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To investigate the causes of abnormally short frenulum induced by circumcision with disposable circumcision suture device and the improvement of the surgical method.We retrospectively analyzed the clinical data on 320 cases of phimosis or redundant prepuce treated from January 2020 to September 2020, including 160 children (group A) and 160 adults (group B), each further divided into an observation group (n = 80, groups A1 and B1) and a control group (n = 80, groups A2 and B2). The patients in groups A1 and B1 underwent circumcision by suture positioning at the frenulum with the disposable circumcision suture device, and those in groups A2 and B2 received conventional circumcision with the disposable circumcision suture device. We compared the operation time, incidence rate of abnormally short frenulum and Visual Analogue Scale (VAS) score at 6 hours after surgery among the four groups of patients.Statistically significant differences were observed between groups A1 and A2 in the operation time (12.00 ［11.00, 13.00］ vs 8.50 ［8.50, 9.00］ min, P0.05) and the incidence rate of abnormally short frenulum (0 vs 10%, P0.05) but not in the VAS score (3.00 ［3.00, 4.00］ vs 3.00 ［3.00, 3.75］, P0.05). Statistically significant differences were also found between groups B1 and B2 in the operation time (12.00 ［11.00, 12.00］ vs 6.25 ［6.00, 7.00］ min, P0.05) and the incidence rate of abnormally short frenulum (0 vs 7.5%, P0.05) but not in the VAS score (2.00 ［2.00, 3.00］ vs 2.00 ［2.00, 3.00］, P0.05).Abnormally short frenulum induced by circumcision with the disposable circumcision suture device is mainly attributed to ligation and fixation of the prepuce with the fixation band. Circumcision with the disposable circumcision suture device by suture positioning at the frenulum is a safe and effective method worthy of clinical promotion.

To present our experience in the diagnosis and treatment of prostate sarcoma and the clinical and prognostic features of the malignancy.We retrospectively analyzed the clinical data on 26 cases of prostate sarcoma treated in our hospital from June 1998 to March 2018. The patients ranged in age from 15 to 64 years (［41 ± 14］ yr) and in the PSA level from 0.345 to 5.213 μg/L (［1.762 ± 1.184］ μg/L), all diagnosed with prostate sarcoma by prostatic biopsy and pathological examination after transurethral resection of the prostate (TURP).Postoperative pathological examination showed 11 cases of leiomyosarcoma, 6 cases of rhabdomyosarcoma, 4 cases of spindle cell sarcoma, 4 cases of fibrosarcoma and 1 case of undifferentiated sarcoma among the total number of patients. Twenty-four of the patients were followed up for 3 to 18 (mean 13) months, of whom 21 died within 12 months and the other 3 within 13－18 months after diagnosis, all due to extensive metastases.Prostate sarcoma is a rare malignancy clinically, highly aggressive and with very poor prognosis. Surgery remains the main treatment option, but multiple disciplinary diagnosis and treatment could probably achieve a better prognosis for prostate sarcoma.

To introduce different surgical treatment for gyncomastia at different grades.37 cases with gynecomastia were divided into three grades as: grade I with fat as main tissue, grade II with proliferated fibro-gland as main tissue, grade III with big and ptosis breasts and sagging skin. Different surgical methods were chosen according to the different grades of gyncomastia. These include liposuction, subareolar fibroglandular tissue removing, combined technique of the two methods, and breasts resection with free transplantation of nipple-areola complex.All patients were satisfied for the appearance of post-operative flat male chest. Complications, such as scar, numbness of nipple and areola were acceptable for them.Different surgical methods should be chosen for the gynecomastia at different grades. It can improve both the physical and psychological problems for patients.

Hypertrophic scars are fibroproliferative disorders of excessive wound healing after skin injury. Vascular endothelial growth factor (VEGF)-induced angiogenesis plays a major role in fibrogenesis and hypertrophic scar formation. Over recent years, there has been a major interest in homeobox gene regulation of VEGF-VEGFR mediated angiogenesis in dermal tissue. In the current study, we investigated the role of homeobox genes in the epidermis, for their role in angiogenesis, with a focus on epidermal-mesenchymal interactions. As epidermal stem cells (ESCs) have a central role in epidermal homeostasis, we tested the hypothesis that these cells play a key role in the pathogenesis of hypertrophic scars through the HOXA9-VEGF/VEGFR signaling pathways. We found significant differences in the expression of homeobox A9 in hyperplastic scar tissue during different phases of development. These differences coincided with similar regulations in VEGF expression and with the distribution of ESCs. HOXA9 is expressed in cultured human ESCs in vitro. Antisense suppression of HOXA9 expression was found to suppress VEGF levels in ESCs. Together these findings indicate that homeobox A9 regulates the expression of VEGF in ESCs.

Bombesin (BBN) is a peptide exhibiting high affinity for the gastrin-releasing peptide receptor (GRPR), which is overexpressed on several types of cancers. Various GRPR antagonists and agonists have been labeled with radiometals for positron emission tomography (PET) imaging of GRPR-positive tumors. However, unfavorable hepatobiliary excretion such as high intestinal activity may prohibit their clinical utility for imaging abdominal cancer. In this study, the modified BBN peptide with a new hydrophilic linker was labeled with (68)Ga for PET imaging of GRPR-expressing PC-3 prostate cancer xenograft model. GRPR antagonists, MATBBN (Gly-Gly-Gly-Arg-Asp-Asn-D-Phe-Gln-Trp-Ala-Val-Gly-His-Leu-NHCH2CH3) and ATBBN (D-Phe-Gln-Trp-Ala-Val-Gly-His-Leu-NHCH2CH3), were conjugated with 1,4,7-triazacyclononanetriacetic acid (NOTA) and labeled with (68)Ga. Partition coefficient and in vitro stability were also determined. GRPR binding affinity of both tracers was investigated by competitive radioligand binding assay. The in vivo receptor targeting potential and pharmacokinetic of (68)Ga-NOTA-MATBBN were also evaluated in PC-3 prostate tumor model and compared with those of (68)Ga-NOTA-ATBBN. NOTA-conjugated BBN analogs were labeled with (68)Ga within 20 min with a decay-corrected yield ranging from 90 to 95 % and a radiochemical purity of more than 98 %. The specific activity of (68)Ga-NOTA-MATBBN and (68)Ga-NOTA-ATBBN was at least 16.5 and 11.9 GBq/μmol, respectively. The radiotracers were stable in phosphate-buffered saline and human serum. (68)Ga-NOTA-MATBBN was more hydrophilic than (68)Ga-NOTA-ATBBN, as indicated by their log P values (-2.73 ± 0.02 vs. -1.20 ± 0.03). The IC50 values of NOTA-ATBBN and NOTA-MATBBN were similar (102.7 ± 1.18 and 124.6 ± 1.21 nM). The accumulation of (68)Ga-labeled GRPR antagonists in the subcutaneous PC-3 tumors could be visualized via small animal PET. The tumors were clearly visible, and the tumor uptakes of (68)Ga-NOTA-MATBBN and (68)Ga-NOTA-ATBBN were determined to be 4.19 ± 0.32, 4.00 ± 0.41, 2.93 ± 0.35 and 4.70 ± 0.40, 4.10 ± 0.30, 3.14 ± 0.30 %ID/g at 30, 60, and 120 min, respectively. There was considerable accumulation and retention of (68)Ga-NOTA-ATBBN in the liver and intestines. In contrast, the abdominal area does not have much retention of (68)Ga-NOTA-MATBBN. Biodistribution data were in accordance with the PET results, showing that (68)Ga-NOTA-MATBBN had more favorable pharmacokinetics and higher tumor to background ratios than those of (68)Ga-NOTA-ATBBN. At 1 h postinjection, the tumor to liver and intestine of (68)Ga-NOTA-MATBBN were 8.05 ± 0.56 and 21.72 ± 3.47 and the corresponding values of unmodified counterpart were 0.85 ± 0.23 and 3.45 ± 0.43, respectively. GRPR binding specificity was demonstrated by reduced tumor uptake of radiolabeled tracers after coinjection of an excess of unlabeled BBN peptides. (68)Ga-NOTA-MATBBN exhibited GRPR-targeting properties both in vitro and in vivo. The favorable characterizations of (68)Ga-NOTA-MATBBN such as convenient synthesis, specific GRPR targeting, high tumor uptake, and satisfactory pharmacokinetics warrant its further investigation for clinical cancer imaging.

To observe the change in albumin concentration in the subeschar tissue fluid of rabbits in early stage after burn, and to analyze its regular pattern.Thirty-four adult male New Zealand rabbits were divided into control group and experiment group according to the random number table, with 17 rabbits in each group. Rabbits in experiment group were subjected to 8% TBSA full-thickness scald on the back and were injected with human serum albumin in subeschar tissue serving as tracing albumin. 1.5 mL blood sample was collected at post scald hour (PSH) 2, 4, 8, 16, 24, 48, 72 respectively. Rabbits in control group were dealt with the above-mentioned procedures except for scald. The concentration of tracing albumin was measured with the enzyme-linked immunosorbent assay kit. The concentration of the serum albumin of rabbits were determined with biochemical analyzer. Pharmacokinetics parameters of tracing albumin were calculated with fitting model of 3P97 practical pharmacokinetics calculating program.(1) Concentration of tracing albumin of rabbits in experiment group was respectively higher than that in control group (P0.01) at each time point, and it peaked at PSH 8 [(421 +/- 10) microg/L]. (2) The concentration of serum albumin of rabbits in experiment group decreased in the beginning and increased later, while no significant change was observed in control group. (3) The distribution phase half-life of tracing albumin of rabbits in experiment group (4.0271 h) was about 1/3 of that of the control group (12.0907 h); while the area under the curve in the experiment group (22 336.38 microg.h.mL(-1)) was about 4 times of that in the control group (5827.77 microg.h.mL(-1)).The albumin in the subcutaneous tissue could be absorbed into blood circulation in normal conditions. The resorption occurs earlier and faster and more when obvious inflammation occurs (such as deep burn). Exudation and resorption of albumin co-exist in the early stage after burn.

To investigate the concentration and pharmacokinetics changes of amikacin in the serum and blister fluid in severe burn patients at early stage.Twenty severe burn patients during early postburn stage were divided into four groups with five patients in each group. Each patient was given a single dose of 400 mg amikacin in 30 minutes during 3-4 postburn hour (PBH) in A group, at 10 PBH in B group, at 20 PBH in C group, and at 30 PBH in D group. The concentration of amikacin in blister fluid was examined at 0.25, 0.5 min and 1, 2, 3, 4, 5, 6, 7 h after treatment by fluorescence polarization immunoassay, meanwhile, the venous blood of 9 patients among them was also collected to determine the concentration of amikacin at the same time points. Pharmacokinetics parameters of model were produced by program 3P97.Among all groups, the concentration of amikacin in blister fluid in A group increased quickest and maintained longest, that of B group ranked second. The amikacin concentration of blister fluid in A, B groups were obviously higher than those in C, D groups at each time point (P0.05 orP0.01), especially at 1PBH (12.53 +/- 1.76, 9.52 +/- 1.51 microg/mL vs 4.65 +/- 0.77, 3.10 +/- 0.41 microg/ml, P0.01). The serum concentration of amikacin in 9 patients were decreasing along with elapse of time. The amikacin concentration-time curves in blister fluid and serum were best fit in two compartment models. Compared with that in normal value, t1/2beta of amikacin from burn patient was shortened in serum and prolonged in blister fluid.Early administration of amikacin in burn patients (within 10 PBH) may form an effective and continuous antibiotics barrier around the wound to prevent bacterial infection.

To determine the adequate timing of antibiotics application in severely burned patients by observing the dynamic changes of amikacin in blister fluid during early postburn stage.Twenty patients in early stage of sever burns were divided into 4 groups (n=5) according to the timing of amikacin administration, namely at 3-4 h (group A), 10 h (group B, 20 h (group C), and 30 h (group D) postburn. Amikacin was administered intravenously via a single dose of 400 mg within 30 min, and at the time points of 0.25 to 7 h after completion of the infusion, the blister fluid was collected from each patient for determination of amikacin concentration with fluorescence polarization immunoassay.Fifteen minutes after intravenous administration, amikacin could be detected in the blister fluid, reaching the highest level at 1-2 h after administration followed by gradual declination. In group B, blister fluid amikacin concentration reached 4.96+1.60 microg/ml 15 min after administration, and at the subsequent time points until 4 h, amikacin concentration was significantly higher in groups A and B than in groups C and D (P0.05). Amikacin concentration in the blister fluid in group D was not sufficient for effective antibacterial therapy.Amikacin administration in the early postburn stage may ensure higher amikacin concentration in the blister fluid and wound exudate. Better antibacterial effect can be expected when amikacin is applied within the initial 10 h postburn.

To investigate the changes in pharmacokinetic parameters of vancomycin in the subeschar tissue fluid (STF) at early post-burn stage in patients with severe burns.Ten patients with severe burns were enrolled in the study and received intravenous injection of 500 mg vancomycin at an even rate within 60 mins 1 to 2 hours after admission. A total of 0.5 ml STF was collected each time and the concentration of vancomycin in the STF was determined by fluorescence polarization immunoassay (FPIA) method at 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 post-burn hours (PBH). Pharmacokinetic parameters of vancomycin were produced by program 3P97 and statistically analyzed by program package SPSS10. 0.The STF concentration-time curves of vancomycin were best fit in two compartment model. Pharmacokinetic parameters of vancomycin in the STF were: t1/2alpha = (3.7 +/- 2.6) h, t1/2beta = (92 +/- 12)h, Vc = (26 +/- 6)L, AUC = (1279 +/- 256) microg x h x ml(-1), CLs = (0.40 +/- 0.08) L/h.When vancomycin is used early after severe burns, the drug can be retained in the third space, and the concentration of the drug can be maintained for over 24hrs, and it is beneficial to form an antibiotic barrier around the wound to prevent an invasive bacterial infection to the burn wound.

To investigate the changes of pharmacokinetic parameters of amikacin in the subeschar tissue fluid (STF) in the early stage of severe burns.Amikacin concentration in the STF of 10 severely burned patients were determined by fluorescence polarization immunoassay (FPIA) at different time points after intravenous amikacin infusion of the initial dose of 400 mg given within 60 min. The pharmacokinetic parameters of amikacin were measured using 3P97 program and statistically analyzed with SPSS10.0 software.After the initial dose of 400 mg of amikacin, the STF concentration-time curves of amikacin were fitted in two compartment model. The pharmacokinetic parameters of amikacin in the STF were: t(1/2alpha)=(4.35-/+1.66) h, t(1/2beta)= (80.04-/+9.52) h, Vc= (13.17-/+1.32) L, AUC= (1802.49-/+285.68) microg. h.ml(-1), and CLs= (0.2272-/+0.0383) L. h(-1), demonstrating significantly lower clearance and longer elimination half life of amikacin in the STF following amikacin administration in early stage of severe burns. Elimination half-life of amikacin in the STF in severely burned patients was 28.20-44.78 times longer than that in the serum of normal volunteers, and the effective inhibitory concentration of amikacin could maintain for at least 24 h, suggesting antibiotic retention in the third space after early and short-term use of potent antibiotics and formation of antibiotic barrier in the STF, which may help prevent bacterial infection of the wound.

The specific aim of this study was to investigate the pharmacokinetic parameters of antibiotics represented by vancomycin and amikacin in the subeschar tissue fluid (STF) in patients with early stage severe burn. Twenty patients were studied: age 30.7+/-8.0 years old, weight 60.6+/-8.4 kg, total burn surface area (TBSA) 68.39+/-17.85%, creatinine clearance (CCr) 95.45+/-23.14 ml/min, mean+/-S.D. Patients received intravenous infusion of 500 mg vancomycin (10 patients) or 400mg amikacin (10 patients) for 60 min at 24h after burn. Subeschar tissue fluid (STF) samples were collected at 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 h at the end of infusion. Concentrations of these antibiotics in the samples were determined by fluorescence polarization immunoassay (FPIA) method. Pharmacokinetic parameters of vancomycin and amikacin were calculated by the use of Program 3P97 and statistical analyses were performed by the use of Program Package SPS S10.0. The concentration-time curves of vancomycin and amikacin in the STF were both fitted in two-compartment model. Pharmacokinetic parameters of vancomycin in the STF were: distribution half-life (t(1)/2alpha)=3.74+/-2.64 h, elimination half-life (t(1)/2beta)=92.18+/-11.73 h, apparent volume of distribution (V(c))=25.64+/-5.68 L, area under the curve (AUC)=1279.42+/-256.12 microg h ml(-1), clearance (CLs)=0.4048+/-0.0788 L h(-1). Pharmacokinetic parameters of amikacin in the STF were: t(1)/2alpha=4.35+/-1.66 h, t(1)/2beta=80.04+/-9.52 h, V(c)=13.17+/-1.32 L, AUC=1802.49+/-285.68 microg h ml(-1), CLs=0.2272+/-0.0383 L h(-1). This study demonstrated significant low clearance, long half life of vancomycin and amikacin in the STF in patients with severe burn compared to the parameters obtained in the serum of normal volunteers in previous studies. Elimination half-lives (t(1)/2beta) of vancomycin and amikacin in the STF of severe burns were 18.75-34.87 times and 28.20-44.78 times longer than those in the serum of normal volunteers, respectively. Concentrations of vancomycin and amikacin in STF at 24h after the end of a single dose infusion was higher than MIC on common pathogenic bacteria. Their effective inhibitory concentration were maintained at least for 24h. There was antibiotic retention in the third space after early and short-term use of potent antibiotics. An antibiotic barrier could form in the STF, and could prevent an invasive bacterial infection from burn wound.

To investigate the effect of intralipid on protein consumption in severe burned patients. METHODS; Sixty-seven nonoperative patients with severe burns were divided into Intralipid treatment group and non-intralipid treatment group (control group), and the former was treated with 20% intralipid (500 ml once a day) from postburn day 4 for 10 consecutive days. Venous blood samples were collected from these patients for testing total protein, albumin, total cholesterol and triglyceride on postburn days 1, 7 and 14, respectively.The levels of total protein, albumin, total cholesterol and triglyceride were within normal range on postburn day 1 in both groups, and only the albumin level was lowered in the groups on day 7 but at comparable magnitudes (32+/-4.83 vs 31+/-5.04 g/L, P0.05). In contrast, the levels of total protein, albumin, total cholesterol and triglyceride were below the normal range on postburn day 14 in both groups, but intralipid treatment group showed more albumin loss than the control group (28+/-6.46 vs 23+/-7.03 g/L, P0.01).Intralipid (20%) provides good energy source to ameliorate albumin loss in severe burned patients.

To investigate the effect of asiaticoside on the expressions of transforming growth factor (TGF)-beta mRNA, matrix metalloproteinases (MMPS) and tissue inhibitors of metalloproteinases (TIMPs) in postburn hypertrophic scars.Nine specimens of postburn (5-8 months) hypertrophic scars with asiaticoside treatment and 9 without asiaticoside treatment were collected for testing the expressions of MMPS, TIMPs, type I and III collagen and TGF-beta mRNA by immunohistochemistry and in situ hybridization methods, followed by image analysis of the results.The expressions of TGF-beta mRNA and MMPS/TIMPS were all detected in the fibroblast cytoplasm. The expression of TGF-beta(1) mRNA in asiaticoside-treated scars was significantly lower than that in scars without asiaticoside treatment (P0.01). In contrast, the expression of TGF-beta(3) mRNA was significantly higher in asiaticoside group (P0.05). The expression of TIMP1 in asiaticoside group was significantly lower than that in non-asiaticoside group (P0.01), and the expression of type I collagen in asiaticoside-treated scars was lower than that in non-asiaticoside-treated specimens (P0.05), but the expression of MMP(1), MMP(2) and TIMP(2) and type III collagen exhibited no significant differences between the two groups (P0.05).Asiaticoside can down-regulate TGF-beta(1) mRNA and TIMP(1) expressions and up-regulate TGF-beta(3) mRNA expression in postburn hypertrophic scars, and is also capable of decomposing the products of type I collagen, contributing to the reduction of hypertrophic scar formation.