Objective To summarize the management of scrotal gangrene.Methods Totally,14 male patients (mean age,48 years;age range,27-74 years) with scrotal gangrene were treated from August 2003 to June 2005.Among these patients,scrotal gangrene was complicated by perianal and penile gangrene in 2 cases;by perianal,penile and inguinal gangrene in 10 cases;by perianal,penile,inguinal gangrene and abdominal subcutaneous gangrene in 2 cases.Three cases had concomitantly necrosis of the penis;and 5 ca- ses,orchitis.Bacterial cultures were performed in all 14 cases with the positive results.All patients underwent surgical treatment,including PhaseⅠincisions,aggressive debridement,drainage,irrigation,and scrotoplas- ty.After operation they received antibiotic therapy and supporting treatment.Three cases of penile necrosis underwent complete penis amputation and transplanting the urethra before the anus.Five cases of orchitis un- derwent unilateral orchiectomy.Two cases of abdominal gangrene underwent surgical subcutaneous treatment, including incision,aggressive debridement,drainage,and irrigation.Results Twelve cases undergoing scrotoplasty achieved PhaseⅠhealing.Two cases undergoing urethral fistulation recovered well.Ten cases of penile skin gangrene received penile dermatoplasty 1 month later,and then recovered.Two cases who had al- ready had AIDS died 2 or 3 d after operation.Conclusions The management of scrotal gangrene primarily consists of early and aggressive debridement,antibiotic therapy and supporting treatment.The PhaseⅠde- bridement and scrotoplasty as well as drainage are effective for the treatment of scrotal gangrene.

Objective To analyze the effect of using standardized patient (SP) tutorial in the spe-cialized training of pancreatic surgery with WeChat platform. Methods 48 surgeons participating in resi-dent standardized training in Changhai Hospital (all for postgraduate education) were enrolled as teaching object. 48 surgeons were divided into two groups: SP group (n=24) receiving WeChat combined with SP tutorial which updates learning plan, learning contents, and clinical discussion by Wechat platform and performs practical teaching by SP method, control group (n=24) receiving traditional tutorial by using tradi-tional clinical teaching methods and video teaching followed by practical teaching. The theoretical exami-nation, questionnaires and expert assessment were used to evaluate the effect of the two teaching methods. Statistical analysis was performed using the SPSS 19.0. Continuous data were expressed as median±stan-dard deviation and compared using the Student's t-test. Categorical data were compared using the Pearson's chi-square test. Results The score of theoretical examination of the two groups showed no significant difference [(85.5±7.6) vs. (81.4±14.9), P=0.238]. The results of questionnaires and expert assessment in WeChat&SP group were significantly better than those in the control group (P<0.001) other than theoretical and analytical ability (P>0.05). Conclusion WeChat platform combined with standardized patient tutorial in the specialized training of pancreatic surgery is feasible and more effective than traditional tutorial to improve teaching effectiveness.

Objective To present the initial experience and results of laparoscopic transvaginal radical cystectomy (LATRC) with orthotopic ileal neobladder. Methods Six female patients with muscle invasive bladder carcinoma underwent LATRC with orthotopic ileal neobladder. The mean age was 61 years (range 55 to 73 years) . The LATRC with orthotopic ileal neobladder consisted of 4 major steps, namely laparoscopic cystectomy, operation on vagina, extracorporeal formation of ileal pouch and laparoscopic urethral pouch anastomosis. With 5 trocars, the bilateral pelvic lymphadenectomy was performed first The ureters were dissected just outside the bladder. Assisted by the uterine manipulator and the LigaSure system, total bladder, uterus and appendage were dissected by the laparoscopic approach. In the transvaginal step, the specimen was removed through the incision of the anterior and posterior vaginal fornix apex and the neovagina was created by the visualized suture. A 30-40 cm ileal loop was taken from the abdominal cavity, isolated, de-tubularized and reconfigured into W shaped pouch with running suture. The anti-refluxing ureter implantation was performed by inserting the 1 cm ureter into the pouch and suturing in place. The urethra neobaldder anastomosis was done under the laparoscope. Results The mean duration of surgery was 6.2 h(range from 4 to 8 h). The estimated blood loss was 665 ml (range from 400 to 1200 ml). All patients achieved urine control and had neither obstruction nor reflux proved by the intravenous pyelography 1-3 months after surgery. The mean value of neobladdermaximum capacity was 427 ml. No vesicovaginal fistula or other serious complication occurred The mean follow-up was 16 months (9-30 months). During the follow-up, there was no mortality. One patient with lymph node involvement developed liver metastasis 8 months post-operatively. Conclusions The LATRC is feasible and effective for the female patients with invasive bladder cancer. Using uterine manipulator and the transvaginal procedure makes the laparoscopic manipulation easier and simpler. The visualized incision and suture on vagina is good for recovery and reducing postoperative vesicovaginal fistula.

In order to increase the SNR of the prostate image, we have designed a RF endorectal coil. Its properties have been evaluated using a network analyzer. Moreover the images got with a special phantom show that the coil has much higher SNR at the region of interest (ROI).
Algorithms ; Equipment Design ; Humans ; Image Enhancement ; instrumentation ; methods ; Magnetic Resonance Imaging ; instrumentation ; methods ; Male ; Phantoms, Imaging ; Prostate ; anatomy & histology ; Sensitivity and Specificity

OBJECTIVETo present that Nickel-Titanium (NT) memory alloy staples in fusionless controlling the growth of the vertebrates in the sagittal plane.

METHODSEighteen infant female goats were selected and equally divided into 3 random groups: long staple group, short staple group and blank control group. Five long staple (the legs' length = 7 mm) and five short staple (the legs' length = 4 mm) were implanted into each goat in long and short staple groups respectively by anterior approach, right on the front of the thoracic vertebrae from T(6) to T(11). The control group was not given any treatment. X-ray examination was performed pre-operatively and post-operatively. Cobb angle of lateral radiograph was measured and the data of Cobb angle were statistically analyzed. At the end of the experiment, whether the staples implanted spinal columns were fused or not were evaluated by gross observation.

RESULTSFinally, all of the goats were included in the final results. Before the operations, T(6-11) sagittal Cobb angle was 7.0° ± 2.3° in short staple group, and 6.2° ± 4.0° in long staple group. And after the operation, the T(6-11) Cobb angle was increased to 12.7° ± 4.7° in short staple group with the increased rate of 81.4%, and 14.0° ± 4.9° in long staple group with the increased rate of 125.8%, respectively. Before and after the surgery, there were no significant differences between long staple group and short staple group in terms of Cobb angle (pre-operation P = 0.655, post-operation P = 0.596). Before the surgery, there were no differences in terms of Cobb angle, between long staple groups and control group (P = 0.929), and short staple groups and control group (P = 0.720). At the end of the experiment, there were significant differences between long staple group and control group in terms of Cobb angle (P = 0.007), and between short staple group and control group (P = 0.021). The staples implanted spinal columns were not fused which was proved by gross observation.

CONCLUSIONSThe memory alloy staple implantation by anterior approach, right on the front of the thoracic vertebrae of goats, can control the growth of thoracic vertebrates leading to kyphosis.

Animals ; Bone Nails ; Female ; Goats ; Nickel ; Thoracic Vertebrae ; growth & development ; surgery ; Titanium

Objective To investigate the utility of plasma procalcitonin (PCT) as an early predictor for postoperative complications in patients who underwent elective pancreaticoduodenectomy (PD).Methods Clinical data of 87 patients who underwent elective PD in Changhai Hospital from March.1, 2016 to Dec.31, 2016 were collected.The general data, postoperative recovery, serum PCT level and white blood cell (WBC) count before, 1 d, 3 d and 5 d after PD were recorded.ROC curve was drawn and AUC was calculated to determine the cutoff value, sensitivity and specificity.Patients were divided into complication group (n=42) and noncomplication group (n=45) based on the occurrence of post-operative complications, and the comparisons between the two groups were performed.Results There were no significant differences on the age, gender, diabetes, obstructive jaundice, laboratory tests including PCT, operative time, blood loss volume during surgery and tumor type between the two groups, which were comparable.Complication group had longer hospitalization than noncomplication group (24 d vs 15 d,P<0.001), and the differences were statistically significant.In complication group, 18 patients had pancreatic fistula, 13 had peritoneal infection, 7 had gastric empty dysfunction, 8 had bleeding, 2 had bile fistula and 2 had incision infection after PD.The postoperative plasma PCT level in patients with gastric empty dysfunction, bleeding, bile fistula and incision infection was not statistically different from those in noncomplication group (all P>0.05), but the plasma PCT level in patients with pancreatic fistula and peritoneal infection on 3 d and 5 d after PD was significantly higher than those in noncomplication group, and the difference was statistically significant (all P<0.05).The combination of plasma PCT and WBC on 3 d and 5 d after PD was superior to PCT or WBC alone in predicting pancreatic fistula (sensitivity 88.9%, 72.7%;specificity 68.5%, 78.2%) and abdominal infection (sensitivity 100%, 100%;specificity 45.9%, 44.4%).Conclusions Plasma PCT could predict the occurrence of abdominal infection and pancreatic fistula after PD.The combination of PCT and WBC might be more valuable in predicting abdominal infection and pancreatic fistula.

AIMTo study the pharmacokinetics and bioequivalence of acipimox sustained-release tablets (SRT) after a single and multiple oral dose in healthy dogs.

METHODSThe plasma concentrations of of SRT and reference capsules with a single and multiple oral doses.

RESULTSThe drug concentration-time profiles fitted to a noncompartment model. After a single dose administration of sustained-release tablets and capsules, the pharmacokinetic parameters were as follows: AUC were (158 +/- 30) and (147 +/- 37) microg x h x mL(-1); Tmax were (4.3 +/- 0.8) and (2.6 +/- 1.3) h; Cmax were (29 +/- 6) and (42 +/- 10) microg x mL(-1); T(1/2) were (2.3 +/- 0.7) and (1.60 +/- 0.10) h; MRT were (6.0 +/- 0.8) and (3.9 +/- 0.7) h, respectively. The relative bioavailability of the sustained-release tablet was (108 +/- 16) %. After a multiple oral administration of sustained-release tablets and capsules, the pharmacokinetic parameters were as follows: AUC were (209 +/- 23) and (195 +/- 26) microg x h x mL(-1); Tmax were (6.3 +/- 0.8) and (3.4 +/- 1.5) h; Cmax were (27 +/- 4) and (36 +/- 5) microg x mL(-1); Cmmin were (2.2 +/- 1.0) and (0.20 +/- 0.20) microg x mL(-1); Cav were (8.7 +/- 1.0) and (8.1 +/- 1.1) micro x mL(-1); FI were (293 +/- 73) % and (448 +/- 91) % , respectively. The relative bioavailability of the sustained-release tablet was (114 +/- 19) %.

CONCLUSIONThe results of two one-side test from single dose administration shown that two preparations were bioequivalent. The Cmax of sustained-release tablet was lower than that of capsules, while the Tmax and MRT of sustained-release tablet were higher than that of capsule, which indicating a good retarding effect. The results from multiple dose administration also shown that two preparations were bioequivalent and the DF of sustained-release tablet was significant lower than that of capsule.

Administration, Oral ; Animals ; Area Under Curve ; Biological Availability ; Capsules ; Delayed-Action Preparations ; Dogs ; Dose-Response Relationship, Drug ; Hypolipidemic Agents ; administration & dosage ; pharmacokinetics ; Pyrazines ; administration & dosage ; pharmacokinetics ; Random Allocation ; Tablets ; Therapeutic Equivalency

Objective To investigate the mobilization of granulocyte-colony stimulating factor(G-CSF) with stem cell factor(SCF) in bone marrow stem cells(BMSC),and to observe the therapeutic effects of BMSC mobilization on repairing ischemia/reperfusion(I/R) renal injury induced by hypoxia inducible factor-1α (HIF-1α) and epidermal growth factor(EGF),and to investigate the mechanism for BMSC mobilization for repairing I/R renal injury.MethodsOne hundred and sixty male Sprague-Dawley rats(age:8-10 weeks) were randomly allocated into 4 groups(40 rats in each group):control group (group A),I/R group(group B),SCF + G-CSF treatment group (group C) and SCF + G-CSF control group(group D).The expressions of CD34 + and EGF were measured by immunohistochemistry technique,and the expression of EGF mRNA was measured by reverse transcriptase-polymerase chain reaction.Results 1.After I/R injury,the renal tubular epithelial cells were in a state of degeneration,necrosis,even exfoliation.As the time prolonged,the necrotic renal tubules were repaired gradually,but the repair in group C was not good compared with that in group B.The level of group C was obviously lower than that of group B on the 5th,10th,17th and 24th day(P ＜ 0.05).2.There was no significant difference in the percentage of CD34 + cells between group A and D(P ＞ 0.05).On 5 d postoperative,the level of CD34 + cells of group B and group C was conspicuous higher than group A and D (P ＜ 0.05),and that of group C was conspicuous higher than that of group B (P ＜ 0.05).They descended gradually from the 5 th day with the time prolonged.3.The expressions of HIF-1c of group B and group C had a highly positive reaction on the 5th day postoperatively and the level of HIF-1α of group B and group C decended to the normal level with the time prolonged,and at each time,the expression of HIF-1α of group C was significantly higher than that of other groups (P ＜ 0.05).4.On the 5th day postoperative,the expression of EGF of group B and group C showed a higher positive reaction on the 5th day postoperatively and the level of EGF in group B and group C descended to the normal level with the time prolonged,and at each time the expression of EGF of group C was significantly higher than that of the other groups (P ＜0.05).5.The expressions of EGF mRNA of group B and C showed higher positive reaction on the 5th day postoperatively(P ＜ 0.05).The level of EGF mRNA of group B was higher significantly than that of group A on the 17th day postoperatively(P ＜ 0.05).The level of EGF mRNA of group C was a peak and higher than that of other groups on the 10th day postoperatively(P ＜ 0.05).The level of EGF of group B and group C descended to a normal level with the time prolonged.6.There was a positive correlation between the expressions of HIF-1α and EGF (r =0.815,P ＜ 0.01).Conclusions Combination of SCF with the mobilization of G-CSF sufficiently homed BMSC to injured renal tissue was an important factor for the recovery of injured renal tubules.Combination of SCF with G-CSF may promote the expression of HIF-lα and EGF in the kidney may be one of the mechanisms of why combination of SCF with G-CSF can promote recovery from renal ischemic reperfusion injury.

OBJECTIVE: To investigate the effect of reinioside C (RC) on the expression of lectin-like oxidized low density lipoprotein receptor (LOX)-1 mRNA and LOX-1 protein induced by oxidized low density lipoprotein (ox-LDL) in cultured human umbilical vein endothelial cells (HUVEC). METHODS: HUVECs were cultured with ox-LDL (50 mg/L) for 24 h in the absence or presence of RC (1, 3, and 10 micromol/L). The expressions of LOX-1 mRNA and LOX-1 protein were examined by RT-PCR and Western-blot. RESULTS: Incubation with ox-LDL (50 mg/L) significantly raised the expression of LOX-1 mRNA and LOX-1 protein,which was concentration-dependent. CONCLUSION RC can inhibit the increased expression of LOX-1 mRNA and LOX-1 protein induced by ox-LDL in HUVECs.
Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Endothelium, Vascular ; Humans ; Lipoproteins, LDL ; pharmacology ; Polygala ; chemistry ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, LDL ; biosynthesis ; genetics ; Saponins ; pharmacology ; Umbilical Veins ; cytology ; metabolism