Outcomes of gracilis muscle interposition for rectourethral fistulas caused by treatment of prostate cancer.

BACKGROUND: Gracilis muscle interposition (GMI) has been associated with favorable outcomes in treating complex perianal fistulas. Outcomes of GMI may vary according to the fistula etiology, particularly between rectovaginal fistulas in women and rectourethral fistulas (RUF) in men. The aim of this study was to assess the outcome of GMI to treat RUF acquired after prostate cancer treatment. METHODS: This retrospective cohort study included male patients treated with GMI for RUF acquired after prostate cancer treatment between January 2000 and December 2018 in the Department of Colorectal Surgery, Cleveland Clinic Florida. The primary outcome was the success of GMI, defined as complete healing of RUF without recurrence. Secondary outcomes were length of hospital stay and postoperative complications. RESULTS: This study included 53 male patients with a median age of 68 (range, 46-85) years. Patients developed RUF after treatment of prostate cancer with radiation (52.8%), surgery (34%), or transurethral resection of the prostate (TURP) (13.2%). Median hospital stay was 5 (IQR, 4-7) days. Twenty (37.7%) patients experienced 25 complications, the most common being wound infection and dehiscence. Primary healing after GMI was achieved in 28 (52.8%) patients. Fifteen additional patients experienced successful healing of RUF after additional procedures, for a total success rate of 81.1%. Median time to complete healing was 8 (range, 4-56) weeks. The only significant factor associated with outcome of GMI was wound dehiscence (p = 0.008). CONCLUSIONS: Although the initial success rate of GMI was approximately 53%, it increased to 81% after additional procedures. Complications after GMI were mostly minor, with wound complications being the most common. Perianal wound dehiscence was significantly associated with failure of healing of RUF after GMI.

[A prospective randomized controlled study of the therapeutic effects of a self-developed novel low-temperature boric acid wet dressing on the face and neck wounds of patients with superficial burns].

Objective: To observe and explore the clinical therapeutic effects of a self-developed novel low-temperature boric acid wet dressing on the face and neck wounds of patients with superficial burns. Methods: A prospective randomized controlled study was conducted. One hundred cases of superficial burn (sunburn) patients who met the inclusion criteria were admitted to Department of Dermatology of Chongqing Hospital of Traditional Chinese Medicine from October 2016 to June 2018, the course of sunburn was less than 15 days. According to the of random number table, the patients were divided into new dressing (ND) group (30 males and 20 females, aged (55±14) years) and conventional dressing (CD) group (28 males and 22 females, aged (59±12) years). Patients in ND group were treated with a self-developed new low-temperature boric acid wet dressing, and patients in CD group were treated with normal temperature boric acid solution wet dressing, 3 times a day. The Eczema area and severity index (EASI) score and Visual Analogue Scale (VAS) score of patients before and 14 days after treatment (patients discharged from hospital within 14 days were recorded on the day of discharge), the number of cured patients at 6, 8, 10, and 11 to 14 days after treatment, and the efficacy were compared between the patients in 2 groups. The nurse operators were investigated by self-made convenience questionnaire, and the time and convenience required of 2 dressings were compared. Data were statistically analyzed with independent sample t test or Mann-Whitey U test. Results: Before the treatment, the EASI and VAS score in those two groups showed no significantly difference (t=1.576, 1.492, P>0.05). At 14 days after treatment, the EASI score (2.4±0.4) points in ND Group was significantly lower than (4.6±0.7) points in CD Group (t=3.552, P<0.01); the VAS score (0.51±0.12) points in ND Group was significantly lower than (0.98±0.19) points in CD Group (t=3.496, P<0.01). At 14 days after treatment, the cured time of sunburns in ND Group was significantly shorter than that in CD Group (Z=-6.690, P<0.01); the treatment effects of ND Group showed better than that in CD Group (Z=3.387, P<0.01). The time for nurses operating ND was significantly shorter than that in CD (Z=-5.575, P<0.01); the nurses also believed the operation of ND was more convenient than CD (Z=-4.304, P<0.01). Conclusions: Compared with that of CD, the application of ND can shorten the recovery time and improve the treatment efficiency. At the same time, the application of ND can significantly reduce the time of nursing operations, and the material is easy to use. This new material is worthy of clinical promotion for the treatment of superficial burns.

Effect of temperature and pH on the properties of skim milk gels made from a tamarillo (Cyphomandra betacea) coagulant and rennet.

Reconstituted skim milk was gelled with a crude protease extract from tamarillo [Cyphomandra betacea or Solanum betacea (syn.)] fruit and compared with gels prepared with calf rennet. The effects of temperature and pH on the gelation of skim milk were investigated by small deformation oscillatory rheology. The tamarillo extract-induced gels had a faster rate of increase in the elastic modulus (G') at the early stage of gelation than rennet-induced milk gels. This was probably due to the broader proteolytic activity of tamarillo protease extracts as shown by sodium dodecyl sulfate-PAGE analysis. Confocal microscopy also showed that the milk gels resulting from the addition of tamarillo extracts had larger voids than rennet-induced milk gels. The proteolytic activity of tamarillo extracts was found to be optimal at pH 11. For both rennet and tamarillo extracts, the aggregation time was similar between pH 6.7 and 6.5, but the aggregation time of rennet-induced milk gels was lower than that of milk gels obtained by the addition of tamarillo extracts at pH lower than 6.5. An increase in temperature was found to have a significant effect on aggregation time, particularly at 20°C, where rennet did not coagulate milk in 3 h but the tamarillo extracts coagulated milk within 2 h. The results of this study suggest that extracts from tamarillo fruit could be used for milk gelation, particularly under lower temperature or high pH conditions.

Rhythmic auditory stimulation with visual stimuli on motor and balance function of patients with Parkinson's disease.

OBJECTIVE: Discuss the effect of rhythmic auditory stimulation with visual stimuli on motor and balance function in patients with Parkinson's disease (PD). PATIENTS AND METHODS: One hundred and sixteen patients with PD participated in this study. The control group used a routine drug treatment for eight weeks. The comprehensive treatment group used conventional drug treatment with sound rhythm metronome released as the rhythmical auditory stimulation, in accordance with the ground fixed ribbon rhythmic visual stimulation walking training for eight weeks. After four and eight weeks, the two groups of subjects took the walking parameters test, and used the disease Parkinson score scale to assess the damaged degree of motor function of PD patients. The Berg Balance Scale was used to evaluate the balance function of the PD patients. A six minute walk test was used to evaluate the walking motor function of the patients. RESULTS: The comparison between the groups suggests that after treatment of rhythmic auditory stimulation with visual stimulation group, the step size increased, frequency decreased, pace increased, and PD score scale part II decreased. As well, the PD score scale part III reduced, the six minute walking distance increased, and the Berg Balance Scale score increased significantly. There were significant differences compared with the control group after the treatment (p < 0.01). Comparison of time points suggests that after rhythmic auditory stimulation with visual stimulation group trained for eight weeks, the step size increased, frequency decreased, pace increased, and PD score scale part II were reduced. As well the PD score scale part III reduced, six minute walking distance increased, Berg Balance Scale increased. There were significant differences compared with the parameters of training for four weeks (p < 0.01). CONCLUSIONS: Rhythmic auditory stimulation with visual stimulation can improve motor and balance function of patients with PD.

Short communication: rapid detection of milk fat adulteration with vegetable oil by fluorescence spectroscopy.

This study assessed the potential application of fluorescence spectroscopy in detecting adulteration of milk fat with vegetable oil and characterizing the samples according to the source of the fat. Pure butterfat was adulterated with different vegetable oils at various concentrations (0, 5, 10, 15, 20, 30, and 40%). Nonfat and reduced-fat milk were also adulterated with vegetable oils to simulate full-fat milk (3.2%). The 2- and 3-dimensional front-face fluorescence spectroscopy and gas chromatography were used to obtain the fluorescence spectra and fatty acid profile, respectively. Principal component analysis and 3-way partial least squares regression analysis were applied to analyze the data. The pure and adulterated samples were discriminated based on the total concentration of saturated fatty acids and unsaturated fatty acids, and also on the 3 major fluorophores: tryptophan, tocopherols, and riboflavin. Fluorescence spectroscopy was able to detect up to 5% of adulteration of vegetable oil into the butterfat. The saturated fatty acids showed higher predictability than the unsaturated fatty acids (R(2) = 0.73-0.92 vs. 0.20-0.65, respectively). The study demonstrated the high potential of fluorescence spectroscopy to rapidly detect adulteration of milk fat with vegetable oil, and discriminate commercial butter and milk according to the source of the fat.

Ursolic acid promotes robust tolerance to cardiac allografts in mice.

Nuclear factor (NF)-κB is an important molecule in T cell activation. Our previous work has found that T cell-restricted NF-κB super-repressor (IκBαΔN-Tg) mice, expressing an inhibitor of NF-κB restricted to the T cell compartment, can permanently accept fully allogeneic cardiac grafts and secondary donor skin grafts. In this study, we explore if transient NF-κB inhibition by a small molecular inhibitor could induce permanent graft survival. Ursolic acid, a small molecular compound, dose-dependently inhibited T cell receptor (TCR)-triggered NF-κB nuclear translocation and T cell activation in vitro. In vivo, ursolic acid monotherapy prolonged significantly the survival of cardiac allograft in mice. Assisted with donor-specific transfusion (DST) on day 0, ursolic acid promoted 84·6% of first cardiac grafts to survive for more than 150 days. While the mice with long-term surviving grafts (LTS) did not reject the second donor strain hearts for more than 100 days without any treatment, they all promptly rejected the third-party strain hearts within 14 days. Interestingly, this protocol did not result in an increased proportion of CD4(+) CD25(+) forkhead box P3(+) regulatory T cells in splenocytes. That adoptive transfer experiments also did not support regulation was the main mechanism in this model. Splenocytes from LTS showed reduced alloreactivity to donor antigen. However, depletion of CD4(+) CD25(+) regulatory T cells did not alter the donor-reactivity of LTS splenocytes. These data suggest that depletion of donor-reactive T cells may play an important role in this protocol.

Cloning and expression analysis of phytoene desaturase and ζ-carotene desaturase genes in Carica papaya.

The fruit flesh color of papaya is an important nutritional quality trait and is due to the accumulation of carotenoid. To elucidate the carotenoid biosynthesis pathway in Carica papaya, the phytoene desaturase (PDS) and the ζ-carotene desaturase (ZDS) genes were isolated from papaya (named CpPDS and CpZDS) using the rapid amplification of cDNA ends (RACE) approach, and their expression levels were investigated in red- and yellow-fleshed papaya varieties. CpPDS contains a 1749 bp open reading frame coding for 583 amino acids, while CpZDS contains a 1716 bp open reading frame coding for 572 amino acids. The deduced CpPDS and CpZDS proteins contain a conserved dinucleotide-binding site at the N-terminus and a carotenoid-binding domain at the C-terminus. Papaya genome sequence analysis revealed that CpPDS and CpZDS are single copy; the CpPDS was mapped to papaya chromosome LG6, and the CpZDS was mapped to chromosome LG3. Quantitative PCR showed that both CpPDS and CpZDS were expressed in all tissues examined with the highest expression in maturing fruits, and that the expression of CpPDS and CpZDS were higher in red-fleshed fruits than in yellow-fleshed fruits. These results indicated that the differential accumulation of carotenoids in red- and yellow-fleshed papaya varieties might be partly explained by the transcriptional level of CpPDS and CpZDS.

Endoscopic decompression using a transanal drainage tube for acute obstruction of the rectum and left colon as a bridge to curative surgery.

OBJECTIVE: The aim of this study was to clarify the usefulness of the management of acute left colon and rectum obstruction because of colorectal carcinoma using a transanal ileus drainage tube before curative surgery. METHOD: Forty-six patients (24 males and 22 females, aged 24-94 years, mean = 56.2) treated between September 2005 and March 2007 for acute left colon and rectal obstruction were identified in a colorectal obstruction database, and their clinical and radiological features were reviewed. After a cleaning enema was administered, urgent colonoscopy was performed. Subsequently, endoscopic decompression using a ileus tube was attempted. RESULTS: Endoscopic decompression using the ileus tube was technically successful in 45 of 46 patients (97.8%). Perforation occurred in one patient 3 days later and emergent operation was performed. The site of obstruction was the rectum in 15 patients, the sigmoid colon in 18, the descending colon in 13. Following adequate cleansing of the colon, patients' abdominal girth were decreased from 91 +/- 4 cm before drainage to 82 +/- 2 cm 7 days later, and one-stage surgery after 8 +/- 1 days (SD; range 7-10 days) were performed. No anastomotic leakage or postoperative stenosis occurred after operation. CONCLUSION: Management of acute left colon and rectum obstruction because of colorectal carcinoma using the ileus tube was found to be effective and safe, considered as a bridged method before curative surgery.

A pulsed electron gun for ultrafast electron diffraction at surfaces.

The construction of a pulsed electron gun for ultrafast reflection high-energy electron diffraction experiments at surfaces is reported. Special emphasis is placed on the characterization of the electron source: a photocathode, consisting of a 10 nm thin Au film deposited onto a sapphire substrate. Electron pulses are generated by the illumination of the film with ultraviolet laser pulses of femtosecond duration. The photoelectrons are emitted homogeneously across the photocathode with an energy distribution of 0.1 eV width. After leaving the Au film, the electrons are accelerated to kinetic energies of up to 15 keV. Focusing is accomplished by an electrostatic lens. The temporal resolution of the experiment is determined by the probing time of the electrons traveling across the surface which is about 30 ps. However, the duration of the electron pulses can be reduced to less than 6 ps.

Studies on the preparation, crystal structure and bioactivity of ginsenoside compound K.

Microbial transformation of Panaxnotoginseng saponins (PNS) using Aspergillus niger afforded, as the main metabolite, ginsenoside compound K (20-O-beta-glucopyranosyl-20(S)-protopanaxadiol). Its structure was determined spectroscopically and by X-ray analysis, and this is the first time the crystal structure of ginsenoside has been reported. In comparison with ginsenoside Rb1, the pro-drug for this metabolite, compound K exhibits potent cytotoxic activity against tumor cell lines. The mean concentrations of compound K needed to inhibit the proliferation of cells by 50% (IC50) were 12.7, 11.4, 8.5 and 9.7 microM for mouse high-metastatic melanoma (B16-BL6), human hepatoma (HepG2), human myeloid leukemia (K562) and human high-metastatic lung carcinoma (95-D) cell lines, respectively. The data show that ginsenoside compound K is a good antitumor drug candidate.

Improved arachidonic acids production from the fungus Mortierella alpina by glutamate supplementation.

The effect of various concentrations of glutamate on arachidonic acid (AA) production from Mortierella alpina in shaker flask culture was studied. Glutamate supplementation promoted Mortierella growth, accelerated substrate metabolism, and increased AA production, and a concentration of 0.8 g/l glutamate resulted in the greatest AA yield (1.41 g/l). In 10 l airlift stirred fermenter culture, AA yield in the cultures exposed to 0.8 g/l glutamate was also greater than that in the control (0.56 g/l).

Cloning of DGAT2, a second mammalian diacylglycerol acyltransferase, and related family members.

Studies involving the cloning and disruption of the gene for acyl-CoA:diacylglycerol acyltransferase (DGAT) have shown that alternative mechanisms exist for triglyceride synthesis. In this study, we cloned and characterized a second mammalian DGAT, DGAT2, which was identified by its homology to a DGAT in the fungus Mortierella rammaniana. DGAT2 is a member of a gene family that has no homology with DGAT1 and includes several mouse and human homologues that are candidates for additional DGAT genes. The expression of DGAT2 in insect cells stimulated triglyceride synthesis 6-fold in assays with cellular membranes, and DGAT2 activity was dependent on the presence of fatty acyl-CoA and diacylglycerol, indicating that this protein is a DGAT. Activity was not observed for acyl acceptors other than diacylglycerol. DGAT2 activity was inhibited by a high concentration (100 mm) of MgCl(2) in an in vitro assay, a characteristic that distinguishes DGAT2 from DGAT1. DGAT2 is expressed in many tissues with high expression levels in the liver and white adipose tissue, suggesting that it may play a significant role in mammalian triglyceride metabolism.

[Identification of seeds of Cuscuta australis and C. chinensis by TLC and HPLC].

Identification of seeds of Cuscuta australis R. Br. and C. chinensis Lam. was carried out by TLC and HPLC. Polyamide membrane was used as stationary phase, MeOH-HOAc-H2O and CHCl3-MeOH-HOAc were used as mobile phase for TLC. For HPLC, Hypersil-ODS column was used; the mobile phase was MeOH-0.025 M H3PO4; the flow rate was 1.0 ml.min-1; detection wavelength was 360 nm; and column temperature was 40 degrees C. Both methods represented significant identification characteristics, and were simple, accurate and reproducible.

[Serapharmacological effect of kangxian ruangan granula on the proliferation of hepatic stellate cells].

OBJECTIVE: To investigate the antifibrotic mechanism of kangxian ruangan granula (KXRGG) at cellular level. METHOD: HSC were isolated from the normal rats by enzyme digestion and density gradient centrifugation, cultured, identified and subcultured. The medicated sera were prepared to incubated with the subcultured HSC. Sodium chloride sera and colchicines sera were taken as control groups. HSC viability was observed by 3H-proline; cell proliferation was measured with 3H-TdR incorporation and MTT colorimetric assay. RESULT: KXRGG medicated serum had no effect on the cellular shape and elevated 3H-proline incorporation (P < 0.01). Drug serum obviously inhibited 3H-TdR incorporation and MTT transformation (P < 0.01), and the latter had a drug concentration-dependent tendency. CONCLUSIONS: KXRGG can elevate cellular viability and has no toxic effect. The formula can inhibit the proliferation of HSC, which may be one of the cellular mechanisms of its antifibrotic action.

Coumarins and bicoumarin from Ferula sumbul: anti-HIV activity and inhibition of cytokine release.

The methanol extract of the dried roots of Ferula sumbul afforded two furanocoumarin esters, fesumtuorin A, B, one bicoumarin, fesumtuorin C, five spirobicoumarins, fesumtuorin D, E, F, G and H, along with nineteen known coumarins. Their structures were established on the basis of spectroscopic studies. Some of the isolated compounds showed anti-HIV activity and very weak inhibition of cytokine release.

[Studies on chemical components of the volatile oil from the leaves of Hypericum perforatum].

OBJECTIVE: To determine the volatile oil of the leaves from Hypericum perforatum L.. METHOD: The essential oil was obtained by simultaneous distillation and solvent extraction. The chemical components were seperated and identified by GC-MS. The relative contents in the volatile oil were determined by area nomalization. RESULTS: 54 chemical constituents were separated and identified representing 92.32% of the total contents. CONCLUSION: Sesquiterpenes are major chemical constituents in the oil from the leaves of Hypericum perforatum L.. They are very different from those of the essential oil from the same species from the other country.

[Light puncture combined with longhu xingnao granules in treating acute traumatic intracranial hematoma].

OBJECTIVE: To confirm the clinical therapeutic effectiveness of Longhu Xingnao Granule (LHXNG) medicated after light puncture in treating acute traumatic intracranial hematoma. METHODS: Patients were randomly divided into two groups, 30 patients of the tested group were treated with LHXNG after light puncture and 20 patients of the control group treated with western medicine alone. RESULTS: The effect of the tested group was evidently superior to the control group (P < 0.05) and with a markedly shortened resuscitation time (P < 0.05). CONCLUSION: LHXNG has the function of promoting blood circulation and arresting bleeding, and improving resuscitation. In coordination with light puncture, it could improve the living quality of patients, shorten the resuscitation and treatment time, so as to reduce the maim and death rate.

[Clinical study of glibenclamide in combination with kelening treatment in non-insulin dependent diabetes mellitus].

OBJECTIVE: To asses the efficacy of combination therapy of glibenclamide and Kelening in treating the non-insulin dependent diabetes mellitus (NIDDM). METHODS: Sixty-five patients with NIDDM were randomly divided into two groups. One group was treated with both glibenclamide and Kelening, the other with glibenclamide alone. RESULTS: After treatment for 12 weeks, the levels of fasting blood glucose (FBG), postprandial blood glucose (PBG) and HBAIC were reduced significantly in glibenclamide-Kelening group. In both groups, the degree dropped of the levels of FBG were almost the same, but the levels of PBG and HBAIC in glibenclamide-Kelening group were reduced more significantly than those in glibenclamide group, and the incidence of hyperinsulinemia had dropped considerably. CONCLUSION: Glibenclamide in combination with Kelening in the treatment of NIDDM is more effective and less toxic, and the combination may reduce the dosage of glibenclamide in NIDDM.

[Detection of konjac glucomannan in seven Amorphophallus Blume species].

Seven Amorphophallus species were detected for konjac glucomananam (KGM). It has been found out that A. albus, A. konjac, A. yuloensis, A. xemengensis and A. dunnii are of higher contents of KGM (30%), but A. sinensis and A. yunnanensis are not as further comfirmed by TLC analysis. It follows that A. albus, A. konjac, A. yuloensis, A. xemengensis and A. dunnii are high quality resources of KGM, but A. sinensis and A. yunanensis cannot be used as substitutes for the above-cited five species.