Hoffa's disease is the clinical condition characterized by anterior knee joint pain secondary to inflammation and/or impingement of the infrapatellar fat pad. The substance P positive nerve fibers rich in the infrapatellar fat pad were stimulated by the noxious stimuli,which may associated with the pain of Hoffa's disease. The relationship between Hoffa's disease and substance P positive nerve fibers in the infrapatellar fat pad was reviewed in this paper.

Objective To compare the long-term prognosis of patients with stage Ⅰ endometrial cancer (EMC) after laparoscopic surgery or open laparotomy. Methods Totally 83 patients with stage Ⅰ EMC who underwent laparoscopic surgery or open laparotomy between 1993 and 2008 were enrolled in this study. The clinical data were analyzed retrospectively to compare the survival time during long-term follow-up between the two groups. Results The total survival rate was 95.2% (79/83) in the 83 cases. The median survival time was 77,51,and 31 months respectively in stages Ⅰa,Ⅰb,and Ⅰc EMC patients. No significant difference was found in the survival rate between open and laparoscopy groups [94.2% (49/52) vs 96.8% (30/31),Z=0.028,P=0.978]. For the stage Ⅰa,stages Ⅰb and Ⅰc,and G2 and G3 patients,the median survival time was similar between the open and laparoscopy groups (80 month vs 63 months,P=0.483; 49 months vs 48 months,P=0.781; and 51 months vs 49 months,P=0.635). However,in the G1 patients,significantly difference was detected in the median survival time between the two groups (77 vs 51 months,P=0.037). Conclusion Laparoscopic surgery should be used as a routine surgical approach for patients with stage Ⅰ EMC considering its minimal invasiveness and promising prognosis.

Objective To evaluate the efficacy of laparoscopic treatment for interstitial tubal pregnancy. Methods A total of 12 cases of interstitial tubal pregnancy underwent laparoscopy in our hospital from 1993 April to June 2007. Among the patients,9 received tubal ligation using lasso (1-0 suture were used during the surgery and the fetal tissues were removed at the same time),1 underwent salpingotomy to remove the fetus,1 were treated by salpingectomy using stapling device,and 1 received injection of MTX (40 mg). Results The procedure was completed within 30-120 minutes. The intraoperative blood loss was ≤20 ml in all of the cases,except one who received salpingectomy (200 ml). In 10 patients,the level of blood hCG decreased to a normal range in 2 weeks,while the other two cases recovered in 4 and 8 weeks respectively postoperation. Conclusion Laparoscopic treatment is safe and effective for interstitial tubal pregnancy.

Objective To investigate the clinical features of Escherichia coli pneumonia, the positive rate of extend-spectrumβ-lactamase (ESBLs) produced by Escherichia coli and antimicrobial resistance of Escherichia coli. Methods Three hundred and thirty-six infants with Escherichia coli pneumonia were divided into community acquired infection group and hos-pital acquired infection group from Jun 2003 to Jun 2013. The clinical data of those patients were collected and analyzed. The ESBLs were examined, and drug susceptibility results were analyzed. Results Infants under 6 months had higher infective rate of Escherichia coli. The Escherichia coli pneumonia had similar clinical manifestations as Gram negative bacterial pneumonia. ESBLs were found in most strains (58.3%, 196/336), positive rate of ESBLs of hospital acquired infection group (84.00%) was higher than that of community acquired infection group (50.96%) (χ2=26.17, P<0.05). There was no difference of ESBLs posi-tive rate between the community acquired infection groups during Jun 2003-May 2008 and those during Jun 2008-Jun 2013 (χ2=0.30, P>0.05). The ESBLs positive rate of hospital acquired infection group was significantly increased from 76.74%(Jun 2003-May 2008) to 93.75% (Jun 2008-Jun 2013) (χ2=3.95, P<0.05). The most sensitive antibiotic was carbapenem. Conclusions Escherichia coli pneumonia mainly occurs in infants, usually with severe clinical situations and more persistent. The hospital acquired infection is the high risk factor of acquiring ESBLs. Antibiotics should be prescribed depending on community acquired infection or hospital acquired infection.

Objective To evaluate the effects of combined detection of sputum and serum procalcitonin (PCT) to identify the etiology of community acquired pneumonia(CAP) in infants.Methods Retrospective analysis from August 2010 to September 2012 enrolled 435 patients with definitely etiological diagnosis of CAP.The all cases were divided into three groups according to the etiological diagnosis:243 cases of bacterial infection group(including mixed bacterial infection),106 cases of viral infection group,and 86 cases of mycoplasma infection group.Sputum and serum PCT levels in all cases were detected,with simultaneous detection of blood leukocytes,C-reactive protein levels.Results Sputum PCT level of bacterial infection group [(8.44 ± 1.08) ng/ml] was significantly higher than viral infection group [(0.32 ±0.12) ng/ml] and mycoplasma infection group [(0.24 ± 0.17) ng/ml],which showed statistically significant difference (F =765.03,P ＜0.01).Serum PCT level of bacterial infection group [(6.69 ± 1.36) ng/ml] was also higher than viral infection group [(0.37 ± 0.22) ng/ml] and mycoplasma infection group [(0.42 ± 0.28) ng/ml],the difference of which was statistically significant (F =240.46,P ＜ 0.01).Meanwhile between the viral infection group and mycoplasma infection group,sputum PCT and serum PCT showed no significant difference (P ＞ 0.05).The levels of blood leukocytes and C-reactive protein among 3 groups showed no statistically significant difference(P ＞ 0.05).As the critical value of the PCT ＞ 0.5ng/ml,the positive rates of sputum and serum PCT were significant difference in bacterial infection group (86.83％ vs 73.66％,x2 =13.92,P ＜0.05).The sensitivity of diagnosing bacterial CAP by sputum and serum PCT levels were 86.83％ and 73.66％,the specificity were 86.98％ and 88.54％,respectively.The sensitivity and specificity of combined detection sputum and serum PCT were 72.02％ and 94.27％.Conclusion Combined detection of sputum and serum PCT has clinical value and efficiency in pathogen identification of CAP.

Objective To investigate the influence of different types of pneumoperitoneum on the ultrastructure of the extraperitoneal muscular tissues in rats. Methods By using pulse-mode or constant-pressure mode insufflators,we established CO2 pneumoperitoneum in 80 rats (40 for each) with the pressure set at 15 mmHg. At 60,90,120 and 180 minutes after the insufflation,the muscular tissues below the peritoneum of the rats (10 rats at each time point) were obtained to observe the ultrastructural change under a transmission electron microscope (TEM). Ten rats that received anesthesia only were set as a control. Results In both the groups,vacuolar degeneration was found in the myocytes below the peritoneum after 60 minutes of pneumoperitoneum,and became more and more marked with time. Moreover,the phenomenon was more significant in the pulse-mode insufflator group,in which,we observed widened gaps and vacuoles among the myocytes at 180 minutes after the insufflation,while in the other group,such changes were not apparently detected. Conclusions CO2 pneumoperitoneum may injure the muscular tissues below the peritoneum in rats. Constant-pressure mode insufflator is helpful to decrease such an injury.

Objective To study the anatomical relationship between the umbilicus and the retroperitoneal major vessels. Methods A total of 80 female patients undergoing laparoscopy in our department were enrolled in this study. The patients were divided into 4 groups according to their body mass index (BMI):low-weight group,normal-weight group,overweight group,and obese group. During the operation,the surgeons palpated the abdominal aorta,right common iliac artery,and left common iliac artery with hand to determine their relationship to the umbilicus. The abdominal aortic bifurcation was used as a reference point to determine its position in relation to the umbilicus. Results (1) The bifurcation was above the level of the umbilicus in 17 (21.2%) cases,at the umbilicus level in 29 (36.3%) cases,and below that in 34 (42.5%) cases. Among the four groups,the position of the bifurcation was significantly different (?2=16.769,P=0.010). In the overweight and obese groups,most of the patients had the umbilicus located under the level of the aortic bifurcation [65.0% (13/20) and 75.0% (6/8) respectively],while in the normal-weight group,47.6% (20/42) of the cases had the umbilicus above the aortic bifurcation(P

Objective To study the inhibitory effect of recombinant adenoviruses carrying the mouse endostatin gene on the therapy of endometriosis in nude mice.Methods Animal endometriosis models were established by inoculating human endometrial fragments.Mice were randomly divided into three groups(10 each):PBS control group,Ad-lacZ group and Ad-mEndo therapy group when ectopic lesion diameter reached 5-10mm.The ectopic lesion size was measured every day.The expression of endostatin in ectopic lesion was detected by immunohistochemical stainining.The microvessel density(MVD) of ectopic lesion was traced by CD34 immunohistological labeling.Meanwhile,the contents of steroid hormone and histological changes in mice uterus and ovary were detected.Results The titer of the recombinant adenovirus was about 5.0?109pfu/ml.The endostatin gene was transferred into mice successfully and expressed effectively.The lesion volume was significantly less in Ad-mEndo group(34.3?11.2mm3) than that in Ad-lacZ group(93.3?10.7mm3) and PBS group(90.4?18.7mm3,P

Objective To explore the role of Cyclin B1 and Cyclin D1 on Barrett esophagus,Barrett's esophagus mixed with atypical dysplasia and esophageal adenocarcinoma.Methods Cyclin B1 and Cyclin D1 were examined with immunohistochemistry.76 esophageal tissues of patients werB collected,including severe reflux esophagitis(RE,25 cases),Barrett esophagus(BE,35 cases),Barrett esophagus mixed with atypical dysplasia(DY,8 cases),esophageal carcinoma(CA,8 cases).Ten cases with normal esophageal mucosa were examined as the control. Results Cyclin B1 and Cyclin D1 were high expression in the specimens of the BE,DY and CA groups and very low expression in the control and RE group.Statistieal difference Was showed(P<0.01).Expression of Cyclin D1 was increasing gradually from the tissues of intestinal metaplasia,atypical dysplasia to adenocarcinoma(50.04 vs 67.94 vs 74.31).There Was significant difference among these three groups(P<0.01).Conclusion Cyclin B1 and Cyclin D1 as markers of tumour development could evaluate the risk from Barrett esophagus to adenocarcinoma.Perhaps it is the earlv event in the development of esophageal carcinoma.

Objective: To assess the values of conventional vascular ultrasound (US) and superb micro vascular imaging (SMI) for diagnosing carotid artery stenosis in relevant patients. Methods: A total of 37 patients of extra cranial carotid stenosis (with 70 blood vessels) treated in our hospital from 2014-08 to 2015-03 were retrospectively studied. Digital subtraction angiography (DAS) examination was used as golden standard, the diagnostic efifcacies for carotid artery stenosis by US and by SMI were compared. Results: The accuracy, sensitivity and specificity for diagnosing carotid stenosis by US were 81.42%, 83.33% and 80.95%; by SMI were 91.43%, 92.16% and 89.47% respectively. Conclusion: US and SMI showed good agreement for diagnosing carotid artery stenosis, while SMI was superior to US for accurately assess the degree of carotid stenosis, it might be used as a more reliable method for evaluating carotid plaque and stenosis in relevant patients.