Objective To investigate the use and effect of subcutaneous flap and tunica vaginalis flap in hypospadias repair and hypospadias fistulas repair. Methods A total of 73 cases of hypospadias and hypospadias fistulas following surgery were included.The new urethras or closed fistulas were wrapped with various types of subcutaneous flaps or tunica vaginalis flaps.In the 45 cases of hypospadias,dorsal dartos flap technique was used in 27,tunica vaginalis flap technique in 3,and adjoining pedicle advance dartos flap technique in 15.In the 28 cases of urethral fistulas,dorsal dartos flap technique was used in 4,X-V skin flap technique in 14,and adjoining U-shaped subcutaneous flap technique in 10. Results All the cases were followed up for 3 to 36 months.Of the 45 cases of hupospadias, fistulas occurred in 3.Of the 28 cases of urethral fistulas, no fistulas occurred.The success rate of operation was 95.9%. Conclusions The use of these techniques can reduce the incidence rate of urethrocutaneous fistulas in hypospadias repair and hypospadias fistulas repair.Based on our experience these techniques are the optimal repair for classical patients with hypospadias and hypospadias fistulas.

Objective To study the chemical constituents of Swertia decora, a traditional herb used to treat hepatitis by the minority.Methods The constituents were separated and purified by column chromatography with silica gel.Their structures were identified on the basis of spectral analysis such as UV, MS, NMR, HMPC, HMQC and by HPLC.Results Three compounds were isolated from the chloroform part and ethyl acetate part of the extracts.Their structures were identified as 1-hydroxy-4, 5, 6, 7-tetra- methoxy -9H-xanthen-9-one (swertiadecoraxanthone-Ⅰ, Ⅰ), 5, 7, 3′, 4′- tetrahydroxyflavone (luteolin, Ⅱ), and 3, 5, 7, 3′, 4′-pentahydroxyflavone (quercetin, Ⅲ), respectively.Conclusion Swertiadecora- xanthone -Ⅰ is a new compound and the other two are found from this plant for the first time.The pentaoxygenated patterns of compound Ⅰ is also found for the first time in the plants of Swertia L.

Background Salivary transplantation or duct transposition can provide continuous physiological secretion of tear substitutes.This may be an ideal method in treatment of dry eye.But the relative anatomical literatures is few,and some of the conclusions in the literatures are still controversial,which limit its clinical application.Objective This study was to discuss the possibility and the advantage and disadvantage of applying three major salivary glands to treat xerophthalmia.Methods The relationship between the branches of the facial nerve out of the parotid gland and the salivary glands,the salivary glands size,origin of blood supply,out diameter of vessels and adjacent relation were observed in 34 sides pate specimens perfused with red latex under the operating microscope.To find the vessels in recipient site to anastomose,the vessels around fossa orbitalis and forehead were anatomized and observed.The parotid gland duct transfer operation,the submandibular gland free transplantation surgery and sublingual gland free transplantation surgery in the human anatomy specimens were simulated.Results The position of parotid duct was constant.The duct length was(4.20± 1.10) cm,duct diameter was (O.60±0.30) cm.The stensen's duct was likely to be prolonged by the cheek mucous membrane or venous andthe damage of buccal branch,zygomatic branch and temporal branches of facial nerve should be avoided during the operation of transplanting stensen' s duct.When submandibular gland was transplanted,facial vessel was taken as its pedicle,whose outside diameter was (2.70 ± 0.28) mm,and the length of the transplant vascular pedicle was (1.90 ± O.30) cm.Thc anastomosed vessel was superficial temporal vessel in recipient site.When sublingual gland was transplanted,sublingual(88.2％,30 sides) or submental vessel(11.8％,4 sides) was taken as its pedicle,whose outside diameter was(1.92±0.36) mm and (1.96±0.54) mm,and the length of the transplant vascular pedicle was(2.60± 1.10) cm and(3.50±0.40) cm,and the anastomosed vessel was the frontal branch of superficial temporal vessel in recipient site.Three sides of specimens lacked sublingual glands.Conclusions It is feasible that treating severe xerophthalmia by the operation of grafting the major salivary glands or transplanting stensen' s duct on the point of anatomical view.Parotid duct inversion and the submandibular gland transplantation have been applied to clinic.However,sublingual transplantation remains to be further confirmed by the animal experiments.

Objective To evaluate the effectiveness of the treatment of high risk benign prostatic hyperplasia (BPH) with transrectal high-intensity focused ultrasound (TR-HIFU) by urodynamic test. Methods One hundred and thirty patients with BPH, most of who suffering with diabetes mellitus,cardio-cerebrovascular disease, respiratory disease. All patients were given the operation with Sonablate-500 high-intensity focused ultrasound (HIFU). International prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), post void residual urine volume (PVR), pressure-flow tests (A-G) were employed for the evaluation of curatives effect on preoperation, 30th and 90th day after the treatment. Results The duration of the TR-HIFU prostate ablation treatment was 15-85 rain. One hundred and seven patients after treatment were followed up for 3 months. Compared the effect before treatment with that after treatment, IPSS improved from (27.0 ±11.5) scores to (8.5±1.4) scores, Qmax increased from (5.7±2.3) ml/s to (14.1±4.2) ml/s, PVR decreased from (118.5±78.0) ml to (30.0±15.0) mI,A-G parameters reduced from 62.4±19.3 to 25.6±13.0 and urine volume (VV) increased from (85.8 + 42.0) ml to (194.0±52.0) ml. The parameters all altered obviously (P < 0.05). Conclusions TR-HIFU appears highly attractive as a new optional, safe and efficacious and minimally invasive treatment for the high risk BPH. Main post-operative urodynamie parameters are more obviously improved than those of the preoperation.

Objective To investigate the use and effect of dorsal dartos flap wrapping technique in complicated hypospadias fistulas repairs. Methods In the experimental group, the closed fistulas were wrapped with transferred dorsal dartos flap in the 32 cases of complicated hypospadias fistulas from March 2004 to January 2008. In the control group, the routine fistulas repairs were preformed in the 50 cases of complicated hypospadias fistulas from January 1998 to February 2004 . Results All cases had been followed up for 3 - 12 months, there were no fistula in the experimental group. There were 6 fistulas in the control group. There was significant difference between two groups (P<0.05). Conclusions The use of the technique can prevent urethrocutaneous fistulas after complicated hypospadias fistulas repairs, the fistulas rate are reduced for all cases combined. The technique would be the optimal repair for complicated hypospa-dias fistulas.

BACKGROUND: The comparative study concerning the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for the treatment of nervous system lesions is insufficient. OBJECTIVE: To assess the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for treatment of nervous system lesions. METHODS: A total of 214 cases with neuropathy were randomly divided into A, B groups. Patients in the A group received umbilical cord derived stem cell transplantation, and those in the B group received bone marrow-derived mesenchymal stem cells transplantation. Totally (5-12)×108 stem cells were transplanted into each patient. RESULTS AND CONCLUSION: The count of lymphocytes, alanine aminotransferase, aspartate aminotransferase, IgA, and IgM were increased compared with those before treatment in both groups (P < 0.01); However there were no significant differences between two groups (P > 0.05). Moreover, white blood cell count and red blood cell count in cerebrospinal fluid of all patients were significantly greater than the normal level. There were no significant differences between two groups (P > 0.05). No significant differences of the positive rate of Pandy test and the incidence rate of adverse effect were found in both groups (P > 0.05). The safety of umbilical cord and bone marrow-derived mesenchymal stem cell transplantation for treatment of nervous system lesions showed no marked differences.

Objective To evaluate the effectiveness of the treatment of slight and moderate benign prostatic hyperplasia(BPH)with large doses of cemilton by urodynamie test.Methods A systematic review of using large doses of cernihon only for 80 patients with BPH with 7 grade ＜ International Prostate Symptom Score(IPSS)≤20 grade.All cases with cemilton had been administered in a dosage of 750 mg,three times a day for one year.All were respectively given IPSS,postvoiding residual urine(PVR),maximum flow rate(Qmax)and pressure-flow(A-G)test in order to assess the effectiveness at pre-treatment and 3,6,12 months after treatment.Results All patients had followed up for(1.2±1.6)years,additionally 26 of those were removed and others had received complete follow-up.Before the treatment IPSS was(20.5±4.5)grade,PVR was(42.5±8.2)ml,Qmax was(10.2±2.3)ml/s,A-G was 56.5±12.8,PQmax was (54.8±13.7)mm Hg(1 mm Hg = 0.133 kPa),and 12 months later,IPSS was(11.0±3.3)grade,PVR was (15.9±7.4)ml,Qmax was(15.7±2.5)ml/s,A-G was 49.2±13.6,PQmax was(43.6±14.9)mm Hg.There were significantly difference between pre-treatment and post-treatment data of the urodynamics(P ＜ 0.05).Conclusions The effectiveness of the treatment of slight and moderate benign prostatic hyperplasia with large doses of cemihon are relatively satisfactory.Main post-treatment urodynamic parameters obviously improves than that of the pre-treatment.

Objective To analyze videourodynamic characteristics of female bladder outlet obstruction (BOO). Methods Retrospective analysis of videourodynamic characteristics were performed in 42 women with BOO. On the basis of the videourodynamic findings, women with BOO were categorized into five groups: bladder neck obstruction, middle urethra (urethral sphincter) obstruction, distal urethra obstruction, external orifice of urethra obstruction, high-grade pelvic organ prolapse. Data of five groups were compared in Qmax, maximum cystometric capacity, Pdet at Qmax, residual urine, detrusor instability and hydronephrosis. Data of all patients were analyzed by SPSS13 statistical software, measurement data by t-test and enumeration data by x2-test. Results Five groups had not significant deviation in the maximum cystometric capacity. however patients with bladder neck obstruction had significant deviation with others in Pdet at Qmax (78. 0 ± 23. 6)cm H2O, residual urine (120. 6±115.2)ml, Qmax (7.0±2.3)ml/s (P<0.05). There was significant deviation between middle urethra (urethral sphincter) obstruction(76.9%)and others in detrusor instability(P<0. 05). In all patients with hydronephrosis, bladder neck obstruction(57. 1 %) had significant deviation with others (P<0. 05). Conclusions Videourodynamic tests could assess lower urinary tract function, and may guide clinic management. The bladder neck obstruction was most serious and harmful to upper urinary tract.

Long-term excessive iodine intake resulted in an increased TT_4 level and a decreased TT_3 level in maternal serum,meanwhile,hepatic and renal type 1 deiodinase activity decreased dose-dependently.A significant reduction in type 2 deiodinase ( D2 ) activity of 12.5 d placenta was found in 3.0 mg/L or above groups.For 19.5 d uterus,D2 activity decreased and type 3 deiodinase activity increased.The results suggest that excessive iodine has an effect on the embryonic development by regulating maternal-fetal thyroid hormone metabolism.