Objective To observe the effect of oral minirin in postoperative transsphenoidal surgery patients with central diabetes insipidus. Methods The changes in the urine volume and osomlality after two weeks of minirin medication (0. lmg, 3 times each day) were observed in 34 patients with central diabetes insipidus underwent transsphenoidal surgery. Results After two weeks of minirin therapy,the average daily urine volume decreased from 7985.40 ±410. 36 ml to 2277. 87 ± 328. 94 ml,and the average plasmas osmolarity increased from 301. 68 ± 3. 59 ml/d to 313. 26 ±4. 87 mOsm/ kg. No adverse reaction was observed during the therapy. Conclusions Minirin is effective and safe in the therapy of postoperative transsphenoidal surgery patients with central diabetes insipidus.

Objective To investigate the effects of estrogen replacement therapy on the serum nitric oxide and endothelin-1 level of ovariectomized rat.Methods The ovariectomized animal model and estrogen replacement therapy rat were established,thirty female rats were randomly divided into three groups:group A,ovariectomy;group B,ovariectomy plus estrogen replacement therapy;group C,sham-ovariectomy.The rats were killed after two months.The serum nitric oxide and endothelin-1 level were determined.Results In group A,the serum nitric oxide level was lower as compared with group C,but the serum endothelin-1 level was higher than those in group C.In group B,the serum nitric oxide level was higher and the serum endothelin-1 level was lower than those in group A.Conclusions Estrogen could modulate the productions of the nitric oxide and the endothelin-1 in the vascular endotheliocytes and improve the function of the vascular endothelial cells,which may be a bases of the benificial effect of estrogen in the prevention of atherosclerosis.

Objective To explore the efficacy of foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in the treatment of concealed penis. Methods Fifty-eight patients diagnosed as concealed penis were included in the study.All of them underwent the foreskin-deglove and shaft-fix procedure.Foreskin was degloved from 5 mm to 10 mm proximal to corona deep to the root,and bilateral tunica albuginea at this level was sutured to suprapubic scarpas' fascia.Z plasty of penis and scrotum skin was applied to cover penile shaft. Results After follow-up for 6 to 12 months,there was no recurrent retraction of the penile shaft,and all the patients were satisfied with the appearance of penis after plastic surgery.Edema of prepuce occurred in 2 patients,and completely regressed in 2 to 3 months.There was no incision scar hyperplasy,and the function of urination and erection were normal. Conclusion Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin can resolve pathologic problems of concealed penis and has favourable aesthetic results with less complications.It is easy to perform and is an ideal procedure in the treatment of concealed penis.

Genomic DNA sequence analysis of phytochrome like photoreceptors in a number of bacteria revealed several open reading frames (ORFs) encoding proteins with amino acid sequences homologous to plant phytochromes. The phytochrome like photoreceptors, collectively called bacteriophytochromes, contain an N-terminal domain homologous to the chromophore-binding domain (CBD) of higher plants and a C-terminal domain of histidine kinase domain( HKD). Due to their simple structure, bacteriophytochromes broaden the view of phytochrome evolution and provide us with a simple model to investigate phytochrome-mediated light signal in higher plants. In this report, the bacteriophytochromes from Synechocystis sp. PCC6803 were investigated. The gene cph1 and its fragment cph1 (C-435) were isolated from the Synechocystis sp. PCC6803 genomic DNA by polymerase chain reaction(PCR) using specific primers. Then, the genes were cloned with the vector pBluescript, yielding plasmids pBlu-cphl and pBlu-cph1 ( C-435), before they are subcloned with the vector pET30, using the EcoRV and Xho I restriction sites. pBlu-cph1, pBlu-cph1 (N-435) were cleaved with Sma I and Xho I, and the released genes were ligated to the pET30a fragment. The E. coli [strain BL21 (DE3)] cells containing recombinant pET30a were grown in medium RB at 20 degrees C, and harvested 6 h later after induction with isopropyl thio-beta-D-galactoside (IPTG). Then, reconstitution systems were employed to study the characteristics of the genes. In the reconstitution system, autoassembly of aprotein of phytochrome with PCB was investigated. The chromophore addition was an autocatalytic process. Reconstitution products were red/infrared (R/FR) photochromic, which was similar to that of the phytoehrome in higher plants. How ever, the spectral change ratios (deltaAmax/deltaAmin) of the two fragments differed from each other. It was also shown that PCB was covalently bound to apo-protein via Zn2+ fluoresc ence SDS-PAGE. After irradiation by light of 700 nm, the maximum absorption spectrum o f holo-Cphl was 650nm. The absorption of it after denaturatior in the dark with ur ea in the presence of hydrochloric acid (pH = 2) was 660nm, which was similar with th at of cis-PCB. In addition, after irradiation by light of 650nm, the maximum absorption spectrum of holo-Cph1 was 700nm. The absorption of it after denaturation in the dark with urea in the presence of hydrochloric acid (pH = 2) was 600nm, which was similar with that of trans-PCB. The result showed that the photochromism of phytochrome resulted from the isomerizaation of chromophore (PCB in this report). The reconstitution of Cph1 (C-435) under the same condition supported the conclusion. Fluorescence emission spectrum of the products suggested that bacteriophytochrom e structure with cis-PCB was more stable than that with trans-PCB. The new reconstitution system in this report sets a base for the application of phytochrome as photochromic biomaterials in biosensors. In addition, phytochrome shows great potential in food, cosmetic and biological engineering, etc.
Bacterial Proteins ; biosynthesis ; chemistry ; genetics ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Gene Expression Regulation, Bacterial ; radiation effects ; Genetic Vectors ; Photochemistry ; Phytochrome ; biosynthesis ; chemistry ; genetics ; Protein Kinases ; biosynthesis ; chemistry ; genetics ; Recombinant Proteins ; biosynthesis ; chemistry ; genetics ; Synechocystis ; chemistry

AIMTo report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases.

METHODSFrom May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old (average 11.62 +/- 7.18 years) with failed previous hypospadias surgery were included in the present study. Indications included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corpora cavernosa. The neourethra was tubularized, and covered with subcutaneous (dartos) tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases.

RESULTSThe buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months (mean 22.6 months), the total complication rate was 15.1%, with five cases of fistula and three cases of stricture.

CONCLUSIONInlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Secondary Prevention ; Transplants ; Treatment Outcome ; Urethra ; surgery ; Urethral Stricture ; prevention & control ; Urinary Fistula ; prevention & control ; Urologic Surgical Procedures, Male ; adverse effects ; methods

BACKGROUNDDiffusion weighted imaging (DWI), with the applying of intravoxel incoherent motion model, has showed promising results in obtaining additional information about microperfusion and tubular flow associated with morphologic changes in chronic kidney diseases. The study aims to evaluate the potential of T2-weighted signal intensity (SI) and DWI with mono- and bi-exponential models to reflect the serial changes on cisplatin (CP) induced rat renal fibrosis models.

METHODSMagnetic resonance exams were performed prior to and 2 nd day, 4 th day, 6 th day, 8 th day, 2 nd week, 3 rd week and 4 th week after CP injection at a 3.0T with an animal coil. Besides T2-weighted images (T2WI), DWI of 13 b values from 0 to 1500 s/mm 2 was acquired. Apparent diffusion coefficient (ADC), fluid fraction f, pure diffusivity D and pseudodiffusivity DFNx01 values were calculated. The regions of interest were placed on cortex (CO), outer stripe of the outer medulla (OM) and inner stripe of the outer medulla (OM), parameters were measured and compared among different time points. Five rats were scarified at each time point for pathological examination.

RESULTSOM revealed remarkable hyperintense and broadened before it became an obscure thread, while CO demonstrated moderate hyperintense and IM didn't show significant change on T2WI. On all three stripes, ADC values decreased firstly then kept increasing since the 4 th day; f values decreased on all stripes; D values had a tendency to increase with fluctuations but the changes didn't achieve statistical significance; DFNx01 values increased at the 2 nd day then tended to be steady thereafter. Pathological findings revealed tubules epitheliums swelling followed by inflammation cells infiltration, interstitial fibrosis was observed since the 2 nd week.

CONCLUSIONSAll of T2-weighted SI, ADC, and biexponential models parameters vary during fibrotic process; biexponential model is superior to monoexponential model in separating changes of microperfusion together with tubular flow from pure diffusion.

Animals ; Cisplatin ; therapeutic use ; Diffusion Magnetic Resonance Imaging ; methods ; Disease Progression ; Fibrosis ; diagnosis ; Kidney Diseases ; diagnosis ; Male ; Models, Animal ; Rats ; Rats, Sprague-Dawley ; Renal Insufficiency, Chronic ; diagnosis

OBJECTIVETo report the clinical characterization of a large Chinese kindred with von Hippel-Lindau (VHL) disease and to evaluate the role of VHL genetic testing in diagnosis of VHL disease and clinical screening for members in VHL disease family.

METHODSA large kindred with VHL disease was studied. DNA extracted from peripheral blood was amplified by PCR to three exons of VHL gene in 27 members. PCR products were directly sequenced. The data on involvement of multi-organs in the VHL disease kindred were obtained by medical history taking and radiography.

RESULTSThere were 47 members in the four generations of the Chinese VHL kindred; among them, 18 members were patients with diagnostically proven VHL disease. Their clinical manifestations included: central nervous system(CNS) hemangioblastoma (n=5), renal cell carcinomas and CNS hemangioblastoma (n=3), renal cell carcinomas and retinal angiomas (n=3), renal cell carcinomas and multiple pancreatic cysts (n=1), renal cell carcinomas and retinal angiomas and multiple pancreatic cysts (n=2), renal cell carcinomas and CNS hemangioblastomas and multiple pancreatic cysts (n=1), and multiple pancreatic cysts and multiple renal cysts (n=1), and multiple pancreatic cysts (n=2). The common lesions of 18 patients in the large kindred were: renal cell carcinomas (56%), CNS hemangioblastomas(50%),retinal angiomas(28%), and multiple pancreatic cysts(39%). Of the 27 members who volunteered for genetic analysis, all 11 affected family patients who are still alive, including 9 affected family patients and 2 asymptomatic patients, presented a codon 78 from Asn to Ser change at nucleotide 446(A to G) in exon 1. Four members were carriers with the same VHL gene mutation. Two asymptomatic cases were initially diagnosed by genetic testing and subsequently confirmed by radiological imaging and surgery. Members not having the gene mutation had no clinical evidence of VHL disease.

CONCLUSIONThe large Chinese kindred with VHL disease was classified as type . The main characteristics of the kindred are higher incidence of renal cell carcinomas and lower incidence of retinal angiomas. The genetic testing played an important role in early detecting asymptomatic patients and the carriers in clinical screening for members in the VHL families. Also, it is important to prevent the transmission of VHL disease to the offspring in the kindred.

Base Sequence ; China ; DNA ; chemistry ; genetics ; DNA Mutational Analysis ; Family Health ; Female ; Genetic Testing ; Humans ; Male ; Mutation ; Pedigree ; Tumor Suppressor Proteins ; genetics ; Ubiquitin-Protein Ligases ; genetics ; Von Hippel-Lindau Tumor Suppressor Protein ; von Hippel-Lindau Disease ; classification ; diagnosis ; genetics

BACKGROUNDVon Hippel-Lindau (VHL) disease is a heraditary cancer syndrome caused by germline mutations of the VHL tumor on the suppressor gene. This study was to show the clinical characteristics of a large Chinese kindred with von Hippel-Lindau disease and to evaluate the role of the genetic test of VHL disease in the diagnosis of VHL disease and clinical screening of members of the VHL disease family.

METHODSDNA extracted from peripheral blood was amplified by PCR to three exons of the VHL gene in 27 members of a large kindred with VHL disease. PCR products were directly sequenced. The involvements of multi-organs in the kindred with VHL disease were confirmed by history taking and radiography.

RESULTSOf 47 members in the four generations of the kindred, 18 members were diagnosed as having VHL disease. Clinical manifestations of 18 patients included: central nervous system (CNS) hemangioblastoma (5), renal cell carcinoma and CNS hemangioblastoma (3), renal cell carcinoma and retinal angioma (3), renal cell carcinoma and multiple pancreatic cysts (1), renal cell carcinoma and retinal angioma and multiple pancreatic cysts (2), renal cell carcinoma and CNS hemangioblastomas and multiple pancreatic cysts (1), and multiple pancreatic cysts and multiple renal cysts (1), multiple pancreatic cysts (2). The common lesions of the 18 patients were renal cell carcinoma (55.6%), CNS hemangioblastoma (50.0%), retinal angioma (27.8%), and multiple pancreatic cysts (38.9%). Among the 27 members who volunteered for genetic analysis, 15 members including 9 affected family patients and 2 asymptomatic patients and 4 carriers, who are still alive, presented a codon 78 from Asn to Ser change at nucleotide 446 (A-->G) in exon 1. Four members were carriers with the same VHL gene mutation. Two asymptomatic patients were initially diagnosed by genetic testing and subsequently confirmed radiologically and surgically. Members without gene mutation had no clinical evidence of VHL disease.

CONCLUSIONSThe large Chinese kindred with VHL disease was classified as type I. The main characteristics in the kindred were higher incidence of renal cell carcinoma and lower incidence of retinal angioma. Genetic test plays an important role in early detecting asymptomatic patients and the carriers in clinical screening of members of the families with VHL disease. It is also important to prevent the transmission of VHL disease to their offsprings in the kindred.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mutation ; Pedigree ; Tumor Suppressor Proteins ; genetics ; Ubiquitin-Protein Ligases ; genetics ; Von Hippel-Lindau Tumor Suppressor Protein ; von Hippel-Lindau Disease ; complications ; diagnosis ; genetics

OBJECTIVETo summarize the experience of radical retropubic prostatectomy (RRP) and the multi-factors which influence on the prognosis and long life quality.

METHODSFrom January 1993 to March 2005, 132 cases radical retropubic prostatectomy were performed. The patients were divided into 2 groups: the early group and recent group. Eleven items in peri-operative time and follow up results were analysed. The erection function of 78 cases were investigated with international index of erectile function 5 score. In these patients, nocturnal electrobioimpedance volumetric assessment (NEVA) were observe in 19 cases.

RESULTSComparing of the 2 groups, the index connected with operative skill changed to optimization. No one died of prostate cancer in 63 follow up patients. Nine cases showed biochemical failure with criterion as prostate specific antigen > 0.4 microg/L. Fifty patients passed urine normal post-operation in 6 months. Eight patients had stress incontinence and 5 had entire incontinence at 6 month. Four patients had vesical neck stricture. Another follow up result shows 33 (58.9%) erection function recovered in 55 bilateral nerve-sparing operation and 7 recovered in 22 of unilateral nerve-sparing operation. NEVA shows 14 cases with artery supply insufficient in whom 4 regained erection function and 5 cases vein leakage in whom no one recovered.

CONCLUSIONSThe radical retropubic prostatectomy remains the procedure of choice for the cure of localized prostatic cancer. The keys for the operation are anatomic dissection, preservation of the neurovascular bundle and good skill. These are also important for a good life quality for the patients.

Aged ; Erectile Dysfunction ; etiology ; prevention & control ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penile Erection ; Postoperative Complications ; etiology ; prevention & control ; Prostatectomy ; adverse effects ; methods ; Prostatic Neoplasms ; physiopathology ; surgery ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Urinary Incontinence ; etiology ; prevention & control

Thirty-eight pregnant inpatients with acute pancreatitis (AP) were retrospectively reviewed from 2006 to 2012 in our hospital. The incidence of pregnancy-associated AP was 2.27‰. Most (78.95%) of the attack occurred in the third trimester. The median of APACHE II score was 6 and severe AP accounted for 31.58% (12 cases). Primary diseases were absent in most cases (57.89%). The most common clinical presentations were abdominal pain (89.47%) and vomiting (68.42%). Pleural effusion and ascites were found only in the third trimester. Elevated white blood cell count, amylase and lipase were commonly found in biochemical examinations. Eleven cases required intensive care in ICU and 21 cases received caesarean section. There were 2 maternal deaths and 12 fetal losses including 4 abortions. It is concluded that AP is a rare entity in pregnancy. The incidence of pancreatitis increases with the gestational age. However, the severity is not necessarily related with the pregnancy trimesters. The diagnosis is based on clinical presentations, laboratory tests and imaging examinations. Although the treatment strategy of a pregnant woman with pancreatitis is similar to the general non-pregnant patient with AP, a multidisciplinary team consisting of gastroenterologist, gastrointestinal surgeon, radiologist, obstetrician, and ICU doctor should be set up.
Adult ; Female ; Fetal Death ; diagnosis ; Humans ; Longitudinal Studies ; Maternal Death ; Pancreatitis ; complications ; diagnosis ; therapy ; Pregnancy ; Pregnancy Complications ; diagnosis ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult