Objective To compare the effects of laparoscopy and open surgery of ligation of spermatic vessel cluster or internal spermatic vein for the treatment of varicocele.Methods By using randomized controlled trial,120 cases with varicocele who stayed and were treated in our hospital were divided into 4 groups(30 cases every group) from Jun.2007 to Oct.2011.The efficacy of 4 groups was observed and compared.Results Four operations were performed successfully.Laparoscopy approached less than open surgery in terms of the days of stay in hospital (P ＜ 0.05).The quality of semen in four groups was all increased by comparing spermatozoa density,motility rate before and after operation(P ＜ 0.05),but no difference was found among four groups (P ＞ 0.05).In 0.5-1 year follow-up,follow-up rate was 92.5％,without atrophy of testes.Conclusion The operation of laparoscopic spermatie vessel cluster ligation in patients with varicoceh has the advantage of confirmed effect,which is an alternative operative method of treatment for patients with varicocele.

Operating methods for XCY2002-1/200 field battle X-ray diagnosis vehicle are expounded. Performance of every function is evaluated. The problems and corresponding improvement are put forward.

Objective To evaluate a new computer-aided technique applicable for myocardial contrast echocardiography(MCE) to quantitate automatically calibrated myocardial contrast intensity(CD and to test the feasibility of calibrated CI in assessing myocardial perfusion. To analyze the relationship on myocardial perfusion,regional contractile function and cell apoptosis in stunned myocardium. Methods According to coronary occlusion and reperfusion at different times, rabbits were divided into three groups: 15 min occlusion/30min reperfusion (group Ⅰ ),30 min occlusion / 60min reperfusion (group Ⅱ ) and 120 min occlusion / 60min reperfusion (group Ⅲ ). MCE was performed on all rabbits at baseline,occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique. Myocardial calibrated CI of each segment was measured automatically by software. Percentage wall thickening (WT) of each risk segment at each stage were also measured by echocardiography. The apoptotic index(AI) in regional left myocardial dysfunction was calculated by terminal deoxynucleotidyl transferease-mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL ). Results (1) During occlusion, WT in the areas at risk decreased to zero or negative and the calibrated CI values were significantly lower than those at baseline ( P ＜0.01 ). After reperfusion, WT in all risk segment remained depressed, but calibrated CI significantly improved in group Ⅰ and Ⅱ while those remained unchanged in group Ⅲ. (2)AI in risk myocytes were (13. 70 ± 5.48 ) %, (36.25 ± 5.55 ) % and ( 62.06 ± 6. 70 ) %, respectively, both statistically significant difference between the two groups ( P ＜0.05 or P ＜ 0.01 ). AI were negatively correlated to WT and calibrated CI ( r = - 0. 87 and r = - 0. 77, P ＜0.05). Conclusions MCE with computer-aided technique can assess quantitatively myocardial perfusion and regional contractile function. Short-term ischemiareperfusion does not cause myocardial necrosis, but it will lead to myocardial cell apoptosis and the phenomenon of myocardial stunning. Prolonged ischemia, even if given sufficient reperfusion, can lead to apoptosis and necrosis simultaneously.

BACKGROUND:Leukocytic infiltration induced by release of inflammatory cytotkines and up-regulation of adhesion molecules is closely associated with the formation of cerebral infarcted focus. The related factors have been widely studied.OBJECTIVE: To explore influence of estrogen on inflammatory reaction in rats after focal ischemia/reperfusion injury.DESIGN: Randomized controlled experiment.SETTING: Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA.MATERIALS:The experiment was performed at the Department of Neurology, Department of Pathology, Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Adult male SD rats were selected to establish cerebral ischemic models, with the body mass of 280-350 g.METHODS:The rats were assigned into 3 groups: control group,ovariectomized group and estrogen treatment group (estradiol, 200 μg/kg,subcutaneous injection, once a week for 4 weeks). Four weeks later, models with right middle cerebral artery occlusion (MCAO) for 1 hour and 2 hours as well as reperfusion for 0, 1, 3, 6, 22 and 70 hours were established with thread embolism method. Mean number of infiltrative neutrophils in brain tissue was calculated under microscope with 10 high power fields in ischemic hemisphere with hematoxylin and eosin staining. Expression of nuclear factor-κB was determined with immunohistochemical method.MAIN OUTCOME MEASURES:Infiltration of neutrophils and expression of nuclear factor-κB in brain parenchyma.RESULTS: ①Expression of nuclear factor-κB: There was expression of nuclear factor-κB in the ovariectomized group at hour 1 after ischemia.Positive cells appeared at hour 2 after ischemia in the control group and estrogen treatment group. The expression was in the peak at ischemia for 2hours and reperfusion for 3 hours in the three groups, and decreased gradually. There was slight expression at reperfusion for 70 hours in the ovariectomized group, while there was no clear factor-κB positive cell at reperfusion for 22 hours in the control group and estrogen treatment group.②Infiltrative neutrophils in cerebral ischemic region in the ovariectomized group significantly increased at ischemia for 2 hours and reperfusion for 22 hours. Compared with the estrogen treatment group, there was significant difference (P=0.045). At ischemia for 2 hours and reperfusion for 70 hours,infiltrative neutrophils in the ovariectomized group were more than those in the control group and estrogen treatment group, but there were significant differences only between ovariectomized group and control group.CONCLUSION: Estrogen can inhibit inflammatory reaction after cerebral ischemia/reperfusion injury.

Objective To investigate clinicopathological features of scalp angiosarcoma, and to analyze the relationship of tumor stage and treatment with prognosis. Methods Clinical and follow-up data were collected from 16 patients with non-metastatic primary scalp angiosarcoma treated in the Department of Plastic and Reconstructive Surgery of Zhongda Hospital, Southeast University from September 2002 to June 2013. According to the seventh edition American Joint Committee on Cancer (AJCC)TNM staging system for soft tissue sarcomas (2010), staging of scalp angiosarcoma was performed for the 16 patients. Statistical analysis was carried out by the Kaplan-Meier method for survival rates and by the Log-rank test for survival curve. The Cox regression model was used for multivariate regression analysis. Results Of the 16 patients, 4 had stageⅠangiosarcoma, 4 stage Ⅱangiosarcoma, and 8 stage Ⅲ angiosarcoma. The tumor usually began as ecchymosis-like lesions on the head or face in early stage, and progressed into dark red infiltrative plaques, nodules and ulcers which easily ruptured and bled in later stage. Histopathological examination showed generalized vascular proliferation and infiltration with high histological morphological diversity. Cytologic atypia was commonly seen. The median time to recurrence was 15 months, and local recurrence occurred in 7 patients. The median time to metastasis was 20.5 months, and distant metastasis was observed in 8 cases, including 4 cases of pulmonary metastasis, 2 lymph node metastasis, 1 liver metastasis and 1 bone metastasis. The survival time was 33.0 ± 4.4 months (median, 32 months)in 4 patients with stage Ⅰangiosarcoma, 24.0 ± 7.9 months(median, 15 months)in 4 patients with stage Ⅱangiosarcoma, and 23.9 ± 3.9 months (median, 24 months)in 8 patients with stage Ⅲ angiosarcoma. Additionally, the survival time was 23.4 ± 5.2 months(median, 21 months), 24.4 ± 5.7 months(median, 24 months)and 35.8 ± 9.7 months(median, 26 months) in 5 patients receiving surgical treatment alone, 7 patients receiving surgical treatment and radiotherapy, and 4 patients receiving surgical treatment, radiotherapy and immunotherapy, respectively. Conclusions Surgical treatment combined with radiotherapy and immunotherapy may serve as the first-choice treatment for scalp angiosarcoma. Tumor size and treatment regimens are main factors influencing prognosis of scalp angiosarcoma.

Objective To investigate the influence of interoperation radiation therapy (IROT) on immunity of patients with cervical cancer at Ⅱ b stage. Methods Before and after radiotherapy, T lymphocyte subsets of 61 cervical cancer patients at Ⅱ b stage including 28 patients with IROT and 31 with simple radiotherapy (SR) were tested by flow cytometry, with 20 normal people as the controls(NC). Results Before radiotherapy, radio CD 4, CD 4/CD 8 decreased obviously in cervical cancer patients. There was no obvious difference in immunity between IROT and SR group. After radiotherapy, radio CD 4, CD 4/CD 8 decreased obviously in 61 cervical cancer patients. But SR group was significantly lower than IROT group. Conclusion The influence of IROT on immunity of patients with cervical cancer at Ⅱ b stage was weaker than that of simple radiotherapy, and IROT contributed to the recovery of patients after radiotherapy.

Objective To observe the effect of acute hypervolemic hemodilution(AHH) combined with nicardipine controlled hypotension on hemodynamics changes in revision operation of total hip replacement.Methods Forty patients were divided into two groups according to the sequence of the surgery(odd number came into group A,even number came into group B,20 in each group).In group A,AHH was carried out with nicardipine controlled hypotension;group B was control group.AHH was carried out in both groups before anesthesia induction.6%voluven was transfused in group A at 15 mL?kg-1 and 30 mL?min-1 and nicardipine was transfused at 0.3-0.5 mL?kg-1?h-1 with MAP altering between 60 and 65 mmHg;Same quantity of physiological saline was transfused in group B.HR,MAP,CVP,Hb,Hct and Plt were recorded and observed at preoperation,1 h after AHH and 24 h after the operation.Results In group A after AHH with nicardipine controlled hypotension,MAP was obviously lower than pre-operation(P

Objective:To develop a rating scale on the knowledge, attitude and practice of stroke-dysphagia for nurses, and to test the reliability and validity.Methods:Based on theoretical framework of the Knowledge, Attitude, Practice (KAP), the scale items were determined through literature review, expert consultation, pre-investigation, and qualitative interviews. 633 nurses in the department of stroke that from 18 hospitals in Hubei Province were selected for the survey, to further screen the items and test reliability and validity of the scale.Results:The positive coefficient of the two-round expert consultation were both 100%; the expert authority coefficient was 0.930; the level of coordination of experts ′ opinions was good. Exploratory factor analysis extracted 4 factors, the accumulative variance contribution rate was 44.278%, Content validity index S-CVI was 0.984, I-CVI was 0.857-1.000; the Cronbach α coefficient of scale was 0.855, test-retest reliability was 0.909. Eventually, the scale was consisted of 3 dimensions, 32 items. Conclusion:The scale has good reliability and validity, and can be used as a survey tool to test the current knowledge, attitude, practice of clinical nurses about patient with stroke-dysphagia.

Objective: To study the effect of notoginsenoside in various doses on local ischemic neurotic dysfunction and the ultrastructure. Methods: 35 Wistar rats were divided at random. The reversible middle cerebral artery occlusion (MCAO) model was made according to the assessment of the literature. The changes of SEP contents of cerebral cortex NO and SOD, and the changes of the ultrastrcture were recorded by evoked potential electrograph before and after MCAO. Results: notoginsenoside 200mg?kg -1 and 400mg?kg -1 could remarkably alter MCAO, shorten the latent period, improve the dysfuntion induced by MCAO, lower the concentration of NO and enhance the activity of SOD. The differential value in MCAO group was statistically remarkable ( P

Objective Diabetic infrapopliteal artery occlusive disease Deep balloon angioplasty ( percutaneoustransluminal an-gioplasty, PTA) near the middle of the treatment effect and the Department of internal medicine ,conservative treatment .Methods Sixty patients with type II diabetes mellitus complicated with severe infrapopliteal arterial occlusive patients , divided into treatment group (41 cases) and Department of internal medicine treatment group (19 cases),all patients had CTA or MRA or DSA imaging;in-terventional treatment group using Deep balloonPTA ,3 days before operation and postoperative long-term Plavix and culture as anti platelet , blood glucose controltherapy;Department of internal medicine treatment group with control of blood glucose ,precedent in im-proving microcirculation ,debridement dressing and anti infection;observed in 2 week,1 month,3 months,6 months ,1 year,2 years,3 years, two groups were compared after treatment of clinical symptoms and changes signs ,ankle brachial index (ABI),the dorsal artery of foot diameter and blood flow velocity ,evaluation and the total efficiency of 6 months,1 year,2 years,3 years and cut rate .Results Interventional arterial blood flow improved significantly after operation in treatment group ,the clinical symptoms,signs were improved obviously, ankle brachial index improved significantly ,compared with the Department of internal medicine treatment group statistical significance ( P <0.05 ) ,and the total efficiency of 3 years the rate of limb salvage and Department of internal medicine therapy group with significant difference ( P <0.05).Conclusions Deep balloon PTA treating diabetic infrapopliteal artery occlusive disease cura-tive effect,can significantly improve the rate of limb salvage;Department of internal medicine treatment forelderly ,important organ dys-function patients .