B-ultrasonic manifestations of 65 cases of cryptorchlchsms including location and size as well as internal structure of tests are analysed.Among these seventy-four per cent cases Were con-firmed by operations.It is Considered that B-ultrasonic imaging has important diagnostic value for cryptorchidism.

Objective To explore the significance on expression of mdr-1, P-gp and DNA heteroploidy in invasive bladder carcinoma. Methods The expressions of mdr-1 and P-gp were detected by RT-PCR and immunohistochemistry(SP) method, and DNA ploidy by flow cytometry method in 26 cases of invasive bladder carcinoma tissues, which were compared with those in 10 normal bladder tissues. At the same time, the flow cytometry was used to determine DNA heteroploidy. Results A of mdr-1 in the neoadjuvant chemotherapy CR, PR, non-respond and control group were (0.61±0.75), (0.71±0.11), (1.68±0.28) and (0.745±0.13),respectively (P＜0.05). Positive rates of P-gp had significant differences between CR, PR and non-respondgroup and control group (P ＜0.05). Positive rates of DNA heteroploid in the above groups were 50 %, 45 %,69 % and 10 %, respectively (P ＜0.05). Conclusion The detections of mdr-1, P-gp and of DNA heteroploid contribute to evaluate neo-adjuvant chemotherapy effects of invasive bladder carcinoma.

ObjectiveTo explore the effect and feasibility of autograft and allograft bone and cartilage transplantation.Methods63 rabbits were made experimental defect in the same side knee joint,and were divided randomly into group A(autograft group),group B(allograft group) and group C(control group).Group A was divided further into 2 column limiting motion subgroup(A2M group),not limiting motion subgroup(A2N group) and 4 column subgroup(A4M group).In the same way,group B was divided further into B2M group,B2N group and B4M group.Every subgroup included nine rabbits,and the transplantation was made in no weight-bear area of knee joint.The generally observation were made,the joint movable range and the thickness of the repairing tissue were measured,histology change of transplanted tissue(through light,electronic microscope)were observed.ResultsGroup A had a satisfactory result,and the result of no limiting groups were better.The result of A4M group was better than A2M group (P≤0.05).The result of group B was not good.ConclusionThe bone-cartilage column of small diameter and general number are beneficial in repairing the defect of joint cartilage.The allograft bone and cartilage transplantation can cause seriously immunoreaction and the absorption of cartilage pole,and is detrimental to repair the defect of joint cartilage.

Objective To investigate the clinical value of ultrasonography in diagnosis and the significance in the pelvic lymph node metastasis in endometrial carcinoma.Methods Endometrial carcinoma admitted for initial treatment of patients with a total of 60 cases,take color Doppler imaging (GE730),the uterine,vaginal examination, accessories and tumor size,internal echo,and the relationship with the surrounding tissue boundaries of tumor four weeks and internal flow characteristics were observed.Results 60 cases of endometrial carcinoma,50 cases of patients with ultrasound findings with operation pathologic examination results,which were positive in 45 cases (75%),8 cases of false negative (13.33%),false positive in 2 cases (3.33%),5 cases were negative (8.33%). The detection sensitivity was 84.91% (45 /53);the rate of missed diagnosis was 15.09% (8 /53);the rate of misdi-agnosis was 28.57% (2 /7);the specificity was 71.43% (5 /7);Youden index 0.5634.Resistance index,CDFI value of carcinoma of endometrium and pelvic lymph node metastasis,there were significant differences (P <0.05). Conclusion Node metastasis in endometrial carcinoma by ultrasonography in diagnosis of pelvic lymph,ultrasonic diagnosis accuracy rate reaches 83.33%,so by ultrasonographic features can be found audio -visual abnormalities in patients,and timely diagnosis of pelvic lymph node metastases in endometrial carcinoma,to lower the risk of blind treatment to the female brought.

Objective To investigate the relationship beween bladder relaxation characters and 3-adrenergic receptor level in DM rats. Methods The studying subjects consist of induced diabetes and normal control rats,30 rats in each group,to detect bladder relaxation charaters in 2 groups and its relationship with 3-adrenergic receptor,cAMP contents.Western blot was performed to probe 3-adrenergic receptor.cAMP products of bladder was studied with radioimmunoassay. Results Bladder relaxation in response to isoproterenal stimulation was observed. Bladder pressure of streptozotocin induced diabetes rats at week 2,4,12 were (11.8?2.3),(11.9?2.2),(11.5?3.0)cm H_2O respectively,and (32.8?7.6),(33.9? 5.2 ),(34.7?2.7)cm H_2O in control group.3-adrenergic receptor level in diabetes group were (104?7),(105?11),(126?14)?m at week 2,4,12,and in control group (151?11),(151?10),(152?13)?m.cAMP products were detected at the same time points,namely,(0.195?0.026),(0.198?0.030),( 0.109? 0.031)pmol/L in diabetes group,and (0.349?0.051),(0.350?0.052),(0.353?0.051)pmol/L in control group. Conclusions Relaxation abilities is impaired in diabetes bladder.Though 3-adrenergic receptor level was up-regulated,cAMP products is donw-regulated,which is responsible for detrusor relaxation.3-adrenergic receptor pathway is impaired via donw-regulating cAMP products in diabetes cystopathy.

Objective To observe the changes in the level of serum cystatin C and the expression of matrix metalloproteinase-9 (MMP-9) in the kidney after the development of diabetic nephropathy in streptozotocin (STZ) induced diabetic rats, and to study their correlation. Methods Sixteen female Wistar rats were used to reproduce diabetes by interperitoneal injection of STZ (60mg/kg). Immunohistochemical staining was employed to detect the expressions of MMP-9 in kidneys with image analysis system, and ELISA was used to determine serum cystatin C after 4 or 8 weeks. The correlation between MMP-9 and cystatin C was analyzed by SPSS 10.0. Results The expressions of MMP-9 in diabetic kidneys both at the 4th and the 8th week (8.180?0.905 and 3.948?0.623, respectively) were significantly lower than that of normal control rats (15.620?3.444 and 16.185?3.120, respectively. P

Objective To determine the radiographic feasibility of oblique lumbar interbody fusion (OLIF) corridor to treat lumbar disease at each lumbar disc level,including the corridor's numerical value and the influence of diaphragmatic crura and aorta abdominalis.Methods A retrospective CT study was conducted on 110 patients (including 69 males and 41 females,average age 47.95 years,range 16-83 years) that continuously collected and analyzed in the PACS system.The oblique corridor was defined as the area between the left lateral border of the aorta abdominalis(or iliac artery) and the right lateral border of the left psoas.The distances and angles of L1-2,L2-3,L3-4 and L4-5 levels were measured.Whether the change of diaphragmatic crura and aorta abdominalis affected the building of the corridor was also observed.Results The mean distances of oblique corridor to the levels of L1-L5 discs were:L1-2 15.90 mm,L2-3 14.82 mm,L3-4 17.57 mm,L4-5 11.16 mm.At the levels of L1-2 and L3-4,all of the images could build the corridor.But there were only 97.27％ images allowing operation at both L2-3 and L4-5,and the other 3 cases couldn't build the corridor since the aorta abdominalis was very close to psoas,and the distance was almost 0 mm.The max mean distance was 36.79 mm at L3-4 level.The mean angles were:L1-2 36.98°;L2-3 37.76°;L3-4 40.96°;L4-5 37.85°.The significant difference was at L3-4,ranged from 13.09 to 61.93°.The level of the aortic bifurcation was from the lower third of the L3 vertebral body to the middle third of the L5 vertebral body.The levels of left diaphragmatic crura's ending point in the lumbar was divided into four groups:1) Group L1 vertebral body level:the level at L1 vertebral body and above,5 cases (4.55％);Group L1-2 disc to L2 vertebral body level:at L1-2 disc and L2 vertebral body,67 cases (60.91％);Group L2-3 disc to L3 vertebral body level:at L2-3 disc and L3 vertebral body,36 cases (32.72％);Group L3-4 disc to L4 vertebral body level:at L3-4 disc and L4 vertebral body,2 case (1.81％).Conclusion The OLIF corridor can be built successfully at L1-2 and L3-4.However,it may be difficult at L2-3 and L4-5 for some patients due to the aorta abdominalis which is too close to psoas.The angles of L1-L5 levels were similar.While the left diaphragmatic crura was mainly impact the corridor insertion at L1-2 and L2-3.And the level of the aortic bifurcation was mainly located at the upper endplate of L4 to the L4-5 disc (87％).

Tibia shaft fracture is the most common long bone fractures clinically and intramedullary nail fixation is the best choice due to superior biomechanical characteristics for unstable tibia shaft fractures.At present,the common approaches for intramedullary nail insertion are divided into supra-patellar approach and infra-patellar approach.The semi-extended position of supra-patellar approach contributes to better fracture reduction but lead to potential patella-femoral cartilage injury.In contrast,flexion or hyper-flexion position of infra-patellar approach might result in unsatisfactory fracture reduction,then have an impact on clinical outcome.Therefore,the clinical outcome might be different because of approach choice.However,there is no consensus about the optimal surgical approach for intramedullary nailing.Thus,we performed the review to discuss the approaches for tibia intramedullary nailing and compare their strengths and weaknesses.

To describe the clinical,radiological and pathological characteristics of idiopathic pulmonary alveolar proteinosis(I-PAP)and to evaluate the methods of diagnosis and treatment.Three patients were successfully diagnosed and treated in our hospital and the literature on the subject was reviewed.Three patients,two males and one female(mean age 46 years),were diagnosed averagely in 4 months.Two severe patients presented with progressive dyspnea and type I respiratory failure,and one mild patient only with dry cough and hypoxemia.Chest X-ray radiographs all showed perihilar "butterfly" shadow and chest CT scans showed diffused ground-glass opacities(GGO),typically with "map" changes and "crazy paving" patterns.All the patients underwent bronchoscope,branchoalveolar lavage fluid(BALF)had grossly opaque and/or milky appearance and its sediment was periodic acid-Schiff stain positive.Transbronchoscopic lung biopsy(TBLB)specimens were obtained and under light microscopy alveoli and some of the small bronchioles were filled with eosinophilic proteinaceous material with needle-like clefts.By electron microscopy numerous cellular debris and extracellular multilamellated bodies were found.Two severe patients were successfully treated with sequential whole-lung lavage and one required repeated lavages.I-PAP is rare and prone to be misdiagnosed.The radiological features may indicate the diagnosis and examinations of TBLB and BALF can make the accurate diagnosis.Whole-lung lavage is the most effective therapy by now and granulocyte-macrophage colony-stimulating factor(GM-CSF)may be beneficial in some patients.

Objective To investigate the effectiveness and rationality of objective structured clinical examination (OSCE) used as achievement assessment for Postgraduate Year 1 surgery residents.Then the form and content of training and examination can be improved according to test results.Methods 31 Postgraduate Year 1 surgery residents were involved in the examination.The examination was composed of 5 stations,which were case analysis,wound dressing change,plaster fixation,laparoscopic simulator basic skills and irregular wound debridement suture.Each station was evaluated by centesimal system score and limited in 15 minutes.A questionnaire on their opinion and perception of the examination was given to each resident at the end of examination.A total number of 31 questionnaires were issued and recycled.The difficulty,discrimination and reliability of each station were calculated,and the correlation between each station was analyzed.Results The average OSCE score was (74.66 ± 4.39).The difficulty of total stations was 0.747.The distinction was 0.578 and the reliability was 0.402.The second station was lowest difficulty,and the fifth station was most difficult.Every station's discrimination was larger than 0.400.The reliability of the second and the fourth station was low.There was moderate correlation between the first station and the second station,as well as the first station and the fourth station.But there was no significant correlation between other stations.Residents' questionnaire survey showed that the fourth and the fifth stations were considered as the most difficult,and the second station was the simplest.They thought the fourth was most helpful for clinic.They performed best at the second station and worst at the fifth station.Conclusions OSCE can effectively evaluate the efficacy of the resident training.The residents' practical competency skills can be assessed better by examination simulating complex clinical scenario.Besides,after examination,we need to objectively evaluate the assessment efficiency,and dynamically adjust the training content and examination form according to residents' subjective opinions.