Osteoarthritis(OA) is a chronic progressive disease in the elderly, there are still no effective therapy for this disease. The objective of this article was to review progress in the clinical studies and therapies on the disease, especially NSAID therapy and total knee replacement.

Objective To compare the treatment accomplishmentsand adverse effects of the mixed- or single-application of etomidate and propofol during modified electroconvulsive therapy (MECT) in schizophrenics with hypertension. Methods Ninety hospitalized schizophrenics with hypertension undergoing MECT were ran-domly assigned to 3 groups: Group EP(etomidate = 0.3 mg/kg and propofol = 1.0 mg/kg), Group E (etomi-date = 0.7 mg/kg) and Group P (propofol = 2.0 mg/kg). Changes of SBP, DBP and HR were recorded before anesthesia, after induction, electrical stimulation instantly and 5 min after electrical stimulation. The average pe-riods of epileptic seizure (ESD), postictal suppression index (PSI) and the adverse reactions were also recorded. Results The ESD and PSI scores were significantly higher in Group EP and Group E than those in Group P (P < 0.05). SBP and DBP in Group E were significantly higher at the electrical stimulation instant than those af-ter induction (P < 0.05). SBP and DBP in Group P were significantly lower after induction than those before anesthesia(P < 0.05). The injection pain of Group EP and Group E were lower than that of Group P(P < 0.05). No significant differences were found among 3 groups in the adverse reactions such as nausea/vomiting anddys-phoria.Conclusion The mixed liquor of etomidate and propofol can extend the time of seizure, reduce the nega-tive reaction of cardiovascular system and adverse reactions during MECT in schizophrenics with hypertension.

Objective To evaluate the outcomes of children with stage Ⅳ malignant extracranial germ cell tumors. Methods Twenty-five patients were enrolled in the retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method with SPSS 13.0. Results Of the 25 children, there were 13 males and 12 females. The mean age at diagnosis was 2 years old (ranged 1 to 11). Five patients receiving chemotherapy in another hospital before (n=1), or giving up treatment after confirmed diagnosis (n=1), or giving up effective treatment after received less than 2 cycles (n=3) were excluded from this analysis. Of the 20 patients, 90.0% (18/20) achieved complete remission and 5.0% (1/20) achieved partial remission after treatment. The 5-year EFS rate and 5-year OS rate were 70.0%±10.2% and 82.4%±9.2% respectively. There was no death occurred due to complications. Conclusions The effect of this treatment program is positive. The cumulative dose of the drugs is not high, compared with other schemes such as PEB, but there are more drugs involved. Whether these drugs may cause long-term adverse reactions needs further research.

Objective: To investigate the long-term efficacy and prognostic factors of pediatric relapsed Wilms tumor (WT) after retreatment. Method: Sixteen children in Shanghai Children′s Medical Center with relapsed Wilms tumor were enrolled consecutively in this study between April 2006 and June 2016. All patients were diagnosed according to pathology, imaging and medical and surgical oncologist′s assistance. Relapse treatment included surgical excision, chemotherapy and selective radiation therapy. The clinical features, long-term outcomes and prognostic factors of patients were analyzed retrospectively.Survival data were analyzed by Kaplan-Meier.Log-Rank analysis was used for univariate analysis. Result: One case was excluded because of giving up the therapy even though no disease progress was identified. A total of 15 cases (5 males and 10 females) were included in this study. The median age at diagnosis was 3.8 years (range 0.5-9.1 years). The tumor staging at diagnosis included one case of stageⅠ, 7 cases of stageⅡand 7 cases of stage Ⅲ. Among cases of stage Ⅲ, 6 cases had radiation therapy history. The pathology of all patients′ recurrent tumor was favorable histology (FH). The median follow-up time was 34.6 months (range 12.5-132.7 months) until March 21, 2017. The time from initial diagnosis to relapse was 7.9 months (range 3.1-17.9 months). Four cases experienced local recurrence, 9 cases relapsed with metastases (6 cases in lungs, 2 in livers, 1 in mediastinum) and 2 cases relapsed in both local site and with metastases. Except to 2 cases received irregular retreatment, 13 cases received regimen I (doxorubicin, vincristine, epoposide and cyclophosphamide for 25 weeks) as relapsed chemotherapy. Five cases received autologous bone marrow transplantation (ABMT). Until the last follow-up, 8 cases achieved continuous complete remission (range 6.7-104.3 months), 3 cases had relapse again or progressing and 4 cases died. The estimated 5-year overall survival (OS) rate and event free survival (EFS) rate were (70±15)% and (52±15)%. According to whether received ABMT or not, the 5-year EFS rate were 51% and 53%. According to whether relapsed within 6 months after diagnosis or not, the 5-year EFS rate were 38% and 56% respectively. Conclusion The 5-year EFS rate of pediatric relapsed FH WT have reached above 50% by multi-disciplinary treatment in our experience and we encourage patients and doctors to receive retreatment.