Objective To investigate the clinical efficacy of three-dimensional (3D) and two-dimensional (2D) laparoscopic surgeries in the treatment of Todani type Ⅰ choledochal cyst.Methods The retrospective cohort study was conducted.The clinical data of 59 patients with Todani type Ⅰ choledochal cyst who were admitted to the People's Hospital of Hunan Province between January 2013 and January 2016 were collected.Thirty patients undergoing 2D laparoscopic surgery between January 2013 and June 2014 were allocated into the 2D group and 29 patients undergoing 3D laparoscopic surgery between July 2014 and January 2016 were allocated into the 3D group.There were the same Trocar placement and surgical procedure in the 2 groups,and surgical procedure completely followed the treatment principle of Todani type Ⅰ choledochal cyst.Observation indicators included (Ⅰ) surgical situations:conversion to open surgery,operation time,volume of intraoperative blood loss,(2) postoperative situations:postoperative complications,(3) follow-up.Patients were followed up by outpatient examination or telephone interview to detect postoperative recovery up to April 30,2016.Measurement data with skewed distribution were presented as M (range) and analyzed using the Mann-Whitney U test.Count data were compared by Fisher exact probability.Results (1) Surgical situations:patients in the 2 groups underwent laparoscopic choledochal cystectomy + Roux-en-Y hepaticojejunostomy.Two patients in the 2D group received conversion to open surgery and patients in the 3D group received the successful surgery without conversion to open surgery.Rate of conversion to open surgery in the 2D and 3D groups were 6.7％ (2/30) and 0,respectively,with no statistically significant difference (P ＞ 0.05).Operation time in the 2D and 3D groups were 285 minutes (range,240-390 minutes) and 190 minutes (range,140-215 minutes),with a statistically significant difference (U =40.0,P ＜ 0.05).Volume of intraoperative blood loss in the 2D and 3D groups were 50 mL (range,10-300mL) and 45 mL (range,20-250 mL),with no statistically significant difference (U =1 018.5,P ＞ 0.05).(2)Postoperative situations:patients in the 2 groups had good recovery,without occurrence of severe complications in Clavien-Dindo≥ Ⅲ stage.Four and 1 patients in the 2D and 3D groups were complicated with bile leakage (in Ⅱ stage of Clavien-Dindo) and 1 and 1 were complicated with upper gastrointestinal hemorrhage (in]][stage of Clavien-Dindo),respectively,with no statistically significant difference (P ＞ 0.05).Overall incidence of complications in the 2D and 3D groups were 16.7％ (5/30) and 10.3％ (3/29),with no statistically significant difference (P ＞ 0.05).All the patients were cured by conservative treatment.(3) Follow-up:59 patients were followed up for 5-36 months,with good recovery and without occurrence of reflux cholangitis,hepatic and intestinal anastomosis stenosis and reoperation.Conclusions 3D and 2D laparoscopic surgeries are safe and effective for Todani type Ⅰ choledochal cyst.Compared with 2D laparoscopic surgery,3D laparoscopic surgery can reduce the operation time and not increase the complications,and it should be discreetly promoted based on the experiences of surgeons.

BACKGROUND:Distal femur is a predilection site for primary bone tumors, most of which are treated with salvage treatment. There are many reports on the early-stage, mid-term and prognosis of the distal femur tumor-type artificial knee joint prosthesis, but reports on long-term function and prognosis are less.
OBJECTIVE:To study the long-term prognosis and limb function after treatment with rotating-hinge knee prosthesis.
METHODS:Thirty-four patients with distal femoral bone tumors admitted to the Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University between January 2000 and June 2008 were retrospectively analyzed, including 19 males and 15 females. Al patients were subjected to rotating hinge knee prosthesis replacement.
RESULTS AND CONCLUSION:The mean fol ow-up period was 62.4 months (range 11 to 126 months). At the final of fol ow-up, 23 patients were event-free alive and 11 patients were dead. Seven of 23 survival patients suffered from prosthesis related complications, including four cases of prosthesis revision and three cases of amputation. The event-free survival rate of 23 patients undergoing replacement of domestic tumor prosthesis around the knee was 67.6%in 5 years. The mean functional score of affected limb was 19.30 (7 to 27 points):excellent in 6 cases, good in 16, fine in 5 and poor in 2. The excellent-good rate was 75.9%. The clinical outcomes suggested that the satisfactory limb function and survival rate could be achieved with the application of domestic tumor prosthesis replacement for treatment of malignant bone tumors around the knee.

Objective To establish the model of myocardial infarction by ligation of the left anterior descending branch in rats.Method Adult inbred strain Wistar rats were randomly divided into sham group(n=6) and model groups(n=79).Model of myocardial infarction were established by ligation of the left anterior descending branch.The electrocardiogram(ECG),HE staining tissue sections,and heart function of the rats were compared in the two groups.Results Rats in the model group had showed special changes of ST-T and Q wave in ECG,show serious necrosis of myocytes and proliferation of fibrous tissue compared with rats in the sham group.The left ventricular systolic pressure(LVSP),left ventricular develop pressure(LVDP),?dp/dt_(max),heart rate(HR) were significantly decreased in the rats of model group than those of the sham group(P

Objective To investigate the effects of electroacupuncture (EA) on spatial learning and memory ability, long-term potentiation (LTP) and synaptophysin (Syp) levels in the dentate gyrus of the hippocampus.Methods Forty Sprague-Dawley rats were randomly divided into a sham-operated control group, a model group, an EA group and a medication group. A rat model of vascular dementia (VD) was established by repeated ischemia and reperfusion after pretreatment with sodium nitroprusside. EA was applied to the rat homologues of the human "Baihui" (GV20) and "Dazhui" (DU14) acupoints of the rats in the EA group for 20 min, once daily for 10 d.Morris water maze tests were conducted for evaluating the rats,learning and memory ability. LTP in the hippocampal dentate gyrus was recorded as an electrophysiological index for evaluating learning and memory. Antigenic Syp produced in hippocampal tissue was examined with immunohistochemical assays. Results In comparison the with model group, escape latency (EL) shortened and target-platform crossing times increased significantly in the EA and medication groups. After high frequency stimulation the population spike (PS) latency shortened in the EA group compared with the model group, and the excitatory postsynaptic potential (EPSP) slope and PS amplitude increased.All of these differences were statistically significant. Syp positive cells also increased significantly in the EA-treated rats. Conclusions EA can increase Syp expression and improve the learning and memory ability of rats with this model of VD. EA could facilitate the induction and maintenance of LTP in the dentate gyrus of the hippocampus through influencing synaptic transmission.

Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.

Objective:To research the therapeutic effect dnd pulmonary ground substance rebuilding in the treatment on IPF patients by Feixian-Fang and.Methods:Treatment 20 cases IPF by Feixian Fang RCT prednisone three months.obsive The therapeutic efficacy and the levels of matrix met alloproteinase 1,2,tissue inhibtor of met alloproteinase(TIMP-1,2).Results: The total effective rate of Feixian-Fang group is 84.2%.The total effective rate of prednisone group is 81.3%.Feixian-Fang can reduce the level of MMP-1,MMP-2,TIMP-1,TIMP-2 in the serum.Concluds:Feixian-Fang can treat IPF probably through inhibiting pulmonary ground substance rebuilding.

Objective To determine the regulation of electroacupuncture(EA)at Zusanli acupoint for the expression of estrogen receptors mRNA in the brain of ovariectomized rats.MethodsFemale Wistar rats were randomly divided into 3 groups:intact group(INT),ovariectomized group(OVX),and ovariectomy and acupuncture group(OVX+EA).Radioimmunoassay(RIA)was used to measure the estradiol(E2)and testosterone(T)levels in plasma.The mRNA levels of estrogen receptor(ER)α and ERβ in the brain of rats were measured with RT-PCR.ResultsThe levels of endogenous estrogen increased significantly in OVX+EA rats compared with OVX rats(P<0.01),while the plasma T levels were lower in the OVX+EA group than those of the OVX group(P<0.01).Eelectroacupuncture can up-regulate ERα expression in the brain of ovariectomized rats(P<0.01).However,it was shown to have a down-regulatory effect on the levels of ERβ expression(P<0.01).ConclusionThere is an intimate relationship between the expressions of estrogen receptors mRNA and the endogenous hormone levels,such as E2 and T.Electroacupuncture can regulate the expression of estrogen receptors mRNA in the brain and the E2 and T levels in plasma of ovariectomized rats,which might,at least in part,explain the mechanisms of acupuncture adjusting the neuroendocrine system.

Air ; analysis ; Chromatography, Gas ; methods ; Methyl Ethers ; analysis ; Workplace

OBJECTIVETo summarize the features and treatment of male infertility induced by autosomal dominant polycystic kidney disease (ADPKD), and compare the outcomes of intracytoplasmic sperm injection (ICSI) for infertile men with ADPKD and those with congenital bilateral absence of vas deferens (CBAVD).

METHODSWe retrospectively analyzed 21 cases of ADPKD-induced infertility, 15 treated by ICSI (group A), and another 164 cases of strictly matched CBAVD-induced infertility (group B). We compared the two groups in the couples' age, the number of ICSI oocytes, and the rates of fertilization, transferrable embryos, good embryos, embryos implanted, clinical pregnancy, biochemical pregnancy, early abortion, singleton and twins in the first cycle.

RESULTSAfter 28 cycles of ICSI, 10 of the 15 ADPKD-induced infertility patients achieved clinical pregnancy, including 7 cases of live birth, 1 case of spontaneous abortion, and 2 cases of pregnancy maintenance. No significant differences were observed between groups A and B in the couples' age, the wives' BMI, or the numbers of ICSI oocytes and embryos transplanted (P >0.05), nor in the rates of ICSI fertilization (72.64% vs 76.17%), transferrable embryos (51.28% vs 63.24%), quality embryos (38.46% vs 49.83%), embryo implantation (17.64% vs 38.50%), abortion (0 vs 9.23%), singleton (50% vs 81.54%) and twins (50% vs 18.46%). However, the rates of clinical pregnancy (13.33% vs 42.68%, P = 0.023 <0.05) and biochemical pregnancy (13.33% vs 39.63%, P = 0.032 <0.05) were significantly lower in group A than in B.

CONCLUSIONICSI is effective in the treatment of male infertility induced by either ADPKD or CBAVD, but the ADPKD cases have a lower success rate than the CBAVD cases in an individual cycle. The affected couples should be informed of the necessity of prenatal genetic diagnosis before embryo implantation and the inevitable vertical transmission of genetic problems to the offspring.

Abortion, Spontaneous ; Embryo Implantation ; Embryo Transfer ; Female ; Humans ; Infertility, Male ; therapy ; Male ; Male Urogenital Diseases ; therapy ; Oocytes ; Polycystic Kidney, Autosomal Dominant ; complications ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Vas Deferens ; abnormalities

Objective　To study the value of renal CT scan in evaluating split renal function.Methods　147 patients undergone CT scan from June 2009 to June 2011 were involved in this study.There were 73 cases of obstructive hydronephrosis and 74 cases of renal tumors.66 patients were males and 81 were females with a mean age of 53 years ( range 17 - 87 years).GFR detected by single-photon emission computed tomography (SPECT) was used as the reference of split renal function.The kidneys were divided into 3 groups according to the GFR:normal renal function (113 cases,GFR ≥ 34 ml/min),mildly impaired renal function (66 cases,GFR:20 -34 ml/min) and severely impaired renal function (41 cases,GFR ＜20 ml/min).One-way ANOVA and linear regression analysis were used to analyze the relationship between the results of CT scan and split renal functions.　Results　There were significant differences in the cortical thickness among the normal renal function,mildly impaired renal function and severely impaired renal function groups.The cortical thicknesses were (0.62 ±0.11) cm,(0.45 ±0.10) cm and (0.26 ±0.07) cm,respectively (P ＜ 0.01 ).The renal cortical thickness was strongly correlated with GFR (r =0.806,P ＜0.01 ).There were significant differences in the enhancement during the cortical phase among the 3 groups,which were (162.1 ±25.3) HU,(121.6 ±21.0) HU and (63.5 ±20.0) HU,respectively (P＜0.01).The enhancement during the cortical phase was strongly correlated with the GFR (r =0.851,P ＜ 0.01 ).The enhancement during the parenchymal phase and excretory phase was moderately correlated with the GFR ( r =0.467 and r =0.451,P ＜ 0.01 ).　Conclusions　The renal cortical tbickness and the enhancement during the cortical phase detected by CT scan might be useful for the clinical evaluation of split renal function.