Objective To assess the continent diversion results of sigma rectum pouch after radical cystectomy. Methods The reconstruction of bladder with sigmoid was modified for treatment of 18 cases of bladder tumor.The intestine was incised over a length of 20～24 cm with the junction of sigmoid colon and rectum as the midpoint so as to create a low pressure reservoir for urine and side-to-side anastomosis was performed on the posterior borders of the rectosigmoid wall.Submucosal tunnel modified technique was em- ployed in antireflux urethral implantation,Urination has been controlled by anal sphincter.Results About 80 minutes was spent to finish a new low pressure pouch after radical cystectomy.Among 18 patients with this op- eration,the controlled emiction were good after pull out the anal duct and"J"stent in 1 week to 2 months.Af- ter 2 months,the times of urination is stable,4～5 times in daytime and 1～3 times during nighttime.Two pa- tients had nocturnal enuresis and the symptom vanished after 2 months. One patient had adhesive ileus, two patients had hyperchloremia acidosis and kaliopenia,one patient had urethral stump cancer.There is no com- plication as anastomotic block,renal function lesion and severe upper urinary tract infection. Conclusion This operative method was easy,emiction control was well,and with higher quality of life for patients.It is al- so a better alternative diversion procedure that would be easily accepted.

Oxidative stress can induce significant cell death by apoptosis. We explore whether prior exposure to H2O2 (H2O2 preconditioning) protects PC12 cells against the apoptotic consequences of subsequent oxidative damages and what role the ATP-sensitive potassium (K(ATP)) channels play in the preconditioning protection. PC12 cells were preconditioned with 90 min exposure to H2O2 at 10 micromol/L, followed by 24-h recovery and subsequent exposures to different concentrations (20, 30, 50 and 100 micromol/L) of H2O2 for 24 h respectively. We used PI staining flow cytometry (FCM) to observe the apoptosis of PC12 cells. It was shown that 24-h exposures to H2O2 at 20, 30, 50 and 100 micromol/L respectively induced substantial cell apoptosis, which was greatly prevented in the preconditioning cells, indicating that H2O2 preconditioning protected PC12 cells against apoptosis induced by H2O2. Administration of pinacidil (10 micromol/L), an K(ATP) channel activator, significantly attenuated the apoptosis of PC12 cells induced by H2O2 at 30 and 50 micromol/L for 24 h respectively. Glybenclamide (10 micromol/L), a K(ATP) channel inhibitor, significantly suppressed or abolished the protective effects caused by the pinacidil but not by H2O2 preconditioning. However, when both H2O2 preconditioning and pinacidil were co-applied, their protection against the apoptosis of PC12 cells was much stronger than that of the individual one of them. These results suggest that H2O2 preconditioning protects PC12 cells against apoptosis and that the activation of K(ATP) channels is not involved in, but synergetically enhances adaptive protection of H2O2 preconditioning.
Animals ; Apoptosis ; drug effects ; Hydrogen Peroxide ; pharmacology ; Oxidants ; pharmacology ; Oxidative Stress ; PC12 Cells ; Potassium Channels ; metabolism ; Rats

OBJECTIVETFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.

METHODSPubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.

RESULTSNine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.

CONCLUSIONThe current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.

Bone Nails ; Bone Wires ; Clavicle ; injuries ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Randomized Controlled Trials as Topic

OBJECTIVETo observe the clinical effect of a combined therapy in the treatment of simple premature ejaculation.

METHODSA total number of 110 patients with simple premature ejaculation were divided into a control group (n = 50), given oral hydrochloric acid sertraline only, and a combined therapy group (n = 60), treated by oral administration of hydrochloric acid sertraline, local inunction of a traditional Chinese medicine and guidance in sexual psychology and knowledge. At the end of a 4-week treatment and 4 weeks after the drug withdrawal, the therapeutic effects were evaluated by ejaculation latency and satisfaction with sexual life.

RESULTSThe total effectiveness rates at the end of the 4-week treatment were 91.6% and 76% in the combined therapy and the control groups, while those 4 weeks after the drug withdrawal were 68.3% and 42% respectively, both with significant differences in between (P < 0.05 and P < 0.01).

CONCLUSIONThe combined therapy has a satisfactory clinical effect and stability in the treatment of simple premature ejaculation.

Adult ; Antidepressive Agents ; chemistry ; therapeutic use ; Combined Modality Therapy ; Ejaculation ; Humans ; Hydrochloric Acid ; chemistry ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Psychotherapy ; methods ; Sertraline ; chemistry ; therapeutic use ; Sexual Dysfunction, Physiological ; physiopathology ; psychology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo analyze the relationship between hepatitis B virus (HBV) precore (PC) and basal core promoter (BCP) mutations and HBV-related acute-on-chronic liver failure (HB-ACLF).

METHODSForty-four patients with HB-ACLF and 28 patients with chronic hepatitis B (CHB; used as controls) were enrolled and venous blood samples were collected from all individuals. The PC and BCP gene fragments were amplified by nested PCR. HBV genotype and BCP/PC mutations were determined by direct sequencing and analysis by BioEdit (version 7.0.9.0). Ten of the HB-ACLF patients were selected for follow-up (range: 2-8 weeks), which included once weekly sera collection to determine the relation of mutations and treatment response. Serum levels of HBV DNA were measured by real-time PCR assay, and alanine aminotransferase, total bilirubin, creatinine and albumin were measured by standard biochemical assay and used to determine the MELD score.

RESULTSAll 44 HB-ACLF patients were infected with HBV genotype C. In the CHB group, 26 patients were infected with genotype C and two with genotype B. Single mutations (A1762T, G1764A, T1753V, G1896A, and G1899A) and combined mutations (A1762T + G1764A, G1896A + G1899A, T1753V+ A1762T + G1764A, G1896A + G1899A + A1762T + G1764A, and A1762T + G1764A + G1896A) were more frequently detected in HB-ACLF patients than in CHB patients (P less than 0.05). A significantly higher proportion of PC/BCP wild-type sequences was found in patients with CHB than in patients with HB-ACLF (17.9% vs. 2.3%; x² = 5.440, P = 0.020). The proportion of patients carrying both PC and BCP mutations was significantly higher in HB-ACLF patients than in CHB patients (79.6% vs. 39.3%; x² = 12.021, P = 0.001). The proportion of patients carrying only BCP mutation was 42.9% in the CHB group and 20.5% in the HB-ACLF group (x² = 4.157, P = 0.041). No occurrences of only PC mutation were detected in either the CHB or HB-ACLF group. The combined mutations were present in all 10 of the HB-ACLF follow-up patients. Mutations G1899A, T1753V, and A1846T were correlated with disease recovery. Significant decreases in the MELD score were accompanied by decreases in the A1846T mutation.

CONCLUSIONSignificantly more HB-ACLF patients carried HBV with mutations in the PC and BCP than CHB patients. Moreover, more HB-ACLF patients carried HBV with PC + BCP combined mutations and PC mutation only. The G1899A, T1753C, and A1846T mutations were associated with HB-ACLF response to treatment and improvement in liver function.

Adult ; Case-Control Studies ; DNA, Viral ; genetics ; End Stage Liver Disease ; Female ; Genetic Variation ; Genotype ; Hepatitis B ; virology ; Hepatitis B Core Antigens ; genetics ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Liver Failure ; virology ; Male ; Middle Aged ; Mutation ; Promoter Regions, Genetic

This study was aimed to investigate the expression of c-MPL in acute myeloid leukemia (AML) and the correlation of the c-MPL expression with CD34 and CD38, so as to define the expression of c-MPL in leukemic stem cells. The expression levels of CD34, CD38 and c-MPL were detected by flow cytometry in bone marrow cells from 29 newly diagnosed AML patients. The relationship of c-MPL positive cell ratio with clinical parameters and correlation of c-MPL with CD34 and CD38 expression in AML patients were analyzed. The results showed that expression level of c-MPL in AML patients was significantly higher than that of normal controls (P < 0.05), and the expression level of c-MPL did not correlate with age, sex, white blood cell count, AML1-ETO fusion gene and remission after chemotherapy, but the expression of c-MPL in M2 and M5 patients was higher than that of normal control (P < 0.05). Expression of c-MPL in CD34 positive AML patients was obviously higher than that in CD34 negative AML patients (P < 0.01). c-MPL was significantly higher expressed in CD34(+) cells than that in CD34(-) cells (P < 0.001), while c-MPL expression was not significantly different between CD34(+)CD38(-) and CD34(+)CD38(-) cell groups. Positive correlation between c-MPL and CD34 expression was observed (r = 0.380, P = 0.042). It is concluded that expression of c-MPL is higher in AML patients, and positively correlates with the expression level of CD34. The c-MPL expresses in leukemic stem cells.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Male ; Middle Aged ; Neoplastic Stem Cells ; metabolism ; Receptors, Thrombopoietin ; metabolism ; Young Adult

OBJECTIVE:To establish the method for "taste" identification of Cyathula officinalis.METHODS:The "taste" of C.officinalis was detected by using electronic tongue:sampling temperature of 25 ℃,sampling time of 120 s,sampling period of 1 s,rolling speed of 1 r/s,cleaning solution of purified water.The response value of electronic tongue sensor at 120 s were used as "taste" analysis data and obtained "taste" related data was analyzed through principal component (PC) analysis and discriminant factor (DF) analysis.C.officinalis and its adulterants,C.officinalis from different regions,different ages and different batches were distinguished.RESULTS:There was significant difference in DF between one batch of C.officinalis and 4 batches of adulterants.The samples from Sichuan Baoxing,Jinkouhe,Tianquan could be clustered together.There was significant difference in DF between annual or biennial samples and triennial or quadrennial samples.There was also significant difference in DF among different batches.CONCLUSIONS:The "taste" is different significantly between C.officinalis and its adulterants,among different regions,different ages and different batches of samples.Electronic tongue can quickly distinguish "taste" of above medicinal materials.

OBJECTIVE Despite the status of cisplatin (DDP) as a classical chemotherapeutic agent in the treatment of cancer, the development of multidrug resistance often leads to a failure of DDP therapy.Traditional Chinese medicine(TCM)as adjuvant chemotherapy of cancer drugs in China has been widely used in cancer treatment.ZuoJin WAN (ZJW),a TCM formula,was proved reversing drug resistance in gastric cancer,but its exact mechanism was still unclear. METHODS CCK-8 assay was used to detect the cell viability. The levels of proteins and mRNA were evaluated using Western blot and q-PCR. Mitochondrial membrane potential was measured by fl ow cytometry. Depolymerisa-tion of F-actin and translocation of G-actin(gamma-actin)from the cytoplasm to the mitochondria was detected using an immuno fl uorescence assay. RESULTS phosphorylated coflin-1 (p-coflin-1) was overexpressed in the DDP-resistant human gastric cancer cell lines SGC7901/DDP and BGC823/DDP, relative to the respective parent cell lines(SGC7901 and BGC823),and DDP induced the dephosphory-lation of p-coflin-1 in both parent lines but not in the DDP-resistant lines. However, ZJW could induce the dephosphorylation of pcoflin-1 and promote coflin-1 translocation from the cytoplasm into the mito-chondria in both SGC7901/DDP and BGC823/DDP cells. This mitochondrial translocation of coflin-1 was found to induce the conversion of flamentous actin to globular-actin, activate mitochondrial dam-age and calcium overloading, and induce the mitochondrial apoptosis pathway. These effects of ZJW on DDP-resistant human gastric cancer cell lines could be reversed via transfection with coflin-1-specifc siRNA,or treatment with a PP1 and PP2A inhibitor.CONCLUSION ZJW can be used as an inhibitor of chemoresistance in gastric cancer, which may partly be due to dephosphorylation of p-coflin-1 via the activation of PP1 and PP2A.

Objective: To explore the application of asymmetrical sculpture in the ear reconstruction with autologous cartilage through comparing the difference of the balanced sculpture and asymmetrical sculpture. Methods: We used the method of retrospective survey and classified the patients who had undergone ear reconstruction because of microtia into two groups. Group A included the patients who had undergone operation with the application of balanced sculpture method. Group B included the patients who had undergone operation with the application of unsymmetrical sculpture method. We picked out 35 patients containing 19 patients of group A and 16 patients of group B according to our grouping criteria and exclusion criteria. The number of cases with complications was recorded, such as collapse of framework, exposure of cartilage, necrosis of skin flap and reconstructed ear infection. The clinical outcomes of two methods in refining the delicate structures of the reconstructed ear were evaluated (that is the definition, shape, size, color and projection). The time for sculpture was compared. Then we analysed the results and evaluated the effectiveness, safety and feasibility of asymmetrical sculpture′s application in the ear reconstruction. Results: Group A had 2 cases which suffered skin flap necrosis. One of them had cartilage exposure and then had secondary infection leading to local cartilage necrosis and absorption, but after active treatment and local skin flap transplantation it was cured. Group B had no skin flap necrosis, cartilage extrusion, framework deformation and distortion, framework collapse and necrosis or absorption. Group B had a higher score in definition, shape, size, color and projection, and the difference was significant in definition, shape, color and projection. In our clinical practice, the sculpture time in both group was similarly about 40 minutes after the surgery operator had skillfully mastered both techniques. Conclusions Both methods are safe and feasible. The method of asymmetrical sculpture does not require additional operative time, and the method of asymmetrical sculpture is a better one compared with the method of balanced sculpture in refining the reconstructed ear.

Humans ; Tranexamic Acid ; Atrial Fibrillation ; Antifibrinolytic Agents ; Arthroplasty ; Blood Loss, Surgical ; Arthroplasty, Replacement, Hip