10 h. Results 15 patients had been misdiagnosed as epididymis orchitis or acute abdomen and undergone orchiectomy because of necrosis of the testicles,including 11 cases of intrascrotal torsion (testicular torsion in scrotum with an orchiectomy rate of 79%) and 4 cases of cryptorchidism with torsion.3 cases scrotal orchidopexy has been performed and during the follow up ( 6～36 months) the testicle in 2 of which appeared viable and normal while testicular atrophy has been observed in 1.In recent years 11 adolescents underwent exploration because of acute scrotal pain,7 cases being testicular torsion and 4 acute epididymitis. Conclusions It is emphasized that in younger patients suffering suddenly from pain in scrotum, especially occurring at night,the diagnosis of testicular torsion should be considered.Differentiating cryptorchidism with torsion from incarcerated hernia or acute abdomen,testicular torsion in scrotum from acute testitis and epididymitis should be serious considered.In order to save the testicle with early surgical exploration orchidopexy might be mandatory to aviod recurrence.

[Objective] To explore the techniques of hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure. [Methods] 18 patients with portal hypertension were operated by hand-assisted laparoscopic splenectomy plus portozygos disconnection. [Results] The operations were completed successfully. The mean operative time was 180(150～260) minutes, the mean blood loss estimated was 540(200～2 000) mL, the mean weight of spleen was 910 (500～2000) g and the mean length of hospital stay was 9.7 (8～18) days after operation. All patients had recovered rapidly and suffered less pain and only 5 patients needed analgesic. The mean recovery time of the bowel function was 52(24～74) hours. The hand incisions healed well, and only one occurred complications and another suffered death. [ Conclusions ] Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure is to be feasible and safe, and has the merits of minimally invasive surgery.

Objective To construct the eukaryotic expression vector of human telomerase RNA component ( hTR) and study its biological function tentatively .Methods hTR Gene was obtained by PCR from cDNA template , which was reverse transcribed from 293T mRNA and cloned into pCDNA3.0 vector.The recombinant plasmid and empty vector were trans-fected into 293T cells, and hTR expression was identified by qRT-PCR.HepG2 cells that stably transfected with pCDNA3.0-hTR were constructed and identified by qRT-PCR.These cells were used to assess the interaction of hTR with human telomerase revese transcriptase ( hTERT ) and dyskerin .Telomerase activity was also detected in HepG 2 cells transfected with pCDNA3.0-hTR.Results pCDNA3.0-hTR eukaryotic expression vector was successfully constructed by double digestion identification .The inserted fragment was confirmed by sequencing .The expression of hTR in human 293T cells and HepG2 pCDNA3.0-hTR stable cell line was identified.In addition, qRT-PCR and Western blotting results showed that hTR could interact with hTERT and dyskerin , while hTR overexpression could not regulate the telomerase activity in HepG2 cells.Conclusion The eukaryotic expression vector of pCDNA 3.0-hTR is successfully constructed and expressed.This study will contribute to the further study of cancer therapy targeting hTR .

Objectives:To investigate the influence of PN via portal vein on insulin and glucagon in liver regeneration. Methods:The rabbits were randomly devided into control group( n =5),PN via portal vein group(group Ⅰ, n =10) and PN via central vein group(group Ⅱ, n =10).The PN was performed for 6 days after partial hepatectomy.The concentration of serum insulin and glucagon in portal and perpheral vein were analysed with radioimmunoassay. Results:The concentration of serum insulin was increased in group Ⅰ and group Ⅱ,and it was increased significantly( P 0.05),but it was increased significantly in portal vein blood in group Ⅰ( P

Objective To analyze the influencing factors of water iodine in Shandong Province.Methods The county-based study set Shandong Province as a research site.The water iodine data of county (city) from 2008 to 2010 were obtained from Shandong Institute for Prevention and Control of Endemic Disease.Water iodine content was used as a dependent variable,and soil type,hydrogeological type,topography and distance to the Yellow River were analyzed as independent variables.Normality test and general linear regression analysis of the dependent variables were performed using SAS 9.3 software;geographically weighted regression (GWR) analysis was performed using SAM V4.0 software;related electronic maps were drawn using ArcGIS 9.3 software.Results A total of 108 164 water iodine content data were collected.General linear regression analysis showed that the constructed regression model was statistically significant (F =16.29,P ＜ 0.01),and the soil type was included in the model with a determination coefficient (R2) =0.51.GWR analysis showed that R2 =0.63 and the adjustive determination coefficient (R2adj) =0.59.Considering the autocorrelation of the variable space,the model's goodness of fit was better than that of the traditional general linear regression model.GWR analysis showed that soil type and distance to the Yellow River were major factors related to water iodine in Shandong Province.There was a negative correlation between soil type and spatial variability of water iodine in most areas of Shandong Province,the correlation coefficients weakened gradually from west to east,indicating a geographic gradient variability.The correlation coefficients of distance to the Yellow River and spatial variability of water iodine were negative in some areas,while they were positive in other areas,indicating a clear geographical variability from southwest to northwest.Conclusion The soil type and the distance to Yellow River are important factors affecting the spatial distribution of water iodine in Shandong Province.

Objective To detect the spatial distribution characteristics of water fluoride in Shandong Province.Methods The county-based study set Shandong Province as a research site.The county level fluoride database was matched with electronic maps to build geographic information system (GIS) spatial data platform.Global Moran's I and Local Moran's I index were calculated,respectively,and the cluster range of water fluoride distribution in Shandong Province was studied through SaTScan software.Results The water fluoride was normal (≤ 1.0 mg/L) in 54 counties in Shandong Province,mainly located in Weihai and Yantai in the eastern,Dongying in northern,and vast region in middle and southeastern of Shandong Province.Eighty-six counties were high water fluoride counties (＞ 1.0 mg/L),mainly distributed in the southwest,northwest and north-central of Shandong Province,showing a significant geographical feature.Global spatial autocorrelation analysis showed that the distribution of water fluoride content in Shandong Province showed significant positive spatial autocorrelation (Moran's I =0.44,Z =6.83,P ＜ 0.01).Local Moran's I analysis showed water fluoride in 13 counties had local spatial autocorrelation,being all high-high clusters.And these results were statistically significant (P ＜ 0.05).A cluster area was detected through SaTScan spatial analysis software,including 15 counties.The center was located in Dongming County of Heze City,with radius of 130.08 km.The results and the local spatial autocorrelation results were basically consistent.Conclusions There are apparent spatial autocorrelation and spatial cluster in water fluoridation in Shandong Province.Spatial autocorrelation and SaTScan software can be combined in exploring the spatial distribution of water fluoride.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.