Objective:To explore the safety and efficacy of continuous pair triangular flap plasty in the treatment of webbed penis.Methods:The clinical data of 5 patients with webbed penis treated by continuous pair triangular flap plasty in Tianjin Baodi Hospital from November 2020 to January 2021 were retrospectively analyzed. The average age was 18.2 (15-24) years old. Physical examination showed a webbed fusion between the ventral skin of the penis and the scrotal skin, the penoscrotal angle disappeared and penile erection was limited. The web extended to or exceeded the middle of the penis in the 5 cases. None of the 5 patients had other penile malformations. Taking the ventral midline of the penis and the junction of the penis and scrotum as the origin, a " Z-shaped" incision was made above and below it respectively, and two triangular flaps with the same size and shape but opposite direction were formed respectively. Then the triangular flaps were switched and sutured.Results:The average operation time of five patients was 13(10-20) minutes. The operative average blood loss was 1.6(1-3)ml. All patients had good wound healing and no surgical complications. Three months after operation, the appearance of the penis was satisfactory and erection was unrestricted.Conclusions:Continuous pair triangular flap plasty overcomes the disadvantages of traditional operation, and has the advantages of simple operation, good operation results and few complications. It is a good choice for the treatment of webbed penis.

Objective:To explore the regulatory role and mechanism of tribbles pseudokinase 3 (TRB3) on hepatocarcinoma (HCC) cells proliferation, apoptosis and migration.Methods:Immunohistochemistry and Western blot were used to detect TRB3 expression in cancerous and adjacent cancerous liver tissues of HCC patients. TRB3 expression was detected in vitro in HepG2 and Huh7 hepatocarcinoma cell lines. Simultaneously, CCK8 and EdU were used to detect cell proliferation after TRB3 targeted inhibition with small interfering RNA. CCK8 and EdU were used to detect cell proliferation. Flow cytometry assay was used to detect apoptosis. Transwell assay was used to evaluate migration ability. Simultaneously, Western blot was used to detect changes in apoptosis, migration-related proteins and AKT phosphorylation activity. The mean comparison between the two groups was performed by t-test, and the comparison between multiple groups was performed by one-way analysis of variance.Results:Western blot showed that the expression of TRB3 was significantly up-regulated in HCC tissues. Compared with normal liver tissues adjacent to cancer, the relative expression levels were 0.78 ± 0.12 and 0.29 ± 0.09, respectively, P < 0.01, and the difference was statistically significant. After interfering siRNA inhibited TRB3, CCK8 and EdU tests showed that the proliferation activity of HepG2 and Huh7 cells were significantly weakened ( P < 0.05). Flow cytometry results showed that the apoptotic proportions of HepG2 and Huh7 cells was significantly increased ( P < 0.01). Western blot also showed that the expression of apoptosis regulatory proteins BAX and BIM were significantly increased ( P < 0.01). Transwell assay results showed that the migration ability of HepG2 and Huh7 cells was decreased ( P < 0.05), and the expression of migration regulatory proteins MMP4 and MMP9 was also significantly down-regulated. Western blot results showed that the AKT phosphorylation level was significantly increased. Conclusion:TRB3 regulates hepatocarcinoma cells proliferation, apoptosis and migration by inhibiting the AKT phosphorylation activity. Therefore, TRB3 may be a potential target site for the liver cancer treatment.

Objective To investigate the clinical effect of S-1 combined with oxaliplatin (SOX regimen) in treatment of the patients with advanced pancreatic cancer. Methods A total of 106 patients with advanced pancreatic cancer in Qingdao Fuwai Hospital from April 2015 to June 2017 were randomly divided into the treatment group (53 cases) and the control group (53 cases) according to the random number table method. Patients in the control group were treated with S-1 combined with cisplatin treatment, and patients in the treatment group were treated with SOX regimen. The cell proportion of CD3+, CD4+, CD8+and CD4+/CD8+before treatment and after 2 cycles of treatment were detected by using flow cytometry of both groups. The clinical curative effects, immunity and adverse reactions of both groups were compared by usingχ2 test and t test. Kaplan-Meier method was used to make the survival analysis. Results After two cycles of treatment, there were 4 cases of complete remission (CR), 23 cases of partial remission (PR), 17 cases of stable disease (SD), 9 cases of progression disease (PD) in the treatment group, and 0 case of CR, 18 cases of PR, 20 cases of SD, 15 cases of PD in the control group. The rate of CR+PR in the treatment group was higher than that in the control group [50.94％(27/53) vs. 33.96％(18/53)], and there was a statistical difference (χ2=5.936, P<0.05). There was a significant difference in the cell proportion of CD4+and ratio of CD4+/CD8+between the two groups before and after treatment [the treatment group: (27.31±2.48)％ vs. (37.05±2.53)％, χ2= 6.491,P< 0.01; 0.91 ±0.23 vs. 1.53 ±0.50, χ2 = 5.913, P< 0.01; the control group: (27.43 ±2.47)％ vs. (30.32 ± 2.41)％,χ2= 11.214, P<0.01; 0.90±0.22 vs. 1.22±0.34,χ2=7.992, P<0.01]. After 2 cycles of treatment, the cell proportion of CD4+and ratio of CD4+/CD8+of the treatment group were higher than those of the control group, and there were statistical differences (χ2=5.309, P<0.01;χ2= 7.112, P< 0.01). The incidence rate of side effects had no significant difference in both groups after two cycles of treatment [22.64％ (12/53) vs. 18.87％ (10/53), χ2= 1.924, P> 0.05]. The progression-free survival time in the treatment group was longer than that in the control group (P<0.05). Conclusions SOX regimen has a favorable effect on the patients with advanced pancreatic cancer. It can help to improve the immunity and prolong the survival time of the patients.

Objective To discuss the correlation between nature of carotid plaque by dual-source CT examination and serum levels of hypersensitive C-reactive protein (hs-CRP),lipoprotein a (LPa) and homocysteine (Hcy),and provide a better theoretical basis for the prevention and treatment of ischemic cerebrovascular disease.Methods Fifty carotid plaque patients with ischemic cerebrovascular disease symptoms (group A),50 carotid plaque patients without ischemic cerebrovascular disease symptoms (group B)and 50 healthy people (group C) were selected.All objects were detected the carotid plaque by dual-source CT,and the serum levels of hs-CRP,LPa and Hcy were detected by the automatic biochemical analyzer.The correlation between the nature of carotid plaque by dual-source CT examination and the serum levels of hs-CRP,LPa and Hcy was analyzed.Results The total number of carotid plaque,number of unstable plaque and number of stable plaque in group A were 357,220 and 137 pieces,respectively.Those in group B were 200,13 and 187 pieces,respectively.There were statistical differences between group A and group B (P ＜ 0.01).Patients in group A and group B were mainly with unstable plaque and stable plaque,respectively.Healthy people in group C were without carotid plaque.The serum levels of hs-CRP,LPa and Hcy in group A were (36.74 ± 13.22) mg/L,(563.15 ± 178.69) mg/L and (40.15 ± 12.31) μ mol/L,respectively.These in group B were (12.36 ± 4.35) mg/L,(393.56 ± 86.45) mg/L and (29.45 ± 7.63) μ mol/L,respectively.These in group C were (3.26 ± 1.26) mg/L,(220.17 ± 35.24) mg/L and (14.32 ± 2.44) μ mol/L,respectively.The serum levels of hs-CRP,LPa and Hcy in group A were significantly higher than those in group B and group C,and those in group B were significantly higher than those in group C,there were statistical differences (P ＜ 0.05).The serum levels of hs-CRP,LPa and Hcy were positive correlation with the number of carotid unstable plaque,the correlation coefficients between the serum levels of hs-CRP,LPa and Hcy and the number of carotid unstable plaque in group A were 0.469,0.398 and 0.363 (P ＜ 0.05),respectively,in group B were 0.276,0.145 and 0.127(P ＜ 0.05),respectively.The correlation coefficients between group A and group B were significantly different (P ＜ 0.05).Conclusions The combination of dual-source CT examination and the serum levels of hs-CRP,LPa and Hcy is more beneficial to judge the stability of plaque,and it can help predict the nature of the carotid plaque.This view is important clinically for the prevention and treatment of the occurrence and the development of the ischemic cerebrovascular disease.

BACKGROUNDAneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive. The optimal treatment of cervical spine lesions remains controversial. This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.

METHODSThis series included eight men and six women diagnosed between 2002 and 2012. A retrospective review of the hospital charts, operating room reports, office charts, and radiographs was performed. The data collected included patient age, sex, radiological features, pathology, treatment methods, outcomes, and complications from biopsies and treatments. The mean age at diagnosis was 17.5 years old with a range of 6-35 years. All patients had experienced local pain for a mean of 7.3 months (range, 0.5-18.0 months), and three patients had neurological deficits (one with radiculopathy and two with myelopathy). The Frankel classification before treatment was E in 12 cases, D in one case, and C in one case.

RESULTSFour patients received radiotherapy alone. Ten patients underwent surgery, including five total spondylectomies, two local resections, and three curettages. Three patients received preoperative selective arterial embolization, and four received adjuvant radiotherapy. The mean follow-up time was 44.5 months (range 12-96 months), and no recurrence was identified. Three patients with neurological deficits achieved complete recovery, as noted at the final follow-up examination. One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy. He refused further treatment.

CONCLUSIONSThe results can be achieved by different treatments (surgical resection/curettage, selective arterial embolization, and radiotherapy) for ABC of the cervical spine. Reconstruction of stability is also important for the treatment of cervical ABC.

Adolescent ; Adult ; Bone Cysts, Aneurysmal ; therapy ; Cervical Vertebrae ; pathology ; Child ; Embolization, Therapeutic ; Female ; Humans ; Male ; Retrospective Studies ; Spinal Diseases ; therapy ; Young Adult

Objective To explore the possibility of using the mammotome system (MMT) with 2.5 cm spiral cutting mode to resect benign tumor of 3-6 cm in diameter.Methods The study group consisted of 160 patients with tumor of 3-6 cm in diameter,who received treatment of MMT cross combination with parallel rotary cutting method.The control group consisted of 160 patients with tumor ＜ 2.5 cm and received routine MMT operation.The therapeutic effects and complications of the two groups were compared.Chi-sqare test was used for statistical analysis.Results All operations were successful on MMT.There was no statistical difference in intraoperative bleeding,skin ecchymosis and postoperative hematomas between the two groups(x2 =0.251 8,P =0.616;x2 =0.328 2,P =0.567 ;x2 =0.146 3,P =0.702).The hospitalization duration,the operation scar and other complications were similar between the two groups.Conclusions The MMT cross combination with parallel rotary cutting method can be used to resect 3-6 cm benign breast tumors.It has the advantages of safety,efficiency,minimal invasiveness,covertincision,good cosmetic effect and low complications.

Objective To investigate the value of combined detection of serum tumor biomarkers including alpha-fetoprotein (AFP),tumor specific growth factor (TSGF),golgi protein 73 (GP73) and osteopontin (OPN) in diagnosis of primmy hepatic carcinoma.Methods AFP,TSGF and GP73 levels were measured by electro-chemiluminescence immunoassay,and OPN levels by enzyme-linked immunosorbent assay (ELISA) in 122 cases of primary hepatic carcinoma,50 cases of liver benign lesions and 50 cases of healthy control.The biological parameters and the levels of AFP,TSGF,GP73 and OPN were studied.Results The serum levels of AFP,TSGF,GP73 and OPN in primary hepatic carcinoma were higher than those in the liver benign disease group and the normal control group (all P ＜ 0.01).Sex and age of the patients at diagnosis showed no significant association with the levels of the four serum tumor biomarkers in the primary hepatic carcinoma groups (all P ＞ 0.05).But the tumor size,amount,tumor stage,metastasis and recurrence showed significant association with the levels of those in the primary hepatic carcinoma groups (all P ＜ 0.05).The sensitivity,specificity and veracity of serum AFP,TSGF,GP73 and OPN as individual diagnostic marker was only 57.38 ％,68.85 ％,70.49 ％ and 69.67 ％,respectively.The sensitivity of combined detection of AFP and TSGF was 80.33 ％,and that of combined detection of AFP,TSGF and GP73 was 85.25 ％.While,the sensitivity of the four serum tumor markers in combination was 98.36 ％,the accuracy was 95.65 ％.The sensitivity and accuracy of combined detection with the four serum tumor markers were significantly higher than those of the individual markers and other combination detection methods (all P ＜ 0.05).Conclusions Serum markers of AFP,TSGF,GP73 and OPN can serve as a means for diagnosis of primary hepatic carcinoma.Combined detection of the four serum tumor biomarkers can improve the sensitivity,accuracy and the negative predictive value,which is benefit to early diagnosis and interference.

Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups: sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the content of substance P in serum and tissue between the sham group and model group at 3 weeks. The expression of substance P in the sham group was (3.12±0.51) times of the model group (P<0.05). Conclusion Substance P may take part in NBD after SCI in rats.

Background Aneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive.The optimal treatment of cervical spine lesions remains controversial.This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.Methods This series included eight men and six women diagnosed between 2002 and 2012.A retrospective review of the hospital charts,operating room reports,office charts,and radiographs was performed.The data collected included patient age,sex,radiological features,pathology,treatment method,outcomes,and complications from biopsies and treatments.The mean age at diagnosis was 17.5 years old with a range of 6-35 years.All patients had experienced local pain for a mean of 7.3 months (range,0.5-18.0 months),and three patients had neurological deficits (one with radiculopathy and two with myelopathy).The Frankel classification before treatment was E in 12 cases,D in one case,and C in one case.Results Four patients received radiotherapy alone.Ten patients underwent surgery,including five total spondyiectomies,two local resections,and three curettages.Three patients received preoperative selective arterial embolization,and four received adjuvant radiotherapy.The mean follow-up time was 44.5 months (range 12-96 months),and no recurrence was identified.Three patients with neurological deficits achieved complete recovery,as noted at the final follow-up examination.One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy.He refused further treatment.Conclusions The results can be achieved by different treatments (surgical resection/curettage,selective arterial embolization,and radiotherapy) for ABC of the cervical spine.Reconstruction of stability is also important for the treatment of cervical ABC.

Objective To study the value of serum tartrate-resistant acid phosphatase 5b (TRACP5b) in bone metastasis in early breast cancer patients with negative axillary lymph nodes.Methods The serum level of TRACP5b was determined by enzyme-linked immumosorbent assay (ELISA) in 26 breast cancer patients and 18 healthy female adults.Results The serum level of TRACP5b was (3.85 ± 0.85) U/L in the group of breast cancer patients and (2.08 ± 0.84) U/L in the control group.The difference had statistical significance (P ＜0.05 ).The sensitivity was 42.31％ and the specificity was 94.44％ for TRACP5 b in predicting bone metastasis of breast cancer with negtive axillary lymph nodes.Conclusions TRACP5b has higher sensitivity and specificity in breast cancer patients than in healthy female adults.TRACP5b is a useful serum marker to predict bone metastasis in breast cancer patients.