Objective To improve the levels of diagnosis and treatment of testicular torsion. Methods The clinical data of 39 cases of testicular torsions were summarized and analyed.All the 39 cases had the essential clinical symptom of colic in testis,and 20 cases had the positive Prehn's sign.Eight cases underwent out examination of radionuclide imaging of scrotum,which showed unilateral defect of radionuclide distribution.The 8 cases were all diagnosed as testicular torsions.B-ultrasound showed that the positions of testis and epididymis were changed in scrotum and the blood supply in testis was reduced clearly or disappeared. Results Five cases who received operation within 12 hours from attack time had testicles survival.Of 5 cases who had operation within 12 to 24 hours from attack time 3 had testicles survival.Of 27 cases who had operation more than 24 hours from attack time only 6 had testicles survival.Two cases had no operation. Conclusions It is helpful to get diagnosis for early testicular torsion by Radionuclide imaging of scrotum and B-ultrasound are helpful to make diagnosis of early testicular torsion.Early diagnosis and timely treatment are key of improving therapeutic effect.

Objective To evaluate the features of ultrasound and elastography of chronic lymphocytic thyroiditis (CLT) with different thyroid functions,analyze the course of the disease and provide a basis for clinical treatment.Methods A total of 77 patients with CLT were retrospectively analyzed in the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University from September 2013 to September 2014.The patients were divided into four groups based on thyroid function,including 20 patients with hyperthyroidism,18 patients with hypothyroidism,20 patients with subclinical hypothyroidism,and 19 patients with euthyroidism.According to 6 indicators consisted of the thyroid size (volume,thickness of the lateral lobe,thickness of the isthmic portion),flow classification(0,Ⅰ,Ⅱ,Ⅲ),the peak systolic velocity (PSV) of the superior thyroid artery(STA),resistance index (RI) of the STA,echo types (diffuse,localized) and ultrasound elastic rate (E2/E1),the features of ultrasound and elastography of CLT were analyzed.According to the thyroid echo types and different thyroid functions,the change of E2/E1 was analyzed and the relationship between E2/E1 in different thyroid function and thyroid function (thyroid stimulating hormone,TSH) was compared.Results The volume,thickness of the lateral lobe of hypothyroidism,subclinical hypothyroidism,hyperthyroidism and euthyroidism groups were respectively as follows:(14.25 ± 4.15),(11.79 ± 3.22),(9.84 ± 2.63),(5.61 ± 1.35) ml and (2.35 ± 0.27),(2.15 ± 0.24),(1.97 ± 0.16),(1.62 ± 0.22) cm,and the differences between different groups were statistically significant (F =27.77,35.56,all P ＜ 0.05).The thickness of the isthmic portion was respectively as follows:(0.53 ± 0.09),(0.47 ± 0.06),(0.44 ± 0.06),(0.38 ± 0.06) cm,and the differences between different groups were not statistically significant (F =14.76,P ＞ 0.05).The PSVs were respectively as follows:(50.53 ± 10.61),(42.93 ± 7.81),(64.96 ± 12.20),(34.74 ± 6.05) cm/s,and the differences between different groups were statistically significant (F =36.06,P ＜ 0.05).The RIs were respectively as follows:0.59 ± 0.04,0.60 ± 0.02,0.63 ± 0.02,0.60 ± 0.02,and the differences between different groups were not statistically significant (F =7.66,P ＞ 0.05).Patients with euthyroidism had Color Doppler Flow Imaging (CDFI) pattern 0 (52.6％,10/19).Patients with subclinical hypothyroidism had CDFI pattern Ⅰ (60.0％,12/ 20).Patients with hypothyroidism had CDFI pattern Ⅱ (66.7％,12/18).Patients with hyperthyroidism had CDFI pattern Ⅲ (55.0％,11/20).The thyroid gland echo in CLT groups was mainly diffuse hypoechoic pattern (62.3％,48/ 77).Focal hypoechoic pattern and diffuse hypoechoic pattern without heterogeneous linear hypoechoic were mainly seen in the groups of hyperthyroidism and euthyroidism (66.7％,26/39).Diffuse hypoechoic pattern with heterogeneous linear hypoechoic and nodular changes were mainly seen in the groups of hypothyroidism and subclinical hypothyroidism (86.9％,33/38).The E2/E1 in focal hypoechoic pattern,diffuse hypoechoic pattern without heterogeneous linear hypoechoic pattern,diffuse hypoechoic pattern with heterogeneous linear hypoechoic and nodular changes were by turns:1.30 ± 0.48,1.68 ± 0.38,1.97 ± 0.55,2.27 ± 0.63,and the differences between different groups were statistically significant (F =32.47,P ＜ 0.05).The E2/E1 in hyperthyroidism,euthyroidism,subclinical hypothyroidism,and hypothyroidism were by turns:1.12 ± 0.50,1.69 ± 0.12,2.21 ± 0.20,2.45 ± 0.32,and the differences between different groups were statistically significant (F =64.54,P ＜ 0.05).The correlation coefficient between E2/E1 and serum TSH was 0.742,which was significant (P ＜ 0.01) in different thyroid function groups.Conclusions CLT with different thyroid functions has different features of ultrasound and elastography.E2/E1 can reflect the hardness of the thyroid parenchyma to a certain extent,and assess the thyroid function and the course of the disease,can prevent the occurrence of hypothyroidism early.

Objective To evaluate surgical therapies for chronic pancreatitis.Method The clinical data of 229 patients admitted for chronic pancreatitis during March 2009 to November 2013 in our hospital was retrospectively analyzed,different operation method and their clinical outcome were compared.Results Drainage operations or resection operations were made to all these 229 patients according to different types.57 patients underwent longitudinal pancreaticojejunostomy (LPJ procedure).118 patients received local resection of the head of pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure in 105 cases,Berne procedure in 6 cases,Beger procedure in 7 cases).7 patients received pancreaticoduodenectomy,21 patients received distal pancreas resection,26 patients received other procedures.Post-operative pain relief rate was 89.3％,overall morbidity was 19.6％.Conclusions In cases of chronic pancreatitis,different surgical types are adopted according to their individual indications.Operation in accordance with pathological types guarantees clinical outcome.

Objective:To establish and evaluate the effect of graded training mode of clinical nutrition nursing in general hospital.Methods:A clinical nutrition nursing group was established, including core management group, quality control group, education and training group and liaison nurse group. Hierarchical training and practice of clinical nutrition nursing was conducted throughout the hospital, and effect of training was evaluated.Results:The nurses' nutrition knowledge increased from (66.60±9.72) to (85.06±7.85) points, nutrition attitude increased from (72.38±5.55) to (92.50±5.10) points, nutrition behavior increased from (66.87 ± 6.83) to (88.76 ± 7.60) points, and the differences were statistically significant ( t values were -15.520, -11.128, -12.238, P<0.01). The nutritional risk screening rate and nutritional intervention rate of patients were improved to 100%, and the academic level of nurses in nutritional nursing was further improved. Conclusion:The application of graded training mode of clinical nutrition nursing can improve nurses' nutritional knowledge and skills, improve nurses' professional and academic level, and improve patient clinical outcomes.

BACKGROUND: Currently, the materials used in clinical practice to repair cruciate ligament of knee joint contain auto-graft bone- mid 1/3 patella tendon-bone (B-T-B), auto-semitendinous muscle, gracilis muscle and allogenic tissue graft. All of them are limited to a certain degree in clinical application. Therefore, people hope to consistently develop artificial ligaments to take the place of auto- and allografts. OBJECTIVE: To investigate the feasibility to construct artificial biological ligament (ABL) by applying a novel biochemical technique using porcine tendon as the raw material. DESIGN: Research of new biological material. SETTING: Department of Orthopedics, Third Affiliated Hospital of Sun Yat-sen University. MATERIALS: Adult pigs of either gender were provided by the Animal Center of Sun Yat-sen University. Scanning electron microscope (SEM, S-520) was provided by Hitachi, Japan, and micro-controlled electron tension-testing device (Model LWK-10B) by Guangzhou Experimental Devices Factory. METHODS: The experiment was performed at the Animal Center of Sun Yat-sen University from January 2004 to June 2005. ABL was established by means of treating porcine tendon with epoxy cross-linking fixation, diversified antigen minimization process, mechanic enhancement modification and surface activating process. Under aseptic condition, a 6-month-old goat's bone marrow was abstracted, and then the bone marrow matrix stem cells were cultured in ABL stent for 3 weeks. Scanning electron microscope was used to observe structure and compatibility of artificial ligament, and mechanics test was used to analyze biomechanics characteristics of ABL. MAIN OUTCOME MEASURES: Structural features, cell compatibility and biomechanics characteristics of ABL.RESULTS: ① Structural features of ABL: The appearance of ABL was similar to that of the normal human ligament. Histological examination showed that the ABL was collagen fibers with no cells. Electron microscope examination revealed that the ABL was composed of hair-looking and fiber-like objects running uniformly in a certain direction and closely parallel-arranged. ② Cell compatibility: Three weeks after xenogenic marrow matrix cells were cultured on the surface of the ABL, it was noted that cells adhered and the matrix secreted by the cells precipitated around the cells. There were no cells found inside the ABL. ③ Mechanical strength of the ligament: The average diameter of ABL was 5 mm and the mechanical test at a speed of 100 mm/min showed that its averaged tensile limit was 927.19 N and the tension-resistant strength was 47.22 N/mm those were close to the corresponding parameters of the normal goat's ACL. The normal goat's ACL was 5 mm. The greatest tensile load was 807.50 N and the tension-resistant strength was 41.13 N/mm.CONCLUSION:As we used the unique biochemical technique and minimized the xenogenic protein immunogenicity of the porcine tendon, ABL has acceptable biomechanical properties and superior biocompatibility. As a substitute of the ligament in the reconstruction of the ACL, ABL has a promising prospect in clinical applications.

Objective To elucidate the roles of TANK-binding kinase-1(TBKl)in hepatitis B virus (HBV)infection induced interferon antiviral immunity.Methods Peripheral blood monocytes were separated by CD14 magnetic microbeads from healthy volunteers(HV)and chronic hepatitis B(CHB)patients.Purified mDCs were induced and proliferated in the culture medium with human granulocyte-macrophage concentration of 25 mg/L were stimulated.The mRNA expressions of TBK1,interferon regulatory factor (IRF)3 and interferon(IFN)-βwere quantified by real time polymerase chain reaction(PCR).The levels of IFN-β in supernatants were determined by enzyme-linked immunosorbent assay(ELISA).Reslllts The mRNA levels of TBK1,IRF3 and IFN-β did not change significantly at 0,12,24 and 48 h after the significantly at 0, 12, 24 and 48 h in CHB group, whereas, it was significantly up-regulated at 12 h in HV group. Conclusions Our results suggest that there may be some disorders in host antiviral signal transduction pathways downstream the binding between ligands and receptors on mDC surface. The insufficient IFN-β expression after HBV infection may result in persistent chronic infection.

Objective:To investigate the role and mechanism of PM(2.5)exposure on airway inflammation in juvenile rats based on macrophage recruitment induced by JNK/CCl2 signaling pathway.Methods:A total of 50 juvenile SD rats were randomly divided into 5 groups(n=10).The control group received no treatment,the PM(2.5)group received PM(2.5)particulate matter expo-sure,and the PM(2.5)+Anisomycin group received PM(2.5)exposure and Anisomycin,an activator of JNK,intravenously.Rats in the PM(2.5)+SP600125 group received PM(2.5)exposure and intravenous administration of the JNK inhibitor SP600125,and rats in the PM(2.5)+Pirfenidone group received PM(2.5)exposure and intravenous administration of Pirfenidone,a CCl2 inhibitor.The rats were euthanized and lung tissue was harvested.JNK,phosphorylated JNK(p-JNK)and CCl2 protein expressions were detected by Western blot.Hematoxylin-eosin(HE)staining was used to detect the pathological changes of lung airway tissue and score the pulmo-nary bronchial inflammation.The number of macrophages in alveolar lavage fluid was analyzed by flow cytometry.The levels of IL-6,IL-1β,and TNF-α in alveolar lavage fluid were determined by ELISA.Results:The expression levels of JNK,p-JNK,and CCl2 among all groups(F=205.296,950.408,260.019;all P<0.001)and macrophage content(F=48.414;P<0.001),pulmonary bronchial inflammation score(F=101.703;P<0.001)and IL-6(H=44.890;P<0.001),IL-1β(H=42.071;P<0.001),TNF-α(F=297.154;P<0.001)were statistically significant.Compared with the control group,the expressions of JNK/CCl2 pathway proteins JNK,p-JNK,and CCl2 in PM(2.5)group were significantly up-regulated(all P<0.05),while the content of macrophages was increased(P<0.05),and the pulmonary and bronchial inflammation score was significantly increased(P<0.05).The levels of IL-6,IL-1β,and TNF-α were up-regulated(all P<0.05).Compared with PM(2.5)group,the content of macrophages in PM(2.5)+Anisomycin group was sig-nificantly increased(P<0.05),the pulmonary bronchial inflammation score was significantly increased(P<0.05),and the levels of IL-6,IL-1β,and TNF-α were increased(all P<0.05).The expression levels of JNK,p-JNK,and CCl2 were increased(all P<0.05).Compared with PM(2.5)group,the content of macrophages in PM(2.5)+SP600125 group and PM(2.5)+Pirfenidone group were signifi-cantly decreased(P<0.05),and the pulmonary bronchial inflammation score was significantly decreased(P<0.05).In addition,the levels of IL-6,IL-1β,and TNF-α were significantly decreased(all P<0.05).Compared with PM(2.5)group,the expression levels of JNK,p-JNK,and CCl2 in PM(2.5)+SP600125 group were down-regulated(all P<0.05),and the expression level of CCl2 in PM(2.5)+Pirfenidone group was down-regulated(all P<0.05).Conclusion:JNK/CCl2 pathway induces macrophage recruitment and pro-motes allergic airway inflammation induced by PM(2.5)particulate matter exposure in juvenile rats.