OBJECTIVETo evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.

METHODSA total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.

CONCLUSIONNo-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.

Adolescent ; Adult ; Circumcision, Male ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Postoperative Complications ; Young Adult

Objective To discuss the surgical method of resection of petroclival tumors used temporal base transtentorial approach.Methods Analyzed 26 cases of petroclival tumors.All of them were surgically treated under intraoperative neurophysiological monitoring by temporal base transtentorial approach.Firstly the supratentorial part of tumors were resected by pieces,and then the tentorium was cut open,in order to resect residue of the subtentorial part of tumors.This surgical maneuver was applied to reduce the retraction to surrounding vessels,nerves and brain stem,as well to protect important structures and to finally achieve radical removal of the tumors.The efficacy and complications were observed.Results Among 26 cases,19 cases (73.1％,19/26) achieved total removal,5 cases (19.2 ％,5/26) achieved subtotal removal and 2 cases (7.7％,2/26) achieved great partial removal.There was no surgery-related death.Eleven cases suffered from partial neurological deficit.All cases were followed up for 3 months to 4 years,3 cases underwent complete recovery,4 cases underwent partial recovery,and 4 cases underwent permanent deficit.Conclusions Using temporal base transtentorial approach to resect petroclival tumors is convenient,applicable,safe and with minimal injury and with high proportionality of total resection.Under intraoperative neurophysiological monitoring,this approach may be an ideal choice for surgical treatment of these tumors.

The article has studied the application and the student-centered teaching mode in clinic medicine teaching and discussed how to cultivate students' self-learning ability and life-time learning skills by means of internet teaching,problem-base learning,case-studying and question-discussion.It has also pointed out that compared with the traditional teaching mode this teaching mode has advantages in cultivating innovative,pioneering and practical medical talents.

Objective To investigate the pathway and mechanism of neuropeptide Y(NPY)-Y1 receptor agonist,[Leu~(31),Pro~(34)]-NPY,on the cultured cerebrovascular smooth muscle cells(SMCs) in the spontaneously hypertensive rats(SHR) in vitro. Methods The SMCs of the arteries from the brain of SHR were cultured in vitro.Cell cycle was detected with flow cytometry,and the concentration of free intracellular calcium was examined with laser scanning confocal microscopy. Results The percentages of S stage cells of 10~(-5) mol/L and 10~(-6) mol/L NPY was higher than those of the control group(P

Objective To compare the prescrotal orchiopexy and traditional inguinal orchiopexy in the clinical treatment of children with low cryptorchidism.Methods Seventy-two patients(78 testes)who underwent orchiopexy in our hospital during March 2006 to May 2011 were retrospectively analyzed.And the undescended testis could be manipulated beyond the external inguinal ring under anaesthesia.Matching conditions were age differences among 3 months,same preoperative testicular positioning,same surgeon and same side.Using the paired study of 1 to 1,all the patients were divided into 2 groups: prescrotal orchiopexy(group A)and the traditional inguinal orchiopexy(group B),each group included 36 patients(39testes).Mean age was 5.4 years(group A)and 5.5 years(group B).The time of operation and restore standing,success rate and complications,including hernia,hydrocele,testicular atrophy and ascent were compared between the 2 groups.Results All the patients were successfully operated.The average surgical time for the prescrotal and inguinal groups were 33 and 41 min(P =0.0022),and average time of standing was 1.2 and 5.4 d(P =0.0003).All the patients had no wound infection.Followup ranged from 3 to 65 months.No hernia,hydrocele,testicular atrophy and ascent were identified in either group.The ratios of successful surgery were 100％ in the two groups.Conclusions The prescrotal orchiopexy is simple,safe,and effective in the cases that testis could be pushed down through the external inguinal ring.Compared with traditional inguinal approach,the advantages of prescrotal approach are shorter operative time,fewer traumas,less pain,faster recovery and cosmetic results.

OBJECTIVETo explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.

METHODSFifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group, 27 cases in each one. In the conventional treatment group, special care, oxygen therapy, nerve nutrition and symptomatic support were applied. In necessary, dehydrant and hypotensive drugs were prescribed for antihypertension, or surgery was given. In the acupuncture group, on the basis of the treatment as the control group, acupuncture was applied at Quchi (LI 11), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Acupuncture was given at the admission, 4 h, 6 h and 12 h after disease onset respectively. Blood pressure was monitored in the whole procedure. 6 h and 24 h after disease onset, the cranial CT was re-examined. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hematoma volume and neurological deficit score were compared at different time points between the two groups.

RESULTS(1) Blood pressure: from the admission to 12 h after disease onset, SBP, DBP and MAP were increased apparently in the conventional treatment group and increased slightly in the acupuncture group. The differences in SBP [(164.3 +/- 21.6) mmHg vs (158.6 +/- 21.5) mmHg] and MAP [(113.4 +/- 4.9) mmHg vs (106.7 +/- 6.1) mmHg] were significant between the two groups (both P < 0.05). From 12 h to 24 h after disease onset, compared with the conventional treatment group, SBP and MAP were decreased apparently in the acupuncture group [(147.3 +/- 21.6) mmHg vs (158.4 +/- 23.5) mmHg, (97.2 +/- 5.3) mmHg vs (106.6 +/- 5.1) mmHg, both P < 0.05)]. (2) Hematoma volume: from the admission to 6 h after disease onset, the volume was increased by (4.15 +/- 0.73) mL in the convertional treatment group and (2.67 +/- 0.33) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). From the admission to 24 h after disease onset, it was increased by (5.57 +/- 1.26) mL in the convertional treatment group and (3.14 +/- 1.18) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). (3) Neurological deficit score: the score was increasing gradually in first 3 days after disease onset in the two groups. The score (38.39 +/- 6.84) in the acupuncture group on the first day was different significantly as compared with that (42.37 +/- 7.46) in the conventional treatment group (P < 0.05). On the 10th days, the score (24.68 +/- 5.42) in the acupuncture group was different significantly from that (29.74 +/- 7.36) in the convertional treatment group (P < 0.05).

CONCLUSIONThere is no peak of blood pressure rising, and the continuous hemorrhagic volume is less in 24 h and neurological deficit score is improved in the acupuncture group. Acupuncture brings the positive significance in the treatment of cerebral hemorrhage at the early stage.

Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Cerebral Hemorrhage ; physiopathology ; therapy ; Female ; Hematoma ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

Objective To develop a laser positioning device for GE OEC850 and Wandong HMC-36 C-arm.Methods The device was composed of two cross-type laser tubes,timing circuit and power source.The optimal 30 cm projection point was determined with laser dual-crossed-line positioning method and considerations on the distance between the tube of GE OEC850 or Wandong HMC-36 C-arm and the image intensifier.Then the projection range was found around 30 cm to define the targeted area.Results The device eliminated the needs of multi times of projection due to improper positioning,decreased the exposure to medical personnel and patient during the operation,prolonged the service life of the tube and reduced the cost for hospital equipment.Conclusion The device behaves well in positioning and easy operation,and thus is worthy promoting clinically.

Objective To study the correlation of ~(18)F-fluorodeoxyglucose (FDG) PET/CT with pathological changes of the VX2 rabbit tumors after treatment of Ar-He knife,and to explore the evolution of the Ar-He knife curative effect for VX2 rabbit tumors.Methods Thirty-six Japanese white rabbits had successfully been implanted with VX2 tumors in thighs.Four weeks later,the rabbits with VX2 tumors were imaged with FDG PET/CT before they were treated with Ar-He cryoablation.The rabbits were evenly and randomly divided into 6 groups (6 rabbits in each group) and imaged with FDG PET/CT respectively on the first day,third day,seventh day,fourteenth day,thirtieth day and sixtieth day after cryoablation.The rabbits in each group were sacriftced after post-treatment FDG PET/CT imaging for pathology and immunohistochemistry studies.The standardized uptake value (SUV) of tumor regions were calculated and compared with pathology and immunohistochemistry findings in the cryoablative area in each group.Paired-samples t-test and bivariate correlation analysis were evaluated by statistical software SPSS 16.0.Results After ArHe cryoablation,pathological changes of "necrosis-inflammatory response→organization" were found.On CT imaging,the tumors enlarged during 3-14 d after treatment and then shrank gradually.On FDG PET imaging,the maximum SUV (SUV_(max)) dropped dramatically on the first day after the operation(from 2.54±1.12 to 0.67±0.12),and increased slightly on the third day (1.71±0.82),and then continually dropped to 0.51±0.32 (60 d afterthe operation).The differences of SUV_(max) between pre-and after cryoablationin each stage were significant,respectively (t=5.471,8.716,11.388,5.713,7.144 and 7.213,all P＜0.05).The size and SUV_(max) of the targeting area did not correlate with each other(r=0.259,P=0.675).The change of the MVD closely correlated with SUV_(max)(r=0.865,P=0.032).Conclusion FDG PET/CT can reveal the pathological change of tumor tissue after Ar-He cryoablation therapy and therefore may be a potential tool for evaluating the curative effect of this treatment modality.

Objective To compare the computed orthopantomography(COPT)with Sh?ller radiography(SR),film orthopantomography(FOPT)and other traditional radiographic techniques in the radiography of temporomandibular joint(TMJ).Methods Ninty-eight cases were randomly divided into 3 groups,and the open and close positions of TMJs of both sides were examined with SR,FOPT,and COPT, respectively.The satisfactory rates of the X-ray pictures were statistically analyzed with Pearson chi-square in SPSS10.0,and the satisfactory rates were analyzed with q test between the groups.Results One hundred and forty-four of the open and close positions of 144 TMJ pictures of the COPT group,128 of 128 of the FOPT group,and 6 of 120 of the SR group were satisfactory in the mandible ramus of the TMJ,with satisfactory rate being 100%,100%,and 5%,respectively(P0.01),respectively between FOPT and COPT groups.The difference was not statistically significant.The exposure was as follows:COPT,99—113 mAs;FOPT,210—225 mAs;and SR,48—75 mAs.Therefore,COPT and FOPT were superior to SR in the pictures of the mandible ramus,coronoid process,and incisure,but inferior in the joint space pictures.The satisfactory rates of the condylar process and articular tubercle were same in the 3 groups.The exposure of the FOPT group was greater than that of the COPT and SR groups.Conclusion COPT is superior to SR and FOPT in TMJ radiography,and should be applied widely in the clinic.

Proteomics is an emerging discipline developed on the basis of genomics.The fundamental techniques of proteomics include sample preparation,protein separation,protein identification and analysis,and its core techniques are two-dimensional gel electrophoresis and mass spectrometry.In recent years,proteomics has been used in researching the field of Mycobacterium tuberculosis(MTB).Proteomics promotes deep understanding of the pathogenesis of MTB and resistance mechanism via isolating,identifying and analyzing the whole-cell protein and secreted proteins.The development of new vaccine against MTB has showed some promising results based on proteomics.Some powerful early diagnostic markers have been discovered via analyzing the protein composition of MTB clinical isolates.Proteomics also applies to find potential new drug targets,and it has shown many valuable research productions in developing new an-ti-MTB drugs.In summary,the application of proteomics has built a solid foundation for the development of prevention,early diagnosis and treatment of tuberculosis.