[Characteristics and clinical analysis of MLH1 c.463dupC gene mutation in a Lynch syndrome family].

In this study, a case of Lynch syndrome (LS) family line with a novel mutation site in the MLH1 c.463dupC gene was reported and the clinical and pathogenic genetic features of this family were analyzed. A 40-year-old female patient with colon cancer diagnosed at the First Affiliated Hospital of Kunming Medical University on October 2, 2020 was retrospectively included. The clinical data of the family were collected and the family lineage was drawn. The family tumor history met the Amsterdam Criteria Ⅱ and the diagnostic criteria of LS in Chinese, which was a typical LS family lineage. A germline code-shift missense mutation c.463dupC in the MLH1 gene located in exon 6, a possible pathogenic variant, was detected by second-generation sequencing (NGS) in the patient. Subsequently, Sanger sequencing was performed on a total of 20 direct lineage members of the family of the MLH1 gene, 7 cases were found to harbor the mutation and included in the LS high-risk control. Follow-up to October 2023 showed that the patient had endometrial and cervical polyps, one case had colorectal cancer, and two cases had intestinal polyps, all were treated with early intervention and therapy; two cases did not show any clinical symptoms. This study is the first to report a new mutation site for the potentially pathogenic MLH1 c.463dupC, providing a rationale for the pathogenicity of the mutation and standardized health management for familial carriers.

Effect of PI3K/AKT/HIF-1α signaling pathway on oxidative stress and apoptosis in nucleus pulposus cells.

OBJECTIVE: The aim of the study was to explore the expression of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB/AKT)/hypoxia-induced factor-1 alpha (HIF-1α) signaling pathway and the apoptosis of nucleus pulposus cells (NPCs) under different oxygen concentrations to clarify the biological characteristics of NPCs and the molecular mechanism of intervertebral disc degeneration (IVDD). MATERIALS AND METHODS: Normal and degenerated human NPCs were collected. Leibovitz's medium with 100 µmol/L CoCl2 was used to establish a hypoxic culture environment, and 100 µmol/L H2O2 was used to establish an oxidative stress culture environment. Third-generation NPCs were divided into 6 groups: normal NPCs + hypoxia, normal NPCs + normoxia, normal NPCs + oxidative stress, degenerated NPCs + hypoxia, degenerated NPCs + normoxia, and degenerated NPCs + oxidative stress. Normal NPCs + hypoxia was used as the experimental control group. Cell viability and proliferation were detected by using the Cell Counting Kit-8 (CCK-8) method. Cell apoptosis rate was assessed by flow cytometry, and expression levels of PI3K, AKT, and HIF-1α were determined by Real-Time-Polymerase Chain Reaction (RT-PCR) and Western blotting. RESULTS: The cell proliferation rate of both normal and degenerated NPCs decreased with increasing oxygen concentration. Conversely, the apoptosis rate increased as the oxygen concentration increased (p<0.05). Compared with the control group, whether the cells degenerated had a very significant impact on the apoptosis rate (p<0.001), and oxygen concentration also had a highly significant impact on both the cell proliferation rate and apoptosis rate (both p<0.001). The interaction between cell degeneration and oxygen concentration significantly affected both cell proliferation and apoptosis rates (p<0.05). Considering the expression levels of PI3K, AKT, and HIF-1α, normal NPCs had the highest levels under low oxygen concentrations, followed by oxidative stress and normoxia. In degenerated NPCs, the expression levels also decrease as the oxygen concentration increases. CONCLUSIONS: The PI3K/Akt/HIF-1α signaling pathway plays a significant role in inhibiting oxidative stress, antagonizing NPC apoptosis, and consequently delaying IVDD.

Comparison of efficacy and safety of flexible ureteroscopy and mini-percutaneous nephrolithotomy for 2-3 cm renal calculi in women: a single-center study.

OBJECTIVE: This study aimed to compare the efficacy and safety of flexible ureteroscopic lithotripsy (FURSL) and mini-percutaneous nephrolithotomy (mPCNL) in the treatment of 2-3 cm renal calculi in women. PATIENTS AND METHODS: Clinical data of 186 patients who underwent mPCNL (n=96) and FURSL (n=90) surgery in our hospital from June 2018 to February 2023 were collected. Several parameters were assessed and compared between the two groups, including operation duration, length of hospital stay, cost of hospitalization, pain intensity measured by the visual analogue scale (VAS), patient comfort assessed using the Bruggrmann Comfort Scale (BCS), decrease in hemoglobin levels, changes in blood urea nitrogen (BUN), fluctuations in serum creatinine (Scr), hypersensitive C-reactive protein (hs-CRP) levels, complication rates, immediate post-operative stone-free rate (RSFR), and long-term stone-free rate (LSFR). RESULTS: The comparative analysis of patient age, body mass index (BMI), stone size, computed X-ray tomography (CT) value of stones, number of stones, and comorbidities revealed no statistically significant differences between the mPCNL and FURSL groups (p>0.05). The mPCNL cohort exhibited a markedly lower duration of operation (p<0.001) and BCS score (p<0.001) compared to the FURSL cohort. Nonetheless, the mPCNL cohort demonstrated significantly higher hospitalization expenses (p<0.001), length of hospital stay (p<0.001), VAS score for pain (p<0.001), and level of hemoglobin decrease (p<0.001) in comparison to the FURSL cohort. Moreover, the immediate post-operative stone-free rate (RSFR) was significantly higher in the mPCNL group (p=0.007). The long-term stone-free rate (LSFR), however, showed no significant difference between the two groups (p=0.160). Furthermore, the FURSL group exhibited significantly fewer overall complications in contrast to the mPCNL group (p=0.006). CONCLUSIONS: mPCNL and FURSL are both safe and effective surgical methods for treating 2-3 cm renal calculi in women. However, FURSL holds distinct advantages, including minimally invasive procedure, accelerated recovery, reduced cost, and lower incidence of complications.

[CT texture analysis for predicting pseudoprogression in metastatic clear cell renal cell carcinoma during PD-1 inhibitor therapy].

Objective: To evaluate the effectiveness of enhanced CT texture feature analysis in predicting pseudoprogression in patients with metastatic clear cell renal cell carcinoma (mccRCC) undergoing programmed cell death protein 1 (PD-1) inhibitor therapy. Methods: A cross-sectional study. Data from 32 patients with mccRCC were retrospectively collected who received monotherapy with PD-1 inhibitors after standard treatment failure at Henan Cancer Hospital, from June 2015 to January 2021. Clinical information and enhanced CT images were analyzed to assess target lesion response. The lesions were divided into pseudoprogression and non-pseudoprogression groups. Manual segmentation of target lesions was performed using ITK-Snap software on baseline enhanced CT, and texture analysis was conducted using A.K. software to extract feature parameters. Differences in texture features between the pseudoprogression and non-pseudoprogression groups were analyzed using univariate and multivariate logistic regression. A predictive model for pseudoprogression was constructed, and its performance was evaluated using ROC curve analysis. Results: A total of 32 patients with 89 lesions were included in the study. Statistical analysis revealed significant differences in seven texture features between the pseudoprogression and non-pseudoprogression groups. These features included"original_ngtdm_Strength"(0.49 vs. -0.61,P=0.006), "wavelet-HLH_glszm_ZonePercentage"(0.67 vs. -0.22,P=0.024),"wavelet-LHL_ngtdm_Strength"(1.20 vs. -0.51,P=0.002), "wavelet-HLL_gldm_LargeDependenceEmphasis"(-0.84 vs. 0.19,P=0.002), "wavelet-HLH_glcm_Id" (-0.30 vs. 0.43,P=0.037),"wavelet- HLH_glrlm_RunPercentage"(0.45 vs. -0.01,P=0.032),"wavelet-LHH_firstorder_Skewness"(0.25 vs. -0.27, P=0.011). Based on these features, a pseudoprogression prediction model was developed with a P-value of 0.000 2 and an odds ratio of 0.045 (95%CI 0.009-0.227). The model exhibited a high predictive performance with an AUC of 0.907 (95%CI 0.817-0.997) according to ROC curve analysis. Conclusions: Enhanced CT texture feature analysis shows promise in predicting lesion pseudoprogression in patients with metastatic ccRCC undergoing PD-1 inhibitor therapy. The developed predictive model based on texture features demonstrates good performance and may assist in evaluating treatment response in these patients.

[Clinicopathological characteristics and differential diagnosis of 6 cases of congenital granular cell tumor].

To provide references for the diagnosis and treatment of congenital granular cell tumor (CGCT), by comprehensive analysis of the clinical data, histopathological and immunohistochemical results. Patients with CGCT were involede, from March 2015 to November 2020, at the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University. A total of 6 children, aged 3-16 days, 1 male and 5 female, 5 maxillary and 1 mandibular, with maximum tumor diameter of 6-70 mm, were included. The lesions of CGCT were single and connected to the alveolar ridge by a pedicle. The surface of the tumor was covered with a vascular network, and two cases had ulcers on the surface of the tumor. All 6 cases had the tumor removed surgically and there was no recurrence or metastasis in the follow-up visit. Although CGCT is rare, it is a benign tumor and generally does not recur or metastasize after surgery, and has a good prognosis. The prenatal imaging, clinical manifestations after delivery, pathological characteristics and immunohistochemical analyses may provide reference for early diagnosis and treatment of CGCT.

Comparison of different radiomic models based on enhanced T1-weighted images to predict the meningioma grade.

AIM: To compare different models in predicting meningioma grade based on enhanced T1-weighted images. MATERIALS AND METHODS: One hundred and eighty-eight patients with meningioma were analysed retrospectively. There were 94 high-grade meningiomas which formed the high-grade group comprising 68 World Health Organization (WHO) grade II meningiomas and 26 WHO grade III meningiomas. Ninety-four low-grade meningiomas were selected randomly to form the low-grade group. Least absolute shrinkage and selection operator (LASSO) regression was used to reduce the dimensions of the texture parameters. Support vector machine (SVM), decision tree (DT), conditional inference trees (CIT), random forest (RF), k-nearest neighbours (KNN), back-propagation neural network (BPNet), and Bayes were used to construct models. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) was applied and compared among different models. RESULTS: Every model performed well and had a high area under the ROC curve (AUC; all >0.80). In the seven models, the highest accuracy was obtained with SVM and KNN (0.79), the highest sensitivity was obtained with DT and Bayes (0.85), and the highest specificity was obtained with SVM and CIT (0.83). SVM and RF had the highest AUC (0.884). KNN had the largest net benefit when the threshold probability was <0.50, whereas SVM had the largest net benefit when the threshold probability was >0.50. CONCLUSIONS: Different radiomic models based on enhanced T1-weighted images can be used to predict meningioma grade. The model of SVM and KNN performed better than other models with a larger net benefit.

[Preliminary efficacy and safety analysis of carrelizumab combined with apatinib in patients with middle-advanced liver cancer progressed after drug-eluting beads-transcatheter arterial chemoembolization].

Objective: To explore the preliminary clinical efficacy and safety of calerizumab combined with apatinib in the treatment of patients with middle-advanced liver cancer whose disease has progressed after drug-eluting beads-transcatheter arterial chemoembolization (D-TACE). Methods: A retrospective analysis of 23 patients with advanced liver cancer after D-TACE who were treated with carrelizumab combined with apatinib from April 2019 to July 2020 at Lianyungang First People's Hospital was carried out. There were 15 males and 8 females with a mean age of (62±9) years. The clinical efficacy was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECRST), and treatment-related adverse events were analyzed after treatment. Results: All the patients received D-TACE therapy with an average of (2.6±1.0) times, TACE-refractory tumor was observed in 7 patients, and distant metastasis was seen in 6 patients. The objective response rates after combined treatment of 1 month and 3 months were 47.8% and 60.9%, respectively. Disease control rate (DCR) was 73.9% and 78.3%, respectively; median progression-free survival (mPFS) was 126 days. Among 18 patients with alpha fatoprotein (AFP)>200 µg/L, the values before and after treatment of 2 months was (497±117) µg/L and (80±19) µg/L, respectively (P<0.05). Among 9 patients of vascular endothelial growth factor (VEGF)>142.2 ng/L, the values before and after treatment of 2 months was (154±51) ng/L and (57±19) ng/L, respectively (P<0.05). The incidence of treatment-related adverse events was 87.0% (20/23). All adverse reactions did not exceed grade 3 and could be controlled by symptomatic supportive treatment or reducing the dose of apatinib,and the serum aspartate aminotransferase (AST) level after treatment of 3 months[(77±33) U/L] was higher than that before treatment [(45±26) U/L] (P<0.05). Conclusion: For patients with advanced liver cancer after D-TACE, the treatment of carrelizumab combined with apatinib is effective and the adverse reactions are controllable.

[Research progress of hepatocyte transplantation treatment for alpha-1 antitrypsin deficiency].

Alpha-1 antitrypsin deficiency is an autosomal codominant genetic disease characterized by low levels of alpha-1 antitrypsin in the blood. Clinically, in young patients, it mainly manifests as emphysema, acute/chronic liver injury and liver cancer. The treatment methods include symptomatic treatment and alpha -1 antitrypsin supplementation. However, the existing treatment cannot prevent the liver fibrosis progression. At present, more than ten cases of the disease have been reported in China, but the understanding of this disease is still indecisive. Moreover, there exists no biotherapy drug for this disorder. This article introduces the research progress of hepatocyte transplantation treatment for this disorder.

miR-92a-3p promotes the proliferation and invasion of gastric cancer cells by targeting KLF2.

MicroRNAs (miRNAs) have pivotal roles in the initiation and progression of gastric cancer (GC), and miR-92a-3p has been proved to act as an oncogene in multiple malignancies. However, the molecular mechanisms by which miR-92a-3p contributes to GC remain unclear. The differentially expressed miRNAs were screened by GEO dataset, and the association of miR-92a-3p expression with clinicopathological characteristics and prognosis in patients with GC was analyzed by TCGA dataset. The target genes of miR-92a-3p were identified by bioinformatic analysis, and their interaction was confirmed by luciferase reporter assay. MTT, EdU and Transwell assays were conducted to determine the role of miR-92a-3p in GC cells. As a result, it was found that the expression levels of miR-92a-3p were increased in GC tissues and were associated with tumor size, lymph node infiltration and distant metastasis, acting as an independent prognostic factor of poor survival in patients with GC. Restored expression of miR-92a-3p facilitated cell proliferation, DNA synthesis and cell invasion, but its inhibitor reversed these effects. KLF2 was further identified as a direct target of miR-92a-3p, indicating a negative correlation with miR-92a-3p expression and harboring a favorable prognosis in GC. In addition, KLF2 repressed cell proliferation and invasion and attenuated the tumor-promoting effects of miR-92a-3p in GC cells. Altogether, our findings demonstrated that miR-92a-3p promoted the proliferation and invasion of GC cells by targeting KLF2.

GPIIb/IIIa expression changes in atrial fibrillation post radiofrequency ablation.

OBJECTIVE: Atrial fibrillation (AF) is one of the most common arrhythmias affecting the patient's quality of life, and its complications of thromboembolism can lead to serious consequences. AF patients are often in hypercoagulation status that can affect the prognosis. GPIIb/IIIa is a fibrinogen receptor that can bind to the ligands of platelet and cause aggregation. Therefore, GPIIb/IIIa can be treated as a marker of hemagglutination. This work aims to analyze the changes of GPIIb/IIIa after radiofrequency ablation of atrial fibrillation, and to investigate its relationship with recurrence. PATIENTS AND METHODS: A total of AF 80 patients in our hospital received radiofrequency ablation from January 2017 to August 2017. Peripheral blood was collected 1 week after surgery. A total of 40 healthy volunteers were enrolled as control group. GPIIb/IIIa was analyzed by enzyme-linked immunosorbent assay (ELISA). High-sensitivity troponin (hs-cTnT), fasting plasma glucose (FPG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglyceride levels (TG) were analyzed by using electrochemical luminescence assay. Body mass index (BMI), smoking index, and age were recorded. RESULTS: Compared with the non-recurrence group, GPIIb/IIIa, hs-cTnT, FPG, LDL, TC, and TG levels increased, whereas HDL level declined in the recurrence group (p < 0.05). There was a positive correlation between GPIIb/IIIa and hs-cTnT, FPG, LDL, TC, TG, BMI, and smoking index, and a negative correlation with HDL (p < 0.05). GPIIb/IIIa was positively correlated with postoperative recurrence (p < 0.05). CONCLUSIONS: Increased GPIIb/IIIa expression after radiofrequency ablation of AF is associated with myocardial injury, suggesting a risk of postoperative recurrence.

Correlations of glucose metabolism, insulin resistance and inflammatory factors with symptom score of patients with benign prostatic hyperplasia.

OBJECTIVE: To investigate the effects of glucose metabolism, insulin resistance, and inflammatory factors on International Prostatic Symptom Score (IPSS) of patients with benign prostatic hyperplasia (BPH), to explore their correlations and evaluate the clinical significance. PATIENTS AND METHODS: 90 patients with BPH were selected and divided into normal blood glucose group and abnormal blood glucose group. The changes of indexes related to prostate function, prostate volume (PV), prostate-specific antigen (PSA), and IPSS in two groups were evaluated. The fasting blood glucose (FBS), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR) index and inflammatory factors interleukin-8 (IL-8) and cyclooxygenase 2 (COX-2) levels in expressed prostatic secretion (EPS) were compared. The correlations of glucose metabolism, insulin resistance and inflammatory factors with IPSS were analyzed by Logistic regression. The changes of these indexes after treatment of BPH were observed. RESULTS: The FBS, FINS, HOMA-IR, and inflammatory factors IL-8 and COX-2 levels were significantly different between high IPSS group and low IPSS group of patients with BPH. Moreover, the PV and PSA were higher in high IPSS group than those in low IPSS group. The FBS, FINS and inflammatory factors IL-8 and COX-2 levels were positively correlated with IPSS (p<0.05). All the indexes above of BPH patients were decreased after treatment. CONCLUSIONS: The FBS, FINS, and inflammatory factors IL-8 and COX-2 levels are closely correlated with IPSS, which can reflect the severity and prognosis of BPH. It can effectively postpone the progression of BPH by lowering blood glucose, improving insulin resistance, and controlling the expressions of inflammatory factors in serum through a healthy lifestyle and clinical comprehensive treatment.

Synthesis of substituted aromatic heterocyclic sulfonyl hydrazone compounds and in vitro anti-hepatoma activity: preliminary results.

OBJECTIVE: Hydrazone compounds and their derivatives are a kind of special Schiff bases. The multiple hydrazone compounds and their derivatives have a variety of biological activities. This study aims to report the synthesis of diverse hydrazone derivatives and to explore the potent antitumor activities. MATERIALS AND METHODS: A series of aromatic heterocyclic sulfonyl hydrazones W1-W15 synthesized from hydrazine or acylhydrazine and aldehydes or ketones were estimated for their in vitro antitumor activities against human cancers. Through the spectral (FT-IR, 1H-NMR, MS) methods, the structure of the compounds was determined. Using MTT (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide) method, the effects of different concentrations of compounds on growth inhibition and viability of HepG-2 cells were detected. RESULTS: Compound W9 exhibited anti-proliferation activity with IC50 values of 63.91 µmol/L in HepG-2 cell line. In addition, mechanism studies indicated that compound W9 could distinctly prohibit the propagation of HepG-2 cells by arresting the cell cycle at G2/M and inducing apoptosis. Furthermore, we investigated the effectiveness of drug combination treatment with W9 and cis-platinum (cis-DDP) or 5-fluorouracil (5-FU) on HepG-2 cell line. CONCLUSIONS: Our results indicated that W9 with synergic treatment of 5-FU or cis-DDP shows better inhibitory cell growth. The combination of the two drugs blocks HepG-2 cells in the G2/M phase. The inhibitory effect of W9 on cell apoptosis was decreased with the increase of drug concentration.

[Extrapleural solitary fibrous tumor with uncommon histology: a clinicopathologic analysis of 7 cases].

Objective: To investigate the clinicopathologic characteristics, immunophenotypes, and differential diagnostic features of extra-pleural solitary fibrous tumor (SFT) with uncommon histology. Methods: Seven cases of extra-pleural SFT with uncommon histology were collected during January 2015 and December 2016 in Zhejiang Provincal People's Hospital; the clinical and radiologic features, histomorphology, immunophenotype and prognosis were analyzed. EnVision method was used for immunohistochemical staining of STAT6, CD34 and other differential diagnosis associated markers. Results: There were five male and two female patients, age from 23 to 54 years (mean=39 years). Three tumors were located in the soft tissue of head and neck, two in trunk subcutaneous soft tissue, one in sella region, and one in the kidney. Grossly the tumors ranged from 0.4 to 8.0 cm (mean=3.1 cm). Microscopically, all three head and neck cases resembled giant cell angiofibroma/giant cell subtype SFT, and one case showed sheet-like pattern of the multinucleated syncytial cells, creating a biphasic arrangement similar to myofibroma. Both truncal tumor resembled lipomatous type SFT, with one similar to dermatofibrosarcoma protuberans and the other to atypical spindle cell lipomatous tumor. The sella tumor showed morphology of a conventional SFT with high grade sarcomatous transformation. The renal tumor demonstrated a malignant SFT with entrapped benign renal tubules, mimicking a biphase synovial sarcoma or a malignant mixed epithelial and stromal tumor. By immunohistochemistry, all seven SFTs showed diffuse and strong nuclear reactivity to antibody against STAT6. Conclusions: Extra-pleural SFTs show a significant heterogeneity of morphology and biological behavior which could cause differential confusion.Careful attention to its characteristic histomorphology with the use of STAT6 immunohistochemistry can help distinguish this tumor from its many mimickers.

[The role and significance of digital reconstruction technique in liver segments based on portal vein structure].

Objective: To study the segment of liver according to the large amount of three-dimensional(3D) reconstructive images of normal human livers and the vascular system, and to recognize the basic functional liver unit based on the anatomic features of the intrahepatic portal veins. Methods: The enhanced CT primitive DICOM files of 1 260 normal human livers from different age groups who treated from October 2013 to February 2017 provided by 16 hospitals were analyzed using the computer-aided surgery system.The 3D liver and liver vascular system were reconstructed, and the digital liver 3D model was established.The vascular morphology, anatomical features, and anatomical distributions of intrahepatic portal veins were statistically analyzed. Results: The digital liver model obtained from the 3D reconstruction of CAS displayed clear intrahepatic portal vein vessels of level four.Perform a digital liver segments study based on the analysis of level four vascular distribution areas.As the less anatomical variation of left hepatic portal vein, the liver was classified into four types of liver segmentation mainly based on right hepatic portal vein.Type A was similar to Couinaud or Cho's segmentation, containing 8 segments(537 cases, 42.62%). Type B contained 9 segments as there are three ramifications of right-anterior portal vein(464 cases, 36.82%). The main difference for Type C was the variation of right-posterior portal vein which was sector shape(102 cases, 8.10%). Type D contained the cases with special portal vein variations, which needs three-dimensional simulation to design individualized liver resection plan(157 cases, 12.46%). These results showed that there was no significant difference in liver segmental typing between genders(χ(2)=2.179, P=0.536) and did not reveal any significant difference in liver segmental typing among the different age groups(χ(2)=0.357, P=0.949). Conclusions: The 3D digital liver model can demonstrate the true 3D anatomical structures, and its spatial vascular variations.The observation of anatomic features, distribution areas of intrahepatic portal veins and individualized liver segmentation achieved via digital medical 3D visualization technology is of great value for understand the complexity of liver anatomy and to guide the precise hepatectomy.

Comparison of laparoscopic hernia repair and open herniotomy in children: a retrospective cohort study.

BACKGROUND: Laparoscopic hernia repair in infancy and childhood is still debatable. The objective of this study is to compare laparoscopic-assisted hernia repair (LH) versus open herniotomy (OH) as regards operative time, postoperative complications, recurrence rate, and contralateral metachronous hernia rate. METHODS: We analyzed all the patients with inguinal hernia who underwent surgery in our hospital from January 1, 2015 to December 31, 2015. There were 1125 patients, of which 202 patients received laparoscopic inguinal hernia repair (group A) and 923 patients received open herniotomy (group B). We recalled all the patients' records to identify operative time, postoperative hydrocele formation, and contralateral patent processus vaginalis (CPP) detection; we recalled all the patients' parents to identify the ipsilateral and contralateral recurrence and the testis position. RESULTS: During the study period, the lost to follow-up rate is 9.9% in group A and 14.1% in group B. The mean follow-up period was about 10.1 months. The mean operative time for females with bilateral hernia in group A was much shorter than that for those in group B (P = 0.001). The postoperative hydrocele formation rate in group A was 1.5%, compared with 8.2% in group B (P = 0.001). The recurrence rate was 0.64% in group A, whereas in group B the recurrence rate was 0.46%. Of patients with unilateral hernia, none in group A experienced a contralateral metachronous hernia (MH) compared with 10.1% in group B (P < 0.001) and 65% MH appeared in 3 months after the first hernia repair. Females and patients with initial left-sided hernia tended to have a contralateral MH after the first open hernia repair. CONCLUSION: Laparoscopic hernia repair in children is safe and effective, especially for female patients and patients with initial left-sided hernia. We recommend repairing the CPP simultaneously when performing laparoscopic procedures.

[Clinical application value of prognostic nutritional index for predicting survival in patients with advanced non-small cell lung cancer].

Objective: To explore the clinical application value of prognostic nutritional index(PNI) for predicting overall survival(OS) in patients with advanced non-small cell lung cancer (NSCLC). Methods: 123 patients with histologically confirmed non-small cell lung cancer were enrolled in this study, and their clinical and laboratory data were reviewed. The PNI was calculated as 10×serum albumin value+ 5×total lymphocyte countin peripheral blood.Univariate and multivariate analyses were used to identify the potential prognostic factors for advanced NSCLC. Results: PNI of the 123 NSCLC patients was 46.24±6.56. PNI was significantly associated with age, weight loss and pleural effusion (P<0.05). However, it showed no relationship with sex, smoking, hemoptysis, chest pain, dyspnea, histological type, clinical stage, and administration of chemotherapy (P>0.05). The median OS of the 123 patients was 19.5 months. The median OS in the higher PNI group (PNI≥46.24) and lower PNI group(PNI<46.24) were 25.2 months and 16.4 months, respectively.The 1-year survival rates were 80.6% and 63.9%, and 2-year survival rates were 54.8% and 19.6%, respectively (P<0.01). Univariate analysis showed that PNI, age, dyspnea, and weight loss were related to the OS of the advanced NSCLC patients (P<0.05). Multivariate analysis identified PNI as an independent prognostic factor for OS of advanced NSCLC (P<0.001). Conclusion: PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced NSCLC in clinical practice.

[Intratympanic dexamethasone vesus post-auricular subperiosteal injection of methylprednisolone treatment for sudden hearing loss].

Objective:To compare the efficacy and side effect between intratympanic dexamethasone and subperiosteal injection of methylprednisolone treatment for sudden hearing loss.Method:One hundred and eight unilateral sudden hearing loss patients were enrolled in this study, randomly divided into A group, which was accepted intratympanic dexamethasone (10 mg/ml) , and B group, which was accepted post-auricular subperiosteal injection of methylprednisolone (40 mg/ml) by every 3 days intotal 5 times. After 3 months follow-up, analysis of the differences of pure tone threshold, tinnitus handicap inventory (THI), dizziness handicap inventory (DHI), blood glucose between pretreatment and postreatment was made. Side effect such as perforation of tympanic membrane, infection of post-auricular skin was also observed.Result:①Both in A and B group, there was no statistical changes in total efficiency and pure tone threshold decrease (P> 0.05), whereas the pure tone threshold statistical change was observed in the low frequency sudden deafness between A and B group (P< 0.05). ②Both in A and B group, there was no statistical changes in THI (P> 0.05), whereas the THI statistical decrease was observed in the high frequency sudden deafness between A and B group (P< 0.05). ③There was no statistical change in THI both in A and B group (P> 0.05). ④Both in A and B group, there was no statistical changes in fasting plasma glucose between pretreatment and postreatment (P> 0.05). ⑤There was no patient who had gotten tympanitis or postauricular infection, although in A group, there were 2 patients had gotten perforation of tympanic membrane, but they all healed after the follow-up.Conclusion:Both topical injection of glucocorticoid can improve pure tone threshold and reduce the score of THI and DHI for sudden hearing loss patients. Intratympanic dexamethasone can reduce more score of THI for high frequency sudden deafness patients whereas subperiosteal injection of methylprednisolone can improve pure tone threshold more for low frequency sudden deafness patients. None of the two administrations elevate blood glucose, but intratympanic dexamethasone have the risk of perforation of tympanic membrane.