Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

Accidents, Occupational ; Adolescent ; Adult ; Arsenic Poisoning ; Child ; Female ; Humans ; Male ; Middle Aged ; Water Pollution, Chemical

Objective To investigate the functional recovery and the effect of CNTF antibody block to the bone marrow mesenchymal stem cells (BMSCs) transplantated by Abdominal aortic on the downstream signaling pathways STAT3/Caspase-9 in spinal cord ischemic reperfusion injury in rats.Methods Adult female SD ratswere assigned randomly to 4 groups. The neurological functional status of the animals was assessed with BBB scores, the Motor evoked potentials (MEP) and Cortical somatosensory evoked potentials (CSEP).The IHC were used to detect the the expressional changes of CNTF, then Western blot and RT-PCR were used to detect the expressional changes of STAT3、p-STAT3、CNTF and Caspase-9 in the ischemic segments of spinal cord.Results Compared with the sham group, in the SCIRI rats, the BBB scores were markedly decreased at all time points (P＜0.01), the latency and the amplitude of MEP and CSEP was longer and lower at 14 d post operation (P＜0.01), and this change was the most significant in the control group the second in the CNTF block group, and the last in the transplantation group, Resutts between each two groups were statistically significant (P＜0.05). At 7 d post operation, compared with the sham group, the immunoreactive products of CNTF were decreased in the CNTF block group (P＜0.05), but were increased (P＜0.05) in the control group and the transplantation group (P＜0.05), and results in the transplantation group were higher than in the control group (P＜0.05). At 7 d post operation, compared with the sham group, the m RNA and protein level of CNTF、STAT3、 p-STAT3 were decreased obviously in CNTF block group (P＜0.05), the levels were increased in the control group and the transplantation group (P＜0.05), and the levels in the transplantation group were higher than that in the control group (P＜0.05); but the m RNA and protein level of Caspase-9 were only decreased in the transplantation group (P＜0.05), the level was increased in the CNTF block group and the control groups (P＜0.05), and the level in the CNTF block group was more significantly increased than that in the control group (P＜0.05). At 14 d post operation, in CNTF block group, the m RNA and protein level of CNTF、STAT3、p-STAT3 were significantly higher than that in the sham group and the control group (P＜0.05), and the m RNA and protein level of caspase-9 was higher than that in the sham group (P＜0.05), but lower than that in the control group (P＜0.05), there were not statistically different in the level of each factor compared with transplantation group (P＞0.05). Conclusions BMSCs, transplanted by the abdominal aorta, can promote the expression of CNTF in the injuried spinal cord and significantly improve the hind limb function recovery by CNTF-mediated signaling pathway downstream of STAT3/Caspase-9 SCIRI in rats, but the role of BMSCs can be weakening by CNTF block that inhibited STAT3/Caspase-9 signaling pathway.

OBJECTIVE: To investigate the expressions and time-dependent changes of phosphatidylinositol-3-kinase (PI3K), phospho-PI3K (p-PI3K), protein kinase B (PKB/Akt) and phospho-Akt (p-Akt) during wound healing process of mice skin. METHODS: The changes of PI3K, p-PI3K, Akt and p-Akt expression in skin wound were detected by immunohistochemistry, Western blotting and real-time PCR. RESULTS: Immunohistochemistry showed the expression of PI3K and p-Akt were observed in mononuclear and fibroblast after skin wound, and reached peak in reconstruction. The positive bands of PI3K, p-PI3K, Akt and p-Akt were observed in all time points of the wound healing process by Western blotting. The expression peak of p-PI3K and p-Akt showed in inflammation and proliferation; the expression peak of PI3K and Akt in reconstruction. Real-time PCR showed the expression peak of PI3K mRNA in inflammation and reconstruction and the peak of Akt mRNA in reconstruction. CONCLUSION During the wound healing process, the expressions of PI3K, Akt, p-PI3K and p-Akt show different changes with significant correlation to wound time. The expression of PI3K/Akt may be a valuable marker for wound time estimation.
Animals ; Blotting, Western ; Class I Phosphatidylinositol 3-Kinases ; Fibroblasts/metabolism* ; Mice ; Phosphatidylinositol 3-Kinase ; Phosphatidylinositol 3-Kinases/metabolism* ; Phosphorylation ; Proto-Oncogene Proteins c-akt/metabolism* ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Skin/injuries* ; Wound Healing

OBJECTIVETo study the effects of rhizoma sparganii and radices zedoariae on hepatic fibrosis.

METHODThe rat immunohepatic fibrosis model was made by intraperitoneal injection of porcine serum and treated with rhizoma sparganii and radices zedoariae. The ALT, GGT, TP, ALb, A/G, IVC, LN, HA and the pathological change of the liver were observed.

RESULTRhizoma sparganii and radices zedoariae could increase TP, ALb, A/G, decrease ALT, GGT, IVC, LN, HA and improve the pathological change.

CONCLUSIONRhizoma sparganii and radices zedoariae can protect hepatic cells, alleviate degeneration and necrosis, recover structure and function, and reduce the proliferation of fibrous tissue.

Animals ; Curcuma ; chemistry ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Liver Cirrhosis ; drug therapy ; pathology ; Magnoliopsida ; chemistry ; Male ; Phytotherapy ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Rhizome ; chemistry

OBJECTIVETo compare the clinical effects of unilateral pedicle screw fixation (uni-PS) assisted by Quadrant system and bilateral pedicle screw fixation (bi-PS) for the treatment of lumbar degenerative diseases.

METHODSFrom October 2008 to October 2010,102 patients with lower back pain, unilateral lower limb radiating pain or paraesthesia were treated with pedicle screw fixation and lumbar interbody fusion. There were 67 males and 35 females with an average age of 51.5 years ranging from 34 to 69 years. The patients were randomly divided into two groups (group A and group B) according to the internal fixation type. The patients of group A (n=50) underwent with minimally transforaminal lumbar interbody fusion (TLIF) and unilateral pedicle screw fixation with one single cage placement assisted by Quadrant system;and the patients of group B (n = 52) underwent with posterior lumbar interbody fusion (PLIF) and bilateral pedicle screw fixation with one single cage placement. There were no significant differences between two groups in general information (P > 0.05). VAS score and ODI score system were used to evaluate the preoperative and postoperative pain and function recovery. Operative time, volume of blood loss, fusion rate and complication rate were compared and analyzed by statistical test.

RESULTSAll the patients were followed up from 12 to 21 months with an average of 18.2 months. In the group A,operative time and volume of blood loss were (87.6 +/- 25.5) min and (105.7 +/- 27.2) ml, respectively; VAS score of low back pain and leg pain, ODI score decreased respectively from preoperative 7.2 +/- 1.4, 7.9 +/- 1.1, 42.2 +/- 11.8 to 3.2 +/- 0.6, 3.0 +/- 0.7,15.6 +/- 2.3 at one month after operation; the fusion rate was 96.0% (48/50) and the complication rate was 4.00% (2/50). In the group B,operative time and volume of blood loss were (160.3 +/- 20.5) min and (220.6 +/- 25.5) ml, respectively; VAS score of low back pain and leg pain, ODI score decreased respectively from preoperative 7.3 +/- 1.1, 8.1 +/- 0.9, 43.1 +/- 12.0 to 3.3 +/- 0.4, 3.2 +/- 0.3, 14.9 +/- 2.6; the fusion rate was 96.2% (50/52) and the compli- cation rate was 5.77% (3/52). There were no statistically significant differences between the two groups in fusion rate, complication rate, VAS pain and ODI score. Whereas the operative time and blood loss in group A were significantly lower than that of group B.

CONCLUSIONMinimally invasive unilateral pedicle screw fixation is a safe and feasible method for the treatment of lumbar degenerative diseases. It is as effective as the bilateral fixation in lumbar spinal fusion. In addition, it has the advantages of short operative time, less volume of blood loss, high fusion rate, etc.

Adult ; Aged ; Bone Screws ; Female ; Humans ; Intervertebral Disc Degeneration ; surgery ; Low Back Pain ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Spinal Fusion ; methods

A 59-year-old man visited our hospital for facial edema and muscle weakness in both lower extremities. He was diagnosed with dermatomyositis (DM) about 1 year previously, and sudden development of proteinuria was noted. Renal biopsy revealed focal global and segmental glomerulosclerosis with slight mesangial expansion. Glomerulonephritis is rare in DM. According to our review of related literature, membranous nephropathy is the main type of DM, while mesangial proliferative glomerulonephritis is the most common type in polymyositis. The mechanism underlying the association between DM and glomerulonephritis remains to be elucidated. We herein report a case of DM associated with focal segmental glomerulosclerosis, which has not been reported previously.
Biopsy ; Dermatomyositis ; Edema ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Lower Extremity ; Middle Aged ; Muscle Weakness ; Polymyositis ; Proteinuria

BACKGROUNDThe prevalence and the spectrum of thyroid dysfunction in the mainland of China are not adequately understood. We performed a population-based study to determine the prevalence of major thyroid dysfunctions including overt and subclinical hyper- and hypothyroidism in a stable cohort.

METHODSAll active and retired employees aged 20 years and older (11 067) of Sinopec Zhenhai Refining & Chemical Company in Ningbo participated in the cross-sectional survey with a questionnaire and blood samples.

RESULTSA total of 10 405 individuals attended for screening. Using biochemical definitions 95.5% were euthyroid. The prevalence of former diagnosed hyperthyroidism was 1.1% in females and 0.4% in males, hypothyroidism 1.7% and 0.3%, and thyroid surgery 1.2% and 0.3%, respectively. In both sex the prevalence increased with age. Twenty-four percent of individuals with thyroid surgery or medications had abnormal thyroid-stimulating hormone (TSH) levels. In individuals without a history of thyroid disease, the prevalence of pathological TSH values in females and males were TSH > or = 10 mU/L 0.60% and 0.29%; TSH 4.8-9.9 mU/L 5.71% and 2.25%; TSH < 0.3 mU/L 0.87% and 0.41%, respectively. Overt hyper- and hypothyroidism were uncommon (0.2%, 0.3%, respectively). The prevalence of subclinical hyper- and hypothyroidism was 0.4% and 3.4%, respectively. Subclinical hypothyroidism was more common in females (male 2.4% vs. female 5.8%, P < 0.001) and with increasing age (P < 0.001).

CONCLUSIONSThe prevalence of thyroid dysfunction is 4.5% in the cohort. Among individuals with thyroid medications or surgery, only 75.7% were within the normal range of TSH. These results indicate that thyroid dysfunction is common in Chinese adults.

Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Hyperthyroidism ; epidemiology ; metabolism ; Hypothyroidism ; epidemiology ; metabolism ; Male ; Middle Aged ; Surveys and Questionnaires ; Thyroid Diseases ; epidemiology ; metabolism ; Thyroid Function Tests ; Thyrotropin ; metabolism ; Young Adult

OBJECTIVETo summarize the experience of surgical treatment of single atrium.

METHODSFrom August 1984 to August 2004, there were 33 patients with single atrium in our study. Plastic surgery for mitral valves were performed for 30 cases with mitral insufficiency. Plastic surgery for tricuspid valves were performed for 18 cases with tricuspid valve insufficiency. There were 3 cases only with complete absence of atrial septum. There were 14 cases with left superior vena cava. All new atrial septums were made with patches including 24 autologous pericardial patches and 9 terylene patches. Complicate abnormalities were corrected in the same time. Tow suture techniques were used in operations to prevent conductive system block, and plastic surgery for mitral valves were performed until the mitral valves were sufficiency.

RESULTSThere weren't death and conductive system block after operation in the group. One case was low-grade mitral insufficiency and the others weren't mitral insufficiency. Twenty-five cases were followed up from 3 months to 11 years, and they could work and study normally.

CONCLUSIONSSingle atrium should be operated as early as possible. The key of surgery is to prevent conductive system block, to properly correct mitral insufficiency and to drastically correct complicated abnormality. The new atrial septum should be made by patch and an autologous pericardial patch is the first selection.

Adolescent ; Adult ; Cardiac Surgical Procedures ; methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; surgery ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency ; surgery ; Treatment Outcome ; Tricuspid Valve Insufficiency ; surgery

Objective To investigate the effect of clopidogrel on platelet function and inflammation factor in treatment of severe carotid artery stenosis after stent-assisted angioplasty.Methods Patients (120 cases) with severe carotid artery stenosis after stent-assisted angioplasty were chosen and divided into two groups,the control group were given atorvastatin combined with aspirin,and the observation group were given atorvastatin combined with chlorine.The serum coagulants DD level,FIB level,inflammation factor P-chosen element level and restenosis event incidence of two groups were observed.Results D-double polymer of two groups had no significant difference;After surgery,the D-double polymer and FIB level of two groups were all higher (P ＜ 0.05).After surgery for 24 h,the D-double polymer and FIB level of observation group were higher,after 3 months of surgery,the D-double polymer and FIB level had no significant differences compared with before surgery,which were all in normal level.After 24 h,1 month,3 months of surgery,the D-double polymer and FIB level of observation group were all lower than control group (P ＜ 0.05).Before treatment,the P-chosen selectin of two groups had no significant differences,which were all decreased after surgery,and the observation group was lower than control group (P ＜ 0.05);The restenosis event of observation group was lower than control group (P ＜ 0.05).Conclusion Clopidogrel could control the platelet aggregation of severe carotid stenosis after surgery to prevent the thrombogenesis and decrease the restriction incidence,while control the inflammation factor expression to prevent the atherosclerosis.