Mesh plug erosion into the small intestine after inguinal hernia repair: A case report.

BACKGROUND: Mesh plug (MP) erosion into the intra-abdominal organs is a rare but serious long-term complication after inguinal hernia repair (IHR), and may lead to aggravation of symptoms if not treated promptly. It is difficult to diagnose MP erosion as there are no obvious specific clinical manifestations, and surgery is often needed for confirmation. In recent years, with the increased understanding of postoperative complications, MP eroding into the intra-abdominal organs has been a cause for concern among surgeons. CASE SUMMARY: A 50-year-old man was referred to the Department of General Surgery with the complaint of abdominal pain in the right lower quadrant for 2 d. He had a surgical history of right open IHR and partial thyroidectomy performed 20 years and 15 years ago, respectively. Computed tomography revealed a circinate high-density image with short segmental thickening of the ileum stuck to the abdominal wall, and no evidence of recurrent inguinal hernia. Laparoscopic abdominal exploration confirmed adhesion of the middle segmental portion of the ileal loop to the right inguinal abdominal wall; the rest of the small intestine was normal. Further exploration revealed migration of the polypropylene MP into the intraperitoneal cavity and formation of granulation tissue around the plug, which eroded the ileum. Partial resection of the ileum, including the MP and end-to-side anastomosis with an anastomat, was performed. CONCLUSION: Surgeons should aim to improve their ability to predict patients at high risk for MP erosion after IHR.

Multiple well-differentiated retroperitoneal liposarcomas with different patterns of appearance on computed tomography: A case report.

BACKGROUND: Primary retroperitoneal liposarcoma (PRPLS) is a rare soft tissue tumor with nonspecific clinical symptoms; it has different computed tomography (CT) image features according to pathological types. Some patients with a single tumor have been previously reported in the literature. We present an exceptional case of a PRPLS patient with multiple large tumors exhibiting different patterns of appearance on CT and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology. CASE SUMMARY: A 64-year-old man presented with abdominal distension for 1 year. The patient was diagnosed with PRPLS based on physical examination, laparotomy, ultrasonography, CT scan, and surgery. Both of the tumors were completely resected through surgery and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology. The postoperative course was uneventful without recurrence or metastasis, as demonstrated by abdominal-pelvic CT during an 18 mo follow-up. CONCLUSION: Multiple large Well-differentiated liposarcomas with different patterns of appearance on CT image can occur simultaneously in the same patient, to which more attention should be paid to make an effective differential diagnosis.

Transcatheter Arterial Chemoembolisation Combined with Radiofrequency Ablation on Hepatocellular Carcinoma and Levels of Relevant Markers.

OBJECTIVE: To investigate the ablative effect and safety of trans-catheter arterial chemoembolisation (TACE) combined with radiofrequency ablation (RFA), and TACE alone for the treatment of hepatocellular carcinoma and compare the changes in the level of relevant serum inflammatory and tumor markers. STUDY DESIGN: Descriptive comparative study. PLACE AND DURATION OF STUDY: Department of Hepatobiliary Surgery, Affiliated Hospital of Hebei University, from January 2016 to June 2018. METHODOLOGY: Patients with hepatocellular carcinoma were randomly chosen and classified into combination group and TACE group, according to the treatment method. The 106 patients in the combination group were given RFA combined with TACE for treatment. The 112 patients in TACE group were given only TACE treatment. The objective response rate (ORR) and disease control rate (DCR) of short-term ablative effect, and adverse effect, serum inflammatory, and tumor markers' levels were compared for both groups before and one month after treatment. RESULTS: ORR and DCR of combination group were significantly higher than those of TACE group: 84 vs. 58%, and 99 vs. 80%, respectively (p=0.013). The differences in the frequency of adverse effects were statistically significant (p<0.05). After treatment, vascular endothelial growth factor (VEGF), alpha fetoprotein (AFP), and matrix metalloproteinase (MMP) of both groups declined significantly (p<0.05), that of the combination group significantly lower than those of TACE group (p<0.05). After treatment, tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), and hypersensitivity C reactive protein (hsCRP) of both groups declined significantly (p<0.05), that of combination group significantly lower than those of TACE group (p<0.05). CONCLUSION: TACE combined with RFA has better ablative effect than pure TACE in the treatment of hepatocellular carcinoma. It can effectively reduce the level of tumor active factor and improve microinflammed state of the body.

p53-induced microRNA-1246 inhibits the cell growth of human hepatocellular carcinoma cells by targeting NFIB.

In recent years, miR-1246 has been identified as a transcriptional target of p53 in Down syndrome and may provide a new p53-miR-1246-DYRK1A-NFAT pathway in cancer. The present study aimed to explore the role of miR-1246 in the tumorigenesis of human hepatocellular carcinoma (HCC). We found that wild-type p53 regulated the expression of miR-1246 in HCC cell lines, and alteration of miR-1246 modulated cell proliferation, colony formation ability and apoptosis. The nuclear factor I/B (NFIB), an oncogene, was identified as a direct target gene of miR-1246 using a fluorescent reporter assay. Overexpression of NFIB abolished the regulation of cell apoptosis caused by miR-1246 in HepG2 cells. This finding suggests that miR-1246 is regulated by p53 and suppresses the growth of human HCC by targeting NFIB. Here, we propose a new p53-miR-1246-NFIB pathway in HCC.