Objective To study the testicular ultrastructure in CBAVD patients. Methods Ultrastructure of testicular tissue was studied in 13 CBAVD patients with azospermia whereas the testicular morphology under light microscopy was normal. Results The presence of thickening,multilayered,finger shaped protuberent to seminiferous tubules in variable degrees in basement membrane was confirmed at ultrastructural level in 13 CBAVD patients.Collagen fibres revealed an increase in number,proliferation,disturbance in variable degrees and no polarity in all the 13.Malformed heads,metachromatic granules nuclei with abundant bulla,full or partial absence of middle mitochondria sheath were seen in most of spermatozoa.Of 5 cases,invagination and low electronic density layered materials were presented in acrosome and acrosomal cyst respectively.Most of sertoli cells presented abundant lipid droplets and degradative bodies in their cytoplasm in all cases.In 2 cases,tight junctions between sertoli cells were not found. Conclusions Microstructural alteration of testicular tissue,especially conspicuous in spermatozoa and in the limiting lamina of testis,might be a contributory cause of azospermia in addition to the clinical absence of vas deferens.

Objective To evaluate mini-percutaneous nephrolithotomy in treating proximal ureteral calculi. Methods 109 patients underwent mini-percutaneous nephrolithotomy for proximal ureteral calculi from March 1998 to July 2001 were reviewed and evaluated. Results All the 109(100%) were rendered stone-free at 1 session.The average operation time was 60 munites,the estimated blood loss volume 25 ml and the average hospitalization 7 days.No major complications were noted. Conclusions Mini-percutaneous nephrolithotomy is safe and effective in treating proximal ureteral calculi and is less invasive for the patients.

Objective To summarize the experience of ES WL and PCNL management for pediatric renal calculi. Methods We retrospectively reviewed the clinical data 105 cases.The series consists of 33 girls and 72 boys.The average age was 8.7 years.Of the 105 children,21(20. 0%) had urinarytract abnormality.68 cases were treated with ESWL,33 with mini-P CNL,and 4 cases with residual stone fragments were treated with min-PCNL and ES WL.Four children underwent open procedures. Results 92 s essions of ESWL were performed in 68 children,57(83.8%)became stone-free.Among them 47 cases ( 69.1 %) were cured by one ESWL session,18 cases(26.5%)had two sessions,three children had three sessions.Two cases who had ureteral steinstras se were rendered stone-free by ureteroscopy.Among 33 children managed by mini- PCNL,24 (72.7%) were cured by one PCNL session,9(27.3%) by two sessions,three pa tients with UPJ obstruction underwent antegrade pyeloureterotomy at the same tim e.Stones were cleared using one PCNL session in 24(72.7%),2 sessions in 29(87.9% ),4 patients were cured with ESWL and mini-PCNL.The overall success rate was 97 .0%.2 of 4 cases in open procedures were performed by means of pyeloplasty,one p atient had residual stone fragments after open surgery. Conclusions ESWL is the first-line treatment for renal calculi in children.PCN L is a option but based on stones status,instrumental and technical conditions. Combining PCNL with ESWL had better outcome.

Objective To compare the efficacy of three procedures,extracorporeal shock wave lithotripsy(ESWL),ureteroscopic lithotripsy(URL) combined with ESWL,and minimally invasive percutaneous nephrolithotomy(MPCNL),for the treatment of complicated upper ureteral calculi.Methods Two hundred and thirty-four cases of complicated upper ureteral calculi were treated in this hospital from December 2002 to December 2003,including 76 cases of ESWL,78 cases of combined use of URL and ESWL,and 80 cases of MPCNL.Results In the ESWL cases,the stone fragmentation rate on one session was 56.6%((43/76),) the stone-free rate one month after operation was 46.1%(35/76),the mean hospitalization expenditure was 912 yuan,and the incidence of postoperative complications was 15.8%(12/76).In the URL combined with ESWL cases,the stone fragmentation rate on one session was 100%(78/78),the stone-free rate one month after operation was 83.3%(65/78),the mean hospitalization expenditure was 7 720 yuan,and the incidence of postoperative complications was 15.4%(12/78).In the MPCNL cases,the stone fragmentation rate on one session was 100%(80/80),the stone-free rate one month after operation was 100%(80/80),the mean hospitalization expenditure was 10 253 yuan,and the incidence of postoperative complications was 13.8%(11/80).The operation time,intraoperative blood loss,length of hospital stay,stone-free rate one month after operation,and hospitalization expenditure were significantly greater in the MPCNL cases than in the ESWL cases and the URL combined with ESWL cases.The stone fragmentation rate on one session was not significantly different between the MPCNL cases and the URL combined with ESWL cases,and was significantly higher in the MPCNL cases and the URL combined with ESWL cases than in the ESWL cases.The incidence of postoperative complications was not significantly different among the three groups.Conclusions Minimally invasive percutaneous nephrolithotomy should be used as the first choice for complicated upper ureteral calculi.

Objective To observe the correlation of estrogen,fasting insulin(FINS),fasting plasma glucose (FPG),glycosylated hemoglobin(HbA1c),blood lipids and carotid arteries -membrane thickening(IMT)in the postmenopausal women with type 2 diabetes.Methods 63 postmenopausal women with type 2 diabetes were divided into normal IMT group(group A),IMT thickening group(group B),plaque group(group C)according to the vascular ultrasound carotid artery intima thickness,at the same time 15 cases of healthy physical examination as control group (group D).All of the groups were detected the plasma total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),fasting plasma glucose(FPG),gly-cosylated hemoglobin(HbA1c),follicle-stimulating hormone(FSH),estradiol(E2).Results Compared with group A,the levels of FINS,IR,HbA1c,TC,LDL-C in group C was higher(t=16.83,14.44,2.50,2.38,2.42,all P<0.01 or P<0.05),however,the results of E2,HDL-C was decreased(t=7.32,5.51,all P<0.01).The levels of FINS,HbA1c,TC,LDL-C,FSH,IR in group D was lower than those of group C(t=19.74,36.44,8.64,7.95, 27.13,6.71,all P<0.01),On the contrast,the levels of HDL-C,E2 were elevated(t=11.34,8.72,all P<0.01). The Pearson's correlation analysis showed that E2 had negative correlation with FINS,IR,TC,LDL-C (P<0.01 or P<0.05).E2 had positive correlation with HDL-C(P<0.05).Logistic regression analysis showed that IMT and FINS,IR,HbA1c,LDL-C were positively correlated(OR=2.94,72.63,27.30,98.18,all P<0.01),while nega-tively correlated with E2 levels(OR=2.94,P<0.01).Conclusion The increased level of estrogen was a protective factor of carotid artery atherosclerosis in postmenopausal women with type 2 diabetes.

Objective To assess the value of 18 F-FDG PET imaging in the localization of epileptic foci.Methods 18 F-FDG PET were performed in 22 patients with medically intractable epilepsy (15 males,7 females,mean years:19.0 years,mean duration:8.2 years). The open skull operations were undergone in 21 patients according to the results of 18 F-FDG PET, combining with scalp EEG and CT or/and MRI. 1 patient was refered for stereotactic operation. During operation,EcoG was detected for identifying the site of epileptogenic focus and lobectomy was performed . All specimens were examninated with the pathological tests. All patients were followed up for the curative effects. Results PET showed abnormalities in 21 patients(95.5%). Among them,single or multiple focal hypometabolisms were found in 20 patients and focal hypermetabolism in 1 patient. The scalp EEGs showed abnormalities in 17 patients(77.3%),but 8 of them did not showed clear latreralizing manifestations.The abnormalities were found on MR or/and CT in only 5 cases (22.7%).The epileptogenic foci detected by PET were consistent well with EcoG in 18cases(85.7%), consistent approximately in 2 cases and not consistent in 1 cases .Among 19 patients with abnormal PET findings , the pathological abnormalities were found in 18 cases (94.7%).No pathological abnormality was found in the patients with nomal PET imaing. After the open skull operations, 9 patients (42.9%) becomed seizure free . 9 patients (42.9%) had more than 50% seizure reduction and 3 patients (14.3%)showed no improvement. The patient treated with stereotactic operation also showed no significant improvement.Conclusion 18 F-FDG PET imaging is a sensitive and accurate modality to localizate the epileptic foci and has important clinical value in surgical therapy.

Objective The aim of this study was to investigate the relationship between serum C-reactive protein (CRP) and muscle strength, physical performance in the elderly. Methods A cross-sectional study was conducted in Hangu district of Tianjin from April to June in 2013. Totally 1 131 subjects aged 60 years or older completed the survey. Every subject filled out a standard questionnaire and underwent grip strength test, timed up and go test (TUGT). Serum CRP concentrations were determined using chemiluminescent immunoassay kits. Multivariate analysis was performed to determine the relationship between CRP and muscle strength, physical performance. Results After adjustment for potential confounding factors including age, BMI, smoking status, drinking status, hypertension, diabetes, cardiovascular disease, anemia, cancer and physical activity, the multiple linear regression analysis suggested that CRP levels were inversely related to handgrip strength (β'=-0.11, P<0.01), and the logistic regression analysis showed that compared with subjects in the lowest quintile, the odds ratios and 95%confidence interval of higher quintile of CRP were 1.09 (0.50, 2.39) and 2.70 (1.34, 5.66) (Ptrend<0.05) in males. However, the relationship between CRP and muscle strength, physical performance was not statistically significant in females. Conclusions In males, higher serum CRP levels were independently correlated with lower muscle strength and poor physical performance in older adults. These results suggested that inflammation-signaling pathways may play an important role in the progression of sarcopenia.

Objective To evaluate the therapeutic effects of capsule Huoluoshugan on schistosomal hepatocirrhosis.Methods Ninety-six patients with schistosomal hepatocirrhosis were selected and divided randomly into three groups:Huoluoshugan group,interferon-?(IFN-?)group and control group,and treated with capsule Huoluoshugan,IFN-? and routine therapy,respectively.The course of treatment was 6 months in all groups.Before and after the treatment,the symptoms,physical signs,indexes of liver function and hepatic fibrosis,and changes of B-type ultrasonic images were detected for all the patients.Results The indexes of liver function,hepatic fibrosis and B-type ultrasonic image of the patients in Huoluoshugan group improved obviously compared with the control group after the treatment(P0.05).In addition,there was no obvious adverse reactions during the treatment in the patients of Huoluoshugan group.Conclusion Capsule Huoluoshugan can reduce the indexes of hepatic fibrosis and improve the liver function in patients with schistosomal hepatocirrhosis.

The financial crisis has made the graduate of grade 2009 career have undergone profound changes in mentality,How to strengthen the ideological and political education of graduates and career guidance is a new task we have to face.In this paper,through a questionnaire survey,students’collective conversation,individual visits,the case summary,we understand the mental state of college graduates in 2009 session in Shenyan,and have analyzed it to provide a basis for career guidance for the targeted colleges and universities under the new circumstances.

Objective To treat the patients suffering from intractable epilepsy after brain injury with low-dosage linac accelerator stereotactic radiosurgery through positron emission tomography (PET) localization. Methods PET examination based on 18 F-2-fluorine-2-deglucose (FDG) was carried out in 32 patients in order to localize epileptogenic foci followed by radiosurgery with peripheral radiation dose of 9-13 Gy. The follow-up was conducted over one year. The seizure frequency of epilepsy was recorded to evaluate the therapeutic effect. Results The PET imaging showed that the cortical area around the cerebromalacia caused by primary injury presented low metabolic change. The metabolic changes in different injury areas mainly concentrated in the epileptic foci. In some cases,the low metabolic areas not only was localized at the part of impact lesion but also at the part of contrecoup lesion. The seizure frequency gradually decreased after radiosurgical treatment in most patients,with obvious statistical significance compared with pretreatment. According to Wieser's classification of operative effect,the cases at the grades Ⅰ-Ⅱ accounted for 44% (14/32),grades Ⅲ-Ⅳ for 41% (13/32) and grades Ⅴ-Ⅵ for 16%(5/32). No fresh complications were found in all the cases. Conclusions Low-dosage stereotactic radiosurgery with the PET localization is a safe,effective and minimally invasive surgical approach to intractable posttraumatic epilepsy.