RESUMO
This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias. We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between October 2012 and October 2022. In total, 31 patients underwent the conventional Byars procedure (conventional group), and 45 patients underwent the modified Byars staged procedure (modified group). Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage. Notably, there were no statistically significant differences in the preoperative baseline characteristics, duration of surgery, amount of blood loss, or occurrence of postoperative complications, including urethral fistula, stricture and diverticulum, or penile curvature, between the conventional and modified groups. However, there was a significantly lower incidence of coronal sulcus fistula (0 vs 16.1%, P = 0.02) and glans dehiscence (0 vs 12.9%, P = 0.02) in the surgical group than that in the conventional group. In addition, the modified group exhibited a notably greater rate of normotopic urethral opening (100.0% vs 83.9%, P = 0.01) and a higher mean score on the Hypospadias Objective Penile Evaluation (HOPE; mean ± standard error of mean: 8.6 ± 0.2 vs 7.9 ± 0.3, P = 0.02) than did the conventional group. In conclusion, the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula. Consequently, it offers a promising approach for achieving favorable penile esthetics, thereby providing a reliable therapeutic option for severe hypospadias.
RESUMO
To select the tree species assembly model for improving the productivity in south subtropical plantations, we carried out an experiment following a random block design with eight native tree species across a richness gradient of 1, 2, 4, and 6 species. The effects of tree species diversity and species mixing with different functional identities on the young tree growth were investigated in the 5th year of the experiment. The results showed that tree growth was not positively correlated with tree species richness. The growth of fast-growing tree species (Pinus massoniana and Mytilaria laosensis) in the monoculture was 2.5-4.5 times of the valuable broadleaved tree species (Castanopsis hystrix and Erythrophleum fordii) monoculture. Tree growth was significantly increased by 51.5%-132.8% in the conifer and broadleaved tree species mixing plantations and in the fast-growing and nitrogen fixation tree species mixing plantations, when two tree species or four tree species were mixed. There was no significant difference in tree growth among different tree species mixed types, when six tree species were mixed. The contents of soil nitrogen, phosphorus and organic matter were the main factors affecting tree growth. The results indicated that young tree growth could be improved through the selecting conifer and broadleaved tree species mixing, fast-growing and nitrogen fixation tree species mixing in south subtropical plantations.
Assuntos
Pinus , Árvores , China , Nitrogênio/análise , Fósforo , SoloRESUMO
MicroRNA 182 has been found to have a distinct contribution in the clonal expansion of activated- and functioning of specialized-helper T cells. In this study we knocked down microRNA 182 in vivo and induced experimental autoimmune encephalomyelitis (EAE) to determine the influences of microRNA 182 in the Treg cells functional specialization through Foxo1 dependent pathway in the peripheral lymphoid organs. Down-regulation of microRNA 182 significantly increased the proportions of Foxp3+ T cells in the peripheral lymph nodes and spleen. In vivo study verified a positive correlation between microRNA 182 levels and symptom severity of EAE, and a negative correlation between microRNA 182 and the transcriptional factor Foxp3. In vitro polarization study also confirmed the contribution of Foxo1 in microRNA 182 mediated down-regulation of Foxp3+ T cells. Together, our results provide evidence that during the development of EAE, microRNA 182 repressed Treg cells differentiation through the Foxo1 dependent pathway.