Objective To investigate the diagnosis and therapy of testicular germ cell tumour.Methods The clinical data of 45 cases that were confirmed by pathology testicular germ cell tumour were retrospectively analyzed.Results All 45 cases were resected successfully.Among of them,28 cases seminoma,3 cases teratoma,2 cases embryoma,2 cases choriocarcinoma,4 cases mixed testicular germ cell tumour,5 cases yolk sac tumor,1 case spermatocytic seminoma.The treatment method was selected by pathology results.Eleven cases were lost,34 cases were followed up for 3 month to 5 years,25 cases seminoma,9 cases non-seminoma,5 cases were died.Conclusion Surgical resection and adjuvant chemotherapy are important factors for testicula disease.

BACKGROUND: Super-resolution reconstruction has been extensively studied and used in many fields,such as medical diagnostics,military surveillance,frame freeze in video,and remote sensing.OBJECTIVE: In order to obtain high-resolution magnetic resonance images,gradient magnetic field is required and the signal-to-noise will be reduced due to the decrease in voxel size with traditional scan.The present study used a self-adaptive regularized super-resolution reconstruction algorithm to acquire high-resolution magnetic resonance images from four half-pixel-shifted low resolution images.METHODS: The least squares algorithm was used as a cost function.The dedvative of the cost function was calculated to obtain an iterative formula of super-resolution reconstruction.In the process of iterative process,the parameter and step size of image resolution were regularized.RESULTS AND CONCLUSION: The new regularization parameter makes cost function of the new algorithm convex within the definition region.The piori information is involved in the regularization parameter that can improve the high-frequency components of the restored image.As shown from the results obtained in the phantom imaging,the proposed super-resolution technique can improve the resolution of magnetic resonance image.

Objective To investigate the relationship of expressions of cylooxygenase-2(COX-2) and hypoxia-inducible factor-1?(HIF-1?) in hepatocelluar carcinoma(HCC) and the possible antineoplastic mechanism of selective COX-2 inhibitor.Methods The expressions of COX-2 and HIF-1? in 53 cases of HCC tissues were detected immunohistochemically.Western blot was employed to evaluate the effects of variant concentration of COX-2 inhibitor meloxicam on expression of HIF-1? in Cobaltchloride-stimulated SMMC-7721 cell.Results Of 53 tumor tissues,the expression of COX-2 was 22/53(41.5%) strongly positive stained,11/53(20.8%) positive stained,and 20/53(37.7%) negative stained.Meanwhile the expression of HIF-1? was 18/53(34.0%) strongly positive stained,18/53(34.0%)positive stained,17/53((32.1%)) negative stained.The expression of COX-2 was correlated positively with HIF-1? in HCC(r=0.440,P

BACKGROUND: Ions doping is an important method for the modification of bioceramic.OBJECTIVE: To evaluate a novel co-substituted bioceramic scaffolds as bone repair material.METHODS: The microstructure and crystallization of the scaffolds were detected by scanning electron microscope and X-ray diffraction. Compression strength test,degradation test and cell culture experiment were assumed to evaluate the properties of KSCPP in vitro. After a short period of muscle pouches implantation,the performance of KSCPP in vivo was evaluated.RESULTS AND CONCLUSION: The results show that KSCPP scaffold has a higher compressive strength and degradation rate. Moreover,the MTT assay and implantation test reveal that the KSCPP scaffold exhibits lower cytotoxicity and better tissue biocompatibility than CPP and HA. The study proved the great potential of KSCPP in bone repair applications.

Objective To investigate the effects of emodin on the triglyceride metabolism and oxidative stress in steatosis in HepG2 cells and possible underlying mechanisms.Methods The appropriate concentration of emodin on HepG2 cells were detected by methyl thiazolyl tetrazolium (MTT) assay.HepG2 cells were induced to fat overaccumulation by 1 mmol/L free fatty acids (FFA) (oleate∶ palmitate =2∶1).The model group exposed to 10 μmol/L,20 μmol/L,40 μmol/L emodin.The intracellular lipid accumulation was documented by Oil Red O staining and the content of triglyceride and total cholesterol was observed.Reactive oxygen species (ROS) was determined by flow cytometry.Western blotting was performed to analyze the protein levels of adenosine monophosphate-activated protein kinase (AMPK),phosphorylated AMPK,and sterol regulatory element-binding protein 1 (SREBP-1).Results Emodin reduced lipid accumulation and triglycerides (TG) content (P ＜ 0.05).At the same time,it significantly reduced ROS production (P ＜ 0.05).Moreover,the levels of AMPK and p-AMPK protein were significantly upregulated,and SREBP-1 protein was significantly downregulated with the treatment of emodin (P ＜ 0.01).Conclusions This study has demonstrated that emodin can reduce fatty degeneration induced by FFAs in hepatocytes,and this effect may be partially mediated by the AMPK/SREBP-1 pathway.

Objective To elevate the efficacy and safety of descending neurogenic evoked potentials (DNEP) monitoring during severe rigid spinal deformity surgery.Methods All of 108 patients (43 males,65 females) who underwent surgical treatment for spinal deformity in our spinal center from July 2010 to August 2013 were retrospectively reviewed.The average age (17.5±5.8) ys(range 12-50 ys),the average following period is 38.6 months(range 24-52 months).Combined monitoring of SEP,MEP and DNEP model were used during surgery.All subjects with no neurological deficits preoperatively and got satisfied outcomes.Respectively evaluate the results of neurophysiological intraoperative monitoring (IOM).Data were collected to elevate the efficacy and safety of DNEP monitoring.Results All of 108 patients,15 patients (13.9％,15/108) showed significant changes of neurophysiological parameters,of which 9 cases (60％,9/15) were identified as true positive and 6 cases (40％,6/15) were identified as false positive.During the following-up period,2 patients developed permanent neurological deficit,and 3 patients showed transient neurological deficit who got fully recovered within 6 months after operation.DNEP showed alert in all 5 patients with truepositive alarm,of which 2 patients developed permanent neurological dysfunction and 3 cases showed postoperative short nerve dysfunction that got fully recovery within 6 months after operation.The sensitivity and specificity of SEP+MEP and DNEP were 100％ and 97.98％,100％ and 98.99％,respectively.Conclusion Combining use of MEP+SEP+DNEP monitoring during surgical treatment of spinal deformities presented to be a highly reliable method for the detection and prevention of iatrogenic injury.The results confirmed a high efficacy and safety of DNEP monitoring during spinal surgery.

Objective To investigate the syndrome types of traditional Chinese medicine ( TCM) in senile hypertension patients by cluster analysis. Methods Case report sheet for senile hypertension was formed, and then the general data and TCM syndrome information of 495 cases of senile hypertension were recorded. The frequency of syndrome information of the enrolled cases was analyzed, and then the syndrome types were classified by cluster analysis. Results The symptoms with high frequency in senile hypertension patients were dizziness ( 75.9%) , insomnia ( 33.1%) , chest distress ( 29.9%) , poor appetite ( 23.2%) , headache (22.4%), slippery pulse (54.9%), greasy fur (51.7%), stringy pulse (49.7%), and white fur (47.8%) . The main syndrome patterns of 495 cases of senile hypertension were upward hyperactivity of liver yang (23.8%), Qi deficiency and phlegm turbidity (21%), kidney qi deficiency (19.8%), phlegm blended with blood stasis (18.4%), and phlegm heat (17.0%) . Conclusion Senile hypertension patients are dominated with the syndrome types of upward hyperactivity of liver yang, Qi deficiency and kidney deficiency, and are usually complicated with phlegm turbidity, phlegm heat and blood stasis. The complicated syndromes of phlegm turbidity and blood stasis are commonly-seen. The results of cluster analysis are expected to supply evidence for the syndrome differentiation of senile hypertension.

The unilateral biportal endoscopic technique is defined as posterior unilateral of two small incision with established percutaneous observation channel and endoscopic observation channel in monitoring field. The operation tools were placed within the channel for each operation inside and outside vertebral canal. The characteristics of dual channel intervention make this technology different from coaxial endoscopic technology. This technique has a clear vision for flexible and convenient operation with the advantages of relatively simple surgical instrument requirements. In recent years, the use of unilateral dual channel endoscopic surgery in treating spinal diseases was gradually increasing, especially in the removal of nucleus including lumbar intervertebral disc protrusion and lumbar spinal stenosis disease decompression, and in endoscopic space-occupying lesions such as vertebral fusion and spinal canal between inside and outside. It was also applied in cervical and thoracic diseases with good clinical effects. Its advantages include less surgical trauma and faster recovery process. In addition, it has a large surgical field of vision under the microscope for easy identification of structures and surgery and with relatively gentle learning curve. Thus, it is conducive to beginners' mastery. However, complications such as nerve injury and postoperative lower limb numbness are still frequently reported. Some factors have to be considered, including insufficient understanding of the new technology, the local anatomy of the dual-channel endoscope, the operation of the spinal canal under the microscope. The successful application of the technique in treating various lumbar diseases needs understanding the operation process of the technique and local anatomy under the microscope.

Objective:To develop a unilateral biportal endoscopic technique and investigate the clinical efficacy of unilateral biportal endoscopic technique in the treatment of lumbar disc herniation and lumbar spinal stenosis.Methods:Between July 2018 and June 2019, 60 patients with lumbar disc herniation or spinal stenosis were treated by unilateral biportal endoscopic technique. According to the inclusion and exclusion criteria, 51 patients were included in the study. There were 25 cases of prolapsed lumbar disc herniation, 26 cases of degenerative lumbar spinal stenosis, all of which were treated with posterior lumbar decompression by unilateral biportal endoscopic laminectomy, and contralateral stealth decompression by unilateral approach was performed on the patients with bilateral stenosis. Endoscopic interbody fusion and percutaneous pedicle screw fixation were performed in 5 patients with instability. Operation time, length of incision, hospital stay and complications were recorded. Visual analogue scale (VAS) for low back pain and leg pain, Oswestry dysfunction index (ODI) and the modified Macnab scale were used to evaluate the clinical efficacy.Results:All operations were completed successfully, and no cases were transferred to open surgery. The operative time was 70.29±19.55 min (44-151 min), while the length of incision was 1.79±0.34 cm (1.4-3.0 cm). Postoperative CT suggested complete decompression with intact contralateral structure. All patients got out of bed 1-3 d after surgery, and the postoperative hospital stay was 3.49±2.76 d (1-14 d). The postoperative follow-up time was 13.59±2.80 months (10-21 months). Forty-six patients returned to work or normal activities within 3 weeks and 5 patients with interbody fusion returned to normal activities within 4 weeks. According to the modified Macnab criteria, the final outcome was excellent in 43 cases, good in 6 cases, and fair in 2 cases. There were 3 cases of dural sac tear during operation and 2 cases of transient numbness of lower limbs after surgery and they all recovered after conservative treatment. The VAS score of low back pain of 26 patients with lumbar spinal stenosis was reduced from 6.69±1.44 before surgery to 3.27±1.43 at postoperative 1 month, 2.69±1.57 at postoperative 3 months, 2.31±1.16 at postoperative 6 months and 2.23±1.28 at the last follow-up, respectively, and the difference was statistically significant ( F=128.534, P<0.005). The VAS scoreof leg pain was reduced from 6.77±1.34 before surgery to 3.27±1.37 at postoperative 1 month, 2.88±1.48 at postoperative 3 months, 2.85±1.52 at postoperative 6 months and 2.54±1.53 at the last follow-up, and the difference was statistically significant ( F=146.951, P<0.005). The ODI score was reduced from 64.18%±8.23% before surgery to 37.53%±4.45% at postoperative 1 month, 27.51%±3.83% at postoperative 3 months, 19.91%±5.27% at postoperative 6 months and 6.84%±2.74% at the last follow-up, and the difference was statistically significant ( F=783.966, P<0.005). The VAS score of low back pain of 25 patients with lumbar disc herniation was reduced from 5.60±1.38 before surgery to 3.04±1.54 at postoperative 1 month, 2.84±1.75 at postoperative 3 months, 3.12±1.86 at postoperative 6 months and 3.44±1.69 at the last follow-up, respectively, and the difference was statistically significant ( F=22.357, P<0.005). The VAS scoreof leg pain was reduced from 5.48±1.45 before surgery to 2.88±1.64 at postoperative 1 month, 2.52±1.83 at postoperative 3 months, 2.76±1.83 at postoperative 6 months and 3.00±1.92 at the last follow-up, and the difference was statistically significant ( F=29.445, P<0.005). The ODI score was reduced from 53.59%±6.87% before surgery to 32.46%±3.78% at postoperative 1 month, 23.39%±2.78% at postoperative 3 months, 16.49%±3.49% at postoperative 6 months and 7.23%±3.15% at the last follow-up, and the difference was statistically significant ( F=790.985, P<0.005). Conclusion:Unilateral biportal endoscopic technique has the advantages of clear and wide field of vision, large operating space, relatively simple surgical instrument need and convenient and flexible operation procedure. It has excellent clinical effects in the treatment of lumbar disc herniation and lumbar spinal stenosis.

Objective To summarize the experience of perioperative treatment of lung transplantation for end-stage lung disease. Methods Perioperative clinical data of 7 recipients undergoing lung transplantation were retrospectively analyzed, including 3 cases with bilateral lung transplantation and 4 cases with unilateral lung transplantation. The perioperative status and clinical prognosis of lung transplantation recipients were observed. Results The operation time of 7 lung transplantation recipients was (344±133) min. Cold ischemia time was (236±74) min in 4 cases of single-lung transplantation and (480±120) min in 3 cases of bilateral-lung transplantation. The length of Intensive care unit(ICU) stay was 21 (13-25) d and the length of hospital stay was 101 (64-117) d. In the first 3 d after surgery, the daily fluid output was significantly larger than the fluid input (all P < 0.05). The arterial oxygen partial pressure (PaO₂) of lung transplantation recipients in the first 3 d after surgery was significantly elevated than preoperative level (all P < 0.05), whereas the arterial carbon dioxide pressure (PaCO₂) did not significantly change (all P > 0.05). All recipients had pulmonary bacterial infection after lung transplantation, including 3 cases complicated with fungal infection. One recipient underwent exploratory thoracotomy for hemostasis due to active thoracic bleeding after operation, 1 recipient suffered from primary graft dysfunction (PGD) and 4 recipients received secondary endotracheal intubation. Two cases died after operation, 1 case died of septicemia caused by multidrug-resistant acinetobacter baumannii, the other case died of rejection reaction after self-terminating use of immunosuppressive agents. The remaining 5 cases were successfully discharged and recovered well. The longest survival period was 3.1 years. Conclusions In the perioperative management of lung transplantation, it has great significance to hold the surgical indications, monitor and manage postoperative refined fluid and hemodynamics, implement the strategy of protective pulmonary ventilation, and early diagnose and treat severe postoperative complications for the recipients of lung transplantation to safety through the perioperative period.