The association between caudal block and urethroplasty complications of distal tubularized incised plate repair: experience from a South China National Children’s Medical Center

BackgroundThe effect of caudal block (CB) on the incidence of urethroplasty complications in hypospadias repair remains controversial. The evidence is conflicting, and some confounding bias issues need to be addressed. We sought to study a more homogenous group of distal hypospadias patients undergoing primary tubularized incised plate (TIP) repair by a senior pediatric urology surgeon in the past 2 years to examine the relationship between urethroplasty complications and the use of CB.MethodsWe reviewed our database to identify consecutive patients who had undergone hypospadias repairs by a senior director surgeon at our Center between January 2018 and November 2020. To be eligible to participate in the study, patients had to meet the following inclusion criteria: (I) have distal hypospadias; (II) have undergone a primary TIP repair; and (III) have attended follow-up appointments for a minimum period of 6 months. The primary outcome was the development of urethroplasty complications during the follow-up period. The principal variable of interest was whether or not CB was used perioperatively. The patients were categorized into a CB group (general anesthesia combined with CB) or a control group (general anesthesia only). Other potential risk factors were analyzed, including patient age at operation, patient weight, glans width, and the length of the urethral plate defect.ResultsThirty (12.2%) of the distal patients developed postoperative surgical complications. The postoperative surgical complication rates were similar between the different anesthesia groups. Weight, the length of the urethral plate length, and glans width did not contribute to the risk. Age was the only independent risk factor for postoperative surgical complications, and the complication rates increased in older patients.ConclusionsOur data from consecutive TIP repairs in distal hypospadias patients indicated no association between the use of CB anesthesia and the postoperative urethroplasty complication rate. Patients who were older in age when they underwent surgery had a higher risk of complications.     

Comparison of the anxiety,depression and their relationship to quality of life among adult acute leukemia patients and their family caregivers: a cross-sectional study in China

Quality of Life Research - To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China....     

Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate-severe allergic asthma

BACKGROUND: Chinese herbal medicine has a long history of human use. A novel herbal formula, anti-asthma herbal medicine intervention (ASHMI), has been shown to be an effective therapy in a murine model of allergic asthma. OBJECTIVE: This study was undertaken to compare the efficacy, safety, and immunomodulatory effects of ASHMI treatment in patients with moderate-severe, persistent asthma with prednisone therapy. METHODS: In a double-blind trial, 91 subjects underwent randomization. Forty-five subjects received oral ASHMI capsules and prednisone placebo tablets (ASHMI group) and 46 subjects received oral prednisone tablets and ASHMI placebo capsules (prednisone group) for 4 weeks. Spirometry measurements; symptom scores; side effects; and serum cortisol, cytokine, and IgE levels were evaluated before and after treatment. RESULTS: Posttreatment lung function was significantly improved in both groups as shown by increased FEV(1) and peak expiratory flow findings (P<.001). The improvement was slightly but significantly greater in the prednisone group (P<.05). Clinical symptom scores, use of beta(2)-bronchodilators, and serum IgE levels were reduced significantly, and to a similar degree in both groups (P<.001). T(H)2 cytokine levels were significantly reduced in both treated groups (P<.001) and were lower in the prednisone-treated group (P<.05). Serum IFN-gamma and cortisol levels were significantly decreased in the prednisone group (P<.001) but significantly increased in the ASHMI group (P<.001). No severe side effects were observed in either group. CONCLUSION: Anti-asthma herbal medicine intervention appears to be a safe and effective alternative medicine for treating asthma. In contrast with prednisone, ASHMI had no adverse effect on adrenal function and had a beneficial effect on T(H)1 and T(H)2 balance.     

尿毒症患者急性缺氧状态下血清红细胞生成素浓度的变化

７例尿毒症贫血患者在自发急性缺氧状态下，其血清红细胞生成素（ＥＰＯ）浓度显著提高（平均７倍），且与ＰＯ２呈负相关。缺氧状态纠正后血清ＥＰＯ浓度下降。提示尿毒症贫血患者的ＥＰＯ氧依赖调控系统功能尚存在，但处于不敏感的低调状态。进一步了解其机遇，则可能通过促进内源性ＥＰＯ的生成，有助于悄毒症贫血的治疗。     

积分加权法评价磷化学烧伤实验病理的意义与应用

目的：积分加权法在病理组织学检查中的应用，方法：在常规病理描述基础上，采用积分加权法将病理结果予以定量，综合评价致伤后实验动物的主要脏器，结果：实验动物同等面积的磷酸烧伤各脏器积分降低，钙治疗后则显著改善，均与其它方面报道的资料一致，结论：积分加以数值使各脏器损伤程度一目了然，对不同脏器间的损伤情况有可比性，从而有助于了解主要受损脏器与总体的关系以及药物的治疗效果。     

超抗原SEA抗肿瘤研究进展

超抗原是指一些细菌或病毒编码的蛋白分子，只需极低浓度即可激活大量的淋巴细胞克隆．作为一种强大的T细胞激活剂，超抗原成为肿瘤免疫治疗研究的热点之一．本文对其特性及目前的研究进展作一综述．     

受体选择与B细胞自身免疫耐受

基因重组机制的存在使得B细胞抗原受体呈现高度的多态性,这其中包括大量的自身反应性抗原受体;而免疫细胞在发育过程中对自身抗原耐受状态的形成正是为了避免对机体自身的攻击。传统认为这主要缘于自身反应性细胞或克隆的死亡性清除,即细胞选择;近年来随基因操作技术特别是转基因及基因靶导技术的成熟运用,发现这些被“清除”的细胞并非全部死亡,其中大部分是通过重新启动基因重组机制以一种“受体选择”(Receptor selection)的方式,以重组的新的非自身反应性受体替代了原自身反应性受体;同时受体选择尚参与成熟B特异性的调整,以使正参与免疫反应B细胞受体更加多样化从而适应当前免疫应答的需要。