Objective To investigate the effect of ketamine on hippocampal uncoupling protein 2 (UCP 2) expression after forebrain ischemia-reperfusion (I/R) in rats and the mechanism of protective effect of ketamine on brain. Method Forty-five male Wistar rats weighing 250～300 g were randomly divided into 3 groups, with 15 animals in each group. Forebrain I/R was estabhshed by occlusion of bilaleral carotid artery combined with hy-potemion,EFG in a sustained low rate of 7 Hz, 30～40 μVθ rhythm was the success signs of forebrain I/R. Con-trol group (C) :sham operation was performed; I/R group (Ⅰ): bilateral common carotid arteries were clamped for lOmin combined with hypotension [MAP:(40±5) mmHg] induced by exsanguinations, then saline (1 mg/kg) was injected into the lateral cerebral ventricle using microsyringe; ketamine group (K):ketamine (1 mg/kg) was injected into the lateral cerebral ventricle using microsyringe after I/R. The animals were decapitated, the brain was immediately removed,and the hippocampal tissues were dissociated at 6 h after reperfusion. The cerebral I/R injury was observed with light microscope, the levels of UCP 2 mRNA expression in hippocampus were detected by using semi-quantitative RT-PCR technique (n=7), coronal sections including hippocampal tissue were obtained for detection of UCP 2 protein expression by immuno-histochemistry (IH) method (n=8). The RT-PCRR and IH data were expressed as the mean±SD, the statistical signiticance was determined by one-way ANOVA. Results The UCP 2 mRNA expression was (1.06±0.02) in group Ⅰ and (1.18±0.06)in group K increased significantly compared with that in group C(0.91±0.02) (P<0.05), there were more UCP2 mRNA expression in group K increased than that in group Ⅰ(P<0.05). The expression of UCP 2 protein was (31.56±4.01) in group Ⅰ and (44.61±4.96) in group K, increased significantly compared with that in group C (17.91±5.49) (P<0.05),there were more UCP 2 protein expression in group K than that in group Ⅰ (P<0.05). Conclusions Ketamine can attenuate the cerebral I/R injury in rats, the underlying mechanism may be related to the up-regulartion of the expression of hippocampal UCP 2 mRNA and UCP 2 protein.

Animals ; Blood Gas Analysis ; Endothelin-1 ; blood ; Hypertension, Pulmonary ; pathology ; Hypoxia ; blood ; physiopathology ; therapy ; Male ; Oxygen ; administration & dosage ; therapeutic use ; Oxygen Inhalation Therapy ; Swine

Aged ; Humans ; Male ; Middle Aged ; Penis ; innervation ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery

ObjectiveTo assess the cause of tadalafil failure and the feasibility of successfully rechallenging nonresponding patients.Methods A total of 80 consecutive erectile dysfunction ( ED ) patients who claimed poor response to tadalafil were enrolled into the study.A self-administered tadalafil-use questionnaire composed of eight questions was applied to assess how they had used tadalafil.Subjects were given thorough instruction based on individual answers and four doses of tadalafil 20mg.After a 2-week follow-up,end point efficacy of rechallenge was evaluated using the sexual encounter profile (SEP),which was recommended by international advisory panel in 2004.ResultsA total of 45 subjects had one or more areas of major suboptimal use of tadalafil:21.2％ did not know that sexual stimulation was necessary for tadalafil to work,87.5％ attempted to use tadalafil less than four times,57.5％ took a maximal dose less than 20 mg,and 84％ felt nervous or anxious.Of the 65 patients undergoing tadalafil rechallenge,30 patients answered “yes” to SEP2 and SEP3.The response rate to rechallenge was 46.2％ ( 30/65 ).ConclusionsInappropriate use of tadalafil was major cause of tadalafil non-pesponse.The efficacy of tadalafil could be improved to a better extent by education of patients.

Objective To evaluate the efficacy of microvasoepididymostomy for the treatment of obstructive azoospermia. Methods Ninety-eight patients were confirmed as obstructive azoospermia by infertility investigations.The mean (range) age was 31 (20-43) years.The mean duration of obstruetion was 4 years.All patients were seen by the surgeon for a complete history and physical examination.Semen analyses proved azoopermia,serum levels of sexual hormone were normal and testicular function for production of sperms were normal certified by biopsy.All patients with suspected epididymal or vasal obstruction were offered scrotal exploration.The decision for microvasoepididymostomy was made during surgery,based on the pateney of the vas towards the abdomen documented by saline and sperm fragments containing in the epididymal fluid on intraoperative light-microscopic examination.Microvasoepididymostomy was performed in 58 patients documented epididymal obstruction The initial semen analysis was then done after usually 3 months postoperatively.Patency was arbitrarily defined as＞10 000 sperm/mL in ejaculate in at least one semen analysis after surgery.Postoperative patency rate and postoperative impregnation rate were followed. Results Fifty patients were followed up for 3-29 months,8 cases lost.Sperm was found by semen analysis in 36 patients.Sperm density was 4×104-2×108 sperms/ml and motility was 2%-70%.Semen analysis reveals azoospermia in 6 patients and the patients were counseled to undergo further testing to determine the ultimate outcome of the procedure.Natural conception occurred in 14 patients followed for more than 12 months.The overall pateney rate was 72%(36/50).Among patients with a follow-up of＞6 months,the natural paternity rate was 28%(14/50).The median time to achieve a natural pregnancy was 6.6 (4.0-10.0)months. Conclusion A more favourable patency can be achieved using microsurgical intussusception vasoepididymostomy and a part of patients with obstructive azoospermia can be cured by this means.

Objective To compare the circumferential approach and suprapubic approach for correcting the concealed penis. Methods Thirty-four patients received circumferential approach (group A,18 cases)or suprapubic approach(group B,15 cases)randomly for the concealed penis.The length of penis without erection before and after surgery treatment,patients'satisfaction and surgical complications were evaluated.All the patients were followed at least 6 months after operation.Results The penile length before and after surgery in group A were(1.78±0.41)cm vs(3.97±0.47)cm,the length of the postoperative penis was significantly longer than that of the preoperative penis(P<0.01).83%of those in group A(15 cases)were satisfied with the cosmic results.The length of preoperative and postoperative penis in group B were(2.07±0.53)cm vs(4.05±0.81)cm respectively,the length of the postoperative penis was significantly longer(P<0.01).Satisfaction was 87%(13 cases).The postoperative penile length between the 2 groups was not different(P> 0.05).Prepuce edema was reported to Occur in 56%and 13%in group A and group B and spontaneously disappeared within 3 months.Fat synchysis occurred in 2 of group B. Conclusions The cosmic effect of the 2 surgical approaches is similar,but circumferential approach is simpler.There is no serious complication in those receiving circumferential approach.

Objective To investigate immunological relationship between early induction of food allergy and occurrence of later asthma in mice, and explore the pathological changes in lung tissues. Methods Thirty-seven female BALB/c mice aged 6 weeks were randomly divided into blank control group ( n = 12), food allergy group ( n = 13) and asthma group (n = 12). After being challenged by ovalbumin (OVA), the levels of serum IgE, IL-4 and INF-γ in bronchoalveolar lavage fluid ( BALF) were detected. The numbers of inflammatory cells and eosinophils ( EOS) in BALF were counted. Lung tissues were obtained for pathological sections, and thickness of bronchial wall and EOS infiltration were observed. Results The level of serum IgE and level of IL-4, ratio of IL-4/IFN-γ and number of EOS in BALF in food allergy group and asthma group were significantly higher than those in control group (P <0.05). The level of IL-4 and number of EOS in BALF in asthma group were significantly higher than those in food allergy group (P <0.05) , while there was no significant difference in serum IgE level between these two groups (P > 0.05), and levels of IFN-7 in BALF in both groups were significantly lower than that in blank control group (P<0.05). There were more EOS infiltration in lung tissues and thicker bronchial wall in food allergy group and asthma group than that in blank control group (P < 0.05), and the number of EOS in asthma group was significantly higher than that in food allergy group ( P < 0.05). Conclusion IgE-mediated immune response is involved in both food allergy and asthma mouse models. Lung immune imbalance of Thl/Th2 and inflammatory cell infiltration caused by food allergy may participate in the occurrence of later asthma.

Objective To review the clinical manifestation,pathological characteristics,treat ment and prognosis of malignant mesothelioma of the tuniea vaginalis testis.Methods A case of ma lignant mesothelioma of the tunica vaginalis testis was reported and relative literature was reviewed.A34 year old man was admitted to hospital with a history of aggravated hydroeele for 5 years.A hardtumor was palpated above the right testis,which was smooth and slight tenderness.The level of β-hCG and AFP was normal.Ultrasonography revealed a 2.05 cm× 1.97 cm,well demarcated,mixedecho tumor.Results An operation was performed to incise the tumor and tunica vaginalis undersubarachnoid space block anesthesia.The tumor was histologically diagnosed as low potential malig nant mesothelioma of the tunica vaginalis testis.Microscopic examination showed that the tumor wasmalignant with a biphasic pattern composed of epithelial and stromal components.The former compo nent was dominant.The epithelial cells proliferated obviously with atypia and mitosis.Immunohisto chemical staining showed cytokeratin and vimentin were strongly positive.The capillary,lymph ves sel,spermatic cord and testis were not infiltrated.Right radical orchiectomy and right scrotectomywas performed one month after the first operation.There was no evidence of relapse during 38 monthfollow up after operation.Conclusions The major symptom of patients with malignant mesotheliomais hydrocele,malignant mesothelioma is diagnosed by histopathology.Due to the invasive potential ofthis disease and the risk of tumor recurrence,radical orchiectomy and close follow up are strongly rec ommended.

Objective To assess the causes of sildenafil failure and the feasibility of successfully rechallenging non-responding patients. Methods A total of 126 consecutive erectile dysfunction (ED) patients from Jan 2009 to Dec 2009 who claimed poor response to sildenafil (sildenafil 100 mg on demand, at lease 4 epiodes) were enrolled into the study. All patients received sexual reeducation and were treated with sildenafil, taken on a daily dose of 50 mg for 4 weeks. The International Index of Erectile Function-5 (IIEF-5), Rigiscan, serum testosterone or penile Doppler were used to evaluate ED and the cause of on-demand sildenafil failure. End point efficacy of rechallenging was evaluated using the IIEF-5 and the sexual encounter profile (SEP) 'Were you able to insert your penis into your partner's vagina?' and 'Did your erection last long enough to achieve successful intercourse?'. Results The recruited patients comprised of 41 cases with psychological ED, 39 cases with hypogonadism ED, 28 cases with diabetes mellitus ED and 18 cases with vascular ED. Compared with pretreatment and on-demand sildenafil baseline, daily administration of sildenafil significantly enhanced all efficacy outcome variables. The IIEF-5 was significantly improved after daily sildenafil (12.3 ± 2.9 vs18. 8±4.4, P＜0.01), 78 patients responded to daily sildenafil. The overall salvage rate was 61.9%(78/126). Conclusions Sexual reeducation and daily administration of sildenafil may be able to salvage many patients with ED who were sildenafil non-responders.

Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P＜0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.