Objective To study the diagnosis and treatment of ectopic testes. Methods 7 cases of ectopic testes were reviewed and studied. Results 5 cases of ectopic testes were diagnosed and located by physical examination and/or type B ultrasonography before operations whereas the ectopic testes was atrophic in the other two.All the ectopic testes were found successfully during surgical exploration.Orchidopexy was performed for 5 patients,and orchiectomy for the other 2 because of marked atrophy.Postoperative follow up has been 2 months to 8 years.All the patients have normal growth.In the 5 cases with reposited testes no displacement,atrophy or malignant change has been noted. Conclusions The diagnosis of ectopic testes should be mainly depended on physical examination and type B ultrasonography.Surgical exploration should be carried out through the inguinal canal and via the pathway of spermatic cord.

Background The measurement of corneal Q value is essential for corneal refractive surgery and calculation of intraocular lens during cataract surgery.Topolyzer was often used for the measurement of Q value,and recently Topcon KR-1W and iTrace were applied in ophthalmology.However,whether the measured values are interchangeable is unclear.Objective This study was to assess the difference and consistency of corneal Q values measured by Topcon KR-1W,iTrace and Topolyzer.Methods Corneal Q values were measured on 100 right eyes of 100 healthy subjects under the approval of Ethic Committee of the Sixth Hospital Affiliated to Shanghai Jiaotong University and informed consent of each subject from November to December in 2014 with Topcon KR-1W,iTrace and Topolyzer.Three valid measurements were obtained for each device,and the average values from each device were calculated.The difference of the outcomes among the instruments was compared by repeated measures analysis of variance (ANOVA),and the consistency among the outcomes from different apparatus was analyzed by Bland-Altman plots.Results The mean corneal Q values were-0.184-±0.112,-0.117±0.167 and-0.269±0.117 from Topcon KR-1W,iTrace and Topolyzer,respectively,with a significant difference among them (P ＜ 0.001).The measured Q value by Topcon KR-1W was 0.085±0.010 larger than that by Topolyzer,and the Q values by iTrace was 0.152± 0.014 larger than that by Topolyzer,while the Q values obtained by Topcon KR-1W was 0.067±0.016 smaller than that by iTrace (all at P＜0.05).The 95％ confidence interval of the values between Topcon KR-1W and iTrace,Topcon KR-1W and Topolyzer,iTrace and Topolyzer were-0.106 to-0.028,0.060 to 0.109 and 0.118 to 0.186,respectively.Bland-Altman plots showed that 6％,6％ and 5％ values were outside of 95％ agreement of limit (LoA) between Topcon KR-1W and iTrace,iTrace and Topolyzer or KR-1W and Topolyzer,respectively,with the maximal differences of 0.28,0.43 and 0.38.Conclusions Corneal Q values measured by Topcon KR-1W and iTrace are larger than those measured by Topolyzer.Due to the poor agreements among the corneal Q values by the 3 kinds of devices,they are not interchangeable in clinical applications for the measurement of corneal Q value.

AIM: To explore the predisposing factors, population characteristics and clinical features of severe fungal keratitis.
METHODS:The data of 233 cases 233 eyes of severe fungal keratitis in my hospital from January, 2008 to November, 2013 was retrospectively reviewed. The predisposing factors, population characteristics and clinical features were analyzed.
RESULTS: In 233 cases of severe fungal keratitis, the number of male patients was 153 ( 65. 7%) and the number ratio of male to female was 1. 9:1. The average age of them was (52. 7±11. 3), and most of them were middle-aged and elderly people living in the rural area (78. 1%) and were farmers ( 66. 1%) with low literacy (59. 7%). In 233 cases, 188 cases (80. 7%) possessed a clear history of ocular trauma, mainly caused by plant-based trauma (60. 9%). 90 cases (57. 3%) were infected with Fusarium, and 47 cases ( 29. 9%) by Aspergillus. The main treatment of severe fungal keratitis was surgery (87. 9%). 83 cases ( 52. 9%) were treated with penetrating keratoplasty, and in Fusarium and Aspergillus infected patients with severe fungal keratitis, 58. 4% ( 80/137 ) were performed with penetrating keratoplasty. In addition, patients treated with eye enucleation or evisceration, 68. 4% (13/19) were infected with Fusarium species.
CONCLUSION: Patients with severe fungalkeratitis in our hospital are mainly elderly male farmers living in rural, because of low economic condition and poor diagnosis consciousness. The main pathogens are Fusarium and Aspergillus species, and the major treatment is penetrating keratoplasty. Most of patients with poor clinical outcomes are infected with Fusarium species.

This study is to investigate the antitumor activity of ophiopogonin B (OP-B). MTT assay, flow cytometric analysis, acridine orange staining, Lyso-Tracker Red staining and HeLa-GFP-LC3 transfect cells assay were used to detect the proliferation activity, apoptosis and autophagy of HeLa cells. The results showed that OP-B exerted potent antiproliferative activity on HeLa cells, the cell growth inhibition effect of OP-B was not due to apoptosis and OP-B could induce autophagy of HeLa cells. OP-B also induced the protein expression up-regulation of Beclin-1 and promoted LC3 I transformation LC3 II, which were representative proteins of autophagy. Furthermore, 3-MA, an inhibitor of autophagy, not only inhibited OP-B-mediated autophagy but also almost completely reversed the antiproliferative effect of OP-B, suggesting that the growth inhibition effect of OP-B was autophagy dependent. Western blotting demonstrated that OP-B inhibited the phosphorylation of Akt and its' downstream vital protein, such as mTOR and p70S6K. In addition, OP-B also induced the protein expression up-regulation of PTEN, which is a negative regulation protein for Akt/mTOR signaling pathway. However, OP-B did not affect the protein expression of total Akt. Collectively, the antitumor effects of OP-B were autophagy-dependent via repression Akt/mTOR signaling pathway. Therefore, OP-B is a prospective inhibitor of Akt/mTOR and may be used as an alternative compound to treat cervical carcinoma.
Adenine ; analogs & derivatives ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; drug effects ; Beclin-1 ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; HeLa Cells ; Humans ; Membrane Proteins ; metabolism ; Microtubule-Associated Proteins ; metabolism ; Ophiopogon ; chemistry ; PTEN Phosphohydrolase ; metabolism ; Phosphorylation ; Plants, Medicinal ; chemistry ; Proto-Oncogene Proteins c-akt ; metabolism ; Ribosomal Protein S6 Kinases, 70-kDa ; metabolism ; Saponins ; pharmacology ; Signal Transduction ; drug effects ; Spirostans ; pharmacology ; TOR Serine-Threonine Kinases ; metabolism ; Up-Regulation

Treatment with the combination of Chinese herbs and cytotoxic chemotherapies showed a higher survival rate in clinical trials. In this report, the results demonstrated that the tanshinone II A, a key component of Salvia miltiorrhiza bunge, when it is combined with the cytotoxic drug cisplatin showed synergistic antitumor effects on human prostate cancer PC3 cells and LNCaP cells in vitro. Antiproliferative effects were detected with MTT assay. Cell cycle distribution and apoptosis were detected by flow cytometer. Protein expression was detected by Western blotting. The intracellular concentration of cisplatin was detected by high performance liquid chromatography. The results demonstrated that tanshinone II A significantly enhanced the antiproliferative effects of cisplatin on human prostate cancer PC3 cells and LNCaP cells with the increase of the intracellular concentration of cisplatin. These effects were correlated with cell cycle arrested at S phase and cell apoptosis. The apoptosis might be achieved through death receptor pathway and mitochondrial pathway. Furthermore, the Bcl-2 family members were also involved in this apoptotic process. Collectively, these results indicated that the combination of tanshinone II A and cisplatin had a better treatment effect in vitro not only on androgen-dependent LNCaP cells but also on androgen-independent PC3 cells.
Androgens ; metabolism ; Antineoplastic Agents ; pharmacology ; Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Diterpenes, Abietane ; isolation & purification ; pharmacology ; Drug Synergism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Humans ; Male ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Prostatic Neoplasms ; metabolism ; pathology ; Salvia miltiorrhiza ; chemistry

Objective To investigate the effects of Ulinastatin (UTI) on the expression of NF-κB and ET-1 in rats with acute necrotizing pancreatitis (ANP)-associated lung injury and morphology of lung tissue.Methods 60 Sprague-Dawley rats were randomly divided into 3 groups with 20 rats in each group,including sham operation (SO) group,ANP group and UTI group.ANP was induced by injection of 5% sodium taurocholate (1 ml/kg) into pancreatic duct;normal saline was injected for SO group with same amount.UTI was injected for UTI group with the amount of 10 000 U/L via tail vein after ANP induction.The rats were sacrificed 24 h later.The contents of serum amylase,TNF-α and wet/dry weight ratio of the lung were measured.The expression of NF-κB and ET-I protein were detected by immunohistochemical method.The level of apoptosis was detected by TUNEL Results The contents of serum amylase,TNF-α,and wet/dry weight ratio of the lungin in UTI group at 24 hours were (5 648±378)IU/L,( 89.19±3.54) ng/L and 4.55 ±0.07,respectively;which were significantly lower than the corresponding (6 799±437 )IU/L,(183.30±8.18) ng/L and 4.89±0.20 in ANP group (P＜0.05 ).There was no NF-κB and ET-1 expression,and no apoptosis was present in SO group.The positive rates of NF-κB and ET-1 in UTI group were (19±3 ) % and(8±1) %,respectively,the corresponding values in ANP group were (25±2) % and (13±1 ) %,respectively (P ＜ 0.05 ).The level of apoptotie index in UTI group was 13.75±1.25,which was higher than that (6.90±0,85) in ANP group ( P ＜ 0.05 ).Conclusions The high expression of NF-κB and ET-1 in lung tissue may cause lung injury.UTI could ameliorate the microcirculation and lung injury caused by inflammation.

Objective To investigate the effect of diabetes on hyperlipidemic acute panereatitis. Methods The clinical data of 96 patients with hyperlipidemic acute pancreatitis from Jun 1996 to Jun 2006 were retrospectively reviewed. Results Of all 96 patients, 21.9% (21/96) suffered from severe acute pancreatitis ( SAP ), 78. 1% ( 75/96 ) suffered from mild acute pancreatitis ( MAP ), respectively. Twenty-four patients (25%) were diabetics. Triglyceride level, obesity rate, SAP cases and APACHE Ⅱ scores in patients with diabetes were significantly higher than those of no-diabetes patients( P < 0. 05 ). The glucose level, diabetes of history length, triglyceride level and fat were the independent factors for prognosis of acute pancreatitis with hyperlipidemia by the Cox model analysis. With the increasing of APACHE Ⅱ score, the blood glucose level of patients increased. Blood glucose level in a short period of time does not correlate with lipid levels. Conclusions The level of blood glucose is related with hyperlipidemic acute pancreatitis, the history of the diabetes to a certain extent influences the development of hyperlipidemic acute pancreatitis.

OBJECTIVETo compare the difference in the clinical efficacy on premature ovarian failure (POF) between the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism.

METHODSSixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral administration of medroxyprogesterone acetate tablets. In a catgut implantation + western medication group, 33 cases were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan (PC 6), Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone (FSH) and estradiol (E2) were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups.

RESULTSThe scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups (P < 0.01, P < 0.05). In the 6-month follow-up visit after treatment, the result in the catgut implantation + western medication group was better than that in the western medication group (8.17 +/- 1.19 vs 13.68 +/- 1.08, P < 0.01). FSH was reduced after treatment in the two groups (all P < 0.01) and E2 was increased (all P < 0.05). The curative and remarkably effective rates were 75.8% (25/33) and 81.8% (27/22) after treatment and in the follow-up visit in the catgut implantation + western medication group, which were better than 67.9% (19/28) and 53.6% (15/28) in the western medication group separately (P < 0.05, P < 0.01).

CONCLUSIONThe acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prostheses and Implants ; Treatment Outcome ; Young Adult

Objective To observe the efficacy and safety of endoscope and laparoscope in treatment of acutebiliary pancreatitis.Methods 84 patients with acute biliary pancreatitis from January 2010 to January 2014 in our hospital during treatment were randomly divided into the study group and control group according to the random num-ber table methods,42 cases in each group.The control group was treated with conservative treatment of department of internal medicine,while the study group was treated with duodenoscopy combined with laparoscopy.To observe and compare the efficacy and adverse reactions of two groups.Results Temperature returned to normal time,abdominal pain relief time,recovery time of amylase in urine,recovery time of biochemical index,hospitalization time and cost of hospitalization of the study group after treatment were (3.44 ±1.63)d,(4.73 ±1.12)d,(7.82 ±3.31)d,(9.81 ± 6.42)d,(12.43 ±4.61 )d,which were significantly lower than (5.94 ±2.43)d,(7.53 ±2.12)d,(11.72 ± 2.21)d,(18.41 ±8.62)d,(20.33 ±6.21)d of the control group(t =3.90,4.02,4.26,4.50,5.01,all P <0.05). 2 cases of the study group occured biliary tract bleeding,2 cases with pancreatic pseudocyst,1 case with wound infec-tion,there was no recurrence,the incidence rate of adverse reaction was 11.90%;3 cases of the control group after treatment occurred pancreatic pseudocyst,2 cases with abdominal cysts,5 cases with recurrence,1 case with acute respiratory distress syndrome (ARDS),1 case with renal failure,the incidence rate of adverse reactions was 28.57%, which of the control group was significantly higher than the study group (χ2 =4.21,P <0.05 ).Conclusion Duodenal endoscopy combined with laparoscopy has good clinical effect,shorter hospitalization time,less cost,less adverse reaction and the recurrence rate is low in treatment of acute biliary pancreatitis,which has high application value.

Objective To explore the diagnostic value and optimal cut-off point of symptom index (SI) in gastroesophageal reflux-induced chronic cough (GERC).Methods The recordings of multichannel intraluminal esophageal impedance and pH monitoring were retrospectively analyzed in 118 patients with suspicious GERC.SI for all the refluxes,acid reflux and non-acid reflux was calculated respectively by analyzing the temporal association between detected reflux and cough recorded on diary card.Based on the favorable response to the anti-reflux therapy,the diagnostic value for GERC of SI was evaluated and compared with that of the symptom association probability (SAP).Results GERC was definitely determined in 100 patients (84.7％).When SI for all the refluxes was used for the diagnosis of GERC,the cut-off point of ≥45％ had the highest diagnostic efficacy,with the sensitivity of 56.0％,the specificity of 83.3％and Youden index of 0.393.SI for acid or non-acid reflux had the same optimal cut-off point of ≥30％ and presented with the similar efficacy in the diagnosis of acid or non-acid GERC.Compared with SAP of ≥75％,SIforall the refluxes of ≥45％ had a lower sensitivity (56.0％ vs 75.0％,x2 =7.988,P=0.005),a higher specificity (83.3％ vs 44.4％,x2 =5.900,P =0.015) and the comparable positive or negative predictive value in the diagnosis of GERC.The diagnostic accuracy for GERC was further improved when combining SI for all the refluxes with SAP.Conclusion SI for all the refluxes has a diagnostic value similar to SAP and its optimal cut-off point for GERC may be ≥45％.