Objective:To investigate the application effect of the compound flap transfer in tubularized incised plate (TIP) urethroplasty.Methods:Children with hypospadias who received TIP in the Department of Pediatric Urology, the Affiliated Xuzhou Children’s Hospital of Xuzhou Medical University from January 2018 to March 2022 were prospectively divided into compound flap transfer group (group A) and traditional TIP group (group B) by random number method. Group A was treated with TIP modified by compound flap transfer, and group B was treated with traditional TIP covered with fascia.The improvement of the compound flap transfer for TIP operation is mainly reflected in the multi-layer cover of the new urethra and the free skin embedded in the incision of the penile head. According to the intention-to-treat (ITT) principle, the final full analysis set (FAS) includes both group A and group B. Some patients were excluded from the analysis of the primary endpoint events due to reasons such as loss to follow-up or treatment group switch. Additionally, the final per-protocol set (PPS) consisting of group A and group B, which adheres to the study protocol, is subjected to statistical analysis.Independent sample t-test or Wilcoxon rank sum test was used for average age, the width of the penile head, degree of chordee, length of neourethra, and operative time. The classification of hypospadias, proportion of dorsal tunica albuginea plication, and incidence of postoperative complications were compared using the Chi-square test or Fisher’s exact test, P < 0.05 was considered statistically significant. Results:According to ITT principles, 50 children were included in FAS group A, ranging in age from 8 months to 15 years and 2 months, with an average age of 4 years. Group B included 50 children, ranging in age from 10 months to 14 years and 9 months, with an average age of 4 years and 1 month. Thirty-seven children in PPS group A were included, ranging in age from 1 year 2 months to 12 years 1 month, with an average age of 4 years. Group B consisted of 41 children, ranging in age from 1 year 2 months to 11 years 9 months, with an average age of 4 years 2 months. Statistical analysis showed that no matter FAS set or PPS, there were no statistically significant differences in the mean age, hypospadias type, average penile head width, average penile subcurvature number, number of dorsal tunica albuginea plication, and the average length of plastic neourethra between group A and group B ( P > 0.05). The average operative time of group A was higher than that of group B. The difference was statistically significant ( P < 0.05). The postoperative follow-up was 3 to 48 months, with an average follow-up of 2 years and 3 months. The complication rate of group A was lower than that of group B [10.81% (4/37) vs 29.27% (12/41)], and the difference was statistically significant ( P< 0.05). Urethral fistula occurred in 3 cases (8.11%), respectively and 6 cases (14.63%) in the two groups, the difference was not statistically significant ( P>0.05); urethral stricture occurred in 1 case (2.70%) and 5 cases (12.20%) respectively, the difference was not statistically significant ( P>0.05), There were 0 case and 1 case (2.44%) of urethral orifice descending or urethral dehiscence respectively, and the difference was not statistically significant ( P> 0.05). Conclusion:TIP with an improved compound flap transfer can reduce the overall postoperative complication rate and is worthy of promotion.

目的 探讨尿道下裂术后阴茎背伸包扎法的护理效果.方法 选取2021年3月至2023年2月9日在医院进行手术诊治的尿道下裂患儿90例作为研究对象.以随机抽签的原则,将患儿分为研究组与对照组,每组各45例.研究组与对照组都给予常规护理与阴茎伸直+尿道成形术+皮瓣转移术.对照组在护理的基础上采用传统的阴茎垂直腹壁套袖式包扎术,研究组给予阴茎背伸包扎法.分析比较两组术后疼痛程度、24h呼叫医护人员的次数与护理满意度.结果 研究组术后1d、术后3d、术后7d的疼痛评分VAS显著低于对照组(P<0.05).研究组护理

Although the use of sterile petroleum jelly gauze combined with nanochitosan film to wrap wounds has been proven to have good results, it has not been applied for modified Devine surgery. The use of sterile petroleum jelly gauze alone in the modified Devine surgery to treat concealed penis in children has different effects. In this study, the systematic evaluation of the effect of the modified Devine technique (Vaseline gauze bandaging the wound) in the treatment of concealed penis in children is conducted. Furthermore, the application of nanochitosan film and Vaseline gauze in the modified Devine technique is proposed. By analytical search in PubMed, China Knowledge Network (CKN), and other Chinese and foreign literature databases, there are 13 studies describing the development of the penis during the follow-up period with high satisfaction of patients and their family members. In addition, systematic evaluations have shown that the complete removal of the fibrotic penile sarcoid tissue is an important reason for the remarkable curative effect of the modified Devine surgery in the treatment of concealed penis in children.

Objective:To investigate the clinical effect of two-stage auricular reconstruction combined with Bonebridge implantation in the treatment of congenital microtia.Methods:The clinical data of 52 patients with congenital microtia and hearing impairment were retrospectively analyzed. The patients were admitted to the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Beijing Tongren Hospital Affiliated to Capital Medical University from June 2017 to August 2019. There were 35 males and 17 females, aged 6-12 years. All patients received the two-stage surgery. The first stage surgery was Nagata’s technique described as follows: rib cartilage harvest and framework implantation. The second stage surgery combined auricle elevation with Bonebridge implantation. Postoperative follow-up was conducted to evaluate the effect of the operation through auricular morphology and auditory evaluation. The auricular morphology was subjectively evaluated by the patient and the patient’s family members. The audiometric evaluation mainly included the comparisons of the pure tone audiometry results and speech recognition rate of the patients before and after the operation. SPSS 19.0 software was used for data analysis. The measurement data were showed as Mean±SD, and the comparison results were analyzed by paired t test. P<0.05 was considered statistically significant. Results:After follow-ups of 3-10 months, with an average of 6 months, the spatial three-dimensional structure and local subunit morphology of the reconstructed ears were satisfactory in 47 patients (90.4%). Four patients had obvious scarring or keloid in retroauricular region, which affected the aesthetic outcome. The results of pure tone audiometry at 3 weeks after surgery showed that the postoperative air conduction threshold was (38.8±7.2) dB HL, which decreased by (33.6±6.2) dB HL compared to that before surgery (72.4±9.0) dB HL, and the difference was statistically significant ( t=38.13, P<0.001). The speech recognition rate was increased by 24%-67%, which was improved from 31.9% before surgery to 85.0% after surgery. The difference was statistically significant ( t=-40.15, P<0.001). Conclusions:Auricular reconstruction and Bonebridge implantation were carried out in one stage of surgery, so that the patients with congenital microtia could obtain good auricular morphology and improve their hearing significantly.

Objective:To introduce the application of a modified scrotoplasty for children with webbed penis.Methods:Retrospective study was carried out.The treatment results of 58 children with webbed penis in Department of Urology, the Affiliated Xuzhou Children′s Hospital of Xuzhou Medical University from June 2012 to April 2018 were analyzed.A total of 26 children with webbed penis and phimosis were treated with circumcision combined with modified scrotoplasty as modified scrotoplasty group, and 32 children with webbed penis and phimosis were treated with V-Y scrotoplasty as V-Y scrotoplasty group.The curative effect of webbed penis was compared between the two groups.Results:The operation time of V-Y scrotoplasty group and modified scrotoplasty group were (26.0±2.4) min and (28.0±3.2) min; the increased penis length in the horizontal position in the two groups were (0.30±0.06) cm and (0.40±0.06) cm; the score of parents′ satisfaction were (3.80±0.47) scores and (4.70±0.56) scores, there were significant differences in the average operation time, the increased penis length in the horizontal position and the score of parents′ satisfaction between the two groups ( t=2.703, 6.061, 6.652; all P<0.05). There was no significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:Circumcision combined with modified scrotoplasty is used to repair webbed penis, which results in a good postoperative appearance, high parent satisfaction and easy clinical implementation.

To compare a novel modified W-incision scrotoplasty (MWS) operation method with the conventional V-Y scrotoplasty for treatment of severe penoscrotal webbing (PSW) in children a retrospective study was conducted on 26 children. Circumcision combined with modified scrotoplasty was used to repair the webbed penis and phimosis of children and another 32 patients undergoing V-Y scrotoplasty served as the control group. There was a statistically significant difference of angle improvements of penis and scrotum in a horizontal position (-66 ± 10; -57 ± 6, P < 0.001) and the parent satisfaction score (Five Likert Scale) (4.7 ± 0.56; 3.8 ± 0.47, P < 0.001) between the two groups. All 26 children who underwent MWS presented with no serious postoperative complications, and there was no significant difference in surgical complications compared to children treated with V-Y scrotoplasty.

Background: Concealed penis is an anomaly in infants and adolescents, accurate diagnosis of different types of which requires extensive experience. In general, an experienced physician can diagnose the type of abnormal penis by careful observation and then provide the corresponding treatment. The appearance of trapped penis and webbed penis is easier to distinguish than that of other abnormal penises. However, congenital concealed penis is easily confused with phimosis and obesity concealed penis, and it is not easy to distinguish clinically, especially for inexperienced physician. Objectives: This study aims to provide an auxiliary measurement method to assist diagnosis of concealed penis types. Methods: This study enrolled 105 children diagnosed as phimosis, 88 as congenital concealed penis, and 78 as obesity concealed penis. Multifunctional protractor was used to measure the foreskin angle and penis-scrotum angle. The foreskin angle was defined as the angle between the ventral and dorsal sides of the penis body and the line extending to the foreskin, which was the sagittal position of the natural state of the penis when the child lies down. The penis-scrotum angle was defined as the angle between the ventral side of penis and the scrotum. All measured data were recorded by professional physicians, and the differences between different groups were compared using t-test. Results: The average foreskin angle in the phimosis, congenital concealed penis, and obesity concealed penis groups were 10.05°, 74.34°, and 8.86°, respectively. The average penis-scrotum angle in the three groups were 6.98°, 118.65°, and 85.59°, respectively. Annular wrinkle numbers in the three groups were 0.26, 0.32, and 2.68, respectively. The difference of the groups was statistically significant (P < 0.05). These results indicated that congenital concealed penis had greater foreskin and penis-scrotum angle. Obesity concealed penis had moderately large penis-scrotum angle and higher number of annular wrinkles. On contrary, the three indicators in phimosis were the lowest. Conclusions: This evaluation system can provide an auxiliary way to help the diagnosis of different types of concealed penis in children and provide a basis for subsequent treatment. In addition, Experienced physicians teaching new physicians/students, can also use this as an auxiliary explanation.

目的:总结小儿阴囊急症的临床特点,探讨治疗方法.方法:2016年1月-2019年12月收治阴囊急症患儿435例,回顾分析临床资料;其中睾丸附件扭转318例,睾丸扭转51例,睾丸附睾炎44例,其他22例.结果:318例睾丸附件扭转患儿,其中左侧132例,右侧184例,双侧2例,5～11岁多见.51例睾丸扭转患儿以左侧多见,左侧39例,右侧12例,1岁以内15例,其中新生儿期8例,1～2岁8例,5～7岁9例,11岁以上12例.鞘膜囊外扭转6例,<1岁仅2例,分别为4 d和8 d.睾丸附睾炎左侧19例,右侧23例,双侧2例;发生在1岁以内26例,>10岁10例.结论:小儿阴囊急症以睾丸附件扭转最多见,其次为睾丸扭转,1岁以内以睾丸扭转和睾丸附睾炎为主,治疗建议以手术探查为主.

目的 探讨小儿尿道下裂术后并发症的预防性护理运用情况.方法 ?90例尿道下裂患儿均行尿道板纵切卷管尿道成形术,将患儿随机分为观察组与对照组,每组45例.给予对照组患儿行常规护理,给予观察组患儿预防性护理,对比两组患儿的平均住院时间、导尿管拔除时间与并发症情况.结果 观察组患儿的平均住院时间、导尿管拔除时间明显低于对照组(P<0.05);观察组患儿尿道憩室、尿道狭窄、尿道瘘、切口感染等并发症总发生率明显低于对照组(P<0.05).结论 对尿道下裂术后患儿针对于常见并发症进行预防性护理,能够减少患儿并发症的发生率,促进患儿快速康复出院,值得临床应用推广.

Objective: To summarize the application experience of Ai Tong (Chinese Shang Ring) disposable oval circumcision anastomat in pediatric urology. Methods: A retrospective study of 1 481 cases of pediatric urology using a disposable oval circumcision anastomat at Xuzhou Children's Hospital from October 2014 to December 2017 was performed. The average age at the time of surgery was 5.2 (2-14 years) years. Among them, there were 1 226 cases of phimosis, 32 cases of scar phimosis in chronic infection, 23 cases of phimosis or redundant prepuce with urethral duplication, 29 cases of foreskin trauma, 35 cases of phimosis or redundant prepuce with urethral cyst, 3 cases of phimosis or redundant prepuce with urethral stricture, 108 cases of phimosis or redundant prepuce with webbed penis, 6 cases of phimosis with penile downward bending, 4 cases of phimosis with short frenulum preputii, and 15 cases of relatively normal foreskin development, I° and II° hypospadias with unapparent penile downward bending, and megalourethra with complete foreskin hypospadias. Results: All operations were completed successfully. The postoperative circumcision time was less than 5 days on 2 cases(0.1%), and was longer than 25 days on 9 cases(0.6%). The average postoperative circumcision time was 13.2 days. During a follow-up period of 3 months, except for 2 cases (0.1%) of frenulum preputii edema, all other cases had a satisfactory foreskin appearance. They had no obvious foreskin scar hyperplasia, the foreskin cutting edge was neat, the foreskin ligament was intact, the foreskin was left and right symmetrical, and the foreskin was preserved in the absence of erection to cover the coronary sulcus to 1/3 of the glans. All children with hypospadias had no urethral stricture and urethral fistula, and the penis was satisfactory. Conclusions: Ai Tong (Chinese Shang Ring) disposable oval circumcision anastomat is satisfactory in the treatment of various diseases of pediatric urology. With a low incidence of postoperative complications, it may be easy to carry out this procedure at grass-roots hospital.

Objective To summarize the experiences of hypospadias repair using prolonged and broadened plate plus Onlay flap urethroplasty.Methods A retrospective review of prolonged and broadened plate plus Onlay flap urethroplasty was performed from October 2015 to April 2016.Among 37 patients with primary hypospadias,the clinical types were penile (n =27) and penoscrotal (n =10).Urethral plate was resected for straightening out corpora cavernosa.All urethral plates measured ≥8 mm and all glans ≥14 mm in diameter.Urethral plate was preserved and penile skin degloved until root of penis.After fully straightening out,lengthway incision was made in the middle of urethral plate for broadening.Then sideling in the most obvious place of penis was bent for prolonging urethral plate.After indwelling catheter,partial urethra formed.Then a foreskin pedicel island flap was chipped and onlaid with urethral plate.Ventral superficial fascia was used as a second layer vascular cover over neourethra.Glansplasty was performed with suturing glans wings to obtain the esthetics of glans and meatus.Results All operations were performed successfully.The average operative duration was 77 (65-95) min.The postoperative complications included urethral fistula (n =4,10.8％)and urethral stricture (n=5,13.5％).All 5 patients stayed in remission after 1-3 urethra dilatation.After a 3-month follow-up period,3 cases (8.1％) were complicated by urethral fistula.There was no occurrence of urethral stricture or recurrent penile curvature.All of them had entopic and slitlike urinary meatus.Conclusions Prolonged and broadened plate plus Onlay flap urethroplasty is effective for severe hypospadias.With a low incidence of postoperative complications,this procedure may be easily performed.It is indicated when transecting urethral plate is required for penile straightening.

Objective To summarize the experience of hypospadias repair with tubularized incision and prolonged plate urethroplasty.Methods From June 2015 to November 2015,a retrospective review of tubularized incision and prolonged plate urethroplasty was performed for 21 primary hypospadias patients.The clinical types were penile (n =17) and penoscrotal (n =4).After reserving urethral plate and degloving penile skin to penile root,full straightening out was performed.Incision of middle urethral plate was intended for broadening urethral plate.And sideway incision in the most obvious bent place of penis was made to prolong urethral plate.After indwelling catheter,urethra was formed.Results The average operative duration was 78 (65-100) min.Postoperative complications included urethral fistula (n =3,14.3％) and urethral stricture (n =4,19.0％).All of them stayed in remission after 1-3 sessions of urethra dilatation.During a follow-up period of 3 months,2 cases (9.5％) were complicated by urethral fistula.There was no instance of urethral stricture or recurrent penile curvature.Conclusions Tubularized incision and prolonged plate urethroplasty are effective for hypospadias.With a low incidence of postoperative complications,this procedure may be easily popularized at grass-roots.

Objective To evaluate the outcomes of penoplasty with penile frenulum lengthening for concealed penis in children.Methods From March 2014 to March 2016,a total of 233 patients with concealed penis who enderwent penoplasty with penile frenulum lengthening were enrolled.The everage age at surgery was 3.7 years (1 year and seven months-12 years).There were 73 cases with obvious small urinary stream,dysuria,or prepuce dilatation when urinating;41 cases with the history of recurrent infections of prepuces;and 9 cases with the history of urinary tract infections.During operation,incise the back side center of the outer plate of the prepuce and fully release the ring-type funicular tissue between the inner and outer plates of the prepuce to make the inner plate fully swell out.After the prepuce is upturned,cut the penile frenulum at the coronary sulcus.Make a "V-shaped" cut on the left and right sides of the far end of the outer plate cut of the prepuce from the cut of the penile frenulum.Lengthen penile frenulum after the prepuce is pressed off.Cover the dorsal side of the penis with the inner plate of the prepuce and cover its ventral side with its outer plate.Results Mean surgical time for patients was 38 min (30-55 min).All operations were completed successfully and the post-operation follow-up lasts 3 months to 2 years.For all cases,the appearance of the penis is improved.The penis stretches out,the balanus is exposed,the prepuce has no obvious swelling and the scrotum angle of the penis is obvious.No phimosis relapses and there is no obvious scar hyperplasia.Conclusions This surgical procedure is an effective treatment choice for concealed penis.It provides a good cosmetic result.

Objective To evaluate the anti-tumor effect of oncolytic adenovirus expressing human interleukin-24 (IL-24) gene on neuroblastomna implanted in nude mice.Methods BALB/c nude mice were subcutaneously inoculated with LA1-55N cells to establish a model of neuroblastoma.Murine models were randomly divided into four groups to be treated with an oncolytic adenovirus carrying interleukin-24 (ZD55-IL-24),adenovirus carrying interleukin-24 (Ad-IL-24),oncolytic adenovirus fusing with enhanced green fluorescent protein (ZD55-EGFP),phosphate buffer saline (PBS),respectively,when the volume of implanted tumor reached 100-150 mm3.The tumor size was measured at all interval of 4 days for 6 weeks.The expression of Caspase-3,E1 A and IL-24 was detected by Western blotting analysis.The apoptosis was determined by TdT mediated dUTP nick end labeling (TUNEL).Results The group treated with ZD55-IL-24 significantly inhibited the growth of tumor.The mean tumor volume was (91.20 ± 39.31) mm3 in the ZD55-IL-24 group,significantly smaller than that in Ad-IL-24 group (997.89 ± 51.65) mm3,ZD55-EGFP group (943.46 ± 69.62) mm3,and PBS group (1 980.24 ± 98.78) mm3 s after 6 week.Western blotting analysis confirmed that ZD55-IL-24 could express IL-24 and E1 A protein in LA1-55N cell line with high efficiency,and obviously activate of Caspase-3.TUNEL showed ZD55-IL-24 could induce obviously apoptotic effects.The percentage of the apoptotic cells was (52.10 ± 6.21) ％,(21.30 ± 3.62) ％,(20.60 ± 2.01) ％ (P =0.003),respectively,after treatment with ZD55-IL-24,Ad-IL-24 and ZD55-EGFP.Conclusion ZD55-IL-24 has a significant inhibitory effect on the growth of neuroblastoma implanted in nude mice,which maybe related with activation of Caspase-3.

Objective To explore the classification and treatment of concealed penis in children.Methods From December 2009 to December 2013,a total of 83 consecutive patients with concealed penis were reviewed and classified by ostium praeputiale angle.The clinical grades of concealed penis were Ⅰ (30-45 degrees,n =3),Ⅱ (46-90 degrees,n =10) and Ⅲ (＞90 degrees,n =70).Grades Ⅰand Ⅱ underwent modified Brisson while grade Ⅲ had modified Shiraki.Based upon the Boemers criteria,the overall postoperative outcomes were good,average and poor.Results Wound dressing and urinary tube were removed at Day 5/6 after operation.All patients were discharged at Day 6/7.During an average follow-up period of 12 (6-24) months,there was no occurrence of voiding problems.Twelve cases with inner prepuce edema recovered within 6-12 weeks.Eventual appearance was satisfactory (n=81) and minuscule (n=2).Conclusions With few complications and satisfactory cosmetics,different grades of pediatric concealed penis may be adequately managed by individualized operations.

The aim of the study was to summarize the preliminary experience of minimally invasive open nephrectomy operation on children with multicystic dysplastic kidney (MCDK). A retrospective review was performed on the clinical materials of the 15 children that had accepted consecutive minimally invasive open nephrectomies during the previous 2 years. The enrolled children were diagnosed with unilateral MCDK under computed tomography, emission computerized tomography and ultrasound and no anomaly in the contralateral functioning kidney was found. Of the 15 children, 12 were boys and 3 were girls, with 5 cases on the right and 10 cases on the left. Operations were completed at the retroperitoneal space in order to open an incision on the waists and ribs of the children, the length of which ranged from 1.5 to 2.0 cm (average 1.7 cm). The age of the children at operation ranged from 3 months to 5.6 years old, with an average of 2.4 years old. Surgery lasted for 30-50 min, with an average of 34.6 min. The estimated blood loss of each child was <5 ml. After operation, prophylactic intravenous antibiotics were administered for 2-4 days to prevent infection. All of the operations proved very successful. Following surgery the children were hospitalized for 2-4 days for observation, with an average of 2.8 days. No complications occurred during the follow-up period. In conclusion, minimally invasive open nephrectomy is effective for children with MCDK. The procedure is superior with regard to operative time, cosmesis, and length of stay. It is a safe and effective treatment choice for patietns with MCDK and can be easily performed on children.

Objetive To determine the effectiveness of modified Shiraki method associated with V-shaped incision as a new surgical treatment method for severe concealed penis. Methods From August 2011 to August 2013,42 patients with severe concealed penis underwent the modified Shiraki method associated with V-shaped incision.The technique consists of 3 steps:1)First is Longitudinal cutting at 3′,9′of inner prepuce and 12′of outer prepuce,the seperation of inner and outer prepuce,skin degloving,resection of fibrous tissue and mobilization of divergent corpus spongiosum;2)transection and longitudinal suture at the frenulum to elon-gate inner ventral prepuce,excise redundant inner prepuce flap,while outer prepuce is preserve as much as pos-sible,with embedding sutures of inner and outer prepuce;3)At last,through V — shaped incision for the ventral side of the penis,penile ventral extension,reconstruction of penis and scrotum angle. Results The operative time ranged from 40 min to 55 min.The follow-up period was for between 12 ~24 months.The appearance of penis was satisfactory in 40 patients.2 patient had sub-optimal result because of underlying obesity.13 cases with inner prepuce edema had good recovery within 12 weeks after operations. Conclusions Modified Shiraki method associated with V-shaped incision has the advantages of less complication,simple operation and satisfac-tory appearance.It should be recommended as an ideal operation to treat severe concealed penis.

目的 评价双V和Z型阴囊成形术治疗儿童先天性阴茎阴囊融合的效果.方法 回顾性研究自2012年7月至2015年12月本院收治的152例先天性阴茎阴囊融合患儿临床资料,均合并包茎或包皮过长.随机采用了双V和Z型阴囊成形方式修复先天性阴茎阴囊融合,术后随访6个月以上.结果 152例先天性阴茎阴囊融合患儿术后9例出现相关并发症(切口出血2例,切口感染1例,切口裂开2例,切口疤痕增生2例,阴茎水肿2例),其中双V阴囊成形术4例,Z型阴囊成形术5例.结论 2种手术方式治疗先天性阴茎阴囊融合安全可行,手术方法的选择取决于外科医生的个人偏好.

The amplification of MYCN is a typical characteristic of aggressive neuroblastomas, whereas acquired mutations of p53 lead to refractory and relapsed cases. We had previously examined the applicability of the replication-competent oncolytic adenovirus, ZD55-shMYCN, to deliver a short hairpin RNA targeting MYCN gene for p53-null and MYCN-amplified neuroblastoma cell line LA1-55N. Our data have shown that ZD55-shMYCN has an additive tumor growth inhibitory response through shRNA-mediated MYCN knockdown and ZD55-mediated cancer cell lysis. In this regard, ZD55-shMYCN can downregulate MYCN and perform anticancer effects, thereby acquiring significance in the administration of MYCN-amplified and p53-null neuroblastomas. Hence, we further investigated the anticancer properties of ZD55-shMYCN in neuroblastomas. Our data showed that ZD55-shMYCN induced G2/M arrest via decreasing the levels of cyclin D1 and cyclin B1 irrespective of p53 status. ZD55-shMYCN effectively induced apoptosis in neuroblastomas through activation of caspase-3 and enhancing PARP cleavage. Furthermore, ZD55-shMYCN could downregulate phosphoinositide 3-kinase and pAkt and upregulate RKIP levels. Similarly, pro-apoptosis was revealed by the histopathologic examination of paraffin-embedded section of resected tumors of mice xenograft. In vitro and in vivo studies, we elucidate the apoptosis properties and mechanisms of action of ZD55-shMYCN, which provide a promising approach for further clinical development.

Neuroblastoma is among the most aggressive tumors that occur in childhood and infancy. The clinical prognosis of children with advanced-stage neuroblastoma is still poor. Interleukin-24 (IL-24) is emerging as a new cytokine involved in tumor cellular proliferation, differentiation, and apoptosis and has been widely studied as a tumor inhibitor. However, little is known about this cytokine's role in neuroblastoma. In this study, we investigated the possible effects of IL-24 on inducing neuroblastoma cell differentiation, growth inhibition, and apoptosis in vitro. Our data show that IL-24 promotes neuroblastoma SH-SY5Y cell differentiation, growth inhibition, and apoptosis. Furthermore, we found that the differentiation- and apoptosis-inducing action of IL-24 depends on the accumulation of reactive oxygen species (ROS). These results suggest that IL-24 can induce neuroblastoma cell differentiation and apoptosis and may be a potential therapeutic agent for neuroblastoma.