Objective To review the management of impalpable testes. Methods Ninty-eight impalpable testes in 82 patients underwent surigcal exploration and all the cases were studied retrospectively. Results 17 testes were found on ultrasonography and 3 of 4 cases were found on ECT pre-operatively.Ninty-eight testes in 82 patients were explored.Eighty-five testes were found,52 in the inguinal canal,33 in the abdomen.Another 13 testes were absent.Ninty-two(94%) testes were found on inguinal exploration or limited laparotomy when necessary. Conclusions Inguinal exploration,with lower abdominal laparotomy if necessary remains the main form of management.If the testes could not be found still laparoscopy should then be performed.

Objective To study the effects of aminoguanidine (AG), a selective inhibitor of inducible nitric oxide synthase (iNOS) on the pathological changes of liver tissues and ultrastructural changes of liver cells in rodent model of endotoxic shock. Methods Twenty-four male Wistar rats were randomly divided into normal control group,lipopolysaccharide (LPS) control group and AG treatment group, each group had 8 rats. Rats were challenged by E.coli LPS to set up the model of endotoxic shock, AG group were treated by aminoguanidine. The pathological and ultrastructural changes of liver tissues and plasma NO contents of three groups were observed and compared. Results Light microscopy revealed that many tiny abscesses scattered in liver tissue in LPS group, accompanied by necrosis of liver cells and neutrophils infiltration, while liver injuries of AG group were much slighter than that in LPS group. Electron microscopy revealed that there were dissolved plaques in hepatocyte nuclears, swelling of mitochondria, decreasing in number of mitochondrial ridges, while AG play a protective role to nuclears and mitochondria of hepatocytes. The plasma NO levels of LPS control group were higher than that of normal control group, and plasma NO levels decreased significantly after AG treatment, but still higher than that of normal control group. Conclusion Aminoguanidine selectively inhibits iNOS activity and prevents the overproduction of NO induced by iNOS, thus attenuates the damages of liver structure induced by NO. This method has potential value in clinical application, which deserves more deep research.

Objective To analyze the clinical and pathological features of collecting duct carcinoma (CDC) of the kidney. Methods 11 patients with CDC were analyzed,among which 6 were males and 5 were females.Their age ranged from 22 to 67 years old with a mean age of 55.4 cases were found by routine health examination,4 cases were presented with gross hematuria and 3 cases had flank or abdomen pain.The CT scan showed an unclear boundary mass in kidney,with tumor sizes from 2.1 to 8.5 cm ( mean 5.6 cm).Only medullary involvement was present on CT in 3 cases,Medullary and cortical involvement in 5 cases,Medullary and pelvic involvement in 2 cases,and all involvement in 1 case.Infiltrative lesion has expanded kidney but maintains reniform contour.Contrast-enhanced CT scan showed lesion mild to moderate enhancement compared with surrounding parenchyma. Results Radical nephrectomy was performed in 8 cases and palliative nephrectomy in 3 cases.All patients were finally diagnosed by pathology.Grossly,the tumor is often appears gray or white.In HE staining,tumor showed prominent tubular or tubulaopapillary structures with desmoplasia and inflammatory reaction.Occasionally,some tumor cells take on a hobnail appearance.Immunohistochemical examination showed UEA-1 positive in all cases,EMA positive in 9 cases,PNA positive in 8 cases,and HMW-CK positive in 7 cases.Only 2 patients showed positive CD10.7 patients died within 6 to 47 months (mean 12.5 months),2 survived with tumor free for 9 months and 8 years respectively,one lost of follow-up,and one patient with distant metastasis is receiving postoperative chemotherapy. Conclusions Collecting duct carcinoma of the kidney is a rare histological type of renal cell carcinoma,whose final diagnosis depends on histopathological examination.Rapid progression,highly malignant,poor prognosis are the characteristics of this disease.

Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter.
Anesthesia ; methods ; Humans ; Signal Processing, Computer-Assisted

Background and purpose:Cytokine-induced killer (CIK) has both the advantages of T lympho-cytes’ powerful anti-tumor activity and NK cells’ tumor killing capacity without MHC restriction. It could directly kill tumor cells, regulate and enhance immune function, without damaging the structure and functions of the immune sys-tem. Its effects on the treatment of malignant solid tumors has been widely recognized. This study aimed to evaluate the anti-proliferation effects of CIK cells obtained and cultivated from lung cancer patients’ lymph nodes. Meanwhile, the safety of clinical transfusion was observed.Methods:The peripheral blood and lymph nodes of 6 surgery patients with lung cancer from Shanghai Chest Hospital were used to cultivate CIK cells for 14 days. The phenotypes of CIK cells were detected by lfow cytometry. The anti-proliferation activities of CIK cells on A549 lung cancer cells were detected by CCK8 assay. The morphological changes of CIK cells were observed by invert microscope. The expression of CEA level and adverse events were evaluated after CIK transfusion.Results:The proportion of CD3+CD56+T lymphocyte in two groups were both more than 30%. The CCK8 assay showed that the suppression rate of lymph nodes group was higher than that of peripheral blood group at each effect/target ratio(P<0.05). The adverse effect of CIK transfusion was mild and tolerable. The expression of CEA level decreased in patients.Conclusion:Lymph nodes of surgery patients with lung cancer can be used for cultivation of CIK cells. The anti-tumor activity of CIK isolated from lymph nodes is better than that of CIK cells cultivated from peripheral blood. Preclinical experiments showed high safety.

Objective To compare the efficacy and safety of sertraline plus doxazosin and tadalafil in the treatment of premature ejaculation (PE).Methods From Feb.to Aug.2011,One hundred and five patients from 19 to 52 years old with PE but without any obvious organic cause were enrolled in this study.They were randomly divided into Groups A,B and C in equal number.All the three Groups received 50 mg sertraline daily 4 to 6 hours before planned sexual activity for 12 weeks,Group B were added with 4 mg Doxazosin every day 8 to 9 hour before planned sexual activity,and Group C were given 20 mg Tadalafil as needed one hour before planned sexual activity.The mean intravaginal ejaculatory latency time,the mean intercourse satisfaction domain values and the sexual activity satisfaction domain values of the patient couples of group A before treatment were 0.6±±0.1 min,8.3±1.3,5.3±1.4; Group B were 0.6±0.1 min,7.6± 1.5,5.6± 1.5 ; Group C were 0.6±0.1 min,8.1 ± 1.1,5.0± 1.2,respectively.We observed before and after the treatment for 12 weeks and the effects were evaluated.Results The mean intravaginal ejaculatory latency time,the mean intercourse satisfaction domain values and the sexual activity satisfaction domain values of the patient couples of group A were 3.9±0.l min,10.6±0.1,9.7±0.1,respectively; Group B were 4.5 ± 0.1 min,12.8±1.3,11.9±1.6; Group C were 5.6±0.3 min,14.6±1.4,13.1±1.5,respectively.The mean intravaginal ejaculatory latency time improved in all of the 3 groups,but more significantly in Group B and C (P＜0.05).The mean intercourse satisfaction domain values of the IIEF were significantly greater in Group B and C than in Group A (P＜0.05) after the treatment; and the sexual activity satisfaction domain values of the patient couples were greater in Group C than in Group B after the treatment,but it is not significant.As for the side effects,5 cases in group A felt headaches and dizzy (14.3％),8 cases in group B felt headaches and dizzy (22.9％),and in group C,9 cases felt headaches and dizzy (25.7％),6 cases experienced flushing episodes on the body (17.1％).there was a higher rate of headaches (P＜0.05) and flushing episodes (P＜0.05) in Group B and C than in Group A.Conelusions Sertraline combined with Tadalafil or Doxazosin can achieve significantly better results than sertraline alone in patients with premature ejaculation.However,the combined treatment is associated with a slightly increased in the drug related side effects,and there is no significant difference in the efficacy of Sertraline Plus Tadalafil or Doxazosin in the treatment of premature ejaculation.

BACKGROUND:The early damaged chondrocytes are susceptible to de-differentiate and exert unstable phenotype during the in vitro culture, thus needing some growth factors.
OBJECTIVE:To observe the promotion effect of insulin-like growth factor 1 on the in vitro proliferation of chondrocytes in adult rabbits with traumatic arthritis.
METHODS:Traumatic arthritis models of adult rabbits were established by using the modified Hulth method. After the models were successful y established, the distal femur and proximal tibia were harvested under sterile conditions, the chondrocytes were cultured. The cultured cells were divided into two groups:control group was cultured with Dulbecco’s modified Eagle’s medium containing 10%fetal bovine serum, while experimental group was cultured with Dulbecco's modified Eagle’s medium containing 100μg/L insulin-like growth factor 1. The effect of insulin-like growth factor 1 on the proliferation of chondrocytes in adult rabbits with traumatic arthritis was determined through the cytomorphology, cellcounting, and cellactivity.
RESULTS AND CONCLUSION:The chondrocytes in adult rabbits with traumatic arthritis were successful y cultured, the majority of cells were mini-cells, presenting smal fusiform, round or polygonal shape. Hematoxylin-eosin staining showed that the number of cells in experimental group was higher than that in control group. MTT assay found that the absorbance of cells in experimental group was greater than that in control group (P<0.01). Our findings indicate that, insulin-like growth factor 1 can promote the in vitro proliferation of chondrocytes in adult rabbits with traumatic arthritis.

BACKGROUND: The complicated localization of intramedullary nails and osteotomy more dependent on surgeons' experience limit the application of conventional total knee arthroplasty (TKA). The occurrence of three-dimensional (3D) printing technology can achieve precise localization and osteotomy in TKA.OBJECTIVE: To explore the effectiveness of 3D printing technology-aided TKA versus conventional TKA for genu varum.METHODS: Thirty-four patients with genu varum undergoing primary unilateral TKA were recruited and were then divided into two groups (n=17 per group) in accordance with the random number table. One group was treated with TKA with 3D printing guild plate (3D printing group), while the other group received the conventional TKA (conventional group).The intraoperative and postoperative blood loss, operation time, as well as the Hospital for Special Surgery score, range of motion, and lower limb mechanical alignment at 2 weeks postoperatively were compared between two groups.RESULTS AND CONCLUSION: (1) The range of motion of knee in the 3D printing group was larger than that in the conventional group, but had no significant difference at 2 weeks postoperatively (P=0.744). (2) There was no significant difference in the Hospital for Special Surgery scores between two groups at 2 weeks postoperatively (P= 0.532). (3) The postoperative lower limb mechanical alignment showed no significant difference between two groups (t=0.218, P=0.632).(4) The operation time in the 3D printing group was significantly shorter than that in the conventional group (P=0.000). (5) The blood loss in the 3D printing group was significantly less than that in the conventional group (P=0.000). (6) Our findings indicate that 3D printing technology-aided TKA exhibits similar results to the conventional TKA in the Hospital for Special Surgery scores, range of motion, and lower limb mechanical alignment, but it shortens the operation time,reduces the blood loss, and achieves precise osteotomy, which is available for the elderly with poor basic condition, and weak tolerance of surgery.

Objective To obtain more information concerning polymorphism of the thyrotropin (TSHR) in Graves diseases(GD). Methods (1)A family of GD was studied (including 3 patients and 9 healthy family members)to examine SNPs of TSHR through direct sequencing of all 10 exons and part of introns. (2)In the current case-control study, 30 patients with familiar GD, 48 sporadic patients and 96 healthy control individuals were used to assess whether SNP of TSHR was associated with GD. Genomic DNA was extracted from peripheral leukocytes isolated from ACD-anticoagulated blood. Ten exons were amplified by PCR, using primers designed by ourselves. After purifying, the products were sequenced. Results Eight polymorphisms were found. There was a novel polymorphism in exon 8. There were no significant differences between patients and controls. Conclusions These findings suggested that the novel and other polymorphisms of the TSHR gene may not be responsible for GD. There are racial differences in the distribution of polymorphisms of TSHR gene.

[Objective] To explore the feasibility and advantages of blood microdialysis technique for the pharmacokinetic study of sinomenine. [Methods] In this study, rats served as the experimental subjects and sinomenine was administered to the rats by intravenous injection. With microdialysis technique for blood sampling, the blood concentration of sinomenine was determined by high performance liquid chromatography (HPLC) and the associated pharmacokinetic parameters were analyzed by 3p97 program. [Results] The pharmacokinetics process of sinomenine in rats presented as the two-compartment model. The half-life of distribution phase was 10.98min and that of elimination phase was 44.71 min. [Conclusion] It is feasible to study pharmacokinetic parameters of sinomenine by using blood microdialysis technique. In comparison with the traditional technique, blood microdialysis technique is superior to the examination of drug blood concentration .