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

BACKGROUND: A Lenke3 type adult idiopathic scoliosis finite element model was established successfully using Mimics software. However, whether the model fits the actual conditions of individualized patients still requires a further revision and validation.OBJECTIVE: To modify and validate the Lenke3 type adult idiopathic scoliosis finite element model by finite element analysis software.METHODS: Based on the characteristics of Lenke3 adult idiopathic scoliosis model, the three-factor and three-level orthogonal experiment was used to optimize the finite element model, making it more close to the actual one. The vertebrae at T1-T4, T5-T8 and L6-S1 levels (sacral lumbarization) were loaded to simulate left and right lateral flexion,as well as extension and flexion, and the range of motion when left and right rotation were compared with Busscher and Yamamoto experiments in vitro.RESULTS AND CONCLUSION: (1) According to the orthogonal experiment, the mean difference and range of each factor and each level were calculated, and finally A1B2C3 combination was the optimal one that can make the model largely consistent with the real situation. The difference in Cobb angles between the clinical lateral flexion test and the parameter pre-modified model simulation was 54.44°, which was decreased to 2.11° after modification. Moreover, the maximum difference in each scoliosis Cobb angle of the modified model was 4.29°. (2) The simulation results of the modified model when compared with the X-ray images when left and right lateral flexion, the two data obeyed normal distribution, so the paired t test was used: left lateral flexion, P =0.082 (P > 0.05); right lateral flexion, P=0.421 (P > 0.05);supine position, P=0.160 (P > 0.05). (3) The range of motion at T1-T4 segments was as followings: left flexion, 3.25°;right flexion, 3.32°; anteflexion 2.52°; extension, 2.89°; left rotation, 3.73°; right rotation 3.76°; the range of motion at T5-T8 segments: left flexion, 1.39°; right flexion, 1.43°; anteflexion 1.35°; extension, 1.34°; left rotation 2.09°; right rotation 2.11°; the range of motion at L6/S1: left flexion: 5.17°; right flexion: 5.19°; anteflexion: 8.92°; extension: 7.35°; left rotation: 1.41°; right rotation: 1.42°. The results were almost consistent with Busscher and Yamamoto experimental results. (4) To conclude, the model is in good agreement with the patient's actual properties after modification. The modified model has good reliability and validity, and provides valid data platform for simulating clinical operation in the future.

Objective To study the epidemiological characteristics and the effects of control measurements in Guangxi by comparing the results from diarrhea-household-surveys conducted in the three different periods of time and to develop control strategies. Methods Data on the incidence, health care seeking and treatment of diarrhea from three household surveys conducted in 1988, 1995 and 2007 was analyzed using SPSS (version 13.0). Results The incidence rates of diarrhea over the three periods of time were 0.562, 0.456 and 0.221 per person-year, respectively (P<0.001). No significant difference was found in the incidence between males and females. The disease mainly attacked young age groups and those with lower educational levels. In recent years, longer durations of disease but less severe were observed in patients with diarrhea. The patients mainly visited first line health services with a health care seeking rate of 28.3%. Antibiotics were used by most of the patients (49.8%-90.2%), while the rate of using oral rehydrathon salts(ORS) was only 1.4%-11.5% but the use of traditional Chinese medicines has increased. Intake of untreated water, contaminated foods and contact with patients were important risk factors on diarrhea. Conclusion The prevalence of diarrhea in Guangxi had declined and the health seeking rate was low in the past two decades. It is necessary to further regulate the treatment, in order to strengthen the health education programs to the general population, in order to improve the accessibility of health services and to increase both the health care seeking rate and effective diagnosis rate.

OBJECTIVETo observe the effect of thalidomide in preventing nausea and vomiting induced by emetogenic cisplatin (CDDP) chemotherapy in patients with advanced non-small cell lung cancer.

METHODSThis study was carried out as a prospective, randomized control clinical trial. 61 patients with advanced non-small cell lung cancer were scheduled to receive chemotherapy (gemcitabin 1000 mg/m(2) i.v. gtt d1, 8 and CDDP 75 mg/m(2) i.v. gtt d1, GP regimen). The patients were randomly divided into a treatment and control groups. All patients in both groups received ramosetron 0.3 mg intravenously (i.v.) and metoclopramide 20 mg intramuscularly (i.m.) 30 min prior to chemotherapy to prevent nausea and emesis on day 1. In the treatment group, addition of thalidomide (50 mg p.o. bid) were administered on days 1 to 5 after the start of chemotherapy.

RESULTSAcute nausea was effectively controlled in 74.2% of the patients in the control group and in 90.0% of treatment group. Acute vomiting was effectively controlled in 90.3% of the patients in the control group and in 93.3% of treatment group. No statistically significant differences showed in effective control of acute nausea and vomiting between the 2 groups (P = 0.108; P = 1.000). Delayed nausea was effectively controlled in 19.4% of the patients in control group and in 56.7% in the treatment group. Delayed vomiting was effectively controlled in 48.4% of the patients in control group and 76.7% in treatment group. Statistically there was a significant differences in effective control of delayed nausea and vomiting between the 2 groups (P = 0.003, P = 0.023). Both antiemetic regimens were well tolerated, and no significant difference was observed in adverse events between the 2 groups (P > 0.05).

CONCLUSIONOur results demonstrate that thalidomide is highly effective in controlling delayed nausea and vomiting episodes in patients induced by moderately emetogenic chemotherapy. Moreover, no serious toxic effects are induced by this treatment.

Antiemetics ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Nausea ; chemically induced ; prevention & control ; Neoplasm Staging ; Prospective Studies ; Thalidomide ; therapeutic use ; Vomiting ; chemically induced ; prevention & control