Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

The study was aimed to investigate the influence of penicillin and streptomycin on proliferation, apoptosis and extracellular secretion (ECS) produced from human umbilical cord derived mesenchymal stem cells (MSC). MSC were isolated from umbilical cord tissue, then the immunotyping, multipotent differentiation and proliferation of these cells were assayed by cytometry, cytochemistry and MTT respectively. The expressions of ECS and apoptosis-related genes (bcl-2, bax) were detected by quantitative RT-PCR. The results showed that the phenotype of these cells matched with the characteristics of MSC. Penicillin and streptomycin of low concentrations promoted MSC proliferation, with the most effective concentration of 100 U/ml. Expressions of ECS cultured in addition of penicillin and streptomycin were down-regulated. Furthermore, apoptosis-related factor (bcl-2/bax) expression levels in low concentrations penicillin and streptomycin groups were higher than that in the control group. It is concluded that low concentrations penicillin and streptomycin can promote the proliferation and reduce the apoptotic rate, but high dose can inhibit the ECS component expression of MSC.
Cell Differentiation ; Cells, Cultured ; Extracellular Matrix ; secretion ; Flow Cytometry ; Gene Expression Regulation ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; secretion ; Penicillins ; pharmacology ; Streptomycin ; pharmacology ; Umbilical Cord ; cytology

Objective:To observe the effect of acupuncture in regulating ubiquitin-proteasome pathway (UPP),and discuss the action of acupuncture in intervening heroin-induced brain damage.Methods:Thirty male Sprague-Dawley (SD) rats were divided into a control group,a model group and an acupuncture group by using the random number table.Rats in the model and acupuncture groups received intramuscular heroin injection for successive 8 d at a progressively increased dose.Afterwards,the injection was suspended for 5 d for withdrawal.The heroin relapse rat model was established by repeating the drug addiction and withdrawal process for 3 times.The control group followed the step of the model establishment,but was given intramuscular injection of normal saline at the stage of addiction and no intervention at the stage of withdrawal;the model group was given intramuscular heroin injection at a progressively increased dose at the addiction stage and no intervention at the withdrawal stage;the acupuncture group was dealt in the same way as the model group at the addiction stage,but received acupuncture at Baihui (GV 20) and Dazhui (GV 14) at the withdrawal stage,with the needles retained for 30 min each time,1 session a day,for successive 5 d.On the 39th day,brain tissues were extracted from the hippocampus and ventral tegmental area (VTA) of the three groups of rats.The apoptosis of brain nerve cells was detected by using terminal deoxynucleotidyl transferase-mediated nick and labeling (TUNEL).The mRNA and protein expressions of ubiquitin (Ub),ubiquitin protein ligase (E3) and 26S were examined by immunohistochemistry and quantitative real-time polymerase chain reaction (RT-qPCR).Results:Compared with the model group,rat's hippocampus and VTA in the acupuncture group showed significantly fewer cells positively stained by TUNEL staining (P＜0.01),and its mRNA and protein expressions of Ub,E3,26S were significantly lower (P＜0.01).Conclusion:Reducing nerve cell apoptosis and regulating the mRNA and protein expressions of Ub,E3 and 26S in rat's hippocampus and VTA are possibly one of the action mechanisms of acupuncture in intervening heroin-induced brain damage.

Objective To explore the influence of the social support on psycho-healthy and therapeutic effect of patients with extremities bone fracture; to provide theory guidance for formulating psycho-healthy education. Methods A total of 90 patients with extremity bone fracture were divided into control group and observation group equally. Carring out routine healthy eduction on control group, while mental intervention and routine healthy education on observation group, undertaking psychological assessment with social support rating scale(SSRS) and state anxiety scale(SAI) one week after hospital admission and one week prior to discharge.Results Comparing the score of social support and anxiety, there was difference between two groups prior to discharge( P ＜0. 05 ). The difference of short-term effect of fracture assess between two groups were statistically significant( P ＜ 0. 05). Conclusions The selectivity mental nursing could improve the social support, psychohealth level and bone fracture therapeutic effect of patients with extremities bone fracture.

OBJECTIVETo develop a method for detection of coxsackie B virus type 1-6 by RT-PCR.

METHODSA pair of primers were designed to amplify all types of coxsackie B virus 1-6 efficiently. The PCR product was hybridized in micro-wells in which 6 type specific oligonucleotide probes had been coated respectively, colorimetric detection was performed to discriminate the types of coxsackie B virus.

RESULTSThis method was shown to be concordant with the IgM ELISA, 71.7% of anti-coxsackie B positive cases could be detected by RT-PCR.

CONCLUSIONThe RT-PCR method can type coxsackie B virus efficiently and provides a tool for clinical diagnosis and epidemiological investigation.

DNA Primers ; Enterovirus B, Human ; classification ; genetics ; isolation & purification ; Enterovirus Infections ; diagnosis ; virology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin M ; blood ; Reverse Transcriptase Polymerase Chain Reaction ; methods

Type 2 diabetes is a major global health problem. It is generally accepted that type 2 diabetes is the result of gene-environmental interaction. However, the mechanism underlying the interaction is unclear. Diet change is known to play an important role in type 2 diabetes. The fact that the global high prevalence of type 2 diabetes has occurred following the spread of food fortification worldwide suggests a possible involvement of excess niacin intake. Our recent study found that nicotinamide overload and low nicotinamide detoxification may induce oxidative stress associated with insulin resistance. Based on the relevant facts, this review briefly summarized the relationship between the prevalence of type 2 diabetes and the nicotinamide metabolism changes induced by excess niacin intake, aldehyde oxidase inhibitors, liver diseases and functional defects of skin. We speculate that the gene-environmental interaction in type 2 diabetes may be a reflection of the outcome of the association of chronic nicotinamide overload-induced toxicity and the relatively low detoxification/excretion capacity of the body. Reducing the content of niacin in foods may be a promising strategy for the control of type 2 diabetes.
Diabetes Mellitus, Type 2 ; epidemiology ; etiology ; Diet ; Food, Fortified ; adverse effects ; Humans ; Niacin ; administration & dosage ; adverse effects ; Niacinamide ; administration & dosage ; adverse effects

Breast Neoplasms ; pathology ; Cell Culture Techniques ; methods ; Cells, Cultured ; Female ; Humans ; Immunohistochemistry ; methods ; Quality Control

OBJECTIVETo explore the influence of vacuum-assisted closure technique (VAC) on expression of Bcl-2 and NGF during wound healing.

METHODSEighty Sprague-Dawley rats were randomly divided into 4 groups with 20 rats of each. Group T was the experimental group; group C1, C2 and C3 were the control groups. In group T and group C1, capsaicin was injected subcutaneously to the back of the rats to destroy the sensory nerve. VAC was employed to the wound of the rats in group T and C2 three times a day at 80 mmHg negative pressure. In all the groups, tissue samples were taken from the wound edge and granulation at 1, 3, 6, 9 and 12 days after the injury. Immunohistochemistry and in situ hybridization were used to detect the expression of Bcl-2 and NGF/NGFmRNA in the samples.

RESULTSIn group C2 and C3, the expression of Bcl-2 and NGF/NGFmRNA was obvious, which increased gradually and reached the peak at the 9th day. In the process of wound healing, the expression Bcl-2 and NGF/NGFmRNA was higher in the group C2 than in group C3 (P < 0.05). The expression Bcl-2 and NGF/NGFmRNA in group T and C1 was lower than group C2 and C3 (P < 0.05).

CONCLUSIONThe application of the vacuum-assisted closure technique during wound healing increases the expression of the apoptosic modulation related protein Bcl-2 and affects the expression of NGF/NGFmRNA, which may promote the wound healing process.

Animals ; Gene Expression ; Immunohistochemistry ; In Situ Hybridization ; Male ; Models, Animal ; Nerve Growth Factor ; analysis ; genetics ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; genetics ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Vacuum ; Wound Healing

OBJECTIVETo improve prognosis of the patients with advanced Wilms' tumor, the authors compared different therapeutic strategies including preoperative transcatheter arterial chemoembolization (TACE), conventional preoperative chemotherapy and initial surgery.

METHODSSixty-two patients aged from 5 months to 10 years (mean 3.2 years) were identified from medical records to have histologically confirmed advanced Wilms' tumor during the period from January 1993 to December 2002. The criteria for choice were huge tumor size with a volume more than 550 ml or the mass extending beyond the midline, involvement of vital structures, inferior vena cava invasion, distal metastasis or bilateral Wilms' tumor judged by imaging examination. All cases were divided into 3 groups according to the treatment received: 31 cases in group TACE received preoperative transcatheter arterial chemoembolization with Lipiodol-Epirubicin (EPI)-Vincristine emulsion. One week after TACE, systemic chemotherapy with Actinomycin D (ACTD) was administered and tumor resected at two weeks after TACE. 20 cases in group PC received conventional preoperative chemotherapy with VCR, ACTD plus EPI for 4-5 weeks, and 11 cases in group IS underwent initial surgery. Postoperative treatment for all patients was based on the postoperative staging and tumor histology.

RESULTSIn the patients treated with TACE, no drug-induced complications such as cardiotoxicity, nephrotoxicity, hepatic dysfunction or bone marrow suppression were observed except for mild fever due to tumor necrosis. The percentages of tumor size shrinkage were 32.4% and 20.3% in group TACE and group PC, respectively (P < 0.05). Complete surgical removal of the tumor was achieved in 27 patients (87.1%) in group TACE, significantly higher in comparison with 14 in group PC (70.0%, P < 0.05) and 2 in group IS (18.2%, P < 0.01). Event-free survival (EFS) at 2 years was 87.1% (27/ 31), 60.0% (12/20) and 18.2% (2/11), respectivrely. EFS at 4 years was 84.6% (11/13), 56.3% (9/16 ) and 18.2% (2/11) in groups TACE, PC and IS, respectively.

CONCLUSIONThe present study has shown that both preoperative TACE and conventional preoperative chemotherapy can be applied to the patients with advanced Wilms' tumor who are not candidates for immediately surgical resection. The survival is significantly increased in the patients undergoing preoperativeTACE when compared with conventional preoperative chemotherapy and initial surgery.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemoembolization, Therapeutic ; Child ; Child, Preschool ; Combined Modality Therapy ; Dactinomycin ; administration & dosage ; Disease-Free Survival ; Epirubicin ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Infant ; Iodized Oil ; administration & dosage ; Kidney Neoplasms ; mortality ; pathology ; therapy ; Male ; Neoplasm Staging ; Nephrectomy ; Preoperative Care ; Survival Rate ; Treatment Outcome ; Vincristine ; administration & dosage ; Wilms Tumor ; pathology ; therapy

OBJECTIVETo evaluate a new method of urethroplasty.

METHODSA total of 212 patients with hypospadias aged from 4 months to 9 years (glans type, n = 8; penis type, n = 181, penoscrotal type, n = 23) underwent tubularized incised plate urethroplasty.

RESULTSFollowed up for 2 approximately 34 months, 188 cases obtained optimal functional and cosmetic results, 22 developed small fistulae and 16 were cured after a second operation 6 months later, 6 waited to be operated again, 2 cases of neourethra dehiscence were cured by second tubularized incised plate urethroplasty one year later.

CONCLUSIONWith its simplicity, low complication rate and reliable creation of a normal-appearing glanular meatus, tubularized incised plate urethroplasty can particularly be applied to boys with proximal hypospadias absent of severe penile curvature.

Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Hypospadias ; surgery ; Infant ; Male ; Penis ; surgery ; Treatment Outcome ; Urethra ; surgery