OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Large Cell ; metabolism ; pathology ; Diagnosis, Differential ; Histiocytic Sarcoma ; metabolism ; pathology ; surgery ; Hodgkin Disease ; metabolism ; pathology ; Humans ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Male ; Melanoma ; metabolism ; pathology ; Receptors, Cell Surface ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

Background/Aims: The incidence of gastroesophageal reflux disease (GERD) is increasing annually. Studies have suggested that psychosocial disorders may be linked to the development of GERD. However, studies evaluating the association between psychosocial disorders and GERD have been inconsistent. Thus, we conducted a systematic review and meta-analysis of observational studies that evaluated the association between psychosocial disorders and GERD. Methods: We systematically searched the PubMed, Embase, Cochrane, and Web of Science databases until October 17, 2020. Pooled OR with 95% CI and subgroup analyses were calculated using a random-effects model. Subgroup analyses were performed to identify thesources of heterogeneity. Sensitivity analysis by one-study removal was used to test the robustness of our results. Results: This meta-analysis included 1 485 268 participants from 9 studies. Studies using psychosocial disorders as the outcome showed that patients with GERD had a higher incidence of psychosocial disorders compared to that in patients without GERD (OR, 2.57; 95% CI, 1.87-3.54; I2 = 93.8%; P < 0.001). Studies using GERD as an outcome showed an association between psychosocial disorders and an increased risk of GERD (OR, 2.23; 95% CI, 1.42-3.51; I2 = 97.1%; P < 0.001). The results of the subgroup analysis showed that the non-erosive reflux disease group had a higher increased risk of anxiety than erosive reflux disease group (OR, 9.45; 95% CI, 5.54-16.13; I2 = 12.6%; P = 0.285). Conclusion: Results of our meta-analysis showed that psychosocial disorders are associated with GERD; there is an interaction between the two.

Objective To summarize our experience with endovascular treatment of vertibrobasilar aneurysms. Methods The clinical data of 21 patients with vertibrobasilar aneurysms admitted between October, 2003 and July, 2007 were retrospectively analyzed. All the 21 patients received endovascular embolization, of whom 11 patients had embolization with Guglielmi detachable coils (GDC), 9 had GDC embolization with Neuroform stent placement, and 1 patient was managed with covered stent placement in the parent artery. Results After the operations, 19 patients were clinically cured with good prognosis, 1 patient was severely disabled, and 1 died due to heart failure. Four patients underwent ventriculo-peritoneal shunting for postoperative hydrocephalus. Conclusions Endovascular embolization with GDC and placement of Neuroform stent and covered stent are effective options for management of vertibrobasilar aneurysms, and most of the vertibrobasilar aneurysms can be treated effectively by these approaches.

OBJECTIVETo evaluate the effect of hypoxia-inducible factor-1 alpha (HIF-la) on angiogenesis in human prostate cancer cells.

METHODSHuman prostate cancer cells of the line LNCaP were cultured and transfected by the recombinant plasmid pcDNA3. 1(-)/HIF-1alpha containing the gene HIF-1alpha with the Lipofectamine 2000 system. The positive clone cells were selected by G418 and confirmed by Western blotting and immunofluorescence (LNCaP/HIF-1alpha cells). The expressions of VEGF, iNOS and Ang-2 were detected by Western blotting.

RESULTSThe expression of HIF-1alpha in the LNCaP/HIF-1alpha cells was distinctly higher than that in the LN-CaP cells. Compared with the LNCaP cells, the expressions of VEGF and iNOS were up-regulated, whereas Ang-2 remained unchanged in the LNCaP/HIF-1alpha cells.

CONCLUSIONThe over-expression of HIF-1alpha can induce an increase in angiogenesis proteins and improve the angiogenesis potency of prostate cancer.

Blotting, Western ; Cell Line, Tumor ; Fluorescent Antibody Technique ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Lipids ; chemistry ; Male ; Nitric Oxide Synthase ; metabolism ; Plasmids ; chemistry ; genetics ; Prostatic Neoplasms ; blood supply ; metabolism ; pathology ; Transfection ; methods ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo observe the clinical efficacy of combined therapy of Shehuang Paste (SHP) with colonic dialysis in treating patients with refractory cirrhotic ascites complicated with azotemia.

METHODSAdopting a multi-centered, randomized, double blinded and 1:1 parallel controlled trial, 120 patients were equally randomized into 2 groups, the control group was treated by conventional basic therapy (umbilical application of placebo paste and colonic dialysis with normal saline), and the treatment group by, besides the same basic therapy, umbilical application of SHP once a day and colonic dialysis with herbal medicine once every other day. The course was 1 month for both groups. Changes of ascites volume, renal function, serum and urinary levels of Na+ and K+, blood vasoactive substance, and portal dynamics in patients before and after treatment were observed.

RESULTSThe total effective rate for ascites was 71.7% (43/60 cases) in the treatment group and 18.3% (11/60 cases) in the control group, showing significant difference between groups (P < 0.01). Significant difference of blood creatinine, urea nitrogen, serum Na+ levels, and urinary Na+/K+ ratio were shown in the treatment group (P < 0.01) before and after treatment, and between groups after treatment (P < 0.05, P < 0.01). Portal vein blood flow was significantly lowered in the treatment group after treatment (P < 0.01), which showed significant difference as compared with that in the control group (P < 0.01). Besides, levels of atrial natriuretic peptide, renin, angiotensin, nitric oxide, and aldosterone decreased and endotoxemia improved remarkably in the treatment group (P < 0.01). One-year follow-up showed that the ascites eliminating rate and the incidence of hepato-renal syndrome in the treatment group was 38.3% (23/60 cases) and 23.3% (14/60 cases) respectively, while in the control group 0 and 41.7% (25/60 cases) respectively, all showed statistical difference between groups (all P < 0.05).

CONCLUSIONCombined therapy of SHP and colonic dialysis with herbal medicine could effectively eliminate the ascites, improve the hemodynamic condition of portal and splenic veins, reduce the content of vasoactive substance and noxious substances like ammonia and endotoxin in blood, and lower the incidence of hepato-renal syndrome.

Adult ; Ascites ; drug therapy ; etiology ; therapy ; Azotemia ; drug therapy ; etiology ; therapy ; Colon ; chemistry ; metabolism ; Combined Modality Therapy ; Dialysis ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis ; complications ; Male ; Middle Aged

BACKGROUNDThe treatment of high-grade developmental spondylolisthesis (HGDS) is still challenging and controversial. In this study, we investigated the efficacy of the posterior reduction and monosegmental fusion assisted by intraoperative three-dimensional (3D) navigation system in managing the HGDS.

METHODSThirteen consecutive HGDS patients were treated with posterior decompression, reduction and monosegmental fusion of L5/S1, assisted by intraoperative 3D navigation system. The clinical and radiographic outcomes were evaluated, with a minimum follow-up of 2 years. The differences between the pre- and post-operative measures were statistically analyzed using a two-tailed, paired t-test.

RESULTSAt most recent follow-up, 12 patients were pain-free. Only 1 patient had moderate pain. There were no permanent neurological complications or pseudarthrosis. The magnetic resonance imaging showed that there was no obvious disc degeneration in the adjacent segment. All radiographic parameters were improved. Mean slippage improved from 63.2% before surgery to 12.2% after surgery and 11.0% at latest follow-up. Lumbar lordosis changed from preoperative 34.9 ± 13.3° to postoperative 50.4 ± 9.9°, and 49.3 ± 7.8° at last follow-up. L5 incidence improved from 71.0 ± 11.3° to 54.0 ± 11.9° and did not change significantly at the last follow-up 53.1 ± 15.4°. While pelvic incidence remained unchanged, sacral slip significantly decreased from preoperative 32.7 ± 12.5° to postoperative 42.6 ± 9.8°and remained constant to the last follow-up 44.4 ± 6.9°. Pelvic tilt significantly decreased from 38.4 ± 12.5° to 30.9 ± 8.1° and remained unchanged at the last follow-up 28.1 ± 11.2°.

CONCLUSIONSPosterior reduction and monosegmental fusion of L5/S1 assisted by intraoperative 3D navigation are an effective technique for managing high-grade dysplastic spondylolisthesis. A complete reduction of local deformity and excellent correction of overall sagittal balance can be achieved.

Adolescent ; Adult ; Child ; Child, Preschool ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Radiography ; Spinal Fusion ; methods ; Spondylolisthesis ; diagnostic imaging ; surgery ; Young Adult

OBJECTIVETo investigate the short-term therapeutic effectiveness of body gamma-knife in patients with advanced pancreatic carcinoma.

METHODSForty-eight patients with advanced pancreatic carcinoma were treated by body gamma-knife therapy. The dosage distribution and other radiotherapeutic plans were established on the basis of the carcinoma position, clinical target volume, and patient health condition. The isodose curve was 50%-60% and covered about 95% of the target volume. The single dose was 350-450cGy. The radiation was performed once every one or two days for 10-12 times.

RESULTSThere were 33 patients with back pain. 63.6% of the patients got completely controlled, 30.3% pain remitted, and 6.1% ineffective after 2 to 18 months of therapy. The analgesic effective rate was 93.9%. Among 28 patients with obstructive jaundice, 21 patients (75.0%) recovered. Among 42 patients who received CT, tumor disappeared in 5 patients (11.9%), tumor size decreased in 30 patients (71.4%), remained unchanged in 5 patients (11.9%), and enlarged in 2 patients (4.8%). The 6-month, 12-month, and 18-month overall survival rates were 77.1%, 37.5%, and 10.4%, respectively. The whole process was tolerable for all patients and no severe side-effect was observed.

CONCLUSIONSBody gamma-knife can achieve a high local control rate and survival rate. Its short-term therapeutic effectiveness is satisfactory. Body gamma-knife is a safe and reliable treatment option for patients with locally advanced pancreatic carcinoma.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms ; mortality ; pathology ; surgery ; Radiosurgery ; methods ; Survival Rate ; Treatment Outcome

OBJECTIVETo study the treatment outcome of rhabdomysarcoma(RMS).

METHODS74 cases of RMS with definite pathologic diagnosis treated in our department during the past 20 years were investigated. The relationship between the therapy and prognosis was analyzed.

RESULTS52 cases among the 74 patients received different surgical treatment and post-operative radiotherapy. 22 cases received radiotherapy or chemoradiotherapy without surgical treatment. The survival rates demonstrated great differences depending on the different clinical stages and therapy.

CONCLUSIONThe combined therapy including radiotherapy after surgical treatment may increase 5-year survival rate.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Infant ; Jaw Neoplasms ; pathology ; surgery ; therapy ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; surgery ; therapy ; Radiotherapy, Adjuvant ; Rhabdomyosarcoma ; pathology ; surgery ; therapy ; Rhabdomyosarcoma, Embryonal ; pathology ; surgery ; therapy ; Survival Rate ; Treatment Outcome

OBJECTIVEThe aim of this study was to investigate the mechanism(MDR) of multidrug resistance(MDR) of mucoepidermoid carcinoma in salivary gland.

METHODS40 cases of mucoepidermoid carcinoma in salivary gland were examined the MDR gene product P-glycoprotein using a monoclonal antibody JSB-1. And 10 of them were also investigated by detecting the expression of GST-pi. All the cases had not been accepted any therapy before the samples were collected.

RESULTS1. Positive expression of JSB-1 was observed in 27 of the 40 specimens. The positive expression was related not only with clinical stage, but also with differentiation degree. 2. The GST-pi positive expression was found in 9 of 10 cases. There was no significant different between the positive expression of JSB-1 and GST-pi.

CONCLUSIONJSB-1 and GST-pi play an important role in MDR of mucoepidermoid carcinoma.

ATP-Binding Cassette, Sub-Family B, Member 1 ; analysis ; Adolescent ; Adult ; Aged ; Antibodies, Monoclonal ; analysis ; Carcinoma, Mucoepidermoid ; immunology ; Child ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Female ; Genes, MDR ; Glutathione S-Transferase pi ; Glutathione Transferase ; analysis ; Humans ; Isoenzymes ; analysis ; Male ; Middle Aged ; Salivary Gland Neoplasms ; immunology ; Salivary Glands ; immunology