Objective To observe the effects of dredging collaterals and activating blood worm Chinese materia medica on angiogenesis related factors of lung cancer in hypoxic environment. Methods The lung cancer A549 cells were cultured in vitro to simulate tumor hypoxia microenvironment by the hypoxia workstation, and different concentrations of Scorpio, Scolopendra and Gecko medicated serum were added. MTT method was used to detect cell proliferation and screen the best medicine concentration and duration of action. Lung cancer A549 cells were administrated by the three kinds of medicated serum, and cells were collected and supernatant was cultured. Contents of VEGF, TGF-β1, and bFGF were detected by ELISA. Results Three kinds of medicated serum had the inhibitory effect on both added normoxia and hypoxia in cultured A549 lung cancer cells. 7.5% concentration of medicated serum was selected, and 24 h later were used in later experiments. Scorpio, Scolopendra and Gecko medicated serum can more reduce the contents of VEGF, TGF-β1 and bFGF in the supernatant of A549 cell compared with the control group (P<0.05, P<0.01). Conclusion Dredging collaterals and activating blood worm Chinese materia medica had inhibitory effect on cancer cells and the regulation of angiogenesis related cytokines in the condition of normoxia and hypoxia.

Objective To evaluate the role of multiple dorsal midline plication (MDMP) procedure in correction of Donnahoo type Ⅲ chordee in postpubertal patient.Methods From September 2010 to July 2013,33 postpubertal patients with Donnahoo type Ⅲ chordee (＞ 20°) were treated with MDMP procedure.The age ranged from 18 to 37 years with an average of 29 years.Primary surgery was indicated in 18 patients including type Ⅲ chordee in 11 and type Ⅲ/Ⅳ in 7,with associated hypospadias in 12.Redo surgery was warranted in 15 patients including type Ⅲ chordee in 13 and type Ⅲ/Ⅳ in 2,with associated urethral defects necessitating repair in 12.Intraoperative artificial erection was induced to confirm the degree and length of chordee.Longitudinal plication sutures,4 dots each,were applied close to the midline in a parallel fashion on each apex of curvature,to achieve satisfactory orthoplasty with 16-dot to 64-dot plication according to the chordee status,and the urethral repair indicated was achieved simultaneously.Results Satisfactory orthoplasty was achieved with 16-dot plication in 16 patients,24-dot in 10,32-dot in 6,and 64-dot in 1 patient whose penile curvature was severe and long.Followup was obtained from 35 to 69 months with an average of 46 months.Three patients lost of followup.Urethroplasty-related complications were noted in 5 patients including urethrocutaneous fistula in 2,urethral dehiscence in 1,urethral diverticulum in 1,and urethral stricture in 1.Mild cicatrical curvature (less than 15 degree) was noted in 2 patients.No postoperative priapism,erectile dysfunction,and paraesthesia was noted,nor chordee recurrence.Conclusions When applied appropriately,MDMP is an effective procedure in correction of Donnahoo type Ⅲ chordee in postpubertal patient with good and long-standing orthoplasty.

Objective To compare the postoperative effects of Onlay transverse island preputial flap and Onlay transverse free island preputial graft for midshaft hypospadias repair.Methods Retrospective analysis of clinical data of 59 patients with midshaft hypospadias who underwent hypospadias repair from January 2013 to December 2018.Among them,49 children were repaired with Onlay transverse island preputial flap,aged from 14 months to 81 months,with the median age of 28 months.Ten children were repaired with Onlay transverse free island preputial graft.The age at surgery was from 15 months to 51 months,with the median age of 30 months.There was no significant difference in term of the age at surgery between the two groups (Z =-0.384,P =0.701).There were 9 cases of Donnahoo Ⅱ and 40 cases of Donnahoo Ⅲ in the traditional Onaly group,and 3 cases of Donnahoo Ⅱ and 7 cases of Donnahoo Ⅲ in the free graft Onlay group,respectively.There was no significant difference in the type of chordee between the two groups(x2 =0.161,P =0.688).The classification of hypospadias,the length of the urethroplasty and surgical complications were compared.The maximum urinary flow rate of some patients was summarized and analyzed after operation.Results Follow-up ranged from 3 to 72 months,with a median period of 38 months.In the children who underwent Onlay transverse island preputial flap,there were 2 cases of distal shaft,5 cases of middle shaft,and 42 cases of proximal shaft.The neourethra was 1.3-3.5 cm,with a median of 2.3 cm.There were 11 cases of fistula,1 case of glan dehiscence,and 1 case of diverticulum.Ten children were treated with Onlay transverse free island preputial graft.There were 1 case of distal shaft,2 cases of middle shaft and 7 cases of proximal shaft.The neourethra was 1.2-2.5 cm,with a median of 2.0 cm.Two cases of fistula occurred after operation.There was no significant difference in hypospadias classification between the two groups(x2 =1.313,P =0.519).There was no significant difference in the length of the urethra between the two groups (Z =-1.732,P =0.083).There was no significant difference in the incidence of postoperative complications between the two surgical methods (x2 =0.001,P =0.973).The patients' parents were satisfied with the appearance of genital organ after operation.Fourteen patients finished the uroflowmetry 3 months after surgery.Twelve patients in the traditional Onlay group had a urine volume of 60.2-147.8 ml,with an average of 98.8 ml.The maximum urinary flow rate was 3.5-13.6 ml/s,with an average of 8.1 ml/s.In the free graft Onlay group,the urine volume was 101.3-165.4 ml,with an average of 133.5 ml,and the maximum urinary flow rate was 9.6-15.7 ml/s,with an average of 12.7 ml/s.Conclusions Onlay transverse free island preputial graft has the same complication incidence with Onlay transverse island preputial flap,but could get a good maximum urinary flow rate and cosmetic result,which could achieve a good choice for midshaft hypospadias repair.

Objective To explore the safety and efficiency of robot-assisted laparoscopic resection of pediatric adrenal region masses.Methods Six cases with adrenal region mass underwent robot-assisted laparoscopic adrenalectomy(RALA)from October 2019 to March 2022 in our hospital by using the da Vinci Robotic Surgery System.The patient was routinely placed in the 60°position on the healthy side.Two robotic arms were used to operate,and additional auxiliary operation holes were added as needed.The tumor was revealed by the combination of sharp and blunt separation,and the tumor trophoblastic vessels were identified.The tumor vessels were isolated by clamping with silk wire or biological clips.The tumor was fully freed and excised completely.Smaller specimens were removed by a slightly enlarged operation hole,and larger specimens were removed by another incision in the lower abdomen.Results All the 6 cases of procedures were successfully performed without conversion to open surgery.The operative duration was 90-240 min(mean,133.3 min),and the blood loss was 15-50 ml(mean,31.7 ml).In 2 cases,the drainage tube was not placed.In the remaining 4 cases,the indwelling time of the drainage tube after surgery was 4-8 d(mean,5.5 d).The postoperative hospital stay was5-15 d(mean,8.7 d).There were no complications except for one patient with postoperative bleeding.All the patients were followed up for 10-24 months(mean,16.7 months).CT examinations showed no recurrence of tumors.Conclusion Robotic-assisted laparoscopic resection of pediatric adrenal region masses is safe with satisfactory results.

OBJECTIVE： To study the effects of ivermectin on the migration and invasion of human gastric cancer cell lines BGC-823 and MGC-803 and its mechanism. METHODS： After treated with 0， 2.5， 5， 10， 20， 40 μmol/L ivermectin for 24 h， inhibitory rate of human gastric cancer cell lines BGC-823 and MGC-803 were detected by MTT assay. Effects of 5 μmol/L ivermectin and phosphate buffercontaining 0.67‰ dimethyl sulfoxide （control group） for 24 h on the migration and invasion of` gastric cancer cells BGC-823 and MGC-803 were observed by Transwell chamber invasion assay.Western blot assay was used to detect the protein expression of TGF-β1， TGF-βR， Smad2 and Smad3 in epithelial-mesenchymal transition （EMT） markers E-cadherin， N-cadherin， Vimentin， Snail and EMT transduction pathway TGF-β/smad of BGC-823 and MGC-803 cells after treated with 5， 10 μmol/L ivermectin and phosphate buffercontaining 0.67‰ dimethyl sulfoxide （control group） for 24 h. RESULTS： Ivermectin could inhibit the growth of BGC-823 and MGC-803， inhibitory rate of it was positively correlated with its concentration. Compared with control group， the number of migration and invasion BGC-823 and MGC-803 cells were decreased significantly after treated with 5 μmol/L ivermectin （P＜0.01 or P＜0.001）； the expression of E-cadherin protein was enhanced significantly in BGC-823 and MGC-803 cells after treated with 5 and 10 μmol/L ivermectin （P＜0.05 or P＜0.01 or P＜0.001）； the protein expression of N-cadherin， Vimentin， Snail， TGF-βR， Smad2 and Smad3 were decreased significantly （P＜0.05， P＜0.01 or P＜0.001）； protein expression of TGF-β1 was decreased significantly after treated with 10 μmol/L ivermectin （P＜0.05）. CONCLUSIONS： Ivermectin can significantly inhibit the migration and invasion of gastric cancer cells BGC-823 and MGC-803， and inhibiting the biological activity of EMT by reducing the expression of TGF-β/smad pathway is one of the mechanisms that inhibit the migration and invasion of gastric cancer cells.

Objective: To assess the reliability and validity of the Urinary Tract Dilation (UTD) classification system as a new grading system for fetal hydronephrosis, and analyze the risk factors for prognosis of fetal hydronephrosis. Methods: The data of patients who presented with fetal hydronephrosis from January to July 2016 at Sichuan Aca-demy of Medical Sciences & Sichuan Provincial People′s Hospital were retrospectively reviewed.The outcome of the patients who were treated with surgery or without surgical treatment was recorded if they were older than 2 years old.All renal nephrons were regraded if UTD classification system had been used for antenatal hydronephrosis assessment reliability previously.Univariate and multivariate analysis was performed to analyze the risk factors for prognosis of fetal hydronephrosis. Results: A total of 94 patients (136 renal nephrons) were eligible for enrollment.During the observation period, 43 kidneys received surgery which had clinical indications for surgery, and the remaining 93 kidneys without surgery were stable until the end of the observation period.Ultrasound finding of fetal hydronephrosis in the second trimester were graded according to UTD grading system.Among the 51 kidneys with UTD A1, 7 kidneys (13.73%) received surgery during the observation period, and 35 kidneys (47.30%) received surgery during the observation period among 74 kidneys with UTD A2-3.In the third trimester of pregnancy, among 54 kidneys with UTD A1, 3 kidneys (5.56%) were operated during the observation period, and among 82 kidneys with UTD A2-3, 40 kidneys (48.78%) were operated during the observation period.Multivariate analysis revealed that parenchymal thickness before 32 weeks and UTD classification system during the third trimester of pregnancy were risk factors for fetal hydronephrosis which required surgical treatment after birth. Conclusions The UTD classification system is reliable for the evaluation of fetal hydronephrosis and is valid in predicting surgical intervention.Parenchymal thickness before 32 weeks and grading UTD A2-3 after 32 weeks is a risk factor for postnatal surgery.Analysis of fetal hydronephrosis data based on UTD grading system and standardized follow-up are helpful to control the risk of fetal hydronephrosis effectively.

【Objective】 To investigate the penile appearance, sexual function, psychological status and related influencing factors of adult patients who underwent hypospadias repair surgery in their minors, so as to provide reference for the diagnosis, treatment and prognosis of hypospadias. 【Methods】 This study included 50 adult hypospadias patients who underwent urethroplasty in our hospital during May 2005 and Aug. 2018. The present appearance, sexual function and psychological status were evaluated. The correlation and consistency between hypospadias objective scoring evaluation (HOSE) and pediatric penile perception score (PPPS) were analyzed. Factors affecting the results were determined with univariate and multivariate regression analysis. 【Results】 The satisfaction rate of HOSE was significantly correlated with the urethral length and complications (P=0.024, P=0.033). The satisfaction rate of PPPS was significantly correlated with the number of urethral operations and postoperative complications (P=0.041, P=0.023). There was a weak correlation between HOSE and PPPS (r=0.291, P=0.040), but almost no consistency (Kappa=0.2, P=0.107). Sixty percent of the patients paid attention to the ventral appearance of penis, whose dissatisfaction rate of PPPS was higher than those who did not pay attention to the ventral appearance of the penis (19/30 vs. 6/20, P=0.021). Patients with multiple operations (>1), postoperative complications or unsatisfactory penile appearance were more likely to have inferiority complex (52.6% vs. 22.6%, P=0.029; 59.1% vs.14.3%, P=0.001;61.5% vs. 24.3%, P=0.015). Multivariate regression analysis showed that dissatisfaction with the appearance of the penis was an independent risk factor for patients’ perception of their own physical defects. Among the patients who believed that they had physical defects, the percentage of patients with grade IV penile erectile hardness was significantly lower than that of those who denied they had physical defects (9/17 vs. 27/33, P=0.047). 【Conclusion】 The undesirable postoperative penis appearance is likely to have a negative impact on patients’ long-term psychological state, which might further damage the sexual function in adulthood. Surgeons should pay attention to the penile appearance during the conduction of hypospadias repair.