Objective To explore a simple and convenient method for the treatment of penis skin defect.Methods Since Jan.1995,the scrotal skin flaps have been used to repair the defects of the penis skin in 8 patients with penis skin infection.6 of these cases lost their whole penis skin,and 2 of them lost 2/3 of their penis skin.The granulation tissues in the defective area of penis skin were cut away,and then the normal aponeurosis of corpus cavernosum or spongiosum exposed.The scrotal skin flaps were designed and shaped.The flaps were transferred to cover the defects,and the incisions were closed.Results All the flaps in 8 cases survived completely.The follow-up period was 3 to 12 months after operation.All cases obtained satisfactory results to the contour and function of the penises.Conclusion This procedure is a much better method for repairing skin defects in the penis.It can be easily operated and completed in one-stage.The postoperative results are satisfactory.

Objective To evaluate clinical features and mortality of primary biliary cirrhosis (PBC) in the aged patients. Methods Clinical data of 108 patients diagnosed with PBC was reviewed. The diagnosis of PBC was made according to the 2000 practice guidelines of American Association for the study of liver Diseases (AASLD). Elderly patients (≥60 years) were compared in terms of clinical, biochemical, immunological features and mortality with younger patients (0.05). After a median follow-up of 36 months, the mortality ratio for liver diseases was higher in the elderly than in younger group (21.4% vs 2.5%, ~P

Objective To explore the relationship between flood ing and the prevalence of schistosomiasis in the river beach area. Met hods The subjects were investigated on the ways of exposure, frequency and duratio n of water conta cted from May to November in 1999, and eggs of Schistosoma were examined bef ore and after flooding. Results Exposure to infested water for human being s in the area comprised productive, living and recreational contacts including 11 kinds of activities, and 53.55% of the subjects contacted infested w ater. The number of person, frequency and duration of water contacted in floodin g strongly increased; the infection rate and density among population stron gly increased after flooding. There was significant difference between the infec tion rate in exposure group and that in non-exposure group. Conclusions It can be inferred that flooding has increased water contacted and i nfection, therefore, health education should be strengthened to avoid or dec rease water contact.

Objective Evaluation the Fractionated Stereotactic Radiotherapy (FSRT) for the patients with small-cell lung cancer (SCLC) after the whole brain radiotherapy (WBRT) failure.Methods We retrospectively analyzed 35 patients with brain metastases from small-cell lung cancer treated with linear accelerator FSRT after the WBRT failure. Multivariate analysis was used to determine significant prognostic factor related to survival.ResultsThe following-up rate was 100％.The median following-up time was 11 months.The median over-all survival (OS) time was 10.3( 1 -30) months after FSRT.Controlled extra cranial disease was the only identified significant predictor of increased median OS time (χ2 =4.02,P =0.045 ).The median OS time from the diagnosis of brain metastasis was 22 (6 - 134 )months.14 patients died from brain metastasis,14 from extra-cranial progression,1 from leptomeningeal metastases,and 3 from other causes. Local control at 6 months and 12 months was 91％ and 76％,respectively.No significant late complications.New brain metastases outside of the treated area developed in 17％ of patients at a median time of 4(2 -20) months; all patients had received previous WBRT.ConclusionsFractionated stereotactic radiotherapy was safe and effective treatment for recurrent small-cell lung carcinoma brain metastases.

PURPOSETo review the efficacy and safety of pegylated interferons (peginterferons) in the treatment of chronic hepatitis C.

DATA SOURCESAn English language literature search (MEDLINE 1988 - 2001) was performed and a total of 19 original articles related to the issue were selected.

DATA EXTRACTIONAfter careful review of the selected papers, the meaningful results and conclusions were extracted using scientific criteria. The papers reviewed pertained mainly to the efficacy and safety profiles of peginterferons in the treatment of chronic hepatitis C.

RESULTSPeginterferon can effectively prolong the half-life of interferon and can be effectively administered conveniently as a once-a-week dose. The antiviral effect using peginterferon was enhanced compared with that of standard interferon, but the frequency and severity of adverse events were typical of those associated with interferon-alpha.

CONCLUSIONSBased on its efficacy, safety and convenient dosing, peginterferon is more favorable than standard interferon in the treatment of chronic hepatitis C.

Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Liver Cirrhosis ; drug therapy ; Polyethylene Glycols ; administration & dosage ; therapeutic use ; Recombinant Proteins ; Ribavirin ; administration & dosage

Objective To verify and assess diagnostic value of noninvasive diagnostic model of liver fibrosis in primary biliary cirrhosis (PBC) based on conventional laboratory markers.Methods Seventythree patients with PBC diagnosed by liver biopsy between January 2003 and June 2011 in Beijing Friendship Hospital,Capital Medical University were recruited in this study.Correlation analysis and logistic regression analysis between the conventional laboratory markers and histology stages were assessed.A liver fibrosis diagnostic model was established based upon aforementioned biomarkers and verified by its sensitivity and specificity for predicting the liver fibrosis.Results The predictive model ( H index) consisting of five conventional laboratory markers,i.e.,platelet count,serum cholinesterase,albumin,HDL-C and prothrombin time activity,could predict advanced fibrosis ( stages Ⅲ-Ⅳ ) with an AUCROC of 0.861.The sensitivity of predicting the absence of advanced fibrosis using H index ＜ - 2.20 was 96.6％ and the specificity of predicting the presence of advanced fibrosis using H index ＞ 0.41 was 93.2％.Conclusion The established noninvasive diagnostic model consisting of five laboratory markers could accurately distinguish pathological changes of early stage PBC ( stages Ⅰ - Ⅱ ) from advanced stage PBC ( stages Ⅲ-Ⅳ).

Objective:To evaluate the application of visual feedback coaching method, which is embedded in an optical surface monitoring system, in deep inspiration breath holding during the radiotherapy in left breast cancer patients after breast-conserving surgery.Methods:Thirty patients with left breast cancer, who were scheduled to receive the whole breast radiotherapy after breast-conserving surgery, met the requirements of deep inspiration breath holding after respiratory coaching with the visual feedback coaching module in the optical surface monitoring system. Active breathing control equipment was used to control breath-holding state and CT simulation was performed. During treatment, optical surface monitoring system was used to guide radiotherapy. All patients were randomly divided into two groups. In group A ( n=15), visual feedback respiratory training method was utilized and not employed in group B ( n=15). In group A, the visual feedback coaching bar of the optical surface monitoring system was implemented, while audio interactive method was employed to guide patients to hold their breath. Real-time data of optical body surface monitoring were used to compare the interfraction reproducibility and intrafraction stability of breath holding fraction between two groups. Besides, the number of breath holding and treatment time per fraction were also compared. GraphPad prism 6.0 software was used for data processing and mapping, and SPSS 21.0 software was used for analyzing mean value and normality testing. Results:Compared with the control group, the reproducibility in the experiment group was reduced from 1.5 mm to 0.7 mm, the stability was reduced from 1.1 mm to 0.8 mm, the mean number of breath holding required per fraction was decreased from 4.6 to 2.4, the mean beam-on time per fraction from 336 s to 235 s, and the treatment time per fraction was shortened from 847 s to 602 s (all P<0.05), respectively. Conclusions:The application of visual feedback coaching method can improve the reproducibility and stability of breath holding during radiotherapy for left breast cancer, and it can also effectively reduce the number of breath holding and shorten the treatment time per fraction.

OBJECTIVETo explore the clinical and histopathological features of primary biliary cirrhosis (PBC).

METHODSThe clinical, laboratory, as well as histological features of 27 cases of PBC were retrospectively analyzed.

RESULTSThe male to female ratio was 1:8 (3:24), aged from 22 to 69 years. The main clinical manifestations included: fatigue (62.9%, 17/27), jaundice (59.2%, 16/27) and pruritus (29.6%, 8/27), with all of patients having markedly elevated serum alkaline phosphatase and gamma-glutamyl transpeptidase and 95.8% (23/27) of the patients being positive for anti-mitochondrial antibody (AMA). The main histopathological changes were: necroinflammation of interlobular bile ducts (100%, 27/27), lymphocyte aggregation or lymphocyte follicles (15%, 4/27), granuloma (26%, 7/27), decreased number of interlobular bile ducts and smaller bile duct proliferation (55%, 15/27), feathery degeneration of hepatocytes (59%, 16/27); bilirubinostasis in hepatocytes and/or canaliculi (52%, 14/27); fibrosis and distortion of lobules (26%, 7/27), pseudolobular formation (11%, 3/27).

CONCLUSIONSThe main clinical features of PBS are fatigue and pruritus, markedly elevated phosphatase and gamma-glutamyl transpeptidase, and positive AMA with or without jaundice. Its histopathological hallmarks are (1)necroinflammmation and ductopenia involved mainly in interlobular bile ducts; (2)lymphocyte aggregation, granuloma formation and bile ductular proliferation in the portal area; and (3)feathery degeneration of hepatocytes.

Adult ; Aged ; Bile Ducts, Intrahepatic ; Fatigue ; Female ; Hepatocytes ; Humans ; Liver Cirrhosis, Biliary ; physiopathology ; Male ; Middle Aged ; Mitochondria ; Pruritus ; Young Adult ; gamma-Glutamyltransferase

Antiviral Agents ; pharmacology ; Gene Frequency ; Genes, Viral ; drug effects ; Hepatitis B virus ; drug effects ; genetics ; Humans ; Lamivudine ; pharmacology ; Mutation ; drug effects

OBJECTIVETo study the clinical features of patients with primary biliary cirrhosis (PBC) in order to improve the doctors' awareness of the disease.

METHODSGeneral status, clinical manifestations and laboratory findings of 40 patients with PBC were reviewed.Thirty-seven patients were females (37/40), and the mean age at diagnosis was 50.5 +/- 7.8 years. The time interval from initial symptoms or preliminary diagnosis to final diagnosis was 24.0 +/- 23.6 months.

RESULTSThe most frequently reported symptoms were fatigue (67.5%, 27/40), jaundice (60%, 24/40) and pruritus (32.5%, 17/40). Eight patients (20%) had associated auto-immune diseases (Sjogren's syndrome and/or rheumatoid a(c)arthritis). Serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (gamma-GT) levels were markedly elevated (520.3 +/- 382.3 IU/L and 648.6 +/- 529.1 IU/L, respectively) in all patients, while alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were mildly elevated (82.6 +/- 54.5 IU/L and 100.7 +/- 47.2 IU/L, respectively). Twenty-four patients (60%) had a total bilirubin level >/= 34.2 micromol/L. Thirty-five patients (87.5%) had elevated serum immunoglobin M,and 97.5% of patients (39/40 ) were anti-mitochondrial antibody (AMA)/AMA-M2 positive.

CONCLUSIONElevated serum ALP and gamma-GT levels, together with a positive AMA/AMA-M2, can help the diagnosis of PBC. Liver biopsy is useful to confirm the diagnosis and to differentiate histopathological stages.

Adult ; Aged ; Biopsy, Needle ; Female ; Hepatitis B, Chronic ; etiology ; Humans ; Liver ; pathology ; physiopathology ; Liver Cirrhosis, Biliary ; complications ; pathology ; physiopathology ; Male ; Middle Aged