To explore the clinical effect of tension-free repair in the treatment of inguinal hernia in elderly patient / 中华老年医学杂志

Objective To explore the clinical effect of tension-free repair in the treatment of inguinal hernia in elderly patient.Methods A total of 124 elderly patients with inguinal hernia admitted in our hospital in 2016 were randomly divided into a study group(n=62)and a control group (n=62).The control group was treated with open tension-free inguinal hernia repair,whereas with laparoscopic tension-free inguinal hernia repair in the study group.The operation time,intraoperative blood loss,the postoperative pain relief-time,mean days of hospitalization,postoperative recurrence rate,and complications rates were compared between the two groups.Results The more significant improvements were found in study group versus control group in the intraoperative bleeding volume [(19.9±2.0)ml vs.(36.8±-2.5)ml,t=41.564,P=0.000],in the mean hours of postoperative pain [(22.1 ± 4.2) h vs.(35.3 ± 7.0) h,t =12.732,P =0.000],in mean days of hospitalization [(5.5 ± 1.0)d vs.(9.2±1.9)d,t=13.569,P=0.000],in incidence rate of postoperative recurrence(0.0％ vs.6.5％,x2 =4.133,P=0.042),and in postoperative complications rate(3.2％ vs.12.9％,x2 =3.916,P=0.048).Nevertheless,the operation time was longer in the study group than in the control group[(87.0±5.0)min vs.(55.5±4.2)min,t=-37.984,=0.000],Conclusions As compared with open tension-free repair,the clinical efficacy of laparoscopic tension-free hernia repair is exactly sure in the treatment of inguinal hernia,with shorter postoperative hospitalization time and lower incidence of complications.

Impact of miR-148a on the proliferation of gastric carcinoma MKN45 cells and its mechanism / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of miR-148a on cell proliferation of human gastric cancer cell lines MKN45.</p><p><b>METHODS</b>Expression level of miR-148a was detected by qRT-PCR in the carcinoma tissues and the tissues adjacent to carcinoma of 60 patients with gastric cancer. Lentivirus packaging was used to establish MKN45 gastric cancer cell line expressing stable miR-148a as transfection group,and the untransfected MKN45 cell line as the control group. Gastric cancer MKN45 cell proliferation was detected by CCK8 method. The target gene of miR-148a was predicted by targetscan. Expression of target gene was examined by Western blotting.</p><p><b>RESULT</b>Expression of miR-148a in gastric cancer tissues of 54 cases(90.0%, 54/60) decreased, and among them, 37 tissue samples(61.7%, 37/60) decreased by 2 times. mir-148a expression in cancer tissues of patients with lymph node metastasis, vascular invasion and TNM stage III(-IIII( was down-regulated more obviously(P<0.05). From the third day after transfection, the growth of MKN45 cells was significantly inhibited(P<0.01). Gene CDC25B might be the target gene of miR-148a according to the results of targetscan. Western blot showed that CDC25B expression in transfection group was lower as compared to control group.</p><p><b>CONCLUSION</b>MiR-148a expression is down-regulated in gastric cancer tissues and inhibits gastric cancer cell proliferation. CDC25B may be the target gene of miR-148a that plays a role in tumor suppressor.</p>

Changes on blood glucose of different operation scheme after gastrectomy for gastric cancer in patients complicated with diabetes mellitus / 中国综合临床

Objective To observe the effect of gastrectomy for gastric cancer on blood glucose in patients complicated with type 2 diabetes mellitus by using different operation strategies.Methods The retrospective analysis was carried out of 68 cases who undergone radical surgery for gastric cancer and complicated with type 2 diabetes mellitus.These patients were divided into 3 groups by different kinds of digestive tract reconstruction,Billroth Ⅰ (n =26),Billroth Ⅱ (n =22) and Roux-en-Y (n =20).The levels of fasting blood glucose (FBG) were detected before and after operation one week,one month and six months in three groups.Results Comparing to the level before operation,the level of FBG after operation showed a descent in group B and group C((10.03 ±5.12) vs.(13.56 ±3.36) mmol/L; (8.44 ±5.21) vs.(13.56 ±3.36) mmol/L;(10.61 ±3.16) vs.(12.84 ±3.36) and(7.68 ±4.88) vs.(12.84 ±3.36) mmol/L) which was better than group A((10.03 ±5.12)vs.(11.12 ±6.32),(8.44 ±5.21) vs.(11.12 ±6.32) mmol/L;(10.61 ±3.16) vs.(11.12 ±6.32) mmol/L),(7.68 ±4.88) vs.(11.12 ±6.32) mmol/L;P＜0.05,but there was no significantly difference between B and group C (P ＞ 0.05).The 3 groups of patients,with B,C groups of patients with diabetes improved obviously,of which nearly 50％ of patients cured,normal blood sugar control,the other part with the exception of a few effective,degradation of diabetes drug treatment,and operation effect was significant.Conclusion It is effective to control the blood glucose of gastric cancer patients complicated with type 2 diabetes with Billroth II or Roux-en-Y gastrectomy.There is a correlation between postoperative blood glucose change and different gastrojejunal anastomosis.