Multicenter epidemiological characteristics of Mycoplasma pneumoniae infection in children in Hainan Province, 2012-2020 / 中国热带医学

@#Abstract: Objective　To analyze the epidemiological characteristics (season, age, gender, mixed infection and clinical manifestations, etc.) of Mycoplasma pneumoniae (MP) infection in children in Hainan Province, so as to provide epidemiological evidence-based medical basis for the prevention and control of MP infection in children in Hainan Province. Methods　The serum IgM antibodies of MP, Legionella pneumophila, Chlamydia pneumoniae, adenovirus, respiratory syncytial virus (RSV), Q fever Rickettsia, parainfluenza virus, influenza A virus and influenza B virus in children with respiratory tract infections (RTIs) who were hospitalized in pediatrics of many hospitals in Hainan Province from March 2012 to February 2020 were detected by indirect immunofluorescence method. The positive serum MP-IgM antibody was defined as MP infection. The epidemiological and clinical data of MP infected cases were analyzed retrospectively. Results　From March, 2012 to February, 2020, a total of 35 731 qualified pediatric inpatients with RTIs in many hospitals in Hainan Province were tested for serum MP-IgM with the total positive rate of 39.12% (13 978/35 731). The yearly positive rates of MP-IgM from 2012 to 2020 were 48.39%, 56.23%, 56.62%, 47.04%, 29.71%, 24.14%, 47.55%, 36.84% and 24.46% respectively. The positive rates of MP-IgM in 2013 and 2014 were significantly higher than those in other years (P<0.05). The positive rate of MP-IgM in summer in Hainan Province was the highest (41.34%) and the lowest in winter (35.77%) (P<0.05). MP infection occurred in all age groups, the positive rate of MP-IgM in children of preschool (51.80%) was significantly higher than that in other age groups (P<0.01), and the positive rate of MP IgM in children of infancy (15.36%) was lower than that in other age groups (P<0.01). The positive rate of MP-IgM in female was 44.77%, which was significantly higher than that in male (35.83%) (P<0.05). MP infection combined with positive IgM of another pathogen accounted for 32.63% (4 561 cases), positive IgM of another two pathogens accounted for 1.26% (176 cases). MP infection was mostly found in pneumonia (68.73%), and the main clinical symptoms were cough (84.72%), fever (51.01%) and wheezing (3.16%). Conclusions　MP is an important pathogen of respiratory tract infection in children in Hainan Province, and infection is more common in children in early school age and early childhood. Mp-specific tests should be performed to identify the pathogen in children suspected of MP infection. In the high incidence season, health education should be strengthened in kindergartens, schools and other places to prevent respiratory tract infection.

Significance of serum irisin expression in patients with ST-segment elevation myocardial infarction without diabetes mellitus / 中华老年心脑血管病杂志

Objective To investigate the correlation of serum irisin level with insulin resistance and left ventricular remodeling after PCI in patients with ST-segment elevation myocardial infarction(STEMI)without diabetes.Methods A total of 485 STEMI patients without diabetes who received emergency PCI in our hospital from January 2017 to August 2020 were recruited in this study.According to the quartile values of baseline serum irisin levels,they were divided into low(＜0.31 mg/L,n=161),medium(0.31-0.97 mg/L,n=150),and high irisin groups(＞0.97 mg/L,n=174).Serum irisin level was measured with ELISA and insulin resistance was assessed by homeostasis model.During a follow-up of 12 months,the relationship between serum irisin level and echocardiographic parameters was evaluated.Results Compared with the baseline irisin level,the level reached a peak of at 8 h after PCI,and decreased a minimum at 3 d after surgery,with statistical differences(P＜0.01).The low irisin group had significantly higher BMI,diastolic blood pressure,fasting blood glucose,fasting insulin,TG,cTnI peak and NT-proBNP levels,but youn-ger age when compared with the medium irisin group and the high irisin group(P＜0.05).Obvi-ously higher diastolic blood pressure,fasting insulin,TG,cTnI peak and NT-proBNP levels were observed in the medium irisin group than the high irisin group(P＜0.05).Pearson correlation analysis showed that baseline serum irisin level was negatively correlated with HOMR-IR,ΔLVEDD,ΔLVESD,ΔLVEDVi and ΔLVESVi(r=-0.338,r=-0.172,r=-0.164,r=-0.154,r=-0.167,P＜0.01).Multiple linear regression analysis indicated that after further ad-justment for impaired glucose tolerance and BMI,low irisin level was still independently associat-ed with ΔLVEDD(P＜0.01).Conclusion Baseline irisin level in STEMI patients without diabetes is correlated with insulin resistance and subsequent poor left ventricular remodeling,and is expec-ted to be a predictor of left ventricular remodeling after PCI.

The pregnancy outcomes in women with gestational diabetes mellitus in one-day outpatient management with or without nutrition specialist involvement: a propensity score matching study / 中华临床营养杂志

Objective:Objective To explore the special role of nutrition specialists in the one-day-care clinic of gestational diabetes mellitus (GDM), and provide a basis for strengthening the standardized construction of one-day-care clinic.Methods:It was a retrospective observation study that the pregnant women who participated in the one-day-care clinic of GDM in our hospital without nutrition specialists in November and December 2017 were divided into control group (177 cases), and who participated in the one-day-care clinic of GDM in our hospital with nutrition specialists in January and February 2018 were divided into observation group (307 cases). The differences of pregnancy outcomes between the two groups were compared after the propensity score matching.Results:176 pairs of patients were successfully matched with a 1:1 propensity score. The incidence of macrosomia in pregnant women with GDM in the observation group (2.8%) was significantly lower than that in the control group (8.5%) ( P=0.036). There were no significant differences in the weight gain during pregnancy, the gestational week of delivery and the incidences of insulin use, hypertension during pregnancy, preeclampsia, cesarean section, premature infants, premature rupture of membranes, umbilical cord around the neck, and fetal distress between the two groups ( P>0.05). Conclusion:Nutrition specialists are indispensable in the multidisciplinary cooperation of one-day-care clinic of GDM, and they play a key role in considerably lowering the prevalence of macrosomia in GDM pregnant women.

Q fever vaccines / 中国人兽共患病学报

Q fever is a worldwide zoonosis and vaccination is the best measure to against its prevalence.Coxiella burnetii (Cb) is an obligate intracellular pathogen responsible for Q fever.Inactivated phase I Cb (Whole cell vaccine,WCV) can provide 100％ protection against Q fever,but its side effect of vaccination is strong.Phase I Cb is treated with chloroform-methanol or trichloroacetic acid and the chloroform-methanol residual (CMR) or the trichloroacetic acid extract (TCA) is used to substitute for WCV.Both CMR and TCA vaccine retain the protective efficient of WCV and significantly reduce the side effects.However,both CMR and TCA vaccine are required to isolate and purify Cb from chick embryos where Cb grows in a biosafety laboratory with the complex procedures.In recent 10 years,the scientists have investigated from protective antigens to CD4+ and CD8+ T cell epitopes of Cb,expecting that the genes encoding the T cell epitopes express highly and induce an efficient protection against Q fever in bodies.

Study on logistics management of non-implantable medical devices of urinary surgery based on inventory control method of ABC classification / 中国医学装备

Objective: To analyze the situation of inventory and consumption of non-implantable medical device of urinary surgery of teaching hospital so as to provide theoretical basis for improving logistics management of non-implantable medical device and effectively implementing decision of cost control.Methods: The inventory and usage situation of non-implantable medical devices of urinary surgery of teaching hospital during 2011 year and 2016 year were collected,and the Pareto rule was applied.And then these non-implantable medical devices of urinary surgery were divided into three categories(A,B and C)according to consumption sum of annual mean.Results: As the calculation results of consumption sum of annual mean,the non-implantable medical devices included 8 kinds of medical devices that were infusion device(49.808％),20mL syringe(10.912％),electrode(7.663％),medical gloves(5.634％),5mL syringe(2.293％),2mL syringe(2.209％),3M adhesive plaster(1.474％)and expander(1.435％),respectively.And the ratios of medical devices of A,B and C in the total amount of consumption of annual mean were 81.43％,9.88％and 8.69％,respectively.And their ratio in non-implantable medical device were 8.64％,9.75％and 81.48％,respectively.Conclusion: Logistics management involves many links,and if the ratio of one kind of medical device in the total amount of mean consumption is 80％while the ratio of type of goods is under 20％,we should strengthen the management for it.

Recurrent Stroke as the Clinical Onset of POEMS Syndrome

No abstract available.

Application of PCR-fluorescent probe in identifying genotypes of HCV / 中华临床感染病杂志

Objective To evaluate the application value of polymerase chain reaction (PCR)-fluorescence probe method in identifying genotypes of hepatitis C virus (HCV).Methods One hundred and sixty six serum samples from patients with chronic HCV infection were collected nationwide from March to June 2016.HCV Core-E1 gene region was amplified and sequenced by nested reverse transcription-PCR (RT nested-PCR)and genetic subtypes were analyzed by phylogenetic tree,meanwhile HCV genotypes were also determined by PCR-fluorescent probe method.Kappa test was used to compare the consistency of two methods.Results Among 166 samples detected by RT nested-PCR,the genotype of 66 samples (39.8%) was 1 b,34 (20.5%)was 2a,16 (9.6%)was 3a,27 was 3b (16.2%),23 (13.9%)was 6a.Two samples with 3b genotype detected by RT nested-PCR were identified as 1 b by PCR-fluorescent probe.The consistency rate of two methods was 98.7% (164 /166),there was no significant difference between two methods (χ2 =0.0492,P >0.05).Conclusion PCR-fluorescence probe method can accurately identify HCV genotypes and can be used in clinic.

Toxic Leukoencephalopathy and Hypokalemia Due to Exposure to Trimethyltin

No abstract available.

Study on the relationship between semen leukocyte and liquefaction and sperm motility / 国际检验医学杂志

Objective To explore the relationship between semen leukocyte and liquefaction and sperm motility through the anal‐ysis of routine semen examination results .Methods Retrospectively analyze on 8 666 cases of routine semen examination .Accord‐ing to the leukocyte count the semen samples which had sperms were divided into three groups ,Group A :white blood cells≤1 × 106/mL ,Group B:(1-4)× 106/mL ,Group C :>4 × 106/mL .Then compare the liquefaction time and sperm motility of these three groups .Results Among the 8 666 cases of semen analysis ,there were 164 cases of azoospermia(accounting for 1 .9% ) and 8 502 fine cases(accounting for 98 .1% ) .There were 7 419 ,1 014 and 69 cases in Group A ,B ,C respectively .In the three groups ,there were 5 323 ,740 and 50 cases of normal sperm motility respectively ;there were 2 096 ,274 and 19 cases of the abnormal motility ca‐ses respectively .In the three groups ,the normal cases of semen liquefaction time were 4 593 ,608 and 43 respectively ;the abnormal were 2 826 ,406 and 26 cases respectively .Statistical analysis showed no significant correlation between semen leukocyte and lique‐faction(P=0 .712) ,and between semen leukocyte and sperm motility(P=0 .486) .There were 1 217 cases of normal sperm motility and 4 027 cases of abnormal sperm motility in normal liquefaction group;there were 1 172 cases of normal sperm motility and 2 086 cases of sperm motility in abnormal liquefied group .There was statistically significant difference between the two groups(P=0 .000<0 .05) .Conclusion There were no correlation between semen leukocyte count and liquefaction or sperm motility ,but sperm mo‐tility and liquefaction are correlated .

Microwave exposure impairs synaptic plasticity in the rat hippocampus and PC12 cells through over-activation of the NMDA receptor signaling pathway / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of this study is to investigate whether microwave exposure would affect the N-methyl-D-aspartate receptor (NMDAR) signaling pathway to establish whether this plays a role in synaptic plasticity impairment.</p><p><b>METHODS</b>48 male Wistar rats were exposed to 30 mW/cm2 microwave for 10 min every other day for three times. Hippocampal structure was observed through H&E staining and transmission electron microscope. PC12 cells were exposed to 30 mW/cm2 microwave for 5 min and the synapse morphology was visualized with scanning electron microscope and atomic force microscope. The release of amino acid neurotransmitters and calcium influx were detected. The expressions of several key NMDAR signaling molecules were evaluated.</p><p><b>RESULTS</b>Microwave exposure caused injury in rat hippocampal structure and PC12 cells, especially the structure and quantity of synapses. The ratio of glutamic acid and gamma-aminobutyric acid neurotransmitters was increased and the intracellular calcium level was elevated in PC12 cells. A significant change in NMDAR subunits (NR1, NR2A, and NR2B) and related signaling molecules (Ca2+/calmodulin-dependent kinase II gamma and phosphorylated cAMP-response element binding protein) were examined.</p><p><b>CONCLUSION</b>30 mW/cm2 microwave exposure resulted in alterations of synaptic structure, amino acid neurotransmitter release and calcium influx. NMDAR signaling molecules were closely associated with impaired synaptic plasticity.</p>

Application evaluation of sperm routine examination in diagnosis and treatment of male infertility / 国际检验医学杂志

Objective To preliminarily understand and evaluate the fertility ability of male infertility patients by analyzing the semen routine testing results to assist further clinical diagnosis and treatment .Methods 7 586 cases of semen routine detection re‐sults were performed the retrospective analysis and statistics by classification according to the indexes of semen volume ,pH value , liquefaction time ,sperm density ,sperm activity and sperm deformation rate .Results Among 7 586 cases of semen routine examina‐tion ,there were 1 450 cases(19 .1% ) of semen volume less than 2 .0 mL ;1 372 cases (18 .1% ) of pH 60 min ;989 cases(13 .0% ) of sperm density lower than 20 × 106 /mL ;3 719 cases(49 .0% ) of sperm activity grade a + b less than 50% ;3 431 cases(45 .2% ) of sperm deformation rate less than 15% ;141 cases(1 .9% ) of aspermatism ;1 119 cases (14 .8% ) had no abnormality in each index .Conclusion Semen liquefaction ,sperm motility and sperm deformation rate are the indexes with the highest abnormal rate in the semen routine detection ;the semen routine detection provides the important exper‐imental data for clinical diagnosis and treatment of male infertility ,the objective and correct analysis of the detection result is of great significance to the judgment of male fertility .

Releasing aqueous humor of anterior chamber to treat early elevated lOP after lCL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

To explore the effect of releasing aqueous humor of anterior chamber through lateral incision of cornea in treating early elevated intraocular pressure ( lOP ) after implantation of implantable collamer lens ( lCL) .METHODS: Patients with elevated lOP were analyzed after lCL implantation. When the lOP>25mmHg, aqueous humor was released slowly through lateral incision of cornea, and made the lOP reduce to 10 ~13mmHg. After operation, lOP was measured every 2h. The releasing of aqueous humor was repeated until the lOP was decreased to normal.RESULTS: One hundred sixty - seven patients ( 330 eyes) were implanted lCL, while the lOP of 32 patients (62 eyes) was higher than 25mmHg after lCL implantation. Viscoelastic material was found in aqueous humor of most of high lOP patients, and the lOP of 48 eyes did not increase again through releasing aqueous humor once. The lOP of all these eyes was decreased to normal through releasing aqueous humor in 3 times at most. There were no abnormal in postoperative follow-up.CONCLUSlON:The main reason of early elevated lOP after lCL implantation is the remaining of viscoelastic material of eyes. Releasing aqueous humor through lateral incision of cornea can decrease lOP effectively. lt is a simple, safe, painless and repetition, which the patients are willing to accept.

AduoLa Fuzhenglin down-regulates microwave-induced expression of β1-adrenergic receptor and muscarinic type 2 acetylcholine receptor in myocardial cells of rats / 生物医学与环境科学（英文）

This paper is aimed to study the effect of ADL on expression of β1-AR and M2-AchR in myocardial cells of rats exposed to microwave radiation. Immunohistochemistry, Western blot and image analysis were used to detect the expression of β1-AR and M2-AchR in myocardial cells at 7 and 14 d after microwave exposure. The results show that the expression level was higher in microwave exposure group and 0.75 g/(kg•d) ADL group than in sham operation group and significantly lower in 1.5 and 3.0 g/(kg•d) ADL groups than in microwave group. So we have a conclusion that the expression of β1-AR and M2-AchR is down-regulated in myocardial cells of rats exposed to microwave radiation. ADL can protect rats against microwave-induced heart tissue injury.

Transfusion of necrotic cells redresses regulatory T cell and Th17 cell imbalance in septic mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of transfusion of necrotic cells on regulatory T (Treg) and Th17 cell balance in septic mice.</p><p><b>METHODS</b>Thirty-four C57BL/6 mice were randomized into PBS group (n=5), sham-operated group (n=5), sepsis group (n=12), and necrotic cell transfusion group (n=12) and subjected to intraperitoneal PBS injection, sham operation by separating the cecum only, cecal ligation and puncture (CLP), and injection of 2 × 10⁷ necrotic cells 5 days before CLP, respectively. All the mice were sacrificed 2 weeks after CLP for analyzing the proportion of CD4⁺Foxp3⁺Treg cells and CD4⁺IL17A⁺Th17 cells in the peripheral blood, spleen and thymus by flow cytometry.</p><p><b>RESULTS</b>The percentage of Th17 cells and Treg/Th17 ratio in the spleen was significantly higher in CLP group than in the sham-operated group and PBS group (P<0.01). The percentage of Treg cells in the thymus was significantly lower in CLP group than in the sham-operated group (P<0.01). Pre-infusion of necrotic cells redressed the abnormality of Treg and Th17 cell percentages and Treg/Th17 imbalance in mice following CLP (P<0.05).</p><p><b>CONCLUSION</b>Pre-infusion of necrotic cells can reverse Treg/Th17 imbalance in septic mice.</p>

Yiqixue buganshen recipe regulates the expression of integrin ανβ3 in the endometrium of controlled ovarian hyperstimulation mice / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effect of Yiqixue Buganshen recipe(, YBR) on the expression of integrin ανβ3 in the endometrium of controlled ovarian hyperstimulation mice.</p><p><b>METHODS</b>A total of 180 mice were divided into three groups: model group, treatment group and control group. The treatment and model groups were intraperitoneally injected with gonadotropin-releasing hormone analogue for 7 days; pregnant mare serum gonadotropin was also injected on the 7th day. After 48 h, human chorionic gonadotropin was injected. The control group was injected with an equal volume of saline at the same time. From the start of the experiment, the treatment group was intragastrically administered Jinghouzengzhi Recipe() and Cuhuangti Recipe(). The model group and the control group were intragastrically administered an equal volume of saline. Real-time reverse transcription polymerase chain reaction and Western blotting were used to detect the mRNA and protein expression of integrin ανβ3 in mouse endometrium.</p><p><b>RESULTS</b>Integrin ανβ3 was expressed in mouse endometrium in all groups. Integrin αββ3 expression increased gradually along with pregnancy, progressing from pregnant day (Pd) 1. Integrin ανβ3 expression significantly increased on Pd 4, then began to decrease on Pd 6. Integrin ανβ3 expression in the treatment group was higher than in the model group, and the difference was statistically significant (P <0.05). The difference between the treatment group and the control group was not statistically significant (P >0.05).</p><p><b>CONCLUSION</b>YBR improves endometrial receptivity, and may play an important role in embryonic implantation.</p>

Discussing on the therapy of warming yang in the treatment of tumor / 国际中医中药杂志

The therapy of removing beat and toxic,strengthening the body to cultivate the fundamental is the mainstream of treating cancer in traditional Chinese medicine up to now,and the therapy of warming yang has been rarely involved.While the pathogenesis of tumor is spleen and kidney yang deficiency in root,and phlegm,stasis,and poison entangled with each other at the secondary position; the main therapeutical principle of tumor is simultaneous application of purging-tonifying therapy while focusing on protecting yang.The author believes that the treatment of cancer should pay attention to the whole concept,especially warming yang for patients with advanced tumors.The therapy of warming yang is an effective way to get rid of phlegm and blood stasis.Patients after radiotherapy and chemotherapy should be paid more attention to warming yang.

Pathological features and origin of primary pineal mixed germ cell tumors / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the origin of mixed germ cell tumors in the pineal region based on the image data, surgical findings and pathological examination of the tumor.</p><p><b>METHODS</b>The preoperative CT and magnetic resonance imaging (MRI) findings and tumor specimens were retrospectively analyzed in 15 cases of pineal mixed germ cell tumors confirmed by postoperative histological examination between January 2000 and September 2010.</p><p><b>RESULTS</b>Radiographic examination of the tumor revealed calcification in 12 cases, cystic changes in 10 cases, and the presence of lipid in 5 cases. On the anteroposterior images, the tumors appeared round or elliptic with smooth edge in 6 cases, and showed irregular shape with multiple processes on the edge in 9 cases. Surgical exploration found all the tumors located in the the suprapineal recess enclosed by the arachnoidal envelope of the Galen vein. Pathologically, 13 specimens contained germinoma component, 9 contained teratoma component, 4 had embryonic carcinoma component, 3 had choriocarcinoma component, 7 showed yolk sac tumor component, and 3 showed rhabdomyoma component. Germinoma components were found on the tumor margin in 7 specimens, and intermingled germinoma and other components were found in 10 specimens.</p><p><b>CONCLUSION</b>Pineal mixed germ cell tumor originates from the residue germ cells around the pineal gland, and most likely evolves from single primordial germ cells.</p>

Clinical study of pineal region tumors: experience with 132 patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To review the clinical manifestations, imaging, tumor markers, treatment methods, pathology results and clinical curative effects of pineal region tumors and to evaluate the characteristics and intervention strategies for those tumors.</p><p><b>METHODS</b>The clinicopathological data of 132 patients with pineal region tumor treated in our department between January 2000 and May 2008 were retrospectively studied.</p><p><b>RESULTS</b>A moderate predominance in males was presented. The clinical manifestations of the disease included increased intracranial pressure and ocular movement impairment. There were some features but no regularity and specific appearance on imaging including CT and MRI. 88.6% of patients associated with hydrocephalus. A high serum level of alpha-fetoprotein (AFP) was presented in 14 cases and high HCG in 9 cases. Eighteen cases received direct radiation therapy and 7 had radiotherapy post biopsy. 107 cases were treated surgically and 63 cases received postoperative adjuvant treatment. 114 cases had pathology results including 56 germ cell tumors. The patients were followed up for 12 approximately 132 months. Recurrence developed in 23 cases and 12 cases died. The 5-year survival rate was 89.3%.</p><p><b>CONCLUSION</b>Pineal region tumors are often associated with hydrocephalus and this makes preoperative diagnosis difficult. Imaging examination may help diagnosis but less specific. Germ cell tumors may diagnosed by some tumor markers. Radiation therapy is the choice of treatment for pure germinomas. Other types of pineal region tumors should receive surgical treatment. Postoperative adjuvant treatment based on pathology can provide a good prognosis in pineal region tumor.</p>

A concept of regulating tumor microenvironment immune and normalizing angiogenesis by Chinese medicine drug therapy for supporting zheng-qi to prop up root / 中国中西医结合杂志

Antiangiogenic therapy can generate a "normalization window" for tumor vasculature. This normalization process prunes immature vessels and improves the integrity and function of the remaining vasculature by enhancing the perivascular cell and basement membrane coverage in tumor, therefor creates a window of opportunity for improved sensitivity to ionizing radiation and the delivery of chemotherapeutic drugs. It provides a rational basis for the combination therapy of traditional Chinese drugs with radiation and perhaps other forms of chemotherapy. Antiangiogenic therapy with the traditional Chinese drug interfering in the the mechanisms of the normalization window in humans maybe harness a new approach to improve the sensitivity of tumors to radio- and chemotherapy.

Clinical pathology of pineal region tumors / 中华神经医学杂志

Objective To investigate the pathological distribution and clinical characteristics of pineal region tumors (PRTs) with variant pathology.Methods We retrospectively analyzed the clinical and pathological data of 133 patients with PRTs that were performed surgical removal from January 2000 to January 2009 in our hospital.Results Sixty-one patients (45.9%) were diagnosed as having germ cell tumors,17 (12.8%) pineal parenchymal tumors,28 (21.1%) gliomas and 27 (20.2%)other resource tumors.Sex ratio of patients with germ cell tumors,pineal parenchymal tumors and gliomas were 14.25:1 (male:female),2.4:1 and 1.15:1,respectively; their median ages were 15.3,24.7 and 28.1,respectively.The serum immunologic test showed abnormal results in 33 patients; except for 1 with metastatic tumors,the others were diagnosed as having germ cell tumors.Conclusion PRTs have many pathological types and patients with PRTs are mainly diagnosed as having germ cell tumors.Correct diagnosis can not be made by imaging,serum immunologic test or biopsy, thus,obtaining complete clinical specimen during the total tumor removal is very necessary in studying the pathology of PRTs.