Dual-sided composite mesh repair of hiatal hernia: Our experience and a review of the Chinese literature

AIM:To summarize our experience in the application of Crurasoft for antireflux surgery and hiatal hernia(HH)repair and to introduce the work of Chinese doctors on this topic.METHODS:Twenty-one patients underwent HH repair with Crurasoft reinforcement.Gastroesophageal reflux disease(GERD)and HH-related symptoms including heartburn,regurgitation,chest pain,dysphagia,and abdominal pain were evaluated preoperatively and 6mo postoperatively.A patient survey was conducted by phone by one of the authors.Patients were asked about"recurrent reflux or heartburn"and"dysphagia".An internet-based Chinese literature search in this field was also performed.Data extracted from each study included:number of patients treated,hernia size,hiatorrhaphy,antireflux surgery,follow-up period,recurrence rate,and complications(especially dysphagia).RESULTS:There were 8 typeⅠ,10 typeⅡand 3 typeⅢHHs in this group.Mean operative time was 119.29min(range 80-175 min).Intraoperatively,length and width of the hiatal orifice were measured,(4.33±0.84and 2.85±0.85 cm,respectively).Thirteen and eight Nissen and Toupet fundoplications were performed,respectively.The intraoperative complication rate was9.52%.Despite dysphagia,GERD-related symptoms improved significantly compared with those before surgery.The recurrence rate was 0%during the 6-mo follow-up period,and long-term follow-up disclosed a recurrence rate of 4.76%with a mean period of 16.28mo.Eight patients developed new-onset dysphagia.The Chinese literature review identified 12 papers with213 patients.The overall recurrence rate was 1.88%.There was no esophageal erosion and the rate of dysphagia ranged from 0%to 24%.CONCLUSION:The use of Crurasoft mesh for HH repair results in satisfactory symptom control with a low recurrence rate.Postoperative dysphagia continues to be an issue,and requires more research to reduce its incidence.

原发性肾血管周上皮样肿瘤1例

血管周上皮样肿瘤(perivascular epithelioid cell tumor,PEComa)于1943年首次被描述,并且在1992年提出作为PEComa的特定形式,阳性标志物是单克隆抗体HMB-45[1]。PEComa起源间充质组织,其特征是具有黑色素的血管周上皮样细胞,通常被认为是低级别的肉瘤(Sarcoma)。

Electrically Conductive and Flame Retardant Graphene/Brominated Polystyrene/Maleic Anhydride Grafted High Density Polyethylene Nanocomposites with Satisfactory Mechanical Properties

Electrically conductive and flame-retardant maleic anhydride grafted high-density polyethylene(MA-HDPE) nanocomposites with satisfactory mechanical properties are fabricated by melt compounding MA-HDPE with polyethyleneimine(PEI)-modified reduced graphene oxide(PEI@RGO) as the conductive nanofiller and brominated polystyrene(BPS) as the flame retardant. The modification with PEI significantly improves the interfacial compatibility and dispersion of the RGO sheets in the MA-HDPE matrix, leading to electrically conductive nanocomposites with enhanced mechanical properties. Furthermore, the addition of 25 wt% of BPS makes the nanocomposite flame-retardant with a UL-94 V-0 rating. Thus, the multifunctional RGO/MA-HDPE nanocomposites with good electrical, flameretardant, and mechanical properties would have potential applications in construction and pipeline fields.

Crystallization Behavior and Dynamic Mechanical Properties of Poly(ε-caprolactone)/Octaisobutyl-Polyhedral Oligomeric Silsesquioxanes Composites Prepared via Different Methods

Two octaisobutyl-polyhedral oligomeric silsesquioxanes(oib-POSS)reinforced biodegradable poly(ε-caprolactone)(PCL)composites were prepared via two different methods,i.e.,melt compounding and solution casting,which were named as m PCL/oib-POSS and s PCL/oibPOSS,respectively,in this work.Oib-POSS dispersed finely in both composites;moreover,oib-POSS aggregates were larger in m PCL/oib-POSS than in s PCL/oib-POSS.Despite the different preparation methods,oib-POSS obviously promoted the crystallization of PCL,especially in s PCL/oib-POSS,but did not modify the crystal structure of PCL.The storage moduli of PCL were improved significantly in both composites.PCL/oib-POSS composites with enhanced crystallization behavior and improved dynamic mechanical properties were successfully prepared through both methods;moreover,the solution casting method was more effective than the melt compounding method.

Simultaneous Functionalization and Reduction of Graphene Oxide with Polyetheramine and Its Electrically Conductive Epoxy Nanocomposites

Simultaneous functionalization and reduction of graphene oxide （GO） is realized by refluxing of GO suspension with polyetheramine （D2000） followed by thermal treatment at 120℃. Compared to GO, the D2000-treated GO （GO- D2000） becomes hydrophobic, thermally stable and highly conductive with an electrical conductivity of 11 S/m, which is almost 8 orders of magnitude higher than that of GO. Due to the high conductivity and improved dispersion of GO-D2000, its epoxy nanocomposites exhibit a sharp transition from electrically insulating to conducting with a low percolation threshold of 0.71 vol%. With 3.6 wt% GO-D2000, the glass transition temperature of the epoxy nanocomposite is 27 K higher than that of neat epoxy.