Clinical observation of extraction-site incisional hernia after laparoscopic colorectal surgery.

BACKGROUND: Laparoscopic colorectal cancer surgery increases the risk of incisional hernia (IH) at the tumor extraction site. AIM: To investigate the incidence of IH at extraction sites following laparoscopic colorectal cancer surgery and identify the risk factors for IH incidence. METHODS: This study retrospectively analyzed the data of 1614 patients who underwent laparoscopic radical colorectal cancer surgery with tumor extraction through the abdominal wall at our center between January 2017 and December 2022. Differences in the incidence of postoperative IH at different extraction sites and the risk factors for IH incidence were investigated. RESULTS: Among the 1614 patients who underwent laparoscopic radical colorectal cancer surgery, 303 (18.8%), 923 (57.2%), 171 (10.6%), and 217 (13.4%) tumors were extracted through supraumbilical midline, infraumbilical midline, umbilical, and off-midline incisions. Of these, 52 patients developed IH in the abdominal wall, with an incidence of 3.2%. The incidence of postoperative IH was significantly higher in the off-midline incision group (8.8%) than in the middle incision groups [the supraumbilical midline (2.6%), infraumbilical midline (2.2%), and umbilical incision (2.9%) groups] (χ2 = 24.985; P < 0.05). Univariate analysis showed that IH occurrence was associated with age, obesity, sex, chronic cough, incision infection, and combined diabetes, anemia, and hypoproteinemia (P < 0.05). Similarly, multivariate analysis showed that off-midline incision, age, sex (female), obesity, incision infection, combined chronic cough, and hypoproteinemia were independent risk factors for IH at the site of laparoscopic colorectal cancer surgery (P < 0.05). CONCLUSION: The incidence of postoperative IH differs between extraction sites for laparoscopic colorectal cancer surgery. The infraumbilical midline incision is associated with a lower hernia rate and is thus a suitable tumor extraction site.

The Modification of In Situ SiOx Chitosan Coatings by ZnO/TiO2 NPs and Its Preservation Properties to Silver Carp Fish Balls.

The composite chitosan coatings were prepared and characterized to evaluate their preservation properties for silver carp fish balls, and the microstructures and physicochemical properties of the coatings were improved by in situ nano silicon oxide (SiOx) and zinc oxide/titania (ZnO/TiO2 ) nano-particles (NPs). In the chitosan coatings, when the chitosan combines with NPs by chemical bonds, the crystal lattice is slightly changed due to the modification of NPs. The chitosan coatings modified by NPs showed few cracks, among which sodium hexametaphosphate (SHMP) modified ZnO/TiO2 /SiOx-chitosan (ZTS-CS) coating is proved to be the optimal one. The change of the freshness index and the texture of the fish balls are delayed by the coatings due to their gas permeability and antibacterial properties. The preservation properties of the chitosan coatings for Silver Carp fish balls are improved by in situ SiOx, and further improved by co-modification of ZnO/TiO2 NPs. Furthermore, the surface modification of ZnO/TiO2 NPs enhances the preservation properties of the chitosan coating. PRACTICAL APPLICATION: In our previous study, in situ SiOx was found to improve antibacterial and preservation properties of chitosan coating, leading to extending shelf time of Sciaenops ocellatus. In order to further improve properties of chitosan coatings, we added nontoxic edible nano materials to the in situ SiOx chitosan coatings. In situ SiOx modified by ZnO/TiO2 NPs were synthesized, measured, and characterized in this study, and were applied for the preservation of silver carp fish balls. It could serve as a potential preservation material due to the increasing mechanical preservation properties. Through the results, the ZnO/TiO2 /SiOx-chitosan (ZTS-CS) coatings have potential as application in the food industry to guarantee food quality and extend shelf life of products.

The composition and variation of the BCR CDR3s in gastric cancer.

Gastric cancer (GC) is the fourth most common type of cancer and the second most common cause of cancer-associated mortality worldwide. B cell-associated autoantibodies against tumor-associated antigens are attractive biomarkers for the development of noninvasive serological tests for the early detection of cancer. This is due to their specificity and stability in the sera. In the present study multiplex polymerase chain reaction and Illumina high-throughput sequencing (HTS) was used to study the composition and variation of the B cell receptor (BCR) complimentary-determining region 3 (CDR3) in GC. The peripheral blood, cancer tissues and peri-cancer tissues were included from 7 patients with GC. On average there was a total of 403,959 CDR3 sequences, with 72,367 unique CDR3 nt sequences and 61,709 unique CDR3 aa sequences per sample identified, which are critical for further understanding the BCR repertoire in GC. The details of GC CDR3s may accelerate the screening process for possible new autoantigens and may provide additional information necessary for generating effective B cell targeted diagnosis and therapeutic strategies.

Selective sampling and measurement of Cr (VI) in water with polyquaternary ammonium salt as a binding agent in diffusive gradients in thin-films technique.

A diffusive gradients in thin films (DGT) device with polyquaternary ammonium salt (PQAS) as a novel binding agent (PQAS DGT) combined with graphite furnace atomic absorption spectrometry (GFAAS) was developed for the selective sampling and measurement of Cr (VI) in water. The performance of PQAS DGT was independent of pH 3-12 and ionic strength from 1 × 10(-3) to 1 molL(-1). DGT validation experiments showed that Cr (VI) was measured accurately as well as selectively by PQAS DGT, whereas Cr (III) was not determined quantitatively. Compared with diphenylcarbazide spectrophotometric method (DPC), the measurement of Cr (VI) with PQAS DGT was agreement with that of DPC method in the industrial wastewater. PQAS-DGT device had been successfully deployed in local freshwater. The concentrations of Cr (VI) determined by PQAS DGT coupled with GFAAS in Nuer River, Ling River and North Lake were 0.73 ± 0.09 µg L(-1), 0.50 ± 0.07 µg L(-1) and 0.61 ± 0.07 µg L(-1), respectively. The results indicate that PQAS DGT device can be used for the selective sampling and measurement Cr (VI) in water and its detection limit is lower than that of DPC method.

[Application of Ligasure vessel sealing system in haemorrhoidectomy].

OBJECTIVE: To investigate the clinical value of Ligasure vessel sealing system (LVSS) in haemorrhoidectomy. METHODS: From December 2002 to November 2003, clinical data of 36 cases undergoing haemorrhoidectomy with LVSS were compared with those of 30 cases undergoing traditional operation,considering visual analogue scale(VAS), hospital time,operation time,hospital expenses,postoperative complication. RESULTS: There were no significant differences in hospital expenses,postoperative complications between the two groups,but the postoperative pain scores of Ligasure haemorrhoidectomy was better than that of traditional operation. The hospital stay and operation time of Ligasure haemorrhoidectomy were shorter than those of the traditional operation. CONCLUSION: Ligasure vessel sealing system has more advantages such as less pain, safety, facility to perform, and a shorter operation time.

[Diagnosis and treatment of mesenteric venous thrombosis early after operation].

OBJECTIVE: To analyze the clinical characteristics diagnosis and treatment of patients with mesenteric venous thrombosis early after operation. METHODS: A retrospective study was performed on the clinical data of 7 patients with mesenteric venous thrombosis early after operation from 1990 to 2004. RESULTS: Patients had main clinical manifestations of severe abdominal pain and vomiting, but abdominal signs were slight. The systemic toxic symptoms occurred in 2 cases at late course. The examination of abdominal X- ray showed intestinal obstruction of all patients. Four patients received abdominal CT- scanning, of whom 3 patients were diagnosed as mesenteric venous thrombosis. Seven patients received exploratory operation. The necrotic intestinal segments were resected. Two patients had short intestinal syndromes after operation, one of them died of serious malnutrition. Four patients who had recurrence of portal, mesenteric and iliac venous thrombosis needed a long-term therapy of warfarin and aspirin after discharge. CONCLUSION: It is easy to make a mistake in diagnosis because of the lacking of characteristic clinical manifestations. Exploratory operation immediately plus anticoagulant therapy is strongly recommended.

[Effect of diode laser coagulation treatment on grade III internal hemorrhoids].

OBJECTIVE: To evaluate the curative effects of diode laser coagulation on grade III internal hemorrhoids. METHODS: From March 2004 to December 2004, 86 patients with grade III internal hemorrhoids were divided into two groups, received laser coagulation (laser group, n=46) or received hemorrhoidectomy (control group, n=40). Complications, symptom relief, pain scores and satisfaction scores were compared between the two groups six months after operation. RESULTS: Pain scores were lower in laser group than that of the control group on the first day and seventh day after operation. Small amount of bleeding occurred in the laser group (12 cases) and control group (35 cases), however, non of them required special hemostasis. Laser coagulation and closed hemorrhoidectomy were equally effective in controlling symptomatic prolapse. There was no difference in terms of continence scores and patients satisfaction between the two groups (P> 0.05). CONCLUSIONS: Diode laser coagulation can be considered as a safe and effective procedure for the treatment of grade III hemorrhoids.