Objective To investigate the feasibility of an ileal reservoir with self controllable urination. Methods A segment of ileum was under taken,the middle portion of which was made into a N shaped reservoir and the proximal portion used as the afferent limb.The distal ileum was pulled out and the two skin flaps were taken and encircled the efferent ileum to constitute the urinary outflow.A urinary controller similar to penile clamp was applied to control the urination with a balloon catheter. Results Ten dogs and five patients underwent this procedure and the patients were followed up for 3 to 14 months.Urodynamic examination showed that on the third month,the reservoir in animals reached a maximum capacity of (150?40)ml and a full filling pressure of (24.4?5.3)cmH 2O.The reservoir in the patients reached a maximum capacity of (290?80)ml,a full filling pressure of (36.3?8.2)cmH 2O,a maximum urinary flow rate of (20.3?4.7)ml/s with no residual urine.X ray examination showed good excretory function of the kidney without hydronephrosis.All patients can control urination themselves through the use of the urinary controller. Conclusions The new procedure has the advantages of self control lable of urination,simple surgical performance and few complications.

BACKGROUND:It is accepted that the best method for spermatogonial stem cells separation is using artificial cryptorchism model combined with surface makers.OBJECTIVE:To explore the feasibility of separation spermatogonial stem cells with ?6-integrin and c-kit as specific surface markers.DESIGN,TIME AND SETTING:The randomized control experiment was performed at the Renmin Hospital of Wuhan University from May to December 2006.MATERIALS:Forty adult,white Kunming mice with 6 weeks old were randomly divided into cryptorchidism and control groups,with 20 animals in each group.METHODS:Artificial cryptorchidism model was prepared by made an incision at the median of abdomen,and testis was pulled into abdominal cavity,which was fixed at the each side of lateral abdominal wall.There was no treatment in the control group.The single cell suspension of seminiferous epithelium was obtained by traditional two step enzyme digestion at 2-3 months after operation.FITC-conjugated anti-?6-intergrin antibody and PE-conjugated anti-c-kit antibodies were added.Then the cells with low side scatter light-scattering properties were sorted and positively stained for ?6-intergrin and negative c-kit expression.Meanwhile,the viability of the isolated cells was assessed by trypan blue staining.MAIN OUTCOME MEASURES:The morphological changes of cryptorchidism,and the sorting results of spermatogonial stem cells.RESULTS:Cell distribution in seminiferous tubule was disorder with reduced numbers.The layer and lumens were disappeared,and cell division phase could be seen in the center of tubules.Compared to the control group,the testicular cells in the cryptorchidism group were increased in the side scatterlow,Forward scatterhi areas,with figure left-upward displacement.The distribution of ?6-integrin+ and c-kit cells were deviated each other,it named that most ?6-integrin+ cell were not spermatogonial stem cells,so do the c-kit-cells.Only 2.8% of testicular cells exhibited side scatterlow,?6-integrin+,and c-kit-,which were spermatogonial stem cells in the cryptorchidism group.And trypan blue staining showed that over 95% of them were viable.CONCLUSION:Using the two surface markers to sort spermatogonial stem cells can advance the purity of the spermatogonial stem cells in cell suspension,but the specificity is insufficient.

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) have been induced to differentiate into cardiomyocyte-like cells in vitro.OBJECTIVE:To explore the association between GATA-4, Nkx-2.5 and α-myosin heavy chain (α-MHC) expression and cell morphological changes and structure formation in the process of BMSCs differentiation into cardiomyocyte-like cells.METHODS:By using myocardial lysate, BMSCs were induced to differentiate into cardiomyocytes.Immunocytochemistry staining was used to detect cardiac troponin T (cTnT) and connexin43, for the identification of cardiomyocytes. In the process of directional differentiation, RT-PCR was used to detect the expression of GATA-4,Nkx2.5 and α-MHC.RESULTS AND CONCLUSION:During the directional differentiation of BMSCs, the cells were changed from long fusiform to short rod, forming protrusions that were interconnected to form mesh-like, bamboo-like or myotube-like structure. When the cells were interconnected like a bamboo, cTNT and connexin43 positive cells were visible, and then the number of positive cells increased with the presence of myotube-like structure. RT-PCR results showed that during the induced directional differentiation of BMSCs, GATA-4, Nkx2.5 and α-MHC mRNA levels increased continuously. When interconnected cells formed a mesh-like structure, GATA-4 expression reached the peak and then kept a high level. When adjacent cells were fused into a myotube-like structure, α-MHC reached the peak. Additionally, the expression of Nkx2.5presented a time-dependent increase trend. Overall, during the induced differentiation of BMSCs into cardiomyocyte-like cells, the expression of cardiomyocyte specific genes, characterized by temporality and spatiality, is related to the changes of cell morphology and special structure formation.

[Objective]To evaluate the prognostic value of skull-base invasion of nasopharyngeal carcinoma(NPC)based on magnetic resonance imaging(MRI).[Methods]A total of 924 patients who were diagnosed with NPC between 2003 and 2004,had undergone MRI scan and received mdiothempy as their primary treatment,and had no distant metastasis were included in this study.MRI images and medical records were analyzed retrospectively.All the 924 eases.patients who developed skull-base invasions based on MRI,315 patients with T3 disease and 227 patients with T2 disease were selected for analysis.The staging was according to the sixth edition of the American Joint Commission on Cancer(AJCC)staging system.[Results]Incidence of skullbase invasion according to MRI was 55.4%.Of 924 cases.skull-base invasion on MRI was not an independent prognostic factor for overall survival(OS)and distant metastasis-free survival(DMFS),but was a marginally significant independent prognostic factor for local relapse-free survival(LRFS),P=0.068.Grading of MRI-detected skull-base erosion according to the site of invasion was an independent prognostic factor for OS(P=0.002 and P=0.005)and DMFS(P=0.001 for both)in the 512 patients with skull-base invasions and 315 patients with T3 disease.Severe-grade of skull-base invasion on MRI was an independent prognostic factor for OS and DMFS in the 924 patients(P ＜ 0.001 for both).No significant differences were observed on OS,LRFS,and DMFS between T2a patients and T3 patients with low-grade of MRI-deteeted skull-base involvement.[Conclusions]Skull-base invasion based on MRI is not an independent prognostic factor for NPC.However,severe-grade of invasion according to the site of involvement has positive prognostic value.

A comparative observation about histological and histochemical study were made onthe preservating methods of local ischemic kidney of dogs.The methods of this exp-eriment were divided into five groups:A.Local hypothermia;B.Hypothermic perfu-sion solution 500ml,4℃,containing Procaine 450 mg and Heparin 100 mg,infusedinto renal artery;C.Hypothermic perfusion solution 500ml,4℃,containing 20% Ma-nniton 32ml,25% MgSO_4 0.36 ml,Heparin 100 ml,infused into renal artery;D.Localhypothermia and heparin 30 mg injected into the same vessel.E.Local room tem-perature.The specimens were taken from the kidneys of the experimental dogs atvarious period after treated with every method.The results were as follows;A,D and E group presented irreversible histological changes within 4 hoursaftertreatment.Four hours later,the reaction of SDH,ATPase,AlPase werenegative.It suggested that the kidney damage was serious,as well as expressed thatthe effect of these preservating methods for ischemic kidney are not satisfactory.In B group,the histological and histochemical alteration is very light and almostreversible,during 60 days after treatment.In C group,hypothermic perfusionsolution containing Mannitol,MgSO_4 etc either during experiment or follow observa-tion for 60 days,no histological and histochemical alterations were found.It indica-ted that this method is an ideal perservating technique for ischemic kidney.

This paper is to clarify the concept of caregiver mutuality,introduce the main measuring tools of caregiver mutuality,analyze its influencing factors and its impact on caregivers. It elaborates the intervention measures of caregiver mutuality,in order to provide basis for better research.

Objective:To explore the mutuality among main caregivers of pancreatic cancer patients with surgery, and its correlations with the perceived social support and resilience.Methods:From March to July 2019, this study selected 150 main caregivers of pancreatic cancer patients with surgery of the First Affiliated Hospital with Nanjing Medical University as subjects by convenience sampling. All of patients were investigated with the General Information Questionnaire, the Mutuality Scale (MS) , Perceived Social Support Scale (PSSS) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) . A total of 150 questionnaires were sent out and 144 valid of them were collected.Results:Among 144 main caregivers of pancreatic cancer patients after surgery, the total average score of MS was (2.75±0.73) . Pearson correlation analysis results showed that the mutuality of main caregivers had positive correlations with the perceived social support and resilience with statistical differences ( P<0.05) . Hierarchical regression analysis showed that the genders, income, perceived social support and resilience went into the regression equation; except for the general information, the perceived social support and resilience could explain 24.5% of the variation. Conclusions:Main caregivers of pancreatic cancer patients with surgery have the above medium level of mutuality which has close correlations with the perceived social support and resilience. Medical staff should pay attention to maintaining the positive relations between caregivers and patients so as to promote the physical and mental health of caregivers.

Objective:To systematically evaluate and summarize the real care experience of family caregivers of pancreatic cancer patients.Methods:We searched The Cochrane Library, Joanna Briggs Institute (JBI) , PubMed, Embase, Institute for Scientific Information (ISI) Web of Science, PsycINFO, CINAHL, China Biology Medicine, China National Knowledge Infrastructure (CNKI) and VIP databases through computer systems to collect qualitative studies on care experience of family caregivers of patients with pancreatic cancer, and the search time was from the database establishment to October 2019. With reference to the Critical Appraisal Tool of Australian JBI Evidence-based Health Care Center (2016) for qualitative research, the collection integration method was used to integrate the existing conclusions.Results:A total of 7 literatures were included, and 44 complete and defined findings were extracted. The similar results were summarized into 10 new categories, and were combined into two integrated results including that the family caregivers of patients with pancreatic cancer experienced self-adjustment and showed positive feelings and responses during care, and they still faced difficulties and challenges in care which affecting their life trajectory.Conclusions:Family caregivers of patients with pancreatic cancer have both negative and positive experiences throughout the care process. Medical staff should be committed to promoting the growth of the personal role of caregivers, adapting and coping, and addressing the existing unmet needs.

OBJECTIVETo investigate changes in gene expression that occur upon treatment with human umbilical cord mesenchymal stem cells (UC-MSCs) for hepatic cirrhosis using a rat model system.

METHODSHepatic cirrhosis was induced in Sprague-Dawley rats by subcutaneous injection of carbon tetrachloride and oral administration of alcohol.UC-MSCs were isolated from human umbilical cord and the cells' immunophenotype and differentiation towards osteogenic and adipogenic lineages were confirmed.The UC-MSC sample or vehicle alone (phosphate buffered saline, PBS) was transplanted by intravenous injection.Histopathological staining and serological testing were used to compare the liver morphology and function among the different groups.The gene expression in the PBS group and UC-MSC group were detected by gene microarray and differences between the groups were statistically analyzed by t-test.

RESULTSTransplantation of the UC-MSCs improved liver function in the hepatic cirrhosis rats.Comparison of the gene expression profiles of the PBS group and the UC-MSC group showed that the latter had up-regulation of the genes related to the complement and coagulation cascades and down-regulation of the genes related to cell proliferation, cell cycle, and collagen synthesis.

CONCLUSIONUC-MSC therapy might improve liver function in cirrhosis by increasing the expression of genes related to the complement and coagulation cascades and by decreasing genes involved in cell proliferation and collagen deposition.

Animals ; Carbon Tetrachloride ; Cell Differentiation ; Cell Proliferation ; Down-Regulation ; Gene Expression Profiling ; Humans ; Liver Cirrhosis ; Mesenchymal Stromal Cells ; Rats ; Rats, Sprague-Dawley ; Transcriptome ; Umbilical Cord ; Up-Regulation

Objective To investigate CT and MRI findings of primary malignant fibrous histiocytoma (MFH)in the kidney. Methods The clinical data and imaging findings of 7 patients with primary renal MFH proved by histopathology were reviewed retrospectively.Results Tumors were unilateral in all patients,in which 5 cases were in the left kidney and 2 cases in the right kidney.The maximum diameter of the lesions ranged from 3.5 to 17.1 cm,with a mean of (8.7±3.9)cm.All the masses showed shallow lobulated or oval, with obscure boundary.On CT plain scan,heterogeneous isodensity/hypodensity were showed in 7 cases,necrosis occured in 7 cases, intratumoral hemorrhage in 2 cases and calcification in 3 cases.MRI also showed heterogeneous signal intensity.No obvious pseudocapsule was found in 6 cases.On dynamic contrast enhancement scan mild-moderate progressive enhancement was showed in corticomedullary and parenchymal phase in all 7 cases.In delay phase slightly decreased enhancement were showed in 5 cases,and similar or slightly higher enhancement corresponding to the parenchymal phase was showed in 2 cases.However,lower enhancement was showed in the tumors on all 3 phases than that in the renal cortex.Besides,the tumors invaded the renal vein (n=1)and the adjacent structure (n=3).Conclusion No specific imaging findings of primary renal MFH are found.The dynamic contrast enhancement might be helpful for its diagnosis to some extent,and clinical data should be integrated with imaging findings together to differentiate renal MFH from other renal neoplasms.The final diagnosis relies on pathology and immunohistochemistry examination.