Objective To investigate the clinical effect of methotrexate combined with leflunomide in the treatment of patients with rheumatoid arthritis.Methods 660 patients with rheumatoid arthritis were selected,they were divided into research group and the control group according to the random number method,with 330 cases in each group.The control group was treated with methotrexate alone,while the research group was treated with leflunomide and methotrexate.The clinical effect and adverse reaction of the two groups were compared after 6 months.Results Compared with before treatment,the pain index[(1 .43 ±0.32)vs.(1 .83 ±0.52)],time of morning stiffness [(0.77 ±0.5)h vs.(1 .1 8 ±0.44)h],grip strength[(1 58.65 ±53.45)mmHg vs.(1 33.29 ±44.1 2)mmHg], swelling[(6.81 ±2.32)vs.(9.32 ±2.43)]and the swelling index[(1 .54 ±0.26)vs.(1 .70 ±0.33)]in the two groups after treatment were improved significantly,and the differences were statistically significant(t =3.84,5.24, 3.54,4.05,6.95,4.33,5.22,3.69,2.98,5.64,all P <0.05).And the indices of the research group were significantly better than the control group after treatment,the differences were statistically significant(t =2.36,2.68,3.02,3.22, 2.87,all P <0.05).ESR[(38.56 ±23.67)mm/h vs.(56.78 ±23.45)mm/h],C -reactive protein[(1 2.98 ± 11.89)mg/L vs.(21 .68 ±9.57)mg/L]and rheumatoid factor[(85.67 ±31 .98)IU /mL vs.(1 32.68 ±96.36)IU /mL] of the two groups after treatment were significantly lower than before treatment,in which the indices of the research group were significantly lower than the control group,and the differences were statistically significant(t =3.65,3.02, 4.22,all P <0.05).The disease activities of the research group(32.73%,58.1 8%,83.03%)were significantly better than those of the control group(7.27%,23.64%,34.85%)at 1 ,6,1 2 weeks after treatment,the differences were statistically significant(χ2 =6.35,4.85,5.02,all P <0.05).In addition,the degree of reduction of joint swelling in the research group at three time points was better than the control group,and the differences were statistically significant(all P <0.05 ).The total effective rate of the research group(98.1 8%)was significantly higher than 81 .82% of the control group,the difference was statistically significant(χ2 =8.1 8,P <0.01 ).The adverse reactions such as itching,rash and gastrointestinal discomfort occurred in the two groups,which did no affect the treatment,and no other serious adverse reactions.There was no significant difference in the incidence of adverse reactions between the two groups(χ2 =1 .29,P >0.05).Conclusion Methotrexate combined with leflunomide has good effect in the treatment of patients with rheumatoid arthritis,which can significantly improve clinical symptoms,as well as effectively reduce the related indicators of rheumatoid arthritis in active phase,with good safety,it is worth promoting.

Objective To study portal vein hemodynamics changes after autoiogous bone marrow stem cell transplantation in patients with liver cirrhosis. Methods The hemodynamic parameters, including portal vein diameter, average portal blood flow velocity and spleen size, were determined by Colour Doppler Ultrasonography in 50 patients after autologous bone marrow stem cell transplantation and all cases were followed for up to 6 months. Results (1) After autologous marrow stem cell transplantation, the portal vein diameter reduced significantly at different timepoints compared to before the treatment ([1.41 ± 0. 15] cm, [1. 38 ± 0. 11]cm,[1.36±0. 17] cm vs. [1. 53 ±0. 18] cm,t = 1. 987,1.994,1. 976, Ps < 0.05), but we found no significant difference in the comparisons among different timepoints (F = 2. 35 ,P >0.05). (2) After autologous marrow stem cell transplantation, the average portal blood flow velocity increased significantly at different timepoints compared to before the treatment ([15. 7 ± 3. 6] cm/s, [16. 1 ± 2.4] cm/s, [15. 9 ± 3.0] cm/s vs.[11.4 ± 3. 3] cm/s ,t = 2. 345, 2.460,2. 381, Ps < 0. 01) , but we found no significant differences in the comparisons among different timepoints (F = 2. 14, P > 0.05) . (3) After autologous marrow stem cell transplantation,the spleen size reduced significantly at different timepoints compared to before the treatment ([4.8±0.3]cm,[4.7±0.6]cm,[4.8±0.5]cm vs. [5. 2 ±0. 7]cm,t =2. 289,2. 390,2.425,Ps <0.01), but we found no significant differences in the comparisons among different timepoints (F = 2. 26, P > 0.05) .Conclusion The autologous bone marrow stem cell transplantation can effectively improve the portal vein blood flow,reduce the spleen size,alleviate portal hypertension in patients with liver cirrhosis.

Objective To evaluate CT scanning value in the diagnosis of pulmonary lymphangioleiomyomatosis(PLAM).Methods CTfindings of PLAM proved pathologically in 13 cases were retrospectively analyzed including distribution,morphosis and complication oflesions.Results 3 were lobar or segmental lesion and 10 were desseminated lesion.The fine nodules and pulmonary cystic space were showed on conventional CT scanner.The fine nodules(1~2 mm in diameter)and pulmonary cyst spaces(1 ~4 mm walled )were seen on high resolution CT.The most of cystic spaces were round.13 cases of pathologic species were retrospectively reviewed.The results showed that 12 cases were PLAM and 1 case was pulmonary tuberous sclerosis.Conclusion In young female, the fine nodules or pulmonary cyst spaces were presented on CT scan,PLAM should been strongly suspected.

Objective To study prospectively HRCT-pathological correlatiion of the small solitary pulmonary nodules in 52 cases.Methods The characterstics of each nodule's margin,internal and peripheral on high resolution CT images was observed with double blind method.Postoperative specimens were fixed in the Heitzman standen method,then specimes were scanned by computed tomography,HRCT signs of nodule were also viewed at same way.Results The results showed :the diameter and distribution of benign and malignant pulmonary nodules was not obviously;the density of benign nodules was more homogeneous than that of malignant nodules.The margin of malignant had slight lobulation in 51%;Halo sign and the peripheral pulmonary emphysema was showed in benign nodules. Conclusion HRCT is of important value to show internal low attenuat of the malignant nodules (diamter

Experiment teaching is an important component of teaching in medical college and university, a key step to foster students practical ability and innovation ability and a guarantee to achieve the goal of medical talent training. The quality and level of experiment teaching is directly related to the college talent training quality and the college overall development. According to the requirement of quality engineering, our college strengthens the connotation construction from the aspects of experiment teaching management, teaching staff training and quality monitoring and improves experiment teaching quality.

Objective To study the method of operation and effect of the application of resonant liposuction in the body figure reconstruction. Methods Resonant liposuction was employed in 136 cases, including local fat deposit in some part of the body. Operation's safety, mircotrauma, speediness, and effect after operation were observed. Results The follow-up for 6 to 24 months showed that the reconstructed body figure was very satisfactory. Conclusion Resonant liposuction is an ideal method to reconstruct the body figure owing to its safety, miniinvasion, easy performance and efficacy.

Objective To study the choice of initial operative approach for thyroid nodule and the necessity of reoperation after local excision of differentiated thyroid cancer.Methods Clinical data of 138 patients with differentiated thyroid cancer after local tumor excision had reoperation at our hospital during a period of four year were retrospectively reviewed.All the reoperations were bilateral thyroidectomy and cervical lymph node excision.Results There were 76.8% patients with residual cancer in thyroid and cervical lymph node.There were 23 patients(16.7%) with recurrent laryngeal nerve injury that included 22 cases with unilateral and 1 case with bilateral injury after the initial operation,and 19 of the 23 patients with recurrent laryngeal nerve injury recovered after nerve repair.After thyroid reoperation,3 cases(2.2%) had recurrent laryngeal nerve injury,2 cases(1.4%) had partial parathyroid gland injury,2 cases(1.4%) had superior laryngeal nerve injury,but there were no cases of esophageal injury or postoperative bleeding.Conclusions The incidence of residual cancer is high after local excision for differentiated thyroid cancer,therefore,reoperation with bilateral thyroidectomy and cervical lymph node excision is necessary.

Numerous studies showed that changes in serum pepsinogen( PG)and gastrin-17( G-17)levels can reflect histological condition of gastric mucosa,that can be served as serological biopsy of gastric fundic glandular mucosa. The decrease of serum PGⅠ level and PGⅠ/ PGⅡ ratio(PGR)as well as increase of G-17 denotes a high risk of gastric cancer. Helicobacter pylori(Hp)infection can cause chronic active gastritis,and the progress of inflammation can lead to atrophy and intestinal metaplasia of mucosa. This article reviewed the diagnostic value of serum PG,G-17 and Hp antibody for atrophic gastritis and gastric cancer.

The laboratory animal science, a comprehensive discipline researching on experimental animal and animal experimentation, is the life sciences research foundation and the support condition. It has very vital significance to sudy the related discipline especially the life sciences. This article discusses the construction of the status of Laboratory Animal Science course combined with the development of laboratory animal science and contacted with the characteristics of medical colleges and related disciplines.

Objective To investigate CT features of solitary fibrous tumor of the mediastinum(SFTM),and to analyze the causes of misdiagnosis of this disease.Methods CT features of 5 patients of SFTM confirmed operatively and pathologically were retrospec-tively analyzed.All patients underwent before operation but were misdiagnosed.Results 3 cases were located in right mediastinum with oval-shap,well-defined margin,and “pleural tail sign”,2 cases were located in right thoracis cavity with unwell-defined margin, and in the adjacent lung were oppressed.In all 5 patients,the mean median of tumors was 1 1.5 cm(8.6-1 5 cm),non-homogeneous density of tumors were seen on plain CT scans,and obvious non-homogeneous enhancement with“geographic pattern”on contrast-en-hanced CT.Conclusion CT can clearly reveal the size and the appearance of SFTM,adjacent architectures,the final diagnosis de-pends on histopathological and immunohistochemical findings of the tumors.To un-know is the main caused of misdiagnosis of medi-astinal SFT.