1.Microscopic electric rotary grinding combined with graft repairing in patients with Peyronie's disease:a report of 21 cases
Dachun JIN ; Yong LUO ; Peng WANG ; Yong ZHANG ; Gang BI ; Dali TONG ; Yihe WANG ; Wanyi ZHOU ; Yanfeng LI
Journal of Army Medical University 2024;46(11):1291-1297
Objective To explore the surgical techniques and experiences in the treatment of Peyronie's disease using electric rotary grinding of tunica albuginea plaques followed by graft repair with tunica vaginalis or bovine pericardium under a microscope.Methods A retrospective cohort study was performed on 21 patients with severe penile curvature due to Peyronie's disease admitted in our department from January 2021 and May 2023.All of them underwent microscopic electric rotary grinding of tunica albuginea plaques followed by graft repair surgery.Short-term and mid-term outcomes were observed.Results For the 21 enrolled patients,12(57.1%)underwent repair using unilateral tunica vaginalis,3(14.3%)underwent repair using bilateral tunica vaginalis,and 6(28.6%)underwent repair using bovine pericardium.The operation time was 170~385(average 272±69)min,and the average postoperative follow-up duration was3~24(average 12.1±7.2)months.Seventeen patients(81.0%)had their penis fully extended,while 4 patients(19.0%)had slight dorsal curvature,which was less than 10°.All patients were satisfied with the shape of their penis during erection.The change in penile length was+(1.1±0.5)cm,and 9 patients(42.9%)reported early postoperative penile head numbness,which spontaneously resolved after an average duration of 3.2±1.9 months.All patients were able to successfully engage in sexual activity,with an average penile erection hardness score of 3.8.The overall satisfaction rate was 90.5%post operatively.Conclusion Meticulous dissection of Buck's fascia under a microscope is advantageous in reliably preserving dorsal neurovascular structures.Application of an electric grinding drill for plaque ablation allows for more precise release of the tunica.Graft repair of tunica albuginea defects with testicular tunica vaginalis or bovine pericardium for Peyronie's disease yields overall favorable clinical outcomes and obtains high satisfaction.It is worthy of promotion in clinical practice.
2.Diagnosis and treatment of congenital anterior urethrocutaneous fistula
Ming BAI ; Lei KANG ; Gaofeng ZHANG ; Jingti ZHANG ; Tao GUO ; Xing MING ; Yihe WANG ; Yanyan ZHOU
Chinese Journal of Urology 2022;43(1):62-66
Objective:To explore the clinical features and treatment strategy of congenital anterior urethrocutaneous fistula.Methods:A total of 7 cases with congenital anterior urethrocutaneous fistula were repaired by surgery between January 2006 and February 2019 in Affiliated Children’s Hospital of Xi’an Jiaotong University. The median age was 30 (18-92) months. All of cases had a intact prepucs and a normal external urethal meatus located at the tip of glans. Fistula located at subcoronal culus in 2 cases, midshaft in 3 cases, penioscrotal region in 1 case, scrotum in 1 case, respectively.Defect longitudinal diameter was 0.5-1.5cm. Associated anomalies including division of scrotum in 3 cases, penile chordee in 2 cases, urethral meatus stenosis in 1 case, right hydrocele in 1 case. Six cases had underwent one-stage fistula repair incluing Duplay procedure in 4 cases(case 1, 2, 4 and 6), Onlay preputial flap in 1 case(case 3), TIP repair with dorsal plication for straightening and urethrotomy in 1 case(case 5). Case 7 had underwent a two-stage repair, which received Duckett flap repair with urethrostomy simultaneously at the base of the penis, and the defect was closed in second procedure. All of neourethras were reinforced by soft tissues from different places.Results:Of 6 cases with one-stage repair, the catheter was removed 10-14 days after surgery in 5 cases. Removal of the catheter was delayed until 3 weeks in case 3 because of poor wound healing. Case 7 received Duckett flap repair with urethrostomy in the initial surgery, who recovered uneventfully and was resolved during the second operation. No recurrence, urethral stricture or chordee occurence were noted in all after a 1-8 years followup period.Conclusions:Congenital anterior urethrocutaneous fistula have a high overall success rate.Duplay could be applied to cases without penile curvature, and well-developed urethral plate. Onlay or TIP is more suitable for cases with narrow urethral plate. The principle of hypospadias repair should be followed for those cases with severe penile curvature.
3.Effect of Modified Longdan Xiegantang in Treatment of Anal Sinusitis Patients with Syndrome of Interior Dampness-heat and on Immune Response, Oxidative Stress
Ning ZHANG ; Xiao-li ZHOU ; Shuai LIU
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(3):78-83
Objective::To explore the effect of modified Longdan Xiegantang in treatment of anal sinusitis patients with syndrome of interior dampness-heat and on immune response, oxidative stress. Method::A total of 80 cases of anal sinusitis patients with syndrome of interior dampness-heat treated in our hospital from May 2017 to May 2018 were randomly divided into two groups, with 40 cases in each group. The control group was treated by enema with Metronidazole injection combined with gentamicin sulfate injection. In addition to the therapy of the control group, the treatment group was also given modified Longdan Xiegantang. The symptoms and signs score, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-
4.Clone, expression and plasminogen binding property of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis
Li, S. ; Lu, B.P. ; Feng, J. ; Zhou, J.J. ; Xie, Z.Z. ; Liang, C. ; Li, X.R. ; Huang, Y. ; Yu, X.B.
Tropical Biomedicine 2020;37(No.4):852-863
Fructose-1,6-bisphosphate aldolase (FbA), a well characterized glycometabolism
enzyme, has been found to participate in other important processes besides the classic
catalysis. To understand the important functions of three fructose-1,6-bisphosphate aldolases
from Clonorchis sinensis (CsFbAs, CsFbA-1/2/3) in host-parasite interplay, the open reading
frames of CsFbAs were cloned into pET30a (+) vector and the resulting recombinant plasmids
were transformed into Escherichia coli BL21 (DE3) for expression of the proteins. Purified
recombinant CsFbAs proteins (rCsFbAs) were approximately 45.0 kDa on 12% SDS-PAGE and
could be probed with each rat anti-rCsFbAs sera by western blotting analysis. ELISA and
ligand blot overlay indicated that rCsFbAs of 45.0 kDa as well as native CsFbAs of 39.5 kDa
from total worm extracts and excretory-secretory products of Clonorchis sinensis (CsESPs)
could bind to human plasminogen, and the binding could be efficiently inhibited by lysine
analog ε-aminocaproic acid. Our results suggested that as both the components of CsESPs
and the plasminogen binding proteins, three CsFbAs might be involved in preventing the
formation of the blood clot so that Clonorchis sinensis could acquire enough nutrients from
host tissue for their successful survival and colonization in the host. Our work will provide us
with new information about the biological function of three CsFbAs and their roles in hostparasite interplay
5. Effect of Modified Qingre Shenshi Tang on Inflammatory Factors, Oxidative Stress and Immune Function in Chronic Antral Sinusitis Patients with Damp-heat Pouring Downward Syndrome
Ning ZHANG ; Xiao-li ZHOU ; Shuai LIU
Chinese Journal of Experimental Traditional Medical Formulae 2019;25(13):93-98
Objective:To explore effect of modified Qingre Shenshi Tang on inflammatory factors, oxidative stress and immune function in chronic antral sinusitis patients with damp-heat pouring downward syndrome. Method:A total of 94 cases of chronic antral sinusitis treated in our hospital from June 2017 to April 2018 were randomly divided into two groups, with 47 cases in each group. Control group was treated with metronidazole combined with gentamicin enema. In addition to the therapy of control group, the treatment group was given modified Qingre Shenshi Tang. The symptom scores, interleukin-2 (IL-2), IL-6, IL-8, tumor necrosis factor-α (TNF-α), gamma interferon (IFN-γ), super oxide dismutase (SOD), malondialdehyde (MDA), advanced oxidation protein products (AOPP), 8-hydroxy deoxyguanosine (8-OHDG), CD3+, CD4+, CD8+ levels of the two groups were observed before and after treatment, and the curative effect, reactions and relapse were observed. Result:After treatment, the total effective rates of treatment group(87.23%) and control group (78.72%) showed statistically significant differences (Z=2.067, P<0.05). The symptoms of anal pain, swelling and dampness in the treatment group were lower than those in control group (P<0.05). The levels of TNF-α, IL-6, IL-8, MDA, AOPP, 8-OHDG, CD8+in the treatment group were lower than those in control group (P<0.05), while the levels of IL-2, IFN-γ, SOD, CD3+, CD4+, CD4+/CD8+were higher than those in control group (P<0.05). After 3 months of follow-up, the recurrence rates of treatment group[4.26% (2/47)] and control group[21.28% (10/47)] were statistically significant (χ2=4.681, P<0.05). Conclusion:Modified Qingre Shenshi Tang has a good curative effect in the treatment of chronic antral sinusitis patients with damp-heat pouring downward syndrome by relieving symptoms, inhibiting inflammatory response, regulating oxidative stress, improving immune function and controlling recurrence rate.
6.The research of inflammatory cytokines and T cell activation in peripheral blood of opportunistic infections and death in HIV
Jing CAO ; Guoqiang ZHOU ; Yihe LIN ; Min WANG ; Yuhuang ZHENG
Journal of Chinese Physician 2018;20(6):844-846,850
Objective The plasma levels of interleukin 6 (IL-6),high sensitive C reactive protein (hs-CRP) and the level of T cell activation were detected in the peripheral blood inflammatory factors of acquired immunodeficiency syndrome (AIDS) patients,and the relationship with opportunistic infection and prognosis was analyzed.Methods 79 human immunodeficiency virus (HIV)-positive/aids cases from May 2014 to January 2015 in first hospital of Changsha were enrolled in the study.They were divided into three groups:HIV-infected without opportunistic infections group (n =20),HIV-infected with infections group (n =43,including HIV-infected with tuberculosis group,HIV-infected with merge fungus group.HIV combined hepatitis C),death group (n =16).Serum IL-6 and the concentration of hs-CRP were detected by enzyme-linked immunosorbent assay (ELISA).Flow cytometry was used to test the CD3 + CD4 + cell count,the percentage of CD4 + CD38 + cell and CD8 + CD38 + cell in peripheral blood mononuclear cell (PBMC).Compare the differences among the three groups.Results The results showed that:the concentration of hsCRP and IL-6 in peripheral blood of HIV death group was significantly higher than that in other three groups (P < 0.05).The concentration of hs-CRP and IL-6 in the peripheral blood of the HIV-infected with tuberculosis group and HIV-infected with merge fungus group were significantly higher than that in the HIV-infected without opportunistic infections group (P < 0.05),and the hs-CRP in the peripheral blood of the HIV combined with the hepatitis C group was higher than that in the HIV-infected without opportunistic infections group (P < 0.05).The number of CD3,CD4T lymph nodes in the death group and the combined opportunistic infection group was significantly lower than that in the HIV-infected without opportunistic infections group (P < 0.05).The HIV-RNA expression in peripheral blood of the death group and the combined opportunistic infection group was significantly lower than that in the HIV-infected without opportunistic infections group (P < 0.05).The expression of CD8+CD38+ on PBMC in the HIV-infected without opportunistic infections group was significantly lower than that in the death group,the tuberculosis group,the fungus group and the hepatitis C group (P < 0.05).The expression of CD4+ CD38 + on PBMC in the HIV-infected without opportunistic infections group was higher than that in the death group (P < 0,05).Conclusions The concentration of inflammatory cytokines (IL-6,hs-CRP) and the expression level of T cell surface CD8 + CD38 + related to immune activation were associated with opportunistic infection and prognosis of AIDS.
7.Relationship between sleep status and the risk of diabetes in adults
Jian SU ; Ran TAO ; Jinyi ZHOU ; Jie YANG ; Yu QIN ; Yihe HU ; Yan LU ; Jianrong JIN ; Zheng BIAN ; Yu GUO ; Zhengming CHEN ; Liming LI ; Ming WU
Chinese Journal of Epidemiology 2017;38(5):597-601
Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3% had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2%,10.0% and 29.5%,respectively.There were 22.6% of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95% CI:1.30-2.05;OR=1.48 for female,95% CI:1.27-1.73),early morning arousal (OR=1.37 for male,95%CI:1.12-1.68;OR=1.31 for female,95%CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95%CI:1.00-1.34;OR=1.39 for female,95%CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95%CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95%CI:1.17-1.60) and females (OR=1.24,95% CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.
8.Impact of Cytoreductive Nephrectomy on Survival in Patients with Metastatic Renal Cell Carcinoma Treated by Targeted Therapy.
Yan SONG ; Chun-Xia DU ; Wen ZHANG ; Yong-Kun SUN ; Lin YANG ; Cheng-Xu CUI ; Yihe-Bali CHI ; Jian-Zhong SHOU ; Ai-Ping ZHOU ; Chang-Ling LI ; Jian-Hui MA ; Jin-Wan WANG ; Yan SUN
Chinese Medical Journal 2016;129(5):530-535
BACKGROUNDThe metastatic renal cell carcinoma (mRCC) patients treated with upfront cytoreductive nephrectomy combined with α-interferon yields additional overall survival (OS) benefits. It is unclear whether mRCC patients treated with vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI) will benefit from such cytoreductive nephrectomy either. The aim of the study was to identify variables for selection of patients who would benefit from upfront cytoreductive nephrectomy for mRCC treated with VEGFR-TKI.
METHODSClinical data on 74 patients enrolled in 5 clinical trials conducted in Cancer Hospital (Institute), Chinese Academy of Medical Sciences from January 2006 to January 2014 were reviewed retrospectively. The survival analysis was performed by the Kaplan-Meier method. Comparisons between patient groups were performed by Chi-square test. A Cox regression model was adopted for analysis of multiple factors affecting survival, with a significance level of α = 0.05.
RESULTSFifty-one patients underwent cytoreductive nephrectomy followed by targeted therapy (cytoreductive nephrectomy group) and 23 patients were treated with targeted therapy alone (noncytoreductive nephrectomy group). The median OS was 32.2 months and 23.0 months in cytoreductive nephrectomy and noncytoreductive nephrectomy groups, respectively (P = 0.041). Age ≤45 years (P = 0.002), a low or high body mass index (BMI <19 or >30 kg/m2) (P = 0.008), a serum lactate dehydrogenase (LDH) concentration >1.5 × upper limit of normal (P = 0.025), a serum calcium concentration >10 mg/ml (P = 0.034), and 3 or more metastatic sites (P = 0.023) were independent preoperative risk factors for survival. The patients only with 0-2 risk factors benefited from upfront cytoreductive nephrectomy in terms of OS when compared with the patients treated with targeted therapy alone (40.0 months vs. 23.2 months, P = 0.042), while those with more than 2 risk factors did not.
CONCLUSIONSFive risk factors (age, BMI, LDH, serum calcium, and number of metastatic sites) seemed to be helpful for selecting patients who would benefit from undergoing upfront cytoreductive nephrectomy.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; mortality ; surgery ; Cytoreduction Surgical Procedures ; Female ; Humans ; Kidney Neoplasms ; mortality ; surgery ; Male ; Middle Aged ; Nephrectomy ; Proportional Hazards Models
9.Clinical study of high frequency oscillatory ventilation combined thoracic close drainage for the treatment of 22 cases of neonatal pneumothorax
Zhifeng CHEN ; Jianwen ZHANG ; Huien ZHOU ; Yanling LU ; Yihe LI
Clinical Medicine of China 2015;31(1):16-19
Objective To explore the clinical effect and safety of high frequency oscillatory ventilation (HFOV) combined thoracic close drainage for the treatment of mechanical ventilated neonates with pneumothorax.Methods Twenty-two neonates were enrolled in this study,who needed mechanical ventilation diagnosed with neonatal pneumothorax and received treatment of HFOV combined thoracic close drainage from Jan.2012 and Jun.2014 in the People's Hospital of Dongguan.We recorded blood gas analysis and parameters of breathing machine before using HFOV and 2,12,24,48 hours after using HFOV respectively.Results There were significant differences between HFOV before use (0) and 2,12,24,48 hours after using HFOV in terms of blood pH value,arterial partial pressure of oxygen(PaO2),partial pressure of arterial carbon dioxide (PaCO2),oxygenation index (OI),the inspired oxygen concentration (FiO2),mean airway pressure (MAP) (F =6.606,17.760,8.387,17.242,25.185; P < 0.05).Compared with before using HFOV combined thoracic close drainage,PaO2 was significantly increased from (51.25 ± 13.16) mmHg to (62.60 ± 15.95) mmHg.PaCO2 was significantly dropped from (63.57 ± 13.81) mmHg to (54.02 ± 11.58) mmHg and OI was dropped sharply from (16.57 ± 9.09) to (11.28 ± 4.67) at 2 hours after using HFOV combined thoracic close drainage (P < 0.05).FiO2 significantly decreased from (0.76 ± 0.15) to (0.60 ± 0.13),as well as MAP from (9.91 ± 1.44) cm H2 Oto (8.50 ± 1.68) cm H2O.Furthermore,pH was significantly improved from (7.24 ± 0.15) to (7.34 ±0.10) at 12 hours later(P <0.05).PH,PaO2,PaCO2 were roughly back to normal at 48 hours after treatment.The main complications were intraventricular hemorrhage (2 cases),subarachnoid hemorrhage (2 cases),ventilator associated pneumonia (1 case) and pulmonary hemorrhage (1 case) (not during the time of HFOV treatment).Conclusion HFOV combined thoracic close drainage for the treatment of neonates with pneumothorax is safety and effective methods.
10.Total hip replacement for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip.
Yihe HU ; Tianjian ZHOU ; Hua LIU ; Kanghua LI ; Guanghua LEI
Journal of Central South University(Medical Sciences) 2009;34(11):1142-1147
OBJECTIVE:
To investigate the surgical techniques and clinical outcomes of total hip replacement for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip.
METHODS:
From May 2004 to March 2008, a total of 36 total hip replacements were performed in 32 patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. The acetabulum cup was reconstructed in the corresponding anatomical position in all cases. Cemented components were used in 16 hips, and cementless components in the other 20 hips. The mean follow-up was 31.3 months. Clinical outcomes were determined with Harris hip score. Radiographs were taken after the surgery and in every follow-up examination for further reference.
RESULTS:
All patients postoperatively gained a limb lengthening with an average of (3.4+/-1.3) cm. Three patients had complications, 2 had nondisplaced fractures of the proximal part of the femur,and 1 sciatic nerve palsy which disappeared after 3 months. There was no infection, dislocation and symptomatic deep vein thrombosis. Compared with preoperation, the mean Harris hip scores on the 3rd day, the 14th day after the operation and at the last follow-up were all improved significantly (all P<0.05). There was no loosening, migration, heterotopic ossification radiographically, and no revision during the follow-up.
CONCLUSION
Total hip replacement is an effective treatment for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. The key is to place the acetabulum cup in the corresponding anatomical position, and choose proper prosthesises during the surgery.
Adult
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Arthroplasty, Replacement, Hip
;
adverse effects
;
methods
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Female
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Hip Dislocation, Congenital
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complications
;
surgery
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Humans
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Male
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Middle Aged
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Orthopedic Procedures
;
methods
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Osteoarthritis
;
etiology
;
surgery
;
Treatment Outcome


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