OBJECTIVE:To observe clinical efficacy and safety of intraarticular injection of betamethasone and hyaluronate in the treatment of elderly knee osteoarthritis. METHODS:A total of 76 elderly patients with knee osteoarthritis were selected from our hospital during Jul. 2012 to Jul. 2015,and then divided into control group and observation group according to random number table,with 38 cases in each group. Control group was given intraarticular injection of Sodium hyaluronate injection 2 mL,once a week,for consecutive 3 weeks. Observation group was given Compound betamethasone injection 1 mL in the first week,and given sodium hyaluronate 2 mL,every week,in the following 2 weeks. Clinical efficacies and the occurrence of ADR as well as VAS score,WOMAC score,GQOLI-74 score and MMP levels before and after treatment were compared between 2 groups. RESULTS:Total response rate of observation group was 92.11％,which was significantly higher than 73.68％ of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in VAS score,WOMAC score,GQOLI-74 score, MMP-1 level or MMP-3 level between 2 groups(P>0.05). After treatment,VAS,joint stiffness,joint pain and daily activity re-striction score as well as MMP-1,MMP-3 were decreased significantly in 2 groups,compared to before treatment;physical pain, physiological function,physiological limitations,vitality,social function,emotional function,mental health and GQOLI-74 total score were increased significantly,and the each index of observation group was significantly better than that of control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:The intraarticular in-jection of betamethasone and sodium hyaluronate in the treatment of elderly knee osteoarthritis can effectively reduce pain degree, improve knee function and quality of life,have good therapeutic efficacy and safety,the mechanism of which may be associated with the reduction of MMP level.

Objective To investigate the imaging features of chest CT and characteristics of laboratory tests in microscopic polyangitis (MPA) with pulmonary infection. Methods Based on the results of sputum culture, 42 patients with MPA were divided into two groups, MPA with pulmonary infection (16 cases)and MPA without pulmonary infection (26 cases). The results of chest CT images and laboratory tests were compared between the 2 groups by χ2 test (or Fisher exact test) and student t test (or Mann-Whitney U test), respectively. Results Compared with patients without pulmonary infection, patients with pulmonary infection showed patchy opacities(15/16 cases versus 14/26 cases,χ2=5.631,P=0.018)and consolidations(7/16 cases versus 2/26 cases,χ2=5.657,P=0.017)more frequently. Patchy opacities showed peripheral distribution less frequently in the MPA with pulmonary infection group than in the MPA without pulmonary infection group (6/15cases versus 12/14 cases,P=0.021). Patients with pulmonary infection showed the same frequent as the patients without pulmonary infection in the following CT findings including ground glass opacities, pleural effusions, mediastinal adenopathy and pulmonary fibrosis (P>0.05). The MPA with pulmonary infection group had higher neutrophil ratio than the MPA without pulmonary infection group (0.84 ± 0.12 versus 0.74 ± 0.11,t= 2.845,P= 0.007). Conclusions The MPA patients with pulmonary infection show patchy opacities and consolidations more frequently, and have higher neutrophil ratio than the MPA without pulmonary infection. The characteristics can be helpful in the diagnosis of pulmonary infection in the MPA patients and guild the treatment.

Objective To prospectively assess the therapeutic procedure and outcome of MR-guided percutaneous sclerotherapy in patients with venous vascular malformations of the extremities. Methods Fifty-seven percutaneous sclerotherapy treatments were performed under MR guidance in 28 patients with venous vascular malformation. Assessment was conducted to analyze (1) individual success of therapy, (2) improvement of clinical symptoms, ( 3 ) occurrence of complications, (4) volume changes at follow-up examinations, (5) contrast-to -noise ration (CNR) changes. Paired-t test was used to compare the volume and CNR of pre- and postintervention. Results All MR-guided percutaneous sclerotherapy were performed successfully and without serious complications. Individual predominant symptoms were improved, especially about the pain and functional impairment. The mean lesion volumes of pre- and post-intervention were (56. 8 ± 11.7 ) cm3 and ( 27.0 ± 7.2 ) cm3 respectively, which showed significant difference ( t = 8. 90, P < 0. 01 ). The percentage of volume shrinkage ranged from 28. 5% to 74. 4% [ mean ( 54. 4 ± 5. 3 ) % ]. The CNR of the pre and post-interventional images were 21.9 ± 2. 0 and 8.4 ± 0. 9 respectively. There was significant difference(t = 21.76, P < 0.01 ) between them, and the percentages of CNR decrease were 40.0% to 78. 0% [ the mean(61.0 ± 3.6)%]. Conclusion MR-guided sclerotherapy of venous vascular malformations of the extremities is a safe and efficient technique.

BACKGROUND:It is accepted that the best method for spermatogonial stem cells separation is using artificial cryptorchism model combined with surface makers.OBJECTIVE:To explore the feasibility of separation spermatogonial stem cells with ?6-integrin and c-kit as specific surface markers.DESIGN,TIME AND SETTING:The randomized control experiment was performed at the Renmin Hospital of Wuhan University from May to December 2006.MATERIALS:Forty adult,white Kunming mice with 6 weeks old were randomly divided into cryptorchidism and control groups,with 20 animals in each group.METHODS:Artificial cryptorchidism model was prepared by made an incision at the median of abdomen,and testis was pulled into abdominal cavity,which was fixed at the each side of lateral abdominal wall.There was no treatment in the control group.The single cell suspension of seminiferous epithelium was obtained by traditional two step enzyme digestion at 2-3 months after operation.FITC-conjugated anti-?6-intergrin antibody and PE-conjugated anti-c-kit antibodies were added.Then the cells with low side scatter light-scattering properties were sorted and positively stained for ?6-intergrin and negative c-kit expression.Meanwhile,the viability of the isolated cells was assessed by trypan blue staining.MAIN OUTCOME MEASURES:The morphological changes of cryptorchidism,and the sorting results of spermatogonial stem cells.RESULTS:Cell distribution in seminiferous tubule was disorder with reduced numbers.The layer and lumens were disappeared,and cell division phase could be seen in the center of tubules.Compared to the control group,the testicular cells in the cryptorchidism group were increased in the side scatterlow,Forward scatterhi areas,with figure left-upward displacement.The distribution of ?6-integrin+ and c-kit cells were deviated each other,it named that most ?6-integrin+ cell were not spermatogonial stem cells,so do the c-kit-cells.Only 2.8% of testicular cells exhibited side scatterlow,?6-integrin+,and c-kit-,which were spermatogonial stem cells in the cryptorchidism group.And trypan blue staining showed that over 95% of them were viable.CONCLUSION:Using the two surface markers to sort spermatogonial stem cells can advance the purity of the spermatogonial stem cells in cell suspension,but the specificity is insufficient.

OBJECTIVE:To explore how to establish good procedure,system and mode of drug management,dispensing and application,in order to provide reference for risk management and rational use of rabies vaccine. METHODS:The use of rabies vaccine and storage temperature monitoring in our hospital during 2013-2014 were analyzed statistically,and risk management and use of rabies vaccine in our hospital were analyzed,and management measures and attentions were put forward. RESULTS:The amount of vaccinum rabiel (Vero cell) and human rabies immunoglobulin in our hospital were increased in 2014,compared to 2013. The position labeled with #1 in storehouse and that of labeled with #1 and #2 in dispensing store could meet the storage condi-tion of rabies vaccine. Risk management could be carried out in fields of drug requisition,cold chain management,drug manage-ment and drug dispensing. ADR should be paid attention. CONCLUSIONS:It is of significance to develop risk management and ra-tional medication guidance of rabies vaccine.

Objective:To analyze the adverse drug reactions(ADR)and clinical application of thalidomide to provide useful reference for rational medication in clinics. Methods:The case reports and literatures from foreign countries on the clinical medication of thalidomide were analyzed and summarized. Results:The ADR of thalidomide included gastrointestinal reaction, hematotoxicity,cadiovascular toxicity,neurotoxicity,skin lesion,pulmonary embolism and so on. Its new medication methods were widely used in clinics. Conclusion:Clinicians and pharmacists should pay more attention to the medication risks and rational use of thalidomide in order to assure the safety and effectiveness of clinical drug use.

In this paper,we made an analysis of the organization and content settings of medical laboratory students' summer clinical practices,and summarizes the students' achievements and experience of clinical practices in many years.Standardized organization and reasonable content settings are the guarantees for the students to have a comprehensive understanding of the basic major contents.Through the summer clinical practices,students can have a good understanding of their major in short period of time.

Objective To establish a rat model of chronic nonbacterial prostatitis (CNP) and investigate the histopathological characteristics of CNP in rat. Methods The prostate tissues of 4 male SD rats were taken out under aseptic condition,and prostate tissue homogenate supernate (PTHS) was made.Another 20 male SD rats were randomly divided into control group and CNP group with 10 rats each.Each rat of group CNP was immunized with 1.0 ml PTHS (20 mg/ml) emulsified by isopyknic Freund's complete adjuvant (FCA) intradermally in the multiple points,and simultaneously immunized with 0.5 ml pertussisdiphtheria-tetanus (PDT) vaccine intraperitoneally on 0 and 30th day.Each rat of control group was injected with equivalent normal saline in the same way.Rats from each group were sacrificed 45 days after immunization,and the prostates were harvested under aseptic condition.Prostatic tissues were examined macropathologically and histologically for degree of inflammation.Another 80 CNP rats were established after confirming success of the modeling.They were divided into high-dose androgen group (H),medial-dose androgen group (M),low-dose androgen group (L) and control group (C) with 20 in each.Rats of group H,M and L were injected with different concentrations of testosterone propionate ( 1,2,4 mg/ml).Rats of group C were injected with sterilized peanut oil.O.5 ml was applied through subcutaneous injection every other day.Each group was equally divided into 4 subgroups,in which the durations of medication were 1,2,4 and 6 weeks,respectively.After the expiration of the injection,animals from each subgroup were sacrificed and the macropathological and histological features of the prostatic tissues were examined as above. Results Macroscopic features of prostate tissues of group CNP at the 45th day were serious congestion and edema,adhesion with surrounding tissues,aneretic prostate capsule and so on.Histologically,the prostatic tissues were characterized by lymphoid tissue proliferation and chronic inflammatory cell infiltration in the stromal connective tissue around the acini or ducts.The rats of control group showed no inflammatory manifestations as above.After injection of testosterone propionate,the inflammatory degree of the CNP rats was lessen in varying degrees.For example,the destructive glands and stroma appeared repair and regeneration,the lymphoid tissue proliferation was alleviated,and the locations,ranges and amount of chronic inflammatory cell infiltration were also decreased.Furthermore,the relief of inflammatory degree had a positive correlation with the concentration and duration of testosterone propionate.The degree of inflammation in group C scarcely changed. Finally,the histopathological characteristics of CNP in rat model were summarized according to the results of histopathology,including inflammation locations,ranges and grades.Inflammation locations:①inflammation in the glands referred to the inflammatory cell infiltration in the ductal epithelium,alveolar epithelial and (or)glandular cavity; ②inflammation in the periglandular tissues referred to the inflammatory cell infiltration in the stroma and around the glandulartube; ③inflammation in the stroma referred to the inflammatory cell infiltration in the stroma without the glandulartube.Inflammation-rangeg:①focal inflammation indicates that the area of inflammatory cell infiltration was less than 10％ ; ②multifocal inflammation indicates that the area of inflammatory cell infiltration ranged from 10％ to 50％ ; ③diffuse inflammation indicates that the area of inflammatory cell infiltration was more than 50％.Inflammation grades:①grade Ⅰ meant that scattered inflammatory cells were in the specific area,cell count 1 - 10/HP; ②grade Ⅱ meant that inflammatory cell assembled without glandular epithelial tissue destruction or lymphoid nodule/follicle formation,cell count l1 -20/HP; ③grade Ⅲ meant that inflammatory cell assembled with part of glandular epithelial tissue destruction or lymphoid nodule/follicle formation,cell count ＞ 20/HP; ④grade Ⅳ meant that inflammatory cell assembled with a mass of glandular epithelial tissue destruction or lymphoid nodule/follicle formation,cell count full field of vision/HP. Conclusions The CNP rat model can be established by immunized with syngeneic PTHS plus FCA and PDT.The histopathological characteristics of CNP in rat can be evaluated according to the locations,ranges and grades of inflammation,which serve for further research of pathogenesis and treatment of this disease.

Objective To investigate the clinical features , diagnosis and key technique points of laparoscopic partial adrenalectomy for small adrenal pheochromocytoma . Methods From Oct.2006 to Jun. 2011, clinical data of 32 cases with small adrenal pheochromocytoma (≤3.0 cm) were collected and retro-spectively analyzed .Hypertension was observed in 12 patients, whereas 20 patients presented with adrenal incidentaloma .Thirteen patients had a left adrenal neoplasm , eighteen patients had a right adrenal tumor , while one patients had bilateral tumors .The positive rate of plasma-free metanephrines ( MNs) and 24-hours urinary catecholamine (CA) in diagnosing small renal pheochromocytomas was 92.6%(25/27) and 81.3%(26/32) respectively.The main localization diagnosis included ultrasonography , 131I-MIBG, and CT or MRI, with positive rates of 71.9%(23/32), 93.8%(15/16) and 96.9%(31/32) respectively.All the laparoscopic adrenalectomies were performed retroperitoneally .During the surgery , the internal part of the adrenal gland closing to the retroperitoneum was dissected first , and the whole adrenal gland was resected completely. Results Partial adrenalectomy was performed for 30 cases and radical adrenalectomy for 2 ca-ses.All operations were successful without perioperative or postoperative complications .The maximum diame-ter of tumor was 1.7±0.2 (1.0-3.0) cm.Histopathological results showed that all the cases were benign pheochromocytoma.The operative time was 82 (40-210) min.The estimated blood loss was 57 (20-180) ml.No patient required blood transfusion . Conclusions Plasma-free MNs, 24-hours urinary CA and VMA are important qualitative examinations in detection of adrenal pheochromocytoma .Ultrasonography , CT,MRI, and 131 I-MIBG are important in the localization of adrenal tumors .Retroperitoneal laparascopic partial adrenalectomy is the preferred choice in the management of small adrenal pheochromocytoma .Dissecting the internal part of the adrenal gland closing to the retroperitoneum first and exploring the whole adrenal tissue are the key technique points during the operations .

Objective To establish a long-term culture system for mouse spermatogonial stem cells(SSCs). Methods Testis cells from 4-6 days postpartum male transgenic BALB/C mice were collected by a modified two-step enzymatic digestion method.After three differential adherence selections,the enriched germ cells were finally suspended in StemPro-34 SFM medium supplemented with other nutrients factors and plated on mouse embryonic fibroblast(MEF)feeder layer.20 ng/ml Glial cell line-derived neurotrophic factor,10 ng/ml basic fibroblast growth factor and 200 ng/ml GDNF-family receptor al were added to the serum-free medium to promote SSCs proliferation.Aduh male BALB/C mice,4-5 weeks old,underwent intraperitoneal injection of 40 mg/kg busulfan as recipient mice.Cultured SSCs were also injected into the seminiferous tubules of the left recipient testis through micromanipulator and right testis as self-control.Testes of recipient mice were observed by a fluorescence stereomicroscope and HE stains at 2 months after transplantation. Results By improved digestion method,the vitality of isolated testis cells was more than 98%and the stem cells was enriched about 18.5 fold. 1-2 days after transferred to MEF feeder, the round germ cells started to proliferate and had the shape of paired or aligned undifferentiated spermatogonia connected by cytoplasmic bridges. After 3-4 days, SSCs proliferated continuously and formed typical colonies. SSCs from BALB/c mice could be cultured and passaged in a steady state for 3 months. Cryostat section through the transplanted testis showed that most of seminiferous tubules were filled with germ cells expressing EGFP.HE staining further showed clearly that seminiferous tubules contained complete spermatogenesis.Conclusions SSCs from BALB/c mice could be cultured in an improved culture system for 3 months.The culture system could facilitate understanding the regulatory mechanism that governs SSCs and might provide an opportunity for the cure of infertility.