OBJECTIVE: To evaluate decision regret among patients receiving penile girth enhancement with acellular dermal matrix (PGE with ADM) and to investigate the potential indicators for decisional regret so as to facilitate the decision-making process for this special group. METHODS: In the study, 78 patients receiving PGE with ADM from Jun. 2016 to Jan. 2019 at Peking University People's Hospital and cooperative hospitals were eligible. Penile girth was taken by only one surgeon 1 week before surgery. Hospital anxiety and depression scale (HAD), international index of erectile function (IIEF) and a 10 cm long visual analogue scale named visualized penile image (VPI) were applied to measure psychological burden, erectile function and satisfaction with penile image respectively at the same time. All the patients were followed up for 3 months. Decision regret scale (DRS) was adopted for measuring decisional regret. Multivariate analysis of variance was applied to investigate the potential indicators for regret. Data analysis process was conducted with SPSS (version 24.0; SPSS, Chicago, IL, USA). RESULTS: Mean penile girth recorded before intervention was (8.29±0.30) cm and increased to (9.46±0.29) cm post surgery (t=76.28, P < 0.01). As for both subscales of HAD measuring psychological burden, a signi-ficant reduction in the mean score was seen, that is, 2.8±1.3 (t=19.28, P < 0.05) for anxiety and 3.0±1.2 (t=20.67, P < 0.05) for depression, respectively. The average score of VPI increased by 3.7±1.1 (t=30.63, P < 0.05). There was no significant change in the average score of IIEF measuring erectile satisfaction (t=1.60, P=0.11). Twenty-nine (38.2%) patients expressed regret to some degree, and the mean DRS score was 23.4±14.8. The scores of DRS correlated negatively with scores of visualized penis image (r=-0.348, P < 0.01), and positively with scores of anxiety (r=0.760, P < 0.01) and depression subscale (r=0.471, P < 0.01). The scores of DRS was irrelevant to those of IIEF (r=0.02, P=0.867). The patients with high annual income (> 120 000 yuan) and education level above undergraduate were more prone to experience decision regret after intervention (P < 0.01). CONCLUSION PGE with ADM did augment penile girth and lower psychological burden, the regret rate of which was acceptably low among the patients. High income and good education might indicate more post-operative regret. Additional decision-making aids should be offered to patients with high income and education level above high school.
Acellular Dermis ; Emotions ; Humans ; Male ; Patient Satisfaction ; Penile Erection ; Penis ; Reconstructive Surgical Procedures

OBJECTIVETo investigate changes in biologic properties of non-small-cell lung cancer (NSCLC) A549 cells whose EGF receptor (EGFR) expression was suppressed by short interference RNA (siRNA).

METHODSA549 cells were transfected with synthetic EGFR sequence-specific siRNA by Lipofectamine. EGFR expression was examined by Western blot and flow cytometry. The biological features of the transfected A549 cells were assessed by cell cycle analysis, colony formation and chemosensitivity assay.

RESULTSSequence-specific siRNAs targeting EGFR significantly down-regulated its expression in A549 cells. Cell growth and colony formation were inhibited by 85.0% and 63.3%, respectively, as compared to the non-sequence-specific siRNA treated cells. Decreased EGFR expression was accompanied by 12.7% increase in A549 cells in G(0)-G(1) phase and 6.6% decrease in S-phase. The EGFR sequence-specific siRNA transfected A549 cells were much more sensitive to the cytotoxic effect of cisplatin with a 77.2% decrease in IC(50) compared to the non-sequence-specific iRNA transfected A540 cells.

CONCLUSIONDown regulation of EGFR expression of NSCLC by sequence-specific siRNA may be considered as an additional option in the treatment of EGFR over-expressing cancers, including NSCLC.

Antineoplastic Agents ; administration & dosage ; pharmacology ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Cell Survival ; drug effects ; Cisplatin ; administration & dosage ; pharmacology ; Humans ; Inhibitory Concentration 50 ; Lung Neoplasms ; metabolism ; pathology ; RNA Interference ; RNA, Double-Stranded ; genetics ; RNA, Small Interfering ; genetics ; Receptor, Epidermal Growth Factor ; genetics ; metabolism ; Transfection

ObjectiveTo evaluate the functional changes of stunned myocardium before and after coronary artery bypass graft(CABG) treatment,and clear the meaning of revascularization which CABG has brought to patients with diffused vascular changes.MethodsA total of 36 patients with 99％ diffused coronary artery stenosis in left anterior descending branch underwent non-pump CABG treatment in the Department of Cardiothoracic Surgery the First affiliated hospital of Harbin Medical University.Real-time three-dimensional echocardiography (RT3DE) was repeatedly performed 1 week before operation and 10 days,1 month,and 3 months after CABG.Regional diastolic volumes,systolic volumes,ejection fractions,regional stroke volume to global diastolic volume and the values of abnormal segments before and after CABG were studied.ResultsOne week before operation and 10 days,1 month and 3 months after CABG,the differences of volumes between groups in the last phases of diastole and systolic were statistically significant in anterior wall basement segment,anterior septal basement segment,anterior wall intercalary segment,anterior septal intercalary segment,anterior wall of apex cordis and septation of apex cordis(F =3.51,3.55,4.08,4.05,2.98,3.01,all P ＜ 0.05; F =4.51,4.55,4.08,3.00,2.96,2.99,all P ＜ 0.05).The values of the six segments mentioned above,3 months after operation[(6.74 ± 1.23),(6.64 ± 1.21),(6.02 ± 1.10),(5.95 ± 1.09),(5.82 ± 1.06),(5.10 ± 0.93)ml; (2.74 ± 0.50),(2.69 ± 0.49),(2.51 ± 0.46),(2.32 ± 0.42),(2.36 ± 0.43),(2.03 ± 0.37)ml] were compared with those of 1 week before operation[(8.33 ± 1.52),(8.20 ± 1.50),(7.43 ± 1.36),(7.36 ± 1.34),(7.19 ± 1.31),(6.29 ± 1.15)ml; (4.94 ± 0.90),(4.85 ± 0.88),(4.53 ± 0.83),(4.18 ± 0.76),(4.25 ± 0.78 ),(3.65 ± 0.67)ml],the differences were statistically significant (all P ＜ 0.05); the differences between groups in regional ejection fractions,regional-global ejection fractions were statistically significant(F =4.56,4.88,4.28,3.15,2.93,2.88,P ＜ 0.01 or ＜ 0.05; F =5.56,5.28,4.98,5.15,3.03,2.78,P ＜ 0.01 or ＜ 0.05).Compared with 1 week before the operation, 1 month after the operation in regional ejection fractions,10 days,1 month in regionalglobal ejection fractions after the operation,4 segments of them were significantly improved(all P ＜ 0.05) and 3 months after operation,all the 6 segments had been improved significantly(all P ＜ 0.05).The maximum volume of the sum of group difference of the 6 segments and the 4 segments in the last phase of diastole was statistically significant(F =2.58,5.81,P ＜ 0.05 or ＜ 0.01 ),and the summation began to decrease 10 days after the operation.The values of 3 months after operation[ (36.27 ± 1.10),(25.35 ± 1.16)ml] were compared with that of 1 week before operation[ (44.80 ± 1.36),(31.32 ± 1.43)ml ] the difference was statistically significant (all P＜ 0.05).The maximum volume summafion comparisons of 6 segments and 4 segments in the last phase of systolic had statistical significance(F =5.77,5.57,all P ＜ 0.01 ),and 10 days after the operation,the summation began to decrease.The values of 1 month[(16.4 0 ± 0.48),(11.58 ±0.51 )ml],and 3 months after operation[ (14.65 ± 0.45),(10.26 ± 0.46)ml],were compared with those of 1 week before operation[ (26.40 ± 0.80),(18.50 ± 0.84)ml],the differences were statistically significant (all P ＜ 0.05).ConclusionsStunned myocardium can be improved through CABG in myocardium systolic,diastole function and ejection fractions of the relevant segments and all of this have proved that patients undergoing CABG revascularization can improve the heart function of the ischemic area.

Objective To analyze the outcome of the epidemiological investigation on an animal plague in Dingbian County of Shaanxi Province.Methods The region of 25 square kiolmeters(km2)in Hongliugou Town was selected as monitoring point of plague to investigate on host animals,etiology and serology.The epidemic area was classified,deratization and depulization were correspondingly adopted.Health education was carried out for prevention knowledge of plague,and questionnaire survey was conducted among residents and medical staff in the epidemic area.Result The average rat density in monitoring site was 8.38 rats per hectare in Hongliugou Town.Average rate infected with flea and flea index were 50.4%(56/111)and 1.81,respectively.The epidemic area was classified 3 types,and came up to the demand after corresponding measures adopted.In the epidemic area,the pass rate of the prevention and control knowledge were 62.00%(31/50)in residents and 92.98%(53/57) in medical staff.Conclusions Plague epizootic can be discovered by exercising regular monitoring and controlledimmed iately and effectively by taking the appropriate control measures.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Genes, Viral ; Genotype ; Hepacivirus ; genetics ; Hepatitis C, Chronic ; epidemiology ; Humans ; Male ; Middle Aged ; Young Adult

Objective: To observe the clinical efficacy of mind-refreshing and balance-restoring needling method combined with Frenkel exercises in treating ataxia after cerebral stroke. Methods: The recruited 120 patients were randomized into an observation group and a control group, with 60 cases in each group. The control group was intervened by mind-refreshing and balance-restoring needling method, while the observation group was given additional lower-limb Frenkel exercises. Before and after treatment and at the follow-up, the ataxic lower-limb function was scored using Berg balance scale (BBS) and international cooperative ataxia rating scale (ICARS), and Barthel index (BI) was adopted to score the activities of daily living (ADL). Results: After treatment, the markedly effective rate was 70.2％ and the total effective rate was 96.5％ in the observation group, versus 39.7％ and 87.9％ in the control group, and the differences in the markedly effective rate and the total effective rate were statistically significant (P<0.01, P<0.05). The intra-group comparisons showed that the BBS, ICARS and BI scores after treatment and at the follow-up were significantly different from those before treatment in both groups (all P<0.01).There were significant differences in the BBS score between the two groups after treatment and at the follow-up (P<0.05, P<0.01); the between-group differences in the ICARS and BI scores were statistically insignificant after treatment (both P>0.05), while the between-group differences in the ICARS and BI scores were statistically significant at the follow-up (both P<0.05). The interaction effects between the scoring time of BBS and BI and the group factor were statistically significant (P<0.01, P<0.05). Conclusion: Mind-refreshing and balance-restoring needling can effectively improve the lower-limb ataxic symptoms and ADL after stroke; when combined with Fenkel exercises, this needling method can produce more significant efficacy.

BACKGROUNDPachymic acid (PA), a natural triterpenoid, is known to significantly reduce cell proliferation and induce apoptosis in vitro through initiation of mitochondria dysfunction. However, its effect on immune cells and anti-rejection following organ transplantation remains unknown.

METHODSIn this study, we investigated PA as a treatment to control acute rejection occurred in rats which had accepted cardiac transplantation. We measured apoptosis of peripheral blood lymphocyte (PBLs), and CD4(+) lymphocyte, as well as the number of CD4(+) and CD8(+) lymphocytes and the effect of PA on acute rejection in rats 7 days after cardiac transplantation.

RESULTSPA treatment might decrease allograft rejection, protect PBLs from apoptosis, and reduce the percentage of CD8(+) lymphocyte. PA neither regulated the number nor the apoptosis rate of CD4(+) lymphocyte.

CONCLUSIONSOur findings indicated that PA has an anti-apoptotic effect acting on PBLs through a novel mechanism involving stabilization of the PBLs mitochondrial transmembrane potential, an anti-rejection effect in rats after cardiac transplantation and an inhibiting effect to CD8(+) lymphocyte.

Animals ; Apoptosis ; drug effects ; Graft Rejection ; drug therapy ; Heart Transplantation ; Lymphocytes ; drug effects ; Male ; Membrane Potential, Mitochondrial ; drug effects ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Transplantation, Homologous ; Triterpenes ; therapeutic use

SARS-CoV is a newly discovery pathogen causing severe acute respiratory problems.It has been established that the S protein in this pathogen plays an important rule in the adsorption and penetration of SARS-CoV into the host cell by interaction with the ACE2 receptor.To determinant which functional motif of the S protein was involved in the interaction with ACE2,seven truncated S proteins deleted from the N or C terminal were obtained by an E.coli expression system and purified by column chromatography to homogeneity.Each truncated S protein was fixed on to the well of an ELISA plate and an interaction was initiated with the ACE2 protein.The adsorption were quantified by ELISA,and the results indicated that amino acids from 388 to 496 of the S protein was responsible for the interaction with the ACE2 receptor,and the interaction could be completely disrupted by an antibody specific to these amino acids.Deletions adjacent to this domain did not appear to have a significant impact on the interaction with ACE2,suggesting that the S protein of SARS-CoV could be developed as a vaccine to prevent the spread of SARS-CoV.

OBJECTIVETo investigate the inhibition of COX-2 gene expression and its effects on malignant proliferation of human lung adenocarcinoma A549 cells after interfering at different target sites in vitro.

METHODSThe 3rd, 7th and 10th exon of COX-2 were selected as the targets and three COX-2 siRNA expression vectors with human U6 promoter were constructed. Three siRNA expression vectors and two vacant vectors were transfected into A549 cells expressing COX-2 with lipofectamine, respectively. The transfected cell strains were constructed and the change of COX-2 expression levels was examined by Western blot and RT-PCR. The effects on the proliferation of A549 cells after interfering at different target sites were studied by cell growth curve and colony formation assay in vitro.

RESULTSThe three siRNAs and U6 promoter were validated by PCR, restriction endonuclease digestion, DNA sequencing and BLAST alignment, and cloned into the pEGFP vector. The cell strains transfected were named as A549-3, A549-7, A549-10, A549-p and A549-pU6, respectively. A549-p cells showed expression of GFP and A549-3, A549-7, A549-10, A549-p and A549-pU6 cells did not show at 24, 48 and 72 hours after transfection. The results of RT-PCR and Western blot showed an inhibition of COX-2 expression after interfering at three target sites (3rd, 7th and 10th exons). In contrast to A549 cells, the levels of COX-2 mRNA of A549-3, A549-7 and A549-10 cells were reduced by 10.6%, 33.4% and 61.2%, respectively. The levels of COX-2 protein of A549-3, A549-7 and A549-10 cells were reduced by 26.7%, 44.7% and 56.2%, respectively. The results of cell growth curve and colony formation assay showed a slowing down of the growth of A549-10 cells and reduction of their colony formation rate. The other two targets had no apparent effect on the growth of A549 cells.

CONCLUSIONThere is a significant inhibiting effect of RNA interference on the malignant proliferation of A549 cells in vitro, and the most striking effect can be seen when the 10th exon of COX-2 is taken as the interference target.

Adenocarcinoma ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Cyclooxygenase 2 ; genetics ; metabolism ; physiology ; Exons ; Genetic Vectors ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Promoter Regions, Genetic ; RNA Interference ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Transfection

OBJECTIVETo improve the diagnosis and treatment of hypoglossal neurilemmoma (HGN).

METHODSThe data of 10 patients with HGN were retrospectively reviewed, 5 of 10 patients (early group) had been reported previously. A comparison of treatment strategy between early and latter group was made.

RESULTSTypical hemiatrophy of the tongue presented in all 10 patients, hypoglossal canal could be showed in the bone window of CT, which, however, might not confirm the existence of tumor if it is very small. MRI was the optical choice for diagnosis. Among the early 5 cases with HGN which were all of dumbbell type, the intracranial part and the extracranial part of the tumor in 2 cases were removed by stages, 3 cases were operated via the far-lateral approach, of which 1 was via trans-condylar approach and 2 were via trans-supracondylar approach; the 5 tumors were removed subtotally except 1 totally; CSF leakage and intra-cranial infection after operation occurred in 1 case; the rating of Karnofsky Prognosis Scale was good in 4 cases and dead in 1 case. However, among the latter 5 cases, 4 cases including 2 of dumbbell type, 1 of intra-cranial type and 1 of intracanal type were operated via the modified far-lateral approach, of which 1 was via trans-condylar approach and 3 were via trans-supracondylar approach; and the tumor of extracranial type in the last case was resected twice via transcervical approach, being removed subtotally in the first operation followed by total removal with the aid of neuronavigation and neuroendoscopy in the second operation when it failed to react to the treatment of gamma knife; the 5 tumors were removed totally except 1 subtotally.; all postoperative courses were uneventful.; follow up was performed successfully in 4 cases, the rating of Karnofsky Prognosis Scale was excellent in 3 cases and fair in 1 case. The outcomes of the latter 5 cases resected via modified approach were better than those of the early 5 cases.

CONCLUSIONHGN is extremely rare and it is difficult to treat it. To achieve a good operative outcome, it is very important to design the approach individually based on its location and size and operate mini-invasively and resect tumor totally as possible as can in the primary stage.

Adult ; Cranial Nerve Neoplasms ; diagnosis ; surgery ; Female ; Humans ; Hypoglossal Nerve Diseases ; diagnosis ; surgery ; Magnetic Resonance Imaging ; Male ; Neurilemmoma ; diagnosis ; surgery ; Retrospective Studies ; Skull Base ; diagnostic imaging ; Tomography, X-Ray Computed