Objective To explore the diagnosis,treatment and outcome of testicular torsion in children. Methods The clinical data (including the onset,treatment and prognosis) of 19 children of acute testicular torsion were reviewed.The age ranged from 5 days to 13 years. Results There were 15 cases of left side testicular torsion and 4 cases of right side.All of the 19 cases underwent operation.Seventeen cases were with intravaginal torsion,of these 14 testicles were removed for necrosis and only 3 testicles were salvaged by operative detorsion.Two cases were of extravaginal torsion with testicular necrosis and therefore were removed. Conclusions Testicular torsion is a common emergency of scrotum in children.Immediately operation after admission to hospital is the key treatment for salvage of the testicle.

The biodiversity of fungi in taxonomy and the biotopes in which they inhabit leads to the production of a variety of secondary metabolites that display a broad range of bioactivities, from which some very important medicines have been discovered. Even though the fungal secondary metabolites are an important source of drug leads, it has become increasingly difficult to discover new natural product scaffolds due to extensive screening of common soil fungi. Those special types of fungi have been largely neglected, presumably due to the difficulty in collecting and culturing of the organisms. Therefore, fungi of significantly underexplored taxonomic and ecological groups provide limitless metabolic potential for the production of new bioactive natural products, and systematic investigations of these fungal species will definitely play a key role in the discovery of new drug leads and understanding the chemical and biological bases for their living strategies. During the past four years, our research group has mainly focused on special types of fungi as sources of new bioactive metabolites, such as the endophytic fungi and the Cordyceps-colonizing fungi. Some results from this work are summarized herein.

Objective To explore vascular smooth muscle cell(SMC) proliferation and cell apoptosis during the development of abdominal aortic aneurysm(AAA). Methods The animal model of AAA was established in Wistar rats and the specimens were harvested at the 3rd day,and 1、2、3 and 4 week after the model initiation. In situ end-labeling of DNA fragments (TUNEL) was used to detect SMC apoptosis and immunohistochemical staining was applied to investigate the expression of SMC apoptosis markers(bcl-2,bax),proliferating cell nuclear antigen (PCNA) and ?-actin. Results TUNEL-positive and PCNA-positive SMC reached the maximum at 2～3 week and 1 week respectively;The count of TUNEL-positive SMC was less than PCNA-positive SMC during the period of day 3 to 1 week and that was vice versa from 2nd to 4th week with SMC amount significantly decreased;Bcl-2 and bax protein was strongly expressed at 1 week and 3 week after operation(all P

BACKGROUND:The patients undergoing lumbar discectomy have a higher risk of recurrence. There are many different ways of reoperation, but there are few studies on spine-pelvis sagittal morphology of patients with recurrent lumbar disc herniation. OBJECTIVE:To compare the effect of discectomy and posterior lumbar interbody fusion on spine-pelvis sagittal morphology of patients with recurrent lumbar disc herniation. METHODS:Sixty-one patients of recurrent lumbar disc herniation after discectomy were divided into discectomy group (n=30) and posterior lumbar interbody fusion group (n=31) according to the re-repair method. The height of intervertebral disc, lumbar lordosis and pelvic projection angle in the two groups before and after treatment were measured and compared based on standing spine lateral X-ray images. RESULTS AND CONCLUSION: After treatment, the height of intervertebral disc, lumbar lordosis and pelvic projection angle of patients in discectomy group were not significantly changed compared with before treatment (P> 0.05). After treatment, the height of intervertebral disc, lumbar lordosis and pelvic projection angle of patients in posterior lumbar interbody fusion group were significantly increased compared with those before treatment (P< 0.05). Before treatment, there were no significant differences in the height of intervertebral disc, lumbar lordosis and pelvic projection angle between discectomy and posterior lumbar interbody fusion groups (P > 0.05).After treatment, the height of intervertebral disc, lumbar lordosis and pelvic pelvic projection angle were significantly increased in the posterior lumbar interbody fusion group compared with the discectomy group (P < 0.05). These results demonstrate that discectomy cannot significantly change the spine-pelvis sagittal morphology of patients subjected to re-operation, but compared with the discectomy treatment, posterior lumbar interbody fusion has a greater impact on spine-pelvis sagittal morphology of patients subjected to re-operation.

Objective To study the effect of chemotherapy on function of islet βcells in patients with breast cancer . Methods One hundred and fifty-six patients with breast cancer who had not received chemotherapy were enrolled from Sep 2012 to Aug 2013 at Chongqing Cancer Institute .One hundred and twenty-three cases completed 2 cycles of chemotherapy;one hundred and twelve cases completed 4 cycles;and, eighty-six cases completed 8 cycles.Height, weight, waist circum-ference(WC), hip circumference(HC) and blood pressure of each patient were measured .Waist-high ratio calculation (WHtR),waist-hip ratio(WHR) and body mass index(BMI) were calculated.All subjects underwent 75 g oral glucose tolerance test(OGTT)and insulin release test before chemotherapy,2 cycles,4 cycles and 8 cycles of chemotherapy, respec-tively.Besides, homeostasis model assessment of insulin resistance index ( HOMA-IR), Matsuda index and pancreatic βcells HOME(HOME-β) were calculated.Results Fasting blood glucose before chemotherapy and after 2 cycles, 4 cycles and 8 cycles of chemotherapy was (4.84 ±0.56), (4.78 ±0.61), (5.02 ±0.56) and (5.96 ±0.52) mmol/L, respec-tively.After therapy, the change in fasting blood glucose after 2 cycles and 4 cycles of chemotherapy was not statistically significant(P>0.05), but was significantly higher after 8 cycles than before therapy(P<0.05).2 h blood glucose before chemotherapy and after 2 cycles, 4 cycles and 8 cycles of chemotherapy was (5.43 ±0.50), (5.66 ±0.58), (8.30 ± 0.66) and (9.65 ±0.80) mmol/L, respectively.With chemotherapy treatment increased , the HOME-IR increased gradu-ally and the sharpest one was after 8 cycles, Matsuda index decreased gradually and the biggest drop was after 4 cycles,and HOME-βdecreased gradually after a transient increase .Conclusion Chemotherapy for breast cancer patients may lead to insulin resistance , pancreatic βcell function decline and the emergence of abnormal glucose tolerance .Four cycles of chemotherapy shoucd be followed by hypoglycemic drugs .

Fifty-four children, aged 1.5-3.5 years, were selected from a nursery and divided into three groups. To the children in group 1 multivitamin fortified formular milk powder of Hai-He brand (70g daily) was given as a supplementary food in addition to the normal diet and whole milk powder of Hai-He brand was given to group 2 as another supplementary food. The third group served as control. This observation was lasted for three months. At the end of the third month, the increments of body weight of the children, tricep skinfold and circumference of upper arm of group 1 were higher than those of group 3 significantly, but there were no significant differences between group 1 and group 2. The hemoglobin content of group 1 increased by 0.8g/dl but group 2 and 3 decreased by 0.53g/dl and 0.72g/dl respectively. At the end of our observation, the concentrations of vitamin B1, C and PP in urine of group 1 were higher than those of other two groups by vitamin load test.Thus, we may consider that the multivitamin fortified milk powder is better than the whole milk powder in improving the vitamin and iron nutritional status of young children.

ObjectiveTo study the effect of ischemia postconditioning intervention in a rabbit's acute mesenteric ischemia-reperfusion injury model.Methods 120 rabbits were divided randomly into Con( only expose SMA by operation),I/R( clamping SMA 30 min,reperfusing 120 min),IpostC1 ( clamping SMA 30 min,3 clamping 30 s/releasing 30 s round,reperfusing 117 min),and IpostC2 (clamping SMA 30 min,3 clamping 60 s/releasing 60 s round,reperfusing 114 min) group (n =30).Levels of MDA and MPO in serum and intestinal tissues were measured. Chiu-6 standard scoring was used to determine the pathology score of injured intestinal mucosae.ResultsCompared with the Con group,MDA and MPO levels in serum and intestinal tissues increased obviously in the three other groups,the same as in the pathology score of injured intestinal mucosae (P ＜ 0.01 ) ; Compared with the I/R group,the MDA and MPO levels in serum and intestinal tissues decreased obviously in the IpostC1 group ( P ＜ 0.01 ),but not in the IpostC2 group ( P ＞ 0.05 ).ConclusionsMDA and MPO levels in serum and intestinal tissues and intestinal mucosal injury decreased obviously in the rabbit's acute mesenteric ischemia-reperfusion injury model by ischemia postconditioning intervention.

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.

Objective This paper focuses on the investigation of the occurrence and influential factors of post-traumatic stress disorder (PTSD)in SARS patients, hospital staffs and the public expo sed to SARS. Methodes Three groups were assessed by scale of self-compiled stressor Questionnaire, impact of event scale-revised (IES-R) , PSSS, SCSQ, SES and EPQ. Results 1. The incidence of PTSD symptoms in the three groups were 55.1% ,25.8 % and 31.18 %. 2. The main cause of the different incidence was the difference of the stressor intensity and characters. Negative coping was the risk factor of SARS patients and the public; Self-esteem was the protected factor of SARS patients and the hospital staffs; Social support was a protected factor on the hospital staffs. 3. Comparing to the first investigate in September,2003 ,the data of follow-up study in September,2004 showed that the prevalence items significant decreased. Conclusions 1. The investigation concludes that all three groups of people exposed o SARS exhibit PTSD symptom. SARS patients have the highest occurrence ( P ＜ 0.01 ). 2. The main influencing factors of different incidence of PTSD in different groups are intensities and characteristics of stressors. Different people who had PTSD symptoms have different influencing factors. 3. With the change of time , the PTSD symptoms significant relieve with the attenuation gradually of exposure degree of stressor.