PURPOSE 10 cases of testicle embryonal rhabdomyosarcoma (RMS) were treated in the Cancer Hospital of Shanghai Medical University from 1971 to 1988. All cases were treated by orchiectomy followed by retroperitoneal node dissection and three of them did not have lymph node metastases. Methods 2 cases were given postoperative irradiation, 7 cases received adjuvant chemotherapy. Results The 2-. 5-year overall survival were 50% and 30% respectively. Conclusion This report analyzes the prognosis of adult testicle embryonal rhabdomyosarcoma. The treatment is a combination of surgery、 chemotherapy and radiotherapy. Intensive chemotherapy should be administered. The prognosis of RMS in adult seems to be worse than in childhood. Patients with negative lymph nodes has better outcome than those with node metastases. Retroperitoneal lymph node dissection after radical inguinal orchiectomy is unnecessary in patients without CT evidence of nodal involvement.

Objective To evaluate imaging findings and treatment experience in central venous stenosis without a history of previous catheterization in hemodialysis patients. Methods Clinical data of 5 haemodialysis cases of central vein stenosis without a previous catheterization history in our hospital from July 2006 to July 2008 were analyzed retrospectively. Results Patients were three women and two men aged 43 to 65 years with mean age(53±8)years and all had arm swelling as the main complaint.The vascular accesses were located at the wrist in all the patients.The mean duration of the vascular accesses from the time of creation was(33.6±35.4)months.Venography showed occlusion in 2 cases and stenosis in 3 cages of central vein including 1 case of stenosis in brachiocephalic vein.1 case of stenosis beth in branchiocephalic vein and subclavian vein,1 case of stenosis in two segments of subclavian vein.The stenosis of branchiocephalic vein was fixed anterior to the tracheal and CT showed the compression of the vein by the aorta.Symptoms were resolved by the treatment of PTA.subclavian vein-contralateral subclavian vein bypass and ligation of the access. Conclusions Central venous stenosis in haemodialysis patients without a history of catheterization may be due to the intimal hyperplasia of the compression site or valve which is accelerated by the high flow of vascular access.Venography is the first choice for the diagnosis and the current management of central venous stenosis is far from being effective for the long term.

Objective To evaluate the therapeutic effect of transanal local excision in the treatment of low rectal cancer.Methods The data of 49 cases of low rectal cancer patients treated by transanal local excision (group A,37 cases of T1 patients and 12 cases of T2 patients) were reviewed retrospectively,and compared with the group of 45 cases treated by radical resection( group B,11 cases of T1 patients and 34 cases of T2 patients).The 5-year survival rates,recurrence rates and postoperative complications between the two groups were compared.Results The incidence of postoperative complications in group A was significantly lower than that in group B(4.1％ vs 15.6％,x2 =4.69,P ＜0.05 ).The 5-year survival rate of group A was 97.9％ and the 5-year survival rate of group B was 95.6％.There was no significantly statistical difference on the 5-year survival rate between the two groups( x2 =0.439,P ＞ 0.05 ).But for the T2 patients,the recurrence rates in group A was 33.3％,which was significantly higher than the T2 patients in group B(5.9％ ) ( x2 =5.89,P ＜0.05 ).All patients with low histopathological grade tumor in group A showed postoperative recurrence and metastasis.Conclusion Transanal local excision with a rigid criteria can get good curative effect in the T1 patients,but not suitable for the T2 patients or patients with low histopathological grade tumor.

The paper carries out statistical analysis on medical source journals of CJCR ( Chinese S&T Journal Citation Reports), in order to evaluate the changing trends of academic influence of medical journals form the view of impact factor. The results show that the overall influence of medical core journals assume trend of escalation during the Tenth Five-year, but the growth rate is relatively slowed down. There arc extremely differences in influence levels of medical journals between in China and international, but the overall superiority of medical journals as well as the increasing impact could be continued.

Objective To research etomidate or propofol in the whole intubation during the induction of elderly coronary heart disease autonomic nervous system function. Methods Ninety patients undergoing abdominal surgery patients with coronary heart disease were randomly divided into etomidate group (E group, 45 cases) and propofol group (P group, 45 cases). In pre-anesthesia, after the induction of anesthesia and after intubatiou with power spectral analysis of heart rate variability (HRPSA) observed in patients with heart rate variability (HRV) changes. Results After the induction of anesthesia, the low frequency(LF)[(316±301) ms2/Hz] end total power(TP)[(756±535) ms2/Hz] decreased significantly in E group(P<0.05) and LF, high frequency (HF), LF/HF ratio(LF/HF)and TP decreased significantly in P group [ (187±168) ms2/Hz, (89±48)ms2/Hz, 2.3±1.6 and (616±462) ms2/Hz] (P<0.05). The duction degree of LF, HF, TP and LF/HF in E group was more significant than that in P group (P<0.05). After intubation, LF, HF, LF/HF and TP increased significantly in both groups and no significant difference of HRV was observed between the two groups (P>0.05). Conclusions Propofol decreases the activity of autonomic nervous system, wherea etomidate produces minimal changes under anesthesia induction in elderly coronary heart disease patients.There is no remarkable difference in cardiovasological changes induced by etomidate and propofol during tracheal intubation.

BACKGROUND:Pain is the main reason for the recovery of knee function after total knee arthroplasty. OBJECTIVE:To explore and analyze the influencing factors of pain after total knee arthroplasty.METHODS:160 patients with knee osteoarthritis underwent total knee arthroplasty. At 12, 24 and 48 hours after total knee arthroplasty, patients were evaluated with visual analogue scale (VAS) and knee function was assessed with KSS score preoperatively and 90 days postoperatively. Factors, including operation time, age, gender, body mass index, anesthesia method, and preoperative score of KSS were analyzed by Pearson correlation and multiple linear regression. These statistics method also was used to analyze the relationship between the postoperative 90 days score of KSS and postoperative VAS score at each time point. RESULTS AND CONCLUSION:(1) Pearson correlation analysis and multiple linear regression analysis showed that operation time, gender, and body mass index had been correlated positively with VAS score at 12, 24 and 48 hours postoperatively. (2) Patient age had been correlated negatively with VAS score at 12, 24 and 48 hours postoperatively. (3) VAS score at 12, 24 and 48 hours postoperatively had been correlated negatively with KSS score at 90 days postoperatively. (4) Gender, operation time, body mass index and age are al the influencing factors of the pain after total knee arthroplasty. Pain after total knee arthroplasty affects the recovery of knee function.

Objective To study the value of three dimensional dynamic contrast and digital subtraction MRI in diagnosing breast cancer.Methods 52 patients with breast diseases were enrolled in this study,including 27 malignant lesions and 36 benign lesions verified by histopathology.the morphologic features and enhancement kinetics of breast lesion on MRI were observed.The morphologic manifestation,early-phase enhancement rate,peak enhancement rate,peak time and time-signal intensity curve were evaluated.Results The benign lesions were mainly characterized by regular mass,well-defined border,internal septation,homogeneous enhancement,and the malignant lesions by irregular shape,speculated margin,rim enhancement,inhomogeneous enhancement.The early-phase enhancement rate,peak time and curve type were significantly different between breast benign and malignant lesions(P

Objective To investigate the anxious behavior in acute parkinson's mice that were induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) injection.Methods Twenty mice were randomly divided into the control group (n =10) and model group(n =10);The model group was induced by injecting MPTP dosage,and the control group was induced by the same dose of saline.The anxious behaviors in mice were tested by the elevated plus-maze test and the light/dark box.Results The model group mice spent a longer time than the control group in the dark box (P ＜ 0.05).The open arm entry (OE),open arm time (OT) and OE％ of model group was significantly less than that in control group in the elevated plus-maze test (P ＜ 0.01),the OT％ was significantly less than control group (P ＜0.05).Conclusions Anxiety symptoms appeared in the model group of early parkinson disease (PD)mice.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

Objective To investigate the relationship of TCM constitution and syndrome elements based on patients with hyperhomocysteinemia. Methods A survey was conducted among 1316 patients with diabetes, coronary disease, hypertension and cerebral infarction. Totally 326 patients with hyperhomocysteinemia were incorporated in diagnostic data and their constitutions were determined. At the same time, syndrome elements identification method for syndrome elements was applied for judgment, and consistency of the constitution and syndrome elements was analyzed. Results The survey showed that prevalence rate of population with hyperhomocysteinemia was 24.77%;there were 6 cases with mild nature, and 320 cases with biased constitution;phlegm dampness, blood stasis, qi deficiency of constitutions 110 cases, 73 cases and 59 cases, respectively;blood stasis, phlegm, qi deficiency, and dampness were the main syndrome elements of hyperhomocysteinemia, of 100 cases, 98 cases, 73 cases and 59 cases, respectively;the consistency of phlegm dampness constitution and syndromes of phlegm was the most obvious (Kappa=0.89, P<0.05). Conclusion Phlegm dampness, blood stasis, and qi deficiency were the most common constitutions of hyperhomocysteinemia;blood stasis, phlegm, qi deficiency and dampness were the main syndrome elements of hyperhomocysteinemia patients. The two results were consistent, and the consistency of phlegm syndrome and phlegm dampness constitution was the most obvious.