To evaluate the therapeutic effect of a modified Devine procedure with a subcutaneous sliding fixation method for the treatment of congenital concealed penis, we retrospectively selected 45 patients with congenital concealed penises who were admitted to General Hospital of Ningxia Medical University (Yinchuan, China) between September 2020 and November 2023. In all cases, the penis was observed to be short, and retracting the skin at the base revealed a normal penile body, which immediately returned to its original position upon release. All patients underwent the modified Devine procedure with subcutaneous sliding fixation and completed a 12-week postoperative follow-up. A statistically significant increase in penile length was observed postoperatively, with the median length increasing from 4.0 (interquartile range [IQR]: 3.5-4.8; 95% confidence interval [CI]: 3.9-4.4) cm to 8.0 (IQR: 7.8-8.0; 95% CI: 7.7-7.9) cm, with P < 0.001. The parents were satisfied with the outcomes, including increased penile length, improved hygiene, and enhanced esthetics. Except for mild foreskin edema in all cases, no complications (such as infections, skin necrosis, or penile retraction) were observed. The edema was resolved within 4 weeks after the operation. This study demonstrates that the modified Devine procedure utilizing the subcutaneous sliding fixation method yields excellent outcomes with minimal postoperative complications, reduced penile retraction, and high satisfaction rates among patients and their families.
Humans ; Male ; Penis/abnormalities* ; Retrospective Studies ; Urologic Surgical Procedures, Male/methods* ; Treatment Outcome ; Child ; Plastic Surgery Procedures/methods*

AIM:To observe the effects of Huazhuo granules on phosphatidylinositol 3-kinase(PI3K)/protein kinase B(PKB/Akt)/glycogen synthase kinase-3β(GSK-3β)and PI3K/Akt/forkhead box protein O1(FOXO1)signaling pathways in the liver tissue of type 2 diabetes mellitus(T2DM)rats,and to explore its mechanism of action in regulating glycogen synthesis and gluconeogenesis.METHODS:Thirty 8-week-old SPF-grade male SD rats were chosen,with 5 ran-domly selected ones as the blank control group.The remaining 25 rats were fed to a high-sugar and high-fat diet for 4 weeks,followed by a single intraperitoneal injection of streptozotocin to establish a T2DM rat model.After successful mod-eling,these rats were randomly divided into 5 additional groups:the model group,a positive control group treated with met-formin,and low,medium,and high-dose Huazhuo granule groups,resulting in a total of 6 groups with 5 rats in each.Rats in the treatment groups were gavaged with the corresponding doses of medication,while those in the blank control and model groups were gavaged with an equal volume of saline once daily for 4 consecutive weeks.After 24-hour fasting with free access to water,the rats were euthanized to measure blood glucose,serum insulin levels,and serum triglyceride(TG),total cholesterol(T-CHO),high-density lipoprotein cholesterol(HDL-C),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels.Liver pathological morphology was assessed by hematoxylin-eosin staining,and liver glycogen storage was detected by periodic acid-Schiff staining.Immunohistochemistry and Western blot analysis were employed to detect the protein levels of p-PI3K,p-Akt,p-FOXO1 and p-GSK-3β in the liver of rats in each group.The mRNA levels of phosphoenolpyruvate carboxykinase(PEPCK),glucose-6-phosphatase(G6Pase),GSK-3β,FOXO1,PI3K and Akt in liver tissues were detected by RT-qPCR.RESULTS:Compared with the model group,the rats in the high-dose Huazhuo Granule group and the metformin group exhibited decreased blood glucose and insulin levels(P<0.01),reduced AST,ALT,TG,and T-CHO concentrations(P<0.01),and increased HDL-C concentrations(P<0.01).The phosphorylation levels of PI3K,Akt,FOXO1,and GSK-3β proteins were up-regulated(P<0.01).In con-trast,the gene expressions of G6Pase,PERCK,FOXO1,and GSK-3β were all down-regulated(P<0.01).Conversely,the gene expressions of PI3K and Akt were upregulated(P<0.01).Pathological morphology of the liver tissue improved,accompanied by increased glycogen deposition in hepatocytes.CONCLUSION:Huazhuo granule manifests effects in lowering blood glucose and serum insulin levels,ameliorating blood lipids,and enhancing liver function in rats.These ef-fects are revealed to increase glycogen synthesis by activating the PI3K/Akt/GSK-3β signaling pathway and reduce gluco-neogenesis by activating the PI3K/Akt/FOXO1 signaling pathway.

Objective:To explore the efficacy in the treatment of chronic apical periodontitis caused by dental trauma in young permanent teeth with the combination of autologous platelet-poor plasma(PPP)and concentrate growth factors(CGF).Methods:80 young children with chronic apical periodontitis of permanent teeth admitted to the Department of Dentistry and Endodontics of Stomatological Hospital from September 2021 to September 2023 were included,and the patients were divided into three groups A,B and C using a computer-generated random number table.Group A was treated with bioceramic material iRoot BP Plus.Group B was treated with CGF,and Group C was treated with CGF combined with PPP.Clinical and imaging evaluations were performed af-ter treatment.Results:At the last follow-up,the treatment effectiveness rate of the CGF+PPP group was 85.71％,which was sig-nificantly higher than the 52.00％of the iRoot BP Plus group and 59.26％of the CGF group(P＜0.05).In terms of root develop-ment,the root canal length and root canal wall thickness increased more significantly in the CGF+PPP group after treatment(P＜0.05).Regarding the reduction in periapical lesion volume,the reduction in lesion volume in the CGF+PPP group was more obvi-ous(P＜0.05).Comparing the recovery status of the affected teeth after treatment,the proportion of normal pulp vitality and normal tooth color in the CGF+PPP group was significantly higher than that in the iRoot BP Plus group(P＜0.05).Conclusion:Autolo-gous platelet-poor plasma combined with CGF can more effectively promote tooth root development and lesion healing than iRoot BP Plus or CGF alone in the treatment of chronic apical periodontitis caused by trauma to young permanent teeth.

Objective:To explore the efficacy in the treatment of chronic apical periodontitis caused by dental trauma in young permanent teeth with the combination of autologous platelet-poor plasma(PPP)and concentrate growth factors(CGF).Methods:80 young children with chronic apical periodontitis of permanent teeth admitted to the Department of Dentistry and Endodontics of Stomatological Hospital from September 2021 to September 2023 were included,and the patients were divided into three groups A,B and C using a computer-generated random number table.Group A was treated with bioceramic material iRoot BP Plus.Group B was treated with CGF,and Group C was treated with CGF combined with PPP.Clinical and imaging evaluations were performed af-ter treatment.Results:At the last follow-up,the treatment effectiveness rate of the CGF+PPP group was 85.71％,which was sig-nificantly higher than the 52.00％of the iRoot BP Plus group and 59.26％of the CGF group(P＜0.05).In terms of root develop-ment,the root canal length and root canal wall thickness increased more significantly in the CGF+PPP group after treatment(P＜0.05).Regarding the reduction in periapical lesion volume,the reduction in lesion volume in the CGF+PPP group was more obvi-ous(P＜0.05).Comparing the recovery status of the affected teeth after treatment,the proportion of normal pulp vitality and normal tooth color in the CGF+PPP group was significantly higher than that in the iRoot BP Plus group(P＜0.05).Conclusion:Autolo-gous platelet-poor plasma combined with CGF can more effectively promote tooth root development and lesion healing than iRoot BP Plus or CGF alone in the treatment of chronic apical periodontitis caused by trauma to young permanent teeth.

AIM:To observe the effects of Huazhuo granules on phosphatidylinositol 3-kinase(PI3K)/protein kinase B(PKB/Akt)/glycogen synthase kinase-3β(GSK-3β)and PI3K/Akt/forkhead box protein O1(FOXO1)signaling pathways in the liver tissue of type 2 diabetes mellitus(T2DM)rats,and to explore its mechanism of action in regulating glycogen synthesis and gluconeogenesis.METHODS:Thirty 8-week-old SPF-grade male SD rats were chosen,with 5 ran-domly selected ones as the blank control group.The remaining 25 rats were fed to a high-sugar and high-fat diet for 4 weeks,followed by a single intraperitoneal injection of streptozotocin to establish a T2DM rat model.After successful mod-eling,these rats were randomly divided into 5 additional groups:the model group,a positive control group treated with met-formin,and low,medium,and high-dose Huazhuo granule groups,resulting in a total of 6 groups with 5 rats in each.Rats in the treatment groups were gavaged with the corresponding doses of medication,while those in the blank control and model groups were gavaged with an equal volume of saline once daily for 4 consecutive weeks.After 24-hour fasting with free access to water,the rats were euthanized to measure blood glucose,serum insulin levels,and serum triglyceride(TG),total cholesterol(T-CHO),high-density lipoprotein cholesterol(HDL-C),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels.Liver pathological morphology was assessed by hematoxylin-eosin staining,and liver glycogen storage was detected by periodic acid-Schiff staining.Immunohistochemistry and Western blot analysis were employed to detect the protein levels of p-PI3K,p-Akt,p-FOXO1 and p-GSK-3β in the liver of rats in each group.The mRNA levels of phosphoenolpyruvate carboxykinase(PEPCK),glucose-6-phosphatase(G6Pase),GSK-3β,FOXO1,PI3K and Akt in liver tissues were detected by RT-qPCR.RESULTS:Compared with the model group,the rats in the high-dose Huazhuo Granule group and the metformin group exhibited decreased blood glucose and insulin levels(P<0.01),reduced AST,ALT,TG,and T-CHO concentrations(P<0.01),and increased HDL-C concentrations(P<0.01).The phosphorylation levels of PI3K,Akt,FOXO1,and GSK-3β proteins were up-regulated(P<0.01).In con-trast,the gene expressions of G6Pase,PERCK,FOXO1,and GSK-3β were all down-regulated(P<0.01).Conversely,the gene expressions of PI3K and Akt were upregulated(P<0.01).Pathological morphology of the liver tissue improved,accompanied by increased glycogen deposition in hepatocytes.CONCLUSION:Huazhuo granule manifests effects in lowering blood glucose and serum insulin levels,ameliorating blood lipids,and enhancing liver function in rats.These ef-fects are revealed to increase glycogen synthesis by activating the PI3K/Akt/GSK-3β signaling pathway and reduce gluco-neogenesis by activating the PI3K/Akt/FOXO1 signaling pathway.

Objective:To investigate the early clinical characteristics of elderly patients with severe burns and the risk factors on prognosis.Methods:This study was a retrospective case series study. Clinical data of 124 elderly patients with severe burns who met the inclusion criteria and were admitted to the 12 hospitals from January 2015 to December 2020 were collected, including 4 patients from the Fourth People's Hospital of Dalian, 5 patients from Fujian Medical University Union Hospital, 22 patients from Guangzhou Red Cross Hospital of Jinan University, 5 patients from Heilongjiang Provincial Hospital, 27 patients from the First Affiliated Hospital of Naval Medical University, 9 patients from the First Affiliated Hospital of Nanchang University, 10 patients from Affiliated Hospital of Nantong University, 9 patients from Tongren Hospital of Wuhan University & Wuhan Third Hospital, 12 patients from the 924 th Hospital of PLA, 6 patients from Zhangjiagang First People's Hospital, 4 patients from Taizhou Hospital of Zhejiang Province, and 11 patients from Zhengzhou First People's Hospital. The patients' overall clinical characteristics, such as gender, age, body mass index, total burn area, full-thickness burn area, inhalation injury, causative factors, whether combined with underlying medical diseases, and admission time after injury were recorded. According to the survival outcome within 28 days after injury, the patients were divided into survival group (89 cases) and death group (35 cases). The following data of patients were compared between the two groups, including the basic data and injuries (the same as the overall clinical characteristics ahead); the coagulation indexes within the first 24 hours of injury such as prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time, D-dimer, fibrinogen degradation product (FDP), international normalized ratio (INR), and fibrinogen; the blood routine indexes within the first 24 hours of injury such as white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, monocyte count, red blood cell count, hemoglobin, and hematocrit; the organ function indexes within the first 24 hours of injury such as direct bilirubin, total bilirubin, urea, serum creatinine, aspartate aminotransferase, alanine aminotransferase, total protein, albumin, globulin, blood glucose, triglyceride, total cholesterol, alkaline phosphatase, creatine kinase, electrolyte indexes (potassium, sodium, chlorine, calcium, magnesium, and phosphorus in blood), uric acid, myoglobin, and brain natriuretic peptide; the infection and blood gas indexes within the first 24 hours of injury such as procalcitonin, C-reactive protein, pH value, oxygenation index, base excess, and lactate; treatment such as whether conducted with mechanical ventilation, whether conducted with continuous renal replacement therapy, whether conducted with anticoagulation therapy, whether applied with vasoactive drugs, and fluid resuscitation. The analysis was conducted to screen the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns. Results:Among 124 patients, there were 82 males and 42 females, aged 60-97 years, with body mass index of 23.44 (21.09, 25.95) kg/m 2, total burn area of 54.00% (42.00%, 75.00%) total body surface area (TBSA), and full-thickness burn area of 25.00% (10.00%, 40.00%) TBSA. The patients were mainly combined with moderate to severe inhalation injury and caused by flame burns. There were 43 cases with underlying medical diseases. The majority of patients were admitted to the hospital within 8 hours after injury. There were statistically significant differences between patients in the 2 groups in terms of age, total burn area, full-thickness burn area, and inhalation injury, and PT, APTT, D-dimer, FDP, INR, white blood cell count, platelet count, urea, serum creatinine, blood glucose, blood sodium, uric acid, myoglobin, and urine volume within the first 24 hours of injury (with Z values of 2.37, 5.49, 5.26, 5.97, 2.18, 1.95, 2.68, 2.68, 2.51, 2.82, 2.14, 3.40, 5.31, 3.41, 2.35, 3.81, 2.16, and -3.82, respectively, P<0.05); there were statistically significant differences between two groups of patients in whether conducted with mechanical ventilation and whether applied with vasoactive drugs (with χ2 values of 9.44 and 28.50, respectively, P<0.05). Age, total burn area, full-thickness burn area, serum creatinine within the first 24 hours of injury, and APTT within the first 24 hours of injury were the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns (with odds ratios of 1.17, 1.10, 1.10, 1.09, and 1.27, 95% confidence intervals of 1.03-1.40, 1.04-1.21, 1.05-1.19, 1.05-1.17, and 1.07-1.69, respectively, P<0.05). Conclusions:The elderly patients with severe burns had the injuries mainly from flame burns, often accompanied by moderate to severe inhalation injury and enhanced inflammatory response, elevated blood glucose levels, activated fibrinolysis, and impaired organ function in the early stage, which are associated with their prognosis. Age, total burn area, full-thickness burn area, and serum creatinine and APTT within the first 24 hours of injury are the independent risk factors for death within 28 days after injury in this population.

Objective:To explore the relationships among perceived social constraints, social participation, as well as anxiety and depression in first stroke patients, and to further analyze the mediating effect of social participation on these variables.Methods:A total of 216 first stroke patients in the Department of Neurology of Affiliated Hospital of Qingdao University from April to December 2020 were recruited by convenience sampling and investigated by general information questionnaire, Social Constraints Scale (SCS), Chinese version of Impact on Participation and Autonomy Questionaire (IPA-C) and Hospital Anxiety and Depression Scale (HADS).Results:The total score of SCS, IPA-C, depression and anxiety were 33.49 ± 6.81, 43.42 ± 9.62, 8.05 ± 4.15 and 8.61 ± 2.59. Social constraints were positively correlated with social participation as well as anxiety ( r=0.644, 0.383, both P<0.05). Social constraints were positively correlated with social participation as well as depression ( r=0.482, 0.371, both P<0.05). The quality of social participation partially mediated the relationship between social constraints and anxiety (intermediary effect was 0.119), and also partially mediated the relationship between social constraints and depression (intermediary effect was 0.270). Conclusions:First stroke patients experience high level of social constraints, low quality of social participation and severe anxiety and depression. Social constraints can affect anxiety and depression through social participation. Medical staff should build a good environment to meet the needs of stroke patients of social participation, help patients to establish a correct psychological coping style, reduce patients' avoidance of social participation due to perceived constraints and exclusion, and thus promote the mental health of patients.

Objective: Through research on the geriatric nursing related literature in Chinese journals and medical care and elderly care combination related keywords from 1979 to 2017, this study provides the development trend of geriatric nursing research. Methods: Searching articles in Wanfang, CNKI, VIP database, selecting the keywords and published time of the paper. Employing descriptive statistics to describe literatures information such as publication time, quantity of keywords, word frequency of keywords, heat degree of keywords, character of keywords and so on. Results: Totally 134 791 articles were got and 58 031 articles were included in the analysis. The amount of literature growth was slow before 2005, The cumulative amount of literature in 1979-2005 was only 12.75% of the total amount of literature. After 2005, the amount of literature increased rapidly year by year. The number of literature published in 2017 has exceeded 12%. The amount of the geriatric nursing related literature was proportional to the number of people aged 65 and over in China. In the research of geriatric nursing, the content related to medical care and elderly care combination was quite dispersed, and it did not involve research at the level of Medical Association. The medical care and elderly care combination and Medical Association were new areas in the research of geriatric nursing. Conclusion The amount of the geriatric nursing related literature from 1979 to 2017 was proportional to the number of people aged 65 and over in China. There are few researches on how to carry out geriatric nursing under the policy of medical care and elderly care combination and Medical Association, which should be the focus of future research and exploration to actively respond to the challenge of aging population.

Background and purpose:Previous studies have suggested Na+-Ca2+ exchanger isoform 1 (NCX1) as a key component of calcium homeostasis was involved in the tumorigenesis. However, the role of NCX1 and calcium signal in tumorigenesis of hepatocellular carcinoma (HCC) has not been explored. This study aimed to investigate the effect of NCX1 on cell proliferation and migration of HCC HepG2 cells in vitro and the possible mechanism.Methods:Both the real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot were applied to assess the expression of NCX1 mRNA and protein in normal hepatic cells (LO2), HCC cell line (HepG2), human normal hepatic tissues and hepatocellular carcinoma tissues. The change of intracellular calcium signal in LO2 and HepG2 cells via acti-vated NCX1 channel in the presence or absence of Na+ was examined by a confocal laser scanning microscope. The effects of NCX1 special inhibitor KB-R7943 on cell proliferation and migration of HepG2 cells were measured by MTT and cellscratch test.Results:Both mRNA and protein expression of NCX1 were higher in HCC tissues and cell line HepG2 than in the normal tissues and cell line LO2 (P<0.05). The activation of NCX1 channel induced a slight rise in cytoplasmic Ca2+concentration ([Ca2+]cyt) in normal cells, but caused a marked increase in cancer cells. And the NCX1 activation induced intracellular calcium increase was significantly reversed by NCX1 inhibitor KB-R7943 (P<0.05). Both NCX1-mediated proliferation and migration of HepG2 were also significantly attenuated by the KB-R7943 (P<0.05).Conclusion:NCX1 is up-regulated in HCC cells and tissues. The activation of NCX1 mediates intracellular calcium homeostasis. The inhibition of NCX1 activity can suppress the proliferation and migration of HepG2 cells. It is suggested that NCX1 may be involved in the development and progression of HCC.

BACKGROUNDHypertension (HTN) is a very prevalent public health problem and as the population ages, cognitive impairment (CI) is also going to be a public health burden. However, the relationship between hypertension duration and cognitive function declination worldwide is still unknown. The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.

METHODSAt baseline, 1 386 HTN patients and 293 normotensive (NT) people were enrolled. The HTN patients were further divided into four subgroups (duration of HTN <6 years, 6-10 years, 11-20 years, and >20 years) according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-state-examination (MMSE) and clock-drawing-test (CDT) in comparison with the NT group.

RESULTSMore HTN patients had CI (45.3%) than NT subjects (30.4%), and increased with HTN duration (P < 0.000 1). Compared with the scores of MMSE and CDT in the NT group, the declines were higher in the HTN patients (P < 0.000 1), and in the four HTN subgroups, both MMSE and CDT scores fall when the HTN duration increased (P < 0.05). Furthermore, in the HTN population without CI, the trend in alteration of CI was relatively mild but still existed (P < 0.05).

CONCLUSIONPeople with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration, both in amnesic and nonamnesic function.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cognition ; physiology ; Cognition Disorders ; etiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged