The incidence of testicular infarction secondary to epididymal-orchitis is extremely low. It usually manifests as acute testicular enlargement and pain, which requires differentation with testicular tumors and testicular torsion. This article reported a case with 10 days unsatisfied conservative treatment. Scrotal exploration operation revealed no obvious formation of abscess cavity. Subdivision of spermatic cord sheath, testicular sheath reversal drainage, and testicular sheath decompression treatment were performed. The pain of the patient relieved significantly after surgery. No abnormality was recorded within 6 months follow-up.

Objective? To construct the critical illness patient inter-hospital referral process of primary hospitals based on Delphi method so as to provide a basis for the inter-hospital critical illness patient standardized referral process in the medical alliance model. Methods? The inter-hospital referral process was designed by retrieving literatures at home and abroad, and was demonstrated and revised with the modified Delphi method. Results? We constructed a total of 30 items from four aspects including work preparation of medical staff as well as reception medical staff before inter-hospital referral, risk-prevention during referral and patients' condition after referral. Among two rounds of expert consultation, the active coefficients were all 100% and the authority coefficients were all 0.843 respectively. Conclusions? The critical illness patient inter-hospital referral process of primary hospitals based on modified Delphi method accords with the principle of scientific nature and operability which has positive a meaning for standardizing clinical inter-hospital critical illness patient referral.

ObjectiveTo investigate the CT and MRI imaging characteristics of autoimmune pancreatitis and its clinical value.MethodsFourteen patients(13males, 1female, mean age 58.3 years) with autoimmune pancreatitis proved histopathologically or clinically were enrolled in the study.Clinical data was studied retrospectively.Among those patients,CT was performed on 12 cases and MR imaging was performed on 8 patients,6 patients underwent both CT and MR imaging.ResultsAll 14 patients had enlargement of the pancreas,which could be divided into three types including diffuse type ( n =7 ),focal type ( n =5 ) and mixed type ( n =2 ).On plain CT the pancreas was of isodensity ( n =5 ) or mild hypodensity ( n =7).In one case there was several small hypodensity cystic lesions within and around the pancreas that was rarely seen in other autoimmune pancreatitis cases.Pancreatic lesions as shown by MRI were all mildly hypointense on T1WI and mildly hyperintense on T2WI,all displayed lesions were detected as high-signal intensity areas on DWI. By medium contrast,autoimmune pancreatitis lesions demonstrated “ snow-like” heterogeneously decreased enhancement on artery phase of dynamic contrast enhanced imaging and then showed gradually delayed enhancement on portal venous phase and later phases.“Capsule-like” rim was present around the autoimmune pancreatitis lesions in 9 cases.Main pancreatic duct was irregular in shape in 4 cases and slightly dilated in 5 patients.Strictures of lower common bile duct and upper bile duct dilatation as well as thickening and enhancement of the bile duct wall were found in 9 cases.Peripheral vascular involvement was seen in 4 cases. Abdominal lymphadenopathy at hepatic portal was observed in 1 patient.Two cases showed tiny decreased enhancement lesions in the kidneys.Steroid therapy was given in 10 cases,all pancreatitis lesions ameliorated as showed by follow-up imaging examinations.ConclusionsAIP specific CT and MRI imaging findings are common in most patients which help establish the diagnosis and differential diagnosis of AIP.

Objective To evaluate MDCT findings and characteristics of metastatic pancreatic tumors. Methods A total of 23 cases with metastatic pancreatic tumors were collected and the CT findings including the size, number, location, density patterns, enhancement patterns and secondary signs (dilatation of the pancreatic duct and/or bile duct, involvement of peripancreatic vessels, atrophy of distal pancreas) were analyzed retrospectively. Results A total of 35 metastatic pancreatic tumors were identified in the 23 patients. Tumors were multiple in 7 patients, the other 16 patients had single metastatic pancreatic tumor. The mean maximum diameter of the tumors was 3. 3 cm; the majority was located in the pancreatic body/tail. Thirty tumors demonstrated no enhancement in the arterial phase, and in the portal phase 23 tumors were hypodensive compared with normal pancreatic tissue, 4 tumors were isodense and 3 tumors showed a peripheral rim of enhancement. Five tumors showed markedly enhancement in the arterial and portal phase. Only 1 patients had dilated biliary and pancreatic duct, and 2 patients had dilated pancreatic duct. Only 1 case demonstrated involvement of splenic vein. 13 of the 23 patients had extra-pancreatic metastasis. Conclusions Pancreatic metastasis showed certain imaging characteristics. The accuracy of CT diagnosis could be improved by understanding of these CT findings and clinical features.

Objective To study the effects of rehabilitation training on learning and memory ability and the expression of growth-associated protein-43(GAP-43)in rats with vascular dementia.Methods Forty-four female Sprague-Dawley rats were randomly assigned to a rehabilitation group(n=20),an immobilization group(n=20),and a sham-operation group(n=4).The rats in the former 2 groups were operated on to establish the experimental vascular dementia model by repeatedly ischemia/reperfusion injury of brain induced by ligation of bilateral common carotid arteries and lowering of blood pressure induced by intraabdominal injection of sodium nitroprusside.The rats in rehabilitation group were administered with rotating bar and rolling cage exercises for 1 hour once daily,while those in the immobilization group were immobilized and without any exercise:the rats in sham-operation group could move freely in cage.Learning and memory tests were preformed by using step-down avoidance test at the 27th and 28th days after operation.Immunohistochemical staining was used to detect GAP-43 expression in hippocampus CA1 area at different time points after operation. Results The rats in rehabilitation group demonstrated better learning and memory ability than those in immobilization group(P<0.01),and more GAP-43 expression in hippocampus CA1 ar-ea than those in immobilization group and sham-operation(P<0.01).Conclusion Rehabilitation training can im-prove the learning and memory ability of rats with experimental vascular dementia,and the mechanism is probably re-lated to the increase of GAP-43 in hippocampus CA1 area.

Objective To analyze the CT appearances with pathologic correlation and improve the recognition of pancreatic mucinous cystadenoma/cystadenocarcinoma.Methods CT findings in 20 patients with pathologically proven pancreatic mucinous cystic tumor were retrospectively and jointly reviewed by two observers blinded to the pathological results.All patients underwent precontrast and postcontrast helical CT.The number,size,location,and margins of the lesions were observed,along with wall thickness,septation,calcification witllin the lesions.and presence of mural nodules and their enhancement.The findings of malignant and benign tumors were compared.Results Twelve cases of mucinous cystadenoma.3 borderline cystadenomas and 5 cystadenocacinomas were included in this study.Sixteen tumors(16/20)were located at pancreatic body or tail.The findings of thick walsl,calcifications and mural nodules appeared in 4,2 and2 cases respectively in benign mucinous cystic tumors,while appeared in 7,5,and 5 cases respectively in malignant mucinous cystic tumom.Presence of tIlick walls.calcifications and mural nodules in the lesions were significantly associated with malignancy(P＜0.05).Conclusion CT manifestations of pancreatic mucinous neoplasm are variable,but has some specific radiographic features.A combination of CT findings is helpful ifl differentiation of malignant and benign pancreatic mucinous adenomas.

Objective To investigate the ability of electrocardiogram-gated multislice CT(MSCT)in the diagnosis of myocardial bfidging.Methods Fifty-one patients(82 coronary arteries)with suspected coronary artery disease underwent multi-detector row CT,conventional coronary angiography and intravascular ultrasonography as well.The sensitivity,specificity and accuracy of MSCT for the detection of myocardial bridging were determined.The interobserver agreement was calculated by using Cohen's Kappa test.Results A total of 26 tunneled arteries exclusively located near the middle segment of left anterior descending coronary artery were found by coronary angiography and intravascular uhrasonography.Compared to the invasive methods,MSCT correctly detected 23 of 26 myocardial bridges with a sensitivity of 88%(23/26),specificity of 96%(52/54)and accuracy of 94%(75/80).The Kappa value for overall interobserver variation Was 0.62.Two myocardial bridges diagnosed by MSCT were missed with the invasive method.With the results of invasive and non-invasive methods combined as the standard of reference,the overall sensitivity.specificity,and accuracy of MSCT in detecting myocardial bridging were 89%(25/28),91%(21/23),and 90%(46/51),respectively.Conclusion As a non-invasive imaging modality,MSCT is feasible and reliable in the detection of myocardial bridging.

Objective To investigate the CT and MRI findings of primary hepatic neuroendocrine carcinomas.Methods Imaging findings of 6 patients with pathologically confirmed hepatic neuroendocrine carcinomas were retrospectively analyzed.Four patients underwent plain CT and contrast enhanced CT examinations.The other 2 patients underwent plain MRI and contrast enhanced MRI.Results One out of the 6 cases manifested multicentric tumor which appeared as one large tumor surrounded with multiple small nodules peripherally,and the tumors of the other 5 cases were solitary.On plain CT images,all lesions were well-defined and hypoattenuating with central areas of even lower density except punctuate calcifications at tumor periphery in 1 case.On pre-contrast MRI,the cases manifested heterogeneous low signal intensity on T1 wI and slightly high intensity on T2 WI.On dynamic contrast enhanced CT and MRI,Tumors manifested slight to mild enhancement in arterial phase,slight enhancement in portal venous phase or delayed phase with no enhancement in the center,accompanied by dislocation of surrounding vessels.There Was no lymphadenopathy in peritoneal cavity and retroperitoniurm. Conclusion CT and MRI scanning can demonstrate specific features of primary hepatic neuroendocrine carcinoma,which may help the diagnosis and differential diagnosis of the tumor.

APOBEC(apolipoprotein B mRNA-editing enzyme catalytic-polypeptide) family members were reported as innate immune molecules with anti-viral activity for many viruses, such as HIV and HBV.In order to understand the function of APOBEC, the APOBEC-3F and-3G were cloned, expressed, and the sub-cellular localization of them was detected.The genes of APBEC-3F and-3G were cloned from PHA-stimulated PMBC and expressed in the MDCK cell by transfection.The sub-cellular localization of APOBEC-3F and-3G were detected by immunofluorescence.APOBEC-3F and-3G were cloned by RT-PCR and confirmed by DNA sequencing.The immunofluorescence indicated APOBEC-3F and-3G were located in the cytosal.APOBEC-3F and-3G could inhibit HBV replication effectively in HepG2.2.15 cell.APOBEC-3F and-3G could not be trans-located into nuclear by nuclear location signal(NLS) or bi-NLS(B-NLS).These results will help the future research on the function of APOBEC.

BACKGROUND: Fibronectin(FN) plays the role of repair in the inflammation. There is no confirmed conclusion whether it can be applied to the refractory corneal epithelial defect.OBJECTIVE: To observe the repair effect of the human plasma FN for the refractory corneal epithelial defect.DESIGN: A controlled experimental study.SETTING: Guangzhou Red Cross Hospital, Guangzhou First People's Hospital, Guangzhou Children's Hospital, Guangzhou Hospital of Traditional Chinese Medicine and Guangzhou Second People's Hos pital.PARTICIPANTS: Totally 383 eyes with the refractory corneal epithelial defect were chosen, of which 309 were in the therapy group, and 74 in the control group.METHODS: The therapy group: Human plasma FN was administered by dropping it into the eyes once every two hours. The controlgroup: 10 g/L celacol M was administered by its dribbling into the eyes once every two hours. Weilesheng was taken orally in both groups, two pills once, three times per day. According to the state of illness, both groups received anti-bacterial or anti-viral treatment and reexamination was given every day or every other day after administration. 10 g/L fluorescein sodium was used to observe the changes of cornea.MAIN OUTCOSE MEASURES: The symptoms, results of staining using fluorescein sodium as well as the corneal epithelial healing of both groups.RESULTS: The symptoms, the results from staining using the fluorescein sodium and the corneal epithelial healing were used for the evaluation. In the therapy group, 309 eyes were followed up and the cure rate was 69.9%. The average therapeutic period was 6.5 days, while those of the control group were 58.1% and 8.7 days respectively. The difference in the curative effect between the two groups was significantly different( P＜0.01 ).CONCLUSION: The application of FN for the refractory corneal epithelial defect displays a more significant effect than conventional treatment.