Changes in sensitivity of clinical strains of Ureaplasma urealyticum from the urogenital tract to nine kinds of antibiotics from 2007 to 2018 / 中华皮肤科杂志

Objective To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum (Uu) to 9 kinds of common antibiotics from 2017 to 2018.Methods The results of drug sensitivity testing of clinical Uu strains,which were isolated from 19 431 patients in Laboratory of Sexually Transmitted Disease (STD),Department of Dermatology and Venereology,The Third Affiliated Hospital,Sun Yat-Sen University from 2007 to 2018,were analyzed retrospectively.Of the 19 431 patients,6 076 were males,and 13 355 were females.Their age ranged from 15 to 68 years.The tested antibiotics included minocycline,doxycycline,erythromycin,azithromycin,clarithromycin,roxithromycin,ciprofloxacin,sparfloxacin and levofloxacin.Results Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08％ and 10.42％ in 2007 to 1.15％ and 2.61％ in 2018,respectively,while sensitivity rates to minocycline and doxycycline gradually increased from 85.88％ and 87.56％ in 2007 to 97.02％ and 96.42％ in 2018,respectively.The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014-2017,with the resistance rate fluctuating around 20％,and the sensitivity rate fluctuating around 50％.The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02％ in 2007 to 8.39％ in 2011,and then fluctuated slightly around 10％.However,the sensitivity rate to azithromycin increased from 8.40％ in 2007 to 86.05％ in 2011,and remained above 80％ from then on to 2018.During 2007-2018,Uu strains showed low resistance rates (10％-20％) and high sensitivity rates to clarithromycin (80％-90％),and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin.Uu strains showed constantly high resistance to ciprofloxacin (more than 80％ after 2013) and low sensitivity (persistently less than 10％).The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40％,while the resistance rate was maintained below 10％ after 2011.The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin,but the sensitivity rate to levofloxacin was relatively lower,which had been maintained at about 30％.Conclusion From 2007 to 2018,clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline,doxycycline and clarithromycin,a high resistance rate and low sensitivity rate to ciprofloxacin,and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin;a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011;the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.

Changes in sensitivity of clinical strains of Ureaplasma urealyticum from the urogenital tract to nine kinds of antibiotics from 2007 to 2018 / 中华皮肤科杂志

Objective@#To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum (Uu) to 9 kinds of common antibiotics from 2017 to 2018.@*Methods@#The results of drug sensitivity testing of clinical Uu strains, which were isolated from 19 431 patients in Laboratory of Sexually Transmitted Disease (STD) , Department of Dermatology and Venereology, The Third Affiliated Hospital, Sun Yat-Sen University from 2007 to 2018, were analyzed retrospectively. Of the 19 431 patients, 6 076 were males, and 13 355 were females. Their age ranged from 15 to 68 years. The tested antibiotics included minocycline, doxycycline, erythromycin, azithromycin, clarithromycin, roxithromycin, ciprofloxacin, sparfloxacin and levofloxacin.@*Results@#Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08% and 10.42% in 2007 to 1.15% and 2.61% in 2018, respectively, while sensitivity rates to minocycline and doxycycline gradually increased from 85.88% and 87.56% in 2007 to 97.02% and 96.42% in 2018, respectively. The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014—2017, with the resistance rate fluctuating around 20%, and the sensitivity rate fluctuating around 50%. The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02% in 2007 to 8.39% in 2011, and then fluctuated slightly around 10%. However, the sensitivity rate to azithromycin increased from 8.40% in 2007 to 86.05% in2011, and remained above 80% from then on to 2018. During 2007—2018, Uu strains showed low resistance rates (10%-20%) and high sensitivity rates to clarithromycin (80%-90%) , and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin. Uu strains showed constantly high resistance to ciprofloxacin (more than 80% after 2013) and low sensitivity (persistently less than 10%) . The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40%, while the resistance rate was maintained below 10% after 2011. The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin, but the sensitivity rate to levofloxacin was relatively lower, which had been maintained at about 30%.@*Conclusion@#From 2007 to 2018, clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline, doxycycline and clarithromycin, a high resistance rate and low sensitivity rate to ciprofloxacin, and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin; a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011; the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.

Relationship between occupational stress and occupational musculoskeletal disorders in coal miners / 中国职业医学

OBJECTIVE: To explore the relationship between occupational stress and occupational musculoskeletal disorders( OMD) in coal miners. METHODS: A total of 362 coal miners were selected through cluster sampling method. The prevalence of OMD was investigated by the Nordic Standardized Questionnaires for Musculoskeletal Disorders( Chinese version). The Job Content Questionnaire and Effort Reward Imbalance Questionnaire were used to assess the occupational stress and depression of coal miners was determined by the Epidemiological Studies Depression Scale. RESULTS: The prevalence of OMD in coal miners was 63. 5%. There were 45. 9%( 166/362) of coal miners suffered from occupational stress with job demand-control model imbalance and 62. 4%( 226/362) of coal miners have occupational stress with effortreward model imbalance. The multiple logistic non-conditional regression analysis showed that the longer service length with exposure to occupational hazard factors,the more working days per week,the lower job contents and technical decisionmaking power,the higher the occupational stress with effort-reward imbalance,and the higher the depression and the higher the risk of OMD( P < 0. 05). CONCLUSION: Occupational stress and depression are both risk factors of OMD in coal miners.

Analysis of provocative test results in 127 cases of suspected inducible urticaria / 中华皮肤科杂志

Objective To analyze the rate and distribution of positive provocative tests in patients with inducible urticaria,and to investigate the role of provocative tests in the etiological diagnosis of chronic urticaria.Methods Among patients who visited the special clinic for urticaria in the Department of Dermatology of the Third Affiliated Hospital,Sun Yat-sen University from January 2016 to December 2017,127 patients with suspected inducible urticaria were selected,and underwent 6 provocative tests for inducible urticaria,including delayed pressure urticaria provocative test (DPUPT),symptomatic dermographism provocative test (SDPT),vibratory angioedema provocative test (VAEPT),cold urticaria provocative test (CUPT),heat urticaria provocative test (HUPT),and aquagenic urticaria provocative test (AUPT).Statistical analysis was carried out by chi-square test for comparison of positive rates between male and female patients.Results Among the 127 patients with suspected inducible urticaria,106(83.46％) showed one or more positive provocative tests.The positive rate of SDPT was the highest (79.53％,101/127),followed by HUPT (22.05％,28/127) and CUPT (9.45％,12/127).The positive rate of HUPT was significantly higher in female patients (30.14％,22/73) than in male patients (11.11％,6/54;X2 =4.301,P ＜ 0.05).The patients with positive DPUPT,VAEPT and AUPT all showed positive SDPT responses.Among the 12 patients with positive CUPT reactions,11 showed positive SDPT responses.Among the 28 patients with positive HUPT reactions,26 showed positive SDPT responses.Of the 48 patients with one or more positive non-SDPT provocative tests,the patients with 2 positive non-SDPT provocative tests accounted for 18.75％ (9/48).Conclusion Provocation tests for inducible urticaria are of great clinical significance for the etiological diagnosis of chronic urticaria.

Determination of minimal persistent pigment dose of normal skin to long-wave ultraviolet among healthy volunteers / 中华医学美学美容杂志

Objective To investigate the minimal persistent pigment dose (MPPD)of normal skin to UVA in Guangzhou city,and to observe its relationship to sex,age,skin type,seasons,ITA,and the years lived in Guangzhou.Methods 316 healthy subjects were exposed to Solar 601-300,and the MPPD was measured and observed by two professional technicians after 2-3 hours.Results The average MPPD value of all subjects was (9.61±2.57) J/cm2.In male and female,the average MPPD values were (11.09 ± 2.82) J/cm2 and (9.01 ± 2.20) J/cm2 respectively,and male was significantly higher than female (P＜0.01).There was significant difference of the MPPD value in different seasons (P＜0.01).The MPPD value in winter (10.66± 2.71) J/cm2) was significantly higher than spring (9.37±2.39) J/cm2,summer (9.53±2.66) J/cm2 and autumn (8.98±2.25) J/cm2.There was significant difference of the MPPD value between different ITA groups (P＜0.01).ITA grade-3 (10.72± 2.84) J/cm2 was significantly higher than grade-1 (8.50±1.45) J/cm2 and grade-2 (9.12±2.31) J/cm2 (P＜0.01),but there was no significant difference from grade-4 (11.87±2.73) J/cm2 (P =0.93).The MPPD value in subjects lived in Guangzhou over 10 years (8.97± 1.88) J/cm2 was significantly lower than those whose residence was less than 1 year and from 1 to 5 years,respectively (P＜0.01),but there was no significant difference from those lived from 5 to 10 years (P =0.47).Conclusions The MPPD value of the subjects in Guangzhou is related to gender,seasons,ITA grade and the years lived in Guangzhou city,while there is no correlation with age and skin types.

Peripheral Mohs micrographic surgery for the treatment of extramammary Paget′s disease Wan Miaojian, Ma / 中华皮肤科杂志

Objective To evaluate effectiveness of peripheral Mohs micrographic surgery for the treatment of extramammary Paget′s disease (EMPD). Methods A total of 28 patients with EMPD were treated with peripheral Mohs micrographic surgery. The depth and extent of tumor infiltration were evaluated before the surgery. One day before the surgery, 20% aminolevulinic acid hydrochloride was topically applied to determine and label surgical margins under a Wood′s lamp. After fluorescence-based localization, peritumoral skin tissues were resected and underwent frozen-section examination according to the protocol for Mohs micrographic surgery. Meanwhile, the tumor was resected. After surgery, patients were followed up every 3 - 6 months to detect local recurrence and metastasis. Results Of the 28 patients, 25 were male and 3 were female. Six patients each underwent 3 sessions of frozen-section examination, and 12 patients each received 2 sessions, with an average of 1.86 sessions for each patient. During the follow-up for 5 - 72 months, local recurrence occurred in 3 cases, and 1 patient died of tumor metastasis and uremia after 2 years of follow-up. Conclusion Peripheral Mohs micrographic surgery is a time-saving and effective treatment for EMPD.

Vitamin D and the recurrence of rheumatoid arthritis / 中国医师进修杂志

Objective To identify the correlation between vitamin D prescription and recurrence in rheumatoid arthritis (RA).Methods A randomized controlled trial study was performed in 170 RA patients who were in remission during the past 2 months.According to the level of vitamin D,170 RA patients were divided into normal vitamin D group (84 patients) and deficiency vitamin D group (86 patients).Deficiency vitamin D group were randomly allocated to receive vitamin D treatment(vitamin D treatment group) or without vitamin D treatment (control group).In the 6-month follow-up period,the recurrence status was observed and compared.Results In the 6-month follow-up period,the recurrence rate of RA in normal vitamin D group was 16.7％(14/84),in vitamin D treatment group was 19.0％(8/42) and in control group was 29.5％(13/44),and there was no significant difference (P ＞ 0.05).In vitamin D treatment group,no hypercalcemia and hyperphosphatemia occured.The age,course of disease and remission time in recurrence patients of three groups were no significant difference (P ＞ 0.05).The level of vitamin D in recurrence patients of vitamin D treatment group was higher than that in recurrence patients of control group:(25.5 ± 8.9) ng/L vs.(20.9 ± 8.6)ng/L,and there was significant difference(P＜ 0.05).Conclusion Vitamin D deficiency is not identified to be a risk factor for RA recurrence.Vitamin D does not reduce the recurrence of RA.

MRI characteristics of pilomyxoid astrocytoma / 中华放射学杂志

Objective To investigate the MRI features of pilomyxoid astrocytoma ( PMA ) in children.Methods MRI features of seven children with pathologically proven PMA in 2011-2013 were retrospectively analyzed.The ages of the patients ranged from 10 months to 32 months at initial diagnosis.Results All tumors were well-circumscribed masses.Six tumors were located in the hypothalamic-chiasmatic-third ventricular region , two tumor involved the bilateral temporal lobe , and one tumor was associated with NF-I.One occurred in the basal ganglia region.Four tumors were solid masses , whereas the other three showed cystic components.Six tumors were hypointense and one was isointense on T 1-weighted image.Five tumors were hyperintense and three were isointense on T 2-weighted image.Four tumors were hypointense , one was iso-hypointense and one was isointense on DWI.After contrast administration , four tumors enhanced homogenously and three tumors enhanced heterogeneously , with intratumoral irregular hypointense region in two tumors and rim enhancement in one tumor.Cerebrospinal fluid ( CSF ) dissemination, hydrocephalus and peritumor edema were observed in 2, 4 and 1 of cases, respectively.Proton magnetic resonance spectrum of two PMA showed elevated Cho /Cr ratios and decreased NAA/Cr ratios.Conclusions The imaging features of pilomyxoid astrocytoma include common origination from the midline of the neuroaxis in younger children about 2-3 years old.The CSF dissemination is common.The presence of hemorrhage and peritumor edema is not common.

Comparing the clinical effect of single incision laparoscopic right hemicolectomy and laparotomy right hemicolectomy / 中国医师进修杂志

Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P ＞ 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P ＞0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P ＞ 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.

Value of susceptibility weighted imaging in grading brain tumors in children / 实用放射学杂志

Objective To investigate the value of susceptibility weighted imaging in grading brain tumors in children.Methods Twenty-eight children with surgically or pathologically proved primary brain tumor were recruited during 2010 to 201 1.All patients were scanned with conventional MRI and SWI sequences on a 1.5T or 3.0T scanner before surgery.The cases of tumors were divid-ed into low grade (9 males and 2 females)and high grade groups (10 males and 7 females),according to the WHO classification of the tumors of the central nervous system in 2007.The low-intense signals within the abnormalities on SWI images were analyzed and classified into the different shapes,including punctuate,tubular,cluster-like,linear signal,irregular patchy signal.As for the num-ber of low-intense signals,we applied the four-score system.The irregular patchy signals were considered to be artifacts of SWI, namely hemorrhage,after exclusion of the isolated veins and calcification.The differences of rate of hemorrhage and scores between the two groups in SWI were analyzed statistically.Results The low-signal scores were significantly different between two groups with higher scores in high grade tumors than in low grade tumors(P <0.001).The rate of intratumor hemorrhage was also signifi-cantly different between two groups.The rate is higher in high-grade group than low-grade group,given the fact that the hemor-rhage was showed in 2 low grade tumors (18.18%),while in 1 1 high grade tumors (76.37%)(P =0.01 5 9<0.001).Conclusion Different grades of pediatric brain tumors manifest significant difference on susceptibility weighted imaging(SWI).It may be helpful in the preoperative classification of brain tumors by analyzing the relevant signals on SWI.

Determination of minimal erythema dose of normal skin to ultraviolet rays / 中华医学美学美容杂志

Objective To investigate the minimal erythema does (MED) of normal skin to UV in Guangzhou city,and to observe its relationship to sex,age,skin type,seasons and the years lived in Guangzhou.Methods 621 healthy subjects were exposed to Solar Simulator (GS2004) and the MED was measured and observed by two professional technicians after (24±2) hours.Results The average MED value of all subjects was (1170.2±333.2) mJ/cm2.In male and female group,the average MED values were (1132.8-339.4) mJ/cm2 and (1182.1 ± 330.7) mJ/cm2,respectively,and there was no significant difference between male and female (P=0.20).The MED value in subjects aged from 30 to 50 (1014.7 ± 359.7) mJ/cm2 was significantly lower than those aged from 20 to 29 (1222.9±304.3) mJ/cm2 and over 50 years (1179.0±374.3) mJ/cm2 (P＜0.01).The MED value in skin type Ⅱ (673.53±228.3) mJ/cm2 was significantly lower than those in type Ⅲ (1224.3±254.2) mJ/cm2 and Ⅳ(1363.1±278.5) mJ/cm2(P＜0.01).There was significant difference of the MED value between different seasons (P＜0.01).The MED value in spring (969.2±355.8) mJ/cm2 was lowest,and followed by summer (969.2± 355.8) mJ/cm2.However,there was no significant difference between autumn and winter (P＞0.05).The MED value in subjects lived in Guangzhou from 5 to 10 years was significantly lower than those whose residence time was from 1 to 4 years and over 10 years,respectively.Conclusions The MED value of the subjects in Guangzhou is quite different from other cities of China,and related to age,skin types,seasons and the years lived in Guangzhou city,while there is no correlation between MED value and gender difference.

Expression and clinical significance of cysteine-X-cysteine chemokine receptor 4, and stromal cell derived factor 1α in the peripheral blood of patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To explore the expressions of stromal cell derived factor 1 α (SDF-1α) and cysteine-X-cysteine chemokine receptor 4 (CXCR4) in the peripheral blood of patients with systemic lupus erythematosus (SLE).Methods Forty hospitalized SLE patients were recruited and twenty healthy volunteers were enrolled as normal controls.The percentage of CD3+CD4+CXCR4+,CD3+CD8+CXCR4+ and the plasma concentration level of SDF-1α in the control group and SLE patients were detected by flow cytometry and ELISA.The relationship between SDF-1α/CXCR4 and SLEDAI was explored.Kruskal-Wallis H,Pearson's and Mann-Whitney U test were used for statistical analysis.Results the expression of SDF-1α [329 (127,539) pg/ml] and CXCR4 [CD3+CD4+CXCR4+:4.20(2.01,6.35)％,CD3+CD4+CXCR4+:2.70(1.68,4.20)％] were significantly elevated in SLE patients when compared to the normal controls (Z=-6.277,-5.707,-4.885,respectively,all P=0.000),and were significantly increased in highly active SLE patients than less active SLE (Z=-5.414,-5.256,-5.312,P＜0.01).The expression of SDF-1α and CXCR4 in the butterfly erythema group,anemia group and proteinuria group were significantly higher than the normal group (P＜0.05).Both SDF-1αand CXCR4 were positively correlated with SLEDAI (r=0.857,0.830,0.861,respectively,all P＜0.01).Conclusion The expressions of SDF-1α and CXCR4 increase significantly in the peripheral blood of SLE patients and there is close relationship between SDF-1α/CXCR4 and disease activity,organ damage.The results of this study suggestthat SDF-1α/CXCR4 may play an important role in the pathogenesis of SLE.

Gene expression and characterisation of three pullulanases from Bacillus cereus GXBC-3 / 生物工程学报

Exploring excellent new pullulanase genes, and enriching pullulanase theory are of great importance to realize the industrialization of pullulanase. Three genes, pulA, pulB and pulC, encoding pullulanases, were cloned from Bacillus cereus GXBC-3 by bioinformatics analyzing the open reading frame in Bacillus cereus, annotated as putative I and II pullulanases in the GenBank database. Characteristics of these recombinant enzymes were inducible intracellular expressed in Escherichia coli, the results showed PulA was typical II pullulanase. Recombinant PulA could hydrolyze alpha-1,4- and alpha-1,6-glycosidic bonds. Its specific activity was 32.89 U/mg with an optimum temperature of 40 degrees C and optimum pH 6.5 using pullulan as substrate. And for soluble starch substrate, its specific activity was 25.71 U/mg with an optimum temperature of 50 degrees C and optimum pH 7.0. PulB and PulC were I pullulanases and only hydrolyzed alpha-1,6-glycosidic bond. The specific activities, optimum temperature and optimum pH of PulB and PulC for pullulan substrate were 228.54 U/mg, 45 degrees C, 7.0 and 229.65 U/mg, 45 degrees C, 6.5, respectively.

Study on the exocellular polysaccharide of Ureaplasma urealyticum biofilm in vitro / 中华微生物学和免疫学杂志

Objective To investigate the extracellular polysaccharide distribution and components of Ureaplasma urealyticum (Uu) after biofilm having been developed in.Methods The standard serotype 3 and serotype 14 belong to biovar Parvo,and the standard serotype 4 and serotype 8 belong to biovar T960 were employed to form biofilrns in vitro.Scanning electron microscope and confocal laser scanning microscope were used to analysis the biofilms and extracellular polysaccharide.We used combination of two different labeled lectins,Canavalia ensiformis(FITC-ConA) and Erythrina cristagalli(ECA) which bind to specific polysaccharide residues to visualize extracellular polysaccharide in biofilms,and average uorescence intensity was evaluated Results All the strains can form the biofilmsin vitro.The biofilm was honeycomb-Like structures mainly,and extracellular polymeric substances accounts for majority of proportions.All the extracellular polysaccharide could be combined with FITC-ConA and ECA,and the total average fluorescence intensity of FITC-ConA was higher than ECA( P＜0.001 ).Conclusion Ureaplasma urealyticum biofilm is honeycomb-like structures mainly.The extracellular polysaccharide contains,galactose,and N-acetyl glucan residual,and the glucose,mannose residual are the main components.

Dermatosis papulosa nigra: a case report / 中华皮肤科杂志

A 36-year-old female presented with multiple dark brown papules on the chest and abdomen for more than 10 years,which had gradually increased in number.Physical examination revealed dozens of dark brown,flat papules measuring 1-3 mm in diameter in the chest and abdomen.Most of the lesions had a smooth surface,and some lesions gave a papilloma-like appearance,with no confluent trend.Biopsy of abdominal lesions showed mild hyperkeratosis of epidermis,acanthosis,extension of epidermal protrusions forming a reticulated appearance,horn pseudocysts in prickle cell layer,enhanced pigmentation of basal layer,and a sparse lymphocytic perivascular infiltrate in superficial dermis.A diagnosis of dermatosis papulosa nigra (DPN) was made.

Cause and management of difficult laparoscopic appendectomy / 中国医师进修杂志

Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.

A case of unilateral mid-dermal elastolysis / 中华皮肤科杂志

A 38-year-old woman presented with a 20-year history of yellow papules and band-like atrophy on the right neck. The lesions developed slowly and were asymptomatic. There was no history of long-term sun exposure or family history of similar diseases. Skin examination revealed multiple irregularly sized yellow papules and plaques on the right anterior neck following cleavage lines, multiple pin cap-sized perifollicular papules on the posterior right neck. Well-defined band-like atrophic patches with fine wrinkling were observed in the whole right neck, giving an aged appearance. The skin of the left neck was nearly normal. Pathological examination of biopsy specimens from the yellow papules showed a normal epidermis, scant lymphohistiocytic and melanophage infiltrates around the vessels in the superficial dermis without solar degradation. The collagen bundles in the mid dermis were slightly thickened and arranged tightly in parallel to the skin surface with the absence of inflammatory infiltrate. Verhoeff-van Giesen's staining confirmed a nearly complete absence of elastic fibers in the mid dermis as well as obvious swelling and breakage of resident scant elastic fibers. Von Kossa's staining was negative. Based on the above findings, the diagnosis was made as unilateral mid-dermal elastolysis.

A case of extranodal NK/T-cell lymphoma, nasal type complicated by hemophagocytic syndrome / 中华皮肤科杂志

A 48-year-old man presented with a 4-day history of fever and 10-year history of papulovesicles on the face, neck, trunk and limbs which had been aggravated 10 days prior to the presentation.Skin biopsy showed a dermal infiltration of numerous small- to medium-sized atypical lymphocytes, which was mainly located around blood vessels or appendages, with the involvement of subcutaneous fat tissue and destruction of blood vessels. The infiltrating atypical cells stained positive for CD45RO, CD8, CD56, T-cell intracellular antigen-1, granzyme B, Epstein-Barr virus-encoded small nuclear RNAs (EBER), but negative for CD20, CD79a, CD3, CD4 or CD30. Cytoplasmic CD3ε was also observed in these cells. Laboratory examinations on admission revealed a progressive decrease in peripheral erythrocytes, white cells and platelets, persistent increase in serum aminotransferase and bilirubin, and decline in serum fibrinogen and hypertriglyceridemia. The B-mode ultrasound of the abdomen showed hepatosplenomegaly. Based on the above findings,the diagnosis was made as extranodal nasal type NK/T-cell lymphoma of skin complicated by hemophagocytic syndrome.

Expression of cathepsin G in photoaged fibroblasts / 中华医学美学美容杂志

Objective To investigate the role of cathepsin G in photoaged fibroblasts. Methods Human fibroblasts were cultured and induced to premature senescence using UVA + MOP methods. Senescence-associated-β-galactosidase (SA-β-gal) stain was used to evaluate the positive rate of aged cells. The mRNA and protein expression of cathepsin G in photoaged fibroblasts were detected by real-time RT-PCR and Western blot techniques. Results Over 98 % induced cells presented a positive SA-β-gal straining. The expression of cathepsin G, detected by Western blot, was increased to (1. 70±0. 028) times of the control. And RT-PCR revealed that the synthesis of cathepsin G mRNA was also up-regulated to 1. 42±0. 09. Conclusion The results of our study demonstrates a significant correlation between photoaged fibroblasts and cathepsin G. The up-regulation of cathepsin G may play an important role in the damages of extracellular matrix and activation of MMPS in photoaged human skin.

The expression of autophagy and related genes in patients with active systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the autophagy and the expression of its related genes in the peripheral blood mononuclear cells (PBMCs) of active systemic lupus erythematosus (SLE) patients.Methods Patients with newly onset or recently-diagnosed SLE (n=20) were enrolled.RA patients (n=10) and healthy blood donors (n=10) were used as controls.PBMCs from all subjects were immediately isolated by Ficoll-Hypaque density gradient centrifugation.And then monocytes were removed by wall sticking method.The morphology was observed using transmission electron microscopy (TEM).Messenger RNA (mRNA) expression of Beclin 1 and microtubule-associated protein 1-light chain 3 (MAPLC3) were determined by reverse transcription polymerase chain reaction (RT-PCR) and real-time quantitative RT-PCR respectively.Results TEM showed autophagic phenomenon in PBMCs from active SLE.On the mRNA level,expression of Beclin 1 and LC3 was significantly increased in fresh isolated SLE cells as compared with RA or healthy donor's PBMCs.Conclusion Based on these results,we can conclude that autophagy occurs in active SLE and the expression of its related genes is significantly higher in active SLE than in RA or normal controls.The enhanced autophagy may indicate its role in the pathogenesis of SLE.