OBJECTIVE:To evaluate the clinical application of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma.METHODS:Sixty-five patients undergoing curative laparoscopic resection for colorectal carcinoma in the Sun Yat-sen Memorial Hospital between September 2011 and June 2013 were prospectively enrolled and randomly divided into label group (with carbon nanoparticles, n=34) and control group (without carbon nanoparticles, n=31). Association between labeled lymph nodes and metastasis was analyzed. The total number of retrieved lymph nodes and lymph nodes metastatic ratio were compared between the two groups.RESULTS:Mean number of retrieved lymph node of the label group was higher as compared to the control group (22.3±4.2 vs. 15.4±3.5, P<0.05). The total number of retrieved lymph node was 725 in the label group and 478 in the control group. Among them, lymph node < 5 mm accounted for 4.6% (33/725) in the label group, which was higher than 2.0% (10/478) (P=0.025) in the control group. The number of black stain label lymph node was 412, with black stain ratio 56.8% (412/725) in the label group. Metastatic ratio of black stain nodes was significantly higher than that of non-stain nodes [28.6% (118/412) vs. 19.5% (61/313), P=0.005].CONCLUSIONS:The technique of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma is easy and effective, which can increase the retrieved number of lymph nodes, especially for nodes < 5 mm. The black stain lymph nodes indicate higher risk of metastasis.

>腹股沟疝包括腹股沟斜疝和腹股沟直疝,是外科领域的常见病、多发病。腹股沟斜疝多见于儿童及青壮年,由腹壁下血管外侧的腹股沟内环突出,疝囊向内、向下、向前斜行经过腹股沟管,再穿破腹股沟外环,可进入阴囊;腹股沟直疝多见于老年男性,由腹壁下血管内侧的直疝三角直接向前突出,不经过内环,也不进入阴囊。在术前诊断中,疝囊是否进入阴囊是重要鉴别点之一 [1-2] 。我院胃肠外科2012年收治48例（50例次）腹股沟直疝患者,其中

Objective Analysis of the inguinal canal anatomical structures and their significance by intraoperative observation. Methods From June 2011 to May 2012,a total of 115 male patients(10 patients with bilateral hernias) whom were undergone open tension-free hernioplasty were involved in the observation. In open operation field, with high definition video equipment for recording and playback of the procedure, distribution of cremaster and nerves inside the inguinal canal and the relationship between spermatic cord and the inguinal canal rings were analyzed. Results The visible rates of the genital branch of genitofemoral nerve, ilioinguinal and iliohypogastric nerves were 90.4%, 98.4% and 38.4%, respectively. Cremaster muscle wasΩshape wrapping the spermatic cord. There were natural anatomic planes between spermatic cord and the inguinal ligament and inguinal falx. The spermatic cord was relatively fixed inside the inguinal canal by attachment of the inner and outer rings. Conclusion Ilioinguinal nerve is relatively constant in the inguinal canal, which theoretically could be safely cut off alike with the iliohypogastric nerve, as they are cutaneous branch in this position. The fixation of spermatic cord by the inguinal rings is a protective mechanism to prevent indirect herniaoccurs. The anatomical planes between the spermatic cord and the inguinal canal can be used of division.

目的探讨伊立替康联合左亚叶酸钙/氟尿嘧啶(5-FU)双周疗法治疗结肠癌肺转移患者的疗效及毒性反应。方法采用伊立替康+左亚叶酸钙+5-FU组成的FOLFIRI双周化疗方案治疗27例结肠癌肺转移的患者。结果完全缓解(CR)1例(3.70%),部分缓解(PR)7例(25.93%),好转(MR)3例(11.11%),疾病稳定(SD)8例(29.63%),疾病进展(PD)8例(29.63%),有效率(RR)为29.63%。其中奥沙利铂治疗无效的15例患者中,3例PR(20.00%),7例MR(46.67%),肺转移瘤缩小8例。毒性不良反应为腹泻6例(22.22%),恶心、呕吐10例(37.04%),急性胆碱能综合征7例(25.92%),白细胞减少18例(66.67%)。结论伊立替康双周疗法对于结肠癌肺转移患者,尤其是奥沙利铂治疗无效的患者疗效确切,且其毒性反应低,是安全有效的治疗方案。

Objective To compare the clinical effect between total extraperitoneal laparoscopic inguinal hernia repair and Lichtenstein repair. Methods Two hundred and forty-five patients with inguinal hernia from April 2008 to May 2009 were randomly divided into Group TEP and Group Lichtenstein. Operating time, hospital stay, medical costs, recovery of daily life, short and long-term complications were compared between two groups. Results Mean operating time for a unilateral hernia with TEP was longer, medical costs and the proportion of operating conversions were higher. However, patients had a faster recovery of daily activities and less short and long-term complications after TEP. Conclusions TEP procedure is associated with longer mean operating time, higher medical cost and the proportion ofoperating conversions but less postoperative pain and faster recovery of daily activities. TEP is recommended in experienced hands.