Objective:To explore the risk factors of seroma after laparoscopic totally extraperitoneal hernia repair.Methods:The clinical data of 236 patients underwent laparoscopic totally extraperitoneal hernia repair from July 2018 to June 2021 in Jiaozhou Central Hospital of Qingdao City were retrospectively analyzed. The related risk factors of seroma after laparoscopic totally extraperitoneal hernia repair were analyzed.Results:Among 236 patients, the seroma occurred in 36 cases (seroma group), the incidence of seroma was 15.25%; no seroma occurred in 200 cases (non-seroma group). There were statistical differences in the duration of disease ≥5 years, scrotal hernia, internal inguinal ring defect ≥3 cm, rupture of hernia sac, experience of operators <5 years between 2 groups ( P<0.01 or <0.05); there were no statistical difference in age, body mass, type of patch, preoperative complications (including diabetes, chronic obstructive pulmonary disease and cardiac cerebrovascular disease) and operative time between 2 groups ( P>0.05). Multivariate Logistic regression analysis result showed that the duration of disease ≥5 years, scrotal hernia, rupture of hernia sac and experience of operators<5 years were independent influencing factors of seroma after laparoscopic totally extraperitoneal hernia repair ( OR = 5.147, 5.006, 0.044 and 3.315; 95% CI 1.513 to 17.516, 1.845 to 13.583, 0.008 to 0.240 and 1.029 to 10.679; P<0.01 or<0.05). Conclusions:The duration of disease ≥5 years, scrotal hernia, rupture of hernia sac and experience of operators<5 years are independent influencing factors of seroma after laparoscopic totally extraperitoneal hernia repair, and preoperative assessment of risk factors is helpful to reduce the incidence of seroma.

Objective To observe the bone marrow mesenchymal stem cells (BMSCs) modified by bone morphogenetic protein-7 (BMP-7) gene on the expression of renal BMP-7, transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF), further to explore its protective mechanism on renal injury in rats with chronic renal failure (CRF). Methods BMSCs with high expression of BMP-7 gene (BMSCs-BMP-7) and empty vector-BMSCs (BMSCs-EV) were obtained by lentiviral-mediated gene transfection. Thirty male Sprague-Dawley (SD) rats were randomly divided into 5 groups, 6 in each group: normal control (CON) group; PBS intervention (CRF with PBS infusion, CRF+PBS) group; BMSCs intervention (CRF with BMSCs infusion, CRF+BMSCs) group;BMSCs-EV intervention (CRF with BMSCs-empty vector infusion, CRF+BMSCs-EV) group and BMSCs-BMP-7 intervention (CRF with BMSCs-BMP-7 infusion, CRF+BMSCs-BMP-7) group. The CRF model was established by 5/6 nephrectomy. The CON group was a sham operation group. The corresponding 12-weeks interventions of each experimental group were performed after 2 weeks of modeling, the rats in the CON group and the CRF+PBS group were injected with 1 ml of PBS through the tail vein, and the other three groups were injected with 1 ml of the corresponding cell suspension once a week. At the time of sacrifice, blood and renal tissue samples were reserved. Serum creatinine (Scr) and blood urea nitrogen (BUN) were measured by routine biochemical methods, and the expression of BMP-7, VEGF, TGF-β1 in kidney was assayed by Western blotting. Results At the time of sacrifice, the levels of Scr and BUN in the CRF+PBS group were significantly higher than those in the CON group (all P<0.01); Compared with the CRF+PBS group, the Scr and BUN of the CRF+BMSCs group, CRF+BMSCs-EV group and CRF+BMSCs-BMP-7 group were decreased to different extents, the differences were statistically significant (all P<0.01);the Scr and BUN of the CRF+BMSCs-BMP-7 group were significantly lower than CRF+BMSCs group and CRF+BMSCs-EV group (all P<0.05). The expression of BMP-7 and VEGF were the lowest in the CRF+PBS group. Compared with the CRF+PBS group, the expression of BMP-7 and VEGF in the CRF+BMSCs group, CRF+BMSCs-EV group and CRF+BMSCs-BMP-7 group were significantly increased respectively (all P<0.05). The expression of the BMP-7 and VEGF in the CRF+BMSCs-BMP-7 group were higher than those in the CRF+BMSCs group and CRF+BMSCs-EV group (P<0.01). Compared with the CON group, the expression of TGF-β1 in the CRF+PBS group was significantly increased (P<0.01);compared with the CRF+PBS group, the expression of TGF-β1 in the CRF+BMSCs group, CRF+BMSCs-EV and CRF+BMSCs-BMP-7 group was significantly decreased (all P<0.01);the expression of TGF-β1 in the CRF+BMSCs-BMP-7 group was lower than the CRF+BMSCs and CRF+BMSCs-EV group (both P<0.01). Conclusions BMSCs modified by BMP - 7 has a protective effect on CRF rats; its protective mechanism may be related to antagonizing TGF-β1 and up-regulation of renal VEGF expression.

Animals ; Embryonic Stem Cells ; metabolism ; Histone Deacetylase 6 ; deficiency ; genetics ; metabolism ; Mice ; Reproduction ; genetics

Objective To investigate the role of silent mating type information regulation 2 homologue 1(SIRT1) in renal ischemia-reperfusion(IR) injury and its effect on NF-κBp65-peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1α) signal pathway in mice.Methods Seventy-two healthy C57BL/6 male mice were randomly divided into four groups:control group(n=18),sham-operated group(n=18),IR group(n=18),resveratrol group(n=18).Bilateral renal pedicle were clamped for 45 min was adopted to establish the model of acute ischemic renal injury,to give 2％ dimethyl sulfoxide or resveratrol by intraperitoneal injection for 7 days before modeling.Determination techniques included routine biochemical methods for the the levels of Scr and BUN,spectrophotometry for the level of superoxide dismutase (SOD),HE staining for the histological changes as well as immunohistochemical method and Western blotting for the expressions of SIRT1,NF-κBp65 and PGC-1α,respectively.Results Compared with that in control and sham-operated groups,the levels of serum Scr and BUN were higher and SOD levels in renal tissues were lower at 12 h and 24 h after operation in IR groups(P ＜ 0.05).HE staining revealed evident pathological lesions including necrosis of renal tubular epithelial cells in IR group.Compared with that in IR group,resveratrol attenuated the above-mentioned changes.Western blotting revealed the up-regulated SIRT1 expression and the activated NF-κB signal pathway,the up-regulated p65 expression and the down-regulated PGC-1αexpression subsequent to IR(P ＜ 0.05).Both Western blotting and immunohistochemistry showed that the expressions of SIRT1 and PGC-1α in resveratrol group were up-regulated compared to that in IRgroup(P ＜ 0.05),while the NF-κBp65 expression in resveratrol group was down-regulated(P ＜ 0.05).Conclusions In mouse model of renal ischemia-reperfusion injury,the activation of SIRT1 can inhibit the NF-κBp65 expression and accordingly up-regulated PGC-1α level,contributing to inhibiting inflammatory reactions and attenuating oxidative stress-induced injury in the protection of the kidneys.

Objective To investigate the expressions of interleukin(IL)-21(IL-21) and IL-22 in patients with Kimura's disease(KD).Methods Expressions of IL-21 and IL-22 were examined immunohistochemically in 36 patients with KD and 7 normal controls.The integral absorbance(IA) of the two groups was compared.Meanwhile, clinical data were reviewed.Results The IA of IL-21[M(Q): 1 373 418 (1 800 926)] and IL-22[M(Q): 462 086(484 672)] in KD was significantly higher than those in normal controls[M(Q): 70 445(44 658), 51 599(71 241), P＜0.05].The overexpression of IL-21 was significantly associated with pruritus(Z=-1.993, P＜0.05).Moreover, IL-21 was identified for disease recurrence(Z=-2.303,P＜0.05).There was a significant association between the expression of IL-22 and the number of affected sites (Z=-1.979, P＜0.05).In addition, IL-22 was significantly higher in the high-eosinophils group than in the low-eosinophils group(Z=-2.025, P＜0.05).There was no association between IL-21, IL-22 and age,gender, laterality, maximum size.Conclusions IL-21 and IL-22 may be involved in the pathogenesis of KD.

OBJECTIVEThis study aims to investigate the expression levels of serum and urinary vascular endothelial growth factor-A (VEGF-A) and epidermal growth factor-like domain 7 (EGFL7) in proliferating infantile hemangioma patients under propranolol treatment.

METHODSPropranolol (0.5-2 mg x kg(-1)) was orally administered to 30 infants every day for 4-8 months. The Achauer method was used to measure the tumor radius and thus evaluate the clinical curative effects of the treatment. Enzyme-linked immunosorbent assay was used to measure the serum and urinary concentrations of VEGF-A and EGFL7 at 0, 4, and 12 weeks after the treatment.

RESULTSThe treatment response was excellent in 2 patients, good in 11, moderate in 14, and poor in 3. Serum VEGF-A (335.692 pg x mL(-1) ± 136.146 pg x mL(-1)) was high before the treatment and then significantly decreased after 4 weeks (264.853 pg x mL(-1) ± 122.120 pg x mL(-1)) and 12 weeks (211.345 pg x mL(-1) ± 104.035 pg x mL(-1)) of treatment (P < 0.05). Urinary VEGF-A (76.234 pg x mL(-1) ± 24.169 pg x mL(-1)) was high before the treatment and then significantly decreased after four weeks (56.454 pg x mL(-1) ± l6.111 pg x mL(-1)) and twelve weeks (34.728 pg x mL(-1)) ± 12.656 pg x mL(-1)) of treatment (P < 0.05). Serum and urinary EGFL7 also decreased after the treatment, showing a positive relationship with VEGF-A.

CONCLUSIONPropranolol can be safely and effectively used to treat proliferating infantile hemangiomas. This treatment can reduce the peripheral serum and urinary concentrations of VEGF-A and EGFL7 in affected children.

Objective To evaluate the clinical efficacy of propranolol in treating proliferating infantile haemangiomas,and to measure the expression levels of vascular endothelial growth factor-A (VEGF-A) and hypoxiainducible factor 1α (HIF-1α) in sera and urine of patients during the treatment.Methods Thirty infants with proliferating haemangiomas were treated with propranolol at doses of 0.5-2 mg/kg per day.The radius of haemangiomas was measured,and blood and urine samples were obtained from these patients before,and at 4 and 12 weeks after the beginning of treatment.Clinical efficacy was estimated according to a four-graded scale as well as the feedback from parents of these patients.Enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum and urine concentrations of VEGF-A and HIF-1α.Thirty check-up infants collected from the Department of Child Health Care served as the healthy controls.Statistical analysis was done by two-way analysis of variance followed by the least significant difference (LSD) test.Results After 12 weeks of treatment,clinical response was excellent in 2 patients,good in 11,moderate in 14,and poor in 3.The serum levels of VEGF-A and HIF-1α were (268.174 ± 95.056) μg/L and (10.809 ± 1.686) mg/L respectively in the control group,sequentially decreased in the patients from baseline to 4 and 12 weeks after the beginning of treatment (VEGF-A:(385.692 ± 136.146) vs.(264.853 ± 122.12) vs.(211.345 ± 104.035) μg/L; HIF-1α:(31.462 ± 7.458) vs.(21.454 ± 5.489) vs.(12.052 ± 3.623) mg/L).The trend in expression changes of VEGF-A and HIF-1α in urine samples was similar to that in blood samples in these patients.Positive correlation was observed between the expression level of VEGF-A and HIF-1α in sera (r=0.730,P＜ 0.05) and urine (r=0.667,P＜ 0.05) of these patients.Moreover,the levels of serum VEGF-A,urine VEGF-A,serum HIF-1α and urine HIF-1α were all negatively correlated with the time course following propranolol administration (r =-0.390,-0.689,-0.806,-0.683,P ＜ 0.05,0.01,0.05,0.01 respectively).Conclusion Propranolol is effective for the treatment of proliferating infantile haemangiomas,likely by reducing serum and urinary concentrations of VEGF-A and HIF-lα in children.

BACKGROUND:Synovial mesenchymal stem cells have the ability of multilineage differentiation in vitro, which are expected to be seed cells for the treatment of cartilage defects in cartilage tissue engineering. Appropriate growth factors are critical for the chondrocyte differentiation of synovial mesenchymal stem cells.
OBJECTIVE:To study the role of secreted factors by chondrocytes to induce chondrogenesis of synovial mesenchymal stem cells.
METHODS:The synovial mesenchymal stem cells and chondrocytes were harvested from rat knee joints and cultured through the digestion method. The supernatant was col ected from chondrocytes, and centrifuged, filtered and cryopreserved. The third passage synovial mesenchymal stem cells centrifuged as pel ets were cultured in the chondrocyte supernatant for 21 days. And the cells morphology was examined and the type II col agen and aggrecan were detected through immunohistochemistry and RT-PCR.
RESULTS AND CONCLUSION:The synovial mesenchymal stem cellpel ets cultured in the chondrocyte supernatant became cartilage-like tissue after 21 days. The type II col agen was detected positively in the matrix of synovial mesenchymal stem cellpel et immunohistochemical y. RT-PCR examination showed that the type II col agen and aggrecan expressed in the synovial mesenchymal stem cellpel et cultured in the chondrocyte supernatant. It suggested that synovial mesenchymal stem cellcould be induced to differentiate into chondrocytes depending on soluble factors secreted by chondrocytes.

BACKGROUND:Compared with other sources of mesenchymal stem cells, synovial-derived mesenchymal stem cells have significant characteristics of chondrogenesis and cloning. Therefore, synovial-derived mesenchymal stem cells are one of the most promising seed cells in cartilage tissue engineering.
OBJECTIVE:To isolate and culture synovial-derived mesenchymal stem cells of Sprague-Dawley rats, identify the multipotential differentiation and the potential ability of chondrogenic differentiation in three-dimensional culture condition.
METHODS:The synovium tissue was harvested from Sprague-Dawley rats. The synovial-derived mesenchymal stem cells were isolated with typeⅠcol agen enzyme digestion method and cultured in vitro. The passage 3 cells were detected with giemsa staining, the cellcycle, adipogenic and osteogenic differentiation were determined. The passage 3 cells were centrifuged as pel ets and cultured in the chondriogenic medium for 21 days. And the pel ets were examined by toluidine blue staining, typeⅡcol agen immunohistochemical staining and RT-PCR.
RESULTS AND CONCLUSION:The mesenchymal stem cells isolated from the synovium tissue of rats have the characteristics of mesenchymal stem cells, and exhibit fibroblast-like morphology after cultured in vitro. The multilineage differentiation potentials were also revealed. After the cellwere cultured in chondrogenic medium for 21 days, chondroid tissue was found, type II col agen and aggrecan could be detected positively by toluidine blue staining, typeⅡcol agen immunohistochemical staining, and expressed by RT-PCR examination. Therefore, synovial mesenchymal stem cells have a chondrogenic differentiation potential.

Objective To understand laboratory diagnosis and clinical characteristics of human immunodeficiency virus (HIV ) infection and AIDS patients in three comprehensive hospitals .Methods Laboratory diagnosis and clinical characteristics dates of people living with HIV/AIDS patients consulted in Chongqing Emergency Medical Center between 2007 to 2013 were retrospective‐ly analyzed .Results Totally 47 355 cases were carried HIV antibody screening during 7 years ,179 cases of HIV antibody were positive in preliminary screening ,171 cases were confirmed as positive .Among 5 cases of HIV antibodies result unconfirmed ,2 ca‐ses were followed up ,1 case was ruled out HIV infection ,1 case was converted to HIV antibody positive .People living with HIV al‐ways merging double or multiple infection with hepatitis b virus (HBV) ,hepatitis c virus (HCV) and treponema pallidum (TP) and so on .People living with HIV aged from 18 to 86 years old ,9 .36% was over 60 years old .Most patient has two or more clinical manifestations when consulted a doctor .Conclusion There were false‐positive of HIV antibody preliminary screening ,HIV anti‐body positive results must be confirmed by Western blot confirmatory test .Uncertainty of HIV antibody results should be judged by regularly follow‐up or combining with other detection methods ,epidemiological data .Routine HIV antibody screening should be adopt for HBV ,HCV and TP infection .Elder patients should not be ignored .Clinical specificity of HIV/AIDS is not strong ,it is need to be valued and identified from other cause similar symptoms of diseases caused by phase identification ,in order to reduce missed diagnosis and misdiagnosis .