Objective To study and analyze the cause, prevention and treatment for complications in patients with serious hypospadias repaired by one-stage urethroplasty. Methods From 1987 to 2002,275 patients with serious hypospadias were repaired by one-stage urethroplasty, there were 35 cases had complications. The classifications were penoscrotal 148 cases, scrotal 95 cases and perineal 32 cases. The lengths of new urethras were from 3.0 to 8.4 cm, the mean was (4.1?0.7) cm. Thirty-two cases were received endocrinotherapy before urethroplasty. Results The rate of complications was 12.7% for 1～3 years following survey. There were urethral fistulas 24 cases (8.7%),urethral strictures 6 (2.2%), diverticulums 3 (1.1%), chordees 2 (0.7%).The rate of urethral fistulas was the first and urethral stricture was the second, they were higher than those of other complications (P

ObjectiveTo discuss the correlation between kidney-deficiency constitution and brain function decline, and material basis of kidney-storing-spirit theory and neurobiology mechanism. Methods By employing the method of “cats scare rats”, composite offspring rat models with deficiency and acquired dystrophy were built, then they were divided into model group,ZuoguiPill group and Yougui Pill group. Blank group was composed from normal pregnant rats. When the intimidation of offspring began,Zuogui Pill andYougui Pill groups received gavage with corresponding doses of medicine, 1 times per day for 2 consecutive months. Model and blank groups received the same amount of normal saline. Exercise capacity was detected by suspension test. Learning and memory capacity was detected by Y maze test. Expressions of NMDA receptor subunits NR2A and NR2B were detected by immunohistochemical method.Results In suspension test, the duration of model group was shorter than blank group (P<0.05), while duration ofZuogui Pill andYougui Pill groups was longer than the model group (P<0.05). In Y maze test, the correct number of model group was less than blank group, and increased significantly after treatment (P<0.05). The optical density of NR2A and NR2B was lower in model group than blank group (P<0.05) and higher inZuogui Pill andYougui Pill groups than model group (P<0.05).ConclusionThe neurobehavioral is abnormal and NMDA receptor expression depresses in rats with kidney- deficiency constitution.ZuoguiPill andYouguiPill can rise NMDA receptor expression and improve brain function of rats, which reveal the correlation between kidney-deficiency constitution and brain function decline, and material basis of kidney-storing-spirit theory and neurobiology mechanism.

Objective To observe the effects of kidney-supplementing TCM on the brain-derived neurotrophic factor (BDNF) expression of rats with kidney-deficiency constitution;To discuss the correlation between functional activity of neurons in hippocampus with the theory of kidney storing aspiration.MethodsComposite rat models with offspring deficiency and acquired dystrophy were built through the method of “cats scare rats”, and then were divided into model group,Zuogui Pill group,Yougui Pill group, and blank group in which offspring came from normal pregnant rats. After the treatment with kidney-supplementing TCM, weight of brain and kidney, brain weight indexes and the BDNF expression were detected.Results Compared with the blank group, the quality of brain, kidney and brain weight indexes, BDNF expression decteased of rats in model group were lower;flaky edema appeared in hippocampus observed by microscope;the number of nerve cells decreased and loosely structured. After the treatment of kidney-supplementing TCM, the weight of brain and kidney and brain weight indexes recovered to some extent;BDNF expression increased;nerve cells in cerebral cortexincluding hippocampus increased;the cell structure compacted and the level cleared as well as no edema.Conclusion The BDNF expression has correlation with the theory of kidney storing aspiration. Kidney-supplementing TCM can improve brain function and significantly improve declining situation of brain function of rats with kidney-deficiency constitution.

Objective To discuss the adjustment effects of kidney reinforcing medicine on growth and development and the content of choline acetyl transferase (CHAc) in rats with kidney-deficiency constitution. Methods The method of cats scare rats was used to build composite offspring rat models with deficiency and acquired dystrophy, and then the models were divided into model group, Zuogui Pill group and Yougui Pill group. The rats in blank group came from normal pregnant rats. Baby rats were scared and received gavage at the same time. All administration groups received suspension of Zuigui Pills or Yougui Pills. Blank group and model group received the same amount of normal saline, once a day, for 3 months. Growth and development of rats were observed. Weight and food utilization of rats aged 5–8 weeks in each group were recorded. The content of brain CHAc was detected by ELISA. Results When offspring were 5–8 weeks old, weights of rats in the model group were lower than blank group (P<0.01); while weights of rats in Zuogui Pill group and Yougui Pill group increased significantly (P<0.05) and the food utilization was positively correlated with weight; the CHAc content in the model group decreased significantly compared with blank group (P<0.05, P<0.01); while the CHAc content in Zuogui Pill group and Yougui Pill group increased significantly compared with the model group (P<0.01). Conclusion Kidney reinforcing medicine can improve backward growth and development of rats with kidney-deficiency constitution and adjust CHAc in the brain, so as to promote the learning and memory ability of rats with kidney-deficiency constitution.

BACKGROUND: At present, bladder acellular matrix grafts have been successfully used for substituting animal bladder and urinary canal, and for repairing hypospadia. However, reports on bladder acellular matrix grafts for substituting albuginea penis need to be investigated. OBJECTIVE: Allogeneic bladder acellular grafts were used for substituting albuginea penis of rabbits, in order to observe repairing results. DESIGN: A randomized controlled observation. SETTING: West China Medical Laboratory Animal Center and West China Laboratory of Tissue Engineering of Sichuan University as well as Laboratory of Tissue Engineering of Guiyang Medical College. MATERIALS: Fifty male healthy New Zealand Rabbits of grade 3, weighing 2.6-3.0 kg, without phimosis and penis dysplasia, and without presence of phallocampsis after normal saline being perfused, were provided by Huaxi Laboratory Animal Center of Sichuan University. METHODS: This study was performed at the West China Laboratory Animal Center and West China Laboratory of Tissue Engineering of Sichuan University as well as Laboratory of Tissue Engineering of Guiyang Medical College between December 2005 and June 2007. Bladders were taken from 10 experimental rabbits for preparing bladder acellular matrix grafts. The other 40 New Zealand rabbits were randomly divided into the control group, and the bladder acellular matrix grafts group, with 20 in each. An area of 10 mm×5 mm of albuginea penis was resected from dorsum penis of each rabbit. Suture in situ of albuginea penis and bladder acellular matrix grafting were conducted in rabbits of the control group and bladder acellular matrix grafts group, respectively. In the 2nd, 6th, 12th and 24th weeks postoperatively, each rabbit was intracavernously perfused normal saline for inducing penile erection, separately, in order to observe phallocampsis. At above-mentioned each time point, experimental animals were sacrificed. Sample was taken from surgical region for haematoxylin-eosin (HE) staining and Masson trichrome staining, in order to observe the changes of tissue and structure of surgical region. Types Ⅰand Ⅲ collagen fiber areas were detected by Stirus red staining, and the expressions of inducible nitric oxide synthase(iNOS) and transforming growth factor-β1 (TGF-β1) were detected by immunohistochemical staining. MAIN OUTCOME MEASURES: ①Phallocampsis status. ② Changes of tissue and structure of surgical region. ③iNOS and TGF-β1 expressions. ④TypeⅠand Ⅲ collagen fiber areas.RESULTS: Forty experimental rabbits were involved in the penile surgery, two of them died from overdose anesthesia, two died from chordapsus, so the remaining thirty-six rabbits were involved in the final analysis. In the 6th week postoperatively, phallocampsis reached its highest level, and 2 rabbits in the control group and 1 rabbit in the bladder acellular matrix grafts group presented phallocampsis. In the 12th week, every rabbit presented phallocampsis. In the 24th week, 1 rabbit in the control group but none in the bladder acellular matrix grafts group presented phallocampsis. In the 2nd week, the structure of surgical regions of each rabbit was poorly clear, with remarkable inflammatory infiltration. In the bladder acellular matrix grafts group, grafting regions presented cells ingrowing the bladder acellular matrix grafts. Masson trichrome staining results showed that in the surgical region, tunica albuginea fibers were thin and poorly arranged. In the 6th week, tunica albuginea recovered its integrity, and bladder acellular matrix grafts could not be distinguished. No significant difference existed between two groups. In the 24th week, tunica albuginea was even and complete in the sugical region, and fibers restored their arrangement of circular muscle in inner layer and longitudinal muscle in outer layer, without difference from normal tunica albuginea. iNOS and TGF-β1 expressions were the strongest in the 2nd week, and they were found in the fibrocytes and vascular endothelial cells in the 6th week, but a little in the 12th and 24th weeks postoperatively. There were no remarkable differences in iNOS and TGF-β1 expressions between two groups at the same time point. In the 2nd week, typesⅠand Ⅲ collagen fibers co-existed with equivalent proportion. Then, typeⅠcollagen fibers were gradually increased, while type Ⅲ collagen fibers were on the contrary. In the 24th week, typeⅠcollagen fibers took the main place and type Ⅲ collagen fibers were unremarkable. CONCLUSION: Bladder acellular matrix grafts have no remarkable inflammatory reactions and fibrosis in repairing tunica albuginea of New Zealand rabbits, so they are very ideal grafting materials for penile surgery.

OBJECTIVETo observe the synergistic effects of paclitaxel and gemcitabine on prostate cancer cell line PC-3 in vitro.

METHODSCell morphology, MTU, flow cytometer and immunocytochemical method were used to observe the effects of 10(-6), 10(-7), 10(-8) mol/L paclitaxel and 10(-7), 10(-8), 10(-9) mol/L gemcitabine on prostate cancer cell line PC-3 by single or synergistic administration for 48 hours in vitro.

RESULTSGemcitabine above 10(-8) mol/L enhanced the growth suppression [suppression ratio > or = (50.8 +/- 4.2)%, P < 0.05] and apoptosis [apoptosis ratio > or = (22.9 +/- 2.3)%, P < 0.05] and down-regulation of the expression of cyclin D1 [expression ratio < or = (9.6 +/- 1.6)%, P < 0.01] induced by paclitaxel above 10(-7) mol/L in PC-3 cells. Gemcitabine changed the ratio of G2/M cell arrest induced by paclitaxel from (70.3 +/- 9.7)% to (38.2 +/- 4.2)%, and reversed the G2/M arrest partially (P < 0.01).

CONCLUSIONPaclitaxel and gemcitabine can enhance the growth suppression and apoptosis induced by paclitaxel in a synergistic way. They show great potential in the treatment of androgen-independent carcinoma of the prostate.

Antimetabolites, Antineoplastic ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Deoxycytidine ; analogs & derivatives ; pharmacology ; Dose-Response Relationship, Drug ; Down-Regulation ; Drug Synergism ; Flow Cytometry ; Humans ; Male ; Paclitaxel ; pharmacology ; Prostatic Neoplasms ; pathology

Objective:To analyze the distribution of ages at the interhospital transfer of outborn very preterm infants in China and to compare their perinatal characteristics and outcomes at discharge and neonatal intensive care unit (NICU) treatment.Methods:A total of 3 405 outborn very premature infants with a gestational age of 24-31 +6 weeks who were transferred to the NICUs of the Chinese Neonatal Network (CHNN) in 2019 were included in this retrospective study. According to the age at transfer, they were divided into three groups: early transfer (≤1 d), delayed transfer (>1-7 d) and late transfer (>7 d) groups. Analysis of variance, t-test, Chi-square test (Bonferroni correction), Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare the general clinical condition, treatment, and outcomes at discharge among the three groups. Results:The median gestational age was 29.7 weeks (28.3-31.0 weeks) and the average birth weight was (1 321.0 ± 316.5) g for these 3 405 infants. There were 2 031 patients (59.6%) in the early transfer group, 406 (11.9%) in the delayed transfer group and 968 (28.4%) in the late transfer group. Infants who received continuous positive airway pressure ventilation and tracheal intubation in the delivery room accounted for 8.4% (237/2 806) and 32.9% (924/2 805), respectively. A total of 62.7% (1 569/2 504) of the mothers received antenatal glucocorticoid therapy and the ratio in the early transfer group was 68.7% (1 121/1 631), which was higher than that in the delayed transfer group [56.1% (152/271), χ2=16.78, P<0.017] and the late transfer group [49.2% (296/602), χ2=72.56, P<0.017]. The total mortality rate of very premature infants was 12.7% (431/3 405), and the mortality rates in the early, delayed and late transfer groups were 12.4% (252/2 031), 16.3% (66/406) and 11.7% (113/968), respectively ( χ2=5.72, P=0.057). The incidences of severe intraventricular hemorrhage, late-onset sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia at the corrected gestational age of 36 weeks or discharge were all higher in the delayed and late transfer groups than in the early transfer group, respectively. The incidences of retinopathy of prematurity, retinopathy of prematurity requiring treatment and bronchopulmonary dysplasia at the corrected gestational age of 36 weeks or discharge in the late transfer group were significantly higher than that in the delayed transfer group (Bonferroni correction, all P<0.017). In the late transfer group, the median age of very premature infants at discharge was 66.0 d (51.0-86.0 d), and the corrected gestational age at discharge was 38.9 weeks (37.1-41.2 weeks), and both were greater than those in the early transfer [48.0 d (37.0-64.0 d), Z=260.83; 36.9 weeks (35.7-38.3 weeks), Z=294.32] and delayed transfer groups [52.0 d (41.0-64.0 d), Z=81.49; 37.4 weeks (36.1-38.7 weeks), Z=75.97] (all P<0.017). Conclusions:Many very premature infants need to be transferred to higher-level hospitals after birth. The later the very premature infants are transferred, the higher the incidence of complications will be. It is suggested that intrauterine or early postnatal transport may improve the prognosis of very premature infants.

Objective:To investigate the effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) on platelet activation in sepsis.Methods:① Clinical trial: a prospective study was conducted. Patients with sepsis and septic shock aged ≥ 18 years old who met the diagnostic criteria of Sepsis-3 admitted to the department of intensive care medicine of the Affiliated Hospital of Binzhou Medical College from January to October in 2021 were selected as subjects. Healthy subjects in the same period were taken as healthy control group. Platelet count (PLT) in the first routine blood test after admission was recorded. Venous blood was taken 1 day after diagnosis, and serum PCSK9 level was determined by enzyme-linked immunosorbent assay (ELISA). The differences of PCSK9 level and PLT between the two groups were compared, and subgroup analysis was conducted based on PLT for patients with sepsis. The correlation between PCSK9 level and PLT in septic patients was analyzed by Pearson correlation method. ② Animal experiment: 80 male C57BL/6 mice were randomly divided into control group, sepsis model group [lipopolysaccharide (LPS) group], PCSK9 inhibitor pretreatment group (PCSK9 inhibitor+LPS group) and PCSK9 inhibitor control group (PCSK9 inhibitor group), with 20 mice in each group. The mouse model of sepsis was reproduced by intraperitoneal injection of LPS 12 mg/kg, and the control group and PCSK9 inhibitor group were intraperitoneally injected with the same amount of sterile normal saline. PCSK9 inhibitor+LPS group and PCSK9 inhibitor group were pretreated with PCSK9 inhibitor 5 mg/kg intraperitoneal injection for 7 days before injection of LPS or normal saline, respectively, and the control group and LPS group were injected with an equal amount of sterile normal saline. The lung tissues were taken for pathological and immunohistochemical observation 24 hours after modeling. Blood was taken from the heart for determining PLT. Platelet activation was detected by flow cytometry. The expression level of platelet-activation marker CD40L was detected by Western blotting.Results:① Clinical trial: there were 57 cases in the sepsis group and 27 cases in the healthy control group. Serum PCSK9 level in the sepsis group was significantly higher than that in the healthy control group (μg/L: 232.25±72.21 vs. 191.72±54.92, P < 0.05), and PLT was significantly lower than that in the healthy control group [×10 9/L: 146.00 (75.50, 204.50) vs. 224.00 (194.00, 247.00), P < 0.01]. Subgroup analysis showed that the serum PCSK9 level in the thrombocytopenia patients ( n = 20) was significantly higher than that in the non-thrombocytopenia patients ( n = 37; μg/L: 264.04±60.40 vs. 215.06±72.95, P < 0.01). Correlation analysis showed a significant negative correlation between serum PCSK9 levels and PLT in septic patients ( r = -0.340, P = 0.010). ② Animal experiment: there were no significant pathological changes in lung tissue in the control group and PCSK9 inhibitor group under light microscope, and no significant differences in PLT, platelet activation and plasma CD40L protein expression was found between the two groups. In the LPS group, a large number of inflammatory cells were infiltrated in the pulmonary interstitium, the alveolar structure was damaged obviously, the alveolar septum was widened, the alveolar cavity was extensively bleeding, the capillary dilatation with bleeding and platelet aggregation were found, the PLT was significantly decreased, the platelet activation and the expression level of CD40L protein in plasma were significantly increased. The infiltration of inflammatory cells in lung tissue of mice in the PCSK9 inhibitor+LPS group was reduced to a certain extent, the thickening of alveolar septa was reduced, the platelet aggregation in lung tissue was decreased as compared with the LPS group, the PLT was significantly increased (×10 9/L: 515.83±46.60 vs. 324.83±46.31, P < 0.05), the platelet activation and the expression level of CD40L protein in plasma were significantly decreased [positive expression rate of platelet activation dependent granule surface facial mask protein CD62P: (12.15±1.39)% vs. (18.33±2.74)%, CD40L protein (CD40L/β-actin): 0.77±0.08 vs. 1.18±0.10, both P < 0.05]. Conclusion:PCSK9 level has a certain effect on promoting platelet activation in sepsis, and inhibition of PCSK9 level may have potential research value in improving adverse outcomes caused by sepsis thrombocytopenia.

【Objective】 To discuss the influence of direct reimbursement of blood expenses in hospitals on the recruitment of blood donors in Xianyang City. 【Methods】 Blood donors or reimbursers, who reimbursed blood expenses either at hospitals or at our blood center were investigated, and these two kinds of blood expense reimbursements were compared in terms of convenience, the impact on the enthusiasm of blood donation, as well as the impact of the awareness of hospital reimbursement on the recruitment of blood donors. 【Results】 The direct reimbursement of blood expenses at hospitals took 22 minutes per person, without any round trips nor transportation costs. The rate of satisfaction, long-term intention to blood donation, and voluntary mobilization of others were 98.11%, 91.89%, and 82.56%, respectively, higher than those in the reimbursers at blood station(P<0.01). 35.16%, 38.90%, 98.56%, 94.24% and 93.37% of the blood donors, who were aware of benefits of hospital reimbursement, had donated for 2~3 times, donated more than 3 times, satisfied with the way of reimbursement, intended to redonate and mobilize others, which were higher than those who were unaware of the the hospital reimbursement(P<0.05). 【Conclusion】 Direct reimbursement of blood expenses at hospitals not only improved the convenience, but also increased the enthusiasm of blood donors by improving their satisfaction, which was conductive to blood donation recruitment.

【Objective】 To understand the frequency and significance of anti-" Mi^a" (anti-" Mi^a" mixtures of antibodies) in local population in Zhongshan, and the influence of different experimental conditions on the activity of human anti-" Mi^a" . 【Methods】 The microplate-based agglutination assay and polybrene method were used to screen anti-" Mi^a" in 3 587 blood samples from voluntary blood donors and patients using O type red blood cells with positive Mi^a antigen, then.rechecked by tube method and microcolumn gel card method. 【Results】 The frequency of anti-" Mi^a" was 1.06% (38/3 587), among which 60.5% (23/38) were IgM and 39.5% (15/38) were mixture of IgM and IgG; 0.61% (13/2 135) in local blood donors and 1.72% (25/1 452) in patients(P<0.01). 65.8% (25/38) of the population carrying anti-" Mi^a" had a history of immunity. 57.9% (22/38) were identified to be anti-" Mur" and 42.1% (16/38) anti-" Mi^a" using GP.Vw erythrocyte. The appropriate incubation time for anti-" Mi^a" test was 10 min. 【Conclusion】 The frequency of anti-" Mi^a" was relatively high among blood donors and patients in Zhongshan, and most of the anti-" Mi^a" carriers had a history of immunity. Most anti-Mi^a antibodies were active in saline, and some of them were mixture of IgM and IgG. It may be helpful to include Mi^a positive red blood cells in the irregular antibody screening cell panel to improve the safety of blood transfusion.