Laboratory diagnostics is an important discipline functioning as a bridge between basic and clinical medicine and it is closely associated with the diagnosis of clinical physician.But there are some problems in the laboratory diagnostic teaching including unreasonable curriculum standard,simple teaching method and unpractical theory.This paper explored and summarized the problems and the reform of laboratory diagnostics teaching mode for students of clinical medicine.

Objective To establish a SYBR Green Ⅰ quantitative real-time PCR method for detecting the expression of APRIL gene(a proliferation-inducing ligand,APRIL) in peripheral blood of patients with auto-immune diseases,e.g.,systemic lupus erythematosus(SLE) and rheumatoid arthritis(RA),and investigate the relationship of APRIL mRNA expression with pathogenesis and prognosis of auto-immune diseases.Methods Plasmid PGEM-T easy-APRIL was cloned as the standard template.SYBR Green Ⅰ quantitative real-time PCR was set up to examine the expression of APRIL mRNA in peripheral blood of 58 patients with auto-immune diseases and 20 healthy controls using Line Gene FQD-33A Detection System.Results The obtained data were normalized by dividing the copy number of target cDNA by those of GAPDH(glyceraldehycle-3-phosphate dehydrogenase,GAPDH).APRIL expression levels ranges from 3.95 to 192 and mean value was 29.68?4.5.APRIL expression of twenty healthy controls showed range from 3.1 to 18.7 and mean value of 10.56?2.0.APRIL expression levels in patients with auto-immune diseases were higher than those in healthy controls.In auto-immune diseases group APRIL expression levels of untreated patients were higher than those of the other patients,and a statistical significance was found.Conclusions APRIL mRNA was successfully detected by SYBR Green Ⅰ quantitative real-time PCR and the method was accurate and reliable.The expression of APRIL mRNA of auto-immune disease patients was higher than those of healthy controls,and the expression of untreated patients was the highest.This method may be used for further study on the high-level expression of APRIL mRNA in mechanism of auto-immune diseases as well as the development and prognosis of diseases.

In order to improve the teaching quality of experimental teaching of laboratory diagnosis and to cultivate the clinical ideation of medical students,we have been trying a series of reform in this course and obtained good results.Here,our experience in the selection of teaching contents,the improvement of teaching methods,and the setting of experimental assessment have been summarized and investigated.

Objective To investigate the epididymal sperm ultrastructure after vasectomy. Methods During the operation of vasovasostomy (38 cases, test group) and vasectomy (13 cases,control group,group A) the proximal vas deferens fluids were collected.The epididymal sperm morphology in the proximal vas deferens fluids was observed using optical and electronic microscopes.Data were analyzed by SPSS program. Results The data from group A showed that there was no significant difference between left and right side in the percentage of normal sperm morphology.The results from both optical and electronic microscopes showed that there was a significant difference in the percentage of normal sperm morphology (a),abnormal sperm head (b),sperm with neck defect (c) and sperm with tail defect (d) between group A and group B(5 years after vasectomy). (electronic microscopes:(a):(40.28?11.53)% vs (16.80?7.93)%,(6.29? 4.57 )%,( 4.63? 5.06 )%; (b):(35.00?14.18)% vs (59.05?14.44)%,(63.43?15.23)%,(82.05? 16.71 )%;(c):(20.83? 6.40 )% vs (13.60?6.78)%,( 14.71? 6.82)%,(9.00?7.18)%;(d):(3.89?4.44)% vs (10.55?11.73)%,(15.57?9.81)%,(4.32?7.65)%. optical microscopes:(a):(49.12?20.55)% vs (19.95?15.42)%,(10.00?9.50)%,(5.84?9.63)%; (b):(35.00?14.55)% vs (22.55?16.24)%,(14.71?15.78)%,(10.68?18.65)%; (d):(15.80?9.55)% vs (57.50?24.74)%,(75.29?23.90)%,(78.21?30.33)%.There existed multi-cell organ and multi-form abnormalities in the inner structures of sperm heads,necks and tails. Conclusions The epididymal sperm defect (including head, neck and tail) after vasectomy was demonstrated in the inner cell organs.The longer after vasectomy, the higher percentage of sperm with abnormality was found.

Objective To observe the long-term effect of surgical treatment in infertile varicocele patients. Methods 180 infertile patients with varicocele accepted modified Palomo operation (retroperitoneal high ligation of internal spermatic cord vein) from 2004 to 2007, and the long-term effect of thesurgery were analyzed retrospectively, such as semen parameters and spouse pregnancy. Results The operations were performed successfully in 180 cases, and semen parameters improved significantly after the surgery (Ps ＜ 0. 05 ).Among all patients, 10 cases had spouse pregnancy within 3 months after operation;47 cases had spouse pregnancy from 3 to 6 months after operation; 25 cases had spouse pregnancy from 6 to 12 months after operation;13 cases had spouse pregnancy from 12 to 24 months after operation. The fertility rate was 52. 8% (95/180) in total. Conclusion Surgical treatment of infertile male patients with varicocele has good long-term effects, made it the first choice in these patients.

OBJECTIVETo evaluate the semen quality of the donors.

METHODSThe semen parameters of the primary samples of 512 donors were examined following the World Health Organization (WHO) guide and computer-aided sperm analysis (CASA, product by Harmilton Thorne) system.

RESULTSOf the 246 (246/512, 48%) donors with potential fertility, only 146 (146/512, 28.5%) came up to the semen standard set by the Chinese Ministry of Health, while 266 (266/512, 52%) were below the WHO reference values of semen parameters.

CONCLUSIONRepeat semen analyses may increase the success rate in screening semen donors. The semen quality of the donors suggests that it is necessary to pay more attention to male reproductive health.

Adult ; Humans ; Image Processing, Computer-Assisted ; Male ; Mass Screening ; Middle Aged ; Reference Values ; Semen ; physiology ; Sperm Banks ; Sperm Count ; Sperm Motility ; Tissue Donors

OBJECTIVETo observe sperm motion parameters in pre-freeze and post-thaw semen samples using computer-assisted sperm analysis (CASA) system.

METHODSSemen analyses of 238 samples before freezing and after thawing were separately performed by Hamilton-Thorne Sperm Analyzer.

RESULTSSperm motility in post-thaw samples was significantly decreased. There was significant correlation and difference between pre-freeze and post-thaw samples in sperm motion parameters, including average path velocity (VAP), straight line velocity (VSL), curvilinear velocity (VCL), amplitude of lateral head displacement (ALH), straightness (STR) and linearity (LIN), except heat cross frequency (BCF). The percentage of sperm movement velocity parameters (VAP, VSL and VCL) and moving pattern parameters (ALH) significantly decreased, while that of LIN and STR significantly increased in post-thaw samples.

CONCLUSIONCASA system is of clinically applied value and is a useful tool for evaluating sperm motion parameters in pre-freeze and post-thaw semen samples.

Cryopreservation ; Diagnosis, Computer-Assisted ; Freezing ; Humans ; Male ; Sperm Motility