Objective To evaluate applicative value of laparoscopy in children for the diagnosis and treatment of non-palpable testes.Method We evaluated retrospectively the laparoscopic approach used in 16 boys for the diagnosis and treatment of 21 non-palpable testes. All of them were diagnosed by non-palpable testis before operation.Results 7 cases (11 testis) in the internal ring were mobilized laparoscopically, and the operation was completed by open orchidopexy. Agenesis or atrophy of the 6 testis in the inguinal region was found. 2 high intra-abdominal testis (left) were found. The testis had no found in the intra-abdomen in two cases.Conclusions Miniinvasive laparoscopy is considered at present the standard method for the localization and treatment of non-palpable testes. No serious complications were recorded during or after operation. It should be the preferred method for the non-palpable testes.

Objective To compare suture bridge and single row techniques in repair of rotator cuff tears in a rabbit model.Methods Seventy-six mature male New Zealand white rabbits were used in this study.The 12-month old rabbits,weighing from 2.5 to 3.0 kg (average,2.8 kg),were made models of full-thickness rotator cuff tear by cutting off at the foot print the supraspinatus tendon.The models were randomly divided into 2 even groups (n =38 each).Their right shoulders were repaired by suture bridge and single row techniques respectively in the 2 groups,with their left shoulders untreated as controls.The rabbits were then sacrificed at the 2nd,4th and 8th weeks after surgery for histological comparisons of healing under microscopy.Biomechanical comparisons were made at the 8th week to analyze advantages and disadvantages of the two methods.Results At 2,4 and 8 weeks postoperatively,there were no significant differences between the anterior and middle 1/3 zones of bone-tendon junction regarding cartilage growth or collagen fiber morphology in the suture bridge group,while the cartilage growth and collagen fiber morphology in the middle 1/3 zone of bone-tendon junction were significantly more mature than in the anterior 1/3 zone in the single row group.At the 8th postoperative week,the load to failure in the suture bridge group (134.59 ± 17.69 N) was significantly higher than that in the single row group (72.23 ± 12.08 N) (P ＜ 0.05),but remained significantly lower than that in the control group (192.61 ± 9.42 N) (P ＜ 0.05).Conclusion The suture bridge technique is a feasible and reliable method for repair of rotator cuff tear and has a better healing effect than the single row technique.

Objective To guide fluid management for sever heart failure patients by using PICCO indicators, in order to direct clinical fluid management and nursing care. Methods Sixty-four heart failure patients with level IV cardiac function were randomly divided into the control group and the experimental group according to random number table, and each one had 32 patients. Fluid management for patients in the control group was implemented with CVP monitoring technology, while the patients in the experimental group accepted PICCO monitoring technology as fluid management. Then compare these indicators between the two groups--length of stay in ICU, mortality rate of 28 days, daily fluid intake, output and time of achieving negative fluid balance, and observe the change of cardiac function index (CFI) and capacity indicators (ITBVI, GEDVI, EVLWI) in the experiment group before and after treatment. Results Indicators of ITBVI、GEDVI、EVLWI in the experiment group recovered to normal state and CFI improved. The indicators which had mentioned above was (1 203.41±111.08) ml/m2, (1 087.78±66.91) ml/m2, (12.91±3.54) ml/kg, (2.91±0.29) L·min-1·m-2 respectively when before the treatment, while the values after the treatment was (895.50 ± 50.27) ml/m2, (728.19 ± 73.33) ml/m2, (6.51 ± 0.75) ml/kg, (4.61 ± 0.69) L · min-1 · m-2, the difference was significant (t=-18.52-54.42, P<0.05). The length of stay in ICU, mortality rate of 28 days, daily fluid intake, output and time of achieving negative fluid balance of the experimental group were significantly lower than those in the control group(t=-17.19,-76.80,-12.38, χ2=3.26, P<0.05). Conclusions PICCO monitoring indicators are better than CVP method in the aspect of fluid management for patients with sever heart failure, which can increase the rescue success rate, promote the treatment effect, improve prognosis, and promote the rehabilitation of patients.

Objective To investigate the value of three-dimensional CT volume rendering in predicting ARDS following pulmonary contusion and identifying high-risk patients.Methods Seventy-one cases of pulmonary contusion (AIS ＞ 2 points) confirmed by chest CT during an emergency admission between July 2010 and June 2011 were enrolled.Using computer-generated three-dimensional reconstruction,contusion volume was measured and expressed as a percentage of total lung volume.The admission data,such as blood gas analysis results,systolic arterial pressure,hematocrit,AIS,ISS,and injury distribution,were prospectively collected.Independent predictive factors of ARDS following pulmonary contusion was identified using logistic regression analysis and further estimation on accuracy and value of the predictors were performed.Influence of contusion volume percentage on clinical outcomes was detected.Results Of all,mean contusion volume percentage was (22.07 ± 14.50)％ (range,5.60％-61.00％),which was not strongly correlated to the admission PaO2/FiO2 ratio (R2 =0.059).ARDS and infection were diagnosed in 31 cases and 25 cases respectively.PaO2/FiO2 ratio and contusion volume percentage were independent predictive factors of ARDS after pulmonary contusion.The best cut-off of contusion percentage in predicting ARDS development was 21.5％ with a specificity of 80.0％,sensitivity of 71.0％,positive predictive value of 73.3％,and negative predictive value of 78.1％.Conclusion Three-dimensional CT volume rendering technique allows quantification of pulmonary contusion and identification of patients at high risk of ARDS,to whom further treatment may be directed.

A series of 6 novel 2-amino-4, 5-diarylpyrimidines were synthesized by the reaction of isoflavones with guanidine. They were identified by the spectra of IR, 1H NMR, 13C NMR and elemental analysis. The protective effects of 2-amino-4, 5-diarylpyrimidines against oxygen-glucose deprivation leading by sodium hydrosulfite in PC12 cells were studied by MTT method. It was shown that 2-amino-4, 5-diarylpyrimidines exhibited neuroprotective effects against oxygen-glucose deprivation injury in PC12 cells, which could increase the amount of survival PC12 cells and reduce their injured degree in the model.

Objective To evaluate the utility of modified Z-stent in treatment for Budd-Chiarisyndrome (BCS). Methods A retrospective study was used in twelve BCS patients treated in twohospitals. The Doppler examination was carried out in all patients preoperatively, so as to confirm thenature of the lesion and chose correct type of endovascular modified Z-stent. Under DSA monitoring formembranotomy and dilation of the inferior vena cava(IVC), after that, insert the marked modified Z-stent to IVC correctly, and put the non-stent part to hepatic vein orifice. The cavography and hepaticvenography should confirm the position of the Z-stent. All of 12 patients with membranous obstructionof the IVC(MOVC) or segmental obstruction of the IVC (SOVC)were underwent modified Z-stentplacement. Results The IVC pressure (IVCP) before smd after membranotomy (dilation) were 27.33± 4.12cmH2O and 18.67 ± 5.07cmH2O (P＜0.01). Comparing with dilation and putting stent group,the IVCP decreased from 18.67 ± 5.07cmH2O to 11.42 ± 2.11 cmH2O ( P ＜ 0.01 ). The modffied Z-stent could avoid hepatic vein orifice getting compression and resist the retraction of IVC throughly infollowing-up period of 2.5 years. Conclusion s The endovascular treatment of BCS with modified Z-stent is more effective and safer to prevent thrombosis. Further study will be required to observe theirlong term effects.

Genes, T-Cell Receptor gamma ; Humans ; Lymphomatoid Papulosis ; classification ; diagnosis ; Skin Neoplasms ; classification ; diagnosis

Objective To study the lignans in Patrinia scabra. Methods The constituents were separated and purified by column chromatographies with silica gel, RP-silica gel, and Sephadex LH-20. Their structures were elucidated on the basis of spectral data (IR, MS, 1H-NMR , 13 C-NMR , DEPT, HMQC and HMBC). Results There were four lignans obtained from P. scabra with the structures identified as pinoresinol-4, 4′-di-O-?-D-glucopyranoside (Ⅰ), and matairesinol-4, 4′-di-O-?-D-glucopyranoside (Ⅱ), lariciresinol-4′-O-?-D-glucopyranoside (Ⅲ), and lariciresinol-4-O-?-D-glucopyranoside (Ⅳ). Conclusion All the four compounds are found in P. scabra for the first time. The NMR data of compound Ⅱ are given first.

Objective To do research on Multi-points EGFR gene mutation and heterogeneity in lung adenocarcinoma and its influence on the prognosis,to analyze EGFR gene mutation and its heterogeneity influence on patients'overall prognosis.Methods The clinical features of patients with lung adenocarcinoma at stage Ⅲa from January 2006 to January 2007 at our institution were retrospectively reviewed.The primary lung tumors and corresponding metastatic lymph nodes tissue specimens were obtained by surgery.The adenocarcinoma primary nodes and corresponding metastatic lymph nodes EGFR mutation were detected by amplification refractory mutation system (ARMS).Univariate analysis and multivariate analysis by Cox proportional-hazard model were used to analyze the impact of EGFR mutation and its heterogeneity as influential factor on patients 'prognosis.Results 76 patients with the adenocarcinoma primary nodes and corresponding metastatic lymph nodes were detected by epidermal growth factor receptor (EGFR) mutation.40 patients with EGFR mutation were detected (40/76,52.63％).There were 9 specimens out of 40 who had lung primary nodes and corresponding metastatic lymph nodes EGFR gene heterogeneity (9/40,22.5％).Log-Rank univariate analysis showed that there was no significant difference in overall survival period between EGFR mutation patients and wild-type patients(x2 =0.382,P =0.537),but there was significant difference in illnessfree progression period(x2 =4.147,P =0.042).Gene heterogeneity factor does not affect on the overall survival period and illness-free progression period of the patients with EGFR gene mutation (x2 =1.774,P =0.183 ;x2 =1.249,P =0.264).Multivariate analysis by Cox proportional-hazard model showed that EGFR gene mutation is not the independent risk factor that has 赵 impact on the prognosis of patients with lung adenocarcinoma.Conclusion Assessment of EGFR gene mutations in a single-point specimen can not reflect the whole EGFR gene mutation status,which may probably cause difference between targeted drugs'predicted effect and its actual usage effect.

Objective: To study the chemical constituents of Bletilla striata (Thunb. ) Reichb. f. Methods: The con-stituents were separated and purified by column chromatography with silica gel and Sephadex LH-20,and were identified byspectral analysis. Results: Five compounds were identified as: 2, 7-dihydroxy-4-methoxy-9, 10-dihydrophenanthrene (1), 2, 7-dihydroxy-3, 4-dimethoxyphenanthrene (2), 3, 7-dihydroxy-2, 4-dimethoxyphenanthrene (3 ), 3', 3--dihydroxy--5-methoxybiben-zyl(4), p-hydroxybenzaldehyde (5), Conclusion: Compound 2, 3, 4 are isolated from this plant for the first time.