Objective To evaluate operative management of complex hypospadias.Methods Twenty-one cases with complex hypospadias were reviewed.Thiresch procedure at 12 cases were taken.Island scrotal septal flap urethroplasty at 7 cases.Snodgrass procedure at 1 case.Mathieu procedure at 1 case.Results Fifteen cases were satisfied without fistula and stricture.Four cases with fistula,1 case with chordee,urethral meatus stricture in 1 case.Overall,the complication rate was 28.5%.Conclusions Selection of surgical procedure should according to the different case circumstance.It′s essential that reduce separative procedure,protect blood supply and carefully manipulation to improve successful rate.

Objective To explore the effect of L-dopa on plasma homocysteine and folic acid in patients with parkinsons' s disease(PD).Methods Twenty eight elderly PD patients and thirty normal subjects were enrolled in this group.The homocysteine,cobalamin and folate were examined in normal group and in PD group before treatment and after being treated with L-dopa for six moths respectively.Then the homocysteine,cobalamin and folate were compared between the two groups.Results The plasma homocysteine levels increased in PD patient group after being treated with L-dopa for six months(19.19? 8.01)?mol/L as compared with those of the PD group before treatment(12.50?3.78)?mol/L and those of control group(12.60?3.94)?mol/L(P

In mammals,there are two RNA-binding proteins,Musashi (Msi)1 and Msi2,constituting the Msi family.Msi2 is mainly distributed among neural,hematopoietic,gastrointestinal,pancreatic and epithelial stein cells.It is of great importance to maintain the balance between proliferation and differentiation of stem cells and regulate their growth and development.The changed expression of this protein will induce genesis and progression of malignant tumor through many kinds of signal pathways.Thus,Msi2 is trusted to provide a predictive mark and a therapeutic target for related tumors.

Objective:To investigate the predictive value of tumor regression rate after induction chemotherapy for survival of patients with locally advanced nasopharyngeal carcinoma.Methods:A total of 161 patients with stage Ⅲ-ⅣA nasopharyngeal carcinoma newly diagnosed at the Daping Hospital of Army Medical University from January 2009 to December 2012 were selected as the research subjects. The relationships between tumor size changes before and after induction chemotherapy and survival time were analyzed. Kaplan-Meier method was used to draw the survival curve accompanied with log-rank test. Cox regression analysis was used to analyze the risk factors affecting the prognosis of patients with nasopharyngeal carcinoma.Results:There were statistically significant differences in the tumor regression rate of primary lesions between N 1and N 2-3( Z=2.177, P=0.029), T 1-2and T 3-4( Z=-4.501, P<0.001)patients after induction chemotherapy. In N 1stage patients, the 5-year overall survival (OS) rates of patients with primary lesions achieving objective response ( n=18) and those without objective response ( n=19) after induction chemotherapy were 88.89% and 57.45%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=19) and those without objective response ( n=18) were 86.72% and 49.10% respectively, with statistically significant differences ( χ2=6.023, P=0.014; χ2=7.441, P=0.006). In N 2-3stage patients, the 5-year OS rates of patients with primary lesions achieving objective response ( n=81) and those without objective response ( n=43) after induction chemotherapy were 77.56% and 50.70%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=85) and those without objective response ( n=39) were 75.11% and 52.04% respectively, with significant differences ( χ2=8.037, P=0.005; χ2=7.268, P=0.007). Univariate Cox regression analysis showed that in patients with stage N 1, the tumor regression rate of primary lesions ( HR=0.048, 95% CI: 0.004-0.644, P=0.022), the efficacy of primary lesions ( HR=0.174, 95% CI: 0.037-0.830, P=0.028), the efficacy of cervical lymph node metastatic lesions ( HR=0.154, 95% CI: 0.033-0.725, P=0.017) after induction chemotherapy were significantly associated with OS; in N 2-3stage patients, the tumor regression rate of primary lesions ( HR=0.178, 95% CI: 0.056-0.564, P=0.003), the tumor regression rate of cervical lymph node metastatic lesions ( HR=0.081, 95% CI: 0.020-0.324, P<0.001), the efficacy of primary lesions ( HR=0.422, 95% CI: 0.228-0.781, P=0.006), the efficacy of cervical lymph node metastatic lesions ( HR=0.439, 95% CI: 0.238-0.813, P=0.009) after induction chemotherapy were significantly associated with OS. In multivariate Cox regression including N stage and tumor regression rate, N stage and efficacy, the interaction items were not statistically significant (all P>0.05). In T 1-2stage patients, the 5-year OS rates of patients with primary lesions achieving objective response ( n=45) and those without objective response ( n=13) after induction chemotherapy were 77.55% and 84.62%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=43) and those without objective response ( n=15) were 78.89% and 80.00% respectively, with no significant differences ( χ2=0.239, P=0.625; χ2=0.005, P=0.943); in T 3-4stage patients, the 5-year OS rates of patients with primary lesions achieving objective response ( n=54) and those without objective response ( n=49) after induction chemotherapy were 78.90% and 45.00%, and patients with cervical lymph node metastatic lesions achieving objective response ( n=61) and those without objective response ( n=42) were 75.10% and 42.89% respectively, with significant differences ( χ2=13.615, P<0.001; χ2=12.752, P<0.001). Univariate Cox regression analysis showed that in patients with stage T 1-2, the tumor regression rate, the efficacy of primary lesions and cervical lymph node metastatic lesions after induction chemotherapy were not related to OS (all P>0.05); in T 3-4stage patients, the tumor regression rate of primary lesions ( HR=0.121, 95% CI: 0.033-0.444, P=0.001), the tumor regression rate of cervical lymph node metastatic lesions ( HR=0.126, 95% CI: 0.036-0.442, P=0.001), the efficacy of primary lesions ( HR=0.297, 95% CI: 0.150-0.588, P<0.001), the efficacy of cervical lymph node metastatic lesions ( HR=0.329, 95% CI: 0.173-0.625, P=0.001) after induction chemotherapy were significantly associated with OS. Multivariate Cox regression analysis showed that the interaction test of T stage and the efficacy of primary lesion trended to be statistically significant ( P=0.062). Conclusion:In patients with stage Ⅲ-ⅣA nasopharyngeal carcinoma, the responsiveness to induction chemotherapy in stage T 3-4patients has important value in predicting survival prognosis.

AIM:To investigate the effect of over-expression of peroxisome proliferator-activated receptor γ co-activator-1α (PGC-1α) on mitochondrial morphology and cell apoptosis in the cortical neurons with oxygen glucose depriva-tion/reoxygenation(OGD/R). METHODS:The whole gene sequence of PGC-1α was obtained from the cerebral cortex of C57BL/6 mice by RT-PCR and cloned into the eukaryotic expression vector pEGFP-N1. The pEGFP-N1-PGC-1α was iden-tified by PCR,and transfected into cortical neurons. The level of PGC-1α expression was identified by Western blot. The cortical neurons transfected with pEGFP-N1 and pEGFP-N1-PGC-1α vectors were treated with OGD/R. The mitochondrial mass,reactive oxygen species (ROS) and ATP production,cell apoptosis and changes of cleaved caspase-3 were detected by MitoTracker Red staining,flow cytometry,ATP metabolic assay kit and TUNEL. RESULTS:Over-expression of PGC-1α inhibited the decrease in mitochondrial biogenesis capacity and the ROS formation of OGD/R neurons(P<0.05),en-hanced the ability of ATP synthesis (P<0.01),inhibited neuronal apoptosis (P<0.01) and decreased the activation of caspase-3 (P<0.01). CONCLUSION:PGC-1α over-expression inhibits neuronal apoptosis with OGD/R treatment by promoting mitochondrial biogenesis,inhibiting the production of ROS and maintaining mitochondrial function. PGC-1α may be used as a target for the development of cerebral ischemia/reperfusion injury drugs.

Alanine Transaminase ; blood ; Animals ; Bilirubin ; blood ; Disease Models, Animal ; Endotoxemia ; etiology ; Endotoxins ; blood ; Gastrointestinal Hormones ; blood ; Gastrointestinal Motility ; physiology ; Intestine, Small ; physiopathology ; Liver ; pathology ; Liver Failure, Acute ; blood ; etiology ; physiopathology ; Liver Function Tests ; Rats ; Thioacetamide ; administration & dosage

OBJECTIVE: To explore the genetic basis for a patient with episodic ataxia and pyramidal tract signs. METHODS: The patient was subjected to high-throughput sequencing, Sanger sequencing and analysis of dynamic variant site associated with spinocerebellar ataxias (SCA). RESULTS: The patient was an adolescent male presenting with episodic ataxia, bilateral knee hyper-reflexia and ankle clonus. By genetic testing, he was found to harbor a c.1159-1162dupAAGT variant of PDHA1 gene. The same variant was not found in his parents and elder sister. No abnormalities were found by SCA dynamic variant screening. The patient was diagnosed as pyruvate dehydrogenase E1alpha deficiency due to variant of the PDHA1 gene. CONCLUSION The de novo c.1159-1162dupAAGT variant of the PDHA1 gene probably underlies the disease in the proband. Patients with pyruvate dehydrogenase E1alpha deficiency have complex phenotypes and very few have pyramidal tract involvement, which may be attributed to abnormal early neuronal development.

Objective To investigate the differences of blood glycosylated hemoglobin (HbA1c) levels between the patients with acute cerebral infarction and healthy controls, and explore the relation between HbA1c level and both neurological deficits scores and imaging of lesions in number. Methods One hundred and eighty-six patients with acute cerebral infarction within 1 week were performed neurological deficits scales after the admission; the HbA1c level was measured within 24 h admission; brain MRI scan was performed on these patients 48 h after onset or stabilization. Glucose tolerance test was taken at the rehabilitation of infarction (except for having a clear history of diabetes before). At the same time, 160 healthy controls were checked on the level of HbA1c and taken the glucose tolerance test. The differences of blood HbA1c levels between the patients with acute cerebral infarction and healthy controls were investigated; and the relation between HbA1c level and both neurological deficits scores and imaging of lesions in number was explored. Results The HbA1c level in patients with acute cerebral infarction (6.982%±1.803%) was significantly higher than that in the controls (5.128%±0.592%, P<0.05). The level of HbA1c in patients with cerebral infarction and the neurological deficits scores were positively correlated (r=0.760, P<0.05). The level of HbA1c in patients with 2 lesions (6.635%±0.427%) was obviously higher than that in patients with 1 lesion (5.803%±0.307%, P<0.05); The level of HbA1c in patients with 3 or more lesions (8.571%±0.519%) was obviously higher than that in patients with 1 or 2 lesions (P<0.05). Conclusion Diabetes is a major risk factor for cerebral infarction. High HbA1c level might cause a series of cerebrovascular diseases, thus it is an important factor in the happening of cerebral infarction and HbA1c level is an important indicator of the early assessment of the severity of the diseases. The incidence of cerebral infarction can be decreased by controlling hyperglycaemia, lowering the HbA1c levels.

OBJECTIVETo understand the underreporting on death cases through web-based reporting system from medical institutions at county level and above as well as to evaluate the quality of death cases reporting through the system.

METHODSA large-scale survey was conducted at 130 medical institutions based on stratified random sampling and to evaluate the underreporting and the quality of death cases reporting from medical institutions through data from survey and reporting system.

RESULTSIn 2005, the total reporting rates were 78.25% at the county level and 37.93% at the institutes. Comparing with the results of 2004, these rates were going down slightly. The eligibility rate of reporting was 79.62%, increased when comparing with results of 2004. The percentage of obvious coding errors among deaths reported by county level and above medical institutions was 24.68%. A total of 5226 death cases were recorded from medical (outpatient and inpatient) sources. An average underreporting rate of 33.07% was found at the selected medical institutions. Statistical difference of underreporting rate was not found at medical institutions at different levels.

CONCLUSIONSince the initiation of the web-based reporting system of death cases at medical institutes from county level and above, the timeliness of data reporting had been increasing remarkably. The system showed irreplaceable advantages. However, there still existed some problems such as the underreporting of death cases,the poor timeliness of reporting, and the poor accuracy of coding. In the meantime, it was noticed that repetitive work existed among medical institutions due to multi-systems, suggesting that it was necessary to establish a national life registration in China.

China ; epidemiology ; Death Certificates ; Forms and Records Control ; standards ; Health Facilities ; standards ; statistics & numerical data ; Humans ; Local Government ; National Health Programs ; standards ; statistics & numerical data ; Public Health Informatics ; standards ; Quality Control

OBJECTIVETo establish a routine procedure for the detection of p53 mutations in hepatocellular carcinoma (HCC) surgical resections using the FASAY (functional analysis of separated alleles of p53 on yeast) procedure.

METHODSp53 status was analyzed by FASAY and cDNA sequencing in 50 cases of HCC. After the extraction of RNA from the frozen tumor and corresponding normal tissues, reverse transcription RT-PCR was carried out using these samples. The assay can detect mutations of p53 mRNA between codons 67 and 347 by the DNA-binding activity of the protein and reveal them as red colonies.

RESULTSOf the 50 specimens, 29 (58%) were positive (mutant) by FASAY. Sequencing analysis confirmed that all 29 FASAY positive tumors harbored mutations, and that no mutations were detectable in any FASAY negative tumors. In 29 p53 mutations, 22 mutations were point missense mutation, 5 were deletions and 2 were splicing mutations. A novel splice mutation on splice donor of intron 6 was reported, which could produce two different mRNAs, respectively using the nearest upstream and downstream recessive splice donor sites.

CONCLUSIONFASAY is a sensitive method for detecting the various types of p53 mutations in HCC, suggesting that the yeast functional assay for the detection of p53 mutations may be essential for elucidating their clinical significance.

Alternative Splicing ; genetics ; Carcinoma, Hepatocellular ; genetics ; DNA Mutational Analysis ; methods ; Gene Frequency ; Genetic Testing ; Humans ; Liver Neoplasms ; genetics ; Mutation ; Reproducibility of Results ; Sensitivity and Specificity ; Tumor Suppressor Protein p53 ; genetics