Objective To study the characteristic of chromogranin A(CgA),synaptophysin(SYN) and neuron-specific enolase(NSE) in cortex and medulla of adrenal.Methods Immunohistochemical method was used to detect the expression of CgA,SYN and NSE in routinely processed tissue specimens from human adrenal neoplasm and hyperplasia.Results The expression of CgA was detected in cortex of adrenocortical adenoma,adrenal neoplasm and chromophile tumor,but not in that of hyperplasia and normal adrenal.The expression of NSE was detected in cortex of adrenal cortical hyperplasia,cortical adenomas and pheochromocyte carcinoma,but not in that of pheochromocytoma and normal adrenal.The expression of SYN was detected in cortex of corticohyperplassia,cortical adenomas,medull neoplasm,chromophile tumor and pheochromocyte carcinoma,but not in that of cortical adenocarcinoma and normal adrenal.The expressions of CgA,NSE and SYN were detected in the medulla of all cases.Conclusion The characteristic of CgA,SYN and NSE in cortex and medulla of adrenal are useful in the differential diagnosis of tumor and hyperplasia in the adrenal.The relationship between the adrenal cortex and medulla is close.Besides the classical hypothalamus-pituitary-adrenal axis(HPAA) and rennin-angiotensin-aldosterone system(RAAS),the adrenal cortex and medulla have the basis of anatomy and endocrinology.

Objective:To study the characteristics of chromogranin(CgA),synaptophysin(SYN) and neuron-specific enolase(NSE) in the cortex of adrenal gland.Methods:Immunohistochemical technique was used to detect the expressions of CgA,SYN and NSE in 56 routinely processed tissue specimens from human adrenal cortical neoplasm and hyperplasia.Results: CgA immunoreactivity was regularly detected in the cortex of adrenal neoplasm,but not in the hyperplasia and normal adrenal gland.The immunoreactive materials appeared in the cytoplasm and in the form of vacuole or grains.Adrenal cortical neoplasm and hyperplasia showed NSE positive cells in the cortex,but not in the normal adrenal gland.SYN positive materials were shown in the cortex of hyperplasia and adrenocorticoadenoma,but not in the adrenocorticoadenocarcinoma and normal adrenal gland.Conclusion: The distributive characteristics of CgA,SYN and NSE in the adrenal cortex help the differential diagnosis of adrenal hyperplasia.The adrenal cortex is closely connected with medulla.Besides the classical hypothalamus-pituitary-adrenal axis(HPAA) and rennin-angiotensin-aldosterone system(RAAS),the adrenal cortex and medulla are mutually regulated on the basis of anatomy and endocrinology.

Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.

Objective To investigate the CT and MRI features of supratentorial primitive neuroectodermal tumors (sPNET)in adults,and to analyze the reasons of misdiagnosis.Methods The CT and MRI features of 1 5 patients with sPNET confirmed by pathology were analyzed retrospective.13 of 15 patients were underwent plain and contrast enhanced MRI,4 patients were also performed CT scan and the other 2 patients were underwent CT plain scan only.Results Nine of 1 5 lesions were located in the temporal and/or frontal lobe,with clear margin in 12 lesions,and mild to moderate peritumoral was noted in most cases.The solid portion of the lesions were hyperdense on CT,isointense or slightly hypointense on T1WI,and isointense or hyperintense on T2WI compared to the gray matter.Calcification (2/6),necrosis or cystic degeneration(1 3/1 5),hemorrhage (8/1 5)and flow void signal (1 1/1 3)were seen.Twelve lesions showed significantly heterogeneous enhancement and 7 lesions showed irregular ring-enhancement.The solid parts in 5 lesions showed hyperintensity on diffusion-weighted imaging. Preoperatively,the lesions were misdiagnosed as glioma in 10 cases,ependymoma in 2 cases,meningioma in 1 case and germ cell tumor in 1 case, respectively;and 1 case was not diagnosed definitely.Conclusion Supratentorial PNET in adults has characteristic CT and MRI features,and the main reasons accounting for misdiagnosis are its extraordinary low incidence and that radiologists do no master its imaging features.

Objective To investigate the influence of Tiaozhi Tongmai(Fat-regulating and Vessel-freeing) Granule (TZTMG) on blood fat, triglyceride-rich remnant-like particle (RLP) and cell adhesion molecule in ApoE-/-mice. Methods After established model of atherosclerosis(AS),ApoE-/-mice(n=30) were randomly divided into model group, fenofibrate group and TZTMG group (each n =10). C57BL/6J mice (n=10) were chosen into normal group. All medicinal groups were fed with high-fat diet, meanwhile were intervened with TZTMG and fenofibrate. The indexes of triglyceride-rich RLP (RLP-C) and 4 items of blood fat were detected detector after 12 weeks. The levels of serum intercellular adhesion molecule-1 (ICAM-1) and vascular adhesion molecule-1 (VCAM-1) were detected by using ELISA. The aortic root was collected to prepare paraffin sections for observing morphological changes af-ter HE staining. Results Since the 4thweek, mouse weight decreased in TZTMG group and fenofibrate group compared with model group. The levels of serum RLP-C, TC, TG, HDL-C and LDL-C increased in model group,fenofibrate group and TZTMG group compared with normal group(P<0.05). The lev-els of serum RLP-C and TG decreased in fenofibrate group and TZTMG group compared with model group (P<0.05). The levels of ICAM-1 and VCAM-1 increased significantly in model group, fenofibrate group and TZTMG group compared with normal group (P <0.05). The levels of serum ICAM-1 and VCAM-1 decreased in fenofibrate group and TZTMG group compared with model group (P <0.05). Comparison in VCAM-1 among normal group,fenofibrate group and TZTMC group had no statistical sig-nificance. HE staining showed there were thickened aortic intima and vulnerable plaques in model group, and thickened aortic intima and stable plaques in TZTMG group. Conclusion TZTMG can decrease the expression of adhesion molecule and delay AS development through reducing RLP-C level.

Objective:To explore the application of micro-lecture system based on ASSURE model in clinical practice teaching of dermatology.Methods:Sixty clinical medicine undergraduate intern doctors in Batch 2014 of Anhui Medical University were randomized into 2 groups, with thirty interns in both experimental group and control group. Micro-lecture system based on ASSURE model teaching method was adopted in experimental group, while traditional teaching method was adopted in control group. At the end of practice, theory test scores and medical record writing was used to evaluate the clinical ability of interns in two groups, and questionnaire survey was conducted to evaluate the satisfaction of interns with the teaching method of micro-lecture system based on ASSURE model. SPSS 16.0 was used for t test. Results:①Theory test scores were higher in experimental group than in control group, with statistically significant differences between the two groups ( P<0.05); ②The scores of history of illness, physical examination, treatment plan and the medical record writing were higher in experimental group than in control group ( P<0.05); ③At the end of internship, the questionnaire showed that the interns in the experimental group were more recognized for this new way of teaching. Conclusion:Micro-lecture system based on ASSURE model teaching method has achieved better results in the teaching of dermatology, which is worthy of future research and promotion.