Progress in the Treatment of Adult Langerhans Cell Histiocytosis --Review / 中国实验血液学杂志

Langerhans cell histiocytosis (LCH) is a rare proliferative disease dominated by the proliferation of Langerhans cells, which is inflammatory myeloid neoplasms. Its clinical manifestations are variable, occurring at any age and at any site, and it is rarer in adults than in children. The gold standard for diagnosis is histopathological biopsy. Due to the rarity of adult LCH and the heterogeneity of this disease, treatment of adult LCH should be developed according to the extent of the disease and risk stratification. With the discovery of MAPK, PI3K and c-KIT signaling pathway activation, especially BRAF V600E and MAP2K1 mutations, targeted therapy has become a hot spot for therapeutic research. Meanwhile, the discovery of high expression of M2-polarized macrophages and Foxp3+ regulatory T cells (Treg) in LCH has provided an important basis for the immunotherapy. In this article, we will focus on reviewing the latest research progress in the treatment of adult LCH in recent years, and provide a reference for clinical research on the treatment of adult LCH patients.

Exploration and practice of the "trinity" rescue system of aviation, ground and Internet emergency treatment / 中华危重病急救医学

With the development of society and economy, the disease spectrum of Chinese residents has undergone a major change, and the public health emergencies have occasionally occurred. The new situation has put forward higher requirements on the emergency capacity, professional technical level and treatment quality of critical care treatment system. Combining with the advantages of hospital aviation, ground and Internet emergency, Henan Provincial People's Hospital established a new construction path of emergency and critical care treatment system, namely "trinity" rescue system of aviation, ground and Internet emergency treatment and the "five-ring" model of critical care treatment system in hospital. The purpose of this paper is to summarize the practical experience of the construction of emergency and critical care system in Henan Provincial People's Hospital, so as to provide reference for the management of emergency and critical care in China.

Human brucellosis mimicking axial spondyloarthritis: a challenge for rheumatologists when applying the 2009 ASAS criteria / 华中科技大学学报（医学）（英德文版）

Although the development of the 2009 SpA classification criteria by Assessment of SpondyloArthritis international Society (ASAS) represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis (axSpA), the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including SpA. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having axSpA in central China. The results showed that clinical manifestations of axSpA could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from axSpA according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.

SEM observation on leaf epidermis of different Ephedra species / 中国中药杂志

<p><b>OBJECTIVE</b>Characters of stem epidermis, leaf epidermis and stoma could be used as important microcosmic morphological characteristic when inheritance trend is studied in Ephedra breeding and identification.</p><p><b>METHOD</b>The stomatic density, stoma major axis and mimor axis, stomatic morphylogy, characters of leaf and stem epidermis of 6 Ephedra plants' stems were examined by SEM.</p><p><b>RESULT</b>The stomatic density and characteristic of leaf epidermis and stem epidermis in six Ephedra species was differenc, there were no obvious morphological differences in stoma shape and size. The guard cells were covered with heavy cuticle and sunken stomata, which were the typical characteristics of xerophytes. The stomas of leaf lower epidermis were oblong or hexagon, but the stomas of steam epidermis were narrowed-oblong or dumbbell-shape, they all belonged to anomalous type.</p><p><b>CONCLUSION</b>The stoma type and characters of Ephedra plants is stable and conservative, there was no obvious morphological differences in stoma shape and size between species, so it is difficult to distinguish different species by the variance of stomas, but that can be applyed to distinguish Ephedra from others at plant taxonomy.</p>