Objective To study the therapeutic effect of Tibetan medicine Flos Saussureae combined with glucocorticoid for progressive stage of radiation pneumonia.Methods A total of 65 post-chemotherapy radiation pneumonia patients with esophageal carcinoma were randomized into western medicine group(20 cases),combined group (21 cases) and Flos Saussureae group (24 cases),which were treated with prednisone (1 mg/kg,orally),prednisone (0.5 mg/kg,orally) plus Flos Saussureae Injection (2 mL/d,by intramuscular injection),and Flos Saussureae Injection (4 mL/d,by intramuscular injection) respectively.The medication lasted for 6 weeks.Before and after treatment,we investigated the scores of chest high resolution CT(HRCT),Leicester Cough Questionnaire (LCQ) scores,6-minute walk distance,pulmonary function indexes of vital capacity (VC),total lung capacity (TLC) and diffusion function DLco,and arterial oxygen partial pressure(PO2).Results (1) The scores of HRCT,6-minute walk distance and LCQ scores of the combined group were improved as compared with those of western medicine group and Flos Saussureae group (P ＜ 0.05).The improvement of psychological scores,social function scores and overall socres of LCQ in Flos Saussureae group was superior to that in western medicine group (P ＜0.05).(2)After treatment,pulmonary function indexes and PO2 of the combined group and Flos Saussureae group were improved compared with those of western medicine group (P ＜ 0.05),and the improvement of DLco and PO2 of the combined group was superior to that of Flos Saussureae group (P＜ 0.05).Conclusion Flos Saussureae Injection combined with glucocorticoid exerts certain therapeutic effect for progressive stage of radiation pneumonia,and large-dose Flos Saussureae Injection is beneficial to the improvement of symptoms and imaging features of the patients.

This study was to retrospectively report the clinical effects of retropublic passage tension free vaginal tape(TVT)vs.transobturator tape(TVT-O)on 254 female patients with stress urinary incontinence(SUI).Our findings showed that mean operative time was significantly lower in TVT-O group than that in TVT group[(19±4)min vs.(27±6)min;P＜0.05].Perioperative complications were more commonly seen in the retropubic procedure(2.9% vs.8.8%;P＜0.01).There was no significant difference in intraoperative blood loss[(19±6)ml vs.(31±8)ml in TVT-O or TVT groups;P＞0.05]and in-hospital stay[(4.1±1.5)d vs.(4.5±1.8)d in TVT-O or TvT groups;P＞0.05]between the two groups.Grouts-Blaivas Score demonstrated that those two treatment groups did not differ significantly in 24-hour(93.6% vs.91.2%;P＞0.05)or long-term postoperative cure rate(94.5% vs.94.3%;P＞0.05).We suggested that TVT or TVT-O seemed to be equally effective in surgical treatment of SUI.However,TVT-O had advantage of relatively lower overall perioperative complication rate.

Objective To evaluate the sickle renal parenchyma incision for the removal of complex staghorn renal calculi. Methods Sickle parenchyma incision was used to remove stones in 37 patients with complex staghorn renal calculi.The procedure was as follows:the kidney was disected free and the pelvis within sinus renalis was isolated.Two rows of botton style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels (Brodie's line) from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower major calyx through the middle major calyx to the plane of upper major calyx.The shape of this incision appeared like a sickle.The renal parenchyma and each calyx along this incision were opened and so was all the stones could then be easily removed.The calyces could well be observed. Results The calculi were completely removed in all the 37 cases.21 needed intraoperative blood transfusion and the mean amount of blood was 120 ml.KUB+IVU were normal 4 weeks postoperatively with improved hydronephrosis,no intrarenal stricture and void of residual calculi. Conclusions This procedure has the advantages of little intraoperative bleeding,slight impairment of renal function,high clearence rate and is indicated for the removal of any intrarenal pelvis complex staghorn calculi.

Leydig cells derived from a SD rat aged one month were transplanted to the hind leg subcutaneous of a 2 week-castrated outbred rat. At 1, 3, 4, 6 months after implantation, the grafts were removed and taken to have a histochemical staining for 3?-hydroxygsteroid dehydrogenase (3b-HSD), light and electron microscopy. The results indicated that there were a lots of 3b-HSD positive leying cells in the grafts. The well revascularized and no lymphocytic infiltration were seen around the implanted cells with 4 months after transplantation. Electron microscopy displayed that the implanted cells had abundant mitochondria and smooth endoplasm reticulum, suggesting that the implanted ceils could survive and had better secretary testosterone function for 4 months.

Objective To study the effect and histocompatibility of urethral extracellular matrix in repair of traumatic urethra defects in rabbits. Methods Model of traumatic urethral defects was made by resecting 1.0-1.5 cm segment of the urethra in 20 rabbits. Then, the defects were repaired by a tube of extracellular matrix of the same length. The dynamic changes of CD4+, CD8+ T cell and CD4+/CD8+ in peripheral blood were detected by flow cytometry at 1,2, 3 and 4 weeks after operation. In the meantime, the immunity response of rabbits was evaluated by lymphocyte transformation test. The repaired segments stained with hematoxylin-eosin (HE) and Van Giesen were studied by histologic and pathologic observations at 10 days, 3, 6 and 24 weeks postoperatively. The urodynamics, urethroscopy and urethrography were performed at 24 weeks postoperatively. Results There was no significant difference in aspects of stimulative index of lymphocyte transformation, T lymphocyte subsets CD4+, CD8+ T cell and CD4+/CD8+ between experimental group and negative control group. Urothelium covered the whole surface of the matrix tube three weeks after operation. The smooth muscle cells increased nearly to normal urethral wall at 24 weeks. Urethrosoopy and urethrography showed glossy matrix tube. There was no statistical difference upon urodynamies between experimental group and control group. Conclusion The urethral extracellular matrix has good histocompatibility and may be a safe and effective material for repairing urethra defects.

A comparative observation about histological and histochemical study were made onthe preservating methods of local ischemic kidney of dogs.The methods of this exp-eriment were divided into five groups:A.Local hypothermia;B.Hypothermic perfu-sion solution 500ml,4℃,containing Procaine 450 mg and Heparin 100 mg,infusedinto renal artery;C.Hypothermic perfusion solution 500ml,4℃,containing 20% Ma-nniton 32ml,25% MgSO_4 0.36 ml,Heparin 100 ml,infused into renal artery;D.Localhypothermia and heparin 30 mg injected into the same vessel.E.Local room tem-perature.The specimens were taken from the kidneys of the experimental dogs atvarious period after treated with every method.The results were as follows;A,D and E group presented irreversible histological changes within 4 hoursaftertreatment.Four hours later,the reaction of SDH,ATPase,AlPase werenegative.It suggested that the kidney damage was serious,as well as expressed thatthe effect of these preservating methods for ischemic kidney are not satisfactory.In B group,the histological and histochemical alteration is very light and almostreversible,during 60 days after treatment.In C group,hypothermic perfusionsolution containing Mannitol,MgSO_4 etc either during experiment or follow observa-tion for 60 days,no histological and histochemical alterations were found.It indica-ted that this method is an ideal perservating technique for ischemic kidney.

This is an experiment on rabbits to evaluate the possibility of ureteral replacement by extracellular matrix. We adopted a biochemical method for preparing a new tissue engineering material named Extracellular Matrix (ECM), and the ECMs were used as homologous grafts to replace the defect in the ureters. Light microscopy, scanning electron microscopy, immunohistochemical technique and intravenous urography were used. The routine blood and biochemical laboratory tests were made before and after operation, and the measured values of pressure in the ureter of experiment and control groups were compared. The ureteral ECM was found in the experiment to promote the regeneration of all ureteral wall components. There were no significant differentces between the regenerative tissue and the normal tissue in morphology and function 16 weeks after replacement. The homologous ECM might be an ideal replacement material for ureteral defect.
Animals ; Biomedical Engineering ; methods ; Bioprosthesis ; Epithelium ; physiology ; ultrastructure ; Extracellular Matrix ; physiology ; transplantation ; ultrastructure ; Female ; Male ; Rabbits ; Random Allocation ; Transplantation, Autologous ; Ureter ; injuries ; pathology ; surgery

OBJECTIVETo summarize the clinical features of idiopathic hypogonadotropic hypogonadism (IHH) diagnosed during childhood, and detect mutations in KAL1 and FGFR1, acting as key clues for diagnoses.

METHODWe collected and analyzed clinical data of 21 cases (including demographic data, chief complaint, history of present illness, family history, physical examination, laboratory tests and imaging studies, etc.) diagnosed with IHH from December 2008 to February 2013. Polymerase chain reaction and gene sequencing was applied to detect mutations on KAL1 and FGFR1. Fifty healthy unrelated individuals were choosen as controls.

RESULTOf 21 patients with IHH, 19 were males and 2 females, they visited us initially from 8-17 years old, with an average of (13.58 ± 2.38) years old. Sixteen cases were KS patients (76%). One boy reported abnormal sense of smelling but having olfactory perfect picture on MRI; 2/19 male cases had no puberty when they were over 13-14 years old without abnormal external genitalia. 8/19 cases only had small penis, 8/19 had both of cryptorchidism and small penis, and the Case 2 also had hypospadias. One boy had cryptorchidism combined with a normal penis. Only 2 girls diagnosed as IHH who visited us because of no puberty signs when they were 13 and 16 years old, respectively. Other clinical manifestations included: one with gynecomastia, 2 had mental retardation, and one was deaf; one with high palatal arch; one with mirror-movement and one with left renal agenesis but normal renal function respectively. Laboratory tests showed that the basic testosterone (T) is low and with inappropriately low or normal gonadotropin hormones. The results of cases of standard human chorionic gonadotropin (HCG) test of 7 cases out of 19 male children's were normal (testosterone>1 100 ng/L), and another nine cases continued to complete the extended HCG test, and the testosterone levels of two of them (cases 6, 8) were still lower than 1 000 ng/L. Family history: the parents in 9/21 family had delayed puberty, involving only one parent in 6 families, involving both in 2 families and the other one was an uncle having micropenis with a child. Among these 21 cases, only one boy's father had hyposmia and his first emission age was 14-15 years. Eleven patients accompanied abnormal sense of smelling and the olfactory organ abnormalities on MRI, 4 had olfactory organ abnormalities on MRI while they had good smelling function self-reportedly. We got 15 samples (12 KS and 3 nIHH cases) to screen the mutation of KAL1 (14 exons) and FGFR1 (18 exons). A splicing mutation c.1062+1G>A in KAL1 is identified in case 17 with IHH. One novel heterozygous FGFR1 mutation, a single base deletion mutation on the exon 1 c.27delC is identified in case 14. This mutation causes the premature termination codons.

CONCLUSIONThis pilot research showed that IHH/KS diagnosis in children depends on clinical manifestation rather than gene analysis. Small penis or cryptorchidism, smelling abnormality and positive familial history may contribute to the KS/HH diagnosis. MRI of olfactory bulb acts as important proof for diagnosis of KS. Mutations in KAL1 and FGFR1 gene are not main causes of Kallmann syndrome.

Adolescent ; Child ; DNA Mutational Analysis ; Exons ; genetics ; Extracellular Matrix Proteins ; genetics ; Female ; Heterozygote ; Humans ; Hypogonadism ; diagnosis ; genetics ; Kallmann Syndrome ; genetics ; Male ; Mutation ; genetics ; Nerve Tissue Proteins ; genetics ; Olfaction Disorders ; Receptor, Fibroblast Growth Factor, Type 1 ; genetics ; Sexual Maturation