Objective To study the diagnosis,management and prognosis of persistent m?llerian duct syndrome (PMDS). Methods 2 cases of PMDS associated with transverse testicular ectopia were reported.Clinically there was azoospermia or testis tumor.Corporeal hysterectomy and orchidopexy were performed and the testis tumor was excised. Results Vascular supply and hormonal function of the testis were normal in both 2 patients after 2 year's follow up. Conclusions PMDS is an inherited male pseudohermaphroditism. Every effort should be made to preserve the testis and its fertility function when surgical management is needed.The possible development of testis tumor should be kept in mind and closely observed.

Objective To explore the clinical efficacy of atorvastatin calcium in the treatment of chronic congestive heart failure(CHF).Methods According to the order of admission with single and double,132 CHF patients were randomly divided into control group and study group,66 cases in each group.The control group was given routine treatment,and the study group was treated with atorvastatin calcium on the basis of routine treatment.The clinical efficacy was assessed.Before and after treatment,the serum TC level was measured,the left ventricular ejection fraction(LVEF) and heart left ventricular end diastolic diameter(LVDD),heart index(CI) were assessed by echocardiography.The adverse reactions during treatment were observed.Results The total effective rate of the study group was 92.42%,which was higher than 83.33% of the control group,the difference was statistically significant(x2=9.35,P<0.05).The serum TC of the study group after treatment was (3.24±0.75)mmol/L,which was lower than (4.70±0.86)mmol/L of the control group,the difference was statistically significant(t=8.96,P<0.05).The level of LVEF of the study group after treatment was (46.39±6.35)%,which was higher than (44.60±5.82)% of the control group,the difference was statistically significant(t=9.47,P<0.05).The levels of LVDD and CI were (47.06±5.39)mm and (2.60±0.62)L·min-1·m-1 respectively,which were lower than (49.53±6.17)mm and (2.97±0.69)L·min-1·m-1 of the control group,the differences were statistically significant(t=10.31,9.40,all P<0.05).There was no significant difference in adverse reactions between the two groups(x2=2.04,P>0.05).Conclusion Atorvastatin calcium in the treatment of CHF patients on the basis of routine treatment has better clinical effect.It can significantly reduce TC and significantly improve cardiac function,and has high safety.

Objective To investigate the effect of nifedipine on brain edema and neurological function in patients with cerebral hemorrhage . Methods 72 patients with ICH from October 2013 to October 2015 in our hospital were selected, and randomly divided into experimental group and control group, 36 cases in each group.The control group used dehydration to reduce intracranial hypertension, improve cerebral circulation, promote nutritional metabolism and anti infection and other conventional treatment,and the experimental group daily intravenous infusion of 1.0 mg of nifedipine on the basis of control group, a course of ten days.The activity dependence, clinical efficacy, MESS score, ICH score, BI score, brain hematoma and brain edema volume were observed and compared between the two groups before and after treatment.Results After treatment, the activity dependence of the experimental group was significantly better than that of the control group ( P <0.05 );the clinical effective rate of the experimental group was significantly higher than that of the control group (P<0.05).BI scores of both groups were increased after treatment, MESS scores were reduced(P<0.05);The BI score of the experimental group was significantly higher than that of the control group (P<0.05),and the MESS score was significantly lower than that of the control group (P <0.05).The volume of cerebral hematoma and the volume of cerebral edema were significantly reduced after treatment in both groups (P<0.05),there was no significant difference in the volume of cerebral hematoma between two groups,there was significant difference in the volume of cerebral edema between two groups (P <0.05).Conclusion Nifedipine can effectively reduce cerebral edema in patients with cerebral hemorrhage, reduce the degree of neurological deficit, improve clinical efficacy.

Objective To discuss the clinical efficacy of point-injection with nerve growth factor (NGF) in treatment of infantile cerebral palsy.Methods According to the time order,50 cases with cerebral palsy were randomly divided into the treatment group(30 cases) and the control group (20 cases).Both groups were given the conventional treatment of Bobath mainly exercise therapy,homework therapy and the language therapy.In addition,the treatment group was given the treatment of point-injection with NGF.Gesell scale was used to evaluate all the patients before and after treatment.Results After treatment,the Gesell evaluation of the treatment group was higher than control group,and the difference was statistically significant (t =-2.096,-2.187,-2.048,-2.053,-2.225,all P ＜0.05).Conclusion On the basis of rehabilitation training,point-injection with NGF could improve intelligence,motor function and language in children with cerebral palsy,and the efficacy was obvious.

Objective To assess the effect of chloramine disinfection on the formation of drinking water disinfection by-products(DBPs )and their mutagenicity.Methods The bacterial indices,chloroform and carbon tetrachloride content in the finished water samples using liquid chlorine and chloramine disinfection respectively were determined in August,2001(plentiful water season)and in March,2002(low water season).The mutagenicities of organic extracts from the water samples were tested using Ames test.The levels of DBPs and the mutagenic activities of water samples treated with different disinfection methods were compared.Results The total count of bateria and coliform bacteria were0/ml and0/L respectively at free chlorine con-centration of about 1mg /L in the chloraminated drinking water,which decreased81%-84%compared with those of the chlori-nated drinking water samples.The carbon tetrachloride concetration were all

Objective To analyze prognostic factors of surgical treatment for elderly patients with non-small cell lung cancer,in order to provide a theoretic basis for improving the prognosis of patients with non-small cell lung cancer.Methods Clinical data of 145 elderly patients with non-small cell lung cancer who had received surgical treatment at our hospital from January 2012 to September 2012 were retrospectively analyzed.The survival rates of patients were investigated.Results The median survival time was 31.5 months,and 1-year,2-year and 3-year survival rates were 61.4％,45.5％ and 40％,respectively.Single factor analysis showed that lesion size,number of metastatic lymph nodes,clinical stage,pathological type and radiotherapy were among the factors affecting prognosis.Multiple COX regression analysis showed that a lesion size ＞3cm,number of lymph nodes with metastasis ＞ 2 and pathological type were independent risk factors for patient prognosis,and radiotherapy was a protective factor for prognosis.Conclusions Surgical treatment has good curative effects on non-small cell lung cancer in elderly patients.Lesion size,number of lymph nodes with metastasis,pathological type and radiotherapy are important factors affecting prognosis,and can be used for prognosis assessment.

Objective To study the effects of esmolol on fluid responsiveness and hemodynamic parameters in patients with septic shock.Methods A prospective self-control study was conducted.Fifteen septic shock patients undergoing mechanical ventilation admitted to Department of Critical Care Medicine of Yijishan Hospital from January 2015 to August 2015 were enrolled.All patients enrolled in this study were given the treatment based on American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus 2012.Esmolol was intravenously injected at a beginning rate of 6 mg·kg-1·h-1, and then the dose was adjusted to reduce heart rate by 10％ from baseline.The changes in hemodynamic and systemic oxygen metabolism indexes were monitored by pulse indicator continuous cardiac output (PiCCO) before and 2 hours after the esmolol administration, and the fluid responsiveness was evaluated by stroke volume variation (SVV).SVV ≥ 10％ was considered to be a positive fluid responsiveness.Results In 15 patients, 9 were male and 6 female, with an age of 65 ± 16.Among them 10 patients suffered from pulmonary infection, and 5 patients with abdominal infection.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 21 ±9;sequential organ failure score (SOFA) was 8 ±4.28-day mortality was 40.0％.SVV was significantly decreased after esmolol infusion as compared with baseline [(14 ± 5)％ vs.(17 ±7)％, t =2.400, P =0.031].Heart rate [HR (bpm): 100±4 vs.112±8, t =8.161, P =0.000], cardiac output [CO (L/min):6.13 ± 1.45 vs.7.88 ± 1.82, t =4.046, P =0.001], cardiac index [CI (mL·s-1·m-2): 51.51 ± 11.00 vs.66.18 ± 11.48, t =4.131, P =0.001], stroke volume index [SVI (mL/m2): 31.0 ± 6.4 vs.35.4 ± 6.5, t =2.577, P =0.020], the maximum rate of left ventricular pressure rise [dp/dt max (mmHg/s): 927±231 vs.1 194±294, t =3.775, P =0.002], global ejection fraction (GEF: 0.21 ±0.05 vs.0.24±0.06, t =3.091, P =0.008), cardiac function index (CFI: 5.03 ± 1.37 vs.6.59 ± 1.92, t =4.769, P =0.000) showed significant decrease during esmolol infusion.On the other hand, central venous pressure [CVP (mmHg, 1 mmHg =0.133 kPa): 9±3 vs.8±3, t =-3.617, P =0.003], diastolic blood pressure (DBP, mmHg: 69± 15 vs.66± 13, t =-2.656, P =0.019), systemic vascular resistance index (SVRI, kPa·s·L-1·m-2:206.8±69.8 vs.206.8±69.8, t =-3.255, P =0.006) were significantly increased during esmolol infusion.No significant difference was found in systolic blood pressure [SBP (mmHg): 120 ± 25 vs.123 ± 18, t =0.678, P =0.509],mean arterial pressure [MAP (mmHg): 86 ± 18 vs.85 ± 14, t =-0.693, P =0.500], global end diastolic volume index [GEDVI (mL/m2): 614 ± 84 vs.618 ± 64, t =0.218, P =0.830], extravascular lung water index [EVLWI (mL/kg):5.99±1.50 vs.5.73±1.14, t =-1.329, P =0.205], central venous oxygen saturation (ScvO2: 0.711±0.035 vs.0.704 ± 0.048, t =-0.298, P =0.773), arterial blood lactate [Lac (mmol/L): 3.1± 0.3 vs.3.0 ± 0.4, t =-0.997, P =0.345],and difference of central venous-arterial carbon dioxide partial pressure [Pcv-aCO2 (mmHg): 4.1 ± 0.9 vs.4.7 ± 0.5,t =1.445, P =0.182] as compared with those before esmolol treatment.Conclusion Heart rate control with esmolol infusion may reduce fluid responsiveness, cardiac function, heart rate and cardiac output without adverse effect on systemic perfusion in septic shock patients.

Objective To compare the incidence of cardiopulmonary complications between treatment of video assisted thoracoscopic operation and traditional thoracotomy operation in elderly patients with non-small cell lung cancer.Methods 122 cases of elderly patients with non small cell lung cancer were treated in our hospital from Mar 2010 to Jun 2014,and randomly divided into observation group (therapeutic lobectomy by video assisted thoracoscopic operation) and control group (therapeutic lobectomy by traditional thoracotomy operation) (n=61,each).The postoperative cardiopulmonary complications and relevant indexes of cardiopulmonary function were analyzed and compared between the two groups.Results Before operation,there was no significant difference in the relevant indexes of cardiopulmonary function between the two groups (P＞0.05).After operation,the forced expiratory volume in one second (FEV1) and maximal ventilatory volume (MMV) were higher and the heart rate was lower in observation group than in control group (t=3.682,2.243,5.677,all P＜0.05).The incidence of cardiopulmonary complication was lower in observation group than in control group (13.1％ vs.27.9％,x2 =4.075,P=0.044).Conclusions Video assisted thoracoscopic operation is better for the recovery of cardiopulmonary function,and can reduce cardiopulmonary complication in elderly patients with non-small cell lung cancer.

Objective To study the effect and reliability of venlafaxine on depression and anxiety symptoms in cervical cancer patient,and to assess the overall quality of life before and after treatment.Methods We treated 63 cervical cancer patients with depression by use of venlafaxine for 8 weeks,at the same time,evaluated their emotion state.change of quality of life and the adverse effect with HAMD,HAMA,TESS and laboratory tests.Results After 8 weeks.patients' scores of anxiety and depression decreased significantly from the baseline(P＜0.01),effective rates were 65%and 52%respectively.Three domains of quality of life(physiology,psychology and independence)became much better than those of baseline(P＜0.05).Conclusions This studyshows that venlafaxine can reduce the depression and anxiety symptoms in cervical cancer patients,and the react time is 2 to 4 weeks.Venlafaxine with the treatment of depression and enxiety can improve the quality 0f patients' life.

Objective To enhance the understanding of MR imaging in neurosyphilis Methods One case of syphilitic gumma with positive treponemal antibody test in the serum was confirmed pathologically after operation, and the other case with positive treponemal antibody test in the cerebrospinal fluid (CBF) was cured by medical therapy Both patients were examined by MRI Results Syphilitic gumma has some characteristic MRI findings The roundish areas of low signal or mixed low and iso signal intensity were revealed on T 1WI with the diameter ranged from 2 0 cm to 2 5 cm The lesions were located at the cortex or infra cortex surrounded by obvious edema The lesions showed high signal or mixed signal made up of iso , high, and low signals on T 2WI Gd DTPA enhanced T 1WI demonstrated irregular circular enhancement on the edge of the lesions and abnormal neighboring meningeal enhancement, and the border of the lesions was angulated with neighboring meninges by obtuse angle Conclusion The final diagnosis of neurosyphilis should depend on laboratory examination or histopathologic examination, but neuroimaging suspicion is paramount to early detection and diagnosis of neurosyphilis