Community structure and species diversity dynamics of a subtropical evergreen broad-leaved forest in China: 2005 to 2020.

Here, we characterize the temporal and spatial dynamics of forest community structure and species diversity in a subtropical evergreen broad-leaved forest in China. We found that community structure in this forest changed over a 15-year period. Specifically, renewal and death of common species was large, with the renewal of individuals mainly concentrated within a few populations, especially those of Aidia canthioides and Cryptocarya concinna. The numbers of individual deaths for common species were concentrated in the small and mid-diameter level. The spatial distribution of community species diversity fluctuated in each monitoring period, showing a more dispersed diversity after the 15-year study period, and the coefficient of variation on quadrats increased. In 2010, the death and renewal of the community and the spatial variation of species diversity were different compared to other survey years. Extreme weather may have affected species regeneration and community stability in our subtropical monsoon evergreen broad-leaved forests. Our findings suggest that strengthening the monitoring and management of the forest community will help better understand the long- and short-term causes of dynamic fluctuations of community structure and species diversity, and reveal the factors that drive changes in community structure.

Adenine phosphoribosyltransferase deficiency after kidney transplantation: a case report and literature review / 器官移植

Objective To summarize the diagnosis and treatment experience of adenine phosphoribosyltransferase deficiency after kidney transplantation. Methods Clinical data of 1 patient with adenine phosphoribosyltransferase deficiency after kidney transplantation were retrospectively analyzed. Clinical characteristics, diagnosis, treatment and prognosis of adenine phosphoribosyltransferase deficiency were summarized by literature review. Results Renal biopsy showed that salt crystallization was found in most renal tubule lumen and positive results were observed under polarized light microscopy. After allopurinol, hemodialysis and anti-crystallization treatment, the graft function was gradually recovered. After postoperative 1-year follow-up, the patient's renal function was properly recovered. Conclusions Adenine phosphoribosyltransferase deficiency after kidney transplantation may lead to delayed graft function or graft dysfunction. Early detection, diagnosis and treatment may delay disease progression and improve renal function.

Correction to "Genome-wide CRISPR-Cas9 screening identifies that hypoxia-inducible factor-1a-induced CBX8 transcription promotes pancreatic cancer progression via IRS1/AKT axis".

[This corrects the article on p. 1709 in vol. 13, PMID: 34853645.].

Comprehensive Risk Assessment of Typical High-Temperature Cities in Various Provinces in China.

Global climate change results in an increased risk of high urban temperatures, making it crucial to conduct a comprehensive assessment of the high-temperature risk of urban areas. Based on the data of 194 meteorological stations in China from 1986 to 2015 and statistical yearbooks and statistical bulletins from 2015, we used GIS technology and mathematical statistics to evaluate high-temperature spatial and temporal characteristics, high-temperature risk, and high-temperature vulnerability of 31 cities across China. Over the past 30 years, most Chinese cities experienced 5-8 significant oscillation cycles of high-temperature days. A 15-year interval analysis of high-temperature characteristics found that 87% of the cities had an average of 5.44 more high-temperature days in the 15-year period from 2001 to 2015 compared to the period from 1986 to 2000. We developed five high-temperature risk levels and six vulnerability levels. Against the background of a warming climate, we discuss risk mitigation strategies and the importance of early warning systems.

Pan-KRAS inhibitors suppress proliferation through feedback regulation in pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is currently one of the most lethal cancers worldwide. Several basic studies have confirmed that Kirsten rat sarcoma virus (KRAS) is a key driver gene for the occurrence of PDAC, and KRAS mutations have also been found in most patients in clinical studies. In this study, two pan-KRAS inhibitors, BI-2852 and BAY-293, were chosen as chemical probes to investigate their antitumor potency in PDAC. Their inhibitory effects on KRAS activation were validated in vitro and their antiproliferative potency in PDAC cell lines were profiled, with half-maximal inhibitory concentration (IC50) values of approximately 1 µM, demonstrating the therapeutic potential of pan-KRAS inhibitors in the treatment of PDAC. However, feedback regulation in the KRAS pathway weakened inhibitor activity, which was observed by a 50 times difference in BAY-293 from in vitro activity. Furthermore, pan-KRAS inhibitors effectively inhibited cell proliferation in 3D organoids cultured from PDAC patient samples; however, there were some variations between individuals. These results provide a sufficient theoretical foundation for KRAS as a clinical therapeutic target and for the application of pan-KRAS inhibitors in the treatment of PDAC, with important scientific significance in translational medicine.

Extracorporeal Shockwave Therapy With a Modified Technique on Tendon and Ligament for Knee Osteoarthritis: A Randomized Controlled Trial.

BACKGROUND: There have been no definitive guidelines on the treatment method and specific points in the body. PURPOSE: The aim of the study was to investigate the effects of extracorporeal shockwave therapy on treating the main tendons and ligaments of knee osteoarthritis. METHOD: A total of 36 patients with knee osteoarthritis were enrolled in trial and organized into two groups: 3-wk extracorporeal shockwave therapy for the intervention group and 3-wk sham extracorporeal shockwave therapy for control group. Both groups received the same physical therapies: (1) transcutaneous electrical nerve stimulation, (2) magnetic field treatment, and (3) quadricep muscle strength training. Evaluation was performed before the start of treatment, at third week after the start of treatment, and 1 wk after the end of treatment. The study used randomized controlled trials (level of evidence, 1). RESULT: Eextracorporeal shockwave therapy group had significant improvement in WOMAC pain score, physical function, and total score (mean difference = -2.8, P < 0.001; -5.1, P = 0.02; -8.3, P = 0.004, respectively), Visual Analog Scale score (mean difference = -2.3, P < 0.001), and the distance of 6-min walk test (mean difference = 28.7, P = 0.01) in the 1 wk after the end of treatment. Statistical significance in WOMAC pain, physical function, and total scores (mean difference = -3.0, P = 0.001; -5.6, P = 0.02; -9.3, P = 0.004, respectively) and Visual Analog Scale score (mean difference = -1.2, P = 0.027) was observed between the extracorporeal shockwave therapy group and control group. CONCLUSIONS: Extracorporeal shockwave therapy for the tendons and ligaments has clinical benefits for pain and physical function improvement in knee osteoarthritis. In addition, improvement in physical performance was observed in the short-term follow-up.

Genome-wide CRISPR-Cas9 screening identifies that hypoxia-inducible factor-1a-induced CBX8 transcription promotes pancreatic cancer progression via IRS1/AKT axis.

BACKGROUND: Pancreatic cancer (PC) is one of the most lethal malignancies worldwide. It is known that the proliferation of PC cells is a critical process in the disease. Previous studies have failed to identify the key genes associated with PC cell proliferation, using bioinformatic analysis, genome-wide association studies, and candidate gene testing. AIM: To investigate the function of the chromobox 8 (CBX8)/receptor substrate 1 (IRS1)/AKT axis in PC. METHODS: A genome-wide CRISPR-Cas9 screening was performed to select genes that could facilitate PC cell proliferation. Quantitative reverse transcription-polymerase chain reaction was used to detect the expression of CBX8 in PC tissues and cells. The regulatory roles of CBX8 in cell proliferation, migration, and invasion were verified by in vivo and in vitro functional assays. RESULTS: CBX8 was upregulated in PC tissues and shown to drive PC cell proliferation. Higher expression of CBX8 was correlated with worse outcomes of PC patients from two independent cohorts comprising a total of 116 cases. CBX8 was also proved to serve as a promising therapeutic target for a PC xenograft model. We demonstrated that hypoxia-inducible factor (HIF)-1a induced CBX8 transcription by binding to the promoter of CBX8. CBX8 efficiently activated the PI3K/AKT signaling by upregulating insulin IRS1. CONCLUSION: CBX8 is a key gene regulated by HIF-1α, and activates the IRS1/AKT pathway, which suggests that targeting CBX8 may be a promising therapeutic strategy for PC.

Roles of the Immune/Methylation/Autophagy Landscape on Single-Cell Genotypes and Stroke Risk in Breast Cancer Microenvironment.

This study sought to perform integrative analysis of the immune/methylation/autophagy landscape on breast cancer prognosis and single-cell genotypes. Breast Cancer Recurrence Risk Score (BCRRS) and Breast Cancer Prognostic Risk Score (BCPRS) were determined based on 6 prognostic IMAAGs obtained from the TCGA-BRCA cohort. BCRRS and BCPRS, respectively, were used to construct a risk prediction model of overall survival and progression-free survival. Predictive capacity of the model was evaluated using clinical data. Analysis showed that BCRRS is associated with a high risk of stroke. In addition, PPI and drug-ceRNA networks based on differences in BCPRS were constructed. Single cells were genotyped through integrated scRNA-seq of the TNBC samples based on clustering results of BCPRS-related genes. The findings of this study show the potential regulatory effects of IMAAGs on breast cancer tumor microenvironment. High AUCs of 0.856 and 0.842 were obtained for the OS and PFS prognostic models, respectively. scRNA-seq analysis showed high expression levels of adipocytes and adipose tissue macrophages (ATMs) in high BCPRS clusters. Moreover, analysis of ligand-receptor interactions and potential regulatory mechanisms were performed. The LINC00276&MALAT1/miR-206/FZD4-Wnt7b pathway was also identified which may be useful in future research on targets against breast cancer metastasis and recurrence. Neural network-based deep learning models using BCPRS-related genes showed that these genes can be used to map the tumor microenvironment. In summary, analysis of IMAAGs, BCPRS, and BCRRS provides information on the breast cancer microenvironment at both the macro- and microlevels and provides a basis for development of personalized treatment therapy.

The Expression and Significance of Serum Protein ROCK2 in Patients with Chronic Graft-Versus-Host Disease / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression and clinical significance of serum protein ROCK2 in patients with chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*METHODS@#The patients were divided into cGVHD group and control group (without cGVHD). The expression levels of serum protein ROCK2 were detected by ELISA in patients with or without cGVHD after allo-HSCT.@*RESULTS@#The expression level of ROCK2 in serum of cGVHD patients was significantly higher than those in control group, moreover, the expression level of ROCK2 in severe cGVHD group was significant higher than that in moderate and mild cGVHD group (P<0.001). The expression level of ROCK2 was significantly decreased in the serum of cGVHD patients after treatment（P＜0.01）; the expression level of ROCK2 was significantly higher in the serum of cGVHD patients with lung as the target organ（P＜0.01）. The median survival time of patients with severe cGVHD were significantly shorter than that of patients with mild and moderate cGVHD（P＜0.05）.@*CONCLUSION@#ROCK2 shows certain reference value in the evaluation of severity and prognosis of cGVHD, and may be a new target for the treatment of cGVHD.

MiR-301a transcriptionally activated by HIF-2α promotes hypoxia-induced epithelial-mesenchymal transition by targeting TP63 in pancreatic cancer.

BACKGROUND: Pancreatic cancer (PC) is one of the deadliest cancers worldwide. PC metastasis involves a complex set of events, including epithelial-mesenchymal transition (EMT), that increase tumor cell invasiveness. Recent evidence has shown that hypoxia is a major EMT regulator in pancreatic cancer cells and facilitates metastasis; however, the mechanisms remain elusive. AIM: To investigate the role of miR-301a in hypoxia-induced EMT in PC cells. METHODS: Real-time PCR and Western blot analysis were used to detect the expression of miR-301a and EMT markers in PDAC cells cultured in hypoxic and normoxic conditions. Western blot analysis was used to detect the expression of EMT markers in PDAC cells with miR-301a overexpression. Wound healing assay and Transwell assay were used to detect the migration capabilities of PDAC cells with miR-301a overexpression and knockout. Luciferase assay was used to detect the miR-301a promoter and the 3' untranslated region activity of TP63. Orthotopic PC mouse models were used to study the role of miR-301a in metastasis of PDAC cells in vivo. In situ hybridization assay was used to detect the expression of miR-301a in PDAC patient samples (adjacent paratumor and paired tumor tissues). . RESULTS: Hypoxic environment could directly promote the EMT of PC cells. The expression level of miR-301a was increased in a HIF2α dependent manner in hypoxia-cultured CFPAC-1 and BxPC-3 cells. Overexpression of miR-301a enhanced the hypoxia-induced EMT of PC cells, while knocking out miR-301a result in the suppression of hypoxia-induced EMT. TP63 was a direct target of miR-301a and involved in the metastatic process of PC cells. Furthermore, miR-301a upregulation facilitated PDAC distant metastasis and lymph node metastasis in vivo. Additionally, miR-301a overexpression was indicative of aggressive clinicopathological behaviors and poor prognosis. CONCLUSION: The newly identified HIF-2α-miR301a-TP63 signaling pathway may play a crucial role in hypoxia-induced EMT in PDAC cells.

Effects of cisapride on digestive symptoms and gastrointestinal hormones in elderly peritoneal dialysis patients / 中华老年医学杂志

Objective:To study the effects of cisapride on digestive symptoms and gastrointestinal hormones in elderly peritoneal dialysis patients.Methods:Forty-two elderly patients with renal failure undergoing peritoneal dialysis in our hospital from July 2017 to December 2017 were randomly selected as the study group.Meanwhile, 20 healthy elderly people in the corresponding time period were selected as the control group.Control group received continuous ambulatory peritoneal dialysis(CAPD)and other conventional basic therapy, and study group received cisapride as add-on therapy to treatment for control group.Serum levels of somatostatin(SS), motilin(MOT)and vasoactive intestinal peptide(VIP)were compared between the two groups.Gastrointestinal symptoms, serum levels of gastrointestinal hormones and biochemical indexes were compared before and after treatment in the study group.Results:The score of acid reflux, nausea, abdominal distension, belching and constipation were lower in the study group after treatment than before treatment( t=4.42, 4.32, 6.80, 6.29 and 6.76, all P=0.00). Before treatment, levels of MOT, SS and VIP were higher in the study group than in the control group[(636.65±32.02)pmol/L vs.(228.47±28.74)pmol/L, (64.02±16.32)mg/L vs.(42.38±6.42)mg/L, (118.64±17.68)ng/L vs.(58.62±11.63)ng/L, t=48.44, 7.47 and 15.93, all P=0.00]. The level of MOT was lower after than before treatment[(385.36±19.64)pmol/L vs.(636.65±32.02)pmol/L, t=43.36, P=0.00], and the levels of SS and VIP had no significant difference before versus after treatment( t=-0.11 and -0.42, P=0.91 and 0.68). After treatment, the level of MOT was still higher in the study group than in the control group[(385.36 ±19.64)pmol/L vs.(228.47 ±28.74)pmol/L, t=22.08, P=0.00]. There was no significant difference in blood urea nitrogen(BUN), creatinine, haemoglobin and kt/v levels between before and after treatment( P>0.05). The level of albumin(ALB)was higher after than before treatment[(38.60±1.89)g/L vs.(37.71±1.96)g/L, t=2.12, P=0.04]. Conclusions:Gastrointestinal symptoms are common in elderly patients with peritoneal dialysis, and the accumulation of gastrointestinal hormones is obvious, which leads to gastrointestinal dysfunction.The conventional treatment in combination with cisapride can improve gastrointestinal symptoms and reduce serum MOT level in these patients.

The design and implementation of power control circuit of ultrasonic scalpel based on DSP / 中国医学装备

Objective:To independently develop a power control system of ultrasonic scalpel so as to reduce the energy consumption and maintain the normal temperature of ultrasonic scalpel.Methods:In this paper, the model of equivalent circuit of ultrasonic transducer nearby syntony was built up, and the hardware control system of ultrasonic scalpel based on digital signal processing (DSP) was designed.Results:Through testing the circuit and work performance of power control system, the series of parameters such as effective value and so on which were produced by this system could adjust frequency of power source in time and attain anticipative functional indicator, and it took the ultrasonic scalpel to work in syntonic situation.Conclusion:The tested indicators of power control system of ultrasonic scalpel based on the kernel design of DSP can attain anticipative requirement, and can take this system to work in syntonic situation.

Postoperative acute urinary retention in anorectal diseases treated with acupuncture combined with grain-moxibustion: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the efficacy differences between acupuncture combined with grain-moxibustion and acupuncture on acute urinary retention after epidural anaesthesia for anorectal diseases.@*METHODS@#A total of 60 patients were randomized into an acupuncture combined with grain-moxibustion group and an acupuncture group, 31 cases in each one. In the acupuncture group, acupuncture was applied at Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6), Shuidao (ST 28), Pangguangshu (BL 28), Sanyinjiao (SP 6) and Yinlingquan (SP 9). In the acupuncture combined with grain-moxibustion group, grain-moxibustion was given at Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6) and Shuidao (ST 28) on the basis of acupuncture. Those who failed to urinate 60 min after the first treatment received the second treatment. 30 min after the second treatment, the lower abdominal symptom scores before and after treatment as well as the bladder residual urine volume after the first urination after treatment were compared between the two groups. In addition, the clinical efficacy and security were evaluated.@*RESULTS@#Compared before treatment, the symptom scores after treatment were reduced in the two groups (<0.05), and the score in the acupuncture combined with grain-moxibustion group was lower than that in the acupuncture group after treatment (<0.05). The bladder residual urine volume in the acupuncture combined with grain-moxibustion group was (26.71±17.01) mL, which was lower than (35.32±20.76) mL in the acupuncture group (<0.05). The total effective rate was 93.5% (29/31) in the acupuncture combined with grain-moxibustion group, which was superior to 71.0% (22/31) in the acupuncture group (<0.05).@*CONCLUSION@#The efficacy of acupuncture combined with grain-moxibustion is superior to simple acupuncture on acute urinary retention after epidural anaesthesia for anorectal diseases, which is safe and reliable.

Effects of cisapride on symptoms of digestive and gastrointestinal hormones in chronic renal failure patients / 中华肾脏病杂志

Objective To study the effects of cisapride on symptoms of digestive and gastrointestinal hormones in chronic renal failure patients.Methods There were 46 cases of chronic renal failure patients in this paper,all patients were given routine treatment of the underlying disease and were randomly divided into two groups.23 patients were additionally treated with cisapride as research group,and the others as control group.The gastrointestinal symptoms,serum somatostatin (SS),motilin (MOT) and vasoactive intestinal peptide (VIP) and other gastrointestinal hormones and renal function in two groups of patients were compared before and after treatment.Results The score of acid reflux,nausea,vomiting,abdominal distension,belching and other symptoms of hard feces and other gastrointestinal after treatment were significantly lower than that before treatment in research group and after treatment in control group (all P ＜ 0.05).There was no significant change between before and after treatment in SS and VIP of two group (all P ＞ 0.05),and MOT in control group (P ＞0.05),but the MOT in research group was decreased significantly(P ＜ 0.05).There was no significant difference in Scr,Ccr and BUN between the control and research group after treatment (all P ＞ 0.05).Conclusion Conventional treatment combined with cisapride can improve the effect of gastrointestinal symptoms in patients with chronic renal failure,while reducing serum motilin level.

Study on Lung Injury of Rats Caused by PM2.5 and Intervention Effect of Platycodonis Radix Total Saponins / 中国中医药信息杂志

Objective To observe the lung injury of rats caused by PM2.5 and the intervention effect of Platycodonis Radix total saponins (PGS); To discuss the repair mechanism of PGS for lung injury caused by PM2.5. Methods The model of lung injury caused by PM2.5 was induced by tracheal instillation. The rats were randomly divided into blank group, model group and PGS high-, medium- and low-dose groups, with 10 rats in each group. After medication for 14 d, BALF and left lung and right lung tissue of rats were collected. HE staining was used to observe the pathological changes of lung tissue. The contents of TNF-α, IL-6, IL-10 and IL-13 in BALF were detected by ELISA. RT-PCR was used to detect the expression of TGF-β mRNA in lung tissues. The expression of TGF-β protein in lung tissue was detected by Western blot. Results Compared with model group, TNF-α and IL-6 decreased significantly while IL-10 and IL-13 increased significantly in BALF in high- and medium-dose group of PGS. Degree of pulmonary interstitial edema and fibroplasia alleviated in PGS groups. Expressions of TGF-βmRNA and protein in lung tissue was reduced in PGS groups. Conclusion PGS can alleviate inflammatory injury caused by PM2.5 via regulating the balance of cytokine and down-regulating the expression of TGF-β and inhibiting the development of fibrosis, which results in the protection and repair on the lung injury of rats caused by PM2.5.

Correlation Research on Photodegradation Products of Cobamamide / 中国药师

Objective:To research the correlation between the cobamamide photodegradation products in the visible light area at different wavelengths and the photodegradation rate intensity. Methods:The 40-minute illumination experiment was conducted for co-bamamide reference solution respectively at the wavelength of 400 nm,450 nm,500 nm,550 nm,600 nm,650 nm and 700 nm under the illumination of 50 Lx,100 Lx,200 Lx,300 Lx,400 Lx and 500 Lx,respectively. An HPLC method was used to detect the cobam-amide content after the irradiation, the contents and proportions of hydroxocobalamin and adenosine (two photodegradation products) were calculated and the two photodegradation products were confirmed by mass spectrum. Results:The main photodegradation products of cobamamide (impurity 1,adenosine and hydroxocobalamin) had the similar photodegradation tendency. Within the scope of 50 Lx-200 Lx,the illumination intensity affected the concentration ratio of hydroxocobalamin and adenosine obviously. Within the scope of 200 Lx-500 Lx,the illumination intensity showed smaller effect. Under the different wavelengths and photodegradation rate intensity, the content of hydroxocobalamin was higher than that of adenosine under the same experimental condition.Conclusion:This paper re-searched the cobamamide photodegradation products in the optimum dark condition. The method is accurate and reliable,which can be used for the control of photodegradation related substances of cobamamide.

Investigation on microbial contamination of infant formula powder during production process / 中国食品卫生杂志

Objective The aim of this study was to investigate the microbial contamination situation in infant formula powder during the processes of production.Methods A total of 880 samples were collected from Gansu Province,which included raw materials,manufacturing facilities,personnel swabs and final infant formula powder.The detection method conducted in this study were complied with the standard of the SN/T 0738-1997 and GB 4789,and the microbial species detected in this study included Enterobacteriaceae,Enterobacter sakazakii,and Bacillus cereus.Results The detection rate of Enterobacteriaceae was 28.41％ (250/880),the detection rates of Enterobacter sakazakii and Bacillus cereus were 0.46％ (4/872) and 16.94％ (31/183) respectively.The prevalence of Enterobacteriaceae (40.00％,40/100) was the highest in raw materials.Four Enterobacter sakazakii strains were isolated from the pretreatment workshop,equipment and environment surface.The prevalence of Bacillus cereus was 22.73％ (10/44) in final product.Conclusion The microbial contamination was existent widely in infant formula powder and the production procession.Rigid laws and managements should be conducted to reduce the microbial contamination in raw materials,production processes and the environment,which might improve the quality of infant formula powder.

Curative effectiveness of human chorionic gonadotropin treatment on hypospadias with micropenis / 中华实用儿科临床杂志

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.

Phrenic Arterial Injury Presenting as Delayed Hemothorax Complicating Simple Rib Fracture.

Delayed hemothorax after blunt torso injury is rare, but might be associated with significant morbidity and mortality. We present a case of delayed hemothorax bleeding from phrenic artery injury in a 24-year-old woman. The patient suffered from multiple rib fractures on the right side, a right hemopneumothorax, thoracic vertebral injury and a pelvic bone fracture after a fall from a fourth floor window. Delayed hemothorax associated with phrenic artery bleeding, caused by a stab injury from a fractured rib segment, was treated successfully by a minimally invasive thoracoscopic surgery. Here, we have shown that fracture of a lower rib or ribs might be accompanied by delayed massive hemothorax that can be rapidly identified and promptly managed by thoracoscopic means.

Phrenic Arterial Injury Presenting as Delayed Hemothorax Complicating Simple Rib Fracture

Delayed hemothorax after blunt torso injury is rare, but might be associated with significant morbidity and mortality. We present a case of delayed hemothorax bleeding from phrenic artery injury in a 24-year-old woman. The patient suffered from multiple rib fractures on the right side, a right hemopneumothorax, thoracic vertebral injury and a pelvic bone fracture after a fall from a fourth floor window. Delayed hemothorax associated with phrenic artery bleeding, caused by a stab injury from a fractured rib segment, was treated successfully by a minimally invasive thoracoscopic surgery. Here, we have shown that fracture of a lower rib or ribs might be accompanied by delayed massive hemothorax that can be rapidly identified and promptly managed by thoracoscopic means.