Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods To review the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy from September 2013 to September 2015.There were 14 males and 21 females, aged 15-70 years, with an average of 45.8 years.Preoperative CT scan was performed to determine the size, shape and location of the tumor.Tumor diameter 10-60 mm, average 31 mm.Results 35 operations were successfully accomplished via the posterior approach.The operation time was 38-138 min (mean 70.1 min) ,and the drainage tube indwelling time was 1-5 d(average 2.1 d) ,the hospital stay was 2-6d(average 3.7 d).Total hospital costs were 14 789-31 992 yuan, average of 21 239 yuan.No complications occurred during the perioperative period.Conclusions Posterior retroperitoneoscopic adrenalectomy might provide clear anatomical views.It could be a safe and effective operation for the clinical treatment of adrenal tumors.

Objective To evaluate the performance of a prediction system built with LASSO regression model and Baidu search query data.Methods Based on a strategy using a combination of Bagging and multi-measure optimization method,this study proposed an ensemble LASSO regression model which had an obviously improved performance,and applied it to predict the epidemics of influenza in China.Results The results showed that the improved model had significantly smaller prediction error rates than that of the conventional LASSO regression model for influenza cases during the study period of 2011-2015.This study designed an open source R package,SparseLearner,which was conveniently used and further developed.Conclusion The combination of Bagging and multi-measure optimization method is an efficient strategy to improve the performance of LASSO regression model.The proposed ensemble LASSO regression model in this study can be applied for the prediction of infectious diseases epidemics.

Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods From September 2013 to September 2015,the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy were reviewed.There were 14 males and 21 females,aged 15-70 years,with the average of 45.8 years.Preoperative CT scan showed 19 adrenal tumors in the left side,16 in the right side,and one case with the left adrenal adenoma combining with right renal cyst.Tumor diameter is between 10 ～ 60mm,with the average of 31mam.Twenty-two cases were diagnosed as primary aldosteronism,4 pheochromocytoma,and 9 non-functional adrenal tumor.The posterior retroperitoneoscopic adrenalectomy were performed in all of the cases,which are under general anesthesia with tracheal intubation and prone position with hip joints and knee joints flexion of 90.Results Thirty-five operations were successfully completed via the posterior approach demonstrating clear anatomical layers.The operation time was 38-138min(mean 70 min),the drainage tube indwelling duration was l-Sd(average 2d),and the hospital stay was 2-6d (average 4d).Total costs of hospitalization were 14 789-31 992 yuan RMB,with an average of 21 239 yuan RMB.No complications occurred during the perioperative period.The average follow-up was 11 months,and no complications such as tumor recurrence occured.Conclusions Retroperitoneoscopic adrenalectomy provided clear anatomical views.It could be a safe and effective operation for the treatment of adrenal tumors.

Objective To explore the relationship between serum cardiac troponin I (cTnI) and high sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-alpha (TNF-α ) in patients with acute organophosphorus pesticide poisoning (AOPP) and their clinical significance.Methods One hundred and twelve patients with AOPP (without sudden death ) were as AOPP group.One hundred and twelve healthy controls were as control group.Serum cTnI,hs-CRP and TNF-α levels were determined by ELISA and compared between two groups.The relationship between serum cTnI and hs-CRP,TNF-α was analyzed.Time for atropinization and acetylcholinesterase activity recovery and days of hospitalization were observed.The effectiveness of AOPP patients in different serum cTnI levels was compared.Results Serum cTnI,hs-CRP and TNF- α levels in AOPP group[0.75 (0.26,0.99) μ g/L,11.57(5.13,21.62) mg/L,( 12.36 ±5.22) μ g/L] were higher than those in control group[0.01 (0,0.03) μ g/L,3.62(2.31,6.80) mg/L,(7.33 ±4.31 ) μ g/L] (P ＜ 0.01 ).Serum cTnI levels were positive correlation with serum hs-CRP and TNF- α levels in AOPP patients (r =0.53,0.62,P ＜ 0.01 ).Time for atropinization and acetylcholinesterase activity recovery and days of hospitalization in higher serum cTnI levels patients ( 56 cases ) [(7.31 ± 1.96),( 15.29 ± 3.66 ),(17.23 ± 3.62) d] was longer than that in lower serum cTnI levels patients (56 cases)[(5.32 ± 1.03),( 11.32 ± 2.59),( 13.66 ± 3.03) d](P＜ 0.01).Conclusions Cardiac insults in AOPP patients are related to inflammation.Sudden death-free AOPP patients with higher cTnI levels have less response to treatments.

BACKGROUND:Bipolar femoral head prosthesis has achieved the desired repair effect in patients with femoral neck fracture, but there is stil much controversy on the biomechanical properties of bipolar artificial femoral head prosthesis. OBJECTIVE:To compare biomechanical properties of the bipolar femoral head prosthesis replacement and internal fixation in the repair of femoral neck fracture in the elderly. METHODS:Twenty-three (46 sides) senile femoral neck fracture specimens were analyzed and randomized into internal fixation group(n=23)and bipolar femoral head prosthesis replacement group (n=23). Specimens in the internal fixation group underwent conventional metal implant fixation. Specimens in the bipolar femoral head prosthesis replacement group underwent bipolar femoral head prosthesis replacement. Mechanical properties of femoral prosthesis stem were tested on universal testing machine. Biomechanical properties after bipolar femoral head prosthesis replacement and internal fixation were compared. RESULTS AND CONCLUSION:(1) The maximum loadwassignificantly higher in the bipolar femoral head prosthesis replacement group than in the internal fixation group (P< 0.05). The maximum load trend images showed that the maximum load was significantly higher in the bipolar femoral head prosthesis replacement group than in the internal fixation group (P< 0.05). (2) The displacement in axial pul test was significantly shorter in the bipolar femoral head prosthesis replacement group than in theinternal fixation group (P< 0.05). The displacement trend images exhibited that the displacement in axial pul test was significantly shorter in the bipolar femoral head prosthesis replacement group than in the internal fixation group (P< 0.05). (3) These findings suggest that compared with the implant, bipolar femoral head prosthesis replacement in the repair of femoral neck fracture in the elderly is more stable, has better repair effects, can elevate hip function and obtain good initial stability.

Objective To evaluate the teaching activity on public health courses from clinical medical students in our university in order to provide a scientific basis for improving the curriculum design and teaching reform. Methods The “Questionnaire on Teaching Evaluation in Public Health Courses”, including teaching attitude, teaching content, teaching methods and teaching effectiveness was designed, and a general investigation was conducted among the clinical medical students of five-year program (840 students) and eight-year program (278 students) in these three aspects to under-stand students' evaluation to the course, who had finished the public health courses, including Preven-tive Medicine, Medical Statistics and Epidemiology (hereinafter referred to as: statistics, epidemiology, prevention) in Sun Yat-sen University. Statistical analysis was made using SPSS 13.0 software. Data analysis methods contain descriptive analysis, T-test, ANOVA, LSD, SNK, hierarchical logistic regres-sion analysis, etc. Results The overall score of teaching evaluation is (4.04±0.60). Differences exist between the evaluation in the five-year medical students and the eight-year medical students. The P values were 0.000 (Medical Statistics), 0.269 (Epidemiology), 0.047 (Preventive Medicine). The com-parison of scores among the four dimensions shows: Teaching effectiveness < Teaching methods β' effectiveness. Conclusions Clinical Medical students' overall evaluation on the public health courses offered by this university was good. Teaching effectiveness and teaching methods still need improvement. Teaching contents are the most influential factor of overall teaching satisfaction, followed by teaching effectiveness.

Objective To discuss the relativity of dyschesia with the change of puborectalismuscle.Methods 68 patients with dyschesia were compared with 68 healthy volunteers at lithotomy position undergoing 3D ultrasonography on resting,contracting and maximum exertion phase respectively.Three dimensionally reconstructed images were reconstructed and pubo-rectal angle and the thickness of puborectalis muscle at 6 o'clock position were measured.Results The pubo-rectal angle of the study group and control group had no significant differences at either resting [(86 ± 8) ° vs.(86 ± 8)°] or contracting phases [(88 ± 9) ° vs.(86 ± 7) °] (t =-0.145,t =0.434,P ＞ 0.05).While at maximum exertion the differences were significant [(80 ± 6) °vs.(95 ± 5) °,t =-5.397,P ＜ 0.05].The d-value of pubo-rectal angle between maximum and resting exertion statistically different [(6 ± 3) °,(-9 ± 7) °,t =5.551,P ＜ 0.05].The thickness of puborectalis muscle between the two groups differed statistically significant only at maximum exertion phase [(4.60 ± 0.60) mm vs.(3.97 ± 0.32) mm,t =6.872,P ＜ 0.05].The d-value of the thickness of puborectalis muscle between maximum and resting exertion were statistically different (t =-11.474,P ＜ 0.05).Conclusions The pubo-rectal angle of the study group is smaller at maximum exertion than the control group.The thickness of puborectalis muscle at six o'clock (lithotomy position) in study group is larger at maximum exertion than the control group.And the severity of constipation changed with the variation of angle.

Objective To explore the effects of penile erectile dysfunction (ED) on the quality of life in male renal transplant recipients.Methods 150 cases of male married recipients undergoing renal transplantation were selected randomly.The recipients were divided into ED group (n =63) and non-ED group (n =87) through the IIEF-5 score.The Short Form-36 Health Status Survey (SF-36)and Hamilton Anxiety Scale were used to compare their living quality and the state of mental health between the two groups,respectively.Results The SF-36 scores in ED group in General Health,Vitality,Social Function,Role Limitation due to Emotional Problems,Mental Health were significantly lower than those in non-ED group (P＜0.05).There were 13 cases in ED group with anxiety disorders (20.6％),significantly more than in non-ED group (3.4％),P＜0.05.Conclusion ED is an important influencing factor for the quality of life in male kidney transplant recipients.

Objective To explore the role of regulatory T cells (Tregs) in skin and heart grafts survival prolongation after different CD47 genotype donor specific splenocytes pretreatment.Methods Mouse skin plus hearts transplantation model was set up by using C57BL/6 as recipients and MHC class I-mismatched bm1 as donors.In CD47-/-DST group,recipients received CD47-/-bm1 splenocytes transfusion at 7th d before transplantation.In CD47+/+DST group,recipients received CD47+/+bm1 splenocytes transfusion at 7th day before transplantation.In control group,recipients only received bm1 skin and heart grafts.The populations of Tregs were analyzed by FACS and immunohistochemistry,respectively.The inhibitory effect of Tregs and anti-donor T cell responses was assessed by MLR.Results Result As compared with control group,the survival time of skin grafts in CD47-/-DST group was slightly longer than in non-DST group (20 days vs.17.5 days,P>0.05),but skin grafts had long-term survival in CD47+/+DST group (46.5 days,P<0.005).The survival time of heart grafts in CD47-/-DST group was similar to that in the control group,and slightly longer than non-DST group (17 days vs.15.5 days,P>0.05),but heart grafts had long-term survival in CD47+/+DST group (42.5 days vs.17 days,P<0.01).At 18th day after transplantation,immunohistochemistry showed that more Tregs infiltration could be observed in CD47-/-DST group,but not in CD47+/+DST group.The number of Foxp3+Tregs from the mice receiving CD47-/-DST increased markedly at 18th day post-transplantation compared to thot from the mice receiving CD47+/+DST (P<0.01),but the ratio of Tregs was decreased significantly (P<0.05).The number of Foxp3+Tregs in both CD47-/-and CD47+/+ DST groups was increased,but there was no significant difference between two groups (P>0.05).As compared with CD47-/-DST group,the ratio of Tregs in lymph node cells in CD47+/+DST group increased significantly (P<0.01).Compared to CD47-/-DST group and control group,anti donor specific T cell proliferation was decreased in CD47+/+DST group at 7th day after transplantation (P<0.05).The inhibitory effects of Tregs were similar among groups.Conclusion CD47 expressed on DST cells plays an important role in grafts survival prolongation.The ratio of Tregs in lymphocytes plays the key role in grafts survival prolongation.but not the number or inhibitory function of single Treg.