ObjectiveTo present the experiences of f re e graft transplantation two-stage urethroplasty for hypospadias repair.Methods58 cases of hypospadias including 10 subcoronal,36 pen ile shaft,9 scrotal and 3 perineal were treated with free full-thickness skin graft or(and) buccal mucosa graft transplantation two-stage urethroplasty.Of th e 58 cases,45 were new cases and 13 had had previous failed surgeries.Single for eskin graft was used in 35 cases,single postauricular skin graft in 8,single b uccal mucosa graft in 6,foreskin grafts combined with postauricular skin grafts in 6 and foreskin grafts combined with postauricular skin grafts and buccal muc osa grafts in 3.ResultsOf 58 cases after the first-st age operation,56 were successful(97%) with grafts healing well,2 foreskin grafts got gangrened.After the second-stage operation,5 cases failed with newly for med urethras ruptured due to infection,8 complicated by fistulas whereas 43 case s healed well(77%).ConclusionsFree graft transplantati on two-stage urethroplasty for hypospaedias repair is a kind of effective treat ment with broad indication,comparatively high success rate,less complications an d good cosmatic results,being indicated for different types of hypospadias repa ir.

Objective Postictal language testing can provide useful diagnostic information for seizure lateralization.However no such a study based on non-English language was done previously.We investigated the latency of language recovery in Chinese patients with temporal lobe epilepsy (TLE).Methods Complex partial seizures in patients with TLE were extracted from our video-electroencephalogram (EEG) database.For all patients,consciousness testing started as soon as seizures were detected.When they were alert and cooperative,they were asked to read out a sentence “昨晚他们听到老在电台里讲话”which was printed on a card.When the patients were able to read the sentence correctly,the language function was considered recovered.Results Totally 65 complex partial seizures from 22 cases of TLE (11 left and 11 right) were included.Patients were cooperative to language testing in 54 seizures (83％).The latency for consciousness recovery (CRL) and latency for consciousness language recovery (LRL) were not associated with seizure duration,but the seizure lateralization.The CRL (median,161 s) and LRL (281 s) in the left TLE were statistically significantly longer than that in the right TLE (30 s,54 s respectively).Using 150 s recovery time as bound language recovery ratio was 87％ (27/31) in right TLE and 13％ (3/23) in left TLE.Conclusion Postictal language testing based on ideographic Chinese words helps to establish seizure lateralization in patients with TLE.

BACKGROUND: There is often a physical and psychosocial effect in burn injury, and the degree of mental stress reaction is related to social support, individual experience and personality characteristics.OBJECTIVE: To investigate the mental stress reaction, the degree of social support and the Minnesota Multiphasic Personality Inventory (MMPI)personality characteristics in acute burn patients, and to analysis the influence factor of mental stress reaction.DESIGN: Cross-sectional study.SETTING: West China Mental Health Center of Sichuan University, Burn Department of Mianyang Municipal Central Hospital, and Burn Department of General Hospital of Panzhihua Iron and Steel Company.PARTICIPANTS: From April 2003 to April 2005, totally 104 mild, moderate or severe burn patients, including 92 males and 12 females, aged 12-60 years, selected from Mianyang Central Hospital and Department of burn of General Hospital of Panzhihua Iron & Steel Co., Ltd took part in the study.METHODS: The emotional problems and personality characteristics were measured with the Hamilton Rating Scale for Depression (HAMD), the Hamilton Rating Scale for Anxiety (HAMA), the Minnesote Multiphasic Personality Inventory (MMPI), the Social Support Rating Scale (SS) as well as general clinical data,by the rating scales 3 day after burn. The patients were divided into anxiety-depression group (n=51) and normal emotion group (n=53) according to their anxiety-depression scores (anxious score＞ 7,depressive score＞ 8), those influencing factor included burning total area,age, sex and society support, Stepwise Regression was introduced to get the main factors that influenced mental stress reaction.MAIN OUTCOME MEASURES: ① Scores of each scale and comparison of general clinical data in each group; ② stepwise regression analysis of depression and anxiety of burn patients.RESULTS: Data of Totally 104 patients was entered the final analysis. ①The scores were 10.4±2.46 and 16.8±5.94 of anxious and depressive patients during acute burn period, which were higher than those in normal group (4.29±2.26, 5.48±2.06, P=0.01). ② The main influential factor for depression were burning area and social supporting availability, and those for anxiety were age, burning area, social supporting availability and subjective social supporting degree. ③ MMPI test results show that T scores in anxiety-depression group were below 60 points, however T-scores were above 60 points in normal group including cheating points, hypomania,schizophrenia, psychasthenia and paranoid ideation CONCLUSION: Burn is a mental crisis to burn patients, which can lead to abnormal emotional reaction and personality change. The depressive and anxious score are positively related with burning area, and are negatively correlated with society supporting availability. The good social support system is benefit to over mental crisis period.

Objective To explore possible mechanisms of hepatic fibrosis by investigating the ultrastructural dynamic changes of liver tissue, especially several kinds of cells related to hepatic fibrosis.. Methods. Murine schistosomal hepatic fibrosis model was established by infecting mice with Schistosoma japonicum cercariae. Routine transmission electron microscopy was used to observe the liver tissue. H.E. staining was used for examining the pathological changes. . Results . H.E. staining showed that the model was established successfully. Ultrastructural observation showed that at the 6th week after infection, the necrosis of hepatocytes around the acute granulomas occurred; the number of sinusoidal endothelial fenestrae and vitamin A droplets in fat-storing cells decreased; large phagosomes and rough endoplasmic reticulum could be seen in the cytoplasm of Kupffer′s cells. At the 8th week, steatosis was found in some hepatocytes, some microvilli emerged on a few inter-hepatocytic surfaces and the inter-hepatocytic spaces were enlarged. Large collagen fibrillar bundles filled in the perisinusoidal spaces, and capillarization of hepatic sinusoids was observed. Secretory vesicles filled with collagen fibrils appeared in the cytoplasm of fat-storing cells with large amount of collagenous fiber bundles surround the cells. Rough endoplasmic reticulum increased in Kupffer′s cells. At the 10th week, fat-storing cells were activated and transformed into myofibroblasts. At the 12th week, the number of myofibroblasts decreased but that of fibroblasts and fiber cells increased. . Conclusion . Activation of fat-storing cells and transformation from fat-storing cells into myofibroblasts are the critical link in the development of hepatic fibrogenesis following schistosome infection. Kupffer′s cells, necrotic hepatocytes and sinusoidal endothelial cells may relate to the activation of fat-storing cells. Capillarization of hepatic sinusoids possibly accelerates the development of hepatic fibrosis.

OBJECTIVEQuantitative EEG and event-related potential P300 were used to evaluate impairment of cerebral function in patient with partial epilepsy.

METHODSW value was calculated (power of EEG δ and θ rhythm divided by power of α and β rhythm ) for the extent of focal cortical dysfunction. The W values in left partial epilepsy group, right partial epilepsy group and control group during interictal period compared. The latency, amplitude and reaction time of P300 potential change were observed in each groups.

RESULTSThe W values in F(8), T(4) and T(6) regions in patients with left partial epilepsy (P <0.05). The W values in T(3). O(1) regions of patients with left partial epilepsy were higher than those in patients with right partial epilepsy (P < 0.05). Furthermore, the W value in T(6) regions of patients with a disease course longer than 5y was significantly higher than that of patients with a disease course 1-5 y or less than 1y; the W value in O(2) regions of patients with a disease course longer than 5y was significantly higher than that of patients with a disease course between 1-5y (P < 0.05). In patients with right or left partial epilepsy, the total abnormal rate of P300 was 54. 76%, the latency, amplitude and reaction team were significantly different to the control group. The abnormal rate of P300 in left and right partial epilepsy groups were 77. 78% and 37.50%, respectively, and the former is significantly higher than the latter. The amplitudes of P300 in C(z) and P(z) of left partial epilepsy were significantly lower than those of right partial epilepsy and control group (P < 0.05). The latency and reaction time of P300 in C(z) and P(z) of all partial epilepsy were significantly longer than those of control group (P < 0.05), however, no difference was found between left and right partial epilepsy.

CONCLUSIONIn partial epilepsy the cortical dysfunction occurs ipsilaterally to the epileptogenic zone, and extent of cortical dysfunction is positively correlated with duration of disease course. Cerebral dysfunction in left partial epilepsy is more severe than that in right partial epilepsy.

Adult ; Electroencephalography ; Epilepsies, Partial ; physiopathology ; Event-Related Potentials, P300 ; physiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

ObjectiveTo investigate the condition of infants with urolithiasis caused by melaminetainted powdered formula at one-year follow-up. Methods Eighty-one young children with melamine-induced urolithiasis were followed up,which included urinalysis,renal-function tests,urinary tests for biochemical markers of renal glomerular and tubular function,and ultrasonography.Eighty-one age-matched healthy infants without exposure to melamine-contaminated formulas were enrolled as controls. Results Fifty-one of the patients were male and 30 female,with a mean age of 26 months (range 13 -48 months).The 81 children were divided into 2 groups according to treatment protocols.Group 1 received conservative treatment ( n =54 ) and Group 2 received surgical treatment ( n =27 ).In Group 1,3 patients (5.6％) had stone-residual:1 girl had calculus of 0.4 cm in diameter in the left kidney and 2 girls had calculus of 0.3 cm in diameter in the right kidney.In Group 2,2 patients (7.4％) had stone-residual,1 boy had crystallization of 0.2 cm in diameter in the right kidney and 1 boy had calculus of 1.5 cm in diameter in the left kidney,positive stone was confirmed by X-ray and accepted percutaneous nephrolithotomy.Urinary microalbumin levels were significantly increased in the children with melamine-induced urolithiasis compared with the control group (P ＜0.01 ).Blood urea nitrogen and serum creatinine were within the normal range with no significant difference between the 2 groups. ConclusionsAt one-year follow-up most of the children exposed to melamine-tainted infant formula in both treatment groups had returned to a healthy state,suggesting a satisfactory outcome for both treatment options.However,surgery is recommended in patients with stoneresidual ＞ 10 mm.

ObjectiveTo investigate the etiology and management of male urethral stricture at 8 medical centers in China during the period from 2004 to 2009 years,and to investigate whether there were any changes in etiology and management of urethral stricture with time change.MethodsThe database on 3455 male patients with urethral stricture who underwent treatment at 8 medical centers in China between January 2004 and December 2009 were prospectively collected.The databases were analyzed for possible cause of stricture and treatment techniques for urethral stricture,and for the changes in etiology and management with time change.ResultsThere were 3455 operations for urethral stricture during the study period.The main causes of urethral strictures were traumas in 1833 patients (53.05％),among which pelvic fractures were in 1327 (38.41％) and perineal trauma in 506 (14.65％).The second cause was iatrogenic causes in 1181 patients (34.18％ ),among which transurethral operations or examinations were in 602 (17.42％),hypospadias surgery in 291 (8.42％) and urethral catheterization in 164 (4.75％ ).Less common causes were urethritis in 201 patients (5.82％),lichen sclerosus in 149 (4.31％),undefined in 91 (2.63％).The treatments of urethral strictures were endourological surgery including internal urethrotomy and dilation and open urethroplasty including end-to-end urethroplasty and the substitude urethroplasty etc.The ratios of using various techniques in total number of patients were obviously different by time.The most application technique for treatment of urethral stricture was endourological surgery ( 709 ) during 2004 -2006 and occupied 52.67％ in total number of patients.It was gradually decreased during 2007 -2009 (726) and only occupied 34.42％ (P ＜0.01 ).Open urethroplasty gradually increased during 2007 -2009 ( 1243,58.94％ ) compared with the first three years (563,41.83％ ) (P ＜ 0.01 ). Conclusions During the recent years there was an increase in the incidence of urethral stricture being trauma and iatrogenic causes.The main treatments of urethral strictures were endourological surgery and open urethroplasty.Endourological surgery was significantly decreased in total number of patients,while open urethroplasty were significantly increased during the late three years.

OBJECTIVETo observe the synergistic effects of paclitaxel and gemcitabine on prostate cancer cell line PC-3 in vitro.

METHODSCell morphology, MTU, flow cytometer and immunocytochemical method were used to observe the effects of 10(-6), 10(-7), 10(-8) mol/L paclitaxel and 10(-7), 10(-8), 10(-9) mol/L gemcitabine on prostate cancer cell line PC-3 by single or synergistic administration for 48 hours in vitro.

RESULTSGemcitabine above 10(-8) mol/L enhanced the growth suppression [suppression ratio > or = (50.8 +/- 4.2)%, P < 0.05] and apoptosis [apoptosis ratio > or = (22.9 +/- 2.3)%, P < 0.05] and down-regulation of the expression of cyclin D1 [expression ratio < or = (9.6 +/- 1.6)%, P < 0.01] induced by paclitaxel above 10(-7) mol/L in PC-3 cells. Gemcitabine changed the ratio of G2/M cell arrest induced by paclitaxel from (70.3 +/- 9.7)% to (38.2 +/- 4.2)%, and reversed the G2/M arrest partially (P < 0.01).

CONCLUSIONPaclitaxel and gemcitabine can enhance the growth suppression and apoptosis induced by paclitaxel in a synergistic way. They show great potential in the treatment of androgen-independent carcinoma of the prostate.

Antimetabolites, Antineoplastic ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Deoxycytidine ; analogs & derivatives ; pharmacology ; Dose-Response Relationship, Drug ; Down-Regulation ; Drug Synergism ; Flow Cytometry ; Humans ; Male ; Paclitaxel ; pharmacology ; Prostatic Neoplasms ; pathology

Objective To investigate the training process of clinical practice ability in medical undergraduates in the context of tutorial system,as well as new clinical training models and evaluation methods.Methods A total of 40 medical undergraduates who entered the stage of clinical practice were randomly divided into tutorial group and control group,with 20 undergraduates in each group.A diversified evaluation system was used to perform a comprehensive evaluation of clinical practice ability of medical undergraduates at different stages,with a combination of professional theory examination,Mini-Clinical Evaluation Exercise,Direct Observation of Procedural Skills,and clinical case report.All the data were analyzed by SPSS 23.0,t test was used for statistical analysis.Results Compared with the control group after the internship ended,the tutorial group had significantly higher scores of clinical professional theory (86.24 ± 2.93),clinical practice ability (7.53 ± 0.48),clinical operation skills (4.35 ± 0.47),and clinical thinking ability (6.31 ± 0.52) (all P＜0.05).Conclusion The application of the tutorial training mode during the internship of medical undergraduates can improve their comprehensive qualities such as professional quality,medical theory,and practical skills.The diversified evaluation system can evaluate the teaching effect and reflect the cultivation of comprehensive quality among students.

Objective To investigate the characteristics of video electroencephalogram (VEEG) in patients with occipital lobe epilepsy (OLE) to improve the clinical diagnostic rate of OLE.Methods Twenty-five patients with OLE were collected in our hospital from June 2013 to February 2017 and received VEEG monitoring in our epilepsy center.Their clinical symptoms and VEEG characteristics were retrospectively analyzed.Results Nineteen patients (76.00％) had visual auras based on previous history,five (38.46％) had visual auras during VEEG monitoring.Three patients had epileptic discharge confined to occipital lobe and two had epileptic discharge confined to posterior temporal lobe in interictal phase,while 20 had epileptic discharge involved more than one lobe of the brain.In ictal phase,8 had clear discharge origin or earliest evolution in occipital lobe.Five showed abnormal EEG in the other brain areas,which needed other clinical information for diagnosing OLE.Conclusions The visual aura is typical characteristic of OLE,and there are specific manifestations of EEG in both inter-ictal phase and ictal phase.