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Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons. Here, we introduced and evaluated a newly modified Mathieu technique, Mathieu combined tunnel (MCT), which involves multiple custom-designed flaps for the shortage of flap source material after repeated operations; we also constructed a tunnel to avoid the glans incision that may carry new risks of dehiscence. This retrospective study included 26 patients who were consecutively admitted to the First Affiliated Hospital of Sun Yat-Sen University (Guangzhou, China) for glans dehiscence repair after failed hypospadias repair from October 2014 to October 2020; sixteen patients underwent surgery using the MCT (MCT group) and ten patients underwent surgery using the tubularized incised plate (TIP) technique (TIP group). The operative time, blood loss, postoperative complications, normal urethral meatus rate, success rate, and Hypospadias Objective Penile Evaluation (HOPE) score were compared between the two groups. The MCT group achieved an overall satisfactory penile appearance and voiding function, with a higher rate of normal urethral meatus (15/16, 93.8%) and a lower rate of glans dehiscence (1/16, 6.2%), compared with the TIP group (70.0% and 30.0%, respectively). However, these differences were not statistically significant, possibly because of the limited number of patients (all P > 0.05). Mean postoperative HOPE scores were similar in the MCT group (mean ± standard deviation: 8.83 ± 0. 89) and TIP group (8.94 ± 0.57) (P > 0.05). No significant differences were found between the two groups in terms of blood loss and success rate, nor in the rates of various complications (e.g., fistula, urethral stricture, and glans dehiscence). In conclusion, the MCT technique appears to be feasible and reliable for repairing glans dehiscence after failed hypospadias repair.
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Niño , Femenino , Humanos , Lactante , Masculino , Hipospadias/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Uretra/cirugía , Procedimientos Quirúrgicos Urológicos Masculinos/métodosRESUMEN
SIRT6 belongs to the conserved NAD+-dependent deacetylase superfamily and mediates multiple biological and pathological processes. Targeting SIRT6 by allosteric modulators represents a novel direction for therapeutics, which can overcome the selectivity problem caused by the structural similarity of orthosteric sites among deacetylases. Here, developing a reversed allosteric strategy AlloReverse, we identified a cryptic allosteric site, Pocket Z, which was only induced by the bi-directional allosteric signal triggered upon orthosteric binding of NAD+. Based on Pocket Z, we discovered an SIRT6 allosteric inhibitor named JYQ-42. JYQ-42 selectively targets SIRT6 among other histone deacetylases and effectively inhibits SIRT6 deacetylation, with an IC50 of 2.33 μmol/L. JYQ-42 significantly suppresses SIRT6-mediated cancer cell migration and pro-inflammatory cytokine production. JYQ-42, to our knowledge, is the most potent and selective allosteric SIRT6 inhibitor. This study provides a novel strategy for allosteric drug design and will help in the challenging development of therapeutic agents that can selectively bind SIRT6.
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Objective:To analyze the whole genome traceability and variation analysis of SARS-CoV-2 in local COVID-19 outbreaks in Binhai New Area, Tianjin.Methods:The whole-genome high-throughput sequencing was performed on throat swab samples collected from one local asymptomatic infected person and five confirmed cases of COVID-19 in Binhai New Area of Tianjin from November 7 to December 5, 2020. The sequencing data were assembled by De novo. MAFFT v7.0 multiple sequence alignment program and MEGA X software were used to compare the above data and construct phylogenetic tree (Neighbor-joining method).Results:The genetic similarity between the sequences of 6 SARS-CoV-2 strains and Wuhan reference sequence (Wuhan-Hu-1) was greater than 99.9%. Two of six strains were genetically identical, conform to the L-Lineage European Branch Ⅱ.1(America Branch)/B.1; The other four strains had the same genes and were in line with the characteristics of L-Lineage European Branch Ⅰ/B.1.1.These six strains belonged to different evolutionary branches and two different transmission chains. There were 18 nucleotide mutation sites in sequences of six SARS-CoV-2 strains, eight of which were synonymous mutation sites, nine of which were missense mutation sites, resulting in nine amino acid mutation sites, and important mutation sites of RDRP-P323L and S-D614G were found in all of the six samples.Conclusions:In this study, there were two COVID-19 outbreaks in Binhai New Area of Tianjin, and the sequences of six SARS-CoV-2 strains belonged to different evolutionary branches and two different transmission chains. It might come from porters′ contact with imported cold chain items contaminated with SARS-CoV-2 from different sources. All the sequences of six SARS-CoV-2 strains had P323L and D614G mutations, which indicated that the virus mutation and transmission ability were stronger. The surveillance of important employees of the cold chain in Tianjin and local and imported cases should be continuously strengthened.
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Objective@#To explore the safety and feasibility of transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments in treatment of cryptorchidism in children.@*Methods@#Thirty-five children with cryptorchidism were treated by transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments from November 2017 to March 2018 at Department of Pediatric Surgery, the First Affiliated Hospital of Guangxi Medical University.Clinical data were recorded including the general information, operation time, intraoperative blood loss, postoperative testicular position and postoperative complications, etc.@*Results@#All 35 patients completed the cryptorchidopexy in one operation.Among those 35 patients, 28 patients had unilateral lesions and 7 patients had bilateral lesions, with a total of 42 sides.Twenty-six patients were of groin type(33 sides), 9 patients abdominal type(9 sides). The average operation time was (40.4±8.2) min for unilateral lesion, and (62.5±15.3) min for bilateral lesions; the average intraoperative blood loss was (3.0±1.8) mL; and the average postoperative hospital stay was (6.4±2.1) h. Testis of 32 patients (40 sides) were fixed in the middle and bottoms of the scrotum, and testis of 2 patients (2 sides) were fixed on the top of the scrotum.One case had poor healing of naval incision, which was recovered in 1 week after dressing change.There were no postoperative complications such as scrotum hematoma, infection of incision, testicular epididymitis, testicular necrosis, testicular retraction or testicular atrophy, etc.No obvious visible scar was found in the abdomen review 2 weeks postoperatively, with the incidence of complications was 2.9%(1/35 cases).@*Conclusions@#Transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments in treatment of cryptorchidism is characterized by small trauma, quick recovery, low complication rate and visible scar free result, which is worthy of clinical promotion, but the operation is relatively complex and the correct procedures are required.
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Wilms′ tumor is a common malignant tumor in children.Most patients have a good prognosis, but its pathogenesis is not yet clear.In recent years, some non-coding RNAs have been found to have a close relationship with the development of this tumor.Some non-coding RNAs may serve as biomarkers for the diagnosis, predictors indicators, or targets for gene therapy.This paper studied the relationship between some non-coding RNAs associated with nephroblastoma is now available.
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Wilms'tumor is a common malignant tumor in children. most patients have a good prognosis,but its pathogenesis is not yet clear. In recent years,some non_coding RNAs have been found to have a close relationship with the development of this tumor. Some non_coding RNAs may serve as biomarkers for the diagnosis,predictors indica_tors,or targets for gene therapy. This paper studied the relationship between some non_coding RNAs associated with nephroblastoma is now available.
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Objective To explore the safety and feasibility of transumbilical single channel laparoscopic cryp-torchidopexy with conventional instruments in treatment of cryptorchidism in children. Methods Thirty-five children with cryptorchidism were treated by transumbilical single channel laparoscopic cryptorchidopexy with conventional instru-ments from November 2017 to March 2018 at Department of Pediatric Surgery,the First Affiliated Hospital of Guangxi Medical University. Clinical data were recorded including the general information,operation time,intraoperative blood loss,postoperative testicular position and postoperative complications,etc. Results All 35 patients completed the cryptorchidopexy in one operation. Among those 35 patients,28 patients had unilateral lesions and 7 patients had bilateral lesions,with a total of 42 sides. Twenty - six patients were of groin type( 33 sides),9 patients abdominal type( 9 sides). The average operation time was(40. 4 ± 8. 2)min for unilateral lesion,and(62. 5 ± 15. 3)min for bilateral le-sions;the average intraoperative blood loss was(3. 0 ± 1. 8)mL;and the average postoperative hospital stay was(6. 4 ± 2. 1)h. Testis of 32 patients(40 sides)were fixed in the middle and bottoms of the scrotum,and testis of 2 patients (2 sides)were fixed on the top of the scrotum. One case had poor healing of naval incision,which was recovered in 1 week after dressing change. There were no postoperative complications such as scrotum hematoma,infection of incision, testicular epididymitis,testicular necrosis,testicular retraction or testicular atrophy,etc. No obvious visible scar was found in the abdomen review 2 weeks postoperatively,with the incidence of complications was 2. 9%(1/35 cases). Conclusions Transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments in treatment of cryptorchidism is characterized by small trauma,quick recovery,low complication rate and visible scar free result, which is worthy of clinical promotion,but the operation is relatively complex and the correct procedures are required.
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Objective To evaluate the therapeutic effect of antibiotics combined with recombinant tuberculosis vaccine AEC/BC02 on Mycobacterium tuberculosis infection in guinea pigs. Methods Two weeks after guinea pigs were challenged subcutaneously with a high dose of Mycobacterium tuberculosis,the guinea pigs with the positive skin test responses to the recombinant ESAT6-CFP10 allergen were randomly di-vided into four groups:normal saline (NS),AEC/BC02,antibiotics and antibiotics+AEC/BC02. In antibiotics+AEC/BC02 group,guinea pigs firstly received isoniazid ( INH) and rifapentine ( RFT) treatment once a week for a total of three times,and then were immunized with a single dose of AEC/BC02 vaccine six times at 10-day intervals. Guinea pigs in AEC/BC02 and antibiotics groups were respectively vaccinated with AEC/BC02 vaccine and given INH and RFT treatment at the same dose and frequency as given to antibiotics+ AEC/BC02 group. Thirteen weeks after challenge,all guinea pigs were sacrificed for necropsy. Results The gross pathological scores of NS,AEC/BC02,antibiotics and antibiotics+AEC/BC02 groups were 83±8,77± 22,45±28 and 19±14,respectively. Antibiotics+AEC/BC02 group had a significantly lower gross pathological score than antibiotics,AEC/BC02 and NS groups (P<0. 05,P<0. 01,P<0. 01,respectively). Moreover,the gross pathological scores of antibiotics and AEC/BC02 groups were significantly decreased as compared with that of NS group (both P<0. 01). However,there was no significant difference between AEC/BC02 and NS groups. The spleen bacterial load of antibiotics+AEC/BC02 group was (2. 50±1. 26) lg CFU,which was sig-nificantly lower than those of NS [(4. 92+0. 52) lg CFU],AEC/BC02 [(4. 78+0. 84) lg CFU] and antibi-otics [(4. 39+0. 50) lg CFU] groups (P<0. 01). Compared with NS group,antibiotic and AEC/BC02 groups showed no significant difference in spleen bacterial load. Histopathological changes indicated different levels of granulomatous lesions appeared in lung tissues of all groups and the most severe change was ob-served in AEC/BC02 group,followed by that in NS,antibiotics and antibiotics+AEC/BC02 groups. Conclu-sion INH and RFT treatment in combination with AEC/BC02 vaccine in the treatment of guinea pigs with Mycobacterium tuberculosis infection was superior to either treatment alone as it significantly alleviated organ lesions and lowered the bacterial loads in spleen and lung.
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After a description of the concept of research frontier, advantages and disadvantages of qualitative and quantitative research frontier analysis methods, application of qualitative and quantitative research frontier analysis methods and existed problems, it was pointed out that the automatic detection method of heterogeneous data source text mining was a trend for the research frontier identification methods.
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Objective To evaluate the curative effectiveness and safety of human chorionic gonadotropin(HCG) treatment on children with microphallic hypospadias.Methods A total of 48 consecutive children with microphalic hypospadias were enrolled in the study,and the children were randomized into the experiment group(HCG treatment) and the control group with the research randomizer.The patients in experiment group were treated with HCG prior to surgery,and the control group did not received any hormone therapy preoperatively.All children in the experiment group and the control group underwent hypospadias repair by using transverse preputial island flap (Duckett technique) urethroplasty.Penile length,diameter of glans penis,bone age,serum testosterone level,and secondary effects were recorded before and after therapy in the experiment group.Postoperative complications were assessed with respect to fistulas,urethral strictures,diverticula,meatal stenosis,and glanular dehiscence in both groups.Results (1)Mean penile length and diameter of the experiment group increased significantly by (1.08±0.47) cm (t=-5.196,P<0.05) and (0.31±0.06) cm and there was a significant difference between before and after treatment (t=-5.080,P<0.05).(2)Urethrocutaneous fistulas were observed in 8 patients in the control group compared to 2 patients in the experiment group with a statistically significant difference (χ2=4.547,P<0.05).There was a significant difference between the overall reoperation rates of control group (9 patients) and the experiment group (3 patients,χ2=4.000,P<0.05).The penile tissue of the patients in the experiment group was soft and able to be easily separated and released during the operation and the flap had more blood supply.Conclusions Pretreatment with HCG therapy prior to hypospadias repair is beneficial to children with microphallic hypospadias.Significant penile growth was seen in the children treated with HCG and there was no obvious side effect.Moreover,pretreatment with HCG is beneficial to decrease the complications and reoperation rates of hypospadias repair which proves to be effective and safe.
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Objective To develop an intelligent evaluation and automatic warning system to improve the diagnosis rate of venous thrombo embolism (VTE) and strengthen its standardized treatment.Methods A clinical data center was constructed by using data extraction,conversion and loading,which involved in military medical system,clinical laboratory system,electronic medical record system and surgical anesthesia system.The warning model was established with international standards,clinician experiences,warning parameters selection by statistical method and weighted assignment.Results The system could predict the risk of the hospitalized patient for VTE rapidly and inform the doctor in time.Conclusion The system facilitates the doctor to prevent and control VTE,and thus is worthy promoting practically.
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The paper introduces system requirements,feasibility,building target,functions and standard procedure of the blood pur ification management system,which is researched and developed independently,explains its development and operation environment,commonly used modules,permission management and other aspects.The system is able to enhance working efficiency and management quality and reduce medical risks.
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The development trend, countries, institutions, co-authors, and subjects in MEDLINE-covered papers were analyzed by Excel, Ucinet and SciMAT respectively in order to understand the current situation in studies on precision medicine, which showed that precision medicine is in a rapid development stage, the impact power of pa-pers on precision medicine published in United States of America is high, the source journals published in United States of America are the core journals in precision medicine, the academic level of papers on precision medicine published in United States of America is high. Co-authors analysis showed that the co-authors network is of the small world effect. Subject evolution analysis revealed that the subjects involved in studies on precision medicine are increasingly rich with genomics, drug treatment and oncology accounted a large proportion. Analysis of the evo-lution in genomics, drug treatment and oncology displayed that the subjects involved in studies on precision medi-cine have experienced macro-stage, micro-stage, and combined macro- and micro-stage.
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Objective To study the application of citation frequency, relative impact power and social network analysis in evaluation of scientific papers. Methods A total of 37919 papers onfemale fertility maintenance published in 2006-2015 were evaluated by citation frequency, relative impact power and social network analysis, respectively. Their coincidence and correlativity, and the effect of citation structure on the papers sequenced according to their citation frequency, relative impact power and social network were analyzed. Results The local citation frequency could measure the publication time of papers and the effect on their sequence. Conclusion Global citation frequency can measure the effect width and depth of papers, intermediary centrality can help to find the core papers, and ap-proximate centrality can help to measure the early published papers.
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<p><b>OBJECTIVE</b>To observe the effects of manganese sulfate on blood pressure, myocardial ultrastructure and heart organ index of rats.</p><p><b>METHODS</b>Forty male SPF SD rats were randomly divided into 4 groups: control group (0 mg/kg), 5 mg/kg dose group, 15 mg/kg dose group and 25 mg/kg dose group, 10 rats each group. Intraperitoneal injection was performed for six months, by five times each week, the rat blood pressure was measured by tail cuff method, and the heart organ index of the rats was computed. Three rats were selected from each group randomly, and the myocardial ultrastructure of the rats was observed by using transmission electron microscopy (TEM). The BMD and BMDL between manganese sulfate injected dose and the rats heart organ index were evaluated by BMD (Benchmark Dose).</p><p><b>RESULTS</b>There was no significant of blood pressure between the experimental group and the control group (P > 0.05).The heart organ indexes of the four groups were 0.24% ± 0.10%, 0.25% ± 0.02%, 0.26% ± 0.02%, and 0.24% ± 0.02%. Statistical significance of heart organ indexes was found between the 15 mg/kg dose group and the control group (P < 0.05). Observed by TEM, we found that-different degrees of mitochondrial crest fracture or disappear, mitochondria swelling, hydropic change and myocardial fibers degeneration happened in the rats of the three exposed groups, but not the control group. The BMD and BMDL were calculated as 9.33 mg/kg and 4.28 mg/kg in the study of manganese sulfate injected dose and the rats heart organ index.</p><p><b>CONCLUSION</b>Chronic manganese poisoning can lead to myocardial mitochondria superfine lesions, myocardial fiber damage and heart organ index change in rats.</p>
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Animales , Masculino , Ratas , Compuestos de Manganeso , Mitocondrias , Miocardio , Miocitos Cardíacos , Ratas Sprague-Dawley , Sulfatos , Toxicidad , Pruebas de ToxicidadRESUMEN
Objective To explore the changes of the internal structure and research topics of oncology from 2005 to 2014,and offer reference for the development of the related studies and research policies. Methods The articles published in 203 journals in the area of oncologyfrom 2005 to 2014 included by JCR were chosen.Firstly,we cleaned the author keywords using the TDA software.After that,we standardized and categorized the keywords according to the Medical Subject Headings (MeSH)manually.In the end,we builted the co-occurrence matrixes of high-frequency words in three stages:2005—2007,2008—2010 and 2011 —2014, and drew the evolution maps and strategic diagrams of each stage to analyze the changes of the internal structure and research topics of oncology.Results While the word frequence increasing rapidly,the main keywords reduced gradually from 2005 to 2014.The traditional treatments such as chemotherapy and radiotherapy,the diagnostic and the epidemiological investigation were the core subject of oncology.With the screening of neoplasms,the research on the cell physiological phenomena and the genetic phenomena gained vigorous expan-sion.Breast neoplasms,the topic whose deep exploration also led the development of other topics,has always been the hard nut as well as the hot topic of the oncology.During this period,researches on the screening of neo-plasms and the genetic phenomena were developed rapidly.Conclusion The content of oncology will be more thoroughly with some merge,division,development,declining and perishing of the internal themes occurred as well.The boundaries among the sub-structure are becoming more and more blurred and the screening of neo-plasms and the genetic phenomena has gradually become the dominant trend in general practices.
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One hundred kinds of excellent books on basic medicine were selected from Wanfang Data Knowledge Platform to develop a books-papers citation database.Their academic levels of the selected books were evaluated by PageRank algorithm.The chapters and sections of the books were divided into 4 parts according to their PageRank value and the distribution characteristics of their citation frequencies to study the PageRank and the top 20 cited chapters and sections of the books.The advantages and disadvantages of PageRank algorithm in book evaluation were described.
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<p><b>OBJECTIVE</b>To compare the advantages and disadvantages of the Foley catheter draining method versus the urethral stent plus gastric tube draining method for urine drainage following urethroplasty for hypospadias.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 361 cases of hypospadias treated by urethroplasty. After operation, 91 of the cases received urine drainage with the Foley catheter (group A) and 270 with a urethral stent plus a gastric tube (group B). We compared the incidence rates of bladder irritation, fistula, urethral stricture, and urethral diverticulum between the two groups of patients.</p><p><b>RESULTS</b>No statistically significant differences were found between groups A and B in the incidences of bladder irritation (9.89% vs 10.70%, P > 0.05) and urethral diverticulum (1.09% vs 2.22%, P > 0.05). The incidence rate of fistula was markedly higher in group A than in B (20.80% vs 13.30%, P < 0.05), and so was that of urethral stricture (10.90% vs 5.55%, P < 0.05).</p><p><b>CONCLUSION</b>The urethral stent plus gastric tube draining method is more effective than the Foley catheter draining method for urine drainage following urethroplasty.</p>
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Anciano , Niño , Humanos , Masculino , Divertículo , Drenaje , Métodos , Hipospadias , Cirugía General , Incidencia , Estudios Retrospectivos , Stents , Uretra , Cirugía General , Estrechez Uretral , Cateterismo Urinario , MétodosRESUMEN
Objective To explore the effectiveness of sandplay therapy combined with family counseling in children with school phobia and its influence of child′ self-consciousness. Methods Integrative sandplay therary with family consulting were used to treat 28 patients with school phobia regularly for 2 months. Sandplay and family consulting therapy were given once a week for 45 minutes . Clinical outcomes were assessed using CGI-GI and Piers-Harris children′s self-consciousness scale before and after treatment as well as 3 months posttreatment. Results Overall response rate was 85%. In addition, the physical appearance and characteristic factor before and after treatment were no significant difference (P>0.05). The rest of the various factors and total score compared with pre-treatment significantly improved (P0.05). Conclusion Integrative sandplay therapy with family counseling has better and long-lasting treatment effect to self-consciousness of children with school refusal.
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Objective To comparatively evaluate the effects of a recombinant Mtb protein ESAT 6-CFP10 ( rESAT6-CFP10 ) and a purified protein derivative ( PPD ) as skin test reagents in guinea pigs . Methods Guinea pigs were sensitized with different Mycobacteria species .After sensitization , all guinea pigs were intradermally injected with rESAT6-CFP10 and PPD.At 48 h after the injection, the size of ery-thema at injection sites was measured by using a double-blind method .For guinea pigs sensitized with viable Mtb, the size of erythema at injection sites were measured at 24 h after the injection .The positive conversion rates of skin test with rESAT 6-CFP10 and PPD were calculated .Results The results of PPD skin test were positive in all guinea pigs sensitized with viable Mtb , killed Mtb and BCG with erythema diameters of (11.4 ±0.9) mm, (11.8±1.1) mm and (13.2±0.8) mm, respectively.Positive skin test with rESAT6-CFP10 was only observed in guinea pigs infected by viable Mtb-showing erythema diameters of (13.7±5.7) mm. The skin test with rESAT6-CFP10 was negative in guinea pigs sensitized by killed Mtb-and vaccinated by BCG.The skin tests by using rESAT6-CFP10 and PPD were performed on randomly selected guinea pigs at ninth day after infection by Mycobacterium tuberculosis H37Rv.At the 2nd week, totally 24 selected guinea pigs showed positive skin test results with rESAT6-CFP10 (24/24) with erythema diameters of (19.9± 3.0) mm, while only 15 out of 24 had positive PPD skin test with erythema diameters of (6.1±5.5) mm. At the 4th week, all guinea pigs showed positive PPD skin test (3/3) with erythema diameters of (12.7± 2.5) mm.Conclusion The skin test by using recombinant ESAT 6-CFP10 protein can effectively distin-guish viable Mtb infection from BCG vaccination and killed Mtb sensitization , which is a more suitable anti-gen than PPD for the early diagnosis of Mtb infection .