Objective To summarize the methods of repairingthe urethral defect in the penis of an adult and the clinical application of the island skin flaps of the scrotum septum to the reparative treatment. Methods From January 2000 to November 2005, twenty-six cases of urethral defect in penis, including 16 cases of congenital urethral defect, 6 cases of traumatic urethral defect in middle penis, and 4 cases of distal urethral defect, were repairedby the local penis fascia flaps.The island skin flaps of the scrotum septum were transferred to cover the penis wound. The pedicle contained the artery of the posterior scrotum and the artery of the anterior scrotum. The flap taken from the scrotum septum was 2.5 cm×5.5 cm in area. Results After a follow-up of 7months to 4 years, all the 26 patients had the healing of the first intention without urethral fistula, urethral narrowness or penis curvature, except 4 patients who developedinfection and leakage of urine, but the wounds healed spontaneously 2-4 weeks after operation. Conclusion The penis fascia flaps and the island skin flaps of the scrotum septum can be used to repair the urethral defect in the penis of an adult. The blood supply to the flaps is sufficient and all theflaps can survive well. A good shape and function of the penis can be obtained.
OBJECTIVE: To explore the expression of basic fibroblast growth factor(bFGF) during the wound healing of human fetal and adult skin and its significance. METHODS: We established the animal model of fetal scarless healing by transplanting full-thickness skin grafts from human fetus to a subcutaneous location on the athymic mouse recipient, and then making the linear incisions. The expression of bFGF was observed in the normal adult skin, normal fetal skin and during wound healing by immunohistochemical method. The positive staining cells were counted under selected high-power focus randomly. RESULTS: bFGF staining was not observed in the normal fetal skin and the wounded one. However, bly positive staining was shown around the vessels in normal adult skin. Moreover, the positive straining became ber in the wounded skin, especially in dermal fibroblasts and endotheliocytes. The number of positive staining cell was 2.1 +/- 0.1 in normal fetal skin, and 2.2 +/- 0.1, 2.1 +/- 0.3, 2.1 +/- 0.3 and 2.0 +/- 0.1 in the fetal skins after 12 hours, 1 day, 3 days and 7 days of wound respectively. The number of positive staining cell were 23.2 +/- 4.2 in normal adult skin and 40.5 +/- 3.6 in the wound adult skin. There was significant difference between the fetal skin and adult skin (P lt; 0.01). CONCLUSION: The negative expression of bFGF in the fetal skin may be one of the important reasons for fetal scarless healing.
ObjectiveTo investigate the efficacy and safety of the phase Ⅰ corpus callosotomy in the treatment of adult refractory epilepsy. MethodsWe conducted a retrospective analysis of 56 adults with intractable epilepsy in Tangdu Hospital from January 2011 to July 2016.All patients were treated for the phase Ⅰ total corpus callosotomy, followed up 1~5 years after surgery. Results14 cases (25.0%) patients achieved complete seizure free after surgery, 19 cases (33.9%) whose seizures reduced more than 90%, 10 cases (17.9%) reduced between 50%~90%, 7 cases (12.5%) between 30%~50%, 6 cases (10.7%) decreased below 30%; Drop attacks of 47 cases (83.9%) patients disappeared. Postoperative complications occurred in 13 cases(23.2%), and most of them recovered well. 5 cases(8.9%) had long-term sensory disassociation, no serious complications and death. The percentage of patients reporting improvement in quality of life was 67.9%. ConclusionsFor patients with intractable epilepsy who can not undergo focal resection, Ⅰ phase total corpus callosotomy has a certain effect on reducing seizure frequency, eliminating drop attacks, and improving the quality of life.
Objective To investigate the long-term clinical results of treatment of adult unicameral bone cyst with cancellous allograft. Methods From 1993 to 1998, 15 patients with unicameral bone cyst were treated by allograft with lyophilized cancellous bone. Among 15 patients, there were 5 males and 10 females, aging 19-41 years with an average of 27 years. The average follow-up time was 7.5 years (6-11 years). The X-ray films were taken and the CT scanning were carried out. Results The X-ray films showed that the allograft particles became vague 2-3 months after operation, that the allograft particles fused and began to form new bone and the bone density increased 5 months after operation, and that new bone formation completed after 7 months of operation. At the end of follow-up, remodelling in new bone occurred. Reoccurrence was not found in all patients. The symptom of pain disappeared or relieved obviously. Conclusion Allograft of lyophilized cancellous bone is an effective treatment for adult unicameral bone cysts.
Retinal degeneration mainly include age-related macular degeneration, retinitispigmentosa and Stargardt’s disease. Although its expression is slightly different, its pathogenesis is photoreceptor cells and/or retinal pigment epithelial (RPE) cel1 damage or degeneration. Because of the 1ack of self-repairing and renewal of retinal photoreceptor cells and RPE cells, cell replacement therapy is one of the most effective methods for treating such diseases.The stem cells currently used for the treatment of retinal degeneration include embryonicstem cells (ESC) and various adult stem cells, such as retinal stem cells (RSC), induced pluripotent stem cells (iPSC). and mesenchyma1 stem cells (MSC). Understanding the currentbasic and clinical application progress of ESC, iPSC, RSC, MSC can provide a new idea for the treatment of retinal degeneration.
Objective To evaluate the effectiveness and safety of ramelteon for chronic insomnia in adults. Methods The following databases as CENTRAL, PubMed, EMbase, ISI, CNKI, CBMdisc, VIP and WanFang Data were searched from the date of their establishment to November 2010. The randomized controlled trials (RCTs) meeting the inclusion criteria were included. The data extraction and quality assessment were conducted according to the methods of Cochrane Reviewers’ Handbook recommend by The Cochrane Collaboration, and meta-analysis was performed with RevMan5.0 software. Results A total of 5 RCTs involving 1 772 patients were included. The results of meta-analyses showed that: a) Effectiveness: In the effectiveness, ramelteon was superior to placebo in latency to persistent sleep (MD=18.36, 95%CI 11.55 to 25.18, Plt;0.000 01), total sleep time (MD= –15.47, 95%CI –22.50 to –8.43, Plt;0.000 1), sleep efficiency (MD= –3.39, 95%CI –5.32 to –1.46, P=0.000 6), sleep quality (MD=0.14, 95%CI 0.03 to 0.25, P=0.01) after one week treatment and latency to persistent sleep (MD=13.02, 95%CI 6.01 to 20.03, P=0.000 3) except for wake after sleep onset (MD= –8.79, 95%CI –17.24 to –0.35, P=0.04) after one month treatment. b) Safety: significant differences were only found in the female prolactin (MD=5.50, 95%CI 2.02 to 8.98, P=0.002) and male free testosterone (MD=15.30, 95%CI 0.62 to 29.98, P=0.04) between the two groups, rather than in all the other hormones concentration, rebound insomnia, withdrawal syndrome, next-day residual effects and incidence rate of adverse reactions. Conclusion Ramelteon has marked effects on adults’ chronic insomnia after 1-week treatment, but its effect is not obvious after 1-month treatment. The adverse reactions are mostly the somnolence, rising of male free testosterone and female prolactin concentration.
Objective To observe the differentiation effect of rabbit amnion-derived stem cells (ADSC) induced into neural cells.Methods ADSC of New Zealand female rabbits were isolated and cultured. Its mRNA level of Fibronectin, Nestin and Vimentin were detected by real-time quantitative polymerase chain reaction. The selfreplication ability of ADSC was confirmed by monoclonal formation experiments. These ADSC were further induced into neural cells in vitro. Five days after induced differentiation, the expression of -tubulin and glial fibrillary acidic protein (GFAP) were detected by immunofluorescent staining. Results ADSC were separated from amnion tissue gradually after 24 hours. There were polygonal cells gathered around the amnion tissue at 72 hours, and were distributed compactly around the amnion at 120 hours. The morphology of cleavage daughter cells was basically the same as parent cells. ADSC has the ability of self-replication. The Nestin, Vimentin, Fibronectin mRNA expressions in ADSC were 15.79, 1.91, 7.65 times those in spleen cells. The differences were statistically significant(Z=-5.243, -3.972, -2.524; P＜0.05). The beta;-tubulin expression was found in cytoplasm of most cells. The GFAP expression was found in cytoplasm in some cells. Conclusions ADSC has self-replication ability. It can be induced into neurons and neuroglial cells under the right conditions.
ObjectiveTo review the progress of clinical diagnosis and treatment of chronic osteomyelitis in adults.MethodsThe literature related to chronic osteomyelitis in recent years was extensively reviewed, and the clinical diagnosis and treatment methods were summarized.ResultsClinical characteristics and laboratory examination can help to diagnose chronic osteomyelitis in adults. Pathogenic identification is the basis for choosing antibiotics. Diagnostic imaging is specific. The treatment includes systemic treatment and local treatment, and the local treatment is the key to radical cure.ConclusionThe diagnosis of chronic osteomyelitis in adults should be made as early as possible. According to the anatomical and physiological classification of the patients, the appropriate treatment plan should be made.
ObjectiveTo measure L1-L5 lumbar isthmus thickness and to construct Chinese adult male lumbar (L1-L5) 3D model by Micro CT 3D reconstruction technique, in order to provide micro-anatomical data for clinical treatment of L1-L5 lumbar spondylolysis. MethodsDry, non-damaged specimens of L1-L5 lumbar isthmus from 60 Chinese adult males were randomly selected from September 2013 to January 2014. Micro CT scanning was carried out, followed by corresponding 3D model construction. The microscopic anatomical parameters such as superior, inferior, inner and outer edge thickness of left and right L1-L5 lumbar isthmus were measured. ResultsL1-L5 lumbar isthmus superior edge thickness was in the order of L1> L2> L3> L5> L4, with the variation ranging from (4.31±0.95) mm to (4.88±0.75) mm. L1-L5 lumbar isthmus inferior edge thickness was in the order of L1< L2< L3< L4< L5, gradually thickened with the variation ranging from (6.03±1.01) mm to (7.27±1.27) mm. L1-L5 lumbar isthmus inner edge thickness amplitude was not obvious, ranging from (6.33±1.21) mm to (6.57±1.27) mm. L1-L5 lumbar isthmus outer edge thickness was in the order of L1< L2< L3< L4< L5, gradually thickened with the variation ranging from (8.44±1.21) mm to (10.27±1.28) mm. ConclusionThere are certain rules within superior, inferior, inner and outer edge thickness of adult L1-L5 lumbar isthmus:the inferior and outer edge thickness of L1-L5 lumbar isthmus gradually becomes thicker, while superior edge gradually becomes thinner. From L1 to L5 lumbar isthmus, the outer edge of the lumbar isthmus is the thickest, followed by inner and inferior edge, and the upper edge is the thinnest.
Objective To review the effects of pulmonary surfactant in adult patients with acute lung injury ( ALI) /acute respiratory distress syndrome ( ARDS) . Methods Randomized controlled trials ( RCTs) were recruited from PubMed ( 1966.1-2011.3) , ISI Web of Knowledge ( all the years) and Wanfang Database ( 1982-2011) . Related published data and attached references were hand searched. All the RCTs about pulmonary surfactant for the adult patients with ALI/ARDS were included, then a meta-analysis was performed. Results Eight eligible trials were enrolled. Pooled analysis showed that treatment with pulmonary surfactant was not associated with reduction in 28 or 30-day mortality compared with the control group [ OR 1.05, 95% CI ( 0.90, 1.22 ) , P = 0.55] , neither did subgroup analysis in the pneumoia/ aspiration, sepsis, and trauma/ surgery induced ALI/ARDS patients. Three RCTs showed the oxygenation was significantly improved in adult ALI/ARDS patients receiving pulmonary surfactant compared with the control group( Plt;0.05) . Shorter mechanical ventilation days was shown in the ALI/ARDS patients receiving pulmonary surfactant in one RCT(Plt;0.05) . Conclusions Meta-analysis showed pulmonary surfactant did not reduce the 28 or 30-day mortality of adult patients with ALI/ARDS, however, improved the oxygenation. Pulmonary surfactant can be considered a therapy in ALI/ARDS.