Objective To investigate the clinical efficacy of posterior anti‐rotation plate plus cancellous screws for treating unicondylar Hoffa fracture and to systematically analyze its injury mechanism ,clinical diagnosis ,treatment method and clinical fol‐low up results .Methods The imageological and clinical data in 9 cases of unicondylar Hoffa fractures treated by anti‐rotation plate plus cancellous screws from March 2009 to April 2014 were retrospectively analyzed .Results All fractures were healed within 4 months .The average follow up time of the patients was 34 months(24~50 months) .Seven cases obtained the anatomic reduction and 2 cases got the satisfactory reduction .The reduction loss and fixation failure were not found in all the cases .One cases of wound infection occurred early after operation and healed within 1 week after anti-infection .One case of knee joint ankylosis complicating pain occurred during the follow up period .According to the KSSs scoring standard ,the knee joint prognosis function scores were ex‐cellent in 4 cases ,good in 4 cases and poor in 1 case .Conclusion Using anti‐rotation plate combined with cancellous screws for con‐ducting the Hoffa fracture fixation can confront the strong shear force beard by femoral condyle with the advantages of rigid fixa‐tion ,reliability fixation and early weight bearing functional exercise .

Objective To discuss the feature,diagnosis and treatment,and proguosis of adrenal teratoma.Methods Clinical data of 5 patients with confirmed adrenal teratoma were retrospectively reviewed.There were 2 males and 3 females,with a median age of 57 years (35-64).The mean tumor size was 5-8.5 cm.The tumors were located on the right side in 3 cases and the left side in 2.Two cases were detected by routine health check up,and 2 were detected with the complains of fatigue and 1 with complains of back pain.All cases had normal value of endocrinology and biochemistry tests.Ultrasound examination showed cystic tumor on adrenal gland with uneven echo.CT showed irregular,inhomogeneous adrenal neoplasms in adrenal gland.The tumor presented as inhomogenous high signal intensity on MRI T1 and T2.Results Five patients underwent laparoscopic adrenalectomy,and histopathology showed adrenal mature teratoma.No recurrence occurred after operation in all patients.Conclusions These cases combined with literature review indicate that adrenal teratoma is extremely rare which has no characteristic clinical manifestations; and laparoscopic adrenalectomy is a feasible,effective technique with excellent results.

Objective To investigate the clinical characteristics , treatment and prognosis of primary ad-renal lymphoma ( PAL) .Methods Clinical data of 8 cases of PAL admitted from Jan .2007 to May.2014 were analyzed retrospectively .Results Of all the cases , 6 patients underwent adrenalectomy , and 2 patients under-went adrenal biopsy .Pathology revealed all the 8 cases had non-hodgkin's lymphoma , 6 cases were B cell type , 1 case was T cell type , and 1 case was NK cell type .One case was followed up for 2 years and was still alive .The other 7 cases died 2 to 9 months after the treatment .Conclusions PAL is extremely rare which has no special imaging characteristics .PET-CT is of great value in diagnosis of the disease .The disease has a high malignant behavior and poor prognosis .The comprehensive therapy has better effects than single therapy .

Objective To investigate the application and effect of hydrocortisone during perioperation of retroperitoneum laparoscopic surgery for Cushing's syndrome.Methods Data of 56 cases of Cushings's syndrome treated by hormone replacement therapy of hydrocortisone were retrospectively analyzed .The hormone replacement therapy was as the following:no hormone before surgery, intravenous drip of hydrocortisone during and the 1st and 2nd day after surgery, oral intake of hydrocortisone from the 2nd after surgery.Clinical symptoms were observed and plasma,24h urine cortisol levels were intermittently measured after the surgery to evaluate the effects of treatment . Results 2 cases had slight cortical dysfunction symptoms, then back to normal after receiving larger dose of hydro-cortisone.6 cases had blood cortisol levels below the normal range , but they did not have cortical dysfunction symp-toms, and at the same time their 24h urine cortisol levels were normal .Urine cortisol concentration significantly de-creased on the 7th day after surgery, and had significant difference compared with that before surgery .Plasma cortisol concentration significantly decreased on the 6th, 7th day after surgery, and had significant difference compared with that before operation.All the cases recovered well.Conclusion Perioperative hydrocortisone replacement in retroper-itoneum laparoscopic surgery for Cushing's syndrome is safe.

A total of 71 patients with premature ejaculation (PE) received hydrochloride sertraline treatment for 8 weeks and their serum levels of leptin and 5-hydroxytrytamine (5-HT) were determined.Their ejaculation functions were assessed with intravaginal ejaculation latency time (IELT) and Chinese index of premature ejaculation (CIPE-5) value.The study was compared with 64 normal males as control.The baseline level of leptin in the trial group was obviously higher than the controls (P ＜ 0.05) while the level of 5-HT in the trial group far lower than the controls (P ＜ 0.05).At 8 weeks,the level of leptin dropped while the level of 5-HT rose in the trial group after treatment.Therefore a high serum level of leptin and a low serum level of 5-HT may become biological indicators for PE.

The levels of IgG2b monoclonal antibodies against LD H-C4 in sera of mice bearing hybridoma backpack tumors secreting anti-LDH-C4-IgG2b were detected by quantitative ELISA． The accuracy between batches is 7.04%～l3.30 %, the intra-assay variation is 3.6l%～l0.20%． Standard curveof monoclonal lgG2b was well correlated (r=0.962　　884～0.996　　795)． The sensitivit y of the assay reach e dup to0.0l?mg/L． The present modified ELISA offers a reproducible, se nsitive, specific method in determination of antigen-specific IgG2b antibody in sera．

Objective To investigate the interrelationship between leptin and 5-hydroxy tryptamine (5-HT)and their significance in diagnosis of premature ejaculation(PE).Methods 71 cases with lifelong PE(the trial group)and 64 healthy males(the control group)were enrolled in this case-control study.Baseline recording of intravaginal ejaculation latency time(IELT) using a stop watch and Chinese Index of Premature Ejaculation-5 (CIPE-5) were done.The serum leptin and 5-HT levels were determined.Then the trial group were given sertraline hydrochloride for 8 weeks,while the control group were not given any medicine treatment in this period.Reassessment was done after 8 weeks.Results At the baseline,the leptin level in the trial group was obviously higher than the control group(P ＜ 0.05),while 5-HT level in the trial group was far lower than the control group(P ＜0.05).After 8 weeks,the leptin level of the trial group dropped and the difference had no statistical significance with that of the control group(P ＞0.05).5-HT level of the trial group rose to the level very close to that of the control group after the treatment.Conclusion The high level of serum leptin and low level of serum 5-HT were the meaningful biological indicators for PE,which can potentially be applied in PE diagnosis.

Fifty nine patients with premature ejaculation (PE) received sertraline treatment for 8 weeks.The average intravaginal ejaculation latency time (IELT) and the scores of Chinese index of premature ejaculation (CIPE) were evaluated and the fasting serum leptin levels were measured before and after treatment,all the values were compared with those of 64 normal male controls.The serum leptin levels were higher,the IELT and CIPE scores were lower in PE patients than those in normal controls before treatment.After 8 weeks of treatment with sertraline,the levels of serum leptin in PE patients decreased to normal levels,CIPE and IELT increased.The results indicate that serum leptin can be used as a bioindicator for diagnosis of premature ejaculation and assessment of therapeutic efficacy in PE patients.

Objective:To investigate the age of onset of functional constipation in children and to explore its relationship with possible factors.Methods:Four hundred and sixteen children with functional constipation who were admitted to the Digestive Specialist Clinic of Nanjing Children′s Hospital from January 2017 to December 2018 were divided into 4 groups (Q1-Q4) according to the quartiles of the onset age.The gender, duration of symptoms and constipation of their parents of the 4 groups were analyzed.Results:Age of onset of 416 children was (1.58±1.64) years, the age of onset in the Q1 group was (0.27±0.19) years, the age of onset in the Q2 group was (0.82±0.17) years, the age of onset in the Q3 group was (1.64±0.32) years, and the age of onset in the Q4 group was (3.91±1.83) years.The constipation duration in 416 patients was (1.50±1.62) years; the constipation duration of Q1, Q2 and Q4 groups was (2.20±1.95) years, (1.33±1.48) years, (1.11±1.05) years and (1.35±1.66) years, respectively, and the group with the youngest age of onset (Q1) had the longest duration of constipation, which was statistically significant compared with the other three groups ( F=9.644, P<0.05). Of the 416 children, 190 cases (45.7%) were boys, 226 cases (54.3%) were girls; 54 boys (50.9%) and 52 girls (49.1%) in the Q1 group, 47 boys (39.8%) and 71 girls (60.2%) in the Q2 group, 39 boys (40.6%) and 57 girls (59.4%) in the Q3 group; 53 boys (55.2%) and 43 girls (44.8%) in the Q4 group; there were no significant differences in gender ( χ2=7.210, P>0.05). Among 416 children with FC, 196 cases (47.1%) had at least one of their parents with constipation symptoms, including 61 cases (57.5%) in Q1 group, and 66 cases (55.9%) in Q2 group, 34 cases(35.4%) in Q3 group, 35 cases (36.5%) in Q4 group.The 2 groups (Q1-Q2) with younger onset compared with the older onset children (Q3-Q4), their parents were more likely to have constipation symptoms, and the difference was statistically significant ( χ2=17.96, P<0.05). Conclusions:The age of onset of functional constipation in children is young, and younger functional constipation children are less likely to receive formal guidance treatment at an early stage; gender has no significant relationship with the age of onset; children with a younger onset, genetic factors are more meaningful to them.

Objective:To investigate the expressions of lysine specific demethylase 1 (LSD1) and podoplanin (PDPN) in tongue squamous cell carcinoma and the correlation between LSD1 or PDPN and clinicopathological characteristics or prognosis.Methods:A total of 67 cases of tongue squamous cell carcinoma and corresponding paracancerous normal tissues in the First Affiliated Hospital of Xinjiang Medical University from January 2011 to January 2016 were selected. The expressions of LSD1 and PDPN in cancer and paracancerous tissues were detected by immunohistochemical method, and the patients were followed up for a long time to analyze the correlation between the expression of LSD1 or PDPN and clinicopathological characteristics or prognosis.Results:The expressions of LSD1 and PDPN in tongue squamous cell carcinoma tissues were higher than those in paracancerous tissues, and the differences were statistically significant ( Z=6.089, P<0.001; Z=5.781, P<0.001). The expression intensities of LSD1 and PDPN were significantly different in patients with different clinical stage ( χ2=11.487, P=0.001; χ2=8.111, P=0.004), lymph node metastasis ( χ2=4.772, P=0.029; χ2=6.206, P=0.013) and tumor size ( χ2=5.985, P=0.014; χ2=4.247, P=0.039). The expression intensity of LSD1 was also significantly different in patients with different degrees of differentiation ( χ2=6.660, P=0.010). In univariate analysis, LSD1 expression intensity was negatively correlated with progression-free survival (PFS) and overall survival (OS) ( χ2=18.930, P<0.001; χ2=16.257, P<0.001), PDPN expression intensity was negatively correlated with PFS and OS ( χ2=31.720, P<0.001; χ2=18.390, P<0.001), and tumor size was negatively correlated with PFS and OS ( χ2=5.326, P=0.021; χ2=8.843, P=0.003). Postoperative radiotherapy and clinical stage were positively and negatively correlated with OS respectively ( χ2=4.197, P=0.040; χ2=6.355, P=0.012). In multivariate analysis, LSD1 was an independent risk factor for PFS and OS ( HR=5.743, 95% CI: 1.012-32.579, P=0.048; HR=17.759, 95% CI: 2.303-136.916, P=0.006), PDPN was an independent risk factor for PFS ( HR=4.380, 95% CI: 1.258-15.254, P=0.020), postoperative radiotherapy was a protective factor for PFS and OS ( HR=0.374, 95% CI: 0.157-0.895, P=0.027; HR=0.218, 95% CI: 0.091-0.521, P=0.001), and clinical stage was an independent risk factor for OS ( HR=2.637, 95% CI: 1.107-6.280, P=0.029). In tongue squamous cell carcinoma tissues, the expression of LSD1 was positively correlated with that of PDPN ( rs=0.655, P<0.001). Conclusion:The expressions of LSD1 and PDPN in tongue squamous cell carcinoma are higher than those in adjacent tissues. LSD1 is an independent risk factor for PFS and OS, PDPN is an independent risk factor for PFS, clinical stage is an independent risk factor for OS, and postoperative radiotherapy is a protective factor for PFS and OS. There is a positive correlation between the expressions of LSD1 and PDPN in tongue squamous cell carcinoma, and they can both be used as independent predictors of prognosis in patients with tongue squamous cell carcinoma.