Objective To investigate the clinical characteristics and choices of management of neonatal testicular torsion (NTF).Methods Between January 2013 and December 2015,the clinical data of 7 cases of neonatal testicular torsion who were confirmed by surgery and pathological examination in the department of pediatric surgery of our hospital was retrospectively reviewed.Of the 7 NTTs (4 in right,2 in left and 1 in both sides),the median age and onset time of NNTs was 3 d (1-21 d) and 1 d (1-21 d),respectively.The presentation of NTTs included swelling of scrotum,scrotal mass and discoloration of scrotum.Features of ultrasonography included enlargement of testicular volume,echo heterogenicity or enhancement of testis,and decreased or disappeared testicular blood flow.Results All NTTs were performed by surgery and confirmed by pathological examination.In the operation,5 patients with extravaginal torsion (1 bilateral) and 2 with intravaginal torsion were detected.The degree of twisted testis was from 270° to 720°(average 438.8°) and resection rate for necrosis testis was 87.5％ (7/8).The median time of follow-up was 12 months (3-36 months),and none of testis underwent re-torsion and the findings of testicular ultrasonography was not abnormal.Conclusions The presentation of neonatal testicular torsion is non-specific.Once the scrotum shows discoloration,swelling,or enlargement of testis,testicular torsion is suspected.Urgent surgical exploration is recommended in order to make an effort to save the testis.

The theory of Medical Immunology is independent,which includes a lot of new knowledge.Optimizing resource of medical immunology,recombinating knowledge structure,building knowledge framework and leading in PBL(Problem Based Learning) teaching method help to arouse students’studying interest and elevate teaching effect.

Objective Poly (ADP-ribose) polymerase (PARP) have been demonstrated to play an important role in systemic lupus erythematosus (SLE). In this study we assessed the expression of PARP on peripheral blood mononuclear cells with active or inacte SLE and tried to investigate the relationship between PARP and cell apoptosis on SLE. Methods Thirty definitive SLE patients and 10 healthy controls were enrolled. PBMC were separated from the peripheral blood samples. Western blot technique was applied to analyze the expression of PARP. Flow cytometry were applied to analyze the cell apoptosis. T test were used. Results The cell apoptosis in active patients with SLE was significantly higher than that of inactive patients with SLE and normal controls (the t values were 4.83 and 5.05 respectively, P<0.05). The level of PARP expression was significantly decreased in active patients with SLE as compared with controls and inactive patients with SLE (the t values were 7.66 and 7.07 respectively, P<0.05). At the same time, the cleavage fragment of PARP increased in active patients. Conclusion The results suggest that PARP may be involved in the pathogenesis of SLE and the expression level may be a good indicator for disease activity of SLE . Decrease of PARP may promote the occurrence and development of SLE. In addition, PARP may play a certain role in adjusting cell apoptosis in patients with SLE.

Objective To compare the inhibition effect of budesonide suspension and dexamethasone on the rats′ pneumonic anaphylacticitis and serum IL-5,and study the effect mechanism in treatment of asthma with glucocorticoids on systemic administration and with budesonide suspension.Methods Twenty-six health wistar rats were randomly divided into normal group,asthmatic group,budesonide suspension group and dexamethasone group.Asthma models were sensitized with egg albumin.Before sensitized,budesonide suspension group were administered inhalation of budesonide suspension,and dexamethasone group were administered abdominal injection of dexamethasone.The level of IL-5 was measured with enzyme linked immunosorbent assay(ELISA) reagent box,lung was eviscera-(ted after collecting) blood,pathological slice was made.Results The rats′ pathological changes of lung and bronchus were significant between asthma group and other groups,while there were no significant difference between budesonide suspension group and dexamethasone group,but both of two groups showed slight difference with normal group.Compared with normal group,the level of serum IL-5 in asthma group raised obviously,and there was significant difference(P0.05).Conclusions The treatment of inhalation of budesonide suspension can inhibit rats′ pneumonic anaphylacticitis,ameliorate rat anaphylactic asthma symptom.

Objective The purpose of this study was to determine if recombinant ?-defensin-2 can prevent the lung from being injured by pseudomonas aeruginosa infection. Methods Ten male SD rats ( class SPF) weighing 250-300 g were randomly divided into 2 groups ( n = 5 each) : I defensin group and II control group. The animals were anesthetized with intraperitoneal thiopental 10 mg? kg-1 and intubated. 50 ? l of 5 ? 107 PFU? ml-1 adenovirus with or without ?-defensin-2 gene was instilled into the trachea via tracheal tube. 48 h later 200 ? l of 6? 108 CFU?ml-1 pseudomonas aeruginosa ATCC27853 was instilled into the trachea in both groups. All the rats were killed after 24 h and the lungs were removed for (1) histologic examination, (2) determination of ICAM-1 expression in the lung and (3) broncho-alveolar lavage. The number of WBC and pseudomonas aeruginosa in broncho-alveolar lavage fluid (BALF) was counted. Results The number of WBC and pseudomonas aeruginosa in BALF was significantly less in defensin group than in control group. The degree of instologic damage and the expression of ICAM-1 in lung tissue were significantly decreased in the defensin group as compared with control group. Conclusion Recombinant ?-defensin-2 can kill pseudomonas aeruginosa in vivo and modulate the expression of ICAM-1. It can protect the lung against injury induced by pseudomonas aeruginosa infection.

AIM: To investigate the effect of high and low shear stress on endothelial permeability and tight junctions(TJs). METHODS: Rabbit abdominal aortas in normal and high fat diet groups were stenosed to 60.7%?7.0% of original cross areas, they were sacrificed after 7 days, and the arteries were stained with Evans blue and Sudan Ⅳ. TJs were investigated with freeze fracture. RESULTS: The non-stenosis aortas were negative, there are 1 mm-wide constant and circular positive areas proximal and distal to the stenosis and scattered, dotted and patched positive areas within 8 mm distal to stenosis. Freeze fracture reveals that in the hyperpermeable regions, the percentages of zonular type of TJs and the numbers of strands of TJs of zonular and macular types in the distal regions are significantly lower than those in the proximal regions (P

AIM: To study the effects of angiotensin converting enzyme inhibitor(ACEI) on elastase after balloon injury. METHODS: The carotid arteries and aortas twelve-weeks-old Wistar male rats were injured by balloon catheter. The rats were divided into experimental and control groups in which ACEI (temocapril-HCl,10 mg?kg -1 ?d -1 ) and the vehicle were administered 2 days before injury respectively and the animals were sacrificed on day 2, 3, 5 and 10, respectively. In situ hybridization, immunohistochemistry and elastase activity bioassay were used for studying elastase . RESULTS: The intimal area on day 10 in the experimental group was significantly suppressed compared to that in the control rats( P

ve To investigate the changes in perioperative levels of circulating procalcitonin (PCT), TNF-?, IL-6, IL-8 and IL-10 in patients undergoing valve replacement with cardiopulmonary bypass (CPB) .Methods Sixteen patients (7 male, 9 female) aged (38.5?5.1) years and weighing (42.9?10.2) kg, undergoing valve replacement under CPB were chosen in this study as CPB group and seven male patients aged (32.6?5.1) years and weighing (58.3?4.4) kg undergoing pericardectomy were enrolled in this study as non-CPB group. Patients with infection or immunodeficiency and those who had received corticosteroid and drugs which may affect immune function were excluded. Premedication consisted of intramuscular midazolam 0.1 mg/kg and morphine 0.1 mg/kg. Anesthesia was induced with midazolam 0.15mg/kg, fentanyl 8?g/kg and vecuronium 0.1mg/kg and maintained with 0.8%-1.2% isoflurane inhalation and intermittent iv boluses of fentanyl and vecuronium. Blood samples were taken from CVP line before induction of anesthesia, 5 min after tracheal intubation, before CPB, immediately after discontinuation of CPB, and on 1st, 3rd, 5th, 7th postoperative day for determination of plasma PCT, TNF-?, IL-6, IL-8, and IL-10 levels. Results In CPB group plasma TNF-?, IL-6, IL-8 and IL-10 levels increased significantly immediately after CPB and returned to the baseline levels on the 3rd postoperative day, while plasma PCT concentration increased significantly after operation and reached its peak level of (10.62?3. 51) ng/ml on the 1st postoperative day. In non-CPB group there was a similar trend of changes in PCT , IL-6, IL-8 and IL-10 but to a much lesser extent.Conclusions CPB leads to a pro- and anti-inflammatory response, as well as procalcitonin release. PCT may play an important role in the systemic inflammation induced by CPB.

[Objective]To investigate the technique and significance of arthroscopic anterior cruciate ligament(ACL) reconstruction with the remaining bundle and ruptured fiber.[Method]In 47 cases of ACL rupture verified with arthroscopy,there were 15 cases of partial disruption,26 cases of complete disruption,and 6 cases of ligament flabby.ACLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy without remove of the remaining bundle or remnants of ACL.The femur tunnel was fixed by the RigidFix system,and the Intrafix system was used to fix the tibia tunnel.[Result]All of 47 cases were followed up for an average of 19 months(ranged from 12 to 24 months).The stabilization was strengthened after operation.Lysholm knee function score increased by 26.3 scores,from average 68.6 scores of preoperation to average 94.9 scores after operation.Lachman test was negative in 43 cases,weakly positive in 3 cases and positive in 1 case.According to Insall knee therapeutic effect evaluation criterion,38 cases achieved excellent results and 9 cases achieved good results.[Conclusion]Arthroscopic reconstruction of ACL with the remaining bundle preserving technique could facilitate revasculization and reinnervation of the reconstructed ligament and maintain stability of knee joint.

Objective To determine risk factors and treatments of capillary leak syndrome (CLS) in infants with congenital heart disease(CHD)after extracorporeal bypass (GBP) . Method A retrospective study of 38 infants with CIS and another 150 cases without CLS of a random choice who underwent extracoiporeal bypass from June 2003 to July 2007 was carried out.Several risk factors with statistical significance were screened out with uni-varite logistic regression analysis, and the independent rask factors of CLS were determined with inultivariate step-wise logistic regression analysis. The outcome of CIS infants was compared with infants of control group. Results Logistic analysis showed the risk factors of CLS were the duration of GBP ( OR = 10. 353) , type of CHD ( OR = 6. 912), age ( OR = 6. 254) and temperature of CBP ( OR = 4. 151) . Of the CLS infants cohort, 10 cases underwent peritoneal dialysis and 4 cases died. Conclusions The risk factors of CLS in infants after CBP are the length of time consumed during CBP, type of CHD, age and temperature of CBP.