Objective To improve the diagnosis and treatment of testicular masses associated with congenital adrenal hyperplasia(CAH).Methods A 25-year-old man presented with bilateral testicular nodules.Physical examination revealed palpable multiple nodules in the bilateral testes and epididymides as well as enlarged and hard right testis with uneven surface.Biochemical examination showed testosterone(T) of 18.7 nmol/L,17?-(OH)P＞20.0 ng/ml,positive results of rapid ACTH stimulation test and dexametha- sone suppression test.B-ultrasound demonstrated diffuse testicular lesions with nodules in parts of the bilater- al testes.Bilateral testicular nodules were biopsied,and pathological diagnosis was interstitial cell hyperplasi- a.Positive staining for?-inhibin was observed immunohistochemically.The clinical characteristics of testicular masses associated with CAH were reviewed in combination with the literature.Results Based on medical history,imaging,laboratory and pathologic examinations,the patient was diagnosed with testicular masses as- sociated with CAH.He received oral cortisol at dose of 40 mg daily for 2 weeks,and then at dose of 30 mg daily as maintenance therapy.After treatment of 8 months,B-ultrasound showed complete regression of the testicular tumors.Follow-up of 24 months showed no recurrence of the tumor.Conclusions For patient with bilateral testicular masses,endocrinological evaluation and clinical history taking are indicated to exclude testicular interstitial cell hyperplasia associated with CAH.By oral steroid replacement therapy,hormone-sen- sitive testicular masses can regress.

Low-level laser effects a special biology stimulation that has been widely used in clinic. In this article, the biological effect of low-level laser irradiation was summarized, and the application in different systems, such as immunity, circulation, metabolism and nerves were reviewed.

ObjectiveTo analyze the relationship between result of hemorheology and non-pathological factors such as sex, age and life habit.Methods3483 healthy adults who had health examination were divided into different groups according to sex and age, and results of hemorheological test of them were analyzed and compared with reference values.ResultsAll hemorheological indexes of men were higher than that of women. The whole blood viscosity of female had an increasing trend along with the age increasing. However, the result of hemorheology of male showed that the index of the age of 30～49 was higher than the age of more than 50, and had a decreasing trend along with the age increasing after the age of 50. The index of high shear viscosity, low shear viscosity and hematocrit of both male and female were all higher than the reference values offered by apparatus.ConclusionEffect of non-pathological factors such as age, sex and life habit on index of hemorheology should be considered.

Objective: To observe the clinical efficacy of electroacupuncture (EA) plus Tanbo-plucking the trigger points for scapulohumeral periarthritis (SP). Methods:A total of 80 patients with SP were randomized into an observation group and an EA group by the random number table, with 40 cases in each group. The EA group was treated with EA therapy, and the observation group was treated with EA therapy plus Tanbo-plucking the trigger points. After treatment, the visual analog scale (VAS) and Melle scores of the two groups were compared to evaluate the improvement of shoulder pain and functional activity, and meanwhile the clinical efficacy was observed. Results: After treatment, the total effective rate of the observation group was 95.0％ and the cure and markedly effective rate was 72.5％. The total effective rate of the EA group was 87.5％ and the cure and markedly effective rate was 42.5％. There was no significant difference in the total effective rate between the two groups (P>0.05). The cure and markedly effective rate of the observation group was higher than that of the EA group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the intra-group differences in VAS and Melle scores of both groups were statistically significant (bothP<0.001). The inter-group differences in the changes of the VAS and Melle scores after treatment were statistically significant (bothP<0.001). Conclusion: EA plus Tanbo-plucking the trigger points has a better curative effect than EA therapy alone in the treatment of SP.

Acute Disease ; Adolescent ; Adult ; Bridged-Ring Compounds ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Poisoning ; therapy ; Treatment Outcome

Objective To investigate whether resting state-fMRI (RS-fMRI) based on local consistency (ReHo), am?plitude low-frequency fluctuate (ALFF) and fALFF can add meaningful information on preoperative localization of epilepto?genic zone in patients with malformations of cortical development (MCD). Methods Ten epilepsy patients with MCD were studied with RS-fMRI using a 3.0 T scanner. The resting state data were preprocessed and analyzed using SPM8 and REST to generate the activation map. Abnormal ReHo, ALFF and fALFF related blood oxygen level dependent (BOLD) signal changes were compared to video EEG (VEEG),PET,MRI findings and the final result of a comprehensive evaluation-de?fined epileptogenic zone. For operated patients, postoperative resection and histology were compared to BOLD responses. Re?sults The results of spike localization of RS-fMRI were consistent with VEEG, PET, MRI findings and final comprehensive evaluation-defined epileptogenic zone in 6, 8, 6, 7 of 10 investigations. Six operated patients (including two negative results of MRI examination) revealed local abnormal changes but not visible on structural MRI, which was confirmed cortical malfor?mations by pathology after operation (2 heterotopia and 4 cortical dysplasia). Conclusion RS-fMRI may help to delineate the epileptic focus in epilepsy patients with MCD.

Objective To investigate the imaging features of sarcomatoid carcinoma(SC)of lung on chest radiography and CT and to improve knowledge of SC.Methods The chest plain films,CT images and clinical data of all 7 cases of pathologically proved lung SC were retrospectively analyzed.Results All cases presented with a spheroid solid lung mass ranged from 3 to 11 cm in diameter(average 7 cm).All the lesions were located in middle and lower fields of the lung:3 lesions in right lower lobe,2 in right middle lobe,and the other 2 in left lower lobe.Among the 7 cases:6 cases were of peripheral type and 1 case was of central type.The peripheral-typed lesions of 5 cases had clear margin and 3 of them were lobulated.Three massess were homogenous in density,and the other 4 were inhomogeneous in density with formation of central cavity or calcification.After intravenous contrast administration.Three lesions showed homogeneous enhancement,and the other 4 lesions had inhomogeneous enhancement.The lesions with diameter larger than 6 cm showed marginal or patch-like enhancement.Five cases had pleural or chest walls invasion.Two cases had mediastinal lymph nodes metastases.One case had multiple remote metastasis.Conclusion There are some relatively specific features of lung SC on chest radiography and CT,which may be helpful for diagnosis.

Objective To explore the expression and mutual relationship between transforming growth factor-?(TGF-?) and hepatocyte growth factor(HGF) in children's renal tissues,as well as the effect of the 2 indexes on the renal pathological change.Methods According to the severity of renal pathological change under light microscope,61 cases were divided into 3 groups:named control group(26 cases,clinically diagnosed as thin basement membrane nephropathy),test group Ⅰ [22 cases,clinically diagnosed as less evident focal segmental glomerulosclerosi(FSGS) nephropathy] and test group Ⅱ(13 cases,clinically diagnosed as evident FSGS nephropathy).Immunity class test(SP method:streptavidinbiotin peroxidase method) was used to detect the representation of HGF and TGF-?.Semi-quantitative analysis had been carried out in all cases.Film reading of cell was viewed by Olympus microscope,brown yellow from cytoplase as the positive signal,10 high power microscope visions were randomly selected from renal glomerali area and 10 from renal interstitium area.Medical image analysis software was used to determine the masculine area of HGF or TGF-? and image intensity;then the immunity class index was defined as masculine area ? image intensity.Results 1.HGF and TGF-? existed in all renal tissues;2.Expressions of HGF and TGF-? increased obviously along with FSGS pathology alteration(Pa

Objective To evaluate the clinical value of 6 h 99mTc-diethyl iminodiacetic acid (99mTc-EHIDA) planar hepatobiliary scintigraphy (HBS),6 h tomographic HBS and 24 h planar HBS in diagnosis on biliary atresia(BA).Methods Seventy cases(32 male,38 female) with continuous jaundice received planar and tomographic HBS in Beijing Friendship Hospital from Jan.2005 to Dec.2007.The mean age was 48.7 d (29 d-4 months).According to final diagnosis,all cases were divided into BA group (45 cases) and non-BA group (25 cases).All cases fasted at least 4 hours before HBS.The equipment was 3 head IRIX from Philips company with low energy high resolution collimator.The tracer was 99mTc-EHIDA and the radiochemistry purity was more than 95 percent.The dosage was 7.4 MBq/kg.All diagnosis demonstrated by operation pathology and clinical follow-up.All cases received HBS at 5,10,15,20,30 min and 1,6 h after tracer injection.HBS would ended if radioactivity appeared in gallbladder or intestine.These cases would received tomographic HBS and 24 h HBS if radioactivity did not appear in gallbladder or intestine at 6 h post injection.All these images were analyzed by 2 or more nuclear medicine physicians.Results There were not radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 27 cases,which suggested the BA.There were radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 30 cases,which suggested the non-BA.Positive rate of 6 h tomographic HBS was significantly higher than that of 6 h planar HBS and there was significantly difference between the 2 methods.Positive rate of 6 h tomographic HBS was significantly higher than that of 24 h planar HBS and there was significant difference between the 2 methods.Conclusions 99mTc-EHIDA HBS is a noninvasive,safety,valuable examing method and has definitely clinical value in the diagnosis on BA.The clinical value of 6 h tomographic HBS is significantly higher than that of 6 h planar HBS and 24 h planar HBS.