[Transumbilical single-site single-port versus single-site double-port laparoscopic varicocelectomy for varicocele in adolescents].

OBJECTIVE: To compare the effect of transumbilical single-site single-port with that of transumbilical single-site double-port laparoscopic varicocelectomy in the treatment of varicocele in adolescents. METHODS: We randomly assigned 80 varicocele patients aged 10 - 16 years to two groups of equal number to receive transumbilical single-site single-port and single-site double-port laparoscopic varicocelectomy, respectively. We compared the operation time, postoperative hospital stay, incisional pain, complications and satisfaction with the abdominal cosmetic outcomes between the two groups. RESULTS: All the operations were successfully performed. The double-port group showed a significantly higher score on the Visual Analogue Scale than the single-port group (4.8 +/- 1.4 vs 3.6 +/- 1.1, t = -4.986, P < 0.01), but there were no significant differences between the two groups in the operation time ([29.8 +/- 4.2] vs [31.2 +/- 4.6] min, t = 1.383, P = 0.171), postoperative hospital stay ([1.95 +/- 0.7] vs [1.82 +/- 0.8] d, t = -0.784, P = 0.436), complications (0 vs 0) and scores on the satisfaction with abdominal cosmetic outcomes (4.6 +/- 0.6 vs 4.8 +/- 0.5, t = 1.253, P = 0.214). No recurrence, umbilical hernia, hydrocele and orchiatrophy were found in the two groups of patients at 6 months after operation, and no visible scar was observed on the abdominal surface. CONCLUSION: With strict surgical indications, single-site single-port and single-site double-port laparoscopic varicocelectomies have similar clinical effects in the treatment of varicocele, which leave no scar on the abdominal surface. Single-site double-port laparoscopy needs no special instruments and therefore is worthier of wide clinical application.

[A comparative study of trans-umbilicus laparoendoscopic one-trocar surgery and trans-umbilicus and abdominal wall two-trocar surgery in the treatment of pediatric hydrocele].

OBJECTIVE: To explore the feasibility and clinical efficacies of umbilical one-trocar laparoendoscopic surgery versus trans-umbilicus and abdominal wall two-trocar laparoendoscopic surgery in the treatment of pediatric hydrocele. METHODS: Retrospective comparative analysis was conducted for 78 cases of hydrocele undergoing laparoscopic surgery at our hospital from January 2012 to May 2012. They were divided into two groups of umbilical one-trocar laparoscopic surgery (one-trocar, n = 32) and trans-umbilicus and abdominal wall two-trocar laparoscopic surgery (two-trocar, n = 46). And their profiles of operative duration, post-operative hospital stay and treatment cost were compared. RESULTS: All procedures were successful. No case converted into open surgery. Visual field of both methods was similar, but two-trocar group had a flexible visual angle. During a follow-up period of 3 - 6 months, there was no occurrence of postoperative complications. The average operative duration was (20 ± 10) min at one side and (31 ± 11) min at both sides in one-trocar group versus (20 ± 8) min and (29 ± 9) min in two-trocar group. There were no statistical significance (all P > 0.05). Cost in one-trocar group was (5199 ± 599) yuan RMB and (5117 ± 684)yuan RMB in two-trocar group (P > 0.05). CONCLUSIONS: Trans-umbilicus laparoendoscopic one-trocar surgery is both feasible and safe in the treatment of pediatric hydrocele. Compared with two-trocar laparoscopic surgery, both approaches are similar in terms of operative duration, post-operative hospital stay and treatment cost. Since there is a single hidden navel scar, the former is labor-saving, may be handled by one operator and offers better cosmetic outcomes.

[The comparison of operative and non-operative treatment for acute embolism of upper extremity artery].

OBJECTIVE: To compare surgical and non-surgical therapy of the upper extremity after acute arterial occlusion. To analyze the relation between prognosis and relevant factors of different therapeutic methods. METHODS: Sixty patients with acute upper extremity arterial embolism treated between January 1990 and October 2007 were retrospectively studied in The First Hospital of China Medical University. RESULTS: There were 60 patients, 32 men and 28 women, with a mean age of 63 years (21 - 86 years). Among them, 31 underwent thrombembolectomies with the Fogarty catheter and 29 received anti-coagulation and thrombolytic therapy. Therapeutic effects were evaluated by Cooley's standard. Therapeutic efficacy was better in the surgical group than in the non-surgical group (P < 0.05). There was no relationship between post-operative ischemic recovery and pre-operative ischemia severity and the site of embolism in the surgical group, while there were significant relationships in the nonsurgical group. The result of Cox proportional hazard regression model showed that the age and Cooley's standard of the patient was correlated with survival time. CONCLUSIONS: A more active surgical approach is better for the treatment of acute arterial occlusion of the upper extremity.

[Clinico-epidemiological features of infrarenal abdominal aortic aneurysm and relevant prognostic factors].

OBJECTIVE: To investigate the clinico-epidemiology features of infrarenal abdominal aortic aneurysm (AAA) and relevant prognostic factors. METHODS: The clinical records of 375 infrarenal AAA patients, 282 males and 93 females, aged (62 +/- 15), hospitalized 1988 -2007 were analyzed. RESULTS: In recent ten years, the number of patients admitted because of AAA was 186.6% as high as that in the last 10 years. The rupture rate of the male AAA patients was 14.4%, significantly higher than that of the female AAA patients (6.5%, P < 0.05). The rupture rate of the AAA aged patients > or = 65 was 3.6%, significantly lower than that of the AAA patients < 65 (17.7%, P < 0.01). The aneurysm diameter of the patients with hyperextension was (6.1 +/- 3.3) cm, significantly lower than that of the patients without hypertension [(6.8 +/- 2.3) cm. P < 0.05]. The general 5-year survival rate was 70.1%. The 5-year survival rates of the female patients, patients > or = 65, without hypertension, and without coronary heart disease were, all significantly higher than those of the male patients, patients < 65, and patients with hypertension or coronary heart disease (all P < 0.05). Cox regression analysis showed that sex, smoking, and hypertension were all prognostic factors (all P < 0.05). CONCLUSION: The morbidity of AAA increases fiercely. The AAA patients being male, smoking, or with hypertension have poorer prognosis, and age and operation method are not related to prognoses.

[JNK/p38 MAPK involves in ginsenoside Rb1 attenuating beta-amyloid peptide (25-35) -induced tau protein hyperphosphorylation in embryo rat cortical neurons].

To explore the effect of ginsenoside Rb1 on JNK/p38 MAPK in the process of beta-amyloid peptide (25-35) -induced tau protein hyperphosphorylation, Western blotting and immunocytochemical stain were performed to observe the tau protein phosphorylation and the expression of JNK/p38 MAPK. The level of tau protein phosphorylation in the sites of Ser396 , Ser199/202 and Thr205 increased after rat cortical neurons exposed to 20 micromol x L(-1) Abeta25-35, meanwhile the level of JNK/p38 MAPK also increased after Abeta25-35 treatment for 12 h. Pretreatment with several doses of ginsenoside Rbl markedly attenuated tau protein hyperphosphorylation and the expression of JNK/p38 MAPK. Ginsenoside Rbl markedly attenuated tau protein hyperphosphorylation through JNK/p38 MAPK pathway.

[Ginsenoside Rb1 attenuates beta-amyloid peptide(25-35) -induced hyperphosphorylation of tau protein through CDK5 signal pathway].

This study is to explore the effect of ginsenoside Rb1 on the process of beta-amyloid peptide(25-35) (Abeta(25-35)) -induced hyperphosphorylation of tau protein, and on the level of cyclin-dependent kinase 5 activator, p25/p35. Western blotting and/or immunocytochemical staining were used to detect the levels of phosphorylation of tau protein at the sites of Thr205, Ser396, Ser404 in hippocampal neurons, cdk5 and p25/p35. After exposure to Abeta(25-35) (20 micromol x L(-1)) for 12 h, the levels of tau protein phosphorylation at the sites of Thr205, Ser396, Ser404 were enhanced, the level of p25 was increased, but the level of protein cdk5 was not changed markedly. Pretreatment with ginsenoside Rb1 reduced Abeta(25-35) -induced hyperphosphorylation of tau protein and decreased the lever of p25, but had no effect on cdk5. Ginsenoside Rb1 can attenuate Abeta(25-35) -induced hyperphosphorylation of tau protein through CDK5 signal pathway.