Objective To observe the long-term effect of surgical treatment in infertile varicocele patients. Methods 180 infertile patients with varicocele accepted modified Palomo operation (retroperitoneal high ligation of internal spermatic cord vein) from 2004 to 2007, and the long-term effect of thesurgery were analyzed retrospectively, such as semen parameters and spouse pregnancy. Results The operations were performed successfully in 180 cases, and semen parameters improved significantly after the surgery (Ps ＜ 0. 05 ).Among all patients, 10 cases had spouse pregnancy within 3 months after operation;47 cases had spouse pregnancy from 3 to 6 months after operation; 25 cases had spouse pregnancy from 6 to 12 months after operation;13 cases had spouse pregnancy from 12 to 24 months after operation. The fertility rate was 52. 8% (95/180) in total. Conclusion Surgical treatment of infertile male patients with varicocele has good long-term effects, made it the first choice in these patients.

Objective To study the efficacy and safety of tacalcitol combined with monochromatic excimer light (MEL) 308 nm vs MEL 308 nm monotherapy in treating vitiligo.Methods Thirty-eight pa- tients with vitiligo were enrolled in the single-blind clinical trial,using plabebo-treated lesions in the same patient as controls.Contralateral or nearby lesions were randomly selected to be treated by either tacalcitol or placebo.All lesions were treated weekly with MEL 308 nm,for a total of 12 sessions.Patients were ex- amined at monthly intervals.The mean number of sessions and the cumulative dosage for initial and excel- lent repigrnentation were calculated.Results Thirty-five patients were evaluated.The mean?SEM cumu- lative dose and number of MEL exposures for initial repigmentation,respectively,were 4.27?3.59 J/cm~2 and 4.89?3.16 on tacalcitol-treated site,5.36?4.12 J/cm~2 and 5.69?3.29 on placebo-treated site,re- spectively (both P＜0.05).For excellent repigrnentation,the cumulative dose and number of exposures were 7.72?5.64 J/cm~2 and 7.79?4.70 respectively on tacalcitol-treated site,and 8.18?4.87 J/cm~2 and 8.4?3.92 respectively on placebo-treated site (both P＞0.05).Treatment with tacalcitol resulted in a sig- nificantly higher percentage (71.4% vs 54.3%) of repigmentation than that with placebo.Conclusions Our results show that MEL 308 nm is safe and effective for the treatment of vitiligo.Additionally,concur- rent topical tacalcitol potentiates the efficacy of MEL 308 nm in the treatment of vitiligo;this combination achieves more rapid pigmentation with a lower total MEL dosage.

Objective To analyze the difference in computed tomography (CT) imaging findings between pulmonary alveolar pneumoconiosis Methods proteinosis (PAP) and occupational pneumoconiosis (hereinafter referred to as ). A total of 44 patients with PAP (PAP group) and 44 patients with pneumoconiosis (pneumoconiosis group) were selected as study subjects using Results convenient sampling method. The CT images of these two groups were comparatively analyzed. The detection rates of - - pulmonary CT pattern changes such as map like performance, ground glass opacity, paving stone sign and sphenoid wing like vs vs changes of pulmonary hilum in the PAP group were higher than those in the pneumoconiosis group (77.3% 0.0%, 75.0% vs vs P 2.3%, 56.8% 0.0%, 18.2% 0.0%, all <0.01); the detection rates of lymphadenopathy and calcification of pulmonary hilum, small pulmonary nodules, emphysema and interlobular septal thickening were lower in the PAP group than those in the vs vs vs vs P Conclusion pneumoconiosis group (34.1% 100.0%, 4.5% 100.0%, 2.3% 45.4%, 0.0% 22.7%, all <0.01). Paving - stone sign and map like performance were most commonly found in the CT imaging of patients with PAP, and it is uncommon in pneumoconiosis. These changes could be used as the CT differential diagnosis of the two diseases.

Objective To analyze the difference in computed tomography (CT) imaging findings between pulmonary alveolar pneumoconiosis Methods proteinosis (PAP) and occupational pneumoconiosis (hereinafter referred to as ). A total of 44 patients with PAP (PAP group) and 44 patients with pneumoconiosis (pneumoconiosis group) were selected as study subjects using Results convenient sampling method. The CT images of these two groups were comparatively analyzed. The detection rates of - - pulmonary CT pattern changes such as map like performance, ground glass opacity, paving stone sign and sphenoid wing like vs vs changes of pulmonary hilum in the PAP group were higher than those in the pneumoconiosis group (77.3% 0.0%, 75.0% vs vs P 2.3%, 56.8% 0.0%, 18.2% 0.0%, all <0.01); the detection rates of lymphadenopathy and calcification of pulmonary hilum, small pulmonary nodules, emphysema and interlobular septal thickening were lower in the PAP group than those in the vs vs vs vs P Conclusion pneumoconiosis group (34.1% 100.0%, 4.5% 100.0%, 2.3% 45.4%, 0.0% 22.7%, all <0.01). Paving - stone sign and map like performance were most commonly found in the CT imaging of patients with PAP, and it is uncommon in pneumoconiosis. These changes could be used as the CT differential diagnosis of the two diseases.

Objective To analyze the difference in computed tomography (CT) imaging findings between pulmonary alveolar pneumoconiosis Methods proteinosis (PAP) and occupational pneumoconiosis (hereinafter referred to as ). A total of 44 patients with PAP (PAP group) and 44 patients with pneumoconiosis (pneumoconiosis group) were selected as study subjects using Results convenient sampling method. The CT images of these two groups were comparatively analyzed. The detection rates of - - pulmonary CT pattern changes such as map like performance, ground glass opacity, paving stone sign and sphenoid wing like vs vs changes of pulmonary hilum in the PAP group were higher than those in the pneumoconiosis group (77.3% 0.0%, 75.0% vs vs P 2.3%, 56.8% 0.0%, 18.2% 0.0%, all <0.01); the detection rates of lymphadenopathy and calcification of pulmonary hilum, small pulmonary nodules, emphysema and interlobular septal thickening were lower in the PAP group than those in the vs vs vs vs P Conclusion pneumoconiosis group (34.1% 100.0%, 4.5% 100.0%, 2.3% 45.4%, 0.0% 22.7%, all <0.01). Paving - stone sign and map like performance were most commonly found in the CT imaging of patients with PAP, and it is uncommon in pneumoconiosis. These changes could be used as the CT differential diagnosis of the two diseases.

Objective To analyze the cause of acute brain swelling,brain encephalocele in brain traumatic injury craniotomy,and the reason,diagnosis and treatment methods of progressive epidural hematoma.Methods The clinical data of 381 patients with brain traumatic injury craniotomy were retrospetively analyzed.Of 318 patients,27cases had progressive epidural hematoma during operation.Results 9 cases died because of functional failure of brain stem,the other 18 cases were all clinically cured.Conclusion If acute brain swelling and encephalocele occured during operation,the cause should be found quickly,especially when there was skull fracture or epidural hematoma on the contralateral brain,the head CT and operation should be taken immediately,and the bulging brain tissue should not be removed blindly,and the skull should not be forced to close,otherwise the prognosis maybe poor.

Objective To study the risk factors in patients with trauma accompanied by multiple organ dysfunction syndrome.Method The data of 107 patients with trauma in ICU,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,were retrospectively studied.All patients were divided into 2 groups:MODS group and non-MODS group.The clinical and laboratory,results,ISS score,APACHEⅢscore and GCS score were studied.Results There were no differences on gender,age and mobility of shock between the two groups.There were significant differences on the treatment of shock,ISS score,APACHEⅢscore,CCS score,the levels of blood sugar and platelet between two groups.The Logistic regression analysis showed the main risk factors were treatment of shock,ISS score and APACHEⅢscore.Conclusions The risk factors in patients with trauma accompanied by multiple organ dysfunction syndrome were the treatment of shock, ISS score and APACHEⅢscore.

Objective To analyze the pathological and clinical characteristics of patients with idiopathic IgA nephropathy accompanied by vasculitic/crescentic lesion (IgA-V/C). Methods Data of 222 patients diagnosed as idiopathic IgA nephropathy by renal biopsy, among them 87 cases with vasculitic/crescenlic (V/C)lesion, from our department in 2004 were analyzed retrospectively. Clinical and pathological data from patients with IgA-V/C were compared to those of non-IgA-V/C patients and of lupus nephritis (LN) patients with V/C lesion. Results Vasculitic/crescentic lesion was found in 39.19% (87/222) patients with idiopathic IgA nephropathy.And about( 14.08?12.75)% of the glomeruli was affected. It should be taken into account that there was no significant differences of clinical manifestations including blood pressure, urinary protein excretion between IgA-V/C group and non-IgA-V/C group .except serum creatinine(Scr)level which was significantly higher in IgA-V/C group. In addition, only 37.9% of IgA-V/C patients presented high Scr level,thus the lesion of V/C in idiopathic IgA nephropathy was easily overlooked. Patients with idiopathic IgA nephropathy were found to have higher percentage of glomerular sclerosis (64.86% vs 40.00%) and ratio of sclerostic glomeruli to total glomeruli [ (26.98 ?24.68)% vs (16.10 ?18.80)% ]as compared to LN group, which further predicated the progressing characteristics of IgA nephropathy. Conclusions Vasculitic/crescentic lesion is a quite common finding in idiopathic IgA nephropathy and often associated with no dramatically symptoms. It is possible for vasculitic/crescentic lesion to induce unmarked lose of nephron slowly and continually, so as to accelerate IgA nephropathy progression to end-stage renal failure.

Objective To construct and express the recombinant plasmid pET28α-Sj26GST-Sj32 of Schistosoma japonicum(Sj) in Escherichia coli BL21 (DE3). Methods Total RNA was extracted from Sj adult worms by ultrasound-breaking, Sj26GST and Sj32 antigen gene was respectively amplified by RT-PCR from the total RNA; Sj26GST-Sj32 fusion gene obtained with gene splicing by overlap extension(SOEing) was cloned into prokaryotic expression plasmid pET28α and transformed into Escherichia coli BL2 (DE3) to construct pET28α-Sj26GST-Sj32;BL21 (pET28α-Sj26GST-Sj32) was induced with isopropyl-β-D-thiogalactopyranosid (IPTG), and the expressed products were analyzed and identified by sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE)and Western blotting. Results The 1991 bp Sj26GST-Sj32 fusion gene was successfully amplified by gene SOEing and cloned into pET28α by restriction analysis and PCR identification, the recombinant plasmid pET28α-Sj26GST-Sj32 was successfully constructed; the relative molecular mass of the expressed recombinant protein was approximately 69 × 103 by SDS-PAGE, and the amount of the expressed protein was 25% of the total bacterial proteins; the fusion protein could be recognized by sera from rabbits infected with Sj by Western blotting.Conclusions The recombinant plasmid pET28α-Sj26GST-Sj32 is successfully constructed and highly expressed in Escherichia coli in fused form with His-tag, and the expressed fusion protein shows specific antigenicity.

Objective To construct and express the recombinant plasmid pET32α-Sj26GST of Schistosoma japonicum(sj)in Escherichia coli(E.coli)B121(DE3).Methods The total RNA was extracted from sj adult worms by ultrasound-breaking,Sj26GST antigen gene was amplified by RT-PCR from the total RNA,then cloned into prokaryotic expression plasmid pET32α(+) and transformed into E.coli B12(DE3)to construct pET32α-Sj26GST;BL21(pET32α-Sj26GST)WaS induced with isopropyl-β-D-thiogalactopyranosid(IPTG),and the expressed products were analyzed and identified by SDS-PAGE and Western blot.Results The 676 bp Sj26GST gene was successfully amplified by RT-PCR and cloned into pET32α(+)by restriction analysis and PCR identification,the recombinant plasmid pET32α-Sj26GST was successfully constructed;the relative molecular mass of the expressed recombinant protein was approximately 49×103 by SDS-PAGE,and the amount of the expressed protein was 24%of the total bacterial proteins;the fusion protein could be recognized by sera from rabbits infected with sj by Western blot.Conclusions The recombinant plasmid pET32α-Sj26GST is successfully constructed and highly expressed in E.coli in fused form with Trx-tag and His-tag,and the expressed fusion protein shows specific antigenicity.