Cognitive flexibility is a kind of ability to convert mental representation,including reactive flexibility and spontaneous flexibility,and as the vital components of executive function.The experience of the childhood maltreatment may damage both reactive flexibility and spontaneous flexibility and result in cognitive flexibility dysfunction.Prefrontal cortex is the main brain regions of cognitive flexibility,childhood maltreatment experience through injuring the growth of frontal lobe leading to the cognitive flexibility dysfunction.Future research could combine the method of behavioral test and brain damage measurement,to carry on minute research on the two components of cognitive flexibility and brain mechanisms at the same time.

The clinical course of mycosis fungoides is indolent except when large cell transformation occurs. Large cell transformation of MF is rare and easy to misdiagnose. A case of large cell transformation of mycosis fungoides is reported. A 40-year-old man presented with a 10-year history of pruritic erythema and papules in the trunk and extremities as well as a 5-month history of nodules on the nape of the neck.Histopathologically, the erythematous patch showed typical changes of mycosis fungoides, while the tumor cells were small and expressed CD3 and CD4, and only a small number of tumor cells expressed CD30. Pathological examination of nodular lesions revealed the infiltration of large pleomorphic lymphoid cells expressing CD3 and CD4 throughout the entire dermis. There was an epidermotropism of large cells, and about 40% of these cells expressed CD30. Based on the medical history and histological findings, the patient was diagnosed with large cell transformation of mycosis fungoides. The lesions improved markedly after 3-week treatment with oral acitretin (30 mg once daily), subcutaneous interferon-alpha (2 × 106 IU thrice a week) and local superficial X-ray irradiation for nodular lesions. Up to the time of this writing, the patient had been followed.

A survey has been made during 1953-1955 on the patented milk substitutes including 58 kinds produced by 25 factories in 5 cities-Peking, Tientsin, Shanghai, Wuhan and Canton. Attention was directed to the annual production, the raw material, the formulae and the wholesale and retail prices. Unpatented products have not been included in the present survey. Nutritional composition, growth promoting effect and availability of some nutients have been studied by chemical, physiological, and pathological methods.On the basis that a 5 kilo child requires 500 calories per day, and assuming that he lives solely upon milk substitutes throughout the year, theannual production of the 25 factories in 1954, i.e. 1830 tons, would supply the need of 40,000 babies.Most of the products are made of rice and wheat flour and cane sugar, with the addition of about 5 % each of egg yolk and l or cow's milk powder, 0.7 % calcium lactate and 0.3% salt. Among the 58 kinds, 9 are free from animal protein, and 3 include soybean as the main source of protein.With respect to the dietary allowance of the babies, the majority of these products are deficient in protein, most of them are deficient in phosphorous and all of them are deficient in calcium. The protein is generally 50 % less than the required amount, while calcium and phosphorous are 10-90% below the recommended level. All are deficient in vitamins. The N:Ca:P proportions are not correct in any of the preparations. The protein content of 2 samples containing soybean amounts to 33-37 % which is much too high, particularly when accompanied by faulty ratios of calcium, phosphorous and other nutrients.Samples containing 10 % or less protein (including some of animal origin) and with restricted mineral supply, not only retarded the general growth of the experimental animals but also produced pathological changes in bone and some internal organs. Nevertheless, one of the samples with excessive protein, ample phosphorous but limited calcium promoted good growth in experimental animals. The bone structure of the latter was fairly normal.It is suggested that new and better formulae with high nutritional quality but low cost, such as the one proposed by the authors (to be published) be employed to replace the old ones.

A milk substitute for infant feeding has been prepared using(parts by weight): soybean flour 28.0, rice flour 45.0, egg-yolk powder 5.0, cane sugar 16.5, soybean oil 3.0, "fermented millet" 0.5, bone meal 1.5 and salt 0.5. Vanilla powder was added as the flavoring material.Soybean was soaked in water for 4 hrs., steamed under atmospheric pressure for 30 minutes and dried at 70-80℃ before milling. Bone meal was prepared from degelatinized animal bones, the by-product of a glue fatctory, Which have been treated with steam under 20-25 lbs. of pressure and repeatedly extracted with hot water for 10 hrs. "fermented millet" was prepared by innoculating the cooked millet with Eremothecium ashbyii as reported by Liu.The ingradients are mixed, pressed slightly into the form of small cubes, steamed and dried. When using, the proper number of cubes are mixed with the desired amount of water, cooked over a gentle fire and then served in the form of a thin paste.The proximate composition, the mineral and vitamin contents of the products, per 100 grams dry Weight, are as follows: protein 17.1 gms, fat 12.8 gms, carbohydrate 66.0 gms, crude fiber 0.82 gms, ash 3.25 gms, calcium 692 mgs, phosphorous(total) 330 mgs, (phytin)97 mgs, iron 5.9 mgs, thiamin 0.11 mgs, riboflavin 0.63 mgs, niacin 1.09 mgs, carotene 40.0 micro-gms, and energy 448 Cals.Aside from analyzing the product as well as the raw materials for the above nutrients, investigations were also made on the following subjects: determination of the essential amino acids, destruction of the trypsin inhibitor, availability of calcium and phosphorous, loss of thiamin, microbiological examination and soma physical changes of the product during storage.With respect to the adequacy of protein, 100 Cals. of the product would supply 3.8 gms of total protein which furnish all the essential amino acids to the amounts that a child would be able to obtain(per kilogram of body weight per day)from mother's milk.The product contains ample amounts of riboflavin, available calcium, phosphorous and iron to meet the diatary allowance of the infants. The amounts of thiamin and vitamin A are limited-the formet would satisfy only the minimum daily requirement while the latter is deficient by about 50％.Animal and human feeding experiments(to be published)indicated that this preparation promoted good growth not inferior to those fed on human or cow's milks. The cost of the new milk substitute is about 50％ less than the current prices of the present commercial products and about 80％ less than that of good grade cow's milk powder.

Objective To analyze the epidemiological,clinical and histopathological characteristics of cutaneous leishmaniasis.Methods This study included six patients with cutaneous leishmaniasis diagnosed in the Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College,over the past 10 years.The epidemiological features as well as clinical and histopathologic presentations of these patients were analyzed retrospectively.Results All of the six patients were male.The mean age at onset of skin eruptions was 47.67 (range:37-67) years,and the mean duration of disease was 10 (range:6-18) months.Clinical presentations included erythema,nodules and ulcers in the face and limbs.Skin biopsy revealed infection-associated granulomatous inflammation with many amastigotes (basophilic bodies) in the cytoplasm of histiocytes,which were highlighted with Giemsa stain.All the patients had a history of working at or travel to epidemic areas.Conclusion The diagnosis of cutaneous leishmaniasis mainly depends on epidemiological data,clinical manifestation and histopathologic findings.

Objective To estimate the prevalence of sexually transmitted diseases(STDs) among men who have sex with men (MSM) in some cities of Jiangsu province.Methods A cross-sectional questionnaire survey was carried out among MSM attending gay bars in some cities of Jiangsu province.Participants underwent screening for STDs in accordance with their personal wishes.Urethral swabs,first void urine and blood samples were collected at these survey sites and delivered to the STD research laboratory for testing.Univariate analysis and multivariate logistic regression analysis were performed to assess factors associated with STDs.Results A total of 388 subjects completed the questionnaire and underwent physical examination and STD screening.Of these subjects,45.6％ had only homosexual behavior.Examination of urine or urethral swab specimens showed that the prevalence rate was 1.3％ (5/388),9.4％ (36/385),17.2％ (66/384) and 28.1％ (109/388) for Neisseda gonorrhoeae,Chlamydia trachomatis,Mycoplasma genitalium and Ureaplasma urealyticum infection respectively.Serological tests revealed that the positivity rate was 1.0％ (4/388) for anti-human immunodeficiency virus (HIV)antibody,18.8％(73/388) for Treponema pallidum particle agglutination assay (TPPA),12.1％(47/388) for rapid plasma reagin (RPR) test,9.8％ (38/388) for human herpes simplex virus (HSV)-2-IgG,9.8％ (38/388) for hepatitis B surface antigen,1.0％ (4/388) for anti-hepatitis C virus antibody and 2.1％ (8/388) for anti-hepatitis E virus antibody.Multivariate analysis indicated that Chlamydia trachomatis infection was independently and significantly associated with polymorphonuclear leucocyte (PMNL) counts in urethral swab smears (adjusted odds ratio (AOR):5.30,95％ CI:2.04-13.77,P ＜ 0.01),Mycoplasma genitalium infection was significantly associated with age (AOR:2.84,95％ CI:1.17-6.87,P＜ 0.05),PMNL counts in urethral swab smears (AOR:2.37,95％ CI:1.01-557,P＜ 0.05) and urethral discomfort in the past three months (AOR:2.43,95％ CI.1.18-5.02,P＜ 0.05),and syphilis (defined as a positive TPPA and RPR test) was associated with age (AOR:2.46,95％ CI:1.05-5.75,P ＜ 0.05) and seropositivity for anti-HSV-2 antibodies (AOR:3.70,95％ CI:1.62-8.44,P ＜ 0.01).Conclusions There is a high prevalence of STDs among MSM attending gay bars in some cities of Jiangsu province,with Chlamydia trachomatis and Mycoplasma genitalium as the most common pathogens of urethritis.

Objective To explore the effects of targeted silencing of the chemokine receptor 7 (CXCR7)gene on the invasion and migration of the melanoma cell line M14. Methods Western-blot analysis was performed to determine the protein expression of CXCR7 in melanoma cell lines M14 and A375, and CXCR7-overexpressing M14 cells were used in this study. Cultured M14 cells were divided into three groups: experimental group transfected with a small interfering RNA(siRNA)targeting CXCR7(CXCR7-siRNA), negative control group transfected with a negative control siRNA, blank control group receiving no treatment. Real-time quantitative PCR and Western-blot analysis were conducted to determine the mRNA and protein expressions of CXCR7 respectively in M14 cells, Transwell chambers were used to evaluate the invasive activity of M14 cells, and wound healing assay to estimate the migratory activity of M14 cells. Results The experimental group showed significantly decreased mRNA and protein expressions of CXCR7 compared with the negative control group and blank control group (CXCR7 mRNA: 0.412 ± 0.023 vs. 1.211 ± 0.117 and 1.000 ± 0.102, F = 30.068, P = 0.001; CXCR7 protein: 0.144 ± 0.005 vs. 1 and 1.016 ± 0.004, F =11 485.5, P = 0.000). The number of M14 cells crossing the polycarbonate membrane per high-power field (× 200)was significantly smaller in the experimental group than in the negative control group and blank control group (20.617 ± 1.503 vs. 42.000 ± 6.018 and 43.627 ± 2.152, F = 32.416, P = 0.001). Similarly, the number of migrating M14 cells in wound healing assay was significantly decreased in the experimental group compared with the negative control group and blank control group (15.00 ± 1.10 vs. 44.90 ± 2.20 and 45.30 ± 2.30, F = 2 411.945, P = 0.000). Conclusion Targeted silencing of the CXCR7 gene can significantly inhibit the invasion and migration of M14 cells in vitro, which may provide a potential target for the treatment of cutaneous melanoma.

Objective To investigate the expression of CXCR7 in several cutaneous malignant tumors including cutaneous squamous cell carcinoma (SCC),basal cell carcinoma (BCC) and invasive cutaneous malignant melanoma and their cell lines,as well as its significance.Methods Tissue specimens were obtained from the lesions of 30 patients with cutaneous squamous cell carcinoma,25 patients with basal cell carcinoma and 30 patients with cutaneous malignant melanoma.Immunohistochemistry was performed to detect the expression of CXCR7 protein in these tissue specimens and several cell lines (A375 human melanoma cells,M14 human melanoma cells,A431 human epidermoid carcinoma cells,HaCaT human keratinocytes).The mRNA expression of CXCR7 in these cell lines was measured by reverse transcription PCR.Results CXCR7 protein was apparently expressed in invasive cutaneous malignant melanoma.The high expression rate of CXCR7 protein was significantly elevated in cutaneous malignant melanoma tissue specimens compared with SCC and BCC tissue specimens [80％ (24/30) vs.26.67％ (8/30) and 8％ (2/25),x2 =17.16,28.36,both P ＜ 0.05].CXCR7 mRNA was expressed in A375,M14 and A431 cells,but not in HaCaT cells,with the strongest expression observed in A375 cells.Immunohistochemistry revealed the expression of CXCR7 protein only in A375 cells.Conclusions CXCR7 is highly expressed in cutaneous malignant melanoma and A375 cells,which may be involved in the malignant invasion and metastasis of melanoma.

OBJECTIVETo investigate the clinical characteristics of juvenile localized scleroderma (JLS).

METHODSThe clinical data of 100 outpatients with JLS who were admitted to PUMC Hospital from 2000 to 2008 were retrospectively analyzed.

RESULTSOf a total of 100 cases, 51 (51%) were confirmed as linear scleroderma, 26 (26%) as plaque morphea, 26 (26%) as deep morphea, 12 (12%) as generalized morphea, and 15 (15%) as a mixed subtype. Nine patients (9%) had family histories of rheumatic or autoimmune diseases, while 16 (16%) might be triggered by unknown factors. Totally 84 patients underwent antinuclear antibody tests and 38 patients (45.2%) had positive results.

CONCLUSIONSLinear scleroderma are the most frequent subtype of JLS. Localized scleroderma may be associated with some autoimmune-related causes.

Adolescent ; Antibodies, Antinuclear ; blood ; Autoimmune Diseases ; complications ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Scleroderma, Localized ; diagnosis ; immunology ; pathology

Objective: To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis. Methods: From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension. Results: There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months. Conclusions The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.