| Objective: to investigate methylation status of individual Cp G sites in Chinese groups throughout the androgen genes by high throughput analysis and access whether the epigenetic modification of the Cp G island methylation related to the mechanism of hypospadias.And to compare the outcomes of the buccal mucosa and lingual mucosa used in the multiple failed hypospadias of children.Method: 1.To investigate the reason of the hypospadias,96 patients were collected in our hospital from January 2012 to May 2015.Age ranges from 3.5y to 8y(mean±SD,5±1.5y).We have separated the patients into two groups(mild :55 vs severe :41)based on the urethral opening during operation.27 age matched control children undergoing a surgical procedure for circumcision were studied with normal development of penis,urethra,and urethral opening.Age ranges from 3.7y to 7.5y(mean±SD,5±0.8y).high throughput analysis was performed on the groups using the Illumina Genome Analyzer IIx,which could lead to the direct investigation of methylation status of AR and SRD5A2 Cp G sites throughout the genome.The methylation level at each Cp G site was compared between cases and controls using t test.2.The treatment of hypospadias we have collected 62 children who have received the buccal or lingual mucosa graft in our hospital from 2012 to 2015.The age ranges from 3.5y-11 y.All cases are multiple failed hypospadias,and they have received operations about 2-4times.They come to our hostipal In order to resolve the problem.All patients have redone with one-stage operation.33 cases were treated with lingual mucosa graft(mean7.5±0.2,3.5-11y),and all are with operations 2-4 times(mean 2.8±0.7).The area of grafts: width: 0.5-1cm,length: 2-5cm.Our follow up is 5months to 2y(average1.3y).25 patients have receive lingual mucosal grafts and 23 have received buccal lingual mucosal.The area of grafts: width: 0.5-1.5cm(mean1.2±0.21cm),length: 2-6cm(mean5.1±0.22cm).Our follow up is 5months to 1y(mean8.3±1.3m).29 cases were treated with buccal mucosa graft(mean7.0±0.5,4-9.2y),and all are with operations 2-4 times(mean 2.5±0.2).The area of grafts: width: 0.5-1.5cm(mean1.0±0.11cm),length: 2-5.3cm(mean4.5±0.14cm).Our follow up is 5months to 1y(mean).25 patients have receive lingual mucosal grafts and 23 have received buccal lingual mucosal.The area of grafts: width: 0.5-1.5cm(mean1.2±0.21cm),length: 2-6cm(mean5.1±0.22cm).Our follow up is 5months to 1y(mean7.6±0.7m).The results are tested by SPSS 18.0.Rates of complications are compared by chi-squre and t test.Results: For the reason: There is no significant difference between the patients and control group about the Cp G island of AR gene(p>0.05),mean±SD,0.112±0.048Vs0.107±0.019,P=0.414;there is significant difference about the Cp G island of SRD5A2 gene(p< 0.05),mean±SD,0.044±0.008 Vs 0.039±0.006,P=0.002.For the treatment,the outcomes of two groups: There is no significant difference between groups on the age,preoperative times,the length and width of the grafts.There is no significant difference between groups on the follow up outcomes.lingual mucosal grafts group: fistula:2/29(6.8%),stricture:1/33(3.0%),ventral curcature: 2/33(6.0%).Complication: 5/29(17.0%),successful rate: 24/29(83.0%),Hose score: 14.28±0.12;buccalmucosal grafts group: fistula2/29(6.8%),stricture2/29(6.8%),ventral curcature: 1/29(3.4%).Complication rate: 5/29(17.0%),successful rate: 24/29(83.0%),Hose score: 14.28±0.12.There is no differences between two groups on the overall success and complication rates and the Hose scores.Conclusion: Methylation status of individual Cp G sites in Chinese groups throughout the androgen genes by high throughput analysis have showed that the epigenetic modification of the Cp G island methylation less corrected to the mechanism of hypospadias.The lingual mucosal graft and the buccal mucosa graft have all reached good outcome,and the lingual mucosa graft makes up the advantages of the buccal mucosa graft which has provided a reliable way to the multiple failed hypospadias of children?... |
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