Two hundred and twenty five children aged 4-12 years with phimosis were treated by flexible dilatation combined with topical betamethasone cream from January 2003 to January 2015.Two hundred and eight cases (92.44％) were completely cured and penile edema and urination were returned to normal 7 d after a single operation;while,17 children received 2-3 additional flexible expansion.During follow-up of 2-24 months,221 children achieved the cure standards with an overall cure rate of 98.22％.Flexible dilatation combined with topical betamethasone cream is effective modality for phimosis in children,with less surgical trauma and low complication rate.

Store-operated Ca(2+) channels (SOCs) are plasma membrane Ca(2+) permeable channels activated by depletion of intracellular Ca(2+) store. Ca(2+) entry through SOCs is known as store-operated Ca(2+) entry (SOCE), which plays an important role in the functional regulation of airway smooth muscle cells (ASMCs). Protein kinase C (PKC) has been shown to have an activating or inhibiting effect on SOCE, depending on cell types and PKC isoforms that are involved. In ASMCs, the effect of PKC on SOCE has not been elucidated so far. In this study, the role of PKC in the activation of SOCE in rat ASMCs was examined by using Ca(2+) fluorescence imaging technique. The results showed that acute application of PKC activators PMA and PDBu did not affect SOCE induced by the sarcoplasmic reticulum Ca(2+)-ATPase (SERCA) inhibitor thapsigargin. The non-selective PKC inhibitor chelerythrine significantly inhibited thapsigargin- and bradykinin-induced SOCE. RT-PCR assay identified PKCα, δ and ɛ isoforms in rat ASMCs. PKCα-selective inhibitor Gö6976 and PKCɛ-inhibiting peptide Epsilon-V1-2 had no effect on SOCE; by contrast, PKCδ-selective inhibitor rottlerin attenuated SOCE dramatically, suggesting that PKCδ was the major PKC isoform involved in the activation of SOCE in ASMCs. Moreover, PKC down-regulation by extended exposure to high doses of PMA or PDBu also reduced SOCE, confirming the essential role of PKC in the activation of SOCE in ASMCs. In addition, PKC down-regulation did not influence the expression of stromal interaction molecule 1 (STIM1) and Orai1, two elementary molecules in the regulation and activation of SOCs. These results identified PKCδ as an essential PKC isoform involved in the activation of SOCE, and confirmed that PKC regulates the function of ASMCs in a SOCE-dependent manner.

In the marketing theory, service disparity model is a simple effective tool, capable of figuring out the five clusters of reasons leading to service failure. This article applies it in the community health service domain. Through the efforts of healing the five gaps in service delivery, including Consumer expectation-management perception gap, Management perception-service quality specification, Service quality specifications-service delivery gap Consumer expectation-management perception gap and Service delivery-external communications gap, we hope to improve the community health service quality radically.

AIM:To investigate the effects of down-regulation of protein kinase C (PKC) on the activity of storeoperated Ca2 + channels (SOC) and the proliferation of airway smooth muscle cells (ASMCs). METHODS:Rat bronchial smooth muscle cells were isolated and cultured. Fluo-3 /AM fluorescence was measured by laser confocal microscope to assessing intracellular Ca2 +. Downregulation of PKC activity was achieved by incubation of ASMCs with PKC activator phorbol-12-myristate-13-acetate (PMA,10 ?mol/L) or phorbol 12,13 -dibutyrate (PDBu,1 ?mol/L) for 24 h. The proliferation of ASMCs was assayed by calculating the reduction rates of Alamar blue. RESULTS:Down-regulation of PKC activity by longterm exposure of PMA or PDBu inhibited the proliferation of ASMCs,the similar results were obtained by using PKC inhibitor chelerythrine. Both downregulation of PKC activity and inhibition of PKC activity by chelerythrine reduced Ca2 + entry through SOC channels. Low concentration of PMA (0. 1 ?mol/L) promoted the proliferation of ASMCs,and this effect was inhibited by SOC blocker SKF-96365. CONCLUSION:Inhibition or down -regu-lation of PKC activity results in the inhibition of SOC channels,suggesting that PKC is involved in the activation of these channels. Ca2 + entry through SOC channels might contribute to PKC-promoted proliferation of ASMCs.

Objective To evaluate the long-term effectiveness of different-dose of botulinum toxin A (BTXA) therapy on axillary hyperhidrosis.Methods Total 86 patients with axillary hyperhidrosis were self-controlled.One group of left axillary was injected with a low-dose of BTXA,50U.Another group of right axillary was injected with a high-dose of BTXA.A total dose of 200 U of BTXA was used per axilla.Patients were followed-up for 29 months.To investigate the effect of two methods,we analyzed two ranked data by rank sum test and x2 test to judge the disparities of the therapeutic effect.Results The results showed that the relapse-free interval of two groups with axillary hyperhidrosis was significant difference through the statistical analysis (P ＜ 0.05).Conclusions High-dose of BTXA treatment is capable of prolonging the antihidrotic effect on axillary hyperhidrosis.

Objective To study the effect and value of hepatoarterical catheter chemotherapy in treating gastric carcinoma with liver metastasis. Methods A total of 31 cases of gastric carcinoma with liver metastasis undergoing radical operation were preoperatively randomly divided into 2 groups: Regional infusion chemotherapy (treatment group, 17 cases) and peripheral venous chemotherapy (control group, 14 cases). Results The short-term effectiveness of the treatment group was 88.3 %(15/17). The survival rates of 1, 2, 3 year were 88.2 %, 62.7 %, 28.9 %, respectively. However, the short-term effectiveness of the control group was 28.6 %(4/14). The survival rates of 1, 2, 3 year were 68.1 %, 38.9 %, 13.0 %, respectively. There was obvious difference between the two groups (χ~2 = 12.87, P <0.05;χ~2 =5.511, P<0.01). Conclusion Hepatoarterical catheter chemotherapy is effective for gastric carcinoma with liver metastasis undergoing radical operation and has less toxic side effects.

Objective To investigate the change of inferior vena cava pressure (IVCP) in type Ⅱ Budd-Chiari syndrome patients undergoing atrial caval shunting and its relationship with postoperative artificial blood vessel (ABV) patency rate.Methods We recruited 209 patients who had undergone atrial caval shunting for type Ⅱ Budd-Chiari syndrome and evaluated IVCP,right atrial pressure (RAP) and free portal vein pressure (PFP) before and after ABV opening.Presure changes were compared by t-test.These patients were followed up by color Doppler ultrasonograthy for ABV patency.The correlation between IVCP and postoperative ABV patency were analyzed By Kaplan-Meier test.Results IVCP (t =0.56,P ＜ 0.05)and PFP (t =0.72,P ＜ 0.05) decreased and RAP increased significantly after ABV opening (t =0.52,P ＜ 0.05).Follow up result showed that ABV patency rate was lower in patients with IVCP descent ＜ 1 kPa than those with IVCP descent ＞ 1 kPa (P ＜ 0.05).Conclusions Significant IVCP descent correlates with high ABV patency rate after atrial caval shunting in type Ⅱ Budd-Chiari syndrome patients.

Objective To explore the effect of intraoperative tension adjustment and postoperative scar formation in the treatment of circular skin defects using modified purse-string suture.Methods Twenty-eight cases of circular lesions in the face region were selected and resected along the edge.We first used purse-string suture technique to reduce the circular defect area,and then closed the wound with linear suture in random direction.After 7 days,the stitches were removed and longterm follow-up effects were observed.Results All patients had no facial organ deformation and displacement,the length of the linear scar lesions was shorter than the preoperative length.In 28 cases,one patient's surgical wound was dehisced after removal of stitches in 24 h,and the rest of the skin defects healed after operation in stage Ⅰ.All cases were followed up for 3 months to 1 year,and had a satisfactory therapeutic effect.Conclusions Modified purse-string suture can linearly close the dicision in stage Ⅰ,reduce the scar area and maintain the normal morphology and relative position of the nearby organs.

Objective To investigate the influence of diameter of liver outflow vein on portal hypertension and artificial blood vessel (ABV) patency rate in Budd-Chiari syndrome (BCS) patients undergoing atrial caval shunting (ACS).Methods We recruited 209 patients,who had undergone ACS for Ⅱ type of BCS.Those patients with unobstructed liver outflow vein were included into group A and the patients with stenosed liver outflow vein into group B.Free portal pressure (FPP) was measured before and after ABV opening.Portal vein velocity (Vpv),liver function,spleen volume and function,esophagogastric varices and ABV patency were evaluated postoperatively.Results After ABV opening,FPP decreased significantly in group A than group B (t =10.45,P ＜ 0.05).Vpv accelerated significantly in group A 2 weeks after operation than group B (t =12.81,P ＜ 0.05).Apparent improvement of liver function,spleen function and esophagogastric varices and reduction of spleen volume were observed in group A patients than group B patients (P ＜ 0.05).Reduction of esophagogastric varices in group A was better than in group B (x2 =44.73,P ＜ 0.05).By postoperative follow up,ABV patency of group A was higher than group B (P ＜ 0.05).Conclusions Patency status of liver outflow vein significantly influences postoperative portal vein pressure and closely correlats to ABV patency rate after ACS.

Objective To introduce an operative method of rhytidectomy with W-incision and fewer complications for facial rejuvenation.Methods A total of 84 patients were treated with rhytidectomy by multi-methods and followed up from January 2007 to December 2012.The rhytidectomy was done along the temporal hairline edge through the combined procedures,including sharp and blunt separation,liposuction and filling with autologous fat,tighting and fixing the fascial flap of superficial musculoaponeurotic system,as well as the suspension of the zygomatic cheek fiber fat pad.Results Follow-up for 3 moths to 2 years after surgery in 84 patients showed that the wound was healing with good concealment and without complications such as facial nerve injury or local uneven.All the cases achieved good results in facelift with high satisfaction rate after the combined operations.Conclusions This combined rhytidectomy is safe,effective,simple and easy.And it is a good and ideal approach of facial rejuvenation worthy of clinical application.