Glucocorticoids(GC) play definite and effective roles in the management of chronic pain,but their toxic and side effects also make them controversial agents.This review discusses various aspects of glucocorticoids including their action mechanism,toxic and side effects,different types of pharmaceuticals and ways of administration.It also ventures some suggestions on rational medication of steroids.

This paper reports the histological observation on PAS-positive granular cells in epididymal epithelium from rat, bull, swine and ram. Caput, corpus and cauda of epididymis from these animals (10～14 for each species) were taken, routine fixed and embeded, 6 ?m section, PAS stained and observed under light microscope. There is a kind of PAS positive granular cell existed in epithelium of all segments of epididymis from all these animals. These PAS positive granules are proved to be neutral polysaccharide and an apocrine secretion pattern is suggested. The so-called clear cell in HE stained slides might be PAS-positive granular cell which has already discharged its contents. Besides, this kind of cells are occasionally located in the vas deferens as well.

OBJECTIVE To introduce the characteristic and advantage of a kind of therapeutic method for chronic tibial osteomyelitis by cleaning the focus,iodophor sterilizing and then bone grafting at some selective time.METHODS Ribbon-gauze immersed with iodophor was used for tamponade and constant hydropathic compress after a surgery of debridement,then intramedullary bone grafting was performed.RESULTS This treating manner was applied in 18 patients with chronic tibial osteomyelitis and 17 cases(94.4%) healed,1 case recrudesced.CONCLUSIONS It is reliable for this kind of therapeutic method by debriding the focus,followed by an open and constant hydropathic compress with iodophor,and then grafting bone,which may promote the healing rate of chronic tibial osteomyelitis.

BACKGROUND: Heal-all oral biofilm is a material utilized in repairing oral mucosa and soft tissues defects and characterized by degradation, easily preparation, long preserved duration, convenient transportation and good ossification, which has been widely used in dental implant as guided bone regeneration materials.OBJECTIVE: To check the clinical effective of Heal-all oral biofllm on guided bone regeneration in dental implant.METHODS: A total of 72 patients with bone defects in the implantation area were selected as subjects, who were divided into control group and experimental group at random. Bone defects around implants were repaired by guided bone regeneration technique with BME-10X medical collagen membrane and Heal-all oral biofilm respectively. X-ray and clinical examination were taken at 1 and 3 months after implantation. The amount of new.formed bone tissue was evaluated when stage Ⅱ operation was performed.RESULTS AND CONCLUSION: In stage Ⅱ operation, osseointegration was formed between implants and bone tissue in all 72 patients. The average rate of bone formation was 92% in the experimental group while 91% in the control group. All implants were successfully repaired with implant denture. Occlusal function was restored successfully with all 72 implants during the follow-up period of 3-24 months after restoration. As an alternative option of BME-10X medical collagen membrane, Heal-all oral biofilm can be used in guided bone formation clinically.

Objective To explore the clinical significance of the coagulation and fibrolysis parameters changes for the knowledge of complicated thrombosis after chemotherapy in malignant lymphomas. Methods Morning fasting anti-coagulation blood samples were taken to detect plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) with automatic coagulation analyzer in 71 hospitalized malignant lymphomas and 20 normal controls. The plasma D-dimer levels of the two groups were detected with immunoturbidimetry. Results The levels of plasma APTT, Fib and D-dimer in 71 malignant lynphomas were (30.44±1.43) s, (3.28±0.20) g/L, (297.05±56.59) μg/L respectively, which were significantly higher than those in normal controls at the levels of (23.72±0.76) s, (2.57±0.22) g/L, (94.50±26.07) μg/L respectively (P ＜0.05). The coagulation and fibrolysis parameters were of no statistic differences between the normal controls and lymphomas of stage Ⅰ and Ⅱ (P ＞0.05). The APTT and Fib levels in lymphomas of stage Ⅲ and Ⅳ were higher than those in normal controls and lymphomas of stage Ⅰ and Ⅱ (P ＜0.05). There are 7 malignant lymphomas complicated venous thrombosis . Of the 7 cases, the FIB and D-dimer levels were higher than those of stage Ⅰ and Ⅱ, furthermore the D-dimer levels were higher than those of stage Ⅲ and Ⅳ. Conclusion The abnormalities of coagulation and fibrolysis parameters occurred in malignant lymphomas with requirement of periodic monitoring. After chemotherapy, the lymphoma patients had a high incidence of venous thrombosis, which need early prevention for prolongation of the survival.

Objective To study the healing effect of recombinant human acidic fibroblast growth factor(rhaFGF) expressed in E.coli on dermal chronic ulcers in diabetic rats.Methods Ten male Wistar rats were used to set up diabetic dermal chronic ulcers models.The wounds were sprinkled with rhaFGF and physiological saline,respectively.The wound area,wound cavity volume and healing time were recorded,granulation tissue growth and epithelization in wound were observed,and wound healing status was evaluated.Results Compared with control group,the wound area and wound volume at different day in rhaFGF group were significantly diminuted(P

Objective To explore the symptoms of anxiety,family structure,and the distribution features of family about in-patients.And to find out the influence of the family structure on in-patients' symptoms of anxiety.The results would provide evidentiary support and suggestions for in-patients to improve quality of life and for prevention and intervention of anxiety.Methods Family table was used to register the family structure which was classified as the nuclear family,stem/expended family and other classification.The anxiety of in-patients was measured by self-rating anxiety scale.Results A total of 512 cases of in-patients completed the survey,there were 483 valid questionnaires.The rate of effective questionnaire was 94.34％.In family structure of in-patients,core family accounted for 48.65％,stem/expended family was 36.85％.The sex of family structure showed significant difference,the female proportion of the nuclear family was significantly higher than male.Among all in-patients,78.05％ did not have anxiety,low-level,medium-level,and severe anxiety showed no significant differences.The effects of anxiety on family structure had significant differences.The anxiety level of stem family was relatively higher.Conclusions Economic development and the population flow due to industrialization and globalization changed family structure of our country,especially in coastal de-velopment cities with fast economic development,fast-paced and stressful work,and it may affect the influ-ence of Chinese traditional family structure on anxiety of the in-patients.

Objective To investigate the differences of multiple factors in acute cerebral infarction (ACI) patients with and without multiple organ dysfunction syndrome (MODS),as well as in ACI patients in different MODS score groups.Methods One hundred and fifty-seven ACI patients were divided into non-MODS group( without concurrent MODS group)and MODS group.The MODS group patients were further divided into four subgroups according to the scores,including 1 -6points,7 - 12 points,13 - 18 points and points over 19.All patients were measured for procalcitonin(PCT) and C-reactive protein(CRP).The National Institutes of Health stroke score( NHISS score),acute physiology and chronic health evaluation( APACHE Ⅱ score)and Watian water test score were calculated.The differences in age,gender,PCT,CRP,NHISS score,APACHE Ⅱ score,Watian water score,breathing support rate,eating rate and mortality rate between the two groups were compared.Results Non-MODS group,compared with the MODS group,was significantly younger( [72.11 ± 16.41 ] years vs.[ 77.88 ±17.67 ] years,t=2.451,P ＜ 0.05 ),and the difference in the ratio of male to female between groups was not significant (57/38 vs.34/28,x2 =0.414,P ＞ 0.05 ).Differed from MODS group,non-MODS group had significant lower PCT value ( 1.83 ± 0.51 vs.2.98 ± 0.71,P ＜ 0.01 ),CRP value ( [ 12.53 ± 7.12] mg/L vs.[69.89 ±43.83 ] mg/L,P ＜0.01 ),NHISS score(9.38 ±5.24 vs.21.35 ±7.47,P ＜0.01 ),APACHE Ⅱ score ( 11.63 ± 4.22 vs.30.92 ± 7.80,P ＜ 0.01 ),Watian water score ( 2.36 ± 0.98 vs.3.88 ± 1.09,P ＜ 0.01 ),breathing support rate ( 2.1％ vs.43.5％,P ＜ 0.01 ) and mortality rate ( 4.2％ vs.43.5％,P ＜ 0.01 ),but had remarkable higher eating rate(95.8％ vs.66.1％,P ＜0.01 ).Pairwised comparison among the four MODS score groups,the PCT,CRP,NHISS score,APACHE score,Watian water test,breathing support rate and mortality rate were significantly different(P ＜ 0.05) ;The differences in age between the 1 -6 points group and the other three groups was significant ( P ＜ 0.05 ).Conclusion Age,PCT,CRP,NHISS score,APACHE score,Watian water test score,breathing support rate,mortality rate of the high-score MODS groups were higher than those of MODS groups with low-score in ACI patients,while eating rate was lower than that of the low-score groups.

Objective To compare the efficacy and safety between flumatinib and imatinib in patients with newly diagnosed chronic myeloid leukemia (CML). Methods A multi-center, randomized and parallel comparison clinical trial was conducted in 24 newly diagnosed patients with Philadelphia chromosome-positive CML-chronic phase (Ph+ CML-CP) who were treated by flumatinib 400 mg/d, 600 mg/d or imatinib for 6 cycles (24 weeks). The hematology was evaluated at pre-medication and the 2nd, 4th, 6th, 8th, 10th, 12th, 16th, 20th, 24th week of post-medication. The morphology, cytogenetics and molecular biology were evaluated at pre-medication and 12th, 24th week of post-medication. Results In terms of efficacy, the main molecular remission (MMR) rate of flumatinib 600 mg/d group was higher than that of imatinib group after 24 weeks [44.44 % (4/9) vs. 14.29 % (1/7), P=0.017]. The rate of bcr-ablIS≤10 % in flumatinib 600 mg/d group was significantly higher than that in imatinib group (P=0.002). PK/PD analysis also hinted that patients treated by flumatinib 600 mg/d was more likely to get molecular reaction in the early stage compared with those treated by flumatinib 400 mg/d. In terms of safety, there was no significant difference in grade Ⅲ-Ⅳ of adverse events among flumatinib 400 mg/d group, flumatinib 600 mg/d group and imatinib group (P >0.05). The common adverse events in flumatinib group included skin toxicity, gastrointestinal reactions and diarrhea.There was no heart and cardiovascular toxicity in flumatinib group, and incidence of edema in flumatinib group was lower than that in imatinib group. Conclusions Flumatinib is a safe and effective drug for newly diagnosed patients with Ph+ CML-CP, and 600 mg/d is the appropriate clinical starting dose. Flumatinib and imatinib have similar safety in clinic.

Objective:To observe the dynamic variation of serum ferritin (SF), folic acid, and vitamin B_(12) levels in patients with acute promyelocytic leukemia (APL) at different disease stages. Methods:Serum SF, folic acid and vitamin B_(12) levels were successively tested in thirty-six patients with primary APL every 1 to 3 months by using chemiluminescence analysis. Five different disease stages were selected as dynamic observation time points: first diagnosed, first complete remission (CR1), six months after CR1, relapsed stage,and CR1 for three years. Results:There were 75.0%(27/36)of patients with abnormal high levels of SF, 77.8% (28/36)of patients with abnormal low levels of folic acid, and 100%(36/36)of patients with increased vitamin B_(12) levels in first diagnosed stage. The number of patients with abnormal variations of SF, folic acid and vitamin B_(12) level was decreased in CR1 stage compared with those in first diagnosed stage (SF: P<0.05;folic acid and vitamin B_(12): P<0.01). The serum SF, folic acid and vitamin B_(12) levels tended to recover step by step with chemotherapy. At six months after CR1 the three parameters of most patients recovered to normal levels. APL was relapsed in 4 patients after 1-year CR. Both SF and vitamin B_(12) levels were increased and the folic acid level was decreased compared with those before replase, but the difference had no significance (P>0.05). The serum SF, folic acid and vitamin B_(12) levels were in normal ranges in the patients who had 3-year CR. Conclusion:The serum SF, folic acid and vitamin B_(12) levels had dynamic variation in APL course. Increase in serum SF and vitamin B_(12) as well as decrease in folic acid are related with the active degree of APL and its tumor load.