Objective To discuss the laparoscopic diagnosis and treatment for non-palpable undescended testis.Methods Laparoscopy was utilized in the diagnosis and treatment of 29 cases of non-palpable undescended testis(34 sides) from July 2002 to March 2005.Results The diagnosis was clarified in all the 29 cases.Intraabdominal testis was found in 21 sides(primary orchidopexy in 16 sides and two-staged Fowler-Stephens orchidopexy in 5 sides) and absent testis,13 sides.Follow-up observations for 0.5~1 year in 29 cases showed no testicular retraction or atrophy.Conclusions Laparoscopic intervention,characterized with accurate diagnosis,little invasion,and quick recovery,can be the first choice for the diagnosis and treatment of(non-palpable) undescended testis.The primary orchidopexy of testis may have satisfactory results if possible.

Objective To improve diagnosis of straight back syndrome.Methods 21 patients with straight back syndrome include 12 male and 9 female,and aged 15～36 years old(mean 21 years old).The standard P-A and left lateral chest film were taken and the A-P diameter and transverse diameter of the chest were measured,and the ratio between the both was calculated.Results The A-P diameter of the chest were 5.3 cm～8.5 cm(mean 6.6 cm)in male and 4.2 cm～8.1 cm(mean 6.2 cm)in female.the ratio between the A-P diameter and transverse diameter of the chest were 0.22～0.37(mean 0.34)in male,and 0.19～0.366(mean 0.31)in female.Conclusion The ratio between the A-P diameter and transverse diameter of the chest ≤0.37 is the diagnostic basis of the straight back syndrome.

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

OBJECTIVE:To evaluate the quality of TCM decoction pieces in our hospital preliminarily and explore the solu-tions for the problem of the quality of decoction pieces purchased by the hospital. METHODS:In Jun. 2012,a system was estab-lished by our hospital,where the quality inspector was designated to daily inspect new batches of TCM decoction pieces such as ap-pearance provided by suppliers. The batches of TCM decoction piece samples inspected and those of unqualified products from Jun. 2012 to May 2014 were calculated. The reasons of unqualified products were analyzed and corresponding solutions were made. RE-SULTS&CONCLUSIONS:Over two years,a total of 94 671 batches of TCM decoction piece samples were inspected by our hos-pital,among which 737 were unqualified products predominantly because of mildew,damage by worms,greasing,containing for-eign substances and others. The solutions to such problems included interviewing the suppliers,returning or discontinuing the use of crude drugs and special focus on particular seasons and on the demand for key varieties. The unqualified products rate in the quality inspection reduced from 0.56%in Jun. 2012 to 0.34%in May 2014. Therefore,setting the post of drug quality inspector in the hos-pital can ensure the quality of TCM decoction piece purchased,however,it need to improve the inspection and acceptance of quali-ty inspection by sampling,scoring and using the new technology.

Objective To explore the effects of comprehensive rehabilitation on nutriture and medical costs in the treatment of patients with dysphagia following stroke. Methods Eighty-seven patients with dysphagia were divided into an intervention group (IG) and a control group (CG). Comprehensive rehabilitation therapy including deglutition training, electric neuromuscular stimulation and acupuncture were used with the IG patients, but not with those in the CG. Nutriture parameters included a biochemistry index and a body measurement index. Medical costs were observed before and after one month of treatment for both groups. Results After one month of treatment, average deglutition scores and nutriture indices were significantly higher in the IG than in the CG. Medical costs for the IG had decreased significantly compared with the CG. Conclusions Comprehensive rehabilitation therapy improved deglutition function and slowed nutriture deterioration, while decreasing medical costs in the treatment of patients with dysphagia following stroke.

ObjectiveTo explore the value of 64-slice CT perfusion imaging(CTPI) in the early diagnosis of radiation-induced lung injury ( RILI ).MethodsForty-eight patients with upper esophageal cancer resection underwent CTPI before and after radiotherapy,and the TNF-α and TGF-β1 were measured from patient's peripheral blood.Serum cytokine,conventional CT appearances and CTPI parameters (rrBF,rrBV,rrPS) in patients with RILI (Group A) and non-RILI (Group B) were compared and analyzed.A randomized block design t-test was used for comparison of serum cytokines and perfusion values between the two groups.The Chi-square ( x2 ) test was used for comparison of detection rate between conventional CT and CTPI.ResultsRILI occurred in 18 of 48 cases ( 18/48,Group A).In Group A,TNF-α and TGF-β1 preand pos-radiation were (36.1 ± 15.0),(30.4 ±t 14.9) ng/L and (17.5 ±9.8),(14.3 ±7.6) μg/L,respectively,and there were no statistically significant differences (t =1.14,1.I0,P =0.264,0.279).At half-dose time point of radiation,there were no significant differences for TNF-α and TGF-β1 pre- and posradiation [ ( 30.4 ± 14.9),( 28.9 ± 14.7 ) ng/L and ( 14.3 ± 7.6),( 14.4 ± 6.0 ) μg/L,respectively ]between Group A and B ( t =0.33,1.23 ; P =0.746,0.227).The rrBF,rrBV and rrPS of post-radiation from Group A were significantly higher than those of pre-radiation ( t =5.67,5.97,6.11,P =0.000,0.000,0.000),the rrBF and rrBV of post-irradiation from Group B were significantly higher than those of pre-irradiation (t =6.52,7.84,P =0.000,0.000).There was no significant difference for rrPS in Group B pre- and post-radiation (t =1.36,P =0.178 ).There were significant differences for all perfusion values detected from radiation lung fields between Group A and B ( t =2.32,2.18,6.04,P =0.025,0.034,0.000).Taking rrPS =1.28 as a threshold value on ROC,the sensitivity and specificity of CTPI for diagnosis of RILI were 77.8％,93.3％,respectively,which were much higher than those ( 11.1％,90.0％,respectively) of conventional CT (x2=13.61,P=0.000).ConclusionCTPI parameters may reflect the hemodynamic changes of post-radiation lung and have potential values for the early diagnosis of RILI.

Objective To observe the effect of acupuncture penetrated from Tiaokou (ST38) to Chenshan (BL57) combined with exer-cise on affected limbs of shoulder-hand syndrome (SHS) at stage I after stroke. Methods 40 inpatients with SHS at stage I after stroke from January, 2013 to December, 2014 were randomly divided into treatment group (n=20) and control group (n=20). The treatment group accept-ed acupuncture from Tiaokou to Chenshan on unaffected sides and exercise of affected upper limbs, and the control group accetpted routine acupuncture on Triple Shoulder Acupoints on affected sides. They were assessed with Pain Rating Index (PRI), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and 4 weeks after intervention. Results The incidence of improvement was 90% in the treatment group, and 80%in the control group (χ2=0.784, P=0.376). The scores of PRI decreased (t>5.37, P<0.001), and the score of FMA and MBI increased (t>4.66, P<0.001) significantly after intervention. The score of FMA and MBI improved more in the treatment group than in the control group (t>2.25, P<0.05). Conclusion Acupuncture from Tiaokou to Chenshan combined with exercise is more effective on SHS at stage I after stroke than conventional Triple Shoulder Acupoints.

Objective To investigate the therapy effects of bone marrow mesenchymal stem cells (MSCs) on renal recovery after ischemia-reperfusion injured. Methods Seventy-two Spargue-Dawley rats were randomly divided into 4 groups as normal control, sham operated control, I/R group(n=30) and the MSCs group. Rats were subjected to 45 min bilateral renal ischemial-reperfusion injury with microvascular clips, after 60 min of reperfusion they were injected in BrdU positive MSCs(1?106/mL)intravenously. The animals were sacrificed at 12 h, 3 d, 7 d, 14 d, and 42 d after reperfusion, and the bilateral kidney and blood samples were harvested. The blood urea nitrogen(BUN) and serum creatinine(Scr) were measured on automatic biochemistry analyzer. Renal morphologic changes were scored with Paller’s criterion on hematoxylin and eosin(H&E) stained sections. The apoptosis of tubular cells were examined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL). PCNA positive tubular cells were detected immunohistochemically as proliferation index. And confocal microscopy were used to identified the distribution of BrdU positive MSCs. Results After 12 h, 3 d of reperfusion, the Scr value of MSCs group were signifcantly lower than I/R group(P

Objective To explore the titre of serum anti-phospholipase A2 receptor antibodies (anti-PLA2 R antibodies) detected by the enzyme-linked immunosorbent assay (ELISA) to provide a more specific serological index for clinical diagnosis and disease judgment of membranous nephropathy (MN).Methods Thirty-four cases of MN confirmed by kidney biopsy ,32 inpatients with autoimmune diseases ,nephrotic syndrome and renal insufficiency in the nephrology department of our hospital and 12 persons un-dergoing physical examination were selected.The serum was collected for detecting anti-PLA2 R antibodies level.Then its diagnostic performance for diagnosing MM was analyzed by combining with serum TP ,ALB ,IgG ,IgA ,IgM ,C3 and C4 indicators.Results The medians of anti-PLA2 R antibodies titres in the MN group ,disease control group and healthy control group were 22.1 ,2.0 ,2.0 RU/mL respectively ,which had statistical difference between the MN group and other two groups (P<0.05).Seventeen cases of anti-PLA2R antibodies positive were in the MN group(positive rate50% )and 17 cases were negative,the disease control group and healthy control group all were negative.Its specificity and positive predictive value were 100% ,TP ,ALB and IgG had statistical difference between the MN group with the disease control group and healthy control group (P<0.05);the relative coefficients of anti-PLA2 R antibodies with TP ,ALB and IgG ,IgA ,IgM ,C3 and C4 were in turn -0.382 ,-0.344 ,-0.502 ,-0.295 ,0.062 , 0.005 and 0.241 respectively ,anti-PLA2R antibodies were negatively correlated with TP ,ALB ,IgG and IgA(P<0.01) ,positively correlated with C4(P<0.05) and had no relation with IgM and C3(P>0.05).Conclusion Anti-PLA2 R antibodies have higher specificity for the diagnosis of MN and can serve as the necessary and specific serologic detection indicator in the patients unable to conduct renal biopsy.Quantitative detection helps to condition judgment.

Objective To explore metformin improves hyperinsulinemia in obese children, glucose metabolism, serum lipid derived hormone levels. Methods 40 cases of healthy children were selected and included in the control group, 40 cases of mild, moderate and severe obese children in the obese group, moderately obese group, obese group given category; metformin in obese children orally for 3 months, then in each group of body mass index (BMI), the learning situation of adipose derived hormones, blood glucose levels were detected and compared. Results Compared the condition of blood glucose metabolism and body weight obviously, obesity group and control group before treatment there are very significant differences after treatment, the obese group appeared to be improved, indicates that the difference is obvious(P<0.05). Compare the hormone levels of serum leptin and adiponectin are visible in before the treatment and health examination Significant differences after the treatment showed some improvement, but the resistin in the treatment had no obvious improvement. Conclusion The application of metformin improves hyperinsulinemia in obese children with sugar metabolism, visible analysis of serum adipose derived hormones, the patients with improvement of glucose metabolism has a positive effect, while improving the serum hormone level, reduce patient weight (BMI), so it is worthy of clinical use.