Objective To review the management of impalpable testes. Methods Ninty-eight impalpable testes in 82 patients underwent surigcal exploration and all the cases were studied retrospectively. Results 17 testes were found on ultrasonography and 3 of 4 cases were found on ECT pre-operatively.Ninty-eight testes in 82 patients were explored.Eighty-five testes were found,52 in the inguinal canal,33 in the abdomen.Another 13 testes were absent.Ninty-two(94%) testes were found on inguinal exploration or limited laparotomy when necessary. Conclusions Inguinal exploration,with lower abdominal laparotomy if necessary remains the main form of management.If the testes could not be found still laparoscopy should then be performed.

BACKGROUND: Vascular injuries to the extremities are frequently concomitant with vascular defects. Vascular transplantation repair can induce infection and vascular occlusion, etc.OBJECTIVE: To analyze the outcome of vascular reconstitution in 44 patients with vascular injuries of the extremities undergoing vascular transplantation.DESIGN: A retrospective case analysis.SETTING: Department of Vascular Surgery and Department of Orthopaedics of Hospital Affiliated to Jinhua College of Profession and Technology.PARTICIPANTS: Forty-four patients with vascular injuries to the extremities undergoing autologous and artificial vascular transplantation were selected at the Department of Vascular Surgery and Department of Orthopaedics of Hospital Affiliated to Jinhua College of Profession and Technology from April 1994 to October 2003. There were 29 patients with open injury and 15 patients with closed injury.METHODS: A total of 52 blood vessels were transplanted into 44 patients, including 42 blood vessels in autologous vein transplantation (35 blood vessels in great saphenous vein transplantation by end-to-end anastomosis, 5 blood vessels in small saphenous vein transplantation by end-to-end anastomosis and 2 blood vessels in superficial femoral vein and popliteal vein transplantation) and 10 blood vessels in artificial and trimming vascular transplantation by interrupted suture technique in end-to-end anastomosis.MAIN OUTCOME MEASURES: Outcomes of autologous and artificial vascular transplantation.RESULTS: Three patients received amputated extremity. Six patients developed ischemic contracture. Seven patients developed imperfect recovery of nerve function. In other patients, blood flow in the graft was satisfactory, and there was good condition of blood circulation at the distal extremities.CONCLUSION: Autologous vein is the first choice in vascular transplantation, and prosthetic material is another choice when necessary. It is important to prevent the occurrence of complication after transplantation such as vascular infection.

Objective To analyze the clinical and pathological features of collecting duct carcinoma (CDC) of the kidney. Methods 11 patients with CDC were analyzed,among which 6 were males and 5 were females.Their age ranged from 22 to 67 years old with a mean age of 55.4 cases were found by routine health examination,4 cases were presented with gross hematuria and 3 cases had flank or abdomen pain.The CT scan showed an unclear boundary mass in kidney,with tumor sizes from 2.1 to 8.5 cm ( mean 5.6 cm).Only medullary involvement was present on CT in 3 cases,Medullary and cortical involvement in 5 cases,Medullary and pelvic involvement in 2 cases,and all involvement in 1 case.Infiltrative lesion has expanded kidney but maintains reniform contour.Contrast-enhanced CT scan showed lesion mild to moderate enhancement compared with surrounding parenchyma. Results Radical nephrectomy was performed in 8 cases and palliative nephrectomy in 3 cases.All patients were finally diagnosed by pathology.Grossly,the tumor is often appears gray or white.In HE staining,tumor showed prominent tubular or tubulaopapillary structures with desmoplasia and inflammatory reaction.Occasionally,some tumor cells take on a hobnail appearance.Immunohistochemical examination showed UEA-1 positive in all cases,EMA positive in 9 cases,PNA positive in 8 cases,and HMW-CK positive in 7 cases.Only 2 patients showed positive CD10.7 patients died within 6 to 47 months (mean 12.5 months),2 survived with tumor free for 9 months and 8 years respectively,one lost of follow-up,and one patient with distant metastasis is receiving postoperative chemotherapy. Conclusions Collecting duct carcinoma of the kidney is a rare histological type of renal cell carcinoma,whose final diagnosis depends on histopathological examination.Rapid progression,highly malignant,poor prognosis are the characteristics of this disease.

Objective: To explore the mechanism of orindonin induced apoptosis on NB4 (Human acute promylocytic leukeamia cell line) cells. Methods: The variation of both morphology and inhibitory rate of NB4 cells were observed in culture medium with various concentrations of orindonin at different time in vitro. The activity of Caspase3 was detected before and after apoptosis occurred. Results: orindonin could increase the activity of Caspase3, inhibit the growth and cause apoptosis on NB4 cells significantly. The variations were both in time and dose dependent manner. Conclusion: Orindonin can inhibit the growth of NB4 cells and induce apoptosis. Increasing the activity of Caspase3 may be one of the most important mechanism.

Objective To compare the efficacy and safety of sertraline plus doxazosin and tadalafil in the treatment of premature ejaculation (PE).Methods From Feb.to Aug.2011,One hundred and five patients from 19 to 52 years old with PE but without any obvious organic cause were enrolled in this study.They were randomly divided into Groups A,B and C in equal number.All the three Groups received 50 mg sertraline daily 4 to 6 hours before planned sexual activity for 12 weeks,Group B were added with 4 mg Doxazosin every day 8 to 9 hour before planned sexual activity,and Group C were given 20 mg Tadalafil as needed one hour before planned sexual activity.The mean intravaginal ejaculatory latency time,the mean intercourse satisfaction domain values and the sexual activity satisfaction domain values of the patient couples of group A before treatment were 0.6±±0.1 min,8.3±1.3,5.3±1.4; Group B were 0.6±0.1 min,7.6± 1.5,5.6± 1.5 ; Group C were 0.6±0.1 min,8.1 ± 1.1,5.0± 1.2,respectively.We observed before and after the treatment for 12 weeks and the effects were evaluated.Results The mean intravaginal ejaculatory latency time,the mean intercourse satisfaction domain values and the sexual activity satisfaction domain values of the patient couples of group A were 3.9±0.l min,10.6±0.1,9.7±0.1,respectively; Group B were 4.5 ± 0.1 min,12.8±1.3,11.9±1.6; Group C were 5.6±0.3 min,14.6±1.4,13.1±1.5,respectively.The mean intravaginal ejaculatory latency time improved in all of the 3 groups,but more significantly in Group B and C (P＜0.05).The mean intercourse satisfaction domain values of the IIEF were significantly greater in Group B and C than in Group A (P＜0.05) after the treatment; and the sexual activity satisfaction domain values of the patient couples were greater in Group C than in Group B after the treatment,but it is not significant.As for the side effects,5 cases in group A felt headaches and dizzy (14.3％),8 cases in group B felt headaches and dizzy (22.9％),and in group C,9 cases felt headaches and dizzy (25.7％),6 cases experienced flushing episodes on the body (17.1％).there was a higher rate of headaches (P＜0.05) and flushing episodes (P＜0.05) in Group B and C than in Group A.Conelusions Sertraline combined with Tadalafil or Doxazosin can achieve significantly better results than sertraline alone in patients with premature ejaculation.However,the combined treatment is associated with a slightly increased in the drug related side effects,and there is no significant difference in the efficacy of Sertraline Plus Tadalafil or Doxazosin in the treatment of premature ejaculation.

Objective: To investigate the apoptotic effects and its mechanisms on K562 cells caused by Interferon-alpha (INF-?) and Cytarabine (Ara-C). Methods: The variation of both morphology and inhibitory rate of K562 cells was observed in culture medium with IFN-? and various concentrations of Ara-C at different time in vitro. The variation of telomerase activity and P53 protein expression were detected before and after apoptosis occurred. Results: INF-? and Ara-C used concurrently could cause apoptosis and inhibit the growth of K562 cells as well as decrease the telomerase activity and increase P53 protein expression significantly. All these processes showed both in time- and dose-dependent manner. Conclusions: INF-? and Ara-C used concurrently can inhibit the growth of K562 cells and induce apoptosis, inhibiting the telomerase activity and increasing the expression of P53 protein may be one of the most important mechanisms.

Objective To investigate the anti-proliferation effect of peroxisome proliferator-activated receptor γ(PPARγ)agonist troglitazone(TGZ)on leukemic Raji cells and its mechanisms.Methods Raji cells in culture medium in vitro were given different concentrations of TGZ(0～60 μmol/L)for 24,48 and 72 h.The inhibitory rates of the cells were measured by MTT assay,cell apoptotic rate was detected by flow cytometry(FCM),agarose gel electrophoresis was used to observe the DNA ladder,and western blotting was used to analyzed the variation of apoptosis related proteins bcl-2,Bax and Survivin.Results TGZ(over 20 μmol/L)could inhibit the growth of Raji cells and cause apoptosis remarkably,the suppression was both in time-and dose-dependent manner.DNA ladder was observed after the cells treated by TGZ for 72 h,and western blotting analysis revealed that anti-apoptotie proteins Survivin and bcl-2 were decreased remarkably while pro-apoptotic protein Bax increased significantly after the cells were treated by TGZ for 48 h.Conclusion PPARγ agonist TGZ can inhibit the growth and induce apoptosis on Raji cells significantly,downregnlating the expression of Survivin and bcl-2 as well as upregulating of Bax expression of Raji cells may be one of its most important mechanisms.

Objective To study the application of implantable telemetry and whole-body plethysmography to observe the changes of circadian rhythm in conscious rats and evaluate the pharmacological safety of doxofylline, and to provide a basis for the future application of this technological system for drug safety evaluation.Methods Eight healthy SPF Sprague-Dawley rats were used in this study, 4 males and 4 females.The rats were implanted with telemetry transmitters by surgery to establish a telemetry system combined with plethysmography to observe the changes of 24 h physiological parameters and circadian rhythm in conscious rats at 14 d after operation, including heart rate (HR), blood pressure, the time interval from the Q wave to point A in the ECG of the aortic pressure wave (QA interval), respiration, activity, body temperature and pulmonary function parameters.The rats were divided into 3 groups: normal control group, doxofylline 40 mg/kg and 80 mg/kg groups, and the performance was validated by aerosolizing saline, doxofylline 40 mg/kg and 80 mg/kg inhalation, respectively, to observe the changes in physiological parameters after the drug administration.Results The physiological parameters of rats showed obvious changes in circadian rhythms at 14 d after operation.Compared with the normal control group, the doxofylline 40 mg/kg-treated group showed significantly increased changes of HR, tidal volume (TV), minute ventilation (MV), 50% expiratory flow (EF50), peak inspiratory flow (PIF) and peak expiratory flow (PEF) (P<0.01), significantly decreased respiratory frequency, QA interval and enhance pause (Penh) (P<0.05, P<0.01), but no significant differences in the blood pressure, activity and body temperature (P>0.05).Compared with the normal control group, the group treated with doxofylline 80 mg/kg had significantly increased HR, blood pressure, TV, MV, EF50, PIF and PEF (P<0.01), significantly decreased respiratory frequency, QA interval and Penh not (P<0.01), but not significantly changed activity and body temperature (P>0.05).Conclusions The application of implantable telemetry and whole-body plethysmography in this study does not obviously affect the circadian rhythm, and can sensitively monitor the relevant cardiovascular and respiratory parameters in conscious rats.It can be used in drug safety pharmacological research of cardiovascular and respiratory systems in conscious rats.

Objective To investigate the apoptosis inducing effect of peroxisome proliferator-activated receptor r(PPARr)agomst on leukemic K562 cells and its mechanisms of action.Methods K562 cells in culture medium in vitro were given different concentrations of PPARragonist rosiglitazone(RGZ)(20-80 umol/L)for O,24,48 and 72h The inhibitory rate of the cells were measured by MTT assay,cell apoptosis was detected by Annexin V/PI staining,and the expression of P53 protein as well as the activity of caspase-3 were also detected.Results RGZ(over 40umoL/L)could inhibit the growth of K562 cells and cause apopto-sis remarkably,the suppression Was both in time-and dose-dependent manner.The expression of P53 pmtein was upregulated and the activity of caspase-3 Was increased concomitantly after the cells werle treated by RGZ.Conclusion PPARr agonist RGZ(over 40 umol/L)can induce apoptosis on K562 cells signifieantly,upregu-lation the expression of P53 protein as well as increasing caspase-3 activity may be one of its most important mechamisms.

Objective To investigate the apoptosis inducing effects of oridonin on leukemic THP-1 cells and its mechanisms of action. Methods THP-1 cells in culture medium in vitro were given different concentrations of oridonin (16～56 μmol/L) for 24, 48 and 72 h. The inhibitory rate of the cells were measured by MTT assay, apoptotic morphology was observed by Hoechst 33258 staining, and Annexin V/PI staining was used to detect cell apoptosis by flow cytometry (FCM). Caspase-3 and poly (ADP-ribose) polymerase (PARP) expression were detected by Western blotting. Results Oridonin (over 32 μmol/L) could inhibit the growth of THP-1 cells and cause apoptosis remarkably, the suppression was both in time-and dose-dependentmanner. Marked morphological changes of cell apoptosis such as condensation of chromatin was clearly observed by Hoechst 33258 staining, and Annexin V/PI staining showed that apoptotic cells gradually increased after the cells treated with oridinon. Western blotting showed cleavage of the caspase-3 zymogen protein (32×103), with the appearance of its 20×103 subunit, and a cleaved 89×103 fragment of 116×103 PARP was also found. Conclusion Oridonin can inhibit cell growth and induce apoptosis in THP-1 cells via activation of caspase-3. The results indicated that oridonin might be an important potential anti-leukemia reagent.