Humans ; Leiomyoma ; pathology ; Microtomy ; methods ; Microwaves ; Paraffin Embedding ; methods ; Specimen Handling ; methods ; Thyroid Neoplasms ; pathology

Objective To investigate the clinical efficacy and mechanism of vacuum-assisted closure (VAC) in the preoperative and postoperative treatment of bedsore united with skin flap.Methods Twenty two cases with bedsore were randomly divided into experimental and control groups.In the control group,the surgery of flap was performed after the treatment of continuous negative pressure about 7-10 days and the VAC was not applied after operation.While in the experimental group,VAC was not used before operation.It was applied on flaps as soon as sutured the border of flap and decubitus ulcers and removed after 7-10 days.By comparing the general appearance of two groups,microvessel count and the detection rate of bacterial culture and other indicators,the clinical effects of two treatments were investigated and the preliminary mechanism was analyzed.Results After preoperative VAC treatment,11 cases of control group showed a little granulation tissue growth,less subcutaneous hematoma and wound effusion,increased microvessel count and negative bacterial culture.However,there were 4 cases of death cavity residual,subcutaneous hematoma and wound effusion,positive bacterial culture and another 4 cases of delayed healing with skin flap repairing bedsore.The application of VAC in experimental group showed close contact of flap with the basement,less effusion,increased microvessel count and negative bacterial culture.One case of skin flap had a small area of separation,after the dressing of skin and the flap survived.The other wounds healed by first intention.Conclusions The use of VAC to repair bedsore can reduce the number of operation,and it is beneficial to the flap survival.

OBJECTIVETo investigate the combined treatment with areola approach for capsular contracture after breast augmentation with implants.

METHODSFrom Feb. 2005 to Jun. 2011, 94 cases (168 sides) with Baker III and IV capsular contracture after breast augmentation with implants were treated with areola approach. The implants cavity was recreated, with or without removal of capsule. The implants were reimplanted behind pectoralis major or breast at the second stage in some patients.

RESULTS46 cases were followed up by clinic visit and the others were followed up by telephone for 6-37 months, with an average of 9.9 months. The capsular contracture was relapsed in 2 cases as Baker III and 1 case as Baker IV. All the other breasts got a good appearance with good soft texture and feeling. No hematoma, infection, implants rupture, breast ptosis or implant displacement happened.

CONCLUSIONSCombined treatment with areola approach has a good therapeutic effect for capsular contracture after breast augmentation with implants. The breast appearance is satisfactory with low occurrence of capsular contracture.

Adult ; Breast Implantation ; adverse effects ; Contracture ; etiology ; surgery ; Female ; Humans ; Mammaplasty ; methods ; Postoperative Complications ; surgery

OBJECTIVETo investigate whether training in the department of urology will help interns acquire more knowledge on male reproductive health in such aspects as male erectile dysfunction (ED), premature ejaculation, male infertility (PE), male contraception, and so on.

METHODSSixty interns receiving rotatory training in the Department of Urology of the Peking University Third Hospital were recruited to complete a questionnaire designed by ourselves. A comparison was made of their knowledge on male reproductive health before and after their training in the department by using the chi-square statistical test in SPSS 11.0 software.

RESULTSWith regard to ED in such questions as "Do you regard ED as a disease affecting the aging male?" and "Do you regard ED as a local symptom of some male systemic disease?", all the interns knew significantly better after trained in the department of urology. Concerning the definition of ED and the effect of sildenafil citrate on ED, no significant difference was found in their knowledge between pre-training and post-training. As to patients' questions about ED, most of them showed interest but rarely made any initiative inquiries, which was not significantly changed after the training. Regarding PE, most of them knew very little even after trained, but they all thought of it as a disease affecting life quality. As regards male infertility, although some knew something about its definition and the normal parameters of semen routine analyses, others remained quite ignorant. As for male contraception, most of them knew little even after trained in the department.

CONCLUSIONInterns generally acquire more knowledge on male reproductive health after trained in the department of urology. However, in regard to male infertility and male contraception, their knowledge is quite insufficient, which implies the need for strengthening the training in the related aspects.

Adult ; Health Knowledge, Attitudes, Practice ; Humans ; Infertility, Male ; Internship and Residency ; Male ; Reproduction ; Surveys and Questionnaires ; Urology ; education

OBJECTIVETo investigate the subcellular expression of mammary serine proteinase inhibitor (Maspin) in oral squamous cell carcinoma and its relationship to the clinicopathological features.

METHODSThe Maspin protein subcellular expression was detected in 45 patients with oral squamous cell carcinoma by immunohistochemical staining. The relationship between the Maspin protein subcellular expression and the clinicopathological parameters was analyzed.

RESULTSThe negative rate of nuclear maspin expression was 64% (29/45), and the weakly positive rate was 11% (5/45), and the strong positive rate was 24% (11/45). Nuclear maspin expression was negatively correlated with T stage (P = 0.019), lymph node metastasis (P = 0.038) and postoperative metastasis (P = 0.004), but positively correlated with the patients' survival rate (P = 0.014). The negative rate of cytoplasmatic maspin expression was 38% (17/45), and the weakly positive rate was 31% (14/45), and the strong positive rate was 31% (14/45). Cytoplasmatic maspin expression was negatively correlated with lymph node metastasis (P = 0.038) and postoperative metastasis (P = 0.004), but positively correlated with the patients' survival rate (P = 0.014).

CONCLUSIONSMaspin expression may be a significant marker in predicting prognosis of oral squamous cell carcinoma.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Brain Neoplasms ; secondary ; Carcinoma, Squamous Cell ; metabolism ; pathology ; secondary ; Cytoplasm ; metabolism ; Female ; Humans ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms ; metabolism ; pathology ; Neoplasm Staging ; Serine Proteinase Inhibitors ; metabolism ; Serpins ; metabolism ; Survival Rate

OBJECTIVETo evaluate the effectiveness of sleeve circumcision of prepuce and coronary sulcus skin in the treatment of patients with multiple condyloma acuminatum (CA) of coronary sulcus of penis.

METHODSIn a randomized clinical control study, 35 patients were randomized to the treatment group and received sleeve circumcision of prepuce and coronary sulcus skin. 34 patients were randomized to the control group, received electric cauterization of verrucae plus the general circumcision. The recurrence of CA was evaluated in follow-up visit within three months after the treatment.

RESULTSThe stitches were taken out 10.2 days after operation in the treatment group, and 8.1 days in the control group. There were no complication in the treatment group, the average healing time of electric cauterization wound was 19.4 days in the control group. There was a statistically significant difference in the recurrence rate of CA between the treatment group and the control group (5.7% vs 26.5% , P <0.05).

CONCLUSIONSThe sleeve circumcision of prepuce and coronary sulcus skin is more effective than electric cauterization of verrucae plus the general circumcision in the treatment of patients with multiple condyloma acuminatum of coronary sulcus of penis.

Adult ; Circumcision, Male ; methods ; Condylomata Acuminata ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penile Diseases ; surgery ; virology ; Prospective Studies

OBJECTIVETo investigate the telomerase activity of human adipose derived stem cells (ADSCs) during proliferation and differentiation in vitro.

METHODSADSCs were highly purified and cultured in vitro. The morphology, phenotype and biological properties of the cultured ADSCs were observed by flow cytometer. Then ADSCs were induced to differentiate into adipocytes and osteoblast. The telomerase activity was detected by TRAP.

RESULTSADSCs had the ability of multi-directed differentiation, like adipocytes and osteoblast. It could also express the stem cell-related surface markers. The telomerase activity was negative or lowly expressed in ADSCs in vitro within 12 generations. The telomerase activity was up-regulated when ADSCs was adipogenic differentiated, but deceased 3-6 days later.

CONCLUSIONSThe telomerase activity of ADSCs is not changed during culture in vitro. It is up-regulated when ADSCs are induced to adipogenic differentiation, but decreased later.

Adipocytes ; cytology ; metabolism ; Adult ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Female ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Stem Cells ; cytology ; metabolism ; Telomerase ; metabolism ; Young Adult

BACKGROUNDSimultaneous pancreas-kidney transplantation (SPKT) frees the diabetic patient with end-stage nephropathy from dialysis and daily insulin injections. Herein, we review consecutive cases of SPKT with bladder drainage performed at our institution over an 8-year period.

METHODSThe study population included 21 patients (16 males and 5 females) who underwent SPKT between September 2001 and September 2009. Seven patients had type-1 diabetes and 14 had type-2 diabetes. Nineteen patients were on dialysis at the time of transplantation. Donation after cardiac death donors were selected for SPKT. The mean human leukocyte antigen match was 2 (range 0 - 4). SPKT was always performed using bladder drainage and vascular anastomoses to the systemic circulation. Immunosuppressive treatment consisted of anti-lymphocyte globulin induction followed by tacrolimus, mycophenolate mofetil, and prednisone.

RESULTSThe mean hospital stay was 45.43 days. After a mean follow-up of 39.4 months, survival rates for patient, kidney, and pancreas were 76.2%, 76.2%, and 66.7% at 1 year; 76.2%, 59.3%, and 55.6% at 5 years; and 57.1%, 39.5%, and 41.7% at 8 years, respectively. Major complications included anastomotic leaks, reflux pancreatitis, and rejection. Six patients died from septic shock (n = 3), duodenal stump leak (1), cardiac arrest (1), or renal failure (1). Eight kidney grafts were lost due to acute rejection (n = 2), chronic rejection (3), and death with a functioning graft (3). Pancreatic graft failure (9) was caused by thrombosis (n = 1), rejection (2), duodenal stump leak (1), and death with a functioning graft (5).

CONCLUSIONSSPKT is a valid therapeutic option for uremic diabetics although few hospitals in China can undertake SPKT.

Adult ; Diabetes Mellitus, Type 1 ; surgery ; Diabetes Mellitus, Type 2 ; surgery ; Female ; Graft Rejection ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; adverse effects ; mortality ; statistics & numerical data ; Male ; Middle Aged ; Pancreas Transplantation ; adverse effects ; mortality ; statistics & numerical data ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Urinary Catheterization

Objective To report our experience with retroperitoneoscopic nephroureterectomy with excision of a bladder-cuff for renal pelvic and ureteral tumors.Methods Thirty-five patients (21 women and 14 men;mean age,67 years;age range,49 -82 years) with upper urinary tract tumors underwent retro- peritoneal laparoscopic nephrourcterectomy with excision of a bladder-cuff.Of the 35 cases,15 had pelvic tumors and 20 had ureteral tumors;19 cases had the tumors on the right side and 16 on the left.Two cases had ureteral tumors combined with bladder tumors.One case had bilateral ureteral tumors then concomitantly had bladder tumors.The needle electrode was used to circleround incise the bladder thoroughly 0.5 cm away from the ureterostoma.Three trocars in the waist were used for dissecting the kidney;and the ureter was dis- sected as far distally downward.Then an incision of 5-9 cm was created in the lower abdomen to allow dis- section of the distal ureter and bladder-cuff and intact specimen extraction.Results The operation was successful in all 35 patients.The mean operative time was 3.1 h ( range,1.5-6.0h).The mean estimated blood loss was 166 ml (range,20-1600 ml).Four cases received blood transfusion.The patient's activity re- covered in 20-32 h after operation.Postoperative pathology showed transitional cell carcinoma in 30 cases, poorly differentiated adenocareinoma in 2 (ureter),squamous cell carcinoma in 1 (ureter),leiomyosarcoma in 1 (ureter),xanthogranulomatous pyelonephritis in 1.Duodenal leakage occurred in 1 patient who had had dialysis a drainage catheter was placed on the third d after operation,and the patient died of heart failure af- ter 2 months.Postoperative vesical irrigation was performed to prevent tumor recurrence.The mean hospital stay was 11 d.During a mean follow-up of 14 months(range,1-32 months),1 patient developed pelvic me- tastasis and was alive with the tumor.The other 33 patients survived free of tumor to date.No patient had re- current transitional cell carcinoma of the bladder.Conclusions Our data demonstrate that retroperitoneo- scopic nephroureterectomy for renal pelvic and ureteral tumors has shorter incision and more rapid postopera- tive recovery compared with open surgery.Using resectoscope to resect the termination of ureter allows more complete excision of the ureter.

OBJECTIVETo study the anti-tumor immunotherapeutic effect induced by the suicidalcancer vaccine FC/TK, and to evaluate the safety of this vaccine.

METHODSThe suicidal cancer vaccine, named FC/TK, was prepared by fusion of suicide gene (HSVI,-TK gene) -modified ovarian carcinoma NuTu-19 cells with rat bone marrow-derived dendritic cells (DCs). The morphology of FC/TK was evaluated by scanning electron microscopy. The stimulatory effect of FC/TK on T cells was determined by T cell proliferation assay. In immunotherapeutic studies in vivo, Fischer344 rats were injected subcutaneously with NuTu-19 cells, followed by treatment of FC/TK on days 7 and 14, compared to controls treated with irradiated FC/TK, FC or PBS, respectively. Tumor incidence and volume were measured in 90 days after challenge. To determine the killing effect of FC/TK in vivo, TUNEL assays were applied to detect apoptotic cell death in spleen of vaccinated rats with prodrug ganciclovir administration.

RESULTSFC/TK cells were of irregular shape with surface membrane processes. Compared to the control groups, FC/TK significantly promoted T cell proliferation (P <0.01). The rats vaccinated with FC/TK and FC significantly inhibited the tumor growth compared to rats vaccinated with irradiated FC/TK (P <0.05) or with PBS ( P <0.01). The immunotherapeutic effect induced by FC/TK was similar to that using FC. Fluorescence microscopy showed that fluorescein-stained FC/TK cells migrated into spleen also showed to be TUNEL-positive, suggesting that the FC/TK cells were killed by ganciclovir in vivo.

CONCLUSIONOur data indicate that suicidal cancer vaccine is an effective and safe therapy for ovarian carcinoma and may serve as a broadly applicable approach for other cancer vaccines in the future.

Animals ; Apoptosis ; drug effects ; Cancer Vaccines ; immunology ; Cell Fusion ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dendritic Cells ; cytology ; immunology ; Female ; Ganciclovir ; pharmacology ; Genes, Transgenic, Suicide ; Herpesvirus 1, Human ; enzymology ; genetics ; Immunotherapy ; methods ; Microscopy, Electron, Scanning ; Microscopy, Fluorescence ; Neoplasms, Experimental ; enzymology ; pathology ; therapy ; Ovarian Neoplasms ; enzymology ; pathology ; therapy ; Rats ; Rats, Inbred F344 ; Survival Analysis ; T-Lymphocytes ; drug effects ; metabolism ; pathology ; Thymidine Kinase ; genetics ; metabolism ; Transfection