BACKGROUND:Studies have found that interleukin-17 secreted from T helper cel s 17 has a high expression in the serum and injured tissues of periodontitis patients, but the specific relationship is stil unclear. Therefore, an appropriate animal model is necessary to analyze the expression of interleukin-17 in model rats. OBJECTIVE:To analyze the expression of interleukin-17 secreted from T helper cel s 17 in experimental periodontitis rat. METHODS:Rats were divided into three groups:the chronic periodontitis model in ligation group was established by ligaturing the first molar on the left maxil ary, and rats were kil ed 8 weeks later;the alveolar resorption model in lipopolysaccharide group was established by injecting lipopolysaccharide, and rats were anesthetized and kil ed 20 days after the model was completed;rats in control group did not receive any disposal. RESULTS AND CONCLUSION:Under light microscope, the number of osteoclasts in the ligation group and lipopolysaccharide group was significantly higher than that in the control group (P<0.05). The rats in the ligation group had swol en and red gums, as wel as periodontal pocket. Immunohistochemical results showed that the expression levels of interleukin-17 in the ligation group and lipopolysaccharide group were both higher than that in the control group (P<0.05). ELISA results showed that there was no difference in the serum concentration of interleukin-17 among three groups (P>0.05). These findings indicate that interleukin-17 exerts an important role in the alveolar resorption, and T helper cel s 17 may be involved in the local periodontal inflammation but have weak effects on the system inflammation.

BACKGROUND:Discogenic pain is a major cause of chronic low back pain,and its inflammation mechanism that is participated by many cytokines is well known by more and more people. However,what is the role of these cytokines in the occurrence and development of pain and how we use them to control pain are still not consistent. OBJECTIVE:To completely learn about the pathogenesis of intervertebral disk herniation,the relative cytokines in the occurrence and development of pain and the advances in the treatment of chronic pain with cytokines. RETRIEVE STRATEGY:A computer-based online search of CNKD was undertaken to identify the relevant articles dated from January 1994 to June 2007 with the Chinese of "cytokine,pain". And totally 153 articles were collected. Meanwhile,PubMed database was searched for English articles published from January 2002 to June 2007 with the keywords of "gene,chronic pain" and 36 were collected. The articles that involved the basic and clinical researches closely related with cytokine were selected. Repetitive articles were excluded. After the trail,6 Chinese and 24 English articles were involved. LITERATURE EVALUATION:Of the 30 articles,10 were focused on the basic research and animal experiment,and 20 were about clinical research. There were 7 of RCT,1 of EBM review,10 of summary analysis,2 of case report,and 10 of experience exchange. DATA SYNTHESIS:The mechanisms of discogenic pain include inflammation and immune ones besides mechanical pressure. Inflammation mechanism of discogenic pain is well known by more and more people,in which many cytokines such as substance P,phospholipase A2,tumor necrosis factor,interleukin,growth factor and NO participate. Meanwhile,the role of immunities should not be ignored. Some researchers have used some cytokines(interleukin 1 receptor antagonist,vascular endothelial growth factor,etc) in clinic to treat pains and got good effect. CONCLUSION:The mechanism of pain and various effects of pain-killer are based on gene. Cytokines play important roles in the occurrence,development and treatment of discogenic pain.

OBJECTIVE: To evaluate the effects of intravenous anesthesia in painless esophagoscopy for extraction of foreign bodies in the esophagus. METHOD: Forty-two patients underwent painless esophagoscopy, and extracted the foreign bodies in the esophagus. RESULT: Thirty-two cases had their foreign bodies extracted smoothly and no serious complication occurred,the other 10 cases were mucosal injuries of esophagus with no obvious foreign body. CONCLUSION Intravenous sedation with propofol in extraction of foreign bodies in the esophagus can relieve the suffering and adverse reactions, and it is safe, quick, comfortable and effective for extraction of foreign bodies in the esophagus and is worthy to be applied in the clinic.
Anesthesia, Intravenous ; methods ; Anesthetics, Intravenous ; Esophagoscopy ; methods ; Esophagus ; injuries ; Female ; Foreign Bodies ; therapy ; Humans ; Male ; Propofol

BACKGROUND: Myelodysplasia induced by spina bifida is one of the common developmental malformations of the nervous system in children, and neurogenic urinary incontinence induced by it can affect the children' s quality of life.OBJECTIVE: To observe the effects of surgical therapy and rehabilitation training for children with hyper-reflexic neuropathic urinary incontinence.DESIGN: A controlled follow-up observation.SETTING: Department of Pediatric Surgery, First Hospital Affiliated to Zhengzhou University.PARTICIPANTS: A total of 81 children(54 males and 27 females), aged 4 to 14 years treated for hyper-reflexic neuropathic urinary incontinence between January 1992 and October 2000 were selected. All the cases were confirmed loose pelvic floor muscle and smaller bladder capaeity before operation. Moreover, all cases with neuropathic urinary incontinence were proved to be hyper-reflexic neurogenic bladder by urodynamic examination.METHODS: Pelvic muscles of the 81 patients were strengthened with bilateral iliopsoas and the bladder was augmented on the basis of ileocystoplasty. Five patients had an additional bladder neck suspension. Wound healing was satisfactory after 3 weeks; therefore, rehabilitative exercise for coordination was performed. The improvements in symptoms and urodynamic results were followed up.RESULTS: Urinary catheters were removed in the 81 patients 2 weeks after operation. Forty patients had voiding desire before micturition, with linear urine current, more than 60 minutes' interval between micturitions, and almost normal or normal maximal bladder capacity and pressure and residual urine volume, which was regarded as significantly improved. Twenty-three patients had voiding desire before micturition, with linear urine current, more than 40 minutes' interval between micturitions, and reduced maximal bladder capacity and residual urine volume, but increased bladder pressure, which was regarded as improved. However, 18 patients were improved after regular bladder training. The postoperative urodynamic results in 9 patients showed that the average bladder pressure, average urethra pressure, residual urine volume and maximal bladder capacity were 1.2 kPa, 1.15 kPa, 30 - 50 mL and 300 -600 mL, respectively. Of the 81 cases, 63 cases were followed up completely for 6 months whereas the others had no complete follow-up data. The follow-up results showed significant outcomes in 56 cases, improvement in 5 and no effect in 2, with the total effective rate of 97%.CONCLUSION: Satisfactory results can be obtained by combined augmentative ileocystoplasty with strengthening of pelvic floor by iliopsoas for children with hyer-reflexic neuropathic urinary incontinence. The combination of micturition reflex and control training after operation produces obvious therapeutic effects.

BACKGROUND: There are various surgical treatments to neurogenic urinary incontinence, and the curative effects differ a lot. The present research was to study the effect of surgical treatment of neurogenic urinary incontinence.OBJECTIVE: To evaluate the therapeutic effect of cystectasy using a demucosalized ileoseromuscular layer patch containing neurovascular pedicle for the patients with overactive neurogenic urinary incontinence to suggest for improvement in operations.DESIGN: A retrospective case analysis based on the study of the patients.SETTING: Department of pediatric surgery of a university hospital.PARTICIPANTS: A follow-up study was conducted to 68 patients who were treated at the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University from April 1998 to January 2004 for neurogenic urinary incontinence. There were 38 cases with full follow-up data.METHODS: All the 38 patients with overactive neurogenic urinary incotinence underwent bladder augmentation using a demucosalized ileoseromuscalar layer patch containing neurovascular pedicle and were followed up for 4to 69 months, and 17.2 months in average. Among the patients, 34 with pelvic diaphragm ptosis were treated with pelvic diaphragm strengthening at the same time.MAIN OUTCOME MEASURES: The preoperative and postoperative symptoms, bladder compliance and maximum bladder capacity and the relative safe bladder capacity were studied.RESULTS: Thirty of 38 patients showed improvement in the symptoms of urinary incontinence(micturition interval ＞ 1 hour) after the operation. The results of urodynamics showed that the all patients with bladder augmentation using a demucosalized ileoseromuscular layer patch containing neurovascular pedicle urinated under abdominal pressure, and no active contraction of detrusor urinae was detected. The compliance, the maximum bladder capacity and the relative safe bladder capacity were increased by(27.43 ± 24.78) mL/kPa (P ＜0.01), (122. 18±79.99) mL(P ＜0.01) and(98.63 ±86.78) mL ( P ＜ 0.01 ) respectively. No aggravation of upper urinary function injury was observed after the operation.CONCLUSION: The bladder augmentation using a demucosalized ileoseromuscular layer patch ontaining neurovascular pedicle can protect the upper urinary function, and it is an effective approach to treating overactive neurogenic urinary incontinence.

BACKGROUND: How to solve the source of material substitute for repair of urethral dcfoct and improve the blood supply of new urethra has become a critical problem in the urethral repair and reconstruction.OBJECTIVE: To investigate the effects of endothelial progenitor cells (EPCs) on improving blood circulation in the new urethra following urethral defect repair.DESIGN,TIME AND SETTING: In vivo tissue engineering experiment,performed at the Laboratory of Deparanent of Surgery,First Affiliated Hospital of Zhengzhou University between January 2006 and February 2008.MATERIALS: Thirteen 3-5-month-old male Japanese rabbits were included for this study.Of them,one was used for preparation of bone marrow mononuclear cells,and the remaining twelve rabbits were divided into EPC repair group (n=8) and model group (n=4).METHODS: Under the aseptic condition,bone marrow was taken from the rabbit bilateral anterior superior lilac spine.Mononuclear cells isolated by Percoll method were induced in vitro using medium supplemented with vascular endothelial growth factors (VEGFs) and bovine basic fihroblast growth factors.When covering the whole bottom of culture flask,the mononuclear cells were digested with trypsin for passage.Animal models of urethral defect were developed in the two groups.One piece of aseptic fresh acellular human amnion (1 cm2) was sutured to each defected urethra using 0/6 DG suture for forming urethra.In the EPC repair group,1010/L passage 3 rabbit bone marrow mononuclear cell suspension was injected to two anastomotic stomas of the new urethra,0.1 mL for each stoma.The subcutaneous tissue was interruptedly sutured to the formed urethra using 0/6 DG suture.In addition,0.5 mL bone marrow mononuclear cell suspension was added to the region between each anastomotic stroma and newly repaired urethra.The same procedure was performed in the model group except that bone marrow mononuclear cell suspension was replaced by cell-free medium.At weeks 4 and 12 after surgery,paraffin sections of urethral tissue were made.MAIN OUTCOME MEASURES: Identification of cellular morphology; vascular regeneration of urethral tissue after urethral defect repair.RESULTS: After surgery,rabbit bone marrow mononuclear cells adhesively grew in vitro.Four days later,these cells exhibited rapid clone-like growth.Ten days later,they had typical slabstone-like change,presenting with strip-shaped and bundle-shaped growth.The phenotype of cultured cells gradually turned from CD34+/CD 133+/CD31+ to CD34+/CD 1337CD31+.At weeks 4 and 12 after surgery,the number of regenerate,d blood capillaries in the urethral tissue was significantly greater in the EPC repair group than in the model group (t=-9.034 to 5.985,P ＜ 0.01).CONCLUSION: Rabbit bone marrow mononuclear cells-differentiated EPCs can apparently improve local blood circulation in the urethral defect repair.

Objective To explore the determination of urinary angiotensinogen (uAGT) in the urine of children with obstructive hydronephrosis and its relationship with impaired renal function, to provide a new and rapid reference index for the preoperative evaluation and postoperative follow-up of the children with hydronephrosis.Methods The data were collected from 48 children who were diagnosed as unilateral congenital renal pelvis and ureter obstruction in the outpatient or inpatient Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University,which were divided into operation group and non-operation group.There were 28 children in operation group(who were all severe hydronephrosis) ,who were all operated with dismembered pyeloplasty.There were 20 children in the non-operation group (who were all mild and moderate hydronephrosis).They temporarily had no surgery signs and hydronephrosis did not become increasingly serious for assuring the regular outpatient follow-up after being diagnosed as hydronephrosis;there were 20 children in the control group, 10 of which were male, and 10 female.The males were hospitalized children with hydrocele and the females were with inguinal hernia.Gender composition among the 3 groups, and the average age difference was not statistically significant.The clean urina of children in 3 groups was collected,3 times for operation group, once before operation and once in 6 weeks and once in 12 weeks after operation;3 times for non-operation group and control group with interval of 6 weeks in outpatient clinic.The children in operation group and non-operation group were all scanned for glomerular filtration rate (GFR) of diseased renal with radionuclide;enzyme-linked immunosorbent assay (ELISA) was adopted to determine the content of uAGT in the urine of the 3 groups of children, and automatic biochemical analyzer was used to measure the amount of urine creatinine (uCr).Results Before operation, in 6 weeks and 12 weeks after operation, uAGT / uCr average water of non-operation group and control group was significantly lower than the operation group, all the differences were statistically significant (F =34.360,14.683,5.035, all P ＜ 0.05).Preoperative and postoperative uAGT / uCr and GFR of diseased renal were of negative correlation(r =-0.647,-0.786, all P ＜ 0.05).In operation group, the preoperative and postoperative GFR average of diseased renal was 37.18 ± 7.31 and 45.27 ± 8.18.The difference of GFR changes was statistically significant before and after treatment (t =-3.971, P =0.000).Conclusions uAGT/uCr increased evidently in congenital renal pelvis and ureter obstruction patients who needed operation, so increase of uAGT might be the indicator of impaired renal function caused by obstructive hydronephrosis of children.

Objective To evaluate the effects on the mineral bone disorder using different calcium concentration citrate-based dialysate in maintenance hemodialysis (MHD) patients.To compare the concentrations of intact parathyroid hormone(PTH) with biointact PTH(1-84) in these patients.Methods Citrate dialysate with different calcium concentration (DCa 1.75,DCa 1.5,DCa 1.25 mmol/L)were used in turn in 15 stable MHD patients each week.Serum tCa and iCa were measured by automatic biochemistry analyzer.The concentrations of iPTH and bio-iPTH were compared.Results (1) The patients treated with DCa 1.75 citrate dialysate had increased serum iCa and tCa after dialysis,and PTH did not change significantly as compared to those findings before the dialysis.With the DCa 1.5 citrate dialysate,serum iCa and tCa were kept stable and PTH level was increased.With DCa 1.25 citrate dialysate,serum iCa and tCa decreased significantly and PTH decreased.(2)iPTH and bioPTH had excellent correlations.Variation of bio-iPTH was more correlated with the changes of calcium than iPTH.Conclusions Serum levels of iPTH,tCa and iCa can be kept stable in MHD patients treated with DCa 1.75 ～ 1.5 citrate dialysate.Bio-iPTH is a more sensitive marker for mineral bone disease than iPTH.

Objective To test the differential proteomics by using proteomic technology of children diagnosed with nephroblastoma and healthy children,thereby for screening non-stress-related protein markers of Wilms' tumor.Methods The serum of children with Wilms' tumor,children with trauma in 1-3 hours and healthy children were collected in the First Affiliated Hospital of Zhengzhou University from May 2010 to May 2014.Then,the differential proteomics were screened and the interference of traumatic stress proteins in the process were eliminated by using proteomic technology of surfaced enhanced laser desorption/ionization time of flight mass spectroscopy (SELDI-TOF-MS),matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF-MS),high performance liquid chromatography(HPLC),and two dimensions-liquid chromatography-linear trap quadrupole-mass spectrometer(2D-LC-LTQ-MS),therefore the non-stress-related protein biomarkers of Wilms' tumor were determined.Results A mass-to-charge ratio 6630.58 Da protein or peptide was selected as tumor-specific marker.And there were no same or similar proteins in mass spectrometry of children with traumatic stress by SELDI-TOF-MS.Finally,by purification through HPLC and identification through MALDI-TOF-MS and 2D-LC-LTQ-MS,apolipoprotein CI(APO CI) was found to be the non-stress-related serum protein of Wilms' tumor.Conclusions It is identified that APO CI is an important serum protein biomarker of Wilms' tumor by using proteomic technology in eliminating the influences of interference factors of stress.Therefore,the results provide possibilities of further studies and investigating the mechanisms of the protein expression changes and early diagnosing the Wilms' tumor.

Objective To evaluate the efficacy and safety of solifenacin in the treatment of bladder spasm after surgical operation of chlidren hypospadias.Methods From January 2014 to May 2015,60 cases of children more than 4 years old after surgical operation of hypospadias who had symptom of bladder spasm on the day of surgery were assigned into the study group (n =30) and control group (n =30),based on simple randomization.On the first day,the frequency of spasm,the duration of spasm and the incidence of urine extravasation were recorded regarded as the first day condition of bladder spasm.Patients in the study group were treated with solifenacin (5 mg once daily) for a nine days period from l th day postoperation.Patients in the control group were not treated with solifenacin.The frequency of spasm,the duration of spasm and the incidence of urine extravasation of the two groups were recorded and compared on the 3th and 9th day.Adverse events with solifenacin of two groups were recorded.The function of liver and kidney in the study group were recorded and compared.Results There were statistically significant differences(P ＜0.01) in favor of the study group over the control group in the aspect of the frequency of spasm,the duration of spasm and the incidence of urine extravasation on the 3th and 9th day.In the study group,the data compared among l th,3th and 9th was statistically significantly different,opposite to the control group.There was no statistically significant difference between the liver and kidney function of preoperation and the 9th day in the study group.The frequency of adverse events between two groups had no statistically significant difference.Conclusions Solifenacin is effective and safe in the treatment of bladder spasm after surgical operation of chlidren hypospadias