Effects of heat waves and cold spells on the incidence of hemorrhagic stroke / 预防医学

Objective@#To examine the impact of heat waves and cold spells on the incidence of hemorrhagic stroke, so as to provide insights into prevention of hemorrhagic stroke.@*Methods@#Data pertaining to the incidence of hemorrhagic stroke in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance, and the meteorological data during the period from 2015 to 2019 were captured from National Meteorological Information Center of China. The air quality index (AQI) was collected from the National Daily Report of Urban Air Quality in China. Heat wave was defined as the highest daily temperature that was no less than the 90th percentile (P90), P92.5, P95 and P97.5 of the highest daily temperature in the warm season for at least 2, 3 or 4 days, and cold spell was defined as the lowest daily temperature that was no more than the P10, P7.5, P5 and P2.5 of the lowest daily temperature in the cold season for at least 2, 3 or 4 days. The effect of heat waves and cold spells on the incidence of hemorrhagic stroke was evaluated using a generalized additive model and described with relative risk (RR) and its 95%CI.@*Results@#A total of 8 844 case with first-onset hemorrhagic stroke were recorded in Zibo City from 2015 to 2019. The lowest daily temperature that was no more than P10, P7.5 or P5 of the lowest daily temperature in the cold season for at least two days, or that was no more than P10 or P7.5 of the lowest daily temperature for at least 3 days resulted a remarkably increased risk of hemorrhagic stroke (lowest RR=1.187, 95%CI: 1.031-1.366; highest RR=1.242, 95%CI: 1.042-1.480), and after adjusting the effect of daily mean temperature, the lowest daily temperature that was no more than P10 or P7.5 of the lowest daily temperature in the cold season for at least two days, or that was no more than P10 of the lowest daily temperature for at least 3 days resulted a remarkably increased risk of hemorrhagic stroke (lowest RR=1.236, 95%CI: 1.009-1.513; highest RR=1.274, 95%CI: 1.023-1.585). However, there was no significant association between heat waves and the risk of hemorrhagic stroke.@*Conclusion@#Cold spells may increase the risk of hemorrhagic stroke, while no significant association is examined between heat waves and the risk of hemorrhagic stroke.

Two cases of Merkel cell carcinoma treated with modified Mohs micrographic surgery / 中华皮肤科杂志

Surgical resection is the preferred treatment of Merkel cell carcinoma, and Mohs micrographic surgery is an ideal method for resecting skin tumors. Intraoperative frozen pathological section in traditional Mohs surgery is changed into paraffin-embedded pathological section in modified Mohs micrographic surgery, which is more suitable for highly malignant tumors. In this article, two elder patients with Merkel cell carcinoma both received modified Mohs micrographic surgery for the excision of tumors. During more than 1 year of follow-up, no recurrence was observed. Compared with traditional extended resection, modified Mohs micrographic surgery is a better choice for patients with Merkel cell carcinoma.

Identification of a novel mutation in the BCS1L gene causing Bj(o)rnstad syndrome / 中华皮肤科杂志

Objective To identify gene mutations in the BCS1L gene in a patient with Bj(o)rnstad syndrome mainly manifesting as congenital pili torti and sensorineural hearing loss.Methods Clinical data were collected and DNA was extracted from the peripheral blood of the patient and her parents.All the exons and their flanking sequences of the BCS1L gene were amplified by PCR followed by Sanger sequencing,and the sequencing results were compared with the normal sequences.A few hairs were collected from the patient,and examined by the scanning electron microscope.Results There were two mutations in BCS1L gene in the patient,i.e.,a heterozygous nonsense mutation in exon 4 and a heterozygous missense mutation in exon 8.The nonsense mutation in exon 4,which caused a change from CGA to TGA at position 144 and resulted in the substitution of arginine by termination codon (p.R144*),was a novel mutation in the BCS1L gene causing Bj(o)rnstad syndrome,and had never been repotted in the literature.The missense mutation in exon 8 led to a change from CGC to CAC at position 306 and resulted in the substitution of arginine by histidine (p.R306H).The patient's mother only carried a heterozygous mutation c.430 C＞T (p.R144*) in exon 4 of the BCS1L gene,and her father only carried a heterozygous mutation c.917 G＞A (p.R306H) in exon 8 of the BCS1L gene.Scanning electron microscopy showed that flats,grooves and longitudinal twisting irregu larly appeared at intervals on the surface of hair shafts.Conclusions A novel mutation in the BCS1L gene,which causes a change from CGA to TGA at position 144 in the BCS1L gene and results in a premature termination codon,is firstly reported in a patient with Bj(o)rnstad syndrome,and the compound heterozygous mutations c.430 C＞T and c.917 G＞A in the BCS1L gene are associated with the clinical manifestations of the patient.Genetic analvsis is helpful for the diagnosis of Bj(o)rnstad syndrome.

Epidemiological characteristics of natural focus and vector borne infectious diseases in Zibo City Shandong Province between 2004 and 2015 / 中华地方病学杂志

Objective To analyze the incidence trends and epidemiological characteristics of natural focus and vector borne infectious diseases in Zibo City between 2004 and 2015,and to provide evidence for control and prevention of the diseases.Method Surveillance data of natural focus and vector borne infectious diseases in Zibo City between 2004 and 2015 from the National Disease Reporting Information System were analyzed via descriptive epidemiological methods.Results A total of 10 natural foci and vector borne infectious diseases and 3 287 cases including 55 death cases were reported in Zibo City from 2004 to 2015.The average annual incidence was 6.24/100 000 and the case fatality rate was 1.67％ (55/3 287).The incidence rate increased in recent years after the lowest rate in 2009 (2.83/100 000),and the rate in 2015 was 8.83/100 000.The top three diseases with higher incidence were hemorrhagic fever with renal syndrome (3.44/100 000),brucellosis (1.48/100 000) and tsutsugamushi fever (0.53/100 000).The top three high-prevalence areas with higher incidence were Yiyuan County (13.22/100 000),Zichuan District (9.73/100 000) and Boshan District (6.13/100 000).The cases mainly occurred from March to May and September,October,which accounting for 27.47％ (903/3 287) and 24.64％ (810/3 287),respectively of the total.The 40-59 year-oldage group was the highest,accounting for 48.13％ (1 582/3 287)of the total.And 75.48％ (2 481/3 287) of reported cases were farmers.Conclusions The overall incidence of the natural focus and vector borne infectious diseases in Zibo City has a annual increasing trend in recent years,while the incidence of brucellosis and tsutsugamushi fever have continued to rise since 2004.These diseases have showed a significant seasonal distribution and population distribution.It is necessary to conduct targeted prevention and control strategies.

A comparison of 20-MHz and 50-MHz ultrasonography in imaging and measuring the skin / 中华皮肤科杂志

Objective To investigate imaging characteristics of human skin in different sites by using 20-MHz and 50-MHz high-frequency ultrasonography,and to compare the reliability of skin thickness measurement by the above two approaches of ultrasonography.Methods A total of 39 healthy volunteers aged 18-39 years were enrolled into this study.Then,20-MHz and 50-MHz ultrasonography were separately performed to image 20 different sites on the body,and the thickness of the epidermis and dermis were measured and evaluated by 3 dermatologists independently.The ultrasonic images were analyzed,and the intraclass correlation coefficient (ICC) was used to assess and compare the reliability of skin thickness measurement by 20-MHz and 50-MHz ultrasound.Results The ICC values were less than or close to 0.7 in epidermal thickness measurement at almost all the tested sites between 20-MHz and 50-MHz ultrasonography,suggesting poor reliability.However,20-MHz and 50-MHz ultrasonography showed excellent reliability in dermal thickness measurement with the ICC greater than 0.75 at almost all the tested smooth and flat body sites.The 20-MHz ultrasound could provide clear images of the dermis and subcutaneous tissue,while 50-MHz ultrasound could only provide clearer images of the dermis in details.In some uneven sites with complex anatomical structures,20-MHz and 50-MHz ultrasound probes had their own advantages and disadvantages in imaging depth and detail resolution.Conclusions The 20-MHz and 50-MHz ultrasono-graphy both can serve as non-invasive imaging techniques to show structures of the epidermis and dermis better.In different parts of human body,ultrasound frequencies should be selected according to their imaging characteristics.

Ginger-partition moxibustion combined with glucocorticoid for thyreoitis at subacute stage: a randomizd controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical effects between ginger-partition moxibustion combined with glucocorticoid and simple oral glucocorticoid for thyreoitis at subacute stage.</p><p><b>METHODS</b>Eighty-one patients were randomly divided into an observation group (41 cases) and a control group (40 cases). In the observation group, ginger-partition moxibustion and hormone were applied. Moxa cones were used at local ashi points, Zusanli (ST 36), Guanyuan (CV 4) and Qihai (CV 6), six cones every point, once every other day and three times a week. Besides, 24 mg methylprednisolone tablets were adopted orally every day, and in two weeks the dose was 16 mg/d, in four weeks 8 mg/d, in six weeks 4 mg/d; all the patients were observed for 8 week. In the control group, simple methylprednisolone was prescribed orally, and the dose, the usage and treatment time were the same as those in the observation group. Erythrocyte sedimentation rate (ESR), triiodothyronine (T3), thyroxin (T4) and ultra-sensitive thyroid stimulating hormone (TSH) before and after treatment were observed in the two groups, as well as fever, the pain of thyroid gland, the regression time of swelling and adverse reaction.</p><p><b>RESULTS</b>The time of thyroid gland pain relieved of the observation group was earlier than that of the control group [(3.07 ± 0.78) days vs (3.62 ± 0.92) days, P < 0.05]. After treatment, T3, T4 and ESR were declined apparently (all P < 0.01), and TSH was obviously increased in the two groups (both P < 0.01). After 2-week treatment, ESR in the observation group was lower than that in the control group (P < 0.05). After 4-week treatment, T3, T4, TSH and ESR in the observation group were better than those in the control group (all P < 0.05). After 8 weeks, all indices in the observation group were superior to those in the control group, without statistical significance between the two groups (all P > 0.05). The effects of the observation group in 2 weeks, 4 weeks and 8 weeks were better than those in the control group (all P < 0.05). The cured course was shorter in the observation group than that in the control group (P < 0.05). The adverse reaction rate in the observation group was lower than that in the control group [4.9% (2/41) vs 22.5% (9/40), P < 0.05]. Three months later after treatment, the cured patients were followed. There was no recrudescence in the observation group and three patients caught the disease again in the control group, but there was no statistical significance between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Ginger-partition moxibustion combined with glucocorticoid achieves better effect than simple oral glucocorticoid for thyreoitis at subacute stage, and the adverse reaction is less, which presents the clinical advantages of the integration of Chinese and western medicine.</p>

Association between serum cystatin C and carotid intima -media thickness in patients with type 2 diabetes mellitus / 中国基层医药

Objective To evaluate the association between serum cystatin C and carotid atherosclerosis in patients with type 2 diabetes mellitus.Methods A total of 318 patients with type 2 diabetes mellitus were enrolled in this study.According to the results of carotid color Doppler ultrasound in the patients were randomly divided into two groups:CIMT abnormal group (CIMT was equal to or larger than 0.9 mm,with or without associated with carotid artery plaque formation)CIMT and normal group (CIMT <0.9 mm,and it was not associated with carotid artery atherosclerotic plaque formation.Differences in serum cystatin C,serum lipid and lipoprotein,fasting plasma glucose and other biochemical markers between the two groups were analyzed by using Student's t test.The correlated factors of the carotid thickness and plaque appearance were analyzed by Logistic regression analysis.Results The serum cystatin C levels of the CIMT abnormal group were higher than the normal CIMT group[(1.24 ±0.22)mg/L vs.(1.05 ±0.41)mg/L, t =4.949,P <0.001).Multivariate logistic regression analysis showed adjusted for gender,age and other factors,ser-um cystatin C was independently associated factor of CIMT (OR =2.563,95% CI:1.026 ~6.403,P =0.044). Conclusion Our data suggest that serum cystatin C is significantly associated with carotid atherosclerosis.

Effects of electroacupuncture at different acupoints on apoptosis and the expression of miRNAs in myocardial cells in rats model of myocardial ischemia / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture (EA) at different acupoints on apoptosis-related serum and expression of microRNA (miRNA) in rats with myocardial ischemia, so as to explore its mechanism of action.</p><p><b>METHODS</b>A total of 48 male Wistar rats were randomly divided into a normal group, a model group, a Neiguan group and a acupoint compatibility group, 12 rats in each group. Isoprenaline hydrochloride (ISO) with a daily dose of 2 mg/kg was subcutaneously injected for 14 days to establish the myocardial ischemia model in the model group, Neiguan group and acupoint compatibility group. Rats in the normal group were subcutaneously injected with an equal volume of normal saline. After modeling, rats in the Neiguan group were treated with EA at "Neiguan" (PC 6), while rats in the acupoint compatibility group were treated with EA at "Guanyuan" (CV 4), "Zusanli" (ST 36) and "Neiguan" (PC 6). Rats in the normal group and model group were treated with immobilization, once day for 21 days. The contents of creatine kinase-MB (CK-MB), vascular cell adhesion molecule-1 (VCAM-1) and endothelin-1 (ET-1) in serum were detected by enzyme-linked immunosorbent assay (ELISA); apoptosis index (AI) of myocardial cells was detected by TUNEL method; the expressions of miRNA-1, miRNA-133, miRNA-208 and miRNA-499 were detected by real-time PCR method.</p><p><b>RESULTS</b>Compared with the normal group, the serum CK-MB, VCAM-1 and ET-1 were significantly increased in the model group, Neiguan group and acupoint compatibility group (all P < 0.01), and the apoptosis index was significantly increased (all P < 0.01). The CK-MB, VCAM-1 and ET-1 in the Neiguan group and acupoint compatibility group were significantly lower than those in the model group (all P < 0.01); the AI was reduced, which was more significant in the acupoint compatibility group (P < 0.05). Compared with the normal group, the expression of miRNA-133 was reduced (P < 0.01) and those of miRNA-208, miRNA-1 and miRNA-499 were significantly increased in the model group (all P < 0.01). Compared with the model group, the expression of miRNA-133 was increased (both P < 0.01) and that of miRNA-208, miRNA-1 and miRNA-499 were significantly reduced (all P < 0.01) in the Neiguan group and acupoint compatibility group. Compared with the Neiguan group, the expression of miRNA-133 was increased (P < 0.01) and those of miRNA-208, miRNA-1 and miRNA-499 were significantly reduced in the acupoint compatibility group (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>EA at acupoints, especially acupoint compatibility group, could effectively prevent and treat myocardial ischemia, and the protective effect is possibly correlated to the double regulation on increasing the expression of miRNA-133 and inhibiting the expression of miRNA-1, miRNA-208, miRNA-499.</p>

Epidemiological characteristics of brucellosis in Zibo City Shandong Province from 2006 to 2014 / 中华地方病学杂志

Objective To analyze the epidemiological characteristics and trend of human brucellosis in Zibo.Methods The data of brucellosis was derived from China information system for diseases control and prevention, from the epidemiology case study and outbreak event of brucellosis.Descriptive statistical analysis was used to analyze the incidence, the distribution of time, region and population, the transmission, seropositive rate of vulnerable groups, and the epidemiological characteristics of the cases from 2006 to 2014.Results A total of 541 brucellosis cases were reported between 2006 and 2014, the incidence rates increased from 0.16 per 100 000 to 4.94 per 100 000, and cases were found in about 65％ (62/95) of the towns.The disease showed a seasonal cycle with peak period between March and August annually, accounting for 70.61％ (382/541) of the total cases.Vocational high risk population were animal keepers, butchers, sellers and producers, accounting for 73.20％ (396/541), and foodbome infection accounted for 9.61％ (52/541).A total of 8 outbreak events were reported from 2006 to 2014.Conclusions The incidence of brucellosis has increased and the epidemic areas have expanded year by year.Spring and summer are the peak seasons of the disease.Foodborne infection is increasing.

Dermoscopy in the differential diagnosis of basal cell carcinoma: a preliminary study / 中华皮肤科杂志

Objective To estimate the application value of dermoscopy in the differential diagnosis of basal cell carcinoma (BCC).Methods Patients who underwent dermoscopic examination and had been definitely diagnosed by pathological examination in the Peking University First Hospital were enrolled in this study.In a blind study,dermoscopic images of 86 BCC lesions from 81 patients (case group) and 68 non-BCC hyperpigmented lesions with similar degree of hyperpigmentation and location from 61 patients (control group) were evaluated for features suggestive of BCC and melanocytic lesions.The diagnostic capability of dermoscopy in patients with BCC was evaluated by diagnostic test.Pathology served as the gold standard method for diagnosis.The frequency of features suggestive of melanocytic lesions was calculated in BCC lesions,and dermatoscopic findings were compared between heavily and lightly pigmented BCC lesions.Results The sensitivity,specificity,positive predictive value,negative predictive value of the classic dermoscopic pattern for the diagnosis of BCC were 98.84％,89.71％,92.39％,98.39％ respectively,with a Youden index of 0.88.The coincidence rate was 94.81％ between pathologic and microscopic diagnosis.Pigment network,multiple brown to black globules/dots,pigmentation around hair follicle openings were observed more frequently in melanocytic lesions compared with BCC lesions (all P ＜0.05).Blue-whitish veil-like structures were observed in 61.63％ of the BCC lesions.The presence of blue-black blotch and blue-whitish veil-like structures was significantly more frequent in heavily pigmented BCC lesions than in lightly pigmented BCC lesions (both P ＜0.01).Conclusions The classic dermoscopic pattern of BCC shows a favorable diagnostic capacity in Chinese population.Large-scale studies are needed to estimate the value of some features proposed in this study,such as peripheral pigment in palisade arrangement,peripheral hyperpigmentation and hypo-or hyperpigrnentation around hair follicle openings,in the differential diagnosis of pigmented diseases.

Dermoscopic features of melanocytic lesions on volar skin: 178 case reports / 中华皮肤科杂志

Objective To investigate the dermoscopic features of palmoplantar melanocytic lesions.Methods The dermoscopic images of palmoplantar melanocytic lesions that underwent examination in the Department of Dermatology in Peking University First Hospital from September 2009 to October 2011,were retrospectively analyzed.Results Totally,155 benign acral melanocytic lesions in 121 patients and 23 acral melanomas in 22 patients were analysed in this study.Among the benign acral melanocytic lesions,the parallel furrow pattern and its variations (34.2％) were the most common,followed by the fibrillar pattern (22.6％).Two benign lesions (1.3％) showed a parallel ridge pattern.Of 23 melanoma lesions,12 (52.2％) exhibited parallel ridge pattern,and 14 (60.9％) showed irregular diffuse pigmentation that was present in all of the invasive melanoma lesions.The fibrillar pattern,as a common benign acral dermoscopic pattern,was also present in 39.1％ of melanoma specimens.Conclusions Dermoscopy is valuable to some extent in the differential diagnosis of benign melanocytic nevi and malignant melanoma in palmoplantar region,and may facilitate the secreening for early melanoma.

Determination of clinical parameters for the differential diagnosis of malignant and benign longitudinal melanonychia / 中华皮肤科杂志

Objective To estimate the value of clinical parameters (such as patients' age,longitudinal melanonychia width and location) for the differential diagnosis of malignant and benign longitudinal melanonychia as well as for the evaluation of the necessity for invasive management.Methods A retrospective study was performed on 28 cases of subungual malignant melanoma collected from 2000 to 2010 as well as on 62 cases of benign longitudinal melanonychia from 2005 to 2010.Clinical analysis was carried out to compare the differences in clinical parameters such as.patients' age,longitudinal melanonychia width and lesional location,between the malignant melanoma and benign longitudinal melanonychia cases.Logistic regression analysis and ROC method were used to determine valuable clinical parameters for the differential diagnosis of malignant and benign longitudinal melanonychia.Results Significant differences were observed in the median age at diagnosis (23.0 years vs.52.5 years,Z =5.44,P ＜ 0.01 ),age at onset (21.0 years vs.48.0 years,Z =4.70,P ＜ 0.01 ),and longitudinal melanonychia width (3.0 mm vs.15.0 mm,Z =5.69,P ＜ 0.01 ) between the patients with malignant melanoma and benign longitudinal melanonychia.The involvement of thumb and hallux was observed in 77.8％ of the subungual melanoma cases,and 48.3％ of the benign cases (x2 =6.57,P ＜ 0.05).ROC method and Logistic regression analysis indicated that the age at onset and diagnosis as well as width of longitudinal melanonychia were of diagnostic value for the differential diagnosis of malignant and benign longitudinal melanonychia.Conclusions Not all longitudinal melanonychia cases need an invasive management at the time of awareness.The age at onset and diagnosis,width of melanonychia and site of the onset appear to be valuable in the differential diagnosis of malignant and benign longitudinal melanonychia,and there is a possibility to guide clinical diagnosis and treatment by establishing a mathematical model with these parameters.

Investigation of anaplasmosis in Yiyuan County, Shandong Province, China

OBJECTIVE@#To investigate the situation of anaplasmosis in Yiyuan county, Shandong Province.@*METHODS@#A total of 26 blood samples from febrile patients suspected of anaplasmosis, 48 blood samples from healthy farmers, 8 from dogs, and 10 from goats and 170 ticks were collected in the same area during 2005-2007, and detected by serological and molecular methods.@*RESULTS@#Eight confirmed cases and 6 probable cases were determined using serologic and molecular methods. The seroprevalence of Anaplasma phagocytophilum (A. phagocytophilum) was 26.7% in healthy cases. Nine out of 10 sheep samples and 7 out of 8 dog samples reacted positively to the A. phagocytophilum antigen. PCR amplification and sequencing of the 16SrRNA of A. phagocytophilum gene showed that some samples from patients, goats and ticks were 100% identical. The seroprevalence of Rickettsia typhi was 22.9%, Orientia tsutsugamushi 6.3%, Rickettsia sibirica 27.1%, Coxiella burnetii 18.8%, Bartonella henselae 31.3%, and Borrelia burgdorferi 41.6%.@*CONCLUSIONS@#It is important to make differential diagnosis of febrile patients and to apply treatment with specific antibiotics. It is needed to enforce essential prevention and control measures including tick control and to improve sanitation conditions.

Skin cancer and precancerous skin lesions:clinical analysis of 632 cases / 中华皮肤科杂志

Objective To investigate the clinical features of skin cancer.Methods Clinical data of skin cancer and precancerous skin lesions confirmed pathologically from 2005 to 2008 in Peking University First Hospital were retrospectively analyzed by using statistical methods.Results A total of 632 cases of skin cancer and precancerous skin lesions were studied.The most common skin cancer was basal cell carcinoma and squamous cell carcinoma (invasive and in situ) which accounted for 29.3%and 24.2%,respectively.The average age at onset was older than 60 years in 55.4%of the patients,between 35 and 59 years in 34.3%,younger than 35 years in 10.3%.The concordance between clinical and pathological diagnosis reached nearly 90.O%for Paget's disease,70.0% for other common skin cancer and precancerous skin lesions.Conclusions Skin cancer and precancerous skin lesions have a predilection for scalp and face.Patients aged from 35 to 59 years account for a significant proportion not only in cutaneous lymphoma but also in melanoma and epithelium-derived nonmelanoma skin cancer.

The characteristics of hepatic stem cells and the expression of growth factor and their receptors in the early embryonic human liver / 生物医学工程学杂志

To study the morphological characteristics of hepatic stem cells and the expression of HGF, IGF-I, TGFbeta1 and their receptors in human embryonic livers at 3-5 weeks of gestation. The SABC immunohistochemical method with HE counterstaining was employed. We found that the hepatic bud formed at the end of the 3rd week. At the 4th week, the cells of hepatic bud migrated into the septum transversum mesenchyme and formed the hepatic cords. The hepatic cells at 3-4 weeks displayed the typical characteristics of immature cells: small size, a round or ovoid nucleus with dark color, scant cytoplasm with slight blue and a high ratio of nuclei/cytoplasm. They were positive for alpha-Fetoprotein (AFP), c-Met and negative for cytokertin 19 (CK19), and proliferating cell nuclear antigen (PCNA). At the 5th week, compared to those at the 4th week, the number of cells within the hepatic cords increased. But the cells at the 5th week were homogeneous and displayed the typical characteristic of immature cells. Those cells began to express PCNA at the 5th week. The hepatic cells at the 5th week were positive for insulin-like growth factor I (IGF-I), transforming growth factor beta1 (TGFbeta1) and their receptors, and were negative for hepatocyte growth factor (HGF), while HGF were positive in the cardiac cells and septum transversum mesenchyme. The results indicated that the cells of hepatic bud and cords were the hepatic stem cells. The difference of morphology and proteins expression at 3-5 weeks of gestation inferred that those stem cells belong to different developmental stage. AFP and c-Met were the markers of hepatic stem cells at the early stage of human embryo. HGF, IGF-I, TGFbeta1 and their receptors may involve in regulating the development of early embryonic human liver.

Study on cases of nasal tumors treated by dermatologic surgery:analysis of 63 cases / 北京大学学报(医学版)

Objective: To study 63 cases of nasal tumors treated by dermatologic surgery, and analyze their generality and characters. Methods: The cases were analyzed with SPSS 10.0 and SAS6.12. Results: The average age of the patients was 46.92?18.63.The number of man was about equal to that of women. Most cases were basal cell carcinoma (42.9%). Nevus came second (38.1%). The other cases were benign tumors. The distribution of operational locations showed the character of nasal surgery. Operations of Alar occupied 52.4%,22.2% were on the dorsal and 15.9% on the tip. Other locations occupied 9.5%. Cases of primary close occupied 69.8%. Cases applying complex close were 30.2%. Statistic analysis illustrated that primary close was different from complex close with distribution of operational locations. The area of defects between primary close and complex close was also different. At the same time, the differentiation of applying complex close was obvious between malignant tumors and benign tumors. Conclusion: Skin cancers and benign tumors usually occur on the nose, so it is very important to master the techniques of plastic surgery to repair the defects of nose, besides removing tumors perfectly by the classical way of dermatologic surgery, Mohs Micrographic Surgery.

Castleman Tumor in Association with Paraneopiastic Pemphigus-A Report of 10 Cases / 中华皮肤科杂志

Objective To obtain a better understaning of the clinical features of Castleman tumor associated paraneoplastic pemphigus. Methods The clinical features and therapy of 10 cases of this disease, diagnosed in the Department of Dermatology of Peking University First Hospital were analyzed. Results Castleman tumor was shown to be the most common neoplasm associated with paraneoplastic pemphigus in China. The clinical presentations, histopathologic characteristics, CT scan findings, and immunologic features were all unique. The early diagnosis and removal of the Castleman tumor are crucial for the treatment of this tumor-associated autoimmune disease. Conclusions Because Castleman tumor is directly related to the induction of autoimmunity, early diagnosis and prompt removal of the tumor are essential to the management of this disease.

Clinical Study of a Patient with Pustular Psoriasis-like Lesion and Cerebral Palsy Due to Biotinidase Deficiency / 中华皮肤科杂志

Objective To investigate the clinical and laboratory profiles of a patient with pustular psoriasis-like skin lesion and cerebral palsy due to biotinidase deficiency. Methods A 5 year and 4 month-old boy with biotinidase deficiency was confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS)and biotinidase activity assay of peripheral blood. His clinical features, laboratory findings, treatment and outcome were studied. Results The boy showed difficulty in taking food after birth, gradually eczema and pustules appeared at the age of 2 months, and generalized erythema and intractable pustular psoriasis-like lesion at the age of 8 months. His intellectual development was normal with retardation of locomotor system. He had muscular dystonia at the age of 6 months. Physical examination showed generalized pustular psoriasis-like lesion, generalized paralysis, hypertonic contracture of extremities, sparseness of scalp hair and severe malnutrition. Routine laboratory tests showed a mild anemia, metabolic acidosis and elevation of plasma creatine phosphokinase. Increased excretion of urinary lactate, pyruvate, 3-OH-propionate, propionylglycine, and 3-methylcrontonylglycine were observed. Biotinidase activity of his peripheral blood was below 0.1 pmol/min/3mm (normal 6.3-9.3 pmol/min/3mm). Biotin (10 mg/day) supplementation led to a dramatic recovery of the skin lesion. After the treatment of rehabilitation, his muscle power was also improved gradually. Conclusions Dermatological and neurological manifestations are the main features of biotinidase deficiency. Early diagnosis and biotin administration can greatly improve the clinical symptoms. Generalized pustular psoriasis-like lesion and cerebral palsy of this boy have improved after the supplementation of biotin, but he may be remained wheelchair-dependent because of delayed diagnosis.

Effect of Chinese Medicinal Herbs on Human Scalp Hair Growth in Vitro / 中华皮肤科杂志

Objective To study the effect of Chinese herbs on human scalp hair growth in vitro. Methods Organ culture of human scalp hair follicles was used to study the effects of extracts of Crataegus cuneata, Ligustrum lucidum, Polyporus umbelatus and Bletilla striata mixture and ginseng saponin on hair growth. Results Low doses of mixture extracts(1.28 ?g/mL and 6.4 ?g/mL) markedly enhanced the hair growth and lengthened the period of hair growth, while high doses of mixture extracts(4 mg/mL and 20 mg/mL) sharply inhibited hair growth and shortened the period of hair growth. High doses of ginseng saponin (40 ?g/mL and 200 ?g/mL) also had an inhibiting effect on hair growth. Conclusion This observation suggests that extracts of Crataegus cuneata, Ligustrum lucidum, Polyporus umbelatus and Bletilla striata mixture can promote hair growth in vitro.