Objective To summarize the management and diagnosis of testicular tumors in children.Methods The clinical characteristics, diagnosis, treatment and outcome of patients with pediatric testicular tumors, who were referred to Department of Pediatric Surgery, Shengjing Hospital of China Medical University from January 2003 to December 2013 ,were analyzed retrospectively.Results All of the 76 prepubertal patients were diagnosed initially with a painless scrotal mass.The mean age of the patients at diagnosis ranged from 1 to 156 months[mean(32.3 ±4.4) months].There were 39 cases(51.3％) with ages of0-1 years,18 cases (23.7％) with ages of 1-3 years,10 cases (13.2％) with ages of ＞ 3-7 years,9 cases(11.8％) with ages of ＞ 7-14 years.There were 37 cases in left side and 39 cases in right.And there were 59 cases (77.6％)of benign tumors and 17 cases(22.4％)of malignant tumors.Of the benign tumors,42 cases(55.2％)were teratomas, including 34 cases of mature teratoma and 8 cases of immature teratoma;11 cases were epidermoid cyst;11 cases were other benign tumors as lymphangioma.Among the 17 cases of malignant tumors, 16 cases (21.1％) were yolk sac tumors, which were I stage;1 case was embryoma.Thirty-three patients had abnormal alpha fetoprotein (AFP)concentrations before surgery,including 9 patients with mature teratoma,7 patients with immature teratoma, 16 patients with yolk sac tumors, 1 patient with embryonal carcinoma of testis.Of the 59 cases of benign tumors,testis-sparing surgery was done in 50 tumors, the other 9 patients underwent testis-excising because of tumor severely oppressing testis.All the 17 cases of malignant tumors underwent testis-excising.There were 76 cases in the follow-up.One patient with yolk sac tumor died for pulmonary metastasis during the follow-up.Others were alive and free of tumor recurrence.Conclusions The age range of the prepubertal testicular onset was 1 year or younger, most of the tumors were benign, and the most common subtype was teratoma.AFP highly expressed in yolk sac tumors, it was help to diagnosis.Testis-sparing surgery should be performed for the benign tumors and testis-excising for the malignant tumors.

Objective To assess the efficacy of the prophylactic de-escalation use of noninvasive positive pressure ventilation(NPPV) in improvement of oxygenation following extubation after stanford type A aortic dissection.Methods 40 patients recovering from the stanford type A aortic dissection operation in the Center for Cardiac Intensive Care,Beijing Anzhen Hospital between December 2015 and April 2016,and meet the inclusion criterion after extubation,were investigated.The patients were random divided into 2 groups with RandA1.0 software,each group contained 20 patients:NPPV with mask vs.traditional oxygen treatment with mask.NPPV initial 2 h(started from extubation) settings:inspiratory pressure(IPAP) of 14-16 cmH2 O,expiratory pressure (EPAP) of 6-8 cmH2 O,the fraction of inspired oxygen (FiO2) of 0.35-0.55.2-8 h the parameters of setting were decreased:IPAP l0-12 cmH2 O,EPAP 4 cmH2 O.After 8 h the NPPV was finished and the oxygen treatment instead.The oxygen treatment settings:the flux inhalation of oxygen was 6-10 L/min,and FiO2 was adjusted to 0.35-0.55.Make a comparison with the two groups in the clinical effect at 2 h,8 h,24 h,3 days,and to compare their reintubation rate.Results PaO2 and PaO2/FiO2 were higher in the prophylactic NPPV group compared to oxygen treatment group after 2 h [94.7(89.7,100.1) mmHg vs.84.5(78.7,87.1) mmHg,P ＜0.05.(192.7 ±31.2) mmHg vs.(167.0 ± 18.9) mmHg,P＜0.05],8 h[99.1(90.3,132.8) mmHgvs.86.3(82.3,95.6) mmHg,P＜0.05.198.2(180.5,246.2) mmHg vs.172.5(164.7,191.2) mmHg,P ＜0.05],24 h[(100.0 ± 18.9) mmHg vs.(87.3 ±12.9) mmHg,P＜ 0.05.(197.5±36.8) mmHgvs.(170.1 ±29.8) mmHg,P＜0.05] and3 days[98.2(87.4,110.5)mmHg vs.86.8 (79.4,89.6) mmHg,P ＜ 0.05.(193.2 ± 37.1) mmHg vs.(164.4 ± 23.8) mmHg,P ＜ 0.05],and respiratory rate was lower in the NPPV group at the same time.Heart rate and mean arterial pressure were lower in the NPPV group at 24 h and 3 days.At 3 days in the NPPV group PaCO2 was lower,and left ventricular ejection fraction was improved.But the treatment of traditional oxygen leaded to a higher incidence of pulmonary atelectasis,and more longer hospitalization time.Conclusion In the early stage after extubation,prophylactic de-escalation therapy of NPPV for patients following operation of stanford type A aortic dissection,may quickly improve PaO2/FiO2,and increase the function of heart,avoid atelectasis.Furthermore,hospital stay was eventually shortened in NPPV group.

Astrocytoma ; blood supply ; pathology ; Capillaries ; pathology ; Central Nervous System Neoplasms ; blood supply ; pathology ; Diagnosis, Differential ; Ependymoma ; blood supply ; pathology ; Glioblastoma ; blood supply ; pathology ; Hemangioblastoma ; blood supply ; pathology ; Humans ; Hyperplasia ; Microvessels ; pathology ; Neoplasms, Neuroepithelial ; blood supply ; pathology ; Oligodendroglioma ; blood supply ; pathology ; Paraganglioma ; blood supply ; pathology

Objective To observe the effect of midazolam plus propofol administered for colonoscopy on cognitive function in middle-aged and aged patients. Methods One hundred and thirty six patients, ASA I and II, aged 40~75 years and undergoing colonoscopy were randomized to propofol group (group P, n=68) and propofol plus midazolam group (group PM, n=68). Baseline cognitive function was measured using Mini mental state exami-nation (MMSE) before anesthesia and the cognitive testing was repeated 10 minutes after emerging from anesthesia. BP, HR, SpO2, analgesic effect and sedative drug doses in both groups were recorded. Procedure time, recovery time and Rasmay sedation score were both recorded. Results Recovery time was significantly longer in group PM than that in group P (P<0.05). The total dose of propofol was significantly smaller in group PM than that in group P (P<0.05). MMSE score of both groups decreased, but the incidence of cognitive decline and the level of cognition in group PM were more notable than those of group P (P<0.05). Conclusions Midazolam plus propofol and propo-fol alone administered for colonoscopy could both increase the incidence of cognitive decline, and the effect of the former is more notable, but midazolam added to propofol could reduce the dosage of propofol.

Adolescent ; Bone Neoplasms ; complications ; Humans ; Male ; Osteoma, Osteoid ; complications ; Scapula ; pathology ; Shoulder Joint ; pathology ; Synovitis ; complications

Adult ; China ; Female ; Humans ; Male ; Middle Aged ; Program Evaluation ; Smoking Cessation ; psychology ; statistics & numerical data ; Young Adult

Objective To construct the lentivirus vector containing the hsa‐miR‐424 gene ,and identify the expression level of miR‐424 in cells .Research the influence of hsa‐miR‐424 on proliferation of cervical cancer Hela cell line .Methods Using the human genomic DNA as template to design the upper and lower primers for synthesis of miR‐424 ,and amplifying the target fragment by polymerase chain reaction (PCR) .Recover the products and conduct sequencing after connecting it into the pMD18T vector .Ampli‐fy the product by PCR template as pMD18T‐miR424 ,and insert the fragment expressing pMD18T‐miR424 into the vector of pLen‐tis‐CMV‐GFP‐MCS‐PGK‐PURO after enzyme cutting to construct the pLentis‐CMV‐GFP‐miR424‐PGK‐PURO .Package the com‐pound with pMD2 .G and pSPAX2 in 293T cell to produce the lentivirus ,and using the supernatant containing lentivirus to infect the Hela cell line .Results The sequencing result proved the sequence of miR‐424 in plasmid vector was correct ,which proved the construction of lentivirus was successful and the target lentivirus was obtained .The expression of miR‐424 almost rise 60 times af‐ter infected the cervical cancer Hela cell by the carrier .The result of M TT method suggested :the cervical cancer Hela cell lines have slowed proliferation with infection miR‐424 lentivirus .Conclusion The miR‐424 lentivirus vector was constructed successfully and the high efficacy expression miR‐424 cell line was established and stable .The cervical cancer Hela cell were infected with the super‐natant containing lentivirus ,inhibited the proliferation of Hela cell successfully ,and laid a good foundation for subsequent research .

Objective To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization (TAE) in treating symptomatic polycystic liver disease (PLD). Methods A total of 8 patients with PLD, who were admitted to authors’ hospital during the period from 2009 to 2013 to receive TAE, were enrolled in this study. The patients included 6 females and 2 males with a mean age of 59.5 years (54-65 years). The used embolic agents were polyvinyl alcohol (PVA) microspheres and micro spring coils. Both plain and contrast-enhanced CT scans of the upper abdomen were performed before TAE as well as at 12 months after TAE; the total volume of the hepatic cysts was measured and the changes of the cystic volume were determined. Statistical analysis was conducted using paired t test. Results The technical success rate was 100%. After TAE, the patients developed fever and different degrees of discomfort at liver area, which were disappeared after active symptomatic medication, and no serious complications occurred. The patients were followed up for 12 months , the mean total volume of the intrahepatic cysts decreased from preoperative (5 794±2 066) cm3 (range 3 120-8 935 cm3) to postoperative (3 832±1 525) cm3 (range 2 019-5 925 cm3), the difference was statistically significant (t=6.971, P<0.001). The reduction ratio of total volume of intrahepatic cysts was 34.6%±11.3%(24.3%-60.4%). Conclusion For symptomatic polycystic liver disease, transcatheter super-selective hepatic arterial embolization is a newly-developed treatment. This technique is safe and effective with reliable response and fewer complications. Therefore, it should be recommended in clinical practice.

Objective To investigate the effect of progressive neurological deterioration ( PND) of cerebral watershed infarction on early prognosis. Methods The consecutive patients with cerebral watershed infarction admitted in the Department of Neurology,Jinling Hospital,Nanjing University School of Medicine and their cerebral watershed infarctions confirmed by the imaging examination from March 2009 to March 2014 were enrolled. The clinical features, laboratory indicators and imaging features of internal watershed infarction,cortical-type watershed infarction,and mixed watershed infarction were identified and analyzed. The National Institutes of Health Stroke Scale was used to score neurological deficit. The modified Rankin scale ( mRS) was used to score the prognosis of patients. Single factor analysis was used to compare the differences between the groups. At the same time,the correlation between PND and poor prognosis of cerebral watershed infarction at day 90 was analyzed by multivariable Logistic regression analysis. Results A total of 89 patients with cerebral watershed infarction were enrolled,including 43 cortical-type watershed infarctions,36 internal watershed infarctions, and 10 mixed watershed infarctions. Single factor analysis indicated that the incidences of PND of internal watershed infarction and mixed watershed infarction were significantly higher than the cortical-type watershed infarction (36. 1% [n=13],50. 0% [n=5], and 16. 3% [n=7],respectively;P=0. 018). At day 90,28 patients had poor prognosis,and mRS was (3.4±1. 0) scores at day 90. There was significant difference in the types of infarction between the patients with poor prognosis and patients with good prognosis (P<0. 05). In patients with poor prognosis, most of them were internal watershed infarctions,accounting for 50. 0% (14/28),while in patients with good prognosis,most of them were cortical-type watershed infarctions(57. 4% [35/61]). The incidence of PND in patients with poor prognosis was significantly higher than that in patients with good prognosis (57.1% [16/28] vs. 14. 8% [9/61];P<0. 05). The result of multivariate Logistic regression analysis showed that after adjustment for confounding factor, PND was independently associated with the poor prognosis of cerebral watershed infarction at day 90 (OR 6. 969,95%CI 2. 451-19. 869;P<0. 01). Conclusion Compared with the cortical-type watershed infarction, the patients with internal watershed infarction is more prone to have PND, and PND is independently correlate with the poor prognosis at day 90.

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