Objective To investigate the feasibility and efficacy of tunica vaginalis flap cover in treatment of recurrent urethrocutaneous fistula (UCF).Methods We reviewed the clinical datas of 25 cases of UCF after urethroplasty of hypospadias from January 2011 to January 2015.The mean age of the patients was 6.2 years(range 1.6-14.0 years).All patients had undergone previous hypospadias repair and at least one previous failed attempt to close the urethrocutaneous fistulae.There were 5 cases of fistula in the coronary sulcus,6 cases of fistula in the penile body and 14 cases of fistula at the junction of penis and scrotum.The diameter of urethrocutaneous fistulae were 3-10 mm.Single fistula was present in all patients.16 cases had undergone UCF repair for two times, 9 cases had undergone UCF repair for more than two times.After closing the fistula with inverting running stitch, a tunica vaginalis flap was mobilized to cover the repair site through a subcutaneous tunnel and the skin closed.Results The mean follow-up time was 2.1 years(range 0.5-4 years).The overall success rate was 96％ (24/25).Penile cosmesis was excellent.There was no evidence of recurrent fistulas or urethral strictures.All parents reported a straight penis when erected, and one patient in whom there was leak from the fistula site because of local wound infection.No postoperative complication was encountered in the testis.The testis was of normal size and position, and the ultrasound findings were normal.Conclusions Repairment of recurrent urethrocutaneous fistulas with a tunica vaginalis flap could be effective regardless of fistula location.The technique is simple to improve the success rate of the repair of UCF effectively and reduce the occurrence of postoperative complications.

Esophagus ; Foreign Bodies ; Humans ; Infant ; Male

Hepatolithiasis is a kind of mixed stone disease which mainly depends on pigment stone.However,the etiology is not clear and the pathogenesis is very complex.A lot of studies confirmed that helicobacter pylori played an important role in the occurrence and development of disease.This paper mainly expounds the problems concerning the characteristic of helicobacter pylori and its connection with hepatolithiasis, its state in the formation of hepatolithiasis.

Objective:To study the antimicrobial properties of CaO/ZnO core-shell nanoparticles.Methods:The CaO/ZnO core-shell nanoparticles were prepared via precipitation method.The pH and calcium ion release from the samples which composed of eugenol and nanoparticles were examined respectively.The form of the particles was observed under electron microscope,the ions were analysed by inductively coupled plasma(ICP).The antibacterial activities against Streptococcus mutans,Enterococcus faecalis,Escherichia coli and Staphylococcus aureus were evaluated by agar diffusion test (ADT).Results:CaO/ZnO core-shell nanoparticles were spherical with core-shell structure and with the diameter of 80-90 nm.The calcium ion release and pH were gradually increasing from the nanoparticles in PBS.The antibacterial activity of CaO/ZnO core-shell nanoparticles-eugenol was significantly greater than that of iRoot SP and zinc oxide-eugenol sealer(P<0.01).Conclusion:CaO/ZnO core-shell nanoparticles possess antibacterial activity.

OBJECTIVETo investigate the effects of Salvia miltiorrhiza (SM) on oxidative stress and microinflammatory state in patients undergoing continuous hemodialysis (CHD).

METHODSThirty-six patients who had received CHD for over half a year were assigned into the routine CHD group (18 cases) and the treated group treated with routine CHD plus SM (18 cases). Meanwhile, 18 healthy adults were taken as the normal control. Indexes related with oxidative stress [malondialdehyde (MDA), advanced oxidative protein products (AOPP) and superoxide dismutase (SOD)) and microinflammation C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were detected before and after 1, 2 and 3 months of treatment.

RESULTSThe levels of AOPP, MDA, CRP, IL-6 and TNF-alpha in patients were higher and SOD was lower than those in the normal control at all the time points (P < 0.01). Compared with the baseline, the levels of AOPP and MDA in the routine CHD group significantly increased and SOD decreased after 3 months of treatment (P < 0.05), but changes of CRP, IL-6 and TNF-alpha showed no significance though there were somewhat increment (P > 0.05). The levels of AOPP and MDA were lower and SOD was higher after 1, 2 and 3 months of SM combined treatment, and CRP was lower after 3 months of treatment in the treated group than those of baselines and those at the corresponding time points in the routine CHD group (P < 0.01), but IL-6 and TNF-alpha reduced insignificantly (P > 0.05).

CONCLUSIONHemodialysis may aggravate the oxidative stress and microinflammation in patients, which could be obviously alleviated by SM.

Adult ; Aged ; C-Reactive Protein ; metabolism ; Female ; Humans ; Interleukin-6 ; blood ; Kidney Failure, Chronic ; blood ; therapy ; Male ; Malondialdehyde ; blood ; Middle Aged ; Oxidative Stress ; Phytotherapy ; Renal Dialysis ; adverse effects ; Salvia miltiorrhiza ; Superoxide Dismutase ; blood ; Tablets ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate cause,treatment and prevention of esophageal fistula caused by anterior cervical spine surgery.Methods Between January 2004 and December 2011,2348 patients underwent anterior cervical spine surgery.Among them,5 patients suffered from esophageal fistula owing to operation,including 3 males and 2 females,with an average age of 34 years (range,14 to 48 years).The diagnosis of these patients included 3 cases of cervi(c)al injury,1 case of cervical spondylosis and 1 case of cervical tuberculosis.There was 1 patient whose esophageal injury was founded during the surgery,and that was directly repaired.For another 4 patients,esophageal fistulas were founded after operation; one case underwent debridement and orificium fistulae repair; one case only underwent debridement; one case underwent debridement and second-stage removal of hardware; and one case underwent debridement and second-stage removal of hardware and esophageal repair with sternocleidomastoid flap.Postoperative treatment included esophageal rest,enteral nutrition,wound drainage,and antibiotic administration.Methylene blue was used to evaluate status of orificium fistulae.Results All patients with esophageal fistula were cured 9 to 61 weeks after treatment,and oral intake was achieved.They were followed up for 6-48 months.There was no recurrence of esophageal fistula,cervical instability and infectious spondylitis in any ease.All patients were satisfied with swallowing function and outcome of cervical spine diseases.The Frankel grade was improved averagely one grade in patients with cervical injury,and the JOA score was improved from preoperative 9 points to postoperative 15 points in patients with cervical spondylosis.Conclusion Successful management of esophageal fistula caused by anterior cervical spinal surgery depends on primary closure of the perforation with or without muscle flaps,surgical drainage,esophageal rest and nutrition support,and removal of hardware if necessary.Prevention consists of the careful operation and gentle tissue handling.

Objective To investigate the influence of chronic pain on the sleep quality in the patients with Parkinson′s disease (PD) .Methods 232 cases of PD in the neurology department of this hospital from March 2009 to March 2013 were selected and di‐vided into the pain PD group (PPD group ,106 cases) and the non‐pain PD group (NPPD group ,126 cases) according to whether accompanying chronic pain .Contemporaneous 140 individual of healthy physical examination were selected as the control group .The Pittsburgh Sleep Quality Index Scale (PSQI) and the fatigue scale (FS‐14) were used to judge whether sleep disorders existing . Then the differences in the sleep quality and fatigue condition were compared among three groups .The related factors of sleeping disorders were also analyzed .Results The scores of PSQI and FS‐4 had statistically significant differences among 3 groups (P<0 .05) ,in which the differences in the aspects of sleep latency ,subjective sleep quality ,sleep continuity ,habitual sleep efficiency and sleep disorders also were statistically significant (P<0 .05) .The influencing factors of sleeping disorders were the Hoehn‐Yahr stage (r = -0 .79 ,P<0 .05) ,dopamine dose (r = -0 .38 ,P=0 .04) ,presence of pain (r = -0 .57 ,P<0 .05) and severity of de‐pression (r = -0 .63 ,P<0 .05) .Conclusion The PD patients accompanying pain are more susceptible to develop sleep disorders , the sleep quality accompanying pain is worse than that without accompanying pain .Therefore the early intervention should be well conducted in clinic .

Adolescent ; Apolipoproteins E ; blood ; Humans ; Hyperlipoproteinemias ; complications ; Hypolipidemic Agents ; therapeutic use ; Kidney Diseases ; blood ; drug therapy ; pathology ; Kidney Glomerulus ; blood supply ; pathology ; Male ; Thrombosis ; pathology

Animals ; Disease Progression ; Kidney Diseases ; physiopathology ; Kidney Glomerulus ; drug effects ; pathology ; Rats ; Renal Agents ; pharmacology ; Renin-Angiotensin System ; drug effects ; Sclerosis

BACKGROUNDThalidomide is reviving for its antiangiogenic effect on corneal neovascularization models. Recently, it has been employed in tumor research in several types of solid carcinomas. However, its effect on hepatocellular carcinoma (HCC) has not yet been clarified.

METHODSA total of 48 nude mice bearing human HCC with a high metastatic potential were randomly divided into 4 groups. Thalidomide (200 mg/kg), paclitaxel (13 mg/kg), or their combination, which was dissolved in 0.5% sodium carboxyl methyl cellulose (CMC) suspension, was intraperitoneally injected in each group since the second day of the establishment of animal model. The group simply administered with 0.5% CMC was set as placebo-control. The mice were sacrificed on the 30th day, for the measurement of tumor size, weight and metastasis in the lungs. The levels of CD34 and endothelial growth factor (VEGF) mRNA in tumor tissues were detected by immunohistochemistry and semiquantitative RT-PCR, respectively, and microvessel density (MVD) was evaluated.

RESULTSNo statistical difference was found in tumor weight and volume between the thalidomide group and control (P>0.05). Paclitaxel showed a growth-inhibiting effect on tumors (P<0.05). The value of MVD and VEGF mRNA and metastases to the lungs in each group were lower than those in the placebo-control group (P<0.05); such difference in the combination group was statistically significant (P<0.05).

CONCLUSIONSPaclitaxel, but not thalidomide, has significant growth inhibitory effect on tumors, but both significantly inhibit angiogenesis and metastasis of human HCC in nude mice, such effects of paclitaxel can be amplified by thalidomide.

Animals ; Antigens, CD34 ; analysis ; Cell Line, Tumor ; Humans ; Liver Neoplasms, Experimental ; blood supply ; drug therapy ; Lung Neoplasms ; secondary ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Neovascularization, Pathologic ; drug therapy ; Paclitaxel ; administration & dosage ; therapeutic use ; Reverse Transcriptase Polymerase Chain Reaction ; Thalidomide ; administration & dosage ; therapeutic use ; Transplantation, Heterologous