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 hypospadi...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.展开更多
Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons.Here,we introduced and evaluated a newly modified Mathieu technique,Mathieu combined tunnel(MCT),which involves multiple...Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons.Here,we introduced and evaluated a newly modified Mathieu technique,Mathieu combined tunnel(MCT),which involves multiple custom-designed flaps for the shortage of flap source material after repeated operations;we also constructed a tunnel to avoid the glans incision that may carry new risks of dehiscence.This retrospective study included 26 patients who were consecutively admitted to the First Affiliated Hospital of Sun Yat-Sen University(Guangzhou,China)for glans dehiscence repair after failed hypospadias repair from October 2014 to October 2020;sixteen patients underwent surgery using the MCT(MCT group)and ten patients underwent surgery using the tubularized incised plate(TIP)technique(TIP group).The operative time,blood loss,postoperative complications,normal urethral meatus rate,success rate,and Hypospadias Objective Penile Evaluation(HOPE)score were compared between the two groups.The MCT group achieved an overall satisfactory penile appearance and voiding function,with a higher rate of normal urethral meatus(15/16,93.8%)and a lower rate of glans dehiscence(1/16,6.2%),compared with the TIP group(70.0%and 30.0%,respectively).However,these differences were not statistically significant,possibly because of the limited number of patients(all P>0.05).Mean postoperative HOPE scores were similar in the MCT group(mean±standard deviation:8.83±0.89)and TIP group(8.94±0.57)(P>0.05).No significant differences were found between the two groups in terms of blood loss and success rate,nor in the rates of various complications(e.g.,fistula,urethral stricture,and glans dehiscence).In conclusion,the MCT technique appears to be feasible and reliable for repairing glans dehiscence after failed hypospadias repair.展开更多
Ferroptosis,a nonapoptotic form of cell death,is an emerging potential therapeutic target for various diseases,including cancer.However,the role of ferroptosis in pancreatic cancer remains poorly understood.Pancreatic...Ferroptosis,a nonapoptotic form of cell death,is an emerging potential therapeutic target for various diseases,including cancer.However,the role of ferroptosis in pancreatic cancer remains poorly understood.Pancreatic ductal adenocarcinoma(PDAC)is characterized by a poor prognosis and chemotherapy resistance,attributed to its high Kirsten rats arcomaviral oncogene homolog mutation rate and severe nutritional deficits resulting from a dense stroma.Several studies have linked rat sarcoma(RAS)mutations to ferroptosis,suggesting that inducing ferroptosis may be an effective strategy against oncogenic RASbearing tumors.展开更多
基金supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX)the National Natural Science Foundation of China(No.82301796 to PL)the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).
文摘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.
基金supported by grants from the National Natural Science Foundation of China(No.81971314)。
文摘Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons.Here,we introduced and evaluated a newly modified Mathieu technique,Mathieu combined tunnel(MCT),which involves multiple custom-designed flaps for the shortage of flap source material after repeated operations;we also constructed a tunnel to avoid the glans incision that may carry new risks of dehiscence.This retrospective study included 26 patients who were consecutively admitted to the First Affiliated Hospital of Sun Yat-Sen University(Guangzhou,China)for glans dehiscence repair after failed hypospadias repair from October 2014 to October 2020;sixteen patients underwent surgery using the MCT(MCT group)and ten patients underwent surgery using the tubularized incised plate(TIP)technique(TIP group).The operative time,blood loss,postoperative complications,normal urethral meatus rate,success rate,and Hypospadias Objective Penile Evaluation(HOPE)score were compared between the two groups.The MCT group achieved an overall satisfactory penile appearance and voiding function,with a higher rate of normal urethral meatus(15/16,93.8%)and a lower rate of glans dehiscence(1/16,6.2%),compared with the TIP group(70.0%and 30.0%,respectively).However,these differences were not statistically significant,possibly because of the limited number of patients(all P>0.05).Mean postoperative HOPE scores were similar in the MCT group(mean±standard deviation:8.83±0.89)and TIP group(8.94±0.57)(P>0.05).No significant differences were found between the two groups in terms of blood loss and success rate,nor in the rates of various complications(e.g.,fistula,urethral stricture,and glans dehiscence).In conclusion,the MCT technique appears to be feasible and reliable for repairing glans dehiscence after failed hypospadias repair.
基金supported by the National Natural Science Foundation of China(82273228,to H.-Z.N.)the Natural Science Foundation of Shanghai(21ZR1461400,to H.-Z.N.).
文摘Ferroptosis,a nonapoptotic form of cell death,is an emerging potential therapeutic target for various diseases,including cancer.However,the role of ferroptosis in pancreatic cancer remains poorly understood.Pancreatic ductal adenocarcinoma(PDAC)is characterized by a poor prognosis and chemotherapy resistance,attributed to its high Kirsten rats arcomaviral oncogene homolog mutation rate and severe nutritional deficits resulting from a dense stroma.Several studies have linked rat sarcoma(RAS)mutations to ferroptosis,suggesting that inducing ferroptosis may be an effective strategy against oncogenic RASbearing tumors.
