By using 5'-nucleotidase-alkaline phosphatase (5'-Nase-AlPase) double staining method, the fine distribution of the lymph vessels in the stomach wall of the rabbit, guinea pig and rat has been observed. Under light microscope lymph capillaries showed strongly 5'-Nase positive reaction with brown or dark brown staining. However blood capillaries revealed significantly A1Pase activity with blue staining. The lymph capillaries were seen in all layers of the stomach wall in three species, but the lymph vessels were only shown in the submucosa, muscularis and serosa. In the mucosa lymph capillaries could be found in the deep layer of the lamina propria. In the submucosa there were lymph vessels and capillaries. In the muscularis lymph capillaries and vessels not only could be found between oblique and circular muscle or between circular and longitudinal muscle, but also among muscle fiber bundles of each layer. In the serosa there were larger lymph vessels situated near the muscularis. The observation on semithin and ultrathin sections also shown the similarity in the lymph vessels distribution. There was no difference in the distribution of lymph vessels in the stomach wall between rabbit, guinea pig and rat.

Objective:To evaluate the role of silent information regulator 1 (SIRT1)/nuclear factor E2 related factor 2 (Nrf2) signaling pathway in sleep deprivation-induced cognitive dysfunction in rats.Methods:Thirty-six adult male Sprague-Dawley rats, aged 54-56 weeks, weighing 600-750 g, were divided into 3 groups ( n=12 each) using a random number table method: control group (group C), sleep deprivation group (group SD) and sleep deprivation+ SIRT1 agonist Srt1720 group (group SD+ Srt). Sleep deprivation model was established by modified multi-platform water environment method.Srt1720 10 mg/kg was injected intraperitoneally every 12 h starting from 24 h before establishing the model in group SD+ Srt, while the equal volume of 0.9% normal saline was injected intraperitoneally in C and SD groups.After the end of sleep deprivation, Morris water maze test was performed to evaluate the cognitive function.Animals were then sacrificed, and their hippocampi were removed for determination of neuronal degeneration rate in hippocampal CA1 region (using HE staining), the apoptosis rate in hippocampal CA1 (using TUNEL assay ), the expression of SIRT1 and Nrf2 in hippocampal CA1 (by immunohistochemistry) and the contents of reactive oxygen species (ROS) and superoxide dismutase (SOD) (by microplate method). Results:Compared with group C, the escape latency was significantly prolonged, the time of staying at the platform quadrant was shortened, and the frequency of crossing the platform was decreased on 2-4 days, the apoptotic rate and neuronal degeneration rate were increased, the expression of SIRT1 and Nrf2 was down-regulated, ROC content was increased, and SOD content was decreased in SD and SD+ Srt groups ( P<0.05). Compared with group SD, the escape latency was significantly shortened, the time of staying at the platform quadrant was prolonged, and the frequency of crossing the platform was increased on 3 and 4 days, the apoptotic rate and neuronal degeneration rate were decreased, the expression of SIRT1 and Nrf2 was up-regulated, ROC content was decreased, and SOD content was increased in group SD+ Srt ( P<0.05). Conclusions:Sleep deprivation can induce oxidative stress response in hippocampus by inhibiting the activation of SIRT1/Nrf2 signaling pathway, leading to cognitive dysfunction in rats.

Objective To investigate the application of the repeated expanded bilateral deltopectoral flap for resurfacing severe facial cervical scar, with review of relating articles to discuss issue of repeated expanding flap.Methods Nine patients suffered from hyperplastic facial and cervical scar.Two soft tissue expanders were implanted into the anterior chest region at both sides of sternum.The center of inner border of the expander was at the cross of second intercostal and parasternal line, and the lengthways axe of the expander was located at the ligature of the second intercostals and mammary areola.After two weeks when the expander was filled, expanded flap was transferred to cervical defect.The transferred flap was repeated expanded after half a year and transferred to resurface facial defect.Results In the first expansion stage, 600 or 800 ml expander were implanted in each side of sternum.In the second stage, 400 or 500 ml were used.The first stage of expanding process was smooth, and 2 of the expanding flaps were ruptured during the second expansion period.400-520 cm2 (average 440 cm2) additional expanded flap was acquired during two stages of expanding.Conclusions The repeated expanded bilateral deltopectoral flap gives us greater opportunity to repair severe facial-cervical scar.The best interval time of the two-stage expansion is over half a year.The speed of second expansion should be lower than that in the first stage, and protecting the expanding flap carefully from external force compression is needed during the second expasion.

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery

Objective To evaluate the reliability and validity of reflective functioning questionary-54 (RFQ-54) in China.Methods School sample:a total of 635 students were selected for the study.Clinical patients:another 75 patients with borderline personality trait who visited Department of Psychiatry in Shengjing Hospital of China Medical University were recruited.All subjects filled the RFQ-54,MIS-BPD,TAS,FFMQ.44 students accepted the retest after three weeks.Results The internal consistency for RFQ-C and RFQ-U were both 0.628.The test-retest reliability was 0.835,0.683,respectively.The correlations with TAS,FFMQ,MIS-BPD supported its validity.The RFQ subscales scores were significant1y different between only-child and non-only child,urban and country,school group and clinical group (22.11 ± 1.34 vs 18.97 ± 1.22,22.59 ± 1.36 vs 17.61 ± 1.12,21.39 ± 1.32 vs 15.34 ± 1.08,10.95 ± 8.43 vs 13.58 ± 8.19,10.95 ± 8.36 vs 13.88 ± 8.26,11.47 ± 8.02 vs 22.43 ± 1.24,respectively.P ＜ 0.01).Conclusion The Chinese version of RFQ-54 shows good reliability and validity,which can be used to assess the reflective function of adults in China.

Objective: To evaluate the histological integration process of the buccal mucosa onlay graft applied on the dorsal corpora cavernosa for urethroplasty in an experimental study in rabbits, as well as to preliminarily investigate potential mechanism of the survival of the buccal mucosa and the impact of the tunica and corpus cavernos. Methods: Six New Zealand rabbits were fed with finasteride powder(10 mg/kg, 7 d)from 19th days of gestation, and the rabbit model of congenital hypospadias was established.At the age of 4 months, after releasing the chordee of the dorsal corpora cavernosa, the urethral defect was created by applying buccal mucosa onlay graft for the penile urethral reconstruction. The animals were sacrificed at 1, 2, 4, 12, 24 and 36 weeks post surgery and their genitals were subjected to morphological observation and histological assessment with hematoxyiin-eosin (HE), Masson and Stirus staining. Results: A total of 23 male rabbits were obtained from natural childbirth, 1 of them were normal rabbits, and the other 22 were hypospadias(1 glandular hypospadias, 15 penile hypospadias and 6 scrotal-perineal type). The buccal mucosa graft showed complete uptake in all animals the location of the graft was macroscopically identifiable, demonstrating its good integration. The typical squamous epithelium of buccal mucosa was observed. One week post operation, the tunica albuginea layer and the submucosa were blurred, with inflammatory cells infiltration. Two weeks after surgery, the epithelial layer was getting thick, few neovascularity and young fibroblasts were observed in the subepithelial layer. Gradual arrangement of epithelial layer was visible, the young fibroblasts were increasing and areas of mature collagen could be seen four weeks post operation. The typical squamous epithelium of buccal mucosa and minimal inflammatory cell infiltration in the subepithelial tissues were observed at the grafted mucosa twelve weeks after surgery. It was distinguishable to identify the cell level of subepithelial layer and the tunica of corpus cavernos. Twenty-four weeks after surgery, the epithelial layer was well integrated with adjacent urethral mucosa. Accentuated fibrosis was noticed with extensive mature collagen and without signs of inflammation and scar proliferation of the grafts. Conclusions The animal model of congenital hypospadias in rabbits could be established using Finasteride. It was feasible to use the animal model to carry out the experimental study of buccal mucosa grafts. The minimal inflammatory cell infiltrations in the subepithelial tissues were observed at the grafted mucosa twelve weeks after surgery. It was distinguishable to identify the cell level of subepithelial layer and the tunica albuginea of corpus cavernos. Buccal mucosa grafting had no obvious limitation effect on the tunica albuginea and the corpus cavernos development.

Objective: To investigate the therapeuctic effect of one-stage reconstruction of distal urethra with free graft of tublar oral mucosa. Methods: Two strips of oral mucosa graft( 0.4—0.6 cm in width), were harvested and sutured around an oiled silk roll to form mucosa tube. The mucosa tube was used to reconstruct distal urethra. Postoperative pressure dressing and earlier urination were recommended. Results: From May 2007 to October 2015, 16 cases with distal urethra defect or stenosis were treated with this method. The urethra defect was 2—4 cm in length. Urethral fistula happened in 3 patients. All the other 13 cases healed primarily. 10 cases were followed up for 1—5 years by telephone with normal function. Conclusions One-stage reconstruction with free graft of bulbar oral mucosa is suitable and reliable for distal urethra defect less than 4 cm in length.

Objecive: To assess the clinical outcomes of patients who received modified penile augmentation by free dermal-fat grafting. Methods: From April 2012 to December 2014, a total of 15 male adults (18-24 years of age) after hypospadias repairs were included. They underwent modified penile augmentation, including girth enhancement using free dermal-fat grafting, and penile elongation (suprapubic skin advancement-ligamentolysis). Penile measurements were performed using ruler before operation and 6 months after operation. The outcome was evaluated by patients, based on the Male Genital Image Scale. SPSS 22.0 was used to analyze the data. In-paired t-test and Wilcoxon test were applied. Results: In 6-84 months of follow-up, all patients achieved excellent cosmetic results, and satisfied with the appearance and diameter. In weak state, the penile length increased from (5.03±0.47) cm to (6.69±0.49) cm. The increased value was (1.67±0.24) cm (t=8.6, P<0.001). Under traction, the penile length increased from (7.29±0.74) cm to (9.21±0.73) cm. The increased value was (1.93±0.21) cm (t=7.8, P<0.001). In weak state, the diameter of the middle part of penis increased from (7.16±0.25) cm to (8.69±0.44) cm, with the increased value of (1.53±0.23) cm (t=8.2, P<0.001). The MGIS score grew from 31.73±4.86 to 40.20±4.54(Z=3.2, P=0.001). Conclusions This modified technique is safe and effective in enlarging penile size for patients who had underwent hypospadias repair. It is confirmed that physical dimensional enhancement does contribute to improving their self-estimation of penile size.

OBJECTIVETo investigate the application of pedicled expanded flaps for the reconstruction of facial soft tissue defects.

METHODSThe expanded skin flaps, pedicled with orbicularis oculi muscle, submental artery, the branch of facial artery, superficial temporal artery, interior upper arm artery, had similar texture and color as facial soft tissue. The pedicled expanded flaps have repaired the facial soft tissue defects.

RESULTSBetween Jan. 2003 to Dec. 2013, 157 cases with facial soft tissue defects were reconstructed by pedicled expanded flaps. Epidermal necrosis happened at the distal end of 8 expanded flaps, pedicled with interior upper arm artery(4 cases), orbicularis oculi muscle(3 cases) and submental artery(1 case), which healed spontaneously after dressing. All the other flaps survived completely with similar color and inconspicuous scar. 112 cases were followed up for 8 months to 8 years. Satisfactory results were achieved in 75 cases. 37 cases with hypertrophic scar at incisions need secondary operation.

CONCLUSIONSIsland pedicled expanded flap with similar texture and color as facial soft tissue is suitable for facial soft tissue defects. The facial extra-incision and large dog-ear deformity could be avoided.

Cicatrix, Hypertrophic ; surgery ; Eyelids ; Face ; surgery ; Facial Muscles ; Humans ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply

OBJECTIVETo compare the effect of three methods for penile reconstruction.

METHODSFrom Sept. 2000 to Dec. 2012, penile reconstruction was performed in 48 cases with free scapular flap transplantation, or pedicled superficial circumflex iliac artery skin flap, or anterolateral thigh skin flap pedicled with lateral circumflex femoral artery. The flaps were 12.0-14.5 cm in length, 10-12 cm in width and the urethra perimeter was about 2-3 cm.

RESULTSFree scapular flaps were used in 21 cases, with flap failure in 3 cases due to insufficient blood supply. Malleable penile prosthesis was implanted in 11 cases, which was exposed in 3 cases. Groin skin flaps were used in 21 cases, with flap failure in 8 cases due to insufficient blood supply. Malleable penile prostheses were implanted in 7 cases, which was exposed in 3 cases. Anterolateral thigh skin flaps were used in 6 cases, with flap failure in 2 cases due to necrosis and infection. No prosthesis was implanted in this group. All the failure cases underwent secondary reconstruction with successful results. 37 cases were followed up for 1-6 years, avevage 2.5 years. 26 cases were satisfied with the results of appearance and function.

CONCLUSIONSAmong these three methods, the free scapular flap is most recommended for its high survival rate, low complication rate and high patient satisfaction.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Penis ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; Treatment Outcome ; Young Adult