Conservative sperm acrosomal antigens that react with a monoclonal sperm antibody against human spermatozoa HS63 were purified by immunoaffinity chromatography from rabbit testes. The purity and the molecular weight of the purified antigens were determined by SDS acrylamide gel electrophoresis. There is only a band on the acrylamide gel. The molecular weight is more than 60000. It is found that the antigen is a glycoprotein with the carbohydrate moiety of 17%. Following successive immunization antisera of high titers were raised and shown to react specifically with antigens on sperm acrosome, but not with any somatic cells as judged. By using mouse in vitro fertilization experiments and sperm penetration assay with zona-free hamster ova, the isoimmune sera from rabbit exhibited high degrees of fertilization inhibition as compared to the control sera. The results suggest that sperm-specific antigen reactive to HS63 may be a good candidates for the development of immunocontraceptive vaccines in humans.

Objective To investigate the value of ultrasound in diagnosis of fetal simple unilateral multicystic dysplastic kidney (MCDK) disease.Methods Pregnant women who underwent prenatal ultrasound screening and follow-up were analyzed retrospectively,and 29 fetues with MCDK were found.After exclusion of pregnancy syndrome,other structural abnormalities and chromosomal abnormalities,15 fetues willing to continue pregnancy and accepting the follow-up tracking observation were observed to postpartum.Ipsilateral renal ultrasonographic characteristics,contralateral renal morphology and size,growth and development of children and the renal function were analyzed.Results The minimum follow-up time of the 15 fetus was pregnancy to 7 months after birth,the maximum follow-up time was pregnancy to 5 years of age in children.Ultrasound showed that ipsilateral kidney volume became large in fetal period,reduced gradually in late pregnancy,and atrophy in 5 6 months after birth,even could not displayed with untrasound.The shape,size,and sonographic characteristics of the healthy kidney were similar to the normal gestational age kidney.Prenatal fetal growth indicators and amniotic fluid volume were normal.After birth,except for 1 child with overweight,other children's growth and development indicators were almost normal.Conclusion Fetus with simple unilateral MCDK has a good prognosis.Ultrasound has important value in the examination and follow-up.It can provide reliable basis for prenatal diagnosis and consultation.

Objective: To investigate mandibular movement characteristics in patients with skeletal class Ⅲ malocclusion during chewing different foods. Methods: 14 skeletal class Ⅲ adult patients with mandibular asymmetry, 10 patients without mandibular asymmetry and 10 normal control cases were chosen to find out the different condylar and incisor movement area ratio based on the aid of ARCUSdigma mandibular moving track analysis system. Results: First,during chewing soft food, the condylar tracing length of skeletal class Ⅲ adult patients with mandibular asymmetry were significant different in sagittal and horizontal plane compared with the other two groups(P<0.05), while the incisor point trajectory difference was not statistically significant. Second, the condylar and incisor movement characteristic showed much more different among three samples during chewing brittle food(P<0.05). Third, in sagittal plane, the deflective condylar movement area ratio was significantly higher than that of the other two groups during chewing hand food(P<0.01). Conclusion: The mandibular movement in skeletal class Ⅲ adult patients are affected obviously by the shape and texture of food. Asymmetric lower mandible patients have a greater preponderance of this phenomenon.

ObjectiveTo evaluate wedge resection of th e back labium renalis in the repairation of iatrogenic pelvis tear. MethodsFrom October 1999 to February 2002,7 cases of iatrogenic pel vis tear were repaired with wedge resection of the back labium of renal hilum.Th ere were 5 male patients and 2 female with an average age of 45.The tear occurre d during lithotomy for pelvis stone in 6 and transureteroscopic lithotripsy in 1.ResultsThe mean operative time was 130 min and the m ean blood loss 300 ml,postoperative IVU showed no obstruction of the renal pelvi s,and the renal function has been normal.All patients have been followed up for 3 months to 3 years.Neither hydronephrosis nor renal pelvis obstruction has been noted.ConclusionsThe procedure has the advantages of no need of predicle occlusion,less bleeding,a clear operation field,easy repaira tion,and the avoidance of pelvis obstruction.

Objective To determine the risk factors for postoperative cognitive dysfunction (POCD) after orthopedic surgery for adolescent idiopathic scoliosis.Methods Sixty-five patients with adolescent idiopathic scoliosis,aged 11-18 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective orthopedic surgery with general anesthesia,were enrolled in this study.On admission to hospital (T0),before surgery (T1),at the end of surgery (T2) and on 2nd day after surgery (T3),blood samples were taken from the peripheral vein for determination of serum interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α) concentrations.Cognitive function was evaluated using a set of neuropsychological tests at 1 day before surgery and 7 days after surgery.Baseline patient characteristics such as age,gender,years of education and medical history,intraoperative fluid intake and output,surgery time,extubation time,postoperative visual analog scale score and related complications were recorded.Patients were divided into either POCD group or non-POCD group according to the diagnostic criteria of POCD.Logistic regression analysis was used to pick out the risk factors for POCD.Results Sixty-three patients completed this trial.The incidence of POCD was 24％.Compared with non-POCD group,the serum IL-10 concentration at T0 and serum TNF-α concentration at T3 were significantly increased,the IL-10/TNF-α ratio was decreased,and the length of postoperative hospital stay was prolonged in POCD group (P＜0.05).The results of logistic regression analysis showed that increased concentrations of serum IL-10 at T0 and TNF-α at T3 were risk factors for POCD.Conclusion Increased serum concentrations of IL-10 on admission to hospital and TNF-α on 2nd after surgery are risk factors for POCD in the patients with adolescent idiopathic scoliosis.

Objective The widely use of ultrasound elastography has increased the detection rate of breast cancer.It has great advantage of differential diagnosis of breast tumor.Our study is to evaluate and compare the value of the quantitative ultrasound elastography parameters of AR ( area ratio) , ESR ( entire strain ratio) , LSR ( locolized strain ratio) , EFLR( entire fat to lesion ratio) and LFLR( locolized fat to lesion ratio) in the differential diagnosis of breast tumor. Methods 110 patients with 113 breast tumors were collected from Nanjing General Hospital of Nanjing Military Region between January 2015 and January 2016 who underwent breast exami-nation.The tumors were divided into two groups according to patholo-gy which acts as gold standard:benign group with 59 lesions and ma-lignant group with 54 lesions.Participants underwent quantitative ul-trasound elastography parameters examination.AR、ESR、LSR、EFLR、LFLR were compared between benign group and malignant group and ROC curve was drawn.Conventional ultrasound and ultrasound elastography parameter are combined to differentiate the benign or malignant lesion.Calculate the various parameters on the accuracy、susceptibility、specificity、positive likelihood ratio、negative likeli-hood ratio of the diagnosis of benign and malignant lesions, and determine the quantitative parameter with the highest accuracy. Results The mean value of AR、ESR、LSR、EFLR and LFLR of malignant lesions were all significantly greater than that of benign le-sions (P=0.000).Compared with the conventional ultrasound, AR、ESR、LSR、EFLR and LFLR have higher AUC in the differentia-tion of benign and malignant breast lesions;AUC of AR and ESR are higher than conventional ultrasound、LSR、EFLR and LFLR( P<0.000).Compared with conventional ultrasound(1.523) alone, conventional ultrasound combined separately with AR、ESR、EFLR and LFLR have higher positive likelihood ratio(11.581、8.272、3.482、2.458、2.100) in the differentiation of benign and malignant breast lesions, so as accuracy、susceptibility、specificity(P<0.000).The AUC of conventional ultrasound combined separately with AR and ESR[0.940(0.890~0.990)、0.941(0.891~0.990)] were higher than conventional ultrasound and conventional ultrasound com-bined separately with LSR、EFLR、LFLR[0.669(0.669~0.768)、0.837(0.759~0.915)、0.763(0.673~0.852)、0.787(0.701~0.874)],so as accuracy、susceptibility、specificity and positive likelihood ratio(P<0.000). Conclusion Quantitative ultrasound elastography may be helpful in differentiation of benign and malignant breast lesions, especially combining conventional ultrasound with AR and ESR, which were superior to combining with the other parameters and provide a more objective and credible basis to differenti-ate benign and malignant breast tumors with conventional ultrasound.

Objective To evaluate wedge resection of the back labium renalis and intrasinusal pyelolithotomy for staghorn calculi of kidney in patients with intrarenal pelvis and renal malrotation. Methods From August 1998 to February 2001, 18 cases of staghorn stones of kidney were removed via the wedge resection of the back labium of hilum renalis and incision of the intrarenal sinus. Results The mean operative time was 110 min and the mean blood loss 300 ml.The biggest stone was 6.5 cm?5.0 cm?3.0 cm and in one case the number of stones amounted to 1 400. Postoperative KUB showed no residual stones and postoperative IVU indicated normal renal function.All patients have been followed up for 1～3 years and have been free of stone. Conclusions The procedure has the advantages of no need of pedicle renalis occlusion,less bleeding,a clear operation field,easy staghorn calculi removal and the avoidance of renal hilum outlet obstruction.

Objective To research high efficiency ,safety and complications of transbronchial needle aspiration biopsy under the guidance of ultrasound bronchoscope (EBUS‐TBNA ) in the early stage diagnosis of pulmonary disease .Methods Totally 28 patients showed intrathoracic mass or mediastinal lymph nodes by chest CT treated from May 2013 to May 2014 underwent EBUS‐TBNA ,and conducted biopsy for pathological examination .Results Among all the 28 patients ,23 patients underwent EBUS‐ TB‐NA ,10 patients were diagnosed as lung cancer ,4 patients had metastatic tumors ,3 patients were diagnosed lymphoma ,3 people were tuberculosis ,2 people were sarcoidosis ,1 patients with inflammatory .The EBUS‐TBNA diagnosis rate of malignant tumor was 74 .0% ,and the diagnosis rate was significantly higher than expectation (53 .2% ,P<0 .01) .The accuracy of EBUS‐TBNA diagno‐sis was as follow :91 .0% for lung cancer ,100 .0% for lymphoma ,75 .0% for metastatic tumor;75 .0% for tuberculosis ,50 .0% for sarcoidosis ,and 100 .0% for inflammatory lesions .Among all EBUS‐TBNA patients ,only two patients had mild hypoxia and one patient had bleeding .Conclusion EBUS‐TBNA was an effective ,minimally invasive ,safe means of inspection for the early diagnosis of respiratory diseases ,especially of mediastinal mass .

Objective To study the relationships between retinal microvascular disease and acute coronary event (ACE) among aged people. Methods A controlled study for senile people in communities was conducted. Xinglong Zhuang Coal Mine Community in Jining city, Shandong province was chosen to carry out the study, and the residents in that area aged≥60 years were asked to take questionnaire survey, physical and laboratory examinations. There were 139 cases met the diagnostic criteria of ACE being in the observation group, and 1 509 cases without ACE were assigned in the control group. The gender, age, smoking, alcohol intake, hypertension, diabetes mellitus, education, physical exercise, retinal microvascular disease, fasting blood-glucose, high density lipoprotein cholesterin (HDL-C), low density lipoprotein cholesterin (LDL-C), triacylglycerol (TG), systolic pressure, diastolic pressure, body mass index (BMI) were collected in the two groups to perform univariate analysis. Multivariate non-conditional logistic regression analysis was used for the factors with statistical significance to screen out the independent risk factors that could affect the occurrence of ACE. Results The univariate analysis showed:the risk factors that might cause the occurrence of ACE included age, gender, smoking, hypertension, diabetes mellitus, LDL-C, systolic pressure, diastolic pressure, BMI, and retinal microvascular disease (P<0.05 or P<0.01). In the ACE patients of observation group, the rates of presence of arteriovenous crossing sign [44.6%(62/139) vs. 27.8%(419/1 509)], hard exudates [9.4%(13/139) vs. 4.9%(74/1 509)] and cotton-wool patches [19.4%(27/139) vs. 7.3%(110/1 509)] in retinal microvascular disease were significantly higher than those in control group (P<0.05 or P<0.01). The logistic regression analysis showed:age [P=0.002, odds ratio (OR)=1.06, 95%confidence interval (95%CI)=1.04-1.09], smoking (P=0.032, OR=2.17, 95%CI=2.04-2.30), retinal microvascular disease (P = 0.010, OR = 2.33, 95%CI = 0.97 - 1.27), hypertension (P < 0.001, OR = 5.21, 95%CI=4.11-6.36), diabetes mellitus (P=0.021, OR=1.03, 95%CI=1.01-1.05) and LDL-C (P=0.020, OR=2.80, 95%CI = 2.65 - 2.99) were the independent risk factors for the occurrence of ACE. Conclusions Retinal microvascular disease is the independent risk factor for the occurrence of ACE. The retinal angiography can be a useful examination to forecast ACE.

OBJECTIVE:To explore hospital pharmacists service mode and the subject construction of hospital pharmacy. ME-THODS:Through reviewing the transformation process of hospital pharmacy and pharmacist's duty,the present structure,con-tent,working model and achievements of pharmacy in our hospital were introduced based onlarge pharmacyof taking clinical pharmacy as core,paying attention to personnel training,technical innovation,physican,pharmacist and nurse cooperation,multi-ple discipline integration,etc.;the direction of hospital pharmacy was explored. RESULTS:Many adjustments were made to facili-tate the smooth and orderly development of hospital pharmacy under the new situation,as that establish the rational drug use and quality safety system,drug supply and operation management system working mode;that the development strategy of pharmacy was identified asfocusing on the rational drug use,combining the management functionandproviding professional pharmaceuti-cal care for the clinic and patients,providing professional technical support for the hospital decision and medical management;that the construction of clinical pharmacy specialty/key discipline and drug clinical trial technology platform in accordance with the international standard and so on were lined in the project of pharmacy;that quality control circle was cited,pharmaceutical supervi-sion and pharmaceutical care were expanded to the public and the fine;that a fine,professional pharmacist team was cultured. CONCLUSIONS:The construction of future hospital pharmacy needs the concept oflarge pharmacywith multi-disciplinary inte-gration to develop towards standardization,refinement,specialization and modernization.