Objective To study a new procedure of surgical repairment of rectourethral fistula.Method By the perineum approach one stage urethroplasty using island skin tubes from perineum and scrotum has been adopted after the resection of fistular urethra and repairment of the defect of the anterior wall of rectum to substitute the defect of urethra in 9 cases during 1992-1998.Result The 9 cases were all cured and have been followed-up for 2 6 years without recurrence of rectourethral fistula.Conclusion This procedure was regarded as an ideal technique for the closure of rectourethral fistula especially for those complicated with urethra stricture.

Objective To investigate the protective mechanism of cyclosporine A to renal autografts in situ.Methods Thirty rabbits were divided into three groups at random (n=10 in each group), subjected to left renal in situ perfusion with normal saline (control group), HC-A solution (HC-A group) and HC-A solution containing CsA (30 ml/L, experimental group) respectively. By ~using self-made in situ cryopreservation device, the left kidney was cryopreserved in situ at 0-4 ℃ for 2 h. Then the right kidney was dissected and the left renal blood flow was opened. At 6th h and 24th h after reperfusion, blood BUN and Cr levels were determined. At 24th h, the left kidneys were ~dissected for the detection of the expression of HSP70 and NF-?B in left renal tissues. The apoptotic rate in left renal tissues was assayed by in situ end-labeling method. Results In the experimental group, the expression level of HSP70 was significantly higher, while the expression of NF-?B and ~apoptotic rate significantly lower than in the other two groups (all P

BACKGROUND: The quantitative measurements based on magnetic resonance imaging (MRI) have been vastly used in evaluating the therapeutic efficacy on multiple sclerosis (MS).OBJ ECTIVE: To determine whether the effect of IFNB-1b on brain atrophy of MS could be shown with analysis of MRI measurement.DESIGN: Randomized controlled observation.SETTING : Center for Neurological Diseases, Utano National Hospital.PARTICIPANTS: Totally 188 patients with MS, including 55 males and 133 females aged from 16-59 years, averagely(36±11) years, from Center for Neurological Diseases, UtanoNational Hospital from January to December 1998 were enrolled. Inclusive criteria: ①according to Poser RR type criteria were considered as having MS for enrollment, ②Expanded Disability Status Scale (EDSS) score of 7.0 or less, ③at least 1 relapse in the past year or at least 2 relapses in the past two years prior to enrollment, but no relapse for 30 days before enrollment, stable neurological state for at least 1 month and negative results of the IFNB-1b needle-prick test, and ④they all knew the detected items and agreed. In the included patients, there were 148 cases of optic nerves and spinal cord type and 40 cases of classical type.METHODS: ①Drug treatment: All the patients were treated with IFNB-1b injectable preparation (provided by Japanese Pharmaceuticals Company). According to the different injected dosage, the patients were divided into low-dosage group (n =93) and high-dosage group (n =95), given with 1.6 million U and 8 million U of IFNB-1b subcutaneously on alternate days for 2 years. ②MRI examination: The patients received MRI in lesion site (optic nerves, cerebrum, cerebellum, brainstem, and spinal cord). T1 and T2-weighted axial MRI scan were performed by a single neurologist. The area of the MS lesions in T2-weighted images was summed slice by slice for a total lesion area and was recorded as mm2. Third ventricle, lateral ventricle width and brain width were measured and expressed by atrophy rate. ③Neurologic impairment examination: Neurologic impairment was evaluated with Kurtzke EDSS (from 0 point to 10 points, 0 point as normal, the higher score represented severe condition). ④Analysis of related factors: Correlation analysis was performed in brain atrophy condition and T2 focus area with EDSS score in 148 MS patients with typical MS. At the same time,correlation analysis was conducted between variance (age, progress, relapse rate, T2 focus area and EDSS score) and brain atrophy.MAIN OUTCOME MEASURES: ①Comparison of brain atrophy in patients of the two groups, and ②analysis of related factors of brain atrophy measurements.RESULTS: Totally 188 patients were involved in the result analysis. ①Outcome of brain atrophy comparison in the two groups: In classical type MS the rates of atrophy measures in high-dosage group were 2.84%, 3.15%, and 1.3% in lateral ventricle width, third ventricle width and brain width, respectively, and significantly lower than those in low-dosage group (4.09%, 5.36% and 1.97%, P ＜ 0.01). In optic nerve and spinal cord type MS patients, the rates of brain atrophy were 0.9%, 1.55% and 0.6% in lateral ventricle width, third ventricle width and brain width, respectively in high-dosage group, and there was no significant difference as compared with the low-dosage group (1.65%, 1.75% and 0.7%, P ＜0.05). ②There was significant correlation of lateral ventricle width, T2 focus area and EDSS score in classical MS patients (r =0.33,0.27, P ＜ 0.01 ). There was significant correlation of third ventricle width, T2 focus area and EDSS score (r=0.31,0.29, P ＜ 0.05). There was significant correlation of brain width, T2 focus area and EDSS score (r =0.11,0.14, P ＜0.05). There was significant correlation of baseline EDSS score and T2 focus area with lateral ventricle width (r =0.23,0.33, P ＜ 0.05). The other baseline variables failed to show a significant contribution to the process.CONCLUSION: The effects of IFNB-1b on brain atrophy were positive and significant differences were also found between both high- and low-dosage groups. This brain atrophy measurement provides an independent MRI confirmation of a therapy and dose effect of IFNB-1b for MS.

OBJECTIVE To analyse the result of mastoid abnormal MRI singals in infants without clinical symptoms and to evaluate the diagnostic value. METHODS The MRI data of abnormal signals in the middle ear and mastoid of 42 infants(62 ears) were analyzed with 1000 Hz probe tone tympanometry and oto-endoscope. RESULTS Of the infants with abnormal MRI signals of the middle ear and mastoid, 50 ears were secretory otitis media(80.7％), 10 ears had dysfunction of middle ear (16.1％), and 2 ears were not identified. CONCLUSION In the infant who had a abnormal long T2 singals MRI but without clinical symptoms, 80.7％ were caused by SOM or AOM. It is valuable for clinical efficacy evaluation and treatment planning in advance.

Objective:To summarize the clinical experiences of managing patients with novel coronavirus(2019-nCoV) infection after kidney transplantation.Methods:Clinical data were retrospectively analyzed for two patients with 2019-nCoV infection after renal transplantation in January 2020. Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months post-transplantation. CT imaging showed multiple patchy ground-glass opacities of both lungs. Case 2 was a 59-year-old male who screened positive for 2019-nCoV nucleic acid due to fever at 9 days post-transplantation and he showed no clinical manifestations of pneumonia. After a definite diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium plus linezolid for anti-infection, gamma globulin for enhancing immunity, methylprednisolone for controlling inflammatory responses and antiviral regimens of arbidol tablets plus lopina-velitonavir tablets. Case 2 was isolated in a single room. The treatment plan included cefoperazone sulbactam sodium for anti-infection, gamma globulin for enhancing immunity, arbidol for antiviral therapy and other symptomatic measures.Results:During a follow-up period of 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test of nasopharyngeal swab turned negative and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms and nucleic acid test of nasopharyngeal swab turned negative thrice.Conclusions:Renal transplant recipients should take precautions to avoid exposure to high-risk environments. A definite diagnosis should be made on the basis of clinical manifestations and results of nucleic acid test and pulmonary imaging. Currently there is no effective antiviral agent and symptomatic treatment is a major option.

Objective:To explore and analyze the clinical characteristics, diagnosis and treatment of infant hairy polyp.Methods:A retrospective analysis was made on 13 cases of hairy polyp confirmed by pathology, who were admitted to the Children′s Hospital of Hebei Province from January 2010 to September 2019, including 4 males and 9 females, with a male-female ratio of 1∶2.25. The age ranged from 3 hours to 1 year, and the median age was 1 month. Twelve of the 13 children were found to have difficulty breathing or feeding. All the children received coblation resection under general anesthesia. The root pedicle of the mass was found in the lateral nasopharyngeal wall in 8 cases, in the junction of palatine and palatopharyngeal arch of tonsil and the tongue and esophageal entrance in 1 case, respectively. Nasal septum was found in 2 cases, including 1 case located between two incisors. The wound at the root pedicle was ablated and the bleeding was stopped completely.Results:Postoperative follow-up lasted from 3 months to 2 years, and there was no recurrence in 12 cases. Fibrolaryngoscope showed a mass of the right eustachian tube and pharyngeal mouth in 1 case 2 years after the surgery, which was considered recurrence of hairy polyps and lost after that.Conclusion:Hairy polyps in infants is a rare clinical disease, and its main symptom is upper respiratory tract obstruction. Early diagnosis and radical surgery are the key to the treatment of the disease.

Objective: To investigate the clinical experience of patients with novel coronavirus (2019-ncov) infection after kidney transplantation. Method: Clinical data of two patients with 2019-nCoV infection after renal transplantationin Jan 2020 Renmin Hospital of Wuhan Universiyt were retrospectively analyzed.Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months after transplantation. CT imaging showed multiple patchy ground-glass images of both lungs. Case 2 was a 59-year-old male, who was screened positive for 2019-nCoV nucleic acid due to fever at 9 days after renal transplantation and showed no clinical manifestations of pneumonia. After diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium + linezolid to resist infection, gamma globulin to enhance immunity function, methylprednisolone to control inflammatory response, antiviral regimens including arbidol tablets + lopina-velitonavir tablets. Case 2 was treated with isolated treatment in a single room. The treatment plan included anti-infection (cefoperazone sulbactam sodium), enhancing immunity function (gamma globulin), antivirus therapy with arbidol and other symptomatic treatment. Result: Follow up with 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test with nasopharyngeal swabs turned negative, and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms, and the nucleic acid test of nasopharyngeal swabs turned negative for 3 times. Conclusion Renal transplant recipients should receive fine protection to avoid exposure to high-risk environments. Diagnosis should be defined with combination of clinical manifestations, nucleic acid test and pulmonary imaging. At present, there are no antiviral drugs and symptomatic treatment is the main choice.

This study was designed to investigate the effect of Gegen Qinlian(GGQL) Decoction and its different compatibility groups on gut microbiota in rats with acute enteritis, and to explore the efficacy of GGQL Decoction in improving acute enteritis and gut microbiota. Male SD rats were randomly divided into control group, model group, positive control group(SASP), GGQL decoction group, Glycyrrhizae-free group(QGC), Puerariae-free group(QGG), Qinlian-free group(QQL), and Qinlian group(QL). The pathological sections and detection indexes of the rats were observed before and after modeling and administration. After 7 days of administration, fecal samples from 24 rats were collected and Illumina Miseq platform was used for high-throughput sequencing. From the anti-inflammatory and pharmacodynamic indicators, the effect was the most obvious in GGQL Decoction group, QGC group, QGG group and QL group(P<0.05). The alpha diversity and beta diversity showed that there were significant differences in the composition of intestinal flora in each group. As compared with the model group, the increased abundance and diversity of the flora caused by acute inflammation could be down-regulated in all groups except QQL group(P<0.05). The differential bacteria were explored by using LEfSe analysis, and the results showed that Bifidobacterium and other beneficial bacteria only appeared in the normal group. As compared with the normal group, Lactobacillus was significantly reduced(P<0.01), and Bacteroides, Flavonifractor and Clostridium_sensu_stricto_1 were up-regulated in model group(P<0.05, P<0.01). As compared with the model group, the number of Akkermansia was significantly increased(P<0.05), and the number of Clostridium_sensu_stricto_1 associated with intestinal inflammatory diseases was decreased in the GGQL Decoction group, QGC group and QL group. QGC group and QQL group caused the up-regulation of Ruminococcaceae and induced enrichment of Desulfovibrio which could lead to colon cell toxicity; QGG group caused the up-regulation of Proteobacteria and Burkhonderiales. The study suggests that the GGQL Decoction may play a role in the treatment of acute enteritis partially through improving the intestinal barrier, regulating the immune response and the structure of gut microbiota.
Animals ; Bacteria/classification* ; Drugs, Chinese Herbal/pharmacology* ; Enteritis/drug therapy* ; Feces ; Gastrointestinal Microbiome/drug effects* ; High-Throughput Nucleotide Sequencing ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2