Objective To analyze the clinical efficacy of laparoscopic transabdominal preperitoneal hernioplasty (TAPP) and open tension-free hernioplasty for the treatment of adult inguinal hernia.Methods The clinical data of 198 patients with inguinal hernia admitted to Lu'an Hospital affiliated to Anhui Medical University from October 2017 to December 2018 were retrospectively analyzed,they were divided into the laparoscopic group (n=90) and the open group (n=108) according to different surgical methods.The laparoscopic group underwent TAPP,and the open group underwent open tension-free hernioplasty.The clinical parameters,the pain degree at different time after operation and the postoperative complications of the 2 groups were compared.Results Compared with the open group,the postoperative bowel sound recovery time,anal exhaust time,spontaneous activity time,the duration time of pain postoperative and hospitalization time significantly shortened in the laparoscopic group (P＜0.05);the operation time and hospitalization costs had no significant difference in 2 groups (P＞0.05).The VAS scores of the 2 groups gradually decreased from 12 hours to 7 days after operation,and the laparoscopic group was significantly lower than the open group (P＜0.05).The incidence of complications in the laparoscopic group was significantly lower than that in the open group (P＜0.05).Conclusion Compared with open tension-flee hemioplasty,TAPP can significantly shorten postoperative duration time of pain in patients with inguinal hernia,and has fewer postoperative complications,which is benefit to postoperative recovery.

Objective To evaluate the efficacy and safety of different surgical treatments for patients with breast cancer. Method 60 patients with breast ( mammary gland ) fibroma were randomly divided into group A (observation group) and group B (control group),and patients in the control group received the conventional surgical method and those in the observation group were treated with areolar incision surgery. Results The total effective rate of patients in the observation group was significantly higher than that in the control group,the rate of breast feeding in the control group was significantly better than that in the control group ( P<0 . 05 ) , and the difference in the recurrence rate between the two groups was not significant ( P>0 . 05 ) . The operation duration and hospitalization length of patients in the observation group were significantly shorter than those in the control group,and the amount of bleeding during operation in the observation group was significantly lower than that in the control group (P<0. 05,P<0. 01). The patients' areola sensation were normal in the observation group,the bilateral breasts were symmetrical in the observation group and the accepted degree of surgical scar was significantly higher than that in the control group ( P<0 . 05 ) . The difference in the scar size at 3 months after operation between the two groups was statistically significant (P<0. 05),but the difference in the haematoma and ecchymosis size was not statistically significant (P>0. 05). Compared with the control group,the postoperative cosmetic effect of patients in the observation group was significantly higher, and the incidence of complications was significantly lower ( P<0 . 05 ) . Conclusion The therapeutic effects of areola incision surgery on mammary gland fibroma should be better,which can reduce the scar,make the breast appearance beauty,and also reduce the incidence of complications and the recurrence rate,with a high safety and high patient satisfaction.

目的 探讨激素依赖性乳腺癌中人表皮生长因子-2(HER-2)、增殖细胞核抗原Ki67的表达与临床病理因素的关系及临床意义.方法 选取安徽医科大学附属六安医院2012年10月至2016年10月接受标准手术治疗的激素依赖性乳腺癌患者术后组织标本,采用免疫组化En Vision二步法检测93例激素依赖性乳腺癌组织标本HER-2和Ki67表达情况,免疫组化结果为HER-2(++)标本给予FISH检测进一步验证HER-2表达,分析HER-2和Ki67表达与临床病理因素的关系.结果 HER-2和Ki67阳性表达率分别为22.58%(21/93)和67.74%(63/93),两者共同阳性表达率为20.43%(19/93),不同年龄、淋巴结有无转移、不同临床分期组间HER-2阳性表达率差异无统计学意义(P>0.05),不同肿瘤直径组间HER-2阳性表达率差异有统计学意义(P<0.05);不同年龄、不同肿瘤直径、淋巴结有无转移、不同临床分期组间的Ki67阳性表达率差异无统计学意义(P>0.05);HER-2和Ki67共同阳性表达率在不同肿瘤直径组间差异有统计学意义(P<0.05),在不同年龄、淋巴结有无转移、不同临床分期组间差异无统计学意义(P>0.05).结论 HER-2和Ki67可用作判断激素依赖性乳腺癌生物学行为的标志物.

儿童手术后肠套叠较为少见,约占儿童腹部手术的0.08%,且多为小肠套叠[1].早期诊断、早期再手术是治疗的唯一方法 [1].安徽医科大学附属六安医院外二科1986～2008年共收治29例,现报告如下.

目的:探讨分化性甲状腺癌合理的外科治疗术式及效果。方法:回顾性分析47例分化性甲状腺癌的临床资料,从甲状腺切除范围、颈淋巴结清除方式等方面探讨分化性甲状腺癌的治疗。结果:乳头状癌41例,滤泡状癌6例;证实有淋巴结转移10例,右侧甲状腺上静脉癌栓1例。行患侧腺叶切除+峡部切除+中央区淋巴结清除术45例,其中3例另加行颈侧区淋巴结清除术;患侧腺叶+峡部切除+对侧甲状腺大部切除术2例,均予行双侧功能性颈淋巴结清除术。全组随访1～10年,目前无死亡病例,1例6年后出现局部复发和骨转移。结论:对于分化性甲状腺癌宜采取个体化手术方式,推荐术式为患侧甲状腺叶切除+峡部切除+选择性颈淋巴结清除术。

Objective:To evaluate the causation and management of subcutaneous fluid after breast cancer surgery.Methods: The clinical data of 328 cases of the breast cancer patients were analyzed retrospectively.Results: 42 cases suffered the complication of subcutaneous fluid,in which six cases occurred after the removal drainage tube.Conclusion: These complications of subcutaneous fluid mainly associates with the surgery skill and the nursing of drainage tube.Two drainage tubes under continued Low negative pressure can prevent the cause of subcutaneous fluid,and the appropriate pressure bandage can promotion wound healing early.