患者,女,30岁,藏族,拉萨市堆龙德庆区德庆乡人,农民.于2018年9月13日出现上腹部疼痛,伴恶心、呕吐,无发热,于当地私人诊所就诊,给予口服药物(具体不详)治疗后无效.后转移至右下腹疼痛,程度加重,至德庆区人民医院就诊.患者既往体健,久居德庆乡.查体:体温38.4℃,脉搏95次/min,呼吸20次/min,血压116/67 mm Hg(1 mm Hg=0.133 kPa),神清、表情痛苦,腹平、未见胃肠型,全腹未扪及包块,右下腹压痛,伴反跳痛、肌紧张.

Objective To compare the efficiency between small-incision and laparoscopic high ligation of hernia sac in children with inguinal hernia. Methods From August 2014 to July 2016, a retrospective analysis was conducted on 56 cases of inguinal hernia in children who were admitted to Duilongdeqing hospital, including 28 cases received the small-incision high ligation of hernia sac in the small-incision group and the other 28 cases received laparoscopic high ligation of hernia sac in the laparoscopic group. The operation states and outcomes were compared between the two groups. Results In the small-incision group, the average operating time was (10. 6±0. 4) minutes, the average bleeding loss was (3. 22±0. 29) ml, and the mean length of hospitalization stay was (2. 46±0. 23) days. While those in the laparoscopic group, the operating time was (10. 2±0. 4) minutes, the average bleeding loss was (3. 18± 0. 34) ml, and the mean length of hospitalization stay was (2. 24±0. 35) days. And those differences were not statistically significant (P>0. 05). In the small-incision group, urinary retention and scrotal edema was occurred in 1 case and 1 case, respectively. In the laparoscopic group, there was no urinary retention, no scrotal hematoma and no wound infection. All patients were followed up for 12 to 23 month, and 1 case of recurrence occurred in the small-incision group and none in the laparoscopic group. The differences between the two groups were not significant (P>0. 05). In the small-incision group, the hospital costs was (2 104± 140) yuan. The hospital costs in the laparoscopic group was (2 950±40) yuan. The differences between the two groups were significant (P<0. 01). Conclusion Two kinds of operation have their own advantages. The surgeons should take the appropriate treatment according to the specific condition of the children.

Objective To evaluate the potential mechanism of the chemoresistance induced by pancreatic stellate cells (PSCs).Methods Human pancreatic cancer cell lines were directly or indirectly co-cultured with PSCs.The inhibition rate and half maximal inhibitory concentration (IC50) values were assessed to determine the ability of chemoresistance.Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analysis were used to evaluate Hes 1expression before and after co-culture with PSCs.Results After treatment of gemcitabine (100 ng/ml), the inhibition rate of the two kinds of pancreatic cells were (52.3±12.1)% and (65.1±16.8)%.After co-culture with PSCs, the inhibition rate decreased to (38.5±11.6)% (PANC-1) and (51.2±10.9)% (BxPC-3).After co-culture with PSCs, the IC50 value of pancreatic cancer cell rose from (78.2±4.8) ng/ml to (206.5±8.2) ng/ml (PANC-1) and (65.4±6.5) ng/ml to (189.6±8.1) ng/ml (BxPC-3).Meanwhile, PSCs promoted the expression of Hes 1 in both PANC-1 and BxPC-3 cell lines as well.After using Notch signaling pathway inhibitor (L1790) or Hes 1 siRNA transfection, the IC50 value decreased to (89.5±16.4) ng/ml (PANC-1, L1790) and (61.6±12.9) ng/ml (BxPC-3, L1790), as well as (94.5±20.4) ng/ml (PANC-1, L1790) and (67.5±11.3) ng/ml (BxPC-3, L1790).ConclusionPSCs can induce the chemoresistance of human pancreatic cancer cell.Notch signal pathway plays an important role in this process.

<正>1病历摘要患者男,38岁,因"车祸致右小腿活动受限肿胀伴流脓1月"就诊。入院渗断:"陈旧性右胫骨开放性骨折合并感染"。患者于1月前因车祸致右小腿外伤,伤处肿胀、出血、活动受限,在当地保守治疗无好转,而来我院。查体发现右小腿肿胀明显,见右胫前约6.8×4.5×3.2cm的不规则开放性伤口,表面

术后胰瘘是胰腺手术后最常见的并发症之一.由于各研究者对胰瘘使用的定义不同,术后胰瘘的发生率存在差异.目前对于术后胰瘘的危险因素、诊断标准、预防措施以及治疗策略等的研究并无一致的结论.笔者就此对近年有关术后胰瘘的研究文献作一综述.

<正>急性重症胰腺炎是临床常见的急腹症,起病急、进展快、病情复杂,易引起全身多脏器功能损害,病死率高达20%～30%。多年来对重症胰腺炎的诊断及治疗一直深受国内外学者的重视,现将近年

腮腺混合瘤为口腔颌面部最常见的肿瘤之一,来源于腮腺上皮,肿瘤内除上皮成份外,还常有粘液,软骨样组织等,其好发部以腮腺为主,其次为腭部及颌下腺.