Objective To investigate the corrective effect of modified Brisson technique to treat concealed penis in children.Methods From July 2014 to July 2016,selected 12 patients (3-10 years old,mean 7.2 years old) with concealed penis were surgically treated with the modified Brisson technique in the Second Affiliated Hospital of Nanjing Medical University.Their clinical manifestations included the penis buried below the surface of prepubic skin which can be palpated and visualized through pushing the skin around the penis to the pubis and the short foreskin which was not attached to the penile corpus cavernosum.Patients with other conditions such as obesity and penial agenesis that caused buried penis were excluded from the study.The modified Brisson technique consisted of 4 steps.Ventral incision was used to gradually slit the narrow ring of the prepuce and to expose the glans followed by circumfe-rential inner foreskin incision made below the coronary sulcus of penis then the foreskin stripping released the corpus cavernosum.Finally the skin coverage was accomplished by posthioplasty.The operation time,blood loss,complications,postoperative treatments and followed-ups were retrospectively analyzed.Results For all the 12 patients,the operations were successful,lasting 40 to 60 minutes.The bleeding was about 5 to 10 mL and there was no operation-related complications like bleeding and infection of incision.Satisfactory cosmetic outcomes were obtained without retraction and the scars were similar to those of circumcision.All patients had penile lymphedema postoperatively which disappeared within 6 months after operation.Follow-up ranged from 6 months to 1 year,and there were no complications like skin necrosis and contracture or voiding difficulty.Conclusions The modified Brisson technique for concealed penis repair is technically easy and safe.In addition,it provides a good cosmetic appearance,functional outcomes and excellent postoperative satisfaction grades.

Objective To evaluate the clinical effect of ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment in managing postpartum bleeding due to pernicious placenta previa. Methods Clinical data of 227 patients with pernicious placenta previa, admitted to Shenzhen Maternity and Child Healthcare Hospital between June 2010 and June 2013, were retrospectively analyzed. Eight-two women,who were admitted between June,2010 to December,2011, receiving B-Lynch sutures combined with uterine lower segment packing after delivering the baby and placenta during cesarean section were assigned as the control group. Another 145 cases, who were admitted between January 2012 to June 2013, receiving ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment, were defined as the observational group. Several indicators during and after the operation were compared between the two groups. T-test or Chi-square test were applied for statistics. Results The duration of operation in the observational group was shorter than in the control [(92±26) vs (106±32) min, t=3.579, P<0.01]. The estimated blood loss during the operation, the total blood loss during the first 24 h after delivery and the blood loss during the operation for placenta percreta in the observational group were all lower than in the control [(1 230±481) vs (1 858±632) ml, (1 475±236) vs (2 482±364) ml, and (2 131±515) vs (2 587±498) ml, t=8.413, 25.295 and 6.484, all P<0.01]. The adjusted postoperative hemoglobin values of the observational group were significantly higher than that of control [(82±21) vs (69±19) g/L, t= - 4.634, P<0.01]. Besides, significant differences were found between the observational and control group on the rates of hysterectomy, blood transfusion, and uterine artery embolization [1%(2/145) vs 7%(6/82), 40%(58/145) vs 66%(54/82), 2%(3/145) vs 12%(10/82), χ2=5.408, 13.945 and 9.904, P < 0.05 or 0.01]. The dosage of Carboprost Tromethamine required was smaller in the observational group [(573±104) vs (729±128) μg, t=9.971, P<0.01]. Conclusions Ligation of descending branch of uterine artery and compression sutures in the lower uterine segment during cesarean section in women with pernicious placenta previa is an effective and simple method to control bleeding resulting reduction of blood loss and the hysterectomy rate.

Adolescent ; Adult ; Aged ; Batroxobin ; therapeutic use ; Double-Blind Method ; Female ; Fibrinolytic Agents ; therapeutic use ; Hearing Loss, Sudden ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Young Adult

Adult ; Cementoma ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Male ; Mandibular Neoplasms ; pathology ; surgery ; Tooth Root ; pathology ; surgery

Objective To study the effects of repetitive transcranial magnetic stimulation (rTMS) combined with hyperbaric oxygen (HBO) therapy on the recovery of neurological functional after cerebral infarction,and to discuss its possible mechanism.Methods Forty-five patients with cerebral infarction were randomly divided into a control group,an rTMS group and an rTMS plus HBO group,each group with 15 patients.The patients in the two treatment groups received 1 Hz rTMS to inhibit the unaffected hemisphere and 3 Hz rTMS to stimulate the affected hemisphere.One of the treatment groups also received HBO therapy,14 daily sessions.The National Institutes of Health stroke scale (NIHSS) and the Barthel index (BI) were evaluated on the 1st,14th and 30th day of treatment.Results The neurological function scores of those in the rTMS group and the rTMS & HBO group improved significantly.On the 1st and 14th day,no significant difference in NIHSS or BI scores was observed among the three groups,but by the 30th day the average neurological functional score in the rTMS & HBO group had improved significantly compared with the control group.The rTMS plus HBO group showed significantly better improvement than the rTMS group in terms of BI scores,but no significant difference in average NIHSS and BI scores was observed between the rTMS group and the control group.Fifteen days after the treatments had finished,the follow up results showed the improvements of the patients in the rTMS plus HBO group were significantly better than those in the other groups.Conclusion For patients with cerebral infarction,rTMS combined with HBO therapy can improve neurological function more significantly than rTMS therapy alone.

Objective To evaluate left atrial function dynamic changes before and after radiofrequency catheter ablation (CA)with persistent atrial fibrillation (AF)and predict the maintain sinus rhythm of postoperative atrial fibrillation by speckle tracking imaging.Methods The study was including 45 cases underwent CA with persistent AF(preoperative 1 week,postoperative 24 hours,3 months,6 months)and 25 normal cases.Left atrial function and strain rate were analysed.These index were measured and calculated:the left atrial diameter index (LADI),left atrial area index (LAAI),left atrial maximum volume index (LAVImax)and left atrial ejection fraction(LAEF),left atrial wall strain rate of left ventricular systolie (SRs),left atrial wall strain rate of left ventricular early diastolie (SRe),left atrial systolic strain rate(SRa) and the average of left atrial wall each phase strain rate.Results ① LADI,LAAI,LAVImax were significantly increased;LAEF,SRs,SRe were decreased significantly;SRa were disappeared with AF compared with the control group.②LADI,LAAI,LAVImax decreased gradually,LAEF,SRs,SRe,SRa were gradually increased with the extension of the follow-up time.③Left atrial average SRs predicted maintenance of sinus rhythm with atrial fibrillation after operation of CA(odds ratio=0.607,95% CI=0.417-0.819,correction of P =0.017)was an independent predictor.Conclusions Speckle tracking imaging can quantitative evaluate left atrial function with persistent AF after CA.Left atrial global reservoir function predicts the efficacy of CA.

Objective To establish a rabbit model of lumbar laminectomy and bone grains replantation and provide experimental evidence for the clinical application.Methods Eighteen healthy male New Zealand rabbits were selected and randomly divided into two groups:the control group (n=6) and experimental group (n=12).The rabbits of control group were given general anesthesia, and taking the L5 spinous process as the center to perfom left L5 laminectomy, using a micro lancet forceps to slowly bite the lamina and ligamentum flavum for fenestration and exposed to an approximately 0.8 cm x 0.3 cm sized bone window and then sutured the skin.The rabbits of experimental group were exposed to an approximately 0.8 x 0.3 cm sized bone window as well, and bone fragments were cut into small grains.Then the small bone grains were embedded in medical collagen sponge, to form an arch shape, and replanted them to the site of epidural fenestration.CT scan and histological changes were observed at 4, 8 and 12 weeks after operation.Results At 8 weeks after operation, CT examination showed that in the experimental group, a thin bone plate was formed by the bone grains.At 12 weeks after operation, the bone plate became thicker and was connected with the vertebral bone, and with continuous bone trabeculae.The spinal canal and volume were not obviously changed, and no spinal cord compression was observed. The rabbits of control group showed segment lamina defects, a small scar protruding into the spinal canal, and the vertebral canal was not completely reconstructed. Conclusions The bone grains replantation can effectively promote bone reconstruction in the laminectomized rabbits, and the formed bone plate can prevent epidural scar from intruding into the spinal canal, and can reduce the postlaminectomy adhesion.

Objective To investigate radiation dose diffent type of anesthesia affected radiation dose when we do interventional therapy for child patent ductus arteriosus (PDA).Methods From 201 1 to 2014,we collected 50 children(3-6 years old)with PDA which received interventional therapy were included in the study.They were divided into two groups:group A (25 cases,male/fe-male=7/18,mean weight=1 5.32 kg±2.41 5 kg)underwent interventional therapy of PDA under general anesthesia,and group B (25 cases,male/female=13/12,mean weight=1 6.40 kg±2.056 kg)using local anesthesia.The surgery were operated by the same doctor,we used DSA children cardiovascular film AE mode (ped CARD)to monitor the surgery,image frames 1 5-30 f/s,used the non-ionic contrast agent (Iodixanol 320 mg I/mL)and recorded the child cumulative incidence of skin surface dose (AK),dose area product(DAP),and time of fluoroscopy,and do statistical analysis.Results All 50 cases were performed the surgery successfully. There were no significant difference of age,weight and gender between groups (age:t=1.924,P =0.06;weight:t =1.703,P =0.095;gender:χ2 =3.00,P =0.083).The cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy were (0.061±0.025)Gy,(5.08±2.19)Gy·cm2 and (3.15±1.16)min in A group,and (0.094±0.046)Gy,(8.41±3.587)Gy·cm2 , (6.86±3.27)min in B group.The sequence and image number of two groups were same.There were significantly differences of cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy between two groups (AK:t =3.152,P =0.003;DAP:t =3.957,P =0.000;time of fluoroscopy:t =5.346,P =0.000).The radiation doses of A group significantly lower than B group,compared with B group,the radiation dose were 40 percent [(1-5.08/8.41)%]lower in A group,the 1.1 7 times discrepancy of time of fluoroscopy between two group [(3.1 5-6.86)/3.1 5].Conclusion Radiation dose is associated with type of anesthesia. Compared with local anesthesia,radiation dose reduced 40% using general anesthesia during interventional therapy for PDA.

BACKGROUND: Occurrence and development of the glioma are not only related to regulative gene of cell cycle, but also dealt with adjustive genes of cell invasion, cell metastasis and apoptosis.OBJECTIVE: To identify the differentially expressed genes related to cell proliferation and apoptosis in glioma cell of different differentiating degree with cDNA microarray, and provide basic data for further research of mechanisms of cell proliferation and apoptosis in human gliomas.DESIGN: Opening-up experiment.SETTING: Institute of Pathology, Southwest Hospital and Department of Neurobiology, Basic Medicine Faculty as well as Department of Pharmacy,Xinqiao Hospital, Third Military Medical University of Chinese PLA.MATERIALS: Human malignant glioma cell line CHG-5 ( Ⅱ grading according to the WHO standard) was constructed, kept and cultured in this experiment. SHG-44 (Ⅳ grade according to the WHO standard) was provided by Institute of Brain Tumor, Second Hospital Affiliated to Suzhou Medical College. Serum of calf was produced and provided by Hangzhou Sijiqing Biomaterial Institute. In experiment RPMI-1640 medium (Gibco),Trizol test kit (Gibco-BRL), RNAsecureTM solutions (Ambion, Austin,Texas), biophotometer (Eppendorf, Hamburg, Germany) were also applied.Gene chip contained 9 984 human cDNA segment, which was prepared and provided by City University of Hongkong (UniGEMV2 cloneset known gene and ESTs were purchased from Incyte Company), Superscript Ⅱ reverse transcriptase was provided by Gibco-BRL Company. Fluorochrome Cy3 & Cy5 was the products of Amersham Pharmacia Company.METHODS: The experiment was performed at Chongqing Third Military Medical University of Chinese PLA and City University of Hongkong between 2001 and 2003. Total RNA was extracted from Trizol test kit. Reverse transcription polymerase chain reaction (RT-PCR) was conducted in Superscript Ⅱ reverse transcriptase, and cDNA product was marked with fluorochrome Cy3 & CyS. Followed by chip hybridizationto detect the difference of gene expressions between human glioma cell line CHG-5 and SHG-44 tumor cell, especially the difference of related genic expression between cell proliferation and apoptosis, and the chip result was verified with Northern blot hybridization.MAIN OUTCOME MEASURES: The difference of gene expression of human glioma cell in different differentiating degree; Comparison of result between Northern blot and related gene chip.RESULTS: ①Compared with CHG-5, 120 gene expressions were detected obvious up-regulation and 22 gene expressions were significant down regulation in SHG-44 cells, and the variety of these differentially expressed genes was many, in which apoptosis related genes were 6, including 3 up-regulation genes and 3 down-regulation genes; Cell cycle and proliferating related genes were 12, including 5 up-regulation genes and 7 down-regulation genes. ②Chip result was supported by Northern blot result further.CONCLUSION: The differentially expressed genes of glioma are revealed primarily, especially the differentially expressed genes related with cell proliferation and apoptosis.

To explore new teaching method of functional experiment,we opened the functional laboratory to encourage students' creativity and train their practical ability and develop their innovative ability.The experiment teaching innovation was attempted and discussed the functional speciality.