Objective:To study CT findings of testicular torsion and improve the recognition of the disease.Methods:The clini-cal and CT findings in 13 cases with testicular torsion proved by operation were analyzed retrospectively.All patients underwent low dose precontrast and postcontrast helical CT.Results:All patients of the disease had feature of urgent onset and short course of disease(two hours～3 days).Two patients of these cases had patient history of injury.CT findings:precontrast CT found the volume of sick testes increased and their densities increased slightly and nonuniform.Postcontrast CT found their features of nonuniform enhancement and gyrate enhancement.Conclusion:CT manifestations of testicular torsion have some specific features,which can help to confirm the diagnosis by referring the patient’s history.

Following the important icleology of "Gorernance of the Country by morals"the author adrocates"undertalce mdical service by merals"in the health front.This artical expounds three theoretical signifieamces:medical practice is a charitable calse,and martvring virtue is the first;correlation and distinction between and key links of medical and headth culture,To explore rmplementation of "undertalce medical fervice by moral",On onehand we should wphold the 4 mian pillars--charity,profcieniy,trust,cooperation; On the other hand.to take the 4 measures --nuturing,stipulation of agrements,estblishment,model so as to estabmish a three--olim ensionoll line of medical ethics and morals.

Objective Statistics and analyze the effect of comprehensive prevention measures for the ventilator associated pneumonia (VAP) morbidity and mortality,and investigate its actual applicate situation in the clinical.Methods Statistics and analyze the clinical date of 183 cases of our ICU mechanical ventilation patients in 2012 (group A),including morbidity,mortality,time of endotracheal intubation,length of stay and the primary pathogenic bacteria,and to compared with the relevant clinical data of 192 cases of our ICU mechanical ventilation patients in 2011 (group B),summarize and analysis the actual applicate situation of the comprehensive prevention measures in the clinical through the data contrast.Results The incidence of VAP in group A was lower than that in group B [31.7％(58/183) vs.58.3％(112/192)] (P ＜ 0.05),but the mortality was no statistical difference in both groups (P ＞ 0.05) ; the endotracheal intubation time and the average length of stay in group A were less than those in group B [6.3 d vs.10.6 d,7.6 d vs.11.9 d](P＜0.05); the main pathogenic bacterium of VAP with mainly gram-negative bacilh.Conclusions Comprehensive prevention measures can effectively reduce the incidence of VAP,but the mortality rate has no significant effect,need further clinical research;comprehensive prevention measures to reduce patients with tube time also confirm its effectiveness.Comprehensive prevention measures are economical and practical,is worth in clinical promotion.

Objective To approach the mechanisms and myocardial protective effect of Qishen Yiqi dropping pills on rats with myocardial infarction. Methods Sixty clean healthy male Sprague-Dawley (SD) rats were randomly divided into sham operation group, model group and observation group (each n = 20). The rat model of acute myocardial infarction (AMI) was established by ligation of left anterior descent (LAD) branch of coronary artery. After modeling, the rats in observation group were given 0.135 g/kg of Qishen Yiqi dropping pills, and sham operation group and model group were administered the same amount of normal saline, once a day for consecutive 28 days. At the end of treatment, the levels of serum inflammatory factors of leukotriene B4 (LTB4), prostaglandin E2 (PGE2), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay (ELISA); the changes of the indexes of hemodynamic [left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), the maximal rate of increase/decrease in left ventricular pressure (±dp/dt max)], the ratio of the heart weight/body weight, and the ratio of the left ventricular weight/heart weight (LVW/HW), the myocardial infarction area, myocardial histopathological changes were observed in the three groups; myocardial tissues inflammatory related factors [the mRNA and protein expressions of cytosolic phospholipase A2 (cPLA2), cyclooxygenase-2 (COX-2), 5-lipoxygenase (5-LOX)], and the expression levels of transforming growth factor-β (TGF-β)/Smads signal transduction pathway related protein (TGF-β1, Smad2/3, Collagen Ⅰ, Collagen Ⅲ ) and cell apoptosis related factors (Bcl-2, Bax) protein were measured. Results Compared with the sham operation group, levels of serum inflammatory factors, the index of LVEDP, the ratio of the heart weight/body weight, LVW/HW, myocardial infarction area, the mRNA and protein expression levels of inflammatory factors in myocardium, the expression levels of TGF-β/Smads signal transduction pathway related protein and the cell apoptosis related factors protein in model group were all significantly elevated, while LVSP and ±dp/dt max were obviously decreased in model group. Compared with the model group, the levels of inflammatory factor in serum [LTB4 (ng/L): 370.11±46.98 vs. 633.23±83.37, PGE2 (ng/L):48.75±26.35 vs. 131.25±29.75, TNF-α (μg/L): 177.28±22.65 vs. 248.47±16.21, IL-6 (μg/L): 493.22±165.99 vs. 638.41±191.66], LVEDP [mmHg (1 mmHg = 0.133 kPa): -2.03±2.98 vs. 7.03±1.39], the ratio of the heart weight/body weight [(6.53±0.11)% vs. (7.14±0.24)%], LVW/HW (0.26±0.01 vs. 0.32±0.02), myocardial infarction area [(27.21±2.87)% vs. (44.98±1.52)%], mRNA and protein expression of myocardial inflammatory factors, the expression of TGF-β/Smads signal transduction pathway related protein, and the protein expression of Bax were all significantly decreased in observation group (all P < 0.05), LVSP (mmHg: 129.01±11.93 vs. 108.11±12.69), the +dp/dt max (mmHg/s: 3101.3±378.6 vs. 2105.3±245.9), the -dp/dt max (mmHg/s: 2612.4±249.7 vs. 1654.4±188.1), while the protein expression of Bcl-2 in observation group were obviously increased (all P < 0.05). It was demonstrated by hematoxylin-eosin (HE) staining that there were no obvious pathological changes in the sham operation group; obvious infiltration of inflammatory factors in myocardium was shown in model group; pathological changes in the observation group were significantly improved as compared with those in the model group. It was shown by Masson staining that there were slight hyperplasia of myocardial fibers and no obvious pathological changes in the sham operation group. Severe collagen hyperplasia was found in model group, and the degree of fibrosis in the observation group was significantly improved. Conclusions Qishen Yiqi dropping pills can reduce the degree of myocardial fibrosis and inhibit the ventricular remodeling via TGF-β/Smads signal transduction pathway. The dropping pills can also suppress the release of inflammatory factors by reducing cPLA2 to decrease the inflammatory response and inhibit apoptosis and alleviate myocardial injury by up-regulating the expression of Bcl-2 and down-regulating the expression of Bax.

Objective To analyze the clinical characteristics of patients with cardiac amyloidosis.Methods The clinical data of 14 patients with cardiac amyloidosis were retrospectively analysed.Results The patients with cardiac amyloidosis had characteristics of large atriums and hypertrophic ventricular walls in echocardiography.And they also had low limb lead voltage in ECG.The ratio of(SV5+RV1)and left ventricle crossing area of all patients were obviously lower than 1.5.Biopsy behaved staining of congo red.And most patients had renal,dermatic and gastrointestinal involvements.Conclusion The patients of cardiac dysfunction with the characteristics of restrictive cardiomyopathy in echocardiogram and feature of low limb lead voltage in ECG,have the possibility of cardiac amyloidosis and need to prove it through biopsy.(SV5+RV1)/CSA may be a promising method for screening cardiac amyloid.

Interventional treatment via portal vein system plays an important role in treating some liver diseases,such as interventional treatment for portal vein tumor thrombus,portal hypertension with liver cirrhosis,portal vein thrombosis and selective portal vein embolization inducing compensatory hypertrophy of the remnant liver.The author introduces the routes,methods and efficacies of the interventional treatment via portal vein.

Adenocarcinoma, Follicular ; epidemiology ; genetics ; metabolism ; pathology ; Carcinoma, Papillary ; pathology ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Genes, ras ; genetics ; Humans ; Point Mutation ; Prognosis ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; epidemiology ; genetics ; metabolism ; pathology ; Transcription Factors

Chinese medical records recorded the whole activities during a syndrome differentiation and treatment of disease. With the characteristics of diversity and lively, the records have important values in establishing TCM therapeutic thoughts and abilities for students. Amount of medical records have been recorded in medical books since the Western Han dynasty. In order to provide the references for teaching prescription aided by medical records, this article discusses the choice and application of medical records to teach prescription by listing examples on the basis of outlining the development of TCM medical records.

Objective:To investigate and compare the effect of sodium hyaluronate and chitosan in the prevention of thyroid post-operative adhesion. Methods:Totally 84 patients with thyroid operation in our hospital from August 2012 to August 2013 were select-ed, and according to the admission time, the patients were respectively divided into group A and B with 42 cases each. In order to pre-vent postoperative adhesion, group A was treated with sodium hyaluronate, and group B was treated with chitosan. The clinical curative effect of the two groups was compared. Results: The adhesion rate in group A was 14. 3%(6/42), which was higher than that in group B (3/42 7. 1%), while the difference was not statistically significant (P>0. 05). All the patients showed no bleeding, aller-gies and other adverse reactions, only in group A, 2 mild infection (4. 8%) occurred. The adverse reactions in the two groups were without significant difference (P>0.05). Conclusion: Sodium hyaluronate and chitosan both have the preventive effect on thyroid postoperative adhesion with similar efficiency and adverse reactions.