statistically significant difference in the total incidence of complications and overall recurrence rate between the two groups(P>0.05).Conclusion Compared with the conventional three-port method,the new transumbilical laparoscopic surgery has the characteristics of convenient operation,less trauma,less pain,faster postoperative recovery and a beautiful incision.It has more advantages when applied in the treatment of unilateral huge indirect inguinal hernia≥15 mm.

Objective To investigate the correlation between the severity of alcoholic fatty liver disease and the amount of fat in the abdominal cavity and the serum inflammatory factor IL-18 and IL-8. Methods From October 2016 to October 2017,one hundred and twenty patients with AFLD in the First Hospital of Hebei Medical University were divided into light,medium,heavy groups according to the severity of fatty lesions by color Doppler Ultrasound. There were 40 mild patients,50 moderate patients and 30 severe patients. Forty healthy subjects were selected as controls. All the participants underwent CT scanning. The intra-abdominal fat area (VAT),abdominal subcutaneous fat area (SAT) and total abdominal fat area (TA) were measured. The liver function was measured by biochemical analyzer and enzyme-linked immunoassay (ELISA). (ELSIA) IL-18 was detected and IL-8 was detected by radioimmunoassay. Results The VAT of the healthy control group and the mild,medium and severe AFLD group were (70. 28±10. 19),(114. 38 ± 9. 97),(146. 73±10. 19),(163. 38±12. 69) cm2. The TA of the healthy control group and the mild, medium and severe AFLD group were ( 256. 72± 34. 56),( 332. 19 ± 33. 28),( 387. 49± 32. 28),( 478. 19 ±31. 02) cm2. The SAT of the healthy control group and the light,medium and severe AFLD group were (156. 23±28. 19),(203. 43±27. 12),(246. 19±26. 89),(271. 19 ±27. 94) cm2,respectively. Aspartate aminotransferase (AST) of the healthy control group and the mild,medium and severe AFLD group were (18. 50±1. 12),(23. 50±1. 21),(25. 50±1. 24),(29. 50± 1. 43) U/L. Alanine aminotransferase (ALT) of the healthy control group and the light, medium and severe AFLD group were ( 18. 50 ± 2. 14), ( 26. 50 ±2. 22),(35. 50±2. 34),(38. 50±2. 11) U/L. γ-glutamyltransferaseof the healthy control group and the light,medium and severe AFLD group were ( 16. 50 ± 2. 11), ( 32. 50 ± 2. 23), ( 47. 50 ± 2. 31), ( 48. 00 ±2. 43) U/L,respectively. Compared with the healthy control group,VAT,TA,SAT,AST,ALT andγ-GT in the light,medium and heavy AFLD group showed statistically significant differences ( P＜0. 05) . Compared with the mild AFLD group, VAT, TA, SAT, AST, ALT and γ-GT in the medium and heavy AFLD group showed statistically significant differences ( P＜0. 05) . Compared with the moderate AFLD group,the VAT, TA,SAT, AST, ALT, and γ-GT of the severe AFLD group showed statistically significant differences ( P＜0. 05). The data of the three AFLD groups showed that the concentration of all indicators were increasing as the severity of fat deepened. IL-18 of the healthy control group and the light,medium and severe AFLD group were (45. 67±4. 51),(52. 18±5. 09),(59. 87±4. 98),(64. 18±5. 12) ng/L; IL-8 of the healthy control group and the light, medium and severe AFLD group were ( 78. 92 ± 5. 07), ( 115. 62 ± 4. 89), ( 223. 76 ± 6. 78),(286. 42±7. 02) g/L. Compared with every group,IL-18 and IL-8 of light,medium and severe AFLD group showed statistically significant differences (F＝1035. 67,2. 93×105,P＜0. 001); compared with mild AFLD group,IL-18 and IL-8 of medium and heavy group showed statistically significant differences;compared with moderate AFLD group,IL-18 and IL-8 of severe group AFLD showed statistically significant differences ( P＜0. 001) . The levels of inflammatory factors IL-18 and IL-8 increased with the severity of steatosis. The severity of AFLD was significantly positively correlated with VAT,TA,SAT,IL-18 and IL-8 ( r 0. 415(P＜0. 001), 0. 435 ( P＜0. 001), 0. 512 ( P＜0. 001), 0. 274 ( P＜0. 001 ), 0. 689 ( P ＜0. 001). Conclusion Fat control is an important measure to prevent AFLD. IL-18 and IL-8 can reflect the severity of liver injury in AFLD and have important significance in judging prognosis.

BACKGROUND:Umbilical cord mesenchymal stem cells are plentifully and conveniently obtained with a high proliferative ability, and have opened up a new way to treat patients with liver failure as they can differentiate into hepatocyte-like cells.OBJECTIVE:To observe the safety and efficacy in the treatment of chronic liver failure by transplanting umbilical cord mesenchymal stem cells.METHODS:Using parallel contrast method, 50 patients with chronic liver failure were divided into two groups, namely a stem cell group and a control group, containing 25 patients in each group. For the first group, transplantation of umbilical cord mesenchymal stem cells, (1.4-2.3)×106/kg, 100 mL, was given on the basis of medical comprehensive treatment,while for the second group only simple medical comprehensive treatment was given. The injection was done every 15 days, totally three times. Liver functions, prothrombin activity, Model for End-Stage Liver Disease (MELD) score, clinical symptoms, survival and side effects of the patients were observed before and 2, 4, 12 and 24 weeks after the treatment.RESULTS AND CONCLUSION:Compared with the control group, the albumin level and prothrombin activity were significantly increased in the stem cell group 12 and 24 weeks after treatment (P < 0.05), while the MELD score was significantly decreased in the stem cell group at 4, 12 and 24 weeks after treatment (P < 0.05). There was no significant difference in alanine aminotransferase and total bilirubin levels between the two groups (P > 0.05). Four weeks after treatment, clinical symptoms of the stem cell group improved significantly in comparison with the control group (P < 0.05).During the 24-week follow-up, the survival rate in the stem cell group was significantly higher than that in the control group (P < 0.05). Additionally, there were no adverse reactions and liver cancer associated with the stem cell therapy.Results show that it is safe and effective to treat patients with chronic liver failure through the transplantation of umbilical cord mesenchymal stem cells, and the cell transplantation can significantly improve patients' survival rate.

Objective To explore the role of CD4+CD25+CD127low/-regulatory T cells (Tregs) in the pathogenesis of psoriasis vulgaris(PV). Methods Flow cytometry analysis was used to detect the amount of Tregs in peripheral blood and ELISA to test the levels of IL-10 and TGF-β1 in blood serum; the suppressive function of Tregs on autologous CD4+CD25-T cells was determined by MTT method. Results No significant difference was found in the proportion of Tregs in PV patients and healthy controls(P>0.05). There was a diminished suppression of Tregs from patients on autologous CD4+CD25- responder T cell proliferation in PV patients when compared with that in controls (P < 0.01). The serum level of IL-10 in patients was lower than that in controls (P < 0.01) while that of TGF-β1 in PV patients was significantly higher than that in controls(P < 0.01). Conclusion Abnormal function of Tregs and low secretion of IL-10 in PV patients might be related to the pathogenesis of psoriasis.