Pseudohypoparathyroidism(PHP) is a rare genetic disorder.The main character is parathyroid hormone resistance,and some with typical Albright's Hereditary Osteodystrothy malformation.The wide range of PHP symptom spectrum may lead to miss or misdiagnosis.This paper reviewed and summarized the pathogenesis,manifestation and the progress on the diagnosis and treatment of PHP Ⅰ,so as to improve the diagnostic level of this disease.

Objective To investigate the changes of plasma microRNA-223 (miR-223) in pediatric severe pneumonia patients and its relationship with severe pneumonia.Methods There were 50 children with severe pneumonia enrolled in the study (observation group),and 50 healthy children were selected as control group (normal control group).The expression levels of plasma miR-223 were detected by real time polymerase chain reaction.The relationship between miR-223 and procalcitonin (PCT),C-reactive protein (CRP),tumor necrosis factor-α (TNF)-α,and interleukin (IL)-10 were analyzed.The predictive value of miR-223 in plasma,PCT,and CRP to severe pneumonia was evaluated by receiver operating characteristic (ROC) curve.The relationship between miR-223,T cells,TNF-α,and IL-10 was analyzed.Results The plasma miR-223 expression levels in observation group were upregulated compared to those in the normal control group [(16.01 ± 5.17) × 10-4 mg/L vs (5.44 ± 2.21) × 10-4 mg/L,t =7.46,P ＜ 0.01].The CRP and PCT expression levels in severe pneumonia patients were higher than those of the normal control group [z =5.496,5.198,P ＜0.05,orP ＜0.01].The expressions of CD4+ CD25+Treg,miR-223,and IL-10 in observation group were higher than those of normal control group (P ＜0.05).The expression of CD4 + CD25 + Treg,miR-223,and IL-10 in the death children were higher.There was a positive correlation between miR-223 and IL-10 (r =0.335,0.571,P ＜ 0.01).The sensitivity and specific degrees to predict the severe pneumonia in mir-223,PCT,and CRP were 83.79％,86.12％,66.68％,91.05％,78.01％,and 44.23％,respectively.miR-223 was better than PCT and CRP to predict severe pneumonia in children.Conclusions The expression levels of plasma miR-223 in children with severe pneumonia could reflect the immunity,and it can be used as early prognostic markers to reflect the severity of inflammation in some degree.

Objective To investigate general and clinicopathological characteristics of male breast cancer and analyze the factors affecting the outcomes of the patients.Methods Fifty-nine male breast cancer patients treated at Cancer Hospital of Zhengzhou University from January 2002 to December 2011 were included into the study.The clinicopathologic features and 5-year survival rate were retrospectively analyzed.The clinicopathologieal characteristics were investigated by univariate analysis to evaluate the impact of these factors on patient survival.Results The median age at diagnosis was 64 years old in these patients.The positive rate of ER/PR was 74.6 ％ (44/59).The patients were followed up for 9-123 months.The 5-year survival rate was 61％.Patients in stages Ⅰ and Ⅱ had better overall survival than those in stages Ⅲ and Ⅳ.Conclusion The male breast cancer patient has special clinical characteristics.TNM stage is a significant predictor of the overall survival.

Cholesteatoma ; diagnosis ; pathology ; Humans ; Petrous Bone ; pathology

Objective To investigate the clinical efficacy of conventional treatment combined with flupentixol and melitracen in patients with reflux esophagitis (RE).Methods From June 2012 to March 2015, a total of 182 patients were selected as study subjects from newly diagnosed RE patients.The anxiety and depression scores were evaluated according to Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD).And then patients were divided into HAMA and HAMD negative conventional treatment group and combined treatment group, HAMA and HAMD positive conventional treatment group and combined treatment group.Rabeprazole and mosapride were administrated in conventional treatment group.For patients in combined treatment group, on the base of conventional treatment flupentixol and melitracen were added.The treatment course was eight weeks.The degree of anxiety and depression, RE symptoms and mucosal healing under gastroscope were evaluated before and after treatment.Adverse drug reaction was observed.Chi square test or t test was performed for statistical analysis.Results Eight weeks after treatment, the scores of HAMA and HAMD in HAMA and HAMD positive combined treatment group were 7.930 ±3.832 and 9.630 ± 3.650, which were both lower than those of conventional treatment group (11.660 ± 4.108 and 12.170 ± 4.459), and the differences were statistically significant (t=3.683 and 2.233;both P＜0.05).The symptom scores of heartburn, regurgitation, chest pain of HAMA and HAMD positive combined treatment group were 0.700±0.591,0.780± 0.629 and 0.720±0.621, respectively, which were lower than those of conventional treatment group (1.280 ± 0.502, 1.370 ± 0.610 and 1.040 ± 0.842), and the differences were statistically significant (t =5.133, 4.413 and 2.114, all P＜0.05).There were no statistical significance in symptoms scores between HAMA and HAMD negative combined treatment group and conventional treatment group (all P＞0.05).After treatment, the mucosal healing rate of HAMA and HAMD positive combined treatment group was 91.3％ (42/46), which was higher than that of conventional treatment group (71.7 ％, 33/46), and the difference was statistically significant (x2 =5.845, P =0.016).The incidence of adverse events of HAMA and HAMD negative combined treatment group was 4.8％ (2/42), and that of HAMA and HAMD positive combined treatment group was 2.2％(1/46).Conclusions The conventional treatment combined with flupentixol and melitracen in RE patients accompanied with anxiety and depression was remarkable and safe.RE patients without obvious anxiety or depression, preventive use of antianxiety and antidepressant medicine can not improve the efficacy.

Moyamoya disease (MMD) is a chronic and progressive cerebrovascular disease which is characterized by the bilateral internal carotid artery ends and (or) stenosis or occlusion of anterior cerebral artery and middle cerebral artery initial segments,compensatory proliferation of small blood vessels in the skull base and formation of abnormal vascular network.Its etiology and pathogenesis remains unclear.The present studies speculate that MMD may be a polygenic disease,inflammation,immune response,abnormal cytokine secretion,endothelial progenitor cell change and nitric oxide level change are associated with the occurrence and development of MMD.This article reviews the advances in research on the genetics and pathophysiological mechanism of MMD.

Objective:To compare the clinical effect of 0.02% atropine eye drops once every two days and 0.01% atropine eye drops once every day in myopia control and adverse reactions in children.Methods:A randomized controlled study was performed.The 231 Han nationality myopic children wearing full-corrected single-vision spectacle lenses enrolled from June 2016 to June 2017 in The First Affiliated Hospital of Zhengzhou University and Henan Eye Hospital were divided into two groups by random number table, with 110 children in the 0.02% atropine group and 121 children in the 0.01% atropine group.The subjects were treated with 0.02% atropine eye drops once every two days or 0.01% atropine eye drops once every day to each eye before bedtime for one year.Ninety-two cases and 101 cases were followed up for one year in the 0.02% and 0.01% atropine group, respectively.The right eyes were selected as experimental eyes, and the spherical equivalent refraction (SER), axial length (AL), amplitude of accommodation (AMP), pupil diameter (PD), anterior chamber depth (ACD), and corneal curvature were recorded at baseline and 12 months after treatment.Discomfort symptoms were also observed during the 1-year follow-up.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2016-35). Written informed consent was obtained from guardians prior to any treatment.Results:After 1 year of treatment, the mean SER change was (-0.46±0.49)D and (-0.48±0.46)D, and the mean AL change was (0.38±0.21)mm and (0.39±0.19)mm, and the mean AMP change was (-1.49±0.29)D and (-1.61±0.26)D, and the mean PD change was (0.72±0.44)mm and (0.70±0.40)mm in the 0.02% atropine group and 0.01% atropine group, respectively.There was no significant difference in the change of SER, AL, AMP, PD between the two groups (all at P>0.05). There were 21 cases (19.1%) in the 0.02% atropine group and 25 cases (20.7%) in the 0.01% atropine group that represented mild photophobia in bright sunlight, which disappeared in 12 and 13 cases during 1-6 months respectively.The photophobia symptoms of the remaining children were alleviated.There existed 5 cases (4.5%) and 6 cases (5.0%) in the two groups that developed mild near blurred vision that lasted no more than 1 month. Conclusions:Compared with 0.01% atropine eye drops once a day, 0.02% atropine once every two days has the same efficacy on controlling myopia progression in children with no more adverse reactions.

Objective To investigate the effect of methylprednisolone on T helper 17 cell (Th17 cells) related cytokines (interleukin (IL)-23,17A,21,22,6,and tansforming growth factor (TGF)-β) in serum and cerebrospinal fluid from patients with relapsing remitting multiple sclerosis and their effects on the pathogenesis.Methods We recruited relapsing remitting multiple sclerosis group (38 patients)and noninflammatory neurological disease group (20 controls),and detected the levels of IL-23,IL-17A,IL-21,IL-22,TGF-β and IL-6 in serum and cerebrospinal fluid (CSF) with ELISA kit in both controls and patients before and after treatment by methylprednisolone.Results After treatment in relapsing remitting multiple sclerosis patients,IL-17A,IL-23,IL-21,and IL-22 levels in cerebrospinal fluid and serum were significantly decreased,however,they were still higher than that in the non-inflammatory neurological disease patients.TGF-β levels was significantly increased (serum:(17.2 ± 5.9) pg/ml vs (34.1 ± 6.5) pg/ml,t =14.351,P =0.000 ; CSF:(26.4 ± 4.7) pg/ml vs (73.2 ± 19.7) pg/ml,t =16.352,P =0.000).The levels of TGF-β in serum and CSF in patients before treatment were lower than those of in non-inflammatory neurological disease patients (serum:(30.2 ± 8.9) pg/ml,t =6.769,P =0.012 ; CSF:(3 1.4 ± 7.5) pg/ml,t =9.368,P =0.017).However,the levels of TGF-β in CSF in patients after treatment were significantly higher than those in non-inflammatory neurological disease patients (t =9.138,P =0.000).Correlation analysis showed that IL-23 and IL-17A were positive correlation in the serum of relapsing remitting multiple sclerosis patients before treatment.Moreover,positive correlations among IL-23,IL-17A and IL-21 were detected in the CSF of relapsing remitting multiple sclerosis patients before treatment.Conclusions Decreased levels of IL-23,IL-17A,IL-21 and IL-22,and elevated levels of TGF-β were detected in serum and CSF of patients with relapsing remitting multiple sclerosis after methylprednisolone treatment.IL-23,IL-17A,IL-21,IL-22 and TGF-β might involve in the pathogenesis of relapsing remitting multiple sclerosis.

Objective To investigate histopathological and ultrastructural differences between melasma tissues and normal skin tissues around pigmented nevus. Methods Eight patients with melasma and 16 patients with facial pigmented nevus were included in this study. Two millimeter punch biopsies were taken from melasma lesions and adjacent normal skin of facial pigmented nevus. Biopsy specimens were then subjected to hematoxylin?eosin (HE) staining, Fonton?Masson staining, Verhoeff?van Gieson staining, and immunohistochemical staining with monoclonal antibodies HMB45 and NKI/beteb. Transmission electron microscopy was used to observe the tissue specimens. Semi?quantitative analysis was performed under a light microscope, and quantitative analysis by using a computerized image analysis system. Results Histopathological study revealed increased number of melanin granules mainly in the basal and prickle cell layers, sometimes in the dermis, in melasma tissues compared with normal skin tissues. Melanocytes were only observed in the epidermis of melasma tissues. Compared with normal skin tissues, melasma tissues showed no significant difference in the quantity of melanocytes, but a significant increase in the volume, staining intensity and dendrite number of melanocytes. In all of the 8 patients with melasma, mild to moderate lymphocytic infiltration was observed in the superficial dermis and around capillaries, with moderate telangiectasis in the superficial dermis. Electron microscopy revealed that there were more melanosomes in melanocytes and keratinocytes, and melanocyte dendrites extended into the dermis in melasma tissues. Conclusions Among the 8 patients, there were only two types of melasma, i.e., epidermal melasma and mixed melasma, and no dermal melasma was found. Inflammation and telangiectasis may induce or aggravate melasma.

Objective To explore the value of urine formaldehyde test in the diagnosis of Alzheimer's disease (AD),and the influential factors of urine formaldehyde level in AD patients.Methods A total of 52 AD patients and 53 cognitively normal controls were recruited in a cohort study.All subjects were no less than 65 years old,and those with acute infection,or dysfunction in heart,liver or kidneys were excluded.The impact of age,gender,onset age,MMSE score,NPI score,MTA score,and ApoE ε4 gene on urine formaldehyde of AD patients were analyzed by multiple regression analysis.Results Urine formaldehyde level of AD group was statistically higher than that of cognitively normal control group ((13.27±4.16)μmol/L vs (10.76±4.47)μmol/L,t=2.99,P=0.15).Urine formaldehyde of AD patients was statistically negatively correlated with MMSE score (β=-0.35,P=0.03) and MTA score (β=-0.38,P=0.02).The impact of onset age,neuropsychiatric disorders and ApoE ε4 gene on urine formaldehyde of AD patients was not statistically significant(all P>0.05).Conclusion Urine formaldehyde level is worthwhile to be explored as a marker in AD diagnosis and severity assessment.