Objective To investigate the expression of bcl-2 and PCNA in mixed tumor of skin. Methods Bcl-2 and PCNA expression in 12 cases of mixed tumor of skin were studied using immunohistochemical S-P method and double-staining. Results Positive reactions of bcl-2 and PCNA were observed in all cases. PCNA staining was positive in tumor cells lining cystic and duct-like structures in tumor nests, but bcl-2 staining was positive in epitheloid tumor cells. Most tumor cells with bcl-2 were PCNA negative and vice versa. Conclusion Aberrant expression of bcl-2 and PCNA in mixed tumor of skin may play a role in tumorigenesis.

Objective To explore the expression and implication of p21and cyclin-dependent kinase2(CDK2)in Bowen's disease.Methods The expression and distribution of p21and CDK2on the skin le-sion and normal skin were detected by using immunohistochemical technique streptavidin-peroxidase(SP)in28cases of Bowen's disease and10normal controls.Results p21and CDK2were significantly highly ex-pressed in Bowen' s disease and were not expressed in normal skins.Positive staining was found in22/28(78.6%)of Bowen' s disease for p21and26/28(92.9%)for CDK2.There was a correlation between the expression of p21and CDK2(r =0.84,P

Objective The purpose of this study was to examine the relationship between acute mountain sickness ( AMS) and AMS susceptibility indices before ascent to high altitude and to evaluate their predictive value for AMS. Methods A total of 314 healthy male a-dults were voluntarily enrolled. Their 22 physiological and mental indices of AMS susceptibility were obtained before exposure high altitude. The diagnoses of AMS were based on the Lake Louise score ( LLS) ,an international standard scoring system for AMS. According to the char-acteristics of selected AMS susceptibility indices and the strong fault tolerance of neural network theory, the learning vector quantization ( LVQ) neural network method was adopted to build the prediction model of susceptibility to AMS. Results The results showed the sensitiv-ity of the LVQ model which distinguishes subjects with no-AMS reached 95. 00%,the average correct-prediction precision ultimately reached 72. 22%. The result of prediction is believable. Conclusion The builded LVQ model provide a scientific method for screening crowd who quickly ascend to high altitude,and also can lead to an effective preliminary screening of susceptibility to AMS.

Objective To investigate the efficacy of ultrashort and short-acting insulin after subcutaneous insulin infusion pump under glucose monitoring in treatment of diabetes.Methods 110 cases with type 2 diabetes were selected,they were randomly divided into two groups with a random number table:the study group and the control group,55 cases in each group.The study group was treated with short -acting insulin after subcutaneous injection of insulin pump,the control group was treated with short -acting subcutaneous insulin infusion by insulin pump therapy, glucose monitoring system was used to monitor glucose during treatment of the two groups.The clinical efficacy after a month of treatment was observed.Results Before treatment,fasting blood glucose(FPG),postprandial 2 h blood glucose(2h PG),bedtime blood glucose of the two groups had no statistically significant differences.After treatment, FPG and 2hPG,bedtime blood glucose in the study group were (6.01 ±1.06)mmol/L,(7.90 ±0.50)mmol/L, (7.13 ±0.95)mmol/L respectively,which of the control group were (5.98 ±1.04)mmol/L,(7.91 ±0.48)mmol/L, (7.14 ±0.94)mmol/L,which were significantly lower than before treatment (t =9.843,23.669,13.569,9.683, 22.881,13.710,P <0.05),the two groups after treatment showed no significant differences(P >0.05).The blood glucose time and insulin dosage in the study group were (5.59 ±1.30)d,(39.98 ±11.01)u/d,which of the control group were (6.98 ±1.40)d,(51.89 ±11.97)u/d,and there were significant differences between the two groups(t =1.825,5.431,P <0.05).The mean blood glucose,blood glucose standard deviation,time percentage of blood glucose≥10 mmol/L,time percentage of blood glucose≤3.9 mmol/L in the study group were (5.95 ±0.61 )mmol/L, (1.28 ±0.25)mmol/L,(14.16 ±2.13)%,(6.35 ±1.45)%,which in the control group were (6.59 ±0.94)mmol/L, (1.54 ±0.29)mmol/L,(15.15 ±2.14)%,(7.96 ±1.42)% respectively,and the differences were statistically significant between the two groups(t =4.236,503.6,2.432,5.883,P <0.05).Conclusion Glucose monitoring system in monitoring blood glucose is accurate and reliable,ultra -short -acting insulin after subcutaneous insulin pump infusion in treatment of diabetes is better than short -acting insulin.

Objective:To analyze dermoscopic and reflectance confocal microscopic characteristics of acanthosis nigricans, and to assess the value of dermoscopy and reflectance confocal microscopy (RCM) in the auxiliary diagnosis of acanthosis nigricans.Methods:A total of 63 patients with acanthosis nigricans were collected from Department of Dermatology, the Third People′s Hospital of Hangzhou from January 2018 to December 2019, and 5 healthy individuals served as controls. Two lesions on the neck and axilla were examined with dermoscopy and RCM separately in each patient. Biopsies were carried out at the sites evaluated by dermoscopy and RCM in 3 patients, followed by routine histopathological examination.Results:Dermoscopy showed papilloma-like hyperplasia in 126 (100%) lesions, "fat finger" structures in 119 (94.4%) , and "gully" structures in 120 (95.2%) . RCM showed hyperpigmentation in the basal layers, downward extension and twisting of dermal papillary rings and "gully" structures in 126 (100%) lesions, moderately to highly refractive particles in the dermal papillary rings in 87 (69.0%) .Conclusion:Acanthosis nigricans has typical dermoscopic and reflectance confocal microscopic characteristics, which can provide a basis for its diagnosis and differential diagnosis.

Objective To detect the levels of IL-9,IL-17,and IFN-γ in CD4+T cells from patients with rheumatoid arthritis (RA).Methods The peripheral blood mononuclear cells (PBMCs) from patients with RA and healthy controls were obtained,then the CD4+ T lymphocytes were tested by immunomagnetic beads.The protein levels of IL-9,IFN-γ and IL-17 were measured by flow cytometry (FCM).The mRNA levels of IL-9,IL-17,RORγt and IFN-γwere also detected by qRT-PCR.Data were analyzed by comparison between groups using variance analysis,and Pearson's correlation analysis was used for linear correlation analysis.Results The isolation of untouched human CD4+ T cells from PBMC was effective and its purity was over 90％.The protein levels of IL-9,IL-17,IFN-γwere higher in patients with active RA as compared with patients with inactive RA (P＜0.01) which were (1.62±0.23)％ vs (1.15±0.24)％(P＜0.01),(1.47±0.20)％ vs (1.04±0.26)％(P＜0.01) and (8.1±0.6)％ vs (6.9±1.0)％(P＜0.01) respectively,so did the patients with RA when compared with healthy controls (P＜0.01).The mRNA levels of IL-9,IL-17,RORγt and IFN-γ were higher in patients with active RA as compared with inactive RA patients (P＜0.01),which were (3.0±0.6) vs (1.8±0.4) (p＜0.01) (4.2±0.9)vs (2.3±0.7) (P＜0.01),(4.1±0.7)vs (2.9±0.3) (P＜0.01)and (4.0±0.8)vs (2.3±0.6) (P＜0.01) respectively,so did the patients with RA when compared with healthy controls (P＜0.01).Intracelluar IL-9 levels were positively correlated with IL-17 (r=0.632,P=0.001),IFN-γ (r=0.515,P=0.008),DAS28 (r=0.519,P=0.009) and ESR (r=0.857,P=0.038) but had no correlation with CRP (r=0.38,P=0.61).Conclusion The levels of IL-17,IL-9,IFN-γare higher in the PBMCs of RA patients,and these cytokines may participate in the pathogenesis of RA.

Objective To evaluate the clinical efficacy of 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) combined with imiquimod for basal cell carcinoma( BCC).Methods 38 patients with BCC were randomly divided into two groups.ALA-PDT plus imiquimod were given in the treatment group (19 patients) , and the control group(19 patients) were treated with only ALA-PDT.All patients were followed for one year,and the efficacy and relapse rate were observed.Results The cure rate and the recurrence rate of the treatment group was 94.74% ( 18/19) and 5.26% (1/19) .however,those of the control group was 68.42% (13/19) and 31.58% (6/19).There was a statistical difference in the cure rate and recurrence rate between the two groups(x2 =4.37,P <0.05).Conclusion The efficacy and relapse rate of ALA-PDT combined with imiquimod was much better than those of ALA-PDT only in treatment of BCC.

Background p21 is a cyclin-dependent kinase inhibitor,and it can prevent cells from going through the G1/S phase checkpoint and inhibit cell proliferation.Stuies determined that the expression level of p21 WAF1/CIP1 is associated with proliferative diseases.Traumatic proliferative vitreoretinopathy (PVR) is a proliferative response of eye.Understaining the relationship of dynamic expression levels of p21 WAF1/CIP1 in PVR is of significance for the prevention and management of PVR.Objective This study was to investigate the expression of p21 WAF1/CIP1 during the course of experimental traumatic PVR in rabbits.Methods Fifty-four pigmented rabbits were randomized into the normal control group and different experimerital groups,and one lateral eye of each rabbit served as experimental eye.PVR models were established by intravitreal injection of human platelet-rich plasma (PRP) (0.4 ml)combined with cryotherapy for 5 seconds,and vitreous and retinas were examined with B type sonography.The rabbits were sacrificed in 7,14,21 and 28 days after operation,and histopathological examination of the retinas was performed by haematoxylin and eosin stain.The expression levels of p21WAF1/CIP1 protein and gene were detected by immunohistochemistry,Western blot and reverse transcription-PCR (RT-PCR).The use and care of the rabbits complied with Statement of ARVO.Results B type sonography showed that the retinal morphology was normal in the normal control group.However,the proliferative membrane was gradually thickened 1 to 7 days after operation.Retinal folds of rabbits were seen in 7 days,and tractional retinal detachment was found in 14 days and 28 days after operation.The histopathological examination of the retinas showed epiretinal membrane and infiltration of inflammatory cells 7 days and fixed ruffle 28 days after operation.The p21WAF1/CIP1 was strongly expressed in the cell nucleus of retinal ganglion cell layer (GCL) and inner nuclear layer (INL) in the normal control group,and the expression was gradually weakened after modeling,with the weakest expression in the retinas in 14 days after modeling.The relative expression levels of p21 WAF1/CIP1 protein was 0.74±0.08,0.60±0.05,0.56±0.03,0.74±0.02 and 0.65 ±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,showing a significant difference among the groups (F =20.55,P =0.00),and the expression levels of p21WAF1/CIP1 protein were significantly lower in the postoperative 7-day group and postoperative 14-day group than those of the normal control group,postoperative 21-day group and postoperative 28-day group (all at P＜0.05).The relative expression levels of p21 WAF1/CIP1 mRNA was 0.65 ± 0.09,0.57 ± 0.05,0.45 ±0.04,0.46±0.02 and 0.47±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,with a significant difference among the groups (F =18.06,P =0.00),and the expression levels were significantly lower in the postoperative 14-day group,postoperative 21-day group and postoperative 28-day group than those of the normal control group and postoperative 7-day group (all at P＜0.05).Conclusions The dynamic expression of p21WAF1/CIP1 in the retinas is consistant with the prograssion of traumatic PVR,and the reduce tendency of p21 WAF1/CIP1expression is similar to cell prolieration change,indicating that reduce of p21WAF1/CIP1 expression in the retinas may promote the development of traumatic PVR.

OBJECTIVE:To provide reference for health service support at high altitude area. METHODS:375 servicemen who rapidly entered high altitude area were investigated by questionnaire in 2013 to investigate the compliance of using high alti-tude special medicines and incidence of mountain sickness and analyze its correlation. RESULTS:375 questionnaires were distribut-ed and 324 questionnaires were collected with effective response rate of 86.4%. The utilization rate of Multivitamin tablet,Skin cream and Lip balm for high altitude area were 30.9%,13.3% and 40.1% respectively. The compliance of using high altitude spe-cial medicines had effect on the incidence of related mountain sickness. The incidence of mountain sickness of people who followed the physician’s instructions was significantly lower than those who did not. The difference was statistically significant(P<0.05). CONCLUSIONS:High altitude special medicines can relieve and prevent the mountain sickness. But the overall compliance of us-ing high altitude special medicines was not ideal. The education of high altitude special medicines should be strengthened,and dos-age forms and medicine instruction should be enhanced to improve its compliance and play better protective effect.

Objective To investigate the percentage of CD5-positive B cells in peripheral blood mononuclear cells(PBMC) of patients with chronic HCV infection and its clinical significance.Methods The expression of CD5 molecule on B cell surface was detected by flow cytometry and HCV RNA copies were detected by real-time PCR.Results The percentage of CD5+-B cells significantly increased in the patients with chronic HCV infection(58.4%?9.8%) compared with healthy controls(22.5%?5.9%)(P