As a powerful intervention to protect ischemic tissues,ischemic preconditioning (IPC) has been a hot spot due to its greatly potential clinical values throughout the past decades.From the triggers and cell-membrane receptors to intracellular signal molecules and mitochondrial signal chains,we inquire in this review the common points and relativities on the signaling transduction of IPC by conferring the cardio-and neuro-protection mechanisms of IPC.

Objective To explore the CT findings, the clinicopathological features of giant lymph node hyperlasia and its combined paraneoplastic pemphigus. Methods The clinical features,the imaging and the follow-up data of 19 patients surgically confirmed as giant lymph node hyperlasia were analyzed. Results Clinically, the majority of patients not accompanied with paraneoplastic pemphigus abnormal pulmonary,showed asymptomatic, and only a very small number had lower abdominal discomfort or pain.The patients associated with paraneoplastic pemphigus and abnormal pulmonary manifested the special clinical manifestations, CT finding, pathological characteristics. Histopathologically, the hyaline-vascular type was found in 18 cases and mixed type in 1 case. CT scanning showed that the lesions in 18 patients appeared as larger(2.5-15 cm in diameter), solitary, cylindrical soft-tissue masses with marked enhancement. One case was presented as multiple enlarge lymph node at left neck (1.5-5 cm in diameter). Seventeen of 19 cases were smooth at the edge, and ten cases were uniform in density. The calcification was characterized of an arborizing and (or) flocculent pattern and central location in 7 cases, of which, 1 case circumferential distribution and 5 cases scattered with multiple spots or strip. Shapes were cylindrical and spherical or elliptical. All patients with giant lymph node hyperlasia showed marked enhancement after contrast administration at arterial phase and delay scan. Conclusion CT scanning is an effective method in diagnosis, guiding surgery and evaluating prognosis of giant lymph node hyperlasia, especially dynamic contrast-enhanced and delayed CT scanning. It is the critical way for patients complicated with paraneoplastic pemphigus and abnormal pulmonary cases, to diagnose early and resect tumor-like lesions in vivo.

Human Y chromosome contains sex determining region and the genes associated with spermatogenesis.Genomics of the human Y-chromosome association with male infertility appeared and new exploration for male infertility was formed.Though the genes of Y chromosome lack of meiotic recombination,Y chromosome did not disappear,but also it is being in evolution.It includes several families of satellite sequences and the alphoid repeats,Alu repeats associated with male infertility.A total of 107 genes were listed in the database in Y chromosome.The male specific region on Y(MSY) harbours 156 transcription units of which half(78) are suspected to encode proteins,27 protein or protein families identified,11 protein only expressed in the testis associated with spermatogenesis.It is likely that the genes on Y chromosome play an important role not only on spermatogenesis,but also on prostate,brain or other organs.

Objective To present a moified technique of island flap (Duckett+Perovic's method)for repair of severe hypospadias.Methods Between January 1996 and May 2002,26 cases of severe hypospadias were repairs using Perovic's method in a lonely or using Duckett's method plus Perovic's method.In all patients,we employed island flaps in one stage.Suprapubic diversion was used for drainage,and 10F or 12F tube was inserted to the proximal end of new urethra.Ceftriaxone was used after the operation on all of patients for one week.Urethral tubes were removed at 6 or 8 days postoperation and the suprapubic tubes at 10 or 12 days postoperation.Results One stage healing was successfully achieved in 23 patients.Three patients suffered from fistula,of them were healed through re-operation at six months later.After the operation,normal function was recovered and perfect appearance was achieved.Conclusion The result of repair turned out to be satisfactory and we believe that the technique is a good alternative for severe hypospadias.

Objective To study the method, advantage and shortcoming of mini-laparoscopic treatment for indirect inguinal hemia in children. Methods 136 cases with indirect inguinal hernia(right:75cases,left:44 cases,bilateral:17 cases) had been treated by high ligation with mini-laparoscopy. Results The mean operation time was 10 mmin for unilateral hernia and 23 mmin for bilateral hernia. Among 119 cases with unilateral hernia,38 cases had been found with contralateral latent hernia. The mean of postoperative inhospital stay were about 1 ～ 2 day(s). All patients had been followed-up for 3 ～ 12 months,there were only 2 cases recurrence found but no complications was detected.Conclusion Mini-laparoscopic high ligation for indirect inguinal hernia in children is a single, safe, satisfactory, effective,and minimally invasive surgical method.

Objective To explore the clinical significance of platelet count, C-reaction protein and D-dimer in Kawasaki disease children with coronary artery lesion. Methods 54 cases of children with KD treated in our hospital from January 2013 to December 2015 were divided into coronary artery injury (CAL) group (n=15) and without coronary artery injury (NCAL) group (n=39), according to the cardiac ultrasound examination. The relationship between the changes of platelet count, C reactive protein and D- two and coronary artery lesion in the 2 groups of acute and convalescent stages were detected. Platelet count, C-reaction protein and D-dimer of 54 healthy children were measured as a control. Results The levels of the platelet count, C-reaction protein and D-dimer of the KD children during acute stage are significantly higher than the control group (P<0.05), while the levels of C-reaction protein and D-dimer of the KD children during recovery stage was significantly decreased after treatment (P<0.05), the platelet count is remarkably increased (P<0.01). The platelet count, C-reaction protein and D-dimer for the KD children with coronary artery malformation, either at acute stage or recovery stage, compared with the control group were significantly different (P<0.05), with statistical significance. Conclusion The changes of the platelet count, C-reaction protein and D-dimer levels have close relations with the cardiovascular damage to the KD children.

OBJECTIVE:To evaluate therapeutic efficacy and ADR of amphotericin B in the treatment of AIDS combined with fungal infections retrospectively. METHODS:The cases of amphotericin B in the treatment of AIDS combined with fungal in-fections were collected our hospital. Total therapeutic efficacy,distribution of pathogenic bacteria,clearance rate and ADR were evaluated. RESULTS:89 patients were involved totally,among which 45 cases were marked effect,32 cases improved and 12 cas-es failed,with effective rate of 86.5%. The fungus were found or cultured in 76 cases,among which 64 strains were cleared,but 12 strains were not,with total clearance rate of 84.2%. There were 41 ADR cases(46.1%),while all completed the treatment ex-cept 2 developing severe renal failure(2.2%). CONCLUSIONS:Domestic amphotericin B could effectively treat AIDS complicat-ing with fungal infections,and the ADRs were acceptable.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Objective To investigate the efficacy and safety of combination of transcatheter arterial chemoembolization (TACE)and percutaneous radiofrequency ablation (RFA)in treatment of hepatocellular carcinoma (PHC).Methods 70 cases of PHC were divided into combined group (TACE +RFA,n =37) and control group (only TACE,n =33).Patients were followed up for1 to 2 years,and the therapeutic effects and side effects were compared between the two groups.Results The patients with tumor completely necrosis and AFP level lower than >50% in combined group were significantly more than those in control group (P <0.05);the half of year,one year and two years survival rate in combined group were greatly higher than those of control group;no severe side effect was observed in two groups.Conclusions TACE+RFA is effective and safe in treatment of PHC of more than 5 cm in diameter.

Objective To investigate the safety and feasibility of fast track surgery (FTS)in patients with vaginal hysterectomy for non -prolapsed uterus.Methods 1 1 0 cases of vaginal hysterectomy for non -prolapsed ute-rus with benign uterine disease were randomly divided into two groups:fast track group (n =55)and conventional group (n =55).The operative time,intraoperative blood loss,postoperative nausea and vomiting,anal exhaust time, postoperative hospital stay,medical cost and perioperative complications were compared between the two groups. Results In FTS group,the incidence rate of postoperative nausea and vomiting,the postoperative anal exhaust time, hospital stay,cost of hospitalization were 1 6.4%,(1 3.73 ±2.41 )h and (4.38 ±1 .08 )d,(7 541 .00 ± 253.1 7)yuan,respectively,which in the control group were 36.4%,(1 8.56 ±1 .54 )h,(4.89 ±1 .26 )d, (8 1 55.1 5 ±495.89)yuan,the differences were statistically significant between the two groups (χ2 =5.67,t =-1 2.53,-2.28,-8.1 7,all P <0.05).There was no significant difference in the operative complications between the two groups (P >0.05).Conclusion FTS has good security.It can short the hospitalization time,reduce medical costs and improve the quality of life in patients who underwent vaginal hysterectomy for non -prolapsed uterus with benign uterine disease.