Congenital Knee Dislocation at Birth - An Extraordinary Case of Spontaneous Reduction / Luxação congênita do joelho no nascimento - Um caso extraordinário de redução espontânea

Abstract Congenital knee dislocation (CKD) is a rare malformation characterized by hyperextension deformity of the knee with anterior tibia displacement, present at birth. Rarely reported, CKD might occur as an isolated deformity or commonly associated with musculoskeletal abnormalities, with the most common ones being developmental dysplasia of the hip (DDH) and clubfoot. The etiology is unknown, but CKD has been associated with certain intrinsic and extrinsic factors. Treatment with conservative methods at an early stage is most likely to yield successful results. We report here a rare case of successful spontaneous reduction of CKD in an infant within 24 hours of life.

Resumo A luxação congênita do joelho (LCJ) é uma malformação rara caracterizada por deformidade de hiperextensão do joelho com deslocamento anterior da tíbia, presente ao nascimento. Raramente relatada, a LCJ pode ocorrer como uma deformidade isolada ou comumente associada a anormalidades musculoesqueléticas, sendo as mais comuns a displasia do desenvolvimento do quadril (DDQ) e o pé torto congênito (PTC). A etiologia é desconhecida, mas a LCJ foi associada a certos fatores intrínsecos e extrínsecos. O tratamento com métodos conservadores em um estágio inicial tem maior probabilidade de produzir resultados bem-sucedidos. Relatamos aqui um caso raro de redução espontânea bem-sucedida de LCJ em um bebê nas suas primeiras 24 horas de vida.

Spontaneous closure of a macular hole in an unusually long time after primary vitrectomy / Fechamento espontâneo de buraco macular em um tempo excepcionalmente longo após vitrectomia primária

ABSTRACT We report the case of a 68-year-old man who presented to our outpatient clinic for routine examination. Fifteen months before, he had undergone combined cataract and idiopathic full-thickness macular hole surgery in his right eye at another institution. In the present evaluation, the best-corrected visual acuity in his right eye was counting fingers. Fundus examination evidenced an idiopathic full-thickness macular hole in that eye, which was confirmed on spectral domain optical coherence tomography. A new surgery was offered, but the patient declined. Twenty-one months after his first consultation with us (36 months after the surgery), spectral domain optical coherence tomography revealed spontaneous closure of the idiopathic full-thickness macular hole, with a gap at the foveal ellipsoid zone. At the final visit, 22 months after the closure of the idiopathic full-thickness macular hole, the patient's best-corrected visual acuity was 20/25, and the gap at the ellipsoid zone had decreased.

RESUMO Este é o relato do caso de um homem de 68 anos que procurou nosso ambulatório para exames de rotina. Quinze meses antes, ele havia se submetido a uma cirurgia conjunta de catarata e buraco macular idiopático de espessura total em seu olho direito, em outra instituição. Durante a consulta em nosso ambulatório, a melhor acuidade visual corrigida no olho direito era de contagem de dedos. O exame do fundo evidenciou um buraco macular idiopático de espessura total naquele olho, o que foi confirmado por uma tomografia de coerência óptica de domínio espectral. Uma nova cirurgia foi oferecida, mas o paciente recusou. Vinte e um meses após sua primeira consulta (36 meses após a cirurgia), a tomografia de coerência óptica de domínio espectral revelou o fechamento espontâneo do buraco macular idiopático de espessura total, com uma lacuna na zona elipsoide foveal. Na última consulta, 22 meses após o fechamento do buraco macular idiopático de espessura total, a melhor acuidade visual corrigida foi de 20/25 e a lacuna na zona elipsoide havia diminuído.

Transient spontaneous remission of childhood acute leukemia: report of 3 cases and review of literature / 白血病·淋巴瘤

Objective:To investigate the clinical characteristics and possible causes of transient spontaneous remission of childhood acute leukemia.Methods:The data of 3 children with acute leukemia who had transient spontaneous remission before standardized chemotherapy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University in July 2018, May 2019 and October 2020 were collected. Moreover, the related influencing factors of spontaneous remission in leukemia were discussed by review of the literature.Results:All 3 children had fever at the onset of the disease, and they achieved transient spontaneous remission after anti-infection therapy. Case 1 obtained partial remission after the initial diagnosis of acute B lymphocytic leukemia (B-ALL), leukemia gene test showed E2A-PBX1 fusion, and relapsed after 12 days. Case 2 obtained spontaneous remission after the initial diagnosis of B-ALL, leukemia gene test showed p16 gene deletion and NRAS and EP300 genes mutation, and relapsed after 20 days. Case 3 obtained spontaneous remission after the initial diagnosis of acute monocytic leukemia, leukemia gene test showed MLL-ENL fusion and NRAS gene mutation, and relapsed after 30 days. A review of the literature showed that the main influencing factors of spontaneous remission in leukemia were Down syndrome, infection and blood transfusion. Other influencing factors included leukemia-related genes, termination of pregnancy and application of drugs.Conclusions:Transient spontaneous remission of childhood acute leukemia is rare in clinical practice, and the possible mechanism is related to infection-induced immune abnormalities. It is recommended that leukemia patients with spontaneous remission should be closely monitored for minimal residual disease.

Hematoma subgaleal espontáneo en lactantes, una enfermedad subestimada, serie de casos / Spontaneous subgaleal hematoma in infants, an underestimated disease, case series / Hematoma subgaleal espontâneo em bebês, uma doença subestimada, série de casos

Introducción. Los hematomas subgaleales son patologías poco frecuentes que suelen originarse y resolverse espontáneamente. En neonatos se asocian con distocias y en lactantes o niños mayores con historial de traumatismo, incluso trivial, que puede pasar inadvertido. Hay un pequeño grupo donde no hay antecedente de trauma ni de otros factores como discrasias sanguíneas, se conforma principalmente por lactantes. El objetivo del presente artículo es mostrar una serie de casos de hematomas subgaleales espontáneos en lactantes, por su poca frecuencia, dificultad diagnóstica y diferencias de acuerdo con el tipo neonatal. Casos clínicos. Se presentan cuatro lactantes, entre 4 y 12 meses de edad, diagnosticados con hematomas subgaleales espontáneos (sin relación directa con traumatismo previo), de diferente severidad y atendidos en el servicio de urgencias. Se les realizó una evaluación diagnóstica dirigida a confirmar el hematoma y descartar trastornos de coagulación asociados. Todos los casos mostraron un curso clínico autolimitado sin complicaciones. Discusión. Los hematomas subgaleales espontáneos en lactantes suelen ser benignos, aunque es de vital importancia descartar discrasias sanguíneas. Dentro de éstas, los trastornos plaquetarios no suelen tenerse en cuenta y deben estudiarse. Su manejo es conservador y se reabsorberán solos en pocas semanas. Conclusiones. se debe establecer la causa de los hematomas subgaleales en niños pequeños y contemplar su posible aparición espontánea o por causa de discrasias sanguíneas.

Introduction. Subgaleal hematomas are rare pathologies that usually arise and resolve spontaneously. In neonates they are associated with dystocia and in infants or older children with a history of trauma, even trivial, which may go unnoticed. There is a small group where there is no background of trauma or other factors such as blood dyscrasias, it is made up mainly of infants. The objective of this article is to show a case series of spontaneous subgaleal hematomas in infants, due to their infrequency, diagnostic difficulty, and differences according to neonatal type. Clinical cases. Four infants are presented, between 4 and 12 months of age, diagnosed with spontaneous subgaleal hematomas (not directly related to previous trauma), of different severity and treated in the emergency unit. They underwent a diagnostic test aimed at confirming the hematoma and ruling out associated coagulation disorders. All cases showed a self-limited clinical course without complications. Discussion. Spontaneous subgaleal hematomas in infants are usually benign, although it is vitally important to rule out blood dyscrasias. Within these, platelet disorders are not usually taken into account and should be studied. Its management is conservative and they will be reabsorbed on their own in a few weeks.

Introdução. Os hematomas subgaleais são patologias raras que geralmente surgem e se resolvem espontaneamente. Em recém-nascidos estão associados a distocia e em bebês ou crianças mais velhas com um historial de trauma, mesmo trivial, que pode passar despercebido. Existe um pequeno grupo onde não há historial de traumas ou outros fatores como discrasias sanguíneas, é constituído principalmente por bebês. O objetivo deste artigo é mostrar uma série de casos de hematomas subgaleais espontâneos em bebês, devido à sua infrequência, dificuldade diagnóstica e diferenças de acordo com o tipo neonatal. Casos clínicos. São apresentados quatro bebês, entre 4 e 12 meses de idade, com diagnóstico de hematoma subgaleal espontâneo (não diretamente relacionado a traumas anteriores), de gravidade variável e atendidos no pronto-socorro. Eles foram submetidos a uma avaliação diagnóstica com o objetivo de confirmar o hematoma e descartar distúrbios de coagulação associados. Todos os casos apresentaram evolução clínica autolimitada e sem complicações. Discussão. Os hematomas subgaleais espontâneos em bebês geralmente são benignos, embora seja de vital importância descartar discrasias sanguíneas. Nestas, os distúrbios plaquetários geralmente não são considerados e devem ser estudados. Seu manejo é conservador e serão reabsorvidos por conta própria em algumas semanas. Conclusões. Deve ser estabelecida a causa dos hematomas subgaleais em crianças pequenas e, se considerar seu possível aparecimento espontâneo ou devido a discrasias sanguíneas.

The correlation between creatine kinase, creatine kinase-isoenzyme MB and different states of bipolar disorder in patients / 中国基层医药

Objective:To correlate creatine kinase (CK) and creatine kinase- isoenzyme MB (CK-MB) with different states of bipolar disorder in patients.Methods:A total of 206 patients with bipolar disorder who received treatment in The 7 th People's Hospital of Wenzhou, China between January 2018 and June 2019 were included in the patient group. A total of 369 healthy controls who concurrently received physical examination were included in the control group. CK and CK-MB levels were detected in all participants. The Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAMD)-7 scale, the Bech-Rafaelsen Melancholy Scale (BRMS), and modified version of the Overt Aggression Scale (MOAS) were used to evaluate the mental symptoms, depression, mania and aggression of patients. The CK and CK-MB levels were compared between patients with different states of bipolar disorder. Results:In the control group, CK and CK-MB levels in males were 112.5 (94.5, 156.5) U/L and 17.0 (15.0, 20.0) U/L, respectively, which were significantly higher than those in females [73.0 (61.0, 86.3) U/L, 15.0 (13.0, 18.0) U/L, Z = -9.732, -3.535, both P < 0.001). In the patient group, CK and CK-MB levels in males were 129.0 (80.0, 233.5) U/L, 12.0 (10.0, 17.0) U/L, respectively, which were significantly higher than those in females [73.0 (55.0, 94.0) U/L, 13.5 (11.0, 17.0) U/L, Z = -9.510, -4.746, both P < 0.001]. There was no significant difference in CK level in males between the control and patient groups ( Z = -1.003, P = 0.316), but significant difference in CK-MB level in males was observed between the two groups ( Z = -6.570, P < 0.001). There were significant differences in CK and CK-MB levels in females between the control and patient groups ( Z = -2.535, -9.707, P = 0.011, P < 0.001). In the patient group, CK level in the manic, depressive, and symptom-alleviated states was 132.0 (78.0, 297.0) U/L, 85.0 (56.0, 145.0) U/L, 128.0 (110.0, 165.0) U/L respectively in males, and it was 73.0 (49.0, 122.3) U/L, 51.0 (45.0, 67.0) U/L and 84.5 (61.0, 193.0) U/L, respectively in females. There was significant difference in CK level in males and females between different states of bipolar disorder ( χ2 = 9.019, 16.720, P = 0.011, P < 0.001). In males, CK level was correlated with the BPRS total score, BRMS total score, and MOAS total score in the manic state, as well as the BPRS total score in the symptom-alleviated state ( r = 0.282, 0.286, 0.236, 0.574). In females, CK level was correlated with the MOAS total score in the manic state ( r = 0.260). In males, CK-MB level was correlated with the BRMS total score in the manic and depressive states ( r = 0.186 and 0.496). In females, CK-MB level was correlated with the MOAS total score and the BRMS total score in the manic state ( r = 0.155, 0.572). Conclusion:CK and CK-MB levels are correlated with bipolar disorder in different states and they are of certain clinical significance and provide innovative insights into the diagnosis of bipolar disorder.

Therapeutic efficacy analysis of diazoxide in treating 145 cases of congenital hyperinsulinism / 中华胰腺病杂志

Objeetive To analyze the efficacy and safety of diazoxide treatment in patients with congenital hyperinsulinism (CHI).Methods The clinical data of 145 patients diagnosed with CHI hospitalized in Beijing Children's Hospital affiliated to Capital Medical University from February 2002 to January 2016 who received diazoxide treatment were retrospectively analyzed.We conducted a detailed analysis on the efficacy,side effects and prognosis of diazoxide treatment for CHI.Results In 145 patients,there were 89 patients (61.4％) who were responsive to diazoxide and 23 patients (15.9％) unresponsive to diazoxide,and the treatment effect of diazoxide for the other 33 cases (22.8％) was still unclear.In the diazoxide effective group,there were 22 cases (24.7％) of neonatal onset,32 cases (36.0％)of onset from 1-6 months after birth and 35 cases (39.3％) of onset after 6 months of birth,and the birth weight was normal in 67 cases,macrosomia in 16 cases,low in 5 cases and unknown in 1 case.In the diazoxide ineffective group,there were 14 cases (60.8％) of neonatal onset,7 cases (30.4％) of onset from 1-6 months after birth and 2 cases (8.6％)of onset after 6 months of birth,and the birth weight was normal in 9 cases and macrosomia in 14 cases.In the unclear diazoxide effect group,there were 20 cases (60.6％) of neonatal onset,9 cases (27.34％) of onset from 1-6 months after birth and 4 cases (12.1％) of onset after 6 months of birth,and the birth weight was normal in 15 cases and macrosomia in 18 cases.After the application of diazoxide,65 cases (44.8％) had hirsutism,and 43 patients (29.7％) had gastrointestinal side effects.In the diazoxide effective group,the symptom of hypoglycemia was spontaneously alleviated at the age of from 3 months to 7 years old in 20 patients (22.5％),and 33 patients continued to be treated by diazoxide.In the diazoxide ineffective group,the symptom of hypoglycemia was spontaneously alleviated around the age of 1 years old in 4 patients (17.3％),5 patients were treated by octreotide in long term to maintain normal blood sugar level,4 patients received pancreectomy including 3 with normal blood sugar and 1 with occasional hypoglycemia after surgery.In the unclear diazoxide effect group,the symptom of hypoglycemia was spontaneously alleviated at the age of from 10 months to 3 years old in 4 patients (12.1％),2 patients were treated by octreotide in long term to maintain normal blood sugar level,8 patients received pancreatectomy including 5 with controlled blood sugar after surgery.Conclusions Diazoxide is effective in treating CHI children.The efficiency may be higher for the CHI with normal birth weight or whose onset age is after the neonatal period.

Remission and remission-related factors in lupus nephritis patients: a cohort study / 中华肾脏病杂志

Objective To explore prognosis and remission-related factors in lupus nephritis (LN) patients.Methods Patients diagnosed as LN by renal biopsy in Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology between Jan 1,2011 and July 31,2016 were enrolled.All related baseline clinical data was recorded and regular follow-up was performed.Kaplan-Meier curves was used to analyze partial remission and complete remission rates.Log-rank test was performed to compare remission rates of patients with nephrotic-range proteinuria (24-hour proteinuria≥3.5 g) and without nephrotic-range proteinuria (24-hour proteinuria＜3.5 g).Univariate and muhivariate Cox regression analyses were performed to evaluate the remission-related factors in different periods.Results A total of 115 patients,with 88.7％ female and (31.5±9.5)years mean age,were followed up for up to 5 years.During follow-up period 2 patients died and 1 dialyzed.The 6-,12-,24-and 36-and 48-month renal partial remission and complete remission rates were 33.3％,58.2％,71.5％,84.0％,89.6％,and 18.9％,40.5％,67.3％,79.4％,87.0％,respectively.Patients without nephrotic-range proteinuria had higher complete remission than patients with nephrotic -range proteinuria (HR=2.01,95％CI 1.15-3.34,P=0.014),but there was no difference in their partial remission (HR=1.33,95％ CI 0.74-2.43,P=0.341).Multivariate Cox regression model indicated that every 1 g/L increase in baseline level of serum albumin was associated with increased 8％ and 9％ risk,respectively,in partial remission (HR=1.08,95％CI 1.01-1.15,P=0.024) and complete remission (HR=1.09,95％CI 1.01-1.07,P=0.038).Conclusions Around half of LN patients reach remission during 1 year.Patients without nephrotic-range proteinuria have higher complete remission,and serum albumin is a remission-related factors.

Confluent and reticulated papillomatosis subsiding spontaneously after delivery: report of one case / Papilomatosis confluente y reticulada que remite espontáneamente después del parto: informe de un caso

Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery.

Rapid Spontaneous Resolution of Acute Subdural Hematoma in a Patient with Liver Cirrhosis / 대한신경손상학회지

Acute subdural hematoma (ASDH) constitutes one of the most critical emergencies in neurosurgery and rapid spontaneous resolution of ASDH is an infrequent phenomenon. Several mechanisms have been attributed to explain this phenomenon including redistribution of subdural blood, dilution by cerebral spinal fluid and brain atrophy. Rapid resolution of ASDH related to coagulopathy is a rare phenomenon; to our knowledge, only one case has been reported. We report on a patient who showed rapid resolution of ASDH with coagulopathy and also discuss such a rare case with speculation of the coagulopathy as a factor to promote this phenomenon.

A Case of Cronkhite-Canada Syndrome Showing Spontaneous Remission

Cronkhite-Canada syndrome (CCS) is a rare, noninherited gastrointestinal polyposis syndrome associated with ectodermal changes such as alopecia, nail dystrophy, and cutaneous hyperpigmentation. The etiology and pathogenesis of CCS are not known, but diarrhea, malnutrition, gastrointestinal bleeding, and infection may occur in the affected patient; moreover, this condition could be fatal. However, previous reports have described several cases of spontaneous remission. We report a 60-year-old man who was incidentally found to have colonic polyposis, alopecia, and hypogeusia and was diagnosed to have CCS. However, this patient experienced spontaneous remission, including regrowth of body hair and alleviation of bowel inflammation, without any specific medications such as steroids, antibiotics, or proton pump inhibitors.

A Case of Spontaneous Remission of Acute Pulmonary Embolism / 결핵및호흡기질환

Acute pulmonary embolism (PE) ranges from asymptomatic to often fatal, incidentally discovered emboli to massive embolism causing immediate death. Acute PE may occur rapidly and unpredictably and may be difficult to diagnose. Mortality and complications can be reduced by prompt diagnosis and therapy. Untreated PE is associated with a mortality rate of approximately 30 percents. Most patients with PE have endogenous fibrinolysis, although it is not effective enough to prevent PE. A case of spontaneous remission of untreated acute PE has not previously been reported. Here we present a case of spontaneously resolved acute PE without any treatment.

Regression of Large Lung Bullae after Peribullous Pneumonia or Spontaneously / 결핵및호흡기질환

BACKGROUND: A lung bulla may rarely shrink as a result of an inflammation within the bulla or a closing of a bronchus involved in the inflammation process, which is termed 'autobullectomy'. The purpose of this study was to describe clinical features of patients with regressions of bullae during follow-up. METHODS: We retrospectively reviewed the cases and individuals who showed unequivocal evidence of interval regressions in a pre-existing bulla. A total of 477 cases with a bulla >5 cm in diameter were screened manually. Thirty cases with bullae that showed regression during follow-up were selected. RESULTS: Regressions of large bullae occurred in 30 of 477 cases (6.3%). The median age of those patients was 61 (range, 53~66) years and 87% of those patients were men. The main cause of a bulla was emphysema (80%). Among 30 cases, 16 cases had pneumonia in the lung parenchyma of the peribullous area. Another 7 cases had a regressed bulla accompanied by an air-fluid level within the bulla. The remaining 7 cases showed a spontaneous regression of the bulla without such events. Complete regression of a bulla occurred in 25 cases. A follow-up chest-X ray showed that in all cases except one, the bulla remained in a collapsed state after 24 months. Forced expiratory volume in one second (FEV1) improved in 3 cases and the other 2 cases had increased forced vital capacity (FVC). In addition, total lung capacity (TLC) and residual volume (RV) decreased in another 2 cases. CONCLUSION: Regression of a lung bulla occurred not only after pneumonia or the presence of air-fluid level within the bulla, but also without such episodes. The clinical course of regression of a lung bulla varied. After regression of a bulla, lung function could be improved in some cases.

An Effect of Letrozole on Gastric Cancer?

Letrozole is a drug used in the treatment of postmenopausal women with breast and ovarian tumours. There is no evidence in the literature indicating its use in treating gastric cancer. We present a 68 year old lady admitted from the emergency department with weight loss, malaise and anaemia. Investigations confirmed the presence of two different primary tumours in the left breast and the stomach. Following that this patient with oestrogen receptor positive breast cancer and oestrogen receptor negative gastric cancer was treated with letrozole for her breast cancer followed by a gastric resection. Independent histology by two pathologists pre-operatively diagnosed gastric adenocarcinoma. Post-operatively, independent analysis of the resected stomach, omentum and lymph nodes revealed no evidence of gastric cancer. Therefore we conclude that there is a possibility of letrozole having an effect on gastric cancer. Further studies are needed.

Spontaneous clearance of high risk human papillomavirus infection / 中华妇产科杂志

Objective To study the clearance of high risk human papillomavirus(HPV)infection among the women with normal cervical pathologic diagnosis.Methods One hundred and seventy.two HPV-positive cases with normal cervical pathologic diagnosis were enrolled in the study.The infection status of HPV was monitored during follow-up from Aug 2006 to Aug 2008.The time of HPV infection spontaneous clearance,as well as effect factors,were analyzed.Results During follow-up,there were 62.2%(107 cases,107/172) of the HPV infection cleared.The medium clearance time was 11.3 months(95% CI:10.6-16.6 months).The medium clearance time of aged<30 years,30-39 years,40-49 years and>49 years were 11.3,12.0,10.9 and 8.5 months.respectively.There were not significant difference among aged intervals (P=0.384).The virus copies of HPV-clearance cases and persistent-infection were 22.6 and 95.0,respectively.There was not significant difference between groups(P=0.061).Conclusions Most of the high risk HPV infection with normal cervical pathologic diagnosis would spontaneously cleared.Age and HPV copies may play little role in the HPV clearance.

Immunohistochemieal features of halo nevi,and mechanisms for their spontaneous regression / 中华皮肤科杂志

Objective To investigate the phenotype,number and distribution of inflammatory cells in early and late stages of spontaneous regression of halo nevi,and to elucidate the immunological mechanisms for spontaneous regression of these nevi.Methods Halo nevi,their surrounding non-lesional skin,and normal control skin were examined by immunohistochemical staining with monoclonal antibodies to CD3,CD4,CD8,CD20,CD1a,CD56 and CD68.Staining results were observed and analyzed by the computer image analysis system,image-pro plus 6.0.Results The number of CD4+,CD8+,CD20+,CD1a+cells,along with the diameter of CD1a+and CD68+ cells was significantly increased in the lesions of early and late stage of spontaneous regression of halo nevi than in non-lesional skin and normal control skin(both P＜0.01).The ratio of CD8+/CD4+ cells in the lesions of late stage of spontaneous regression was also higher than that in the lesions of early stage (2.05∶1 VS 1.82∶1).A massive infiltrate of CD8+ cells was observed in the nests of nevus cells.ConclusionsCD4,CD8,CD20,CD1a,CD56 and CD68 positive cells are all involved in the spontaneous regression of halo nevi,and CD8+ cells may play a predominant role in this process.

Natural History of Acute Symptomatic Hepatitis C in Korea / 대한소화기학회지

BACKGROUND/AIMS: Acute hepatitis C (AHC) has a high chronicity rate of up to 85%. Recently, several studies have demonstrated AHC has a self-limited course in about 50% especially in symptomatic cases. However, there is no investigation about the natural course of AHC in Korea. We intended to define the natural course of AHC and the influential factors on it. METHODS: We enrolled the patients with AHC from 2001 to 2004. The diagnosis of AHC was based on seroconversion to anti-HCV antibodies or the clinical and biochemical diagnostic criteria satisfactory to AHC and on the presence of HCV RNA in first serum sample. The self-limited course of AHC was defined as permanent (>6 months) loss of HCV RNA in serum and normalization of ALT. RESULTS: Eighteen patients presented with AHC. Seventeen out of eighteen was symptomatic. Twelve out of eighteen (66.7%, 95% CI 41.7-84.9%) showed spontaneous remissions. Presence of anti-HCV on first serum samples predicted chronic courses. Antibody to HCV was not detected during follow-up periods in nine patients, who all showed spontaneous viral clearance. CONCLUSIONS: AHC has a high rate of spontaneous viral resolution. Further study is needed to define the influential factors on the viral clearance in AHC.

The Pathology of Skin Lesions with Different Clinical Manifestations of Plane Warts / 中华皮肤科杂志

Objective To find out the pathologic changes and possible influencing factors in the process of spontaneous regression of plane warts.Methods One hundred and five lesional specimens taken from patients with plane warts were observed microscopically.Results The histologic features indicated slight hyperkeratosis,acanthosis and ballooning degeneration of keratinocytes in stable lesions;a combination of tower-peak shaped hyperkeratosis,cuneate hypergranulosis and ballooning degeneration in progressively increasing lesions;and infiltration of lymphocytes and necrosis of keratinocytes in inflammatory icthing lesions.Conclusions Specific cell-mediated immunity against keratimocytes may be involved in the process of regression of plane warts.There is a positive correlation between the activity of skin lesions and the induction of cellular immunity.

Changes of ?-adrenoceptors in peripheral lymphocytes at different stages of asthma / 中国病理生理杂志

AIM:To study the changes of ?-adrenoceptors in peripheral lymphocytes at different stages of asthma. METHODS:?-adrenoceptors in peripheral lymphocytes, cAMP and cGMP levels in blood plasma were measured by radioligand binding assay and radioimmunoassay.RESULTS:Bmax and Kd of ?-adrenoceptors in asthma at remission stage were markedly higher than that in normal subjects, while cAMP levels in blood plasma were not different between them. Bmax of ?-adrenoceptors and cAMP levels in blood plasma in asthma at acute exacerbation stage were significantly lower than that in normal subjects, Kds between these two groups were not much different. There was no correlation between ?-adrenoceptors, cAMP and cGMP levels in blood plasma and ventilatory functions.CONCLUSIONS:Changes of ?-adrenoceptors in asthma rather be a pathological change accompanied by the course of the disease than a primary defect.