Objective To evaluate the efficacy of surgical retrieval of testicular spermatozoa,and to present the preliminary results of the retrieved testicular spermatozoa used in intracytoplasmic sperm injection (ICSI) for treatment of non obstructive azoospermic infertility. Methods Forty nine cases of non obstructive azoospermia underwent open testicular biopsy and diagnostic testicular sperm extraction (TESE).Those who had sperms in diagnostic TESE underwent ICSI at least 3 months later. Results Sperms were detected in diagnostic TESE in 12 cases (24.9%). The testicular volume,FSH level and testicular pathology did not accurately predict the presence or absence of sperm in testes.Seven (87.5%) of 8 cases had sperm in re TESE, which were used in their ICSI cycles,resulting in 3 clinical pregnancies. Conclusions The diagnostic TESE should be performed to determine the presence or absence of testicular spermatozoa in testicular failure before ICSI,and the surgically retrieved testicular spermatozoa can be adopted in ICSI for treatment of non obstructive azoospermic infertility.

Objective To investigate the value of high frequency 2-Dimensional and color Doppler flow imaging combined with mammography on the diagnosis of breast cancer. Methods 90 patients with breast cancer and benign breast lesions in 22 cases, respectively, separate by color Doppler ultrasound and mammography and their combination were compared. Results The blood flow signals were Ⅱ～Ⅲ grade(76.32% ) in breast cancer and benign breast lesions less blood flow to 0 ～Ⅰ grade ( 87.10% ); The detection rate of blood flow 89.48% in breast cancer were significantly higher than 38.71% in benign breast lesions ( x2 = 4.57, P ＜ 0. 05 ); 68 cases (75.5 % ) were diagnosed by mammography 38 cases(55.8% ) in diameter≤2. 0em were significantly higher than 30 cases(44.4% ) in ≤ 1.0 cm( x2 = 3.97, P ＜ 0. 05 ); The corresponding rate of Joint Inspection 85.7 % (96/112) was higher than the r 72.3% (81/112) in color Doppler ultrasound and 75.8% (85/112) in mammography ( x2 = 3.87, x2 = 3.85, all P ＜0. 05 ). Conclusion Color ultrasonography combined with mammography could raise diagnostic rate of breast cancer.Their combination is the best one of breast imaging examinations.

8 years for 4 cases;5~8 years for 8 cases;3~5 years for 3 cases;less than 1 year for 1 case respectively.12 cases were followed up by color-sonography examination.The remaining 6 cases were followed by mail or phonecall.Results All cases reached clinical cure with relief or diasppearance of relevant symptoms and signs after 2~7 days PTA.88.9%(16/18) of the cases regained obility to labour or return to work.2 cases of the patients had lung infarction and heart failure immediately after the treatment,1 patient had recurrent stenosis and thrombosis after 1 year of PTA.Conclusion For treatment of membranous BCS,PTA should be the first choice.The majority methods of preventing recurrent stenosis and thrombosis are antithrombin application before PTA and adequate angioplasty during PTA.

Objective To study the appearances of split cord malformation(SCM)and evaluate the diagnostic value of CT for SCM.Methods Clinical and CT data of 48 cases with SCM were analyzed retrospectively ,21 were males and 27 were females,ranged from 1 day to 8 years with a mean of 11.6 months. All cases evaluated by plain CT with coronal and sagittal reconstructions.Results Type I accounted 75%, consisted of two hemicords, each contained in its dural tube and separated by a rigid median septum .TypeⅡaccounted 25%, consisted two hemicords contained in a single dural sac separated by a non-rigid, fibrous median septum. Associated abnormalities: tethered cord syndrome(n=38), syringomyelia(n=9), intradural lipomas(n=10), meningocele(n=18).Conclusion CT can clearly demostrate the position, the septum and the shape of the SCM, as well as associated abnormalities.

Objective To explore the extensively drug resistant mechanism and clinical treatment strategy of Klebsiella pneu-moniae .Methods The isolate was identified by Vitek2 Compact System.Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.KPC-2 carbapenemase was detected by modified Hodge test.The gene encoding KPC-2 carbapenemase was amplified by polymerase chain reaction (PCR)and then sequenced.Results The strain was resistant to all antibiotics used in routine antimicrobial susceptibility testing except amikacin.Modified Hodge test showed positive result.KPC-2 gene was detected by PCR.The sequence was consistent with that of 11844849 in GenBank.After treatment for one month,no exten-sively drug resistant K.pneumoniae strain was detected from the patient.Conclusions It is necessary to strengthen the monito-ring and improve the awareness of extensively drug resistant K.pneumoniae for better control of such infections.

Objective To explore the effect of multimodal exercise combined with enteral nutrition dur-ing radiotherapy in the patients with esophageal cancer complicating diabetes.Methods A total of 52 patients with esophageal cancer complicating diabetes in Zhejiang Provincial Tumor Hospital from January to Decem-ber 2021 were selected as the study subjects and divided into the control group(n=27)and intervention group(n=25)by using the random number table method.The control group implemented the routine exercise scheme,while the intervention group was given the multimodal exercise intervention on the basis of routine exercise.The blood glucose metabolism indicators,related biochemical indicators during radiotherapy and the incidence rate of adverse events during exercise were compared between the two groups.Results The levels of fasting blood glucose,random blood glucose and blood glucose before sleep in the intervention group during radiotherapy were(7.79±1.61)mmol/L,(9.47±1.77)mmol/L and(9.97±3.02)mmol/L,which were lower than(11.84±3.47)mmol/L,(14.18±5.42)mmol/L and(14.62±3.83)mmol/L in the control group with statistically significant differences(P<0.05).During the radiotherapy period,the levels of albumin,total protein and prealbumin in the intervention group were(37.96±2.13)g/L,(68.13±5.02)g/L and(232.89±41.11)g/L,which were lower than(36.05±2.89)g/L,(64.96±5.95)g/L and(207.76±47.59)g/L in the control group with statistically significant differences(P<0.05).The incidence rates of adverse e-vents such as falls,hypoglycemia and accidental extubation during multimodal exercise in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The multimodal exercise could significantly improve the nutritional status during radiotherapy in the patients with esophageal cancer complicating diabetes,stabilize the blood glucose level of the patients,and has good feasibility and safety.

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO
COVID-19 ; Healthy Volunteers ; Humans ; Masks ; Oximetry ; Oxygen/blood*