Objective To study the effect and pathological mechanisms of the neuro-immune response to viral encephalomyelitis caused by virulence reversion following the intrathalamic neurovirulence test for poliomyelitis vaccine in rhesus macaques.Methods Stock solutions(≥7000 lgCCID50/L)of inactivated polio vaccines(Vero cells)of type I,type Ⅱ,and type Ⅲ Sabin strains and 10-1 dilution of each type of polio vaccine were given to macaques,which were subjected to a intrathalamic neurovirulence test.Using immunohistochemical method,the pathological changes caused by polio,as determined by the distribution of CD 155 and CD4+receptor T lymphocytes,CD20+B lymphocytes,and CD68+microglia,were detected.Results Lesions were observed on the virulence-reverted polio cases.Inflammatory cell infiltration,neuronal degeneration and necrosis,satellite phenomena,perivascular cuffing,and glial cell proliferation were observed in the spinal cord.The inflammatory cells in the perivascular cuffing and proliferative glial nodules were mainly CD4+T lymphocytes,CD20+B lymphocytes,and CD68+microglia.There was no significant difference in the distribution of the poliovirus receptor CD 155 in the neurons and glial cells of monkeys with and without polio,and no expression was observed in their vascular endothelial cells.Conclusions Polio caused by virulence reversion of the intrathalamic neurovirulence test is viral encephalomyelitis.

To evaluate the advantages of using PBL case library in teaching circulatory system diseases to clinical medicine undergraduate students, a PBL case library was established and applied in teaching practice in the reform of circulatory system teaching. The PBL case library achieved the characteristics of combining theories with cases, morphology with functions, and basic knowledge with clinical knowledge. The PBL case library also realized the informatization, query, and update of cases. Preliminary application showed that the median practical score of students in the case library group was 94.00 points, which was significantly higher than the 92.00 points in the control group ( P=0.005). The average lesson preparation time for teachers in the case library group was (5.00±1.00) hours, which was significantly shorter than the (6.89±0.42) hours in the control group ( P<0.001). The difficulty score for lesson preparation among teachers in the case library group was significantly lower than that of the control group [(1.89±1.05) vs. (3.22±0.44), P<0.001]. However, there were no significant difference in theoretical scores and student satisfaction with teachers and courses. These results suggest that the construction of case library can improve practical teaching effectiveness and enhance the efficiency of lesson preparation for teachers.

【Objective】 To explore the surgical treatments and therapeutic outcomes for benign testicular tumor. 【Methods】 Clinical data of 53 patients with benign testicular tumor treated with surgery during May 2004 and Jul.2021 were retrospectively analyzed. 【Results】 The postoperative pathological diagnosis of 53 patients included 33 patients with epidermal cysts, 12 with mature teratomas, 2 with bilateral testicular tumors (one of them was epidermal cysts in the left and mature teratoma in the right, and the other was bilateral leiomyomas), and 6 benign cases. Testis sparing surgery (TSS) group had 23 patients and radical orchiectomy (RO) group had 30 patients. There were no significant differences in patients’ age, tumor location, disease course, and ultrasound examination results between the two groups (P>0.05). The tumor size of the RO group was (2.60±0.94) cm, which was larger than that of the TSS group (1.55±0.52) cm (P<0.001). There were no statistically significant differences in surgical time and postoperative hospital stay between the two groups (P>0.05). A total of 15 patients (13 with TSS and 2 with RO) underwent intraoperative frozen rapid pathological examination (FSA), which was consistent with post-operative paraffin pathological results. Durign the follow up of 2-219 months,median 38 months, there was no recurrence in either groups. 【Conclusion】 Testis sparing surgery is a reliable treatment modality for benign testicular tumor, which may also decrease the level of androgen and incidence of asthenozoospermia. It can be considered for tumors less than 2 cm with benign tendency or uncertain nature.

Objective To investigate the structural and functional changes of immune system in aging Sprague-Dawley rats. Methods Sixty SPF 4-6-week old SD rats(male:female=1:1)were used in this study. Ten of them were randomly taken and euthanized every 6 months. The dynamic changes of T cell proliferation,expression of cytokines,serum levels of SOD and MDA and histopathology were examined. Results Obvious histological changes of thymus and spleen were observed in the aging rats. Compared with the young SD rats,in the aging rats,the lymphocyte transformation ability was decreased(P<0.05,P<0.01),number of splenic cells was declined(P<0.05,P<0.01),NK(P<0.05,P<0.01)and T cell subset was reduced(P<0.05,P<0.01),and the production of IL-2 was decreased as well(P<0.05, P<0.01). The serum level of SOD in old rats was lower,MDA was increased,with significant differences(P<0.05,P<0.01). The immunohistochemical staining showed that more extensive staining was found in the nuclei of thymocytes from the aging rats,while the 8-OHdG formation in thymic tissues was mostly located in the thymic medulla. Conclusions Aging process is accompanied by immune impairment,oxidative stress can also impair the immune response in aging rats. Our findings indicate that structural and functional alterations of immune system in aging rats may be closely related with ox-idative damages.

Objective: To explore the postoperative effect, prognosis, and prognostic factors for benign testicular tumors. Methods: We retrospectively analyzed the clinical data of 35 patients with benign testicular tumors between May 2004 and May 2017 from Sun Yat-sen University Cancer Center, and the patients were followed up until October 2017. Results: The mean age of the 35 patients was 18.8 (0.4-44.0) years. Among them, 14 patients (40.0%) underwent testis-sparing surgery and 21 (60.0%) underwent radical orchiecto-my, and the tumor sizes were 1.8 (0.4-4.0) cm and 2.7 (1.0-8.0) cm, respectively. All patients had been cured without obvious perioper-ative complications. Postoperative histopathological tumor types included 18 epidermal cysts, 10 mature teratomas, 4 interstitial cell tumors, and 3 adenomatoid tumors. Frozen section examination of 10 cases had been operated, and all results were consistent with paraffin pathology. No patient who underwent testis-sparing surgery showed recurrence and/or metastasis during follow-up, and their sexual function and fertility were well preserved. Conclusions: Testis-sparing surgery is reliable, and the size of the tumor determines its implementation. An intraoperative rapid frozen section examination should be performed in patients with testicular neoplasms of a benign or variable nature diagnosed before operation. Patients with benign testicular tumors should undergo testis-sparing surgery, whereas others should undergo radical orchiectomy.

Objective To evaluate the efficacy of Ganoderma lucidum preparation on the behaviors,biochemistry,and autoimmunity parameters of mouse models of APP/PS-1 double transgenic Alzheimer's disease(AD).Methods A total of 44 4-month-old APP/PS-1 double transgenic AD mice were randomly divided into AD model group,Aricept group,Ganoderma lucidum middle-dose(LZ-M)group,and Ganoderma lucidum high-dose(LZ-H)group,with 11 mice in each group.In addition,10 4-month-old C57BL/6 mice were used as the control group.Water maze test was conducted to observe the behavior changes,and the protein expressions in brain tissues were detected by Western blot analysis.The autoimmune indicators were detected by indirect immunofluorescence method.Results In the navigation experiment,the time of finding the platform was gradually shortened since the 2day in the control,LZ-H,and LZ-M groups,and the time of searching the platform in the AD model group gradually increased.On the 5day,the time of finding platform was significantly shorter in control group (t=5.607,P=0.000) and LZ-H group(t=2.750,P=0.010)than AD model group.In the space exploration experiment,the number of crossing the target platform(t=2.452,P=0.025)and the residence time in the target quadrant(t=2.530,P=0.020)in AD model group mice was significantly smaller/shorter than those in control group;in addition,the number of crossing the target platform in the AD model group was significantly smaller than that in LZ-H group(t=2.317,P=0.030)and LZ-M group(t=2.443,P=0.030),while the residence time in target quadrant decreased significantly(t=2.770,P=0.020)compared with LZ-H group;the number of crossing through the target platform quadrant(t=2.493,P=0.022)and residence time in the target quadrant(t=2.683,P=0.015)in LZ-H group were significantly higher than in Aricept group.Western blot analysis showed that the expression of ApoA1 in the brain tissues of mice in LZ-H and LZ-M groups were significantly higher than those in AD model group(P<0.01,P<0.05);Aβ-40 expression in LZ-H group was significantly lower than that in AD model group(P<0.05);the expressions of Syt1,ApoE,and ABCA1 in brain tissues of mice in LZ-H group were significantly higher than those in model group(P<0.01,P<0.05).The plasma IgG level in Aricept group(t=30.945,P=0.000),LZ-M group(t=25.639,P=0.000)and LZ-H group(t=4.689,P=0.001)were significantly higher than that in the control group.Conclusion Ganoderma lucidum preparation can improve behavior disorders of AD model mice,promote the expressions of ApoA1,ApoE and Syt1,inhibit the expression of Aβ-40 protein,and improve the autoimmune function.

Objective To observe the effects of 630 nm red light and 460 nm blue light emitting diode irradiation on the healing of skin wounds in Japanese big-ear white rabbits. Methods The skin wound model was established with 8 Japanese big-ear white rabbits. Three parts of vulnus in each rabbit were used:two parts of vulnus were irradiated vertically by red and blue LED light,respectively(15 min/time),and the distance between lights and wounds was 15 cm;the 3part of the wound was used as a control. On the 21day of the wounds exposure to light,the number of healing wounds and the percentage of healing area were recorded and the treatment effect of these two light sources was compared. HE staining was used to analyze the newborn tissue structure. Masson staining was used to observe the proliferation of skin collagen fibers. Immuohistochemical staining was used to analyze fibroblast growth factor(FGF),epidermal growth factor(EGF),endothelial growth factor(CD31),proliferating cell nuclear antigen(Ki-67),and inflammatory cytokines(CD68)infiltration in the skin. Results The healing rate in the red light,blue light,and control groups was 50.0%(4/8),25.0%(2/8),and 12.5%(1/8),respectively. Since the 12day after modeling,the healing area percentage in the red light group was significantly higher than those in the blue light and control groups(P<0.05,P<0.01). On the 21day after modeling,the skin thickness of the red light group was(2.95±0.34)mm,which was significantly higher than that in control group [(2.52±0.42)mm;F=3.182,P=0.016)]. The average optical density of collagen fibers was 0.15±0.03 in red light group,which was significantly higher than that of the blue light group(0.09±0.01;F=7.316,P=0.012)and control(0.07±0.01;F=7.316,P=0.003). The results of immunohistochemistry showed the expression levels of EGF,FGF,CD31 antigen,and Ki-67 in the red light group were significantly higher than those in the blue light and control groups,whereas the CD68 expression was significantly lower(P<0.05 or P<0.01). Conclusion LED red light irradiation can promote the healing of skin wounds in Japanese big-ear white rabbits,which may be achieved by the effect of red light irradiation in stimulating the proliferation of skin epidermal cells,vascular endothelial cells,and fiberous tissue.

Objective:To investigate the clinical characteristics of adrenal incidentaloma and explore the management strategies for this disease. Methods:The clinical data of adrenal neoplasm patients admitted in The First Affiliated Hospital and Cancer Center of Sun Yat-sen University from January 2001 to January 2013 were analyzed retrospectively. Results:The data of 667 patients with adre-nal incidentaloma were analyzed. Adenoma was the most common tumor in 511 cases with pathological results (240/511, 47%). Fur-thermore, the pathologic results indicated that 18%(90/511) of these cases were pheochromocytoma and 8%(41/511) were adreno-cortical carcinoma. Of the 511 cases, 266 had≤4 cm tumors, and 245 had>6 cm tumors. In cases with≤4 cm tumors, 260 (98%) had benign tumors, and 183 of these cases underwent laparoscopic adrenalectomy. In cases with>6 cm tumor, 91 cases (37%) had malig-nant tumors, and 162 of these cases underwent open adrenalectomy. Conclusion:The suggested cut-off size for adrenal incidentalo-ma diagnosis is 4 cm. Laparoscopic adrenalectomy is the recommended management strategy for small (≤4 cm) and nonfunctional ad-renal incidentaloma.

Objective To study the outcomes of Lennox-Gastaut syndrome (LGS) with single-stage total corpus callosotomy combined with different resective surgeries. Methods Nine LGS patients, admitted to our hospital from May 2010 to May 2014, were chosen in our study. Their clinical data were retrospectively analyzed. According to the results of anatomy, electrophysiology and clinical comprehensive evaluation, all the 9 children received single-stage total corpus callosotomy combined with different resective operations. The differences of epileptic seizures of these children before and after surgery were compared. Results The 9 LGS children were followed up for 2 years;5 achieved Engel grade I, 3 achieved Engel grade II, and one achieved Engel grade III. The surgical effective rate was 88.9％ (8/9). The frequencies of drop seizures, convulsive seizures, tonic seizures and tonic-clonic seizures were decreased of different degrees, with drop seizures enjoying the best control. Three patients had transient silence, remarkable relief one week after surgery and total recovery half year after surgery. Conclusion Early single-stage total corpus callosotomy combined with different resective operations can help to control seizures in children with intractable LGS.

Objective To evaluate the efficacy of patients with stage T2 bladder cancer who underwent combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy.Methods The survival data of bladder cancer paients from January 2000 to December 2014 with stage T2N0M0 were retrospectively analyzed.Thirty-five patients of cT2N0M0 receive combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy(group A),and 80 patients of pT2N0M0 underwent radical cystectomy (RC) (group B).The pathological diagnosis of all patients was urothelial carcinoma.In group A,there were 33(94.2％) males and 2 (5.8％) females;20 (57.1％) tumor size less than 3 cm and 15 (42.9％) larger than 3 cm;24 (68.6％) with single tumor and 11 (31.4％) with multiple tumors;11 (31.4％) patients with primary tumors and 24 (68.6％) recurrent tumors.In group B,there were 71 (88.7％) males and 9 (11.3％) females;35 (43.8％) tumor size less than 3 cm and 45(56.2％) larger than 3 cm;44 (55.0％) with single tumors and 36 (45.0％) with multiple tumors;22(27.5％) patients with primary tumors and 58 (72.5％) recurrent tumors.Results Groups A and B consisted of 35 and 80 patients and median follow-up time was 68 (13-157)and 67 (4-198)months,respectively.There was no significantly statistical difference in disease-specific survival (DSS) between the two groups(P =0.888),76.5％ for group A and 60.6％ for group B respectively.In group A,26 (74.3％) patients achieved complete response (CR) to intra-arterial chemotherapy.Additionally,amounts of 21 (60.0％) patients preserve their functional bladder successfully and their median follow-up time was 69 (13-134)months.8 patients receive delayed radical cystectomy when suffered tumor recurrence and none of them had lymph node metastases.Of those pathological stage was presented as stage T2 5 cases,T3 2 cases and T4 1 case.Importantly,the 8 patients who receive delayed RC did not confer worse DSS when compared with those underwent immediate RC in group B (P =0.809).Cox proportional hazards model showed that tumor number and CR to intra-arterial chemotherapy was independent prognostic factor for disease-free survival (HR =0.238,P =0.007) and DSS(HR =0.085,P =0.004) respectively.During the period of intra-arterial chemotherapy,we did not observe hematological toxicity of grade Ⅳ and the hematological toxicity of grade Ⅰ-Ⅲ was 9 (25.7％),6 (17.1％) and 4 (11.4％).Conclusions For patients with T2N0M0,combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy could be a therapy with long-term survival outcome and safety.The therapy could be offered as alternative treatment option for patients who were unsuitable for receiving RC.