OBJECTIVETo evaluate the effect of meatoplasty with the pedicle flap in the treatment of meatal stenosis secondary to chronic balanitis.

METHODSWe retrospectively analyzed 32 cases of meatal stenosis secondary to chronic balanitis treated by meato- plasty with the pedicle flap. All the patients had a history of chronic balanitis and had received meatal dilatation or simple ventral mea- totomy without significant effect. Their mean maximum urinary flow rate (Qmax) was (4.3 ± 2.4) ml/s. During the operation, A "/\"-shaped incision was made in the healthy epidermis and a flap was harvested from the frenulum. After complete removal of the scar, the flap was placed into the urethral wall, followed by reconstruction of the external urethral orifice.

RESULTSThe patients were fol- lowed up for 6 to 30 months, which revealed smooth urination in all the patients with Qmax of (26.7 ± 4.5) ml/s and normal erectile function and uresiesthesis.

CONCLUSIONWith little invasiveness and few complications, meatoplasty with the pedicle flap is an ideal surgical method for the treatment of meatal stenosis secondary to chronic balanitis. However, there might be some change in the normal appearance of the balanus postoperatively, and its long-term effect needs further observation.

Balanitis ; complications ; Constriction, Pathologic ; etiology ; surgery ; Dilatation ; Humans ; Male ; Postoperative Period ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery ; Urination

Objective: To determine biological effect ratio (BER) on anti-herpes simplex virus-Ⅰ (HSV-Ⅰ)of Liyan Dan (LYD) complex pharmaceutics and its active components alignment (ACA), and to discuss the new identification method of Chinese patent medicine expressed by standard BER. Methods: Protective effect to cells infected by HSV-Ⅰ was evaluated by a 3-(4,5-dimethyl-2 thiazoyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The ACA was determined by high performance liquid chromatography (HPLC) and ultraviolet spectrophotometry. By the protective percent (PP) to cells infected by HSV-Ⅰ of LYD and its ACA the BER was calculated. BERS= PPS / PPACA (protective percent to cells infected by HSV-Ⅰ of sample/protective percent to cells infected by HSV-Ⅰ of ACA; the concentration of sample was 2-x mg/mL). Results: LYD can inhibit cytopathogenic effect (CPE) and its BER was 1.16. Conclusion: BER and ACA of Chinese patent medicine can reflect connotation of Chinese patent medicine quality. This index described intrinsic quality of curative effect on Chinese materia medica.The new concepts of BER and ACA were pulled into the study. This research offered a new train of thought and method to study Chinese patent medicine quality as follows. Firstly, establish standard biological effect of ACA as a standard of effect; secondly,measure the biological effect of sample by the method of measuring effective standard of ACA; thirdly, calculate BER according to the formula (BERS=PPS/PPACA). Standard of BER on quality evaluation is as follows. If 1 ≥ BERS ≥ 0.9, the sample is eligible; if BERS＞1, the sample is of high quality; if BERS＜0.9, the sample is disqualification. This quality evaluation method is much more scientific than the method that evaluate quality only by one or two components contents.

AIM: To study the effect of vitrectomy combined with macular epiretinal membrane peeling on visual acuity, central macular thickness(CMT)and metamorphopsia degree in patients with idiopathic macular epiretinal membrane(IMEM).

METHODS: Totally 31 cases(31 eyes)of patients with IMEM were treated with vitrectomy combined with macular epiretinal membrane peeling, and the best corrected visual acuity(BCVA), CMT, ellipsoid zone(IS/OS)connectivity and macular morphology were examined before and after operation. The treatment effect was assessed, and the relationship between BCVA, macular structure and morphology before and after operation was studied. All the factors that might affect the surgical outcomes were analyzed.

RESULTS: The mean BCVA and CMT were 0.59±0.14 and 429.35±86.17μm respectively before operation, and were decreased to 0.38±0.09 and 304.87±62.54μm at 6mo after operation(P<0.05). The metamorphopsia degree after operation was gradually decreased, and the metamorphopsia degree at 1, 3 and 6mo after operation was lower than before operation(P<0.008). At 1mo after operation, the IS/OS connectivity ratios were 65%, and there was no significant difference compared with that before operation with 52%(P>0.008). The ratio of IS/OS connectivity was 81% and 90% at 3mo and 6mo after operation, and the difference was statistically significant compared with that before operation(P<0.008). There was significant difference in the macular morphology at different time after operation(P<0.008). The proportions of patients with normal macular morphology at 1, 3 and 6mo after operation were 26%, 52% and 77% respectively, and the differences were statistically significant compared with before operation(P<0.008). Pearson or Spearman correlation analysis showed postoperative BCVA in IMEM patients was positively correlated with preoperative BCVA and postoperative CMT(P<0.05), but that was negatively correlated with preoperative macular morphology, preoperative and postoperative IS/OS connectivity and postoperative macular morphology(P<0.05).

CONCLUSION: Vitrectomy combined with macular epiretinal membrane peeling can significantly reduce the CMT of patients with IMEM, and improve the IS/OS connectivity and macular morphology, so as to improve the visual acuity and reduce the metamorphopsia degree.

OBJECTIVETo study the expression of NFkappaB p65 and its target genes in intestinal metaplasia (IM), dysplasia (Dys), gastric cancer (GC) infected with Helicobacter pylori (Hp) and explore the mechanism of infection by cytotoxin-associated antigen A expressing Hp (CagA(+)Hp) in the development of gastric cancer.

METHODSCagA antibody in blood sample of 289 patients was determined by ELISA. Hp was detected by rapid urease test and Warthin starry staining. Expression of NFkappaB p65 and its target genes in IM, Dys and GC was examined by immunohistochemistry.

RESULTSIn IMI approximately II, IMIII, DysI, DysII approximately III and GC, the expression of NFkappaB p65 was significantly higher in patients with CagA(+)Hp infection than those without CagA Hp infection. In IMIII and DysII approximately III, the expression of NFkappaB p65, c-myc, CyclinD(1) and bcl-xl was significantly higher in patients with CagA Hp infection than those without CagA Hp infection. In gastric cancer infected with CagA(+)Hp, the expression of NFkappaB p65, c-myc, CyclinD(1) and bcl-xl was significantly higher in intestinal type than in diffuse type.

CONCLUSIONThere are different mechanisms in intestinal type and diffuse type in the development of gastric cancer. The occurrence of intestinal type gastric cancer is associated with CagA(+)Hp infection which by NFkappaB p65 upregulating the expression of c-myc, CyclinD(1),bcl-xl in patients with IMIII, DysII approximately III. It may be an effective method to prevent gastric cancer by inhibiting NFkappaB p65.

Adult ; Aged ; Antigens, Bacterial ; analysis ; Bacterial Proteins ; analysis ; Cyclin D1 ; metabolism ; Female ; Helicobacter Infections ; complications ; metabolism ; microbiology ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Precancerous Conditions ; metabolism ; microbiology ; pathology ; Proto-Oncogene Proteins c-myc ; metabolism ; Stomach Neoplasms ; metabolism ; microbiology ; pathology ; Transcription Factor RelA ; genetics ; metabolism ; bcl-X Protein ; metabolism

OBJECTIVETo investigate the spectrum of pathogens for community-acquired pneumonia (CAP) in children, and to provide a basis for the diagnosis and treatment of CAP.

METHODSRespiratory secretions and venous blood samples were collected from 1560 children with CAP aged from one month to 9 years within 2 hours after admission, for detection of multiple pathogens. Respiratory virus antigens in nasopharyngeal swab specimens were detected by immunofluorescence. Sputum was used for bacterial culture. Levels of Mycoplasma pneumoniae (MP)-IgM and Chlamydia pneumoniae (CP)-IgM in venous blood were measured by enzyme-linked immunosorbent assay.

RESULTSA total of 579 strains of bacteria were isolated from all respiratory secretions, including 213 (36.8%) Gram-positive strains and 366 (63.2%) Gram-negative strains. The five most common strains were Haemophilus influenzae (7.50%), Streptococcus pneumoniae (6.73%), Staphylococcus aureus (6.35%), Moraxella catarrhalis (5.19%), and Escherichia coli (3.46%), wherein the beta-lactamase-producing strains accounted for 3.3% of all strains. The non-bacterial pathogens mainly included respiratory syncytial virus (12.88%), MP (7.88%), and CP (8.91%). Mixed infection of pathogens was serious, and the mixed infection of respiratory syncytial virus with Haemophilus influenzae infections were the most common. For most pathogens, the infection rate was higher in children aged under one year than in those aged over one year.

CONCLUSIONSHaemophilus influenzae, respiratory syncytial virus, MP and CP are the main pathogens for children with CAP. For most pathogens, the infection rate is higher in children aged under one year than in those aged over one year. Mixed infection rate of pathogens is high.

Child ; Child, Preschool ; Coinfection ; etiology ; microbiology ; Community-Acquired Infections ; etiology ; microbiology ; Female ; Humans ; Infant ; Male ; Pneumonia ; etiology ; microbiology

Coronary Vessel Anomalies ; diagnosis ; Electrocardiography ; Humans ; Infant ; Pulmonary Artery ; abnormalities

Objective To investigate the clinical and pathological features of pediatric CNS atypical teratoid/rhabdoid tumor(AT/RT)and evaluate the role of INI1 antibody on the differential diagnosis and prognosis of AT/RT.Methods The clinical data and pathological features of 12-year-old boy with AT/RT were concluded.The protein expression of INI1 was detected by immunohistochemistry;follow-up was performed and relative documents of that disease were compared;the above data were retrospectively analyzed.Results Mioroanatomy showed typical teratoid cells and primitive mesenchymal cells in the tumor.Both of these 2 tumor components displayed positive reactions of vimentin and CD99.The SMA and EMA positive expressions were noted in the teratoid cells.Immunohistochemical staining demonstrated that INI1 antibody was nuclear negative in tumor cells,but positive within endothelial cells of the blood.Follow-up information showed the patient was dead 2 months after the operation.Conclusions CNS atypical AT/RT is highly aggressive tumor.The appearance of rhabdoid cells is its important morphologic features and its main differential diagnosis evidence.Mesenchymal components and the various results of immunohistochemical staining indicate that AT/RT tumor cells,having the character of the embryonal tumors,have various differentiation potential.The expression of INI1 antibody suggests that a mutation or deletion in the INI1 gene occurs in the tumor,which has important value in diagnosing and differentiating the tumor.

Objective To investigate the clinical efficacy of finger reconstruction in child with second toe transplantation,and evaluate the postoperative appearance and function regarding the reconstructed donor feet.Methods From June 2002 to May 2011,sixteen cases were reconstructed in sub-emergency with second toe transplantation.Two thumbs,eight index fingers,and 6 middle fingers were reconstructed.All patients were followed-up from 12 to 24 months.The functions of reconstructed fingers were analysed.Results All the reconstructed fingers survived.Vascular crisis occurred in 1 patient,and survived after re-anastomosis.Necrosis of skin grafts at the domon site with exposed tedons was seen in 1 ease,and healed after changing dressings.All the reconstructed fingers showed good in growth and development,and performed good functions as grabbing,grasping and nipping.Two-point discrimination was between 6 mm and 10 mm.The donor site of the foot had normal gait,without obvious influence on walking.Also,no pain was complained.Conclusion The method of transplanting the second toe can reconstruct the appearance and function of the finger defects in child,and has little effect on the appearance and motion of feet.It is an effective treatment method.

·AIM: To explore the effect of intravitreal injection of Conbercept combined with 23G minimally invasive vitrectomy on retinal hemorrhage, retinal proliferation and visual prognosis in patients with proliferative diabetic retinopathy (PDR). ·METHODS: Totally 56 cases of PDR patients (56 eyes) admitted to our hospital were randomly divided into the conbercept group ( n=28) and the pars plana vitrectomy (PPV) group ( n=28). The conbercept group was given intravitreal injection of Conbercept and 23G minimally invasive vitrectomy, and the PPV group was given the 23G minimally invasive vitrectomy only. The operative time, retinal hemorrhage, retinal proliferation and visual acuity were compared between the two groups. ·RESULTS: The operative time and intraoperative blood loss in the conbercept group were significantly lower than those in the PPV group (P<0. 05). The visual acuity and macula thickness in the conbercept group were significantly better than those in the PPV group (P<0. 05). The postoperative retinal hemorrhage score, retinal proliferative score, vitreous rebleeding rate and vascular endothelial growth factor ( VEGF) level in the conbercept group were significantly lower than those in the PPV group (P<0. 05). · CONCLUSION: Intravitreal injection conbercept combined with 23G minimally invasive vitrectomy for PDR can not only shorten the operative time, reduce the intraoperative retinal hemorrhage and postoperative rebleeding and the retinal proliferation, but also help patients with postoperative visual acuity recovery.

OBJECTIVETo explore the association between the progression of gastric cancer and the aberrant methylation of CDH1 gene in preoperative abdominal lavage fluid.

METHODSReal-time methylation-specific polymerase chain reaction(qMSP) was used to investigate the methylation status of the CDH1 gene promoter 5'-CpG islands from preoperative abdominal lavage fluid in 92 patients with gastric cancer. The associations between methylation of CDH1 genes and clinicopathologic features and prognosis were investigated.

RESULTSAmong the 92 patients with gastric cancer, aberrant methylation of CDH1 gene was detected in 45(48.9%) patients, including total aberrant methylation in 12(13.0%) cases and partly aberrant methylation in 33(35.9%) cases. Significant associations were found between CDH1 methylation status and tumor size, growth pattern, differentiation, lymphovascular invasion, infiltration depth, lymph node metastasis, distant metastasis, and clinical staging(all P<0.05). However, there were no significant associations between CDH1 methylation status with gender, age, tumor location, or Helicobacter pylori infection(all P>0.05). The median progression-free survival was 20 months for CDH1 methylation group and 38 months for non-methylated group, and the difference was statistically significant(P<0.01). Cox model analysis revealed that CDH1 methylation status in preoperative peritoneal lavage fluid was an independent factor associated with postoperative survival in patients with gastric cancer(P=0.000, RR=332.88, 95%CI:21.71-5105.07).

CONCLUSIONSThe aberrant methylation of 5'-CpG of CDH1 gene promoter is common in gastric cancer. The examination of CDH1 methylation status of abdominal lavage should be considered in the progression of gastric cancer.

Adult ; Aged ; Cadherins ; genetics ; CpG Islands ; genetics ; DNA Methylation ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Promoter Regions, Genetic ; Stomach Neoplasms ; genetics ; pathology