Condoms ; standards ; supply & distribution ; Humans ; Quality Control ; Sexually Transmitted Diseases ; prevention & control

Acromioclavicular Joint ; anatomy & histology ; injuries ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Male ; Shoulder Dislocation ; surgery

Hirschsprung's disease (HD) is a conginental disorder of enteric nervous system (ENS) and is associated with the abnormal migration of gut neural cerst cell (GNCC).Recent studies showed that the regulation of this migration is a complex gene network.By the development of epigenetic and stem cells,this network is becoming much more clear.Transplantation of the modified gut neural crest stem cells/gut neural crest precursors(GNCSC/GNCP) acquired from the HD bowl is becoming the potential therapy of HD.This paper summerizes the recent advances and is to promote better understanding the pathogenesis of HD.

Objective To investigate the pathogenesis of interleukin-21 (IL-21)role in primary biliary cirrhosis (PBC).Meth-ods 38 cases of PBC were selected for the study.35 caeses of healthy subjects were selected as the control group in January 2012 to January 2014 from Shenzhen Fuyong People’s Hospital of Baoan District and the Third People’s Hospital of Shenz-hen.The levels of IL-21,IL-17 of two groups were measured with Enzyme-linked immunosorbent assay (ELISA).The levels of T helper lymphocytes 17 (Th17),regulatory T cells (Treg)cells ratios of two groups were measured with flow cytome-try.The relationship of IL-2 1 and liver function were analyzed with pearson correlation.Another analysis of pyruvate through the establishment of in vitro deaminase complex E2 subunit (PDC-E2)peptides relationship with Th17 and Treg cell.Results The levles of IL-17 (18.23±4.12)ng/L,IL-21 (512.25±18.25)ng/L,Th17 (3.98±0.98)%,Th17/Treg (39.25±3.25)% of PBC group were significantly higher than the control group (7.89±3.26)ng/L,(212.98±21.52)ng/L,(0.92±0.21)% and (12.98±3.12)%,while the PBC group Treg (3.11±0.85)% were lower than the control group (8.36±1.12)%.IL-21 were positive correlation with IL-17,Th17 (t=8.886,7.021,4.448,10.112,5.125,P<0.05).In vitro experiments showed that the addition of IL-21 in the culture system,the levels of Th17 (2.41±0.82)%,Th17/Treg cells(32.98±3.12)% were significantly higher than the control group(0.98±0.21)%,(12.25±3.25)%,while Treg (4.75 ±0.68)% were lower than the control group(11.85±0.96)%,the difference was statistically significant (8.521,6.489, 8.236,P<0.05).Conclusion IL-21 levels increased with the pathogenesis of PBC has a close relationship,which can pro-mote the reaction of PDC-E2 Th1 7/Treg immune imbalance caused thereby occurs mediated by PBC.

Objective To explore the best minimal invasive method in treating renal pelvic stones less than 1.5 cm.Methods A total of 90 patients with renal pelvic stone less than 1.5 cm were enrolled, including 47 cases of retrograde intrarenal surgery(RIRS)by rigid and flexible ureteroscopy with holmium laser lithotripsy,and 43 cases of percutaneous nephrolithotomy(PCNL)by holmium laser lithotripsy.Opera-tion time,stonefree rate(SFR),hospitalization,and complications were analyzed for comparison.Results The average sizes of stone in the RIRS group and PCNL group were 1.2 cm(range 1.0 ~1.5 cm)and 1.3 cm (1.0 ~1.5 cm),respectively.In the RIRS group,45(95.74%)patients out of 47 had complete clearance and 32 patients needed combination of flexible ureteroscopy to fragmentate the stones falling into the renal calices.The operation time was 44 min(range 27 ~70 min)with postoperative fever in 2 cases.The decrea-sing in hemoglobin and hematocrit was(0.18 ±0.06)g/L and 0.11%,respectively.No major complication was recorded.In PCNL group,the mean operation time was 70min(range 45 ~90 min)with a stone-free rate of 95.35%(41 /43).The decreasing in hemoglobin and hematocrit was(17.25 ±6.70)g/L and 5. 62%,respectively.The complications in PCNL group were postoperative fever in two cases and bleeding in two cases.Conclusion RIRS has the advantages of natural orifice endoscopic surgery in shortening opera-tion time,reducing blood transfusion requirements,and decreasing postoperative complications.For renal pelvic stone less than 1.5 cm,RIRS can be the primary choice.

In the medical field, the innovation education is to cultivate residents in China, which is an important way to senior medical elite. By analyzing competency-based neurosurgery residency training mode, the training methods for innovative ability of competency-based neurosurgeon are further discussed, for the purpose of reforming the training mode of neurosurgeon, improving creative ability and scientific clinical thinking ability.

Objective To explore the effect of gamma-aminobutyric acid (GABA) on the growth, apoptosis and telomerase activity of Cholangiocarcinoma cell line QBC939. Methods Cholangiocarcinoma cell line QBC939 was cultured by routine method, and then treated with different concentrations of GABA (1-1000 μmmol/L). The proliferation, apoptosis and cell cycle of QBC939 cells was investigated by MTT, Flow cytometry and transmission electron microscopy. The telomer-ase activity of QBC939 cells was examined by modified PCR-ELISA assay. Radioimmunoassay was used to measure the intracellular cyclic adenosine monophosphate(cAMP) content. Results The dif-ferent concentrations of GABA inhibited the growth of QBC939 cells and promoted the apoptosis. The apop-totic rate of QBC939 cells was increased from 4. 8% to 28. 03%, which had significant difference (P<0.05). It had no effect for distribution of cell cycle. Cell nuclear condensation and apoptotic bodies were seen by transmission electron microscopy. Telomerase activity was inhibited by GABA(0. 82±0. 048 vs 0.56±0. 054, P<0.05). The content of intracellular cAMP was increased with the increase of GABA concentration in a dose-dependent manner [(0. 59±0. 049) nmol/L vs (0. 82±0. 033)nmol/L, P<0. 05]. Conclusion GABA can inhibit the proliferation of QBC939 cells by promoting apoptosis and inhibiting telomerase activi-ty, which may be mediated by the information transmission of post-receptor.

Objective To investigate the significance of myelography for selecting operation methods in microendoscopic discectomy(MED).Methods A total of 196 patients with lumbar disc herniation diagnosed by CT/MRI received a myelography before MED.According to their clinical manifestations,signs,and outcomes of myelography,the patients were given three different operation methods.①Simple discectomy was performed in 105 patients with patent spinal canal,lateral impression at intervertebral level,and shift of the nerve root sleeve;②Discectomy with spinal decompression was performed in 70 patients with patent spinal canal and compression of the nerve root sleeve;③Discectomy with semilaminectomy was performed in 21 patients with patent spinal canal,semispherical compression of the nerve root sleeve,and 7-shaped nerve root.Results The operation time was 30~90 min(mean,50 min) and the intraoperative blood loss was 30~120 ml(mean,50 ml).No intraoperative complications occurred.Conversions to open surgery were required in 21 patients,including partial spinal stenosis in 16 patients and thickened vertebral plate in 5 patients.Follow-ups were carried out in 196 patients for 3~58 months(mean,34 months).According to the Japanese Orthopedic Association(JOA) scoring system,the final scores significantly increased postoperatively(25.86?2.96) than preoperatively(13.21?4.96)((t=)38.24,P=0.00).According to the Macnab and Watts standard,the rate of excellent or good results was 93.7%(164/175).Conclusions Myelography has an important reference value for selecting operation methods of microendoscopic discectomy in patients with lumbar disc herniation.

Objective To explore the clinical application of function-preserving pancreatic surgery for treating pancreatic neuroendocrine neoplasms (pNENs).Methods Twenty-eight patients with pNENs treated by the function-preserving pancreatic surgery at Anhui Province Hospital from January 2002 to December 2015 were analyzed retrospectively.Results Among the 28 patients, enucleation surgery was performed in 18 cases, distal pancreatectomy was performed in 8 cases, and middle pancreatectomy was performed in 2 patients.Total average operation time was (197±68) min, and the blood loss was (106±99) ml.The postoperative pancreatic fistula was observed in 7 patients, seroperitoneum was in 4 patients, incisional infection was in 1 patient, pulmonary infection was in 2 patients, and all the patients were cured by conservative treatment.There was no death during perioperative period.The postoperative hospital stay was (13±6)d.Analysis of pathological examination and clinical symptoms showed that 24 cases were diagnosed as functional pNENs (including 23 with insulinoma and 1 with gastrinoma), and 4 cases were as non-functional pNENs.The tumor grade G1 was categorized in 19 cases, G2 was in 9 cases.The TNM was I stage in all patients.There were no vascular or nerve invasion or lymph node metastasis.The follow-up period ranged from 4 to 144 months.2 patients were lost, and other patients were all alive.No diabetes or hypoglycemia occurred.Conclusions The function-preserving surgery for pNENs was safe and feasible, especially for well-differentiated functional pNENs.

Bile Duct Neoplasms ; surgery ; Bile Ducts ; pathology ; surgery ; Bile Ducts, Intrahepatic ; pathology ; surgery ; Biliary Tract Diseases ; surgery ; Biliary Tract Surgical Procedures ; methods ; trends ; Cholecystectomy, Laparoscopic ; methods ; trends ; Cholelithiasis ; surgery ; Humans