Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits.Methods From October 2014 to June 2015,36 male rabbits (weighing 1.8-2.4 kg,10-14 months of age) were randomly divided into experimental group and control group,18 in each group.Produced by surgical testicular torsion model (720° counterclockwise rotation of the left side testicle),every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water,all the testicles were observed no significant improvement in colors,and no fresh blood flow after opening tunica albuginea,then all the testicles were retained and fixed.Low molecular dextran(5 ml/kg,ear marginal vein injection,1/d),papaverine(1.5 mg/kg,intramuscular,3/d) and low molecular weight heparin sodium (200 IU/kg,subcutaneous,l/d) were applied to promote testicular revascularization for 5 days in experimental group,and penicillin (40 000 U/kg,intramuscular,1/d) for 7 days.Control group was only given penicillin (40 000 U/kg,intramuscular,1/d) to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0,1,2,3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened,according to color,texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened,to determine whether the testicle was alive.The testicle was ruddy,flexible,and fresh blood was observed,which could prove testicular survival.Results In experimental group,the testicular blood flow siganals:0 class 4 cases,1 class 3 cases,2 class 4 cases,3 class 7 cases.In control group,the testicular blood flow siganals:0 class 9 cases,1 class 2 cases,2 class 4 cases,3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group,which was significantly difference (P ＜ 0.05).Conclusions The combined application of low molecular dextran,papaverine,low molecular weight heparin sodium can promote the recovery of testicular blood after reduction of testicular torsion,and improve testicular survival rate.

Objective To improve the skills and level of TURP and peri-operative period managements to the high risky senile patients with large volume benign prostatic hyperplasia.Methods The clinical data of 318 high risky and senile patients whose ages above 80ys,ASA score ＞ 2 and prostate volume ＞ 60g were analyzed retrospectively.They underwent the treatment of TURP.ResultsTotal 318 patients underwent TURP were safe.The operating time ranged from 40 to 85 minutes,averaged 58.2minutes;the volume of blood transfusion ranged from 200ml to 600ml;No serious complications happened during and after the operation.With follow up of 1 ～ 12 months,the International Prostate Symptom Scores(I-PSS) decreased 14.7 averagely,Quality of Life(QOL) decreased 3.3 averagely,Maximal flow rate( Qmax ) increased 6.4ml/s averagely,and Post-voided Residual(PVR) decreased 85.3ml averagely.Conclusion The actions including sufficient preparations and evaluations pre-operatively,the maintenance to the stability of circulatory system during the operation,guaranteeing the demands of blood exchange in the vital organs such as heart,lungs and brain,are the key points to the success.

ObjectiveTo improve the treatment of urethral stricture and evaluate the applicative effects of wire-guided supporting catheterization in clinical urology. MethodsDuring January 2004 and December 2005, the patients with urethral stricture were dwelled with the catheters using the traditional guideless catheterization (group A). If the dwelling failed,it will be replaced by the wire-guided supporting catheterization using the improved catheters. During January 2006 and December 2009, the patients with urethral stricture were dwelled with the improved catheters using wire-guided supporting catheterization ( group B) straightly. Compared the first-time dwelling success incidence,the incidence of catheter associated urinary tract infection and side-effect events. Then after 1 year, compared the urethral stricture recrudescence and the course of treatment. ResultsThe success incidence of first-time catheterization in group A was 48.98％ (24/49) ,and in group B was 97.94％ (95/97) ,there was significant difference between 2 groups;The incidence of catheter associated urinary tract infection in group A was 12.24％, and 8. 25％ in group B, there was significant difference between 2 groups; As for the course of treatment, group A was 46. 2w,group B was 32.7w;The urethral stricture recrudescence in group A and B were 16.33％ and 9.28％ respectively,and there was significant difference between 2 groups. ConclusionThe wire-guided supporting catheterization, which minimize the injury and simplify the operation of internal urethrotomy,could makes the improved catheter easy to induct and replace, improve the success rate of first time-catheterization and prevent the false tunnel damage and new scar expansion. It could make benefit to reduce of incidence of catheter associated urinary tract infection and urethral stricture recrudescence,but also could shorten the course of treatment significantly.

Objective To investigate the clinical significance of transvaginal ultrasound, hysteroscopy and MRI in the assessment of endometrial cancer lesions size. Methods Data from 56 patients who successively underwent transvaginal ultrasound, MRI and hysteroscopy inspection preoperative endometrial carcinoma were retrospectively analyzed to assess the accuracy of lesions size. Results The pathologic lesions size measured mean maximum diameter of 56 cases was (3.05 ± 0.23) cm, while the mean maximum diameter measured by vaginal ultrasound, MRI and hysteroscopy were respectivelly (2.46±0.31) cm, (3.12± 0.08) cm, and (3.18 ± 0.21) cm. Compared with the pathologic measured values, the compliance rates of transvaginal ultrasound, hysteroscopy and MRI were respectively 54%(30/56), 71%(40/56)and 75%(42/56), which vaginal ultrasound measurement value was significantly different than that by pathologic measured ( P=0.031), while there were significant difference between the hysteroscopy measured lesion size and pathologic measured, or between MRI measured values and pathologic measured (all P>0.05). Conclusion Preoperative assess the endometrial cancer lesions size, significance of vaginal ultrasound examination is limited, and MRI and hysteroscopy examination is accurate, but easy to over-estimated lesion size.

BACKGROUND:Neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine can induce the clinical, biochemical and pathological characteristics similar to those observed in primary Parkinson’s disease. OBJECTIVE:To observe the effects of repetitive transcranial magnetic stimulation on the proliferation of endogenous neural stem cells of Parkinson’s disease model mice and the mood change.
METHODS:A total of 72 male C57BL/6J mice were randomly divided into four groups:normal saline group, Parkinson’s disease model group (model group), sham-repetitive transcranial magnetic stimulation group (sham group) and repetitive transcranial magnetic stimulation group. The mice received 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine injection×4 to establish acute Parkinson’s disease models. The mice in the normal saline group were injected the same volume saline. And 24 hours after the last injection of 1-methyl-4-phenyl-1,2,3, 6-tetrahydropyridine, the mice in the repetitive transcranial magnetic stimulation group received five trains of repetitive transcranial magnetic stimulation, 1 Hz for 25 seconds, at an intensity of 1 Tesla daily for 1, 3, 7 consecutive days. Sham group mice were not exposed to the magnetic field. No treatment was performed in the mice of model group. The mood change was evaluated using the elevated-plus maze testing before and after repetitive transcranial magnetic stimulation treatment. The change in expression of nestin in the subventricular zone was observed by using immunohistochemical technique.
RESULTS AND CONCLUSION:(1) Elevated-plus maze testing:There was no statistical significance about percentage of opening arm time accounting for total time among groups and at different time points in each group, but after stimulation, the percentage of opening arm time accounting for total time showed a declined tendency. (2) The results of nestin immunohistochemical staining:Compared to the normal saline group, the number of nestin-positive cells of the model group was increased at days 3 and 7, and there was no statistical significance in the number of nestin-positive cells between model group and sham group;Compared to the sham group and model group, the number of nestin-positive cells of repetitive transcranial magnetic stimulation group were evidently increased;The proliferation of endogenous neural stem cells was time-dependent, endogenous neural stem cells exhibited outward migration gradual y along the certain way, and some cells were able to migrate to the corpus cal osum at day 3, and even to the cerebral cortex at day 7. Repetitive transcranial magnetic stimulation can promote the endogenous neural stem cells in a time-depended manner.

Objective To evaluate the efficacy of fascia iliaca compartment block with dexmedetomidine combined with ropivacaine for analgesia in the patients suffering from proximal femoral fractures.Methods Eighty emergency patients with proximal femoral fractures,aged 25-70yr,weighing 55-82 kg,of ASA physical status Ⅰ-[Ⅲ,were equally and randomly divided into 2 groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).All the patients underwent fascia iliaca compartment block described by Dalens.0.4％ ropivacaine 30 ml was injected in group R,and 1 μg/kg dexmedetomidine 30 ml containing 0.4 ％ ropivacaine was injected in group DR.The severity of pain was assessed by VAS scores,and the level of sedation was assessed by Ramsay scores.At 30,60,90 and 120 min after injection (T1-4),VAS scores at rest and during activity were recorded,the effective analgesia (VAS scores at rest and during activity≤6) and satisfactory sedation (Ramsay scores 2-4) in group DR were also recorded,and the development of hemorrhage or hematoma at the puncture site,local anesthetic poisoning,adverse cardiovascular events and over-sedation was also recorded.Results Compared with group R,the rate of effective analgesia during activity was significantly increased at T2-4,and no significant change was found in the rate of effective analgesia at rest in group DR.In group DR,the rate of satisfactory sedation was 73 ％,88％,95％ and 95％ at T1-4,respectively,and no over-sedation occurred.No patients developed hemorrhage or hematoma at the puncture site,or local anesthetic poisoning in the two groups.Conclusion Fascia iliaca compartment block with 1 μg/kg dexmedetomidine combined with 4％ ropivacaine 30 ml can alleviate the early pain caused by passive activity without inducing obvious adverse reactions in the patients suffering from proximal femoral fractures.

Objective To evaluate the efficacy of patient-controlled infraclavicular brachial plexus block for analgesia after elbow arthrolysis.Methods Eighty patients with elbow stiffness of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective elbow arthrolysis, were equally and randomly assigned to receive either the infraclavicular (Ⅰ group) or axillary (A group) brachial plexus block.All catheters were placed using ultrasound visualization preoperatively.When patients complained of pain in the recovery room after regaining consciousness, 0.2％ ropivacaine was injected via the catheter, 15 min later patient-controlled infraclavicular brachial plexus block was performed with 0.2％ ropivacaine (400 ml), and an electronic pump was set up with a 5 ml bolus dose, a 30 min lockout interval and background infusion at a rate of 5 ml/h.The patients underwent rehabilitation exercise everyday for 3 consecutive days starting from 24 h after operation.The catheter insertion time, successful block, and occurrence of moderate or severe pain (numeric rating scale [NRS] score ＞ 4) and greater inserting resistance (inserting resistance score＞ 1) during insertion, and the occurrence of paresthesia and vascular damage during insertion were recorded.NRS score was recorded at 24, 48 and 72 h after operation during rehabilitation exercise.The elbow articular range of motion was recorded at 72 h after operation, and the improvement in articular range of motion was calculated.The satisfaction with the improvement in articular range of motion (improvement ≥ 80％) and occurrence of complete improvement in articular range of motion (improvement=100％) were recorded.Catheter-related adverse reactions (such as oozing from the insertion site, obstruction, prolapse) and local anesthetics-related adverse reactions (nausea and vomiting, central nervous system toxicity) were recorded.Results The success rate of blockade was 100％ during insertion in both groups.Compared with group A, the catheter insertion time was significantly shortened, the incidence of moderate or severe pain and greater inserting resistance during insertion was decreased, the incidence of paresthesia and vascular damage during insertion was decreased, NRS score at 24 h after operation durig rehabilitation exercise was decreased, the incidence of complete improvement was increased (P＜0.05), and no significant change was found in the improvement in articular range of motion and satisfaction with the improvement in group I (P＞0.05).Conclusion Patient-controlled infraclavicular brachial plexus block can be safely and effectively used for analgesia after elbow arthrolysis, and it provides better efficacy than patient-controlled axillary brachial plexus block.

BACKGROUND:Rat models of diabetes mellitus type 2 (T2DM) are usually induced by the combination of high-fat diet and low-dose streptozotocin, but their effects on the intervertebral disc have not yet been reported. Endplate sclerosis is an important factor contributing to intervertebral disc degeneration. OBJECTIVE:To evaluate whether the rat T2DM model induced by high-fat diet combined with low-dose streptozotocin is suitable for the study of T2DM related intervertebral disc degeneration. METHODS:Thirty-two 3-month-old female Sprague-Dawley rats were divided into four groups (n=8 per group), including sham, bilateral variectomy, DM, and bilateral variectomy plus DM groups, followed by subjected to bilateral ovariectomy and/or high-fat diet combined with low-dose streptozotocin, respectively. The blood glucose level, body mass and glucose tolerance were determined. The bone mineral density of the lumbar spine was measured after 8-week streptozotocin treatment. The L5-6 segments were removed and cut through midst sagittal plane after decalcification, and then underwent Von Gieson staining and histological degeneration scoring, and the disc height and endplate thickness were measured. RESULTS AND CONCLUSION:Fasting blood glucose and random blood glucose levels in the DM and bilateral variectomy plus DM groups were significantly higher than those in the other two groups, and the insulin sensitivity in the DM and bilateral variectomy plus DM groups were significantly lower than that in the other groups (P<0.05). L4-6 vertebral bone mineral density in the bilateral variectomy group was significantly lower than that in the sham group (P<0.05);L5-6 vertebral bone mineral density in the DM and bilateral variectomy plus DM groups was significantly lower than that in the sham group (P<0.05). L5-6 vertebral histological scores in the DM and bilateral variectomy plus DM groups were significantly higher than those in the other groups (P<0.05). Similar with the bilateral variectomy group, there were chondrometaplasia and mucoid degeneration of nucleus pulposus cells in the bilateral variectomy plus DM group, and the histological scores were significantly higher than those in the sham and DM groups (P<0.05). Compared with the sham group, the intervertebral disc height in the bilateral variectomy and bilateral variectomy plus DM groups was significantly decreased (P<0.05). While, there was no significant difference in the endplate thickness among groups. These results indicate the combination of high-fat diet and low-dose streptozotocin-induced rat T2DM models possess diabetic characteristics, but the rat intervertebral disc tissues show no significant differences from the normal ones;therefore, this model may be unsuitable for the study on T2DM-related intervertebral disc degeneration.

Objective:To explore the etiology and treatment of one case of bilateral mandibular second molar impaction with paradental cyst, and to provide a reference for its diagnosis and treatment. Methods:Root canal treatment of the left mandibular first molar of the patient was performed before operation.The left mandibular second molar of the patient was removed;the residual dental follicle, the granulation tissue and the cyst wall were stroken off under local anesthesia.The diamond ball was used to polish the wound cavity and sharp bone edge, and to mill the distal apical part of left mandibular first molar.The tissue removed during the procedure was used for the pathological examination.Results:The X-ray image showed that the bilateral mandibular second molar was impacted with the left mandibular first molar root's absorption, and there was a clear round-like density reduction zone around the second molar crown.The pathologic result was paradental cyst.Conclusion:Dental impaction complicated with paradental cyst could occur in other tooth position except for the third molar.Its diagnosis should be combined with the clinical manifestations, the pathologic manifestations and the medical imaging.Multidisciplinary consultation is in favor of its diagnosis and treatment.

Objective To explore the associations between microsatellites in gonadal receptor genes and dysfunctional attitudes in adolescent with major depressive disorder(MDD).Methods Polymerase chain reaction(PCR),capillary electrophoresis and genetic scanning were performed in testing the length of microsatellites in first-onset adolescent depressive patients.Dysfunctional attitudes scale(DAS) was used in rating the dysfunctional cognition of adolescent depressive sample.These results were tested by correlative analysis and comparison analysis.Results 1.There existed significantly negative correlation between microsatellite′s length in estrogen receptor ?(ER?) gene and total score of DAS in female adolescent patients with first-onset depressive disorder.2.DAS′ total score of shorter alleles′ group was significantly higher than that of longer alleles′ group on female′ estrogen receptor ?(ER?) Gene.Conclusion The microsatellite′s length of ER? and ER? gene may have associations with dysfunctional attitudes of female adolescent with MDD.