Objective To investigate the value of predicting testicular viability following unilateral testicular torsion by color-Doppler ultrasound (CDU). Methods The clinical manifestations, intraoperative findings and scrotol CDU appearances before and after operation of 42 cases with testicular torsion were compared. According to a bleeding test intraoperatively, testicular viability was divided into A-D level. Testis of level A-C would be saved .while the level D removed. Testicular viability assessed by follow-up CDU was then classed into Ⅰ-Ⅲ level. In Ⅰ-Ⅱ level, the salvaged testis were recovery ultimatelybut atrophy in level Ⅲ. Results Seventeen cases of the 42 underwent orchidopexy and the remaining 25 cases underwent orchidectomy. As followed up, however, testis in only 7 cases were recovered, including 2 cases in level A,3 cases in level B and 2 cases in level C. respectively. The preoperative scrotal CDU appearances of the recovered testis were mainly as follows: ① Homogeneous parenchyma with decreased or disappeared blood perfusion. ②Sheet or radial hypoechoic in the local testis but with preserved blood perfusion in most area else. Testis in the remaining 10 patients, including 8 cases in level C and 2 cases in level D, respectively, were atrophy finally. And large radial hypoechoic or diffuse inhomogeneous echo with none or a small amount of blood supply on the edge parenchyma were found during their preoperative CDU (similar CDU performance was present in the orchidectomy group. The CDU appearances of contralateral testes both in orchidopexy and orchidectomy group were not obviously abnormal during follow-up. Conclusions The scrotal CDU examination is competent to predict testicular viability after detorsion. In addition, timely operation would be a key to CDU evaluation.

OBJECTIVETo explore the influence of different strength intermittent treadmill training of growth period rats on the bone metabolism, so as to provide the training intensity of teenagers to set theory support.

METHODSSelect 70 male four weeks Wistar rats according to body weight randomly divided into seven groups (n = 10): the control group and the exercise group. According to the VO2max the exercise group was divided into 6 groups: 65%, 70%, 75%, 80%, 85% and 90% group. Nine weeks treadmill training, training six days a week, each group of training three times, each time not less than 10min, the interval was 30 min. The last movement after 24 h, took the femur and blood to measured the bone mineral density (BMD), bone mass (BMC) and alkaline phosphatase (AKP), resist tartaric acid acidic phosphatase (Str-ACP).

RESULTS1. The femoral BMD (0.1393 +/- 0.0031), BMC (0.4525 +/- 0.0335) of 70% group were significantly higher than those in the control group (BMD: 0.1200 +/- 0.0095, BMC: 0.3238 +/- 0.0485) and the other sports group (65% BMD:0.1339 +/- 0.0062, BMC: 0.4058 +/- 0.0492, 75% BMD: 0.1296 +/- 0.0015, BMC: 0.3869 +/- 0.0254, 80% BMD: 0.1223 +/- 0.0082, BMC: 0.3454 +/- 0.0483, 85% BMD: 0.1250 +/- 0.0044, BMC: 0.3731 +/- 0.0381, 90% BMD: 0.1171 +/- 0.0047, BMC: 0.3051 +/- 0.0286) (P < 0.05), the femoral BMD, BMC of 90% group were lower than those of the control group, the other in the exercise group were higher than those in the control group; 2. Serum AKP in the exercise group were significantly higher than those in the control group, the group of 65% (41.015 +/- 2.114), 70% (46.035 +/- 2.611), 75% (43.834 +/- 3.155), and 80% (38.043 +/- 4.073) were very significantly higher than those in the control group (26.875 +/- 1.188) (P < 0.01); 70% group and 75% group were significantly higher than those in the 80% group , 85% group and 90% group, while 70% group serum AKP level were significantly higher than those in 65% group (P < 0.05), it showed that 70% of the VO2 max training intensity of osteoblasts was most active. The serum Str-ACP of exercise group were significantly higher than those in the control group, along with the increase of the training intensity, serum Str-ACP level was rising and the group of 80% (22.430 +/- 1.591), 85% (23.990 +/- 1.870), and 90% (28.009 +/- 1.839) serum of Str-ACP were significantly higher than those in the group of 65% (18.503 +/- 2.429), 70% (16.447 +/- 2.120) and 75%(17.769 +/- 1.642) ( P < 0.05), the group of 90% serum Str-ACP were significantly higher than those in the group of 80% and 85% (P < 0.05).

CONCLUSIONThe training of 70% of the VO2max, moderate intensity intermittent running, make the growth period rat bone mass and bone mineral density to increase obviously.

Animals ; Bone Density ; Bone Development ; Bone and Bones ; metabolism ; Male ; Physical Conditioning, Animal ; Rats ; Rats, Wistar ; Resistance Training

OBJECTIVETo compare the impact of unilateral acute testicular ischemia on the hemodynamics and histology of the contralateral testis of the rabbits under consistent anesthesia with that of the rabbits in the conscious state.

METHODSForty-two healthy male white rabbits were randomly divided into an anesthetic group (Group A) to receive injection of sodium pentobarbital (PS) and a non-anesthetic group (Group B), each including a control group of 5 animals (A0 and B0), an incomplete testicular ischemia group of 8 (A1 and B1), and a complete testicular ischemia group of 8 (A2 and B2). Testicular ischemia models were constructed by color Doppler ultrasonography. Contrast-enhanced ultrasound (CEUS) was used to observe the perfusion of the contralateral testes before and after ligating and loosening the unilateral spermatic cord in each experimental group. The control animals also underwent CEUS and measurement of the heart rate (HR) and blood pressure (BP) at the corresponding time. Histological structure changes in the contralateral testes of the rabbits were observed in both anesthetic and conscious states.

RESULTSPS anesthesia markedly suppressed the HR and BP of the rabbits. The parameters in Groups of A0, A1 and A2 showed no statistically significant changes after unilateral ligation of the spermatic cord, while Groups B1 and B2 displayed significantly decreased peak-base difference (PBD) and prolonged arrival time (AT) and half time of descending peak intensity (HT). Groups A1, B1 and B2 showed significantly increased PBD and prolonged HT shortly after loosening the spermatic cord. Focal pathological and ultrastructural changes were observed in the contralateral testes of the ischemic rabbits, but no significant difference was found in Johnson's score in comparison with the controls. The apoptotic cells were remarkably increased in Groups A1, B1 and B2.

CONCLUSIONAcute testicular ischemia may induce injury to the contralateral testis to some degree, and a reflexive sympathetic response may cause hemodynamic changes in the non-anesthetic state. And the neural and vascular inhibitory effects of anesthesia could make insignificant changes of blood perfusion in the contralateral testis.

Animals ; Disease Models, Animal ; Ischemia ; diagnostic imaging ; pathology ; Male ; Rabbits ; Reperfusion Injury ; diagnostic imaging ; pathology ; Testicular Diseases ; diagnostic imaging ; pathology ; Testis ; blood supply ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo evaluate relative factors affecting the efficiency of ultrasound-guided compression repair in iatrogenic femoral artery pseudoaneurysm.

METHODSUltrasound-guided manual compression was performed in 42 patients of iatrogenic femoral artery pseudoaneurysm from June 2004 to June 2010. There were 28 male and 14 female patients, with a mean age of (52 ± 5) years. These patients were presented with femoral artery pseudoaneurysm after catheterisation procedure by percutaneous femoral artery puncture and confirmed by color doppler flow image. Ultrasound-guided manual persistent compression with probe was performed at the puncture site between femoral artery and pseudoaneurysm, until completely thrombosis of pseudoaneurysm, whereas the pseudoaneurysm failed to complete closure required surgical repair.

RESULTSOut of 42 patients, 34 patients (81.0%) were successfully treated by compression resulted in completely thrombosis. There were 8 (19.0%) failures conversion to surgery. Factors associated with success were size of pseudoaneurysm (< 25 mm, 25 - 40 mm, > 40 mm; χ(2) = 13.956, P = 0.001), anti-coagulation status (χ(2) = 5.578, P = 0.010), depth of artery break (< 50 mm, 50 - 80 mm, > 80 mm; χ(2) = 14.055, P = 0.001), pseudoaneurysm communicated with common femoral artery, superficial femoral artery and profunda femoral artery (χ(2) = 8.968, P = 0.011), as well as days to presented with pseudoaneurysm (< 3 d, ≥ 3 d; χ(2) = 5.733, P = 0.012). In multivariate Logistic regression analysis, success by compression was associated with size of pseudoaneurysm (WALD = 5.34, P = 0.021) and with depth of artery break (WALD = 4.84, P = 0.028).

CONCLUSIONThe ultrasound-guided compression repair of iatrogenic femoral artery pseudoaneurysm is safe, convenient, inexpensive and reliable treatment.

Aged ; Aged, 80 and over ; Aneurysm, False ; surgery ; therapy ; Female ; Femoral Artery ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Ultrasonography, Interventional

OBJECTIVETo investigate the protective effect of ischemic postconditioning (IP) against different degrees of testicular ischemia-reperfusion (IR) injury in rabbits.

METHODSForty-two white male rabbits were equally randomized into 7 groups: a control, 3 IR (R1, R2 and R3), and 3 IP (P1, P2 and P3) groups. Testicular models of different degrees of ischemia were established in the IR and IP groups. Before reperfusion, ultrasonography showed homogeneous echoes with slightly decreased blood flow in R1 and P1, heterogeneous echoes with obviously decreased blood flow in R2 and P2, lamellar or fragmental low echo areas absent of blood flow signals in R3 and P3. Then the IR groups were directly subjected to perfusion, and the IP groups to 3 episodes of 30-second reperfusion followed by 30-second ischemia. All the groups underwent contrast-enhanced ultrasonography (CEUS) before reperfusion and, after 3 days, examined for the contents of malonaldehyde (MDA), superoxide dismutase (SOD) and histology, and observed for the pathological changes of the testicular tissue.

RESULTSBefore reperfusion, no significant differences were found in the CEUS parameters beta, time-to- peak (TTP), peak-base intensity (PBD) and half of declining time (DT/2) between R1 and P1, R2 and P2, and R3 and P3 (P>0.05). There were remarkable differences in MDA and SOD between R1 and P1, and R2 and P2 (P<0.05), but not between R3 and P3 (P >0.05). Johnson's score, apoptosis index and ultrastructure showed marked differences between R1 and P1 (P<0.05) but not between R2 and P2, and R3 and P3 (P >0.05).

CONCLUSIONIP can attenuate IR-induced testis injury, but the effect varies with the degree of ischemia, and its pathological manifestation differs from the biochemical one.

Animals ; Ischemic Postconditioning ; Male ; Malondialdehyde ; analysis ; Rabbits ; Reperfusion Injury ; Superoxide Dismutase ; analysis ; Testis ; pathology

OBJECTIVEThe aim of this study was to explore the frequency of mDC and pDC and expression of surface markers of the neonates and to discuss the effect of different status of HBV infection of mother on biological characteristics of DC.

METHODSUmbilicus cord blood in neonates of HBeAg positive HBV infected mother, HBeAg negative HBV infected mother, and normal mother were collected respectively; peripheral blood of healthy adults were selected as control group. Flow cytometry was employed to detect frequency of the mDC and its expression of CD86, frequency of pDC and its expression of CD80, CD83, CD86, and FlowJo software was used to compare these indicators among the groups.

RESULTSCompared with control group, the frequency of mDC of cord blood (0.29 +/- 0.16 vs 0.81 +/- 0.17), CD86 positive rate of mDC (10.72 +/- 10.01 vs 32.13 +/- 7.46), the frequency of pDC (0.15 +/- 0.07 vs 0.30 +/- 0.07), and CD86/CD83 positive rate of pDC (31.61 +/- 12.81 vs 74.96 +/- 9.78; 42.66 +/- 20.83 vs 82.00 +/- 6.94) were lower (t = -7.86, P = 0.00; t = -5.36, P = 0.00; t = -5.43, P = 0.00; t = -8.49. P = 0.00; t = -4.90, P = 0.00).

CONCLUSIONSThe frequency of mDC and pDC in umbilical cord blood was lower than the peripheral blood of healthy adult, which was the possible mechanism of newborns easier to chronicity after the infection of hepatitis B virus. A significant correlation was found between different status of HBV infection and costimulatory molecule CD86 positive rate of mDC, but not for the frequency of mDC and pDC, and the expression of pDC molecules.

Adult ; B7-2 Antigen ; analysis ; Dendritic Cells ; immunology ; Female ; Fetal Blood ; immunology ; Hepatitis B, Chronic ; immunology ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Infectious ; immunology

The paradigm of a real world study has become the frontiers of clinical researches, especially in the field of Chinese medicine, all over the world in recent years. In this paper, ethical issues which probably exist in real-world studies are raised and reviewed. Moreover, some preliminary solutions to these issues such as protecting subjects during the process of real-world studies and performing ethical review are raised based on recent years' practices to enhance the scientificity and ethical level of real-world studies.
Biomedical Research ; ethics ; methods ; Humans

Objectives: To compare the effect of 2 different occlusion devices for treating cryptogenic stroke (CS) patients combining patent foramen ovale (PFO) and large right-to-left shunt (RLS). Methods: A total of 123 CS patients combining PFO and large RLS treated in our hospital from 2013-05 to 2016-08 were enrolled. All patients received percutaneous PFO interventional closure, based on different occlusion devices, the patients were divided into 2 groups: Cardi-O-fix PFO occluder group, n=80 and Amplatzer PFO occluder group, n=43. CS diagnosis was confirmed by 3 experienced neurologists via medical imaging examination; PFO and large RLS were diagnosed by transthoracic echocardiography and right heart contrast echocardiography. The baseline features, clinical symptoms, operation and follow-up data were reviewed to observe the efficacy of 2 occlusion devices. Results: Each group had 1 patient suffered from paroxysmal atrial fibrillation after the operation; 1 patient in Cardi-O-fix PFO occluder group had inguinal hematoma. No stroke recurrence, no death during follow-up period; the residual shunt was similar between 2 groups. Conclusions: PFO occlusion was beneficial for preventing stroke recurrence in CS patients combining PFO and large RLS. The safety and efficacy were similar in Cardi-O-fix and Amplatzer PFO occlusion devices.

Background/Aims: Four-week treatment of linvencorvir (RO7049389) was generally safe and well tolerated, and showed anti-viral activity in chronic hepatitis B (CHB) patients. This study evaluated the efficacy, safety, and pharmacokinetics of 48-week treatment with linvencorvir plus standard of care (SoC) in CHB patients. Methods: This was a multicentre, non-randomized, non-controlled, open-label phase 2 study enrolling three cohorts: nucleos(t)ide analogue (NUC)-suppressed patients received linvencorvir plus NUC (Cohort A, n=32); treatment-naïve patients received linvencorvir plus NUC without (Cohort B, n=10) or with (Cohort C, n=30) pegylated interferon-α (Peg-IFN-α). Treatment duration was 48 weeks, followed by NUC alone for 24 weeks. Results: 68 patients completed the study. No patient achieved functional cure (sustained HBsAg loss and unquantifiable HBV DNA). By Week 48, 89% of treatment-naïve patients (10/10 Cohort B; 24/28 Cohort C) reached unquantifiable HBV DNA. Unquantifiable HBV RNA was achieved in 92% of patients with quantifiable baseline HBV RNA (14/15 Cohort A, 8/8 Cohort B, 22/25 Cohort C) at Week 48 along with partially sustained HBV RNA responses in treatment-naïve patients during follow-up period. Pronounced reductions in HBeAg and HBcrAg were observed in treatment-naïve patients, while HBsAg decline was only observed in Cohort C. Most adverse events were grade 1–2, and no linvencorvir-related serious adverse events were reported. Conclusions 48-week linvencorvir plus SoC was generally safe and well tolerated, and resulted in potent HBV DNA and RNA suppression. However, 48-week linvencorvir plus NUC with or without Peg-IFN did not result in the achievement of functional cure in any patient.

[Objective]To establish stable glioma stem cells with a high expression level ofred fluorescent protein (RFP) in vitro.[Methods]The glioma stem cells SU2 were transfected with lentivirus vector containing RFP gene;cell expression of RFP was observed by fluorescent microscopy;RFP-positive glioma stem cells were sorted out by fluorescence-activated cell sort.The transfection efficiency of SU2 cell before transfection and 20-passaged RFP-SU2 cells after transfection were assayed by flow cytometry.Dynamic viewing was performed to observe the cell division and cloning of RFP-SU2 single cell;RFP -positive cells were collected and immunostained with antibodies against CD133 and nestin.[Results] PFP-SU2 cells grew as levitated sphere with high RFP expression;the transfection efficiency of SU2 cell before transfection was only 1.5％,while that of20-passaged RFP-SU2 cells after transfection reached to 75％.RFP-SU2 single cell could proliferate into brain tumor stem cell spheres,having the abilities of self-renewing and clonal proliferation.Immunofluorescence showed positiveCDt 33 and nestin expressions in RFP-SU2 cells.[Conclusion] A SU2/RFP cell line marked by RFP is established;and it can serve as a promising tool for further basic research.