China ; Congresses as Topic ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery

Objective To evaluate the clinical applicability of Traditional Chinese Medicine (TCM) Clinical Practice Guidelines of Perirectal Abscess (ZYYXH/T322-341-2012); To provide the evidences for the revision. Methods Questionnaire survey was performed in this study. 50 surgeons in department of anorectal surgery from different hospitals were asked to fill in a questionnaire designed by State Administration of TCM, and the investigated data were statistically analyzed in respect to the general information, quality, and application status. Results 76% of investigated surgeons were familiar with the guideline, but only 48% of them have used this guideline. In statistical agreement rates of those items to reflect the quality of the guideline, except for rates of "syndrome classification is reasonable" item was 76%, and "recuperating reserve is reasonable" item was 0%, which were referred as not qualified, the rates of the other items were all more than 90%. In statistical application rates of items to reflect the application of the guide, except for the rate of "comparing with expert experiences", the rates of the other items were all more than 90%. Conclusion The general applicability of TCM Clinical Practice Guidelines of Perirectal Abscess is relatively well. The next revised work should uptake not only the experiences of prominent TCM doctors, but also the therapeutic programs of distinctive hospitals and all kinds of research achievements.

Objective To evaluate the nutritional status of iodine of pregnant and lactating women in coastal and inland areas of Zhejiang province,and to provide scientific basis for iodine supplementation.Methods In 2009,five coastal cities,five coastal counties and three inland areas from Zhejiang province were selected by the cluster sampling method,and one sub-district(township) was randomly selected in each city (county),then one community (village) was randomly selected in each sub-district (township).Thirty pregnant women,thirty lactating women and fifty children aged 8 - 10,were randomly selected in each community(village) as the investigation objects to collect instant urine samples to detect urine iodine,and to collect thirty resident edible salt and some water samples to detect salt iodine and water iodine,if the numbers of water source were more than 5 then 1 water sample was collected by their location of east,south,west,north and center in each community(village),otherwise,the numbers of water samples collected were equal to the number of community (village).Results The medians of salt iodine of coastal city,coastal county and inland area were 28.42,25.29,and 33.24 mg/kg,respectively,and the medians of water iodine correspondingly were 5.41,11.52,and 2.80 μg/L,respectively.The medians of urinary iodine of pregnant and lactating women in Zhejiang province were 148.72 and 161.34 μg/L,respectively,which were less than that of children aged 8 - 10(231.02 μg/L,Z =8.57,8.24,all P ＜ 0.017).The medians of urinary iodine in pregnant women from different areas were ranked in order as inland areas(211.42 μg/L),coastal counties (150.51 μg/L) and coastal cities (123.33 μg/L,Z =2.80,5.31,2.42,all P ＜ 0.017),and in lactating women,the medians of urinary iodine in inland areas( 197.43 μg/L) was higher than that in coastal cities( 139.64 μg/L,Z =4.03,P ＜ 0.017).Conclusions The overall levels of iodine nutrition in lactating and pregnant women in Zhejiang province are in the appropriate level,but that of the pregnant women in the coastal cities is inadequate.

OBJECTIVETo observe the effect of Zhitiaokang capsule (ZTK) on serum insulin-like growth factor-2 (IGF-2) in patients with hyperlipidemia (HLP).

METHODSPatients with HLP were randomly divided into the treated group (n = 124) and the control group (n = 62), they were treated by ZTK and Zhibituo tablet respectively for 8 weeks as one therapeutic course. The changes of blood lipids and serum IGF-2 before and after treatment were observed.

RESULTSZTK could significantly reduce blood lipids and increase serum content of IGF-2.

CONCLUSIONZTK could improve the insulin resistant status and inhibit the development of hyperlipidemia in patients by means of raising serum content of IGF-2 and suppressing vascular endothelial cell apoptosis.

Adolescent ; Adult ; Aged ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperlipidemias ; blood ; drug therapy ; Hypolipidemic Agents ; therapeutic use ; Insulin-Like Growth Factor II ; Male ; Middle Aged ; Phytotherapy ; Proteins ; metabolism

OBJECTIVETo explore the activation and proliferation of specific T cells induced by artificial antigen-presenting cells (aAPCs) simulated dendritic cells (DCs) and to observed the effect of these T cells on leukemic cell killing.

METHODSaAPCs were developed by coating a human leukocyte antigen-immunoglobulin fusion protein ( HLA-lg), which was connected each one of the four CML28 antigen epitopes (DLMSSTKGL, DLMSSTKGL, ALFCGVACA, VLTFALDSV), and CD28-specific antibody, to magnet-beads CML cell specific peptides (CML28) served as target peptides. Bone marrow (BM) or peripheral blood (PB) mononuclear cells (MNCs) were isolated from HLA-A2 healthy volunteers, and co-cultured with aAPCs. Specific T lymphocyte were detected by flow cytometry. The fresh acute leukemic cells were used as target cells. The specific T cells incubated with leukemic cells for 4 h at ratios of 5:1, 10:1, 20:1, 40:1, 80: 1, respectively. The effect of leukemic cells killing was detected by lactate dehydrogenase release test.

RESULTSThe average ratio of CML-28 specific T lymphocyte in control group was (2.2 +/- 0.4)% and in experimental groups (DLMSSTKGL, DLMSSTKGL, ALFCGVACA, VLTFALDSV) were (13.5 +/- 1.6)%, (15.2 +/- 1.5)%, (14.7 +/- 1.8)% and (34.3 +/- 3.5)%, respectively, being significantly higher than that in control group (P < 0.01). Induction efficiencies of acute leukemic cells killing were significantly enhanced by increase of effector cells. The cytotoxic activity of specific T lymphocyte in one experimental group (VLTFALDSV) was much higher than that in other three experimental group (P < 0.05).

CONCLUSIONThis "prime and expand" regimen should be an alternative method for large scale amplification of rare tumor-specific CTLs and aAPCs might be a useful tool for leukemia immunotherapy.

Adolescent ; Adult ; Antigen-Presenting Cells ; immunology ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Cytotoxicity, Immunologic ; Female ; Humans ; Leukemia ; immunology ; pathology ; Lymphocyte Activation ; Male ; Middle Aged ; T-Lymphocytes ; cytology ; immunology ; Young Adult

OBJECTIVETo assess the prognostic value of metastatic lymph node ratio in gastric cancer patients undergoing radical gastrectomy (D2).

METHODSPrognostic analysis of 1042 gastric cancer patients undergoing radical gastrectomy (D2) was performed based on metastatic lymph node ratio (MLR), the N staging in the 6th and 7th edition of UICC staging system respectively. Homogeneity, discriminatory ability, and gradient monotonicity of these three staging methods were compared using linear trend χ(2), likelihood ratio χ(2) statistics and Akaike information criterion (AIC) calculations, respectively. The area under the ROC curve (AUC) was calculated to compare the prognostic value of these three staging methods.

RESULTSThe 5-year survival rate of 1042 patients was 47.5%. The metastatic lymph node ratio (P<0.01) and N staging of the 7th edition UICC (P<0.05) were independent prognostic factors according to univariate and multivariate analyses. The AUC was 0.754 in MLR staging group, higher than that in N staging of the 6th (0.692) and 7th (0.705) edition of UICC group. Compared to the 6th and 7th edition of UICC N staging group, homogeneity and linear curve were better and AIC value was lower in MLR staging group (7240.017 vs. 7364.073 and 7325.731).

CONCLUSIONPrognostic value of MLR staging is better than that of UICC N staging for patients undergoing radical gastric cancer resection. The MLR staging can be a new method of lymph node staging for gastric cancer patients.

Aged ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

Objective To achieve detailed genomic characterization and investigate the antibiotic-resistant mechanisms of plasmid pA1137 carrying the aminoglycoside resistance gene aacC2.Methods Antibiotic-resistant genes were deter-mined by PCR.Conjugation experiments were performed to verify the transferability of plasmid pA 1137.The minimum in-hibitory concentration(MIC)values of bacterial strains were tested with microdilution method.The genetic background, mobile elements and antibiotic resistance mechanisms of pA 1137 were determined using a whole genome sequencing meth-od.Results Both carbapenem-resistant gene blaIMP-8and aminoglycoside-resistant genes aacC2 and aacA4 were carried by A1137 isolated from Enterobacter cloacae(ECL).aacC2 was located in plasmid pA1137 while the other two resistant genes were observed in chromosomes.Plasmid pA1137 was an IncFⅡplasmid,whose total length was 68.97 kb,and GenBank accession number was MF190369.Plasmid pA1137 contained multiple replicons and intact conjugative transfer regions,so it could be transferred into ECL through conjugation experiments and confer corresponding antibiotic resistance to the transconjugant A1137-EC600.Conclusion IncFⅡ plasmid pA1137 has a single accessory region, the first reported Tn5403-based aacC2-tmrB-related region,which can cause stable inheritance and mediate the resistance to aminoglycoside antibiotics in ECL A1137.

OBJECTIVETo investigate the application of pedicled expanded flaps for the reconstruction of facial soft tissue defects.

METHODSThe expanded skin flaps, pedicled with orbicularis oculi muscle, submental artery, the branch of facial artery, superficial temporal artery, interior upper arm artery, had similar texture and color as facial soft tissue. The pedicled expanded flaps have repaired the facial soft tissue defects.

RESULTSBetween Jan. 2003 to Dec. 2013, 157 cases with facial soft tissue defects were reconstructed by pedicled expanded flaps. Epidermal necrosis happened at the distal end of 8 expanded flaps, pedicled with interior upper arm artery(4 cases), orbicularis oculi muscle(3 cases) and submental artery(1 case), which healed spontaneously after dressing. All the other flaps survived completely with similar color and inconspicuous scar. 112 cases were followed up for 8 months to 8 years. Satisfactory results were achieved in 75 cases. 37 cases with hypertrophic scar at incisions need secondary operation.

CONCLUSIONSIsland pedicled expanded flap with similar texture and color as facial soft tissue is suitable for facial soft tissue defects. The facial extra-incision and large dog-ear deformity could be avoided.

Cicatrix, Hypertrophic ; surgery ; Eyelids ; Face ; surgery ; Facial Muscles ; Humans ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply

OBJECTIVETo compare the effect of three methods for penile reconstruction.

METHODSFrom Sept. 2000 to Dec. 2012, penile reconstruction was performed in 48 cases with free scapular flap transplantation, or pedicled superficial circumflex iliac artery skin flap, or anterolateral thigh skin flap pedicled with lateral circumflex femoral artery. The flaps were 12.0-14.5 cm in length, 10-12 cm in width and the urethra perimeter was about 2-3 cm.

RESULTSFree scapular flaps were used in 21 cases, with flap failure in 3 cases due to insufficient blood supply. Malleable penile prosthesis was implanted in 11 cases, which was exposed in 3 cases. Groin skin flaps were used in 21 cases, with flap failure in 8 cases due to insufficient blood supply. Malleable penile prostheses were implanted in 7 cases, which was exposed in 3 cases. Anterolateral thigh skin flaps were used in 6 cases, with flap failure in 2 cases due to necrosis and infection. No prosthesis was implanted in this group. All the failure cases underwent secondary reconstruction with successful results. 37 cases were followed up for 1-6 years, avevage 2.5 years. 26 cases were satisfied with the results of appearance and function.

CONCLUSIONSAmong these three methods, the free scapular flap is most recommended for its high survival rate, low complication rate and high patient satisfaction.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Penis ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; Treatment Outcome ; Young Adult