Objective To study the localization of Smad 2 and Smad 4 proteins, which are intracellular signaling molecules of transforming growth factor ? family in adult rat testis. Method Immunohistochemical ABC method with glucose oxidase DAB nickel enhancement technique was used in the present study. Results Smad 2 immunoreactivity was mainly located in the spermatogonia, spermatocytes, spermatids, Sertoli cells in the seminiferous tubule and Leydig cells in the interstitial tissue. The reactive substance distributes in cytoplasm with negative nuclei. While Smad 4 is mainly expressed in cytoplasm of Leydig cells, and Sertoli cells is weak stained. Conclusion Our findings of Smad 2 expression in spermatogenic cells and Smad 4 expression in Leydig cells provide direct evidence for the molecular mechanism of TGF ? action during spermatogenesis.

Objective To compare the clinical effect between CO2-1aser assisted and cold instrument assisted suspension laryngoscopic surgery for vocal fold cyst.Methods From January, 2011 to December, 2014, 72 patients with vocal fold cyst, which diagnosed by strobolaryngoscopy, were randomly divided into CO2-1aser assisted group and cold instrument group.Strobolaryngoscopy, acoustic analysis and perceptual voice analyses were performed on each patient before surgery, 1 month, and 3 months after surgery, respectively.Results All operations were successfully completed.The complete vocal fold cyst resection rate of CO2-1aser assisted group was significantly higher than cold instrument group (29/36, 80.5％ vs 21/36, 58.3％, P ＜ 0.05), especially the left vocal fold cyst (13/16, 81.3％ vs 9/19, 47.4％, P ＜ 0.05).The complete right vocal fold epidermoid cyst resection rate was significantly higher than retention cyst (17/19, 89.4％ vs 11/18, 61.1％, P ＜ 0.05).Two recurrent cases were found in cold instrument group but no recurrent cases in CO2-laser assisted group (0/36, 0％ vs 2/36, 5.6％, P ＞ 0.05).Correlation analysis showed that vocal fold cyst recurrence was related to complete resection rate and has no relation with surgical methods, histopathological types and position.Subjective and objective assessment of voice quality in preoperative, 1-month postoperative and 3-month postoperative were similer between CO2-1aser assisted group and cold instrument group (P ＞ 0.05).Conclusion The CO2-laser assisted suspension laryngoscopic surgery for vocal fold cyst, can increase the surgical precision, reduce the left hand impact, improve the complete resection rate and reduce the recurrence rate.

0bjective To evaluate the application of whole body MR diffusion weighted imaging (DWI)in the detection of bone metastasis using skeletal scintigraphy as the referenee.Methods Fonv.two healthy volunteers and 38 patients with malignant tumors were enrolled in our studv.A11 the patients received MR examination and skeletal scintigraphy within one week.MR examination was performed on GE signa 3.0T MR scanner using a build.in body coil.The skeletal system Was divided into eight regons and the images of the whole body MR DWI and skeletal seintigraphy were reviewed to compare the two modalities patient by patient and region by region.The images were reviewed separately by two radiologists and two nuclear medicine physicians,who were blinded to the results of another imaging modality.Results A total of 169 metastatic lesions in 69 regions of 30 patients were detected by whole body MR DWI while 156 lesions in 68 regions of 29 patients were identified by skeletal seintigraphy.There were two cases negative in scintigraphy but positive in whole body MR DWI and one case positive in scintigraphy only.There were eight lesions negative in scintigraphy but positive in whole body MR DWI,mainly located in the spine.pelvis and femur.Seven 1esions were only detected by scintigraphy,mainly located in the skull.sternum.clavicle and scapula.Conclusion The whole body MR DWI reveals excellent consistency with skeletal scintigraphy regarding bone metastasis.and the two modalities are complementary for each Other.

Objective: To investigate the level of foot care behaviors of in patients with type 2 diabetes mellitus in Jinshan District of Shanghai, analyze the influential factors, and provide information for the intervention study. Methods: With convenient sampling method, a questionnaire survey was conducted with a sample of 110 inpatients with type 2 diabetes mellitus from Jinshan District of Shanghai. The investigation contents included patients′ demographic data, foot care knowledge and behaviors. The investigation tools were the questionnaire of diabetes general information, the questionnaire of foot care knowledge, and the questionnaire of foot care behaviors. Survey tools included general information questionnaire, foot care knowledge scale for diabetic patients and Nottingham Foot Care Assessment Scale in Chinese version. Independent-samples t test and oneway ANOVA were used in univariate analyses, whereas multiple stepwise linear regression was used in multivariate analyses. And Pearson correlation analysis was used to measure correlation between variables. Results: The scores of foot care behaviors were statistically significant in the group comparison of sex and glycosylated hemoglobin(t=-2.142, F=3.071, P<0.05). The patients′score of foot care behaviors was (45.31±7.74) scores. 50.9 percent (54/106) patients′scores were less than 45. And the score of foot care knowledge was (16.10±4.18) scores, which was in the medium level. The foot care behaviors level was lower in the patients whose foot care knowledge was poorer (t=-5.591, P<0.01). Foot care knowledge, glycosylated hemoglobin level and gender were the main influencing factors on foot care behaviors of type 2 diabetic patients (R²=0.221, F=9.664, P=0.000). Pearson analysis demonstrated that there was a positive correlation between knowledge score, glycosylated hemoglobin level and behavior score (r=0.377, 0.207, P<0.05). Conclusions The status of foot care knowledge and behaviors of type 2 diabetic patients are not optimistic in Jinshan District of Shanghai. It′s very important to strengthen the education and management on diabetic patients′foot care knowledge and behaviors, especially in male patients. Meanwhile, the patients whose glycosylated hemoglobin are well controlled should not be ignored.

ObjectiveTo understand the current drug resistance status and bacterial multilocus sequence typing （MLST） of human and avian Campylobacter jejuni in Jinshan District， Shanghai. MethodsFecal samples were collected from diarrhea patients in the annuity mountainous area from 2021 to 2022， and poultry and related samples were collected from 2 poultry farms in the Jinshan area for detection of C. jejuni. Minimal inhibitory concentration （MIC） drug sensitivity test was performed on the detected C. jejuni， and some strains were selected for whole genome sequencing and MLST analysis. ResultsA total of 823 samples of diarrhea disease were collected， and 32 strains of C. jejuni were detected， with a detection rate of 3.89%. Out of 600 poultry related samples， 62 strains of C. jejuni were detected， with a detection rate of 10.33%. Human multidrug resistance reached 93.75% （30/32）， while avian multidrug resistance reached 100.00%（62/62）. The top four drug resistance rates of human and avian C. jejuni were azithromycin （100.00% from humans and 100.00% from birds）， naphthoic acid （93.75% from humans and 87.10% from birds）， ciprofloxacin （90.63% from humans and 98.39% from birds）， and tetracycline （84.38% from humans and 98.39% from birds）. The relatively low resistance strains of human derived C. were erythromycin， chloramphenicol， and thalithromycin. The relatively low resistance strains of avian C. jejuni were erythromycin， clindamycin， and flufenicol. MLST analysis showed that the selected 16 strains of bacteria were divided into 9 ST types， among which the evolutionary relationship of avian C. jejuni was relatively concentrated， while human C. jejuni was relatively dispersed. It was found that one strain of avian C. jejuni was closely related to two strains of human C. jejuni. ConclusionsC. jejuni infection is severe in patients with diarrhea in this region， with a detection rate second only to salmonella and Vibrio parahaemolyticus. C. jejuni infection in poultry is relatively common， and both are highly resistant. Therefore， monitoring and control should be strengthened. MLST analysis shows new ST types in both avian and human sources of C. jejuni， indicating the emergence of new mutations that require continuous monitoring to avoid the epidemics caused by new strains. The isolated strains with close genetic relationships between avian and human sources reveal the evidence of the spread of C. jejuni from poultry to humans. Therefore it is necessary to strengthen the monitoring of C. jejuni in relevant samples from breeding farms.

ObjectiveTo understand the concentration levels of benzene， toluene and xylene in the workplaces of enterprises involved in benzene and benzene series in Jinshan District， and to provide the basis for the government to formulate key occupational disease prevention and control strategies. MethodsFrom 2016 to 2021， enterprises involved in benzene and benzene series were sampled individually， and the monitoring results of benzene and benzene series were statistically analyzed through workplace air sampling and laboratory detection. ResultsFrom 2016 to 2021， a total of 80 enterprises were monitored， and the total passing rate of individual monitoring was 87.50%， which decreased first and then increased. The difference was not statistically significant. A total of 387 individuals were sampled with a total passing rate of 95.61% and a detection rate of 73.38% （284 individuals）. The detection rates of benzene， toluene and xylene were 6.46%， 29.97% and 36.95%， respectively. The exceedance rates were 1.03%， 0.26% and 3.10%， respectively. Among the companies exceeding the standard， the metal products industry had the highest rate of exceedance （19.05%）. For individuals， those working in the printing and recording media reproduction industry had the highest rate of exceedance （10.26%）. ConclusionThe passing rate and detection rate of benzene and benzene series are relatively high in Jinshan District. The metal products industry and the printing and recording media reproduction industry have a higher exceedance rate of benzene and benzene series.

Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.

Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications. Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors. All donor nephrectomy was successful. There were no donor deaths and no conversion to open surgery. Mean operation time was 112 min (range, 70-200 min). Intraoperative blood loss was 10-150 mL with an average of 30 mL. Warm ischemia time was 1.3 to 6 min with an average of 3.1 min. Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications. Donors were discharged from the hospital 5 to 10 days postoperation. Average postoperative hospital stay was 6.4 days. One graft was removed due to acute rejection. Delayed graft function occurred in two recipients but renal function returned to normal within four weeks. The other recipients had normal renal function in two weeks except three recipients in four weeks. We believe that retroperitoneal laparoscopic live donor nephrectomy is safe, reliable, and less invasive.

Objective The Rex shunt has been used to treat children with extrahepatic portal hypertension by creating a venous bypass between the superior mesenteric vein and the left portal vein to circumvent the extrahepatic portal venous obstruction.This retrospective study aimed to analyse our results in the use of this novel approach.Methods 52 patients with cavernous transformation and obstructed main portal veins were treated by Rex shunts.Results The age of children was 1.4 ～ 12 year,the mean age was 3.7 years.The patients were followed up from 1.5 to 5 years.In 48 patients,there was no recurrence of gastrointestinal bleeding after surgery making an efficacy rate of 92.3％.In the recurrence group,the postoperative venous pressure in the superior mesenteric vein was (27.6 ± 3.2) cmH2O (1 cmH2O =0.098kPa) which was significantly higher than the non-recurrence group (23.5 ± 3.1)cmH2O.The difference between the pre-and post-Rex shunting was significantly lower in the recurrence group (5.7 ± 1.8)cmH2O than the non-recurrence group (11.7 ± 3.3) cmH2 O,P ＜ 0.05.Thus,a low reduction in postoperative pressure was an early manifestation of poor prognosis.Conclusions The Rex shunt was safe and efficacious.The degree of reduction in postoperative venous pressure in the superior mesenteric vein could be used to predict recurrence of gastrointestinal bleeding.

ObjectiveTo investigate the value of platelet-albumin-bilirubin score (PALBI) in predicting the 30-day mortality of patients with liver cirrhosis and acute upper gastrointestinal bleeding (AUGIB). MethodsA retrospective analysis was performed for the clinical data of 211 patients with liver cirrhosis who were admitted to Jinshan Hospital of Fudan University due to AUGIB from January 2016 to February 2020, and according to the survival status within 30 days, they were divided into death group with 24 patients and survival group with 187 patients. Epidemiological data (including age and sex) and laboratory examination results (including routine blood test results, hepatic and renal function, and coagulation function) were collected, and the scores of PALBI, albumin-bilirubin (ALBI), Child-Turcotte-Pugh (CTP), and Model for End-Stage Liver Disease (MELD) on admission were calculated and compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. With the application of 95% confidence interval, the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the predictive ability of the model. The DeLong test was used for comparison of ROC curve. ResultsCompared with the survival group, the death group had significantly higher PALBI score (-1.47±0.35 vs -1.94±0.36, P＜0.001), ALBI score (-0.74±0.49 vs -1.38±0.51, P＜0.001), CTP score (10.25±1.98 vs 8.06±1.70, P＜0.001), and MELD score (17.25±4.68 vs 11.63±4.83, P＜0.001). PALBI, ALBI, CTP, and MELD scores had an AUC of 0.827, 0.824, 0.790, and 0811, respectively, and there was no significant difference in AUC between any two scores (P＞0.05). ConclusionPALBI score has good performance in predicting the 30-day mortality of patients with liver cirrhosis and AUGIB and is comparable to CTP and MELD scores.