Objective To assess the role of MRI in the preoperative characterization and local staging of testicular neoplasms.Methods A retrospective study of 24 patients suspected of testicular neoplasm was conducted.The histological diagnosis of testicular neoplasms was made and local extension of testicular malignancy was evaluated.The MRI findings were correlated with the pathologic results.Results Histological examination revealed 26 intratesticular lesions,14 of which were nalignant,including 4 cases of diffuse large B cell lymphoma,7 cases of seminoma,2 cases of embryonal carcinoma,one case of teratoma.Twelve lesions were benign,including 5 cases of epidermoid cyst,2 cases of simple cyst,2 cases of inflammatory granuloma,2 cases of testicular mediastinal tubular expansion and one case of testicular pseudo fibroma.Six malignant testicular tumors were confined within the testis,4 invaded the testicular tunicae or epididymis,2 invaded the spermatic cord,and 2 invaded the scrotal wall.The accuracy of MRI in the diagnosis of intratesticular lesions was 92％.The accuracy of MRI diagnosis in the local staging of testicular tunors was 86％.Conclusions MRI is highly accurate in the preoperative characterization and local staging of testicular neoplasms.It is of great significance to the clinical diagnosis and treatment.

ObjectiveTo study the effect of fibrin glue(FG) and growth hormone(GH) on the anastomosis of the small bowel at peritonitis. MethodsResection and anastomoses of the small bowel at peritonitis was performed in rats. In group N:normal control;in group A:a standard anastomosis was constructed with 12 silk sutures;in group B:an incomplete anastomosis was constructed with only 4 silk sutures;in group C: incomplete anastomosis+FG;in group D: incomplete anastomosis+GH;in group E: incomplete anastomosis+FG+GH.On days 1,3 and 5,ten rats in each group were sacrificed.The healing of anastomosis were evaluated,the anastomotic bursting pressure and hydroxyproline concentration were measured. Results In group A the bursting pressure was low from day 1 to day 3(18?10?mm?Hg and 36?11?mm?Hg each).The percent of false-healing was 30%,significantly higher than group N.The bursting pressure in group C was significantly higher than in group A(32?7?mm?Hg and 65?9?mm?Hg each),the healing of the anastomosis was significantly improved,the percent of false-healing was 11.7%.Hydroxyproline concentration of each group showed no differences. Conclusion Fibrin glue helps the healing of the anastomosis of the small bowel at peritonitis in rats,and can protect it from complications. The addition of GH does not improve healing.

The artical analyzes the problems existing in the aspects of textbooks,teaching outlines,qualified teachers and students'attitude and puts forward some corresponding solutions in the hope of arousing the recognition of the academy and departments concerned.

Antineoplastic Agents ; therapeutic use ; Chemotherapy, Adjuvant ; methods ; China ; Glioblastoma ; drug therapy ; surgery ; Humans ; Neurosurgery ; Physicians

Objective: To evaluate the applicability of modified MDRD equation in predicting Glomerular filtration rate in patients with chronic kidney disease (CKD). Methods: Totally 481 CKD patients, who were diagnosed based on K/DOQI guideline from Jan. 2005 to Jan. 2007 in our hospital, were enrolled in this study. The sex, age, body weight and height of patients were recorded; the plasma creatinine, serum albumin and 99mTc-GFR (standardized by body surface area) were measured. GFRs were estimated by abbreviated MDRD equation and the modified MDRD equation separately. The bias, accuracy and precision of both equations were compared. Results: The estimated GFRs (eGFRs) by both equations were significantly correlated with the rGFR(P<0.01). Except for the slightly decreased precision, the modified MDRD equation showed great improvements in the 5%, 30%, and 50% accuracy and bias when compared with the original abbreviated MDRD equation(P<0.05). Compared with the original equation, the modified MDRD equation showed smaller bias in all stages of CKD except for stage 5(P<0.05). The modified MDRD equation also decreased the absolute bias and improved the 30% accuracy in stage 2 CKD (P<0.01). Conclusion: Compared with original equation, the modified MDRD equation has great advantages in predicting the total GFR and GFRs at different CKD stages. Currently it can be used in predicting the GFR of Chinese CKD patients.

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.

Objective To compare the patency rate of percutaneous balloon angioplasty or stenting for restenosis of femoral-popliteal artery artificial vascular grafting.Method 78 cases of femoral-popliteal artery artificial vascular graft postoperative occlusion patients were divided into 2 groups:anastomotic balloon angioplasty group (36 cases) and stent angioplasty group (42 cases) after double-lumen catheter embolectomy.Patients in anastomotic balloon dilatation group were given balloon angioplasty only becaus fine narrow flow signals were seen in angiography.Patients in stenting group received balloon angioplasty followed by suitable caliber self-expanding stent placement.Patency rates were compared between the two groups after 12,36 months of interventional treatment.Results The patency rate in stenting group was higher than that of percutaneous balloon angioplasty group (x2 =7.422,P ＜ 0.05).Conclusions Balloon stenting angioplasty had advantages of high patency rate over balloon dilatation for the treatment of postoperative occlusion of femoral-popliteal artery grafting.

Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD).Methods The clinical interventional case series study included 104 patients (112 eyes) with DTRD,who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas.Among the eyes,there were 6 eyes with iris neovascularization (INV),1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment.There were no pre-existing retinal holes or breaks prior to surgery nor any iatrogenie retinal breaks developed during vitrectomy.Cataract removal combined with intraoeular lens implant surgeries were performed on 15 eyes.Follow-up duration varied from 12 to 65 months (mean: 29 months).Results Subretinal fluid was completely absorbed within 2 months after surgery.In 107 eyes (95.54%),the retina reattached after surgery and remained attached till the end of follow-up period.Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%),remained unchanged in 14 eyes (12.500%) and got worse in 19 eyes (16.79%).The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes,66.00% Vs 46 eyes/62 eyes,74.19%,χ2=0.89,P=0.344).No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries.Seven (6.25%) eyes showed INV (5 new onset eyes),and none of them developed into NVG.In multivariate logistic regression,factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis I-adjusted odds ratio (OR)= 10.2],low preoperative BCVA (OR= 11.1) and low postoperative BCVA (OR = 16.7).Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oil or gas tamponade if there are no preoperative or intraoperative retinal breaks,and only using irrigation fluid could access a good long-term prognosis result.

Objective To investigate the diagnostic value of serum TPSA, the ratio of free PSA(FPSA)and TPSA(F/T) and PSAD in prostate cancer(PCa).Methods The serum TPSA and PSAD levels and the ratio of F/T of 467 patients with BPH,116 patients with PCa and 50 healthy men as normal control were determined, analyzed and compared. Results Serum TPSA of PCa (53.26±33.10) were significantly higher than that of BPH (8.12±9.70) (P ＜0.01), and normal control (1.51 ±1.17) (P ＜0.01); Serum PSAD of PCa[(1.59±1.46) ng·ml-1·cm-3] were significantly higher than that of BPH [(0.14±0.17) ng·ml-1·cm-3] (P ＜0.01),and normal control [(0.08±0.07) ng·ml-1·cm-3] (P ＜0.01); F/T of PCa (0.22±0.16) was significantly lower than that of BPH (0.27±0.15) and normal control (0.36±0.14) (P ＜0.01). When TPSA was limited specificity at 4 ～10 ng/ml, F/T of PCa (0.18±0.13) were significantly lower than that of BPH (0.27±0.14), (P ＜0.05), PSAD of Pca [(0.21 ±0.07) ng· ml -1· cm -3] were significantly higher than that of BPH [(0.11 ±0.06) ng· ml-1· cm-3], (P ＜0.001). When F/T was 0.16, PSAD used 0.15 as the critical value, the sensitivity, specificity of diagnostic value and positive prediction value were 81.6 ％, 78.2 ％, 96.1％ and 53.8 ％, 76.9 ％, 97.9 ％, respectively;And the diagnostic efficiency was the highest. ConclusionF/T and PSAD have valuable role as the diagnose marker of PCa. When PSA level between 4 ng/ml and 10 ng/ml, F/T ratio and PSAD are of significant value to differentiate PCa from BPH patients.