Teriparatide regulates osteoblast differentiation in high-glucose microenvironment through the cAMP/PKA/CREB signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate the effect of teriparatide on the differentiation of MC3T3-E1 cells in high-glucose microenvironment and explore the possible mechanism.@*METHODS@#MC3T3-E1 cells cultured in normal glucose or high-glucose (25 mmol/L) medium were treated with 10 nmol/L teriparatide with or without co-treatment with H-89 (a PKA inhibitor). CCK-8 assay was used to detect the changes in cell proliferation, and cAMP content in the cells was determined with ELISA. Alkaline phosphatase (ALP) activity and mineralized nodules in the cells were detected using ALP kit and Alizarin red staining, respectively. The changes in cell morphology were detected by cytoskeleton staining. Real-time PCR was used to detect the mRNA expressions of PKA, CREB, RUNX2 and Osx in the treated cells.@*RESULTS@#The treatments did not result in significant changes in proliferation of MC3T3-E1 cells (P > 0.05). Compared with the cells in routine culture, the cells treated with teriparatide showed significantly increased cAMP levels (P < 0.05) with enhanced ALP activity and increased area of mineralized nodules (P < 0.05). Teriparatide treatment also resulted in more distinct visualization of the cytoskeleton in the cells and obviously up-regulated the mRNA expressions of PKA, CREB, RUNX2 and Osx (P < 0.05). The opposite changes were observed in cells cultured in high glucose. In cells exposed to high glucose, treatment with teriparatide significantly increased cAMP levels (P < 0.05), ALP activity and the area of mineralized nodules (P < 0.05) and enhanced the clarity of the cytoskeleton and mRNA expressions of PKA, CREB, RUNX2 and Osx; the effects of teriparatide was strongly antagonized by co-treatment with H-89 (P < 0.05).@*CONCLUSION@#Teriparatide can promote osteoblast differentiation of MC3T3-E1 cells in high-glucose microenvironment possibly by activating the cAMP/PKA/CREB signaling pathway.

Silencing of Myh3 Gene by siRNA Inhibits Glycolysis in C2C12 Cells / 中国生物化学与分子生物学报

The Myh3 (myosin heavy chain 3) gene is a marker gene of muscle cell differentiation and regulates the utilization of energy in muscle cells, but whether it affects the glycolysis process of muscle cells in different states is rarely reported. In this paper, the expression patterns of Myh3 and glycolysis-related genes Pkm (M-type pyruvate kinse), Prkag3 (protein kinase adenosine monophosphate-activated γ3-subunit), and Gsk3β (glycogen synthase kinase-3β) were studied by the qRT-PCR (quantitative-Real-Time-PCR) method using C2C12 cells at different stages of myoblast and adipogenic differentiation as models. It was found that in the process of myoblast differentiation of C2C12 cells, the relative expression trends of Myh3 and glycolysis genes Prkag3 and Pkm were basically the same, and the relative expression levels first increased, reached the peak on the second day of differentiation, and then decreased; glycogen synthase the expression trend of the inhibitory gene Gsk3β was relatively stable. In the process of adipogenic differentiation of C2C12 cells, the relative expression trend of Myh3 and glycolysis genes Prkag3 and Pkm remained basically the same, and the relative expression gradually increased, reaching the highest value on the 8th day of differentiation; glycogen synthase inhibitory gene Gsk3β expression remained stable. In the myogenic differentiation state of C2C12 cells, qRT-PCR and Western blotting were used to detect the effects of interfering Myh3 on the mRNA and protein expressions of glycolysis-related genes Pkm, Prkag3, and Gsk3β. The results showed that after interfering with Myh3, the mRNA expressions of glycolysis genes Pkm and Prkag3 were significantly decreased (P 0.05). The protein levels of Myh3 and Pkm were significantly lower than those in the blank group and NC group. Under the adipogenic differentiation state of C2C12 cells, after interfering with Myh3, the mRNA levels of glycogen synthase inhibitor Gsk3β and glycolysis gene Prkag3 were significantly increased (P<0.01), and the mRNA level of glycolysis gene Pkm was decreased; the protein levels of Myh3 and Pkm in the Myh3 interference group were also lower than those in the blank group and NC group. Based on the above studies, there are significant differences in the levels of glycolysis in C2C12 cells in the myogenic and adipogenic states, and the expression patterns of Myh3 and glycolysis genes are similar. Further results showed that Myh3 suppression could inhibit the glycolysis of C2C12 cells in the myogenic state without affecting the glycogen synthesis. Unlike in the myogenic state, interfering expression of Myh3 in the adipogenic state of C2C12 cells inhibited both glycogen synthesis and glycolysis.

Relationship of urine cobalt and individual exposure levels of cobalt and its compounds in cobalt exposed workers / 中国职业医学

@#Objective - To analyze the relationship between cobalt level of post shift urine and individual exposure level of ， cobalt and its compounds in cobalt exposed workers and to explore the feasibility of using urine cobalt as a biomarker. Methods - A total of 148 occupational cobalt exposed workers from a new material company were selected as the exposed ， - - group and 44 non occupational cobalt exposed workers from the company were selected as the control group using the typical sampling method. The exposure concentration of time weighted average of cobalt and its compounds in the workplace air of the - two groups was determined by inductively coupled plasma mass spectrometry as the individual exposure level. The cobalt levels - - of pre shift and post shift urinary samples of the two groups were detected by this method. The linear relationship between the - cobalt level of post shift urine and the individual exposure level of cobalt and its compounds in the air of the workplace was Results - 3 analyzed. The individual exposure level of cobalt and its compounds in the exposed group was 1.10 131.71 μg/m with （M） 3 the median of 12.23 μg/m. No cobalt and its compounds were detected in the workplace air in the control group. The cobalt - - levels of pre shift and post shift urines in exposed group were higher than those in the control group at the same time point （M： vs ， vs ， P ） - - 1.54 0.56 μg/L 8.77 0.83 μg/L all <0.01 . The cobalt level of post shift urine was higher than that in pre shift （M： vs ，P ）， urine in the exposed group 8.77 1.54 μg/L <0.01 and it was positively correlated with the individual exposure level （ ，P ） ， of cobalt and its compounds Spearman correlation coefficient=0.86 <0.01 . After common logarithm conversion the linear regression equation of the cobalt level of post shift urine and the common logarithm of individual exposure level of cobalt and （x） ：ŷ x（ ；F ， its compounds in the exposed group was as follows = −0.178 + 0.988 coefficient of determination=0.72 =374.75 P ；t ， P ） Conclusion - <0.01 = - 19.36 <0.01 . There was a linear correlation between cobalt level of post shift urine and occupational cobalt exposure level of cobalt exposed workers. Urinary cobalt can be used as a biomarker of occupational cobalt

Surgical treatment of infracardiac total anomalous pulmonary venous connection: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare the outcomes of sutureless technique and conventional technique in the surgical repair for infracardiac total anomalous pulmonary venous connection (TAPVC). Methods    The clinical data of 46 consecutive patients with infracardiac TAPVC undergoing surgical repair in our hospital between June 2014 and April 2019 were retrospectively analyzed. Patients with combined congenital cardiac anomalies such as single ventricle and tetralogy of Fallot were excluded. Patients were divided into a conventional technique group and a sutureless technique group according to the surgical techniques. There were 35 patients in the conventional technique group, including 28 males (80.0%) and 7 females (20.0%) with a median age of 21 (8, 42) d and a median weight of 3.6 (3.0, 4.0) kg. There were 11 patients in the sutureless technique group, including 8 males (72.7%) and 3 females (27.3%) with a median age of 14 (6, 22) d and a median weight of 3.5 (2.9, 3.6) kg. The curative effect of the two groups was compared. Results    There were 5 deaths (10.9%) in the conventional technique group, including 4 in-hospital deaths (8.7%) and 1 late death (2.2%). Overall mortality of the conventional technique group (14.3%, 5/35) was higher than that of the sutureless technique group (0.0%, 0/11), although the difference was not statistically significant (P=0.317). Cox regression analysis showed that sex (P=0.042), age at repair (P=0.028), cardiopulmonary bypass time (P=0.007), aortic cross-clamping time (P=0.018) and duration of ventilation (P=0.042) were risk factors for postoperative mortality. The median follow-up was 18.00 (5.00, 37.75) months. Postoperative pulmonary venous obstruction occurred in 22 patients of the conventional technique group, which was significantly more than that of the sutureless technique group (P=0.000). Conclusion    For infracardiac TAPVC, sutureless technique can reduce the incidence of postoperative pulmonary venous obstruction compared with conventional technique.

Biological evaluation of 2,3-dioxoindolin-N-phenylacetamide derivatives as potent CDC25B and PTP1B phosphatase inhibitors

A series of 2,3-dioxoindolin-N-phenylacetamide derivatives was evaluated for inhibitory activity against CDC25B and PTP1B enzymes. Most of the derivatives showed inhibitory activity against CDC25B (IC50 = 3.2-23.2 µg/mL) and PTP1B (IC50 = 2.9-21.4 µg/mL). Compound 2h showed the most inhibitory activity in vitro with IC50 values of 3.2 and 2.9 µg/mL against CDC25B and PTP1B, respectively, compared with the reference drugs Na3VO4 (IC50 = 2.7 µg/mL) and oleanolic acid (IC50 = 2.3 µg/mL). The results of selectivity experiments showed that the 2,3-dioxoindolin-N-phenylacetamide derivatives were selective inhibitors against CDC25B and PTP1B. Enzyme kinetic experiments demonstrated that compound 2h was a specific inhibitor with the typical characteristics of a mixed inhibitor. In cytotoxic activity assays compound 2h had potent activity against A549, HeLa, and HCT116 cell lines. In addition, compound 2h showed potent tumor inhibitory activity in a colo205 xenograft model in vivo.

Acute kidney injury after on-pump or off-pump coronary artery bypass grafting in elderly patients / 中国胸心血管外科临床杂志

@#Objective    To compare the impact of cardiopulmonary coronary artery bypass grafting (CCABG) and off-pump coronary artery bypass grafting (OPCAB) on the incidence of postoperative acute kidney injury (AKI) in the elderly patients (age≥70 years). Methods    The clinical data of the isolated coronary artery bypass grafting (CABG) patients (age≥70 years) in our center from January 1, 2009 to December 31, 2017 were collected and retrospectively analyzed. The patients with long-term dialysis, missing serum creatinine data, emergent surgery or CABG combined with other cardiac procedures were excluded. Totally there were 3 346 patients undergoing isolated CABG, and finally 1 405 patients (age≥70 years) entered the study. The elderly patients were divided into a CCABG group (956 patients) and an OPCAB group (449 patients) according to whether they used extracorporeal circulation. The incidence and severity of postoperative AKI in the two groups were compared. Results     AKI occurred in 306 (32.0%) patients in the CCABG group and in 138 (30.7%) patients in the OPCAB group with no significant difference (P=0.677). According to the acute kidney injury network (AKIN) criteria, the severity of AKI in the CCABG vs. OPCAB was as followings, AKIN stage Ⅰ: 211 (22.1%) vs. 93 (20.7%); AKIN stage Ⅱ: 51 (5.3%) vs. 23 (5.1%); and AKIN stage Ⅲ: 44 (4.6%) vs. 22 (4.9%) with no significant difference (P=0.579, 1.000 and 0.788). There was no significant difference in the new onset of dialysis between   the CCABG group (31 patients, 3.2%) and the OPCAB group (10 patients, 2.2%, P=0.376). Conclusion     AKI is a common complication in the elderly CABG patients, with AKIN stage Ⅰ accounting for the most proportion, but rate of postoperative renal replacement therapy is low. Compared with CCABG, OPCAB is not associated with a significantly low rate or reduced severity of AKI in elderly patients.

Expression and role of neutrophil gelatinase-associated lipocalin (NGAL) signaling pathways in the early stage of vein graft restenosis of a pig model / 中国胸心血管外科临床杂志

@#Objective     To investigate the expression of neutrophil gelatinase-associated lipocalin (NGAL) signaling pathways in the early stage of porcine vein graft restenosis, and to explore the possible role and mechanism in the early vein graft restenosis after coronary artery bypass surgery. Methods     We selected 18 ordinary healthy pigs weighing 25-30 kg and collected samples of the vein graft of pigs at the preoperation and postoperative days 7, 14 and 30. Hematoxylin-eosin (HE) staining and Masson staining, immunohistochemical method were used to observe the neointimal hyperplasia, the migration of smooth muscle cells and and vascular remodeling of the vein bypass graft. The expression changes of NGAL, matrix metalloprotenase (MMP)9, MMP2 and tissue inhibitor of metalloproteinase (TIMP)1 in different periods of the vein bypass graft was tested. Results     By HE and Masson staining, with the passing of modeling time, degradation of collagen matrix in the vein graft, gradually thickening of muscle fibers and the migration to the inner membrance and vascular remodeling caused the vascular stenosis. By immunohistochemistry, NGAL, MMP9  and MMP2 of normal vein in the model were seldom expressed and even did not express. At 14 days after the modeling, NGAL expression in the membrane layer of blood vessels began to appear, peaked at postoperative 30 days, and began to appear in the inner membrance. MMP9, MMP2 expression began to appear at postoperative 7 days, peaked at postoperative 14 days, and tended to decline at postoperative 30 days. TIMP1 expression was less in normal vascular walls and at the 14 days after the modeling, expression peaked in the vein graft. Conclusion     NGAL, MMP9, MMP2 and TIMP1 may be involved in the formation of early vascular graft restenosis. NGAL as initiator, results in the expression of MMP9 and MMP2, and participates in the degradation of collagen matrix and the migration of smooth muscle cells in vein grafts. TIMP1 as a negative factor, may play an important role in maintaining their own balance.

Implementation of the hierarchical medical system :an analysis based on the Smith policy implementation process model / 中华医院管理杂志

Objective To analyze the problems existing in the implementation of the hierarchical medical system in China under the new situation .Methods The Smith policy implementation process model was used as an analytic framework.By means of literature analysis ,stakeholder analysis and PEST analysis ,the analysis was conducted in terms of such elements as the Smith policy implementation process model ,namely ,the idealized policy ,the implementing organization ,the target group and the environmental factors ,as well as its mechanism of action .Results The literature review found that the main obstacle that hinders the smooth implementation of the hierarchical medical system was the lagging of relevant supporting measures ,which accounted for 16.6％ (161)of the problems.In addition ,defects in policy design(the lack of division and cooperation mechanism etc .)and constraints in existing institutional mechanism (separation of revenue and expenditure ,unclear orientation ,etc .) were suggested to accelerate the introduction of supporting policies ,respectively accounting for 6.0％(58) and 9.3％ (90 ) of the results .Conclusions In the process of policy implementation ,the relationship between the four elements of the ideal policy outcomes ,the implementing organization ,the target group and the environmental factors needs to be coordinated to ensure the effective implementation of the hierarchical medical system .

Analysis of nursing effect of different feeding ways in children with congenital cleft lip after surgery / 口腔疾病防治

Objective@# To investigate the influence of different feeding ways on the incidence rate of complication in patients with congenital cleft lip and their family satisfaction degree.@*Methods@# A retrospective analysis were conducted from 90 cases underwent surgery of congenital cleft lip with clinical data, were randomly assigned to the control group and the observation group, 45 cases in each. The control group routinely take spoon feeding way after surgery, whereas patients in the observation group does not change the feeding way in the past, continuely taking the nipple feeding or breastfeeding. Wound infection rate, wound rupture rate, crying in the process of feeding and parents' satisfaction were compared between the two groups.@*Results@#The wound infection rate and wound rate of the observation group were 2.2% and 0 respectively, the control group were 4.4% and 0 respectively. There was no significant difference between the 2 groups in the 2 index (P > 0.05). In the observation group, the crying children were less than the control group, In the observation group, the degree of coordination, parental satisfaction and acceptance of feeding were 84.4%, 88.9%, 93.3%, respectively, the control group were 55.6%, 60.0%, 66.7%. The observation group were better than the control group. The differences between groups was statistically significant (χ2coordination degree = 8.94, χ2satisfaction degree = 9.87, χ2recognition degree = 10.00, P < 0.05).@*Conclusion@# Children under the age of 1 with congenital grade Ⅰ and Ⅱ cleft lip do not change the way of feeding after surgery , who continue to take the bottle or breastfeeding can better meet the needs of children fed liquid diet, crying reduce, get parents' recogniton and reduce the burden on parents than the control group conventionally fed with a spoon.

Predictive Value of Initial Serum Human Chorionic Gonadotropin Levels for Pregnancies after Single Fresh and Frozen Blastocyst Transfer / 华中科技大学学报（医学）（英德文版）

As one of the earliest markers for predicting pregnancy outcomes,human chorionic gonadotropin (hCG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer (ET).In this retrospective study,patients with positive hCG (day 12 after transfer) were included to examine the hCG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles.For patients who got clinical pregnancy,the mean initial hCG value was significantly higher after frozen cycles than fresh cycles,and the similar result was demonstrated for patients with live births (LB).The difference in hCG value existed even after adjusting for the potential covariates.The area under curves (AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 mIU/mL for clinical pregnancy after fresh ET,0.894 and 399.50 mIU/mL for clinical pregnancy after frozen ET,0.812 and 222.86 mIU/mL for LB after fresh ET,and 0.808 and 410.80 mIU/mL for LB after frozen ET with acceptable sensitivity and specificity,respectively.In conclusion,single frozen blastocyst transfer leads to higher initial hCG values than single fresh blastocyst transfer,and the initial hCG level is a reliable predictive factor for predicting IVF outcomes.

The role of Wnt/β-catenin signaling pathway in the process of adipose-derived stem cells differentiating into neurons / 西安交通大学学报(医学版)

Objective To investigate the role of Wnt/β-catenin signaling pathway in the process of adipose-derived stem cells (ADSCs)differentiating into neurons.Methods The third generation of ADSCs were divided into three groups.Neural induction medium was used in induction group and DDK-1 was added into neural induction medium in inhibition group.Normal culture medium was used in control group.Ten days after culture,Real-time PCR and Western blot were used to detect the expressions of NSE,β-catenin and GSK-3βin each group.Results The expressions of NSE and β-catenin were high but the expression of GSK-3 was low in induction group.The expression ofβ-catenin was lower but GSK-3 was higher in inhibition group;the expression of NSE was much lower than that in induction group,but higher than control group.Conclusion The differentiation of ADSCs into neurons is related to activation of Wnt signaling pathway,but Wnt signal pathway is not the only pathway to regulate ADSCs differentiation which may be controlled by different signaling pathways.

The role of Wnt/β-catenin signaling pathway in the process of adipose-derived stem cells differentiating into neurons / 西安交通大学学报(医学版)

Objective To investigate the role of Wnt/β-catenin signaling pathway in the process of adipose-derived stem cells (ADSCs)differentiating into neurons.Methods The third generation of ADSCs were divided into three groups.Neural induction medium was used in induction group and DDK-1 was added into neural induction medium in inhibition group.Normal culture medium was used in control group.Ten days after culture,Real-time PCR and Western blot were used to detect the expressions of NSE,β-catenin and GSK-3βin each group.Results The expressions of NSE and β-catenin were high but the expression of GSK-3 was low in induction group.The expression ofβ-catenin was lower but GSK-3 was higher in inhibition group;the expression of NSE was much lower than that in induction group,but higher than control group.Conclusion The differentiation of ADSCs into neurons is related to activation of Wnt signaling pathway,but Wnt signal pathway is not the only pathway to regulate ADSCs differentiation which may be controlled by different signaling pathways.

Mild Encephalopathy/Encephalitis with a Reversible Splenial Lesion (MERS): A Report of Five Neonatal Cases / 华中科技大学学报（医学）（英德文版）

Mild encephalopathy/encephalitis with a reversible spleniat (MERS) lesion is a clinic-radiological entity.The clinical features of MERS in neonates are still not systemically reported.This paper presents five cases of MERS,and the up-to-date reviews of previously reported cases were collected and analyzed in the literature.Here we describe five cases clinically diagnosed with MERS.All of them were neonates and the average age was about 4 days.They were admitted for the common neurological symptoms such as hyperspasmia,poor reactivity and delirium.Auxiliary examinations during hospitalization also exhibited features in common.In this report,we reached following conclusions.Firstly,magnetic resonance imaging revealed solitary or comprehensive lesions in the splenium of corpus callosum,some of them extending to almost the whole corpus callosum.The lesions showed low intensity signal on Tl-weighted images,homogeneously hyperintense signal on T2-weighted images,fluid-attenuated inversion recovery and diffusion-weighted images,and exhibited an obvious reduced diffusion on apparent diffusion coefficient map.Moreover,the lesions in the magnetic resonance imaging disappeared very quickly even prior to the clinical recovery.Secondly,all the cases depicted here suffered electrolyte disturbances especially hyponatremia which could be easily corrected.Lastly,all of the cases recovered quickly over one week to one month and majority of them exhibited signs of infections and normal electroencephalography.

Effects of immunoglobulin D on expression of IgD receptor and protein tyrosine kinase signaling in human CD4+ T cells / 中国药理学与毒理学杂志

OBJECTIVE To observe whether human CD4 + T cells could be activated by immuno-globulin D (IgD) via IgD receptor(IgDR)-Lck. METHODS Human CD4+ T cells were purified from peripheral blood mononuclear cells (PBMCs) with microbeads. The viability of T cells were detected by CCK-8. The binding affinity and expression of IgDR on T cells were detected by flow cytometry. The protein expression of IgDR, Lck and P-Lck were analyzed by western blot. RESULTS IgD could concentration-dependent bind to IgDR on CD4+ T cells. The expression of IgDR was increased in response to treatment with IgD in a time- dependent and concentration- dependent manner. Stimulating by IgD resulted in enhanced phosphorylation of Lck compared with that in the medium control sample. The expression of Lck was not changed. As inhibitor of PTK, Herbimycin A or A770041, which combined with IgD could significantly inhibit phosphorylation of Lck(Tyr394). The proliferation promoting effect of IgD was blocked by Herbimycin A or A770041. IgD could stimulate CD4+ T cell activation and proliferation through upreg?ulating activating tyrosine residue of Lck (Tyr394) phosphorylation. CONCLUSION These results demon?strate that IgD exaggerates CD4+T cell activities, which may be through promoting Lck phosphorylation.

Function of IgD on lymphocyte activation and effect of hIgD-Fc-Ig fusion protein on human PBMC proliferation / 中国药理学与毒理学杂志

OBJECTIVE This study aimed to investigate the influence of IgD on T/B cell activationand construct hIgD-Fc-Ig fusion protein to competitive inhibition IgD binding with IgDR. METHODS T/B cells were sorted by magnetic cell sorting. The differences of mIgD and IgD-R level between different T/B cell subtypes were detected by FCM. Serum IgD level was detected by ELISA. Human IgD-Fc-IgG1- Fc sequence was amplified by cross- PCR and then subcloned into PET28a(+ ) empty vector. After prokaryotic expression through escherichia coli, we obtained the hIgD-Fc-Ig fusion protein by affinity chromatograph. Western blot was used to identify the hIgD- Fc- Ig fusion protein. Human peripheral blood monouclear cells (PBMC) and fibroblast like synoviocytes (FLS) proliferation were detected using a cell counting kit-8 (CCK-8). RESULTS The percentage of CD3+/CD4+, CD3+/IgD+, CD3+/CD4+/IgD+, CD3+/IgD-R+ and CD3+/CD4+/IgD-R+ cells increased significantly in RA patients comparing to healthy people. IgD can stimulate PBMC proliferation. IgD (1, 3, 10, 30 μg·mL-1) stimulate PBMC proliferation significantly after 24 h. We obtained stable and active hIgD-Fc-Ig fusion protein. The hIgD-Fc-Ig fusion protein showed no effect on PBMC proliferation. But it could downregulate human IgD protein promoting proliferation effects in human PBMC. CONCLUSION This result suggests that IgD and IgDR play an important role on T/B cell activation in RA patients and the hIgD-Fc-Ig fusion protein may competitively inhibit IgD's function and may play an therapeutic role in autoimmune diseases.

The pedicled anterolateral thigh flap for penile reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the application of pedicled anterolateral thigh (ALT) flap for total penile reconstruction and to investigate its feasibility and effect.</p><p><b>METHODS</b>From May 2011 to May 2015, 12 male patients presented with absence of the penis or congenital malformation received phalloplasty with the pedicled ALT flap. Of them, the median age was 35 years old (range, 20-57 years). The size of the flaps ranged from 11 cm x 11 cm to 12 cm x 15 cm. 8 patients underwent urethra reconstruction with tube-in-tube flaps and other 4 patients with scrotal septal flaps. In this series, we performed one-stage urethral anastomosis in 4 cases and second-stage urethral anastomosis 6 months after the phalloplasty in 8 cases.</p><p><b>RESULTS</b>An acceptable reconstructed phallus was achieved in 10 patients. These flaps were primarily healed with satisfactory functional and cosmetic results. The reconstructed penis was completely necrosis because of the flap failure in one case. The distal half of the phallus was lost due to infection in one case. Both of them were treated with pedicled ALT flap from the other side. Reliable results were achieved. At a median follow-up of 1.5 year (range 1 to 4 years), 9 patients (90%) were fully satisfied with phallic cosmesis and size, and 4 patients who was married had successful sexual intercourse. 8 patients had normal urinate function. Fistula was developed in 2 patients (20%) which was treated with delayed repair at 6-12 months with local scrotal flaps.</p><p><b>CONCLUSIONS</b>The pedicled ALT flap can be simply used to reconstruct an entire penis as well as a urethra. It has several advantages including a less conspicuous donor site, greater bulk, better color match and no necessary for microsurgery.</p>

Massive and painful ascites as a presenting manifestation of systemic lupus erythematosus flare: a case report and literature review / Ascitis dolorosa y masiva como forma de presentación de una reactivación lúpica: Presentación de un caso

Lupus peritonitis (LP) is extremely rare. Acute LP is characterized by rapid onset of ascites and severe abdominal pain, in addition to other well-recognized clinical features of a general systemic lupus erythematosus (SLE) fare. Ascites associated with acute LP has been rarely reported as the prominent feature of a SLE fare. We report a 39-year-old woman who developed massive, painful ascites as the presenting manifestation of a SLE fare. Diagnostic workup ruled out the possibility of hepatic, cardiovascular, infectious, or malignant diseases, and confirmed the presence of a SLE fare. The patient was treated with methyl prednisolone and hydroxychloroquine resulting in dramatic improvement of her condition. During ambulatory follow up, she has remained asymptomatic up to the moment of this writing. Adrenal steroids and hydrocychloroquine may be useful for the management of SLE fares in patients with massive, painful ascites due to acute LP.

La peritonitis lúpica es rara. El cuadro agudo se caracteriza por ascitis de comienzo rápido, dolor abdominal severo y otras manifestaciones de una recidiva de un lupus eritematoso sistémico (LES). Sólo ocasionalmente e ha informado que la ascitis y peritonitis lúpica sean las principales manifestaciones de una recidiva lúpica. Presentamos a una mujer de 39 años que presentó ascitis masiva y dolorosa como la primera manifestación de una reactivación lúpica. El estudio diagnóstico descartó problemas hepáticos, pulmonares, cardiacos, cáncer o infecciones y confirmó la reactivación lúpica. La paciente se trató con metilprednisolona y cloroquina, resultando en una mejoría dramática. Al momento de preparar este informe, la paciente permanece asintomática en control ambulatorio. Los corticoides y cloroquina pueden ser medicamentos útiles para el tratamiento de pacientes con ascitis dolorosa y masiva secundaria a peritonitis lúpica.

Synthesis and antitumor activity of S-hexyl(heptyl) substituted ethanethioate derivatives / 药学学报

To simplify the macrocyclic fragment and to modify the zinc binding group of the natural product apicidin, two series of S-hexyl (heptyl) ethanethioate derivatives were designed and synthesized. Twenty-six compounds were synthesized and confirmed with 1H NMR, IR, MS and HR-MS spectrum, which were not reported. Take vorinostat as control, their antiporliferative activities against cancer cell lines, MCF-7 and HL-60, were tested with MTT assay or trypan blue staining method. Generally in both series it was found that, the chiral carbon atom at 7 position is not necessary, compounds II-1, II-3, II-6 and II-13 showed good activity on HL-60 cells in vitro, with the IC50 values less than 10 micromol x L(-1). II-7 and II-8 showed stronger activity against MCF-7 than Vorinostat, with the IC50 of 3.19 and 6.29 micromol x L(-1), respectively.