Objective To investigate the clinicopathology characteristics, immunopheotypic of anaplastic large cell lymphoma (ALCL) in order to improve its diagnostic and therapeutic accuracy. Methods The clinical, immunophenotypic and histopathologie features of 19 cases ALCL were retrospectively studied. The expression of CD30, ALK, CD43, CD45RO, EMA and TIA-1 was detected using EnVision immunohistochemical technique. Results All patients were primary systemic ALCL. Among the 19 patients, 11 were males and 8were females. The age ranged from 2 to 71 years, average age 26 years old. It shows a broad morphologic spectrum of the tumor cell and the hallmark cells characterized by sheets of large lymphoid cells withchromatin-poor horseshoe-shaped nuclei containing multiple nucleoli were encountered in all ALCL variants. 16patients (84.2 %) showed B-symptoms, and extranodal involvement was present in 14 (73.7 % ).Immunohistochemical study showed that the tumor cells expressed CD30 (100 %), ALK (78.9 %), EMA(52.6 %), TIA-1 (73.7 %) and 2 cases (10.5 %) neither expressed ALK, nor EMA,TIA-1.17 cases were reached the correct diagnosis according to combination of clinic, histological and immunological features.Conclusion The correct diagnosis of ALCL may be reached by combination of clinic, histological and immunological features according to WHO classification. Immunohistoehemical staining for CD30, ALK, EMA and TIA-1 is useful in making a correct diagnosis.

Objective To observe the clinical efficacy and safety of local injection of botulinum toxin type A (BTX-A) in the treatment of Migraine.Methods 31 patients in the treatment group were injected BTX-A 25 U at 10 positions at the muscles.30 patients in the control group were given 2％ lidocaine 1 ml plus prednisolone acetate 1 ml at the same muscle sites as in the treatment group.Days,frequency,and intensity of headache were evaluated by visual analogue scale (VAS),migraine disability was evaluated by migraine disability assessment guestionnaire (MIDAS),and adverse reactions were assessed on 1 month before the treatment and 1st,2st,3st months after the treatment.Results The therapeutic effect between the treatment and control groups was significantly different in terms of days,frequency,and intensity of headache and migraine disability.Compared with preinjection,days and frequency of headache and migraine disability were decreased significantly after injection in treatment group,lasting more than 2 months.No patients in two groups reported any serious treatment-related adverse event.Conclusions Botulinum toxin type A in the treatment of Migraine is effective and relative safe,and can decrease migraine disability.

Objective To investigate epidemiological and clinical features of human ehrlichiosis.Methods The epidemiological, clinical, laboratory, therapeutic and prognostic data of 21 clinically diagnosed cases of human ehrlichiosis were retrospectively analyzed. Results The epidemic regions where the ticks' activity was high located at the boundary between Hubei and Henan Provinces. All cases were farmers. The median age was 50 years ranged from 19 to 69 years. The male female ratio evident history of tick bite 1 week before the onset. The common symptoms included fever, diarrhea,cough, nausea and vomiting, abdominal pain and expectoration. The complications included hemorrhage, toxic encephalopathy, acute renal insufficiency, secondary infection and respiratory failure. The common abnormalities of routine lab data were thrombocytopenia, hypoeosinophilia,elevated lactate dehydrogenase, creatine kinase and aminotransferases, leucopenia and proteinuria.Nine cases were tested with peripheral blood smear and intracytoplasmic inclusions in neutrophils were found in one case. Seventeen cases were tested with serological assay and antibodies against Ehrlichia were positive in five cases. After doxycycline, symptomatic and supportive treatments, 14 cases were recovered and seven died. The average age of the deaths was 56 years. Conclusions Human ehrlichiosis is an acute tick-borne zoonosis and multiorgan could be involved. The older cases prone to develop complications and the prognosis is poor.

Objective To investigate the correlation between body mass index (BMI) and features of tongue manifestation.Methods A total of 1 655 physical examination individuals were selected,and height and body weight were measured to calculate BMI.Traditional Chinese Medicine tongue inspection was performed,and map of tongue manifestation was photographed by a digital camera.Results Among the 1 655 physical examination individuals,prevalences of normal weight,overweight/obesity and low weight were 50.94％,43.74％ and 5.32％,respectively.The prevalences of individuals had dark red tongue (37.98％ vs.24.56％;x2=40.883,P＜0.001),purplish tongue (5.94％ vs.3.44％;x2=8.133,P=0.017),dark purplish tongue (2.35％ vs.0.59％;x2=10.398,P=0.006),yellow fur (63.95％ vs.58.84％;x2=9.570,P=0.008),thick greasy fur (24.86％ vs.17.20％;x2=18.698,P＜0.001) in the overweight/obesity group were significantly higher than those in the normal weight group,and the prevalence of individuals had exfoliative fur/little fur/less fur in the overweight/obesity group was significantly higher than that in the normal weight group (1.93％ vs.3.91％;x2=6.454,P=0.040).The prevalences of individuals had red or deep red tongue (48.86％ vs.24.72％;x2=24.608,P＜0.001),red dot tongue (7.95％ vs.1.93％;x2=12.254,P=0.002),thin whitish fur (22.73％ vs.9.53％;x2=14.030,P=0.001) in the low weight group were significantly higher than those in the normal weight group.Binary logistic regression analysis showed positive correlation between dark red tongue (OR 1.830,95％ CI 1.515-2.211;P＜0.001),purplish tongue (OR 1.874,95％ CI 1.211-2.901;P=0.005),dark purplish tongue (OR 4.259,95％ CI 1.610-11.266;P=0.003),yellow fur (OR 1.294,95％ CI 1.093-1.531;P=0.003),gray-black fur (OR 6.147,95％ CI 1.816-20.811;P=0.004),thick greasy fur (OR 1.597,95％ CI 1.289-1.978;P＜0.001) and BMI,and negative correlation between pink tongue (OR 0.766,95％ CI 0.637-0.920;P=0.004),red or deep red tongue (OR 0.659,95％ CI 0.549-0.789;P＜0.001),red dot tongue (OR 0.548,95％ CI 0.326-0.921;P=0.023),thin whitish fur (OR 0.695,95％ CI 0.536-0.900;P=0.006),whitish fur (OR 0.821,95％ CI 0.683-0.986;P=0.035) and BMI.Conclusions There is some correlation between BMI and features of tongue manifestation.Abnormal tongue color is mainly dark red tongue in the overweight/obesity individuals,and red or deep red tongue in low weight individuals.Abnormal tongue fur is mainly thick yellow fur.The tongue shape is normal in different body weight groups.

This study was aimed to discuss the diagnosis significance of the diseased tongue demonstration in Shanghuo (heatiness) people. Based on 303Shanghuo cases, the relevance of diseased tongue demonstration and inquiry data were analyzed. The results showed that 53.14%Shanghuo cases had at least more than 2Shanghuo inducing causes. The most common inducing cause combinations were pathogenic factors neither endogenous nor exogenous (unbalanced diet, overworked) and internal factors (over stressed, emotional). When there were several Shanghuo causes occurred at the same time, the probability of appearing diseased tongue demonstration increased significantly. There were 29.95%Shanghuo cases occurredShanghuo experience frequently. And in these cases, the probability of appearing diseased tongue demonstration increased significantly. It was concluded that when Shanghuo people had diseased tongue demonstration appeared, it was not merely just“is going to get ill”, but was already suffering from heat syndrome. In traditional Chinese medicine (TCM) physical examination, to effectively differentiate“is going to get ill” and“being ill” was initially important. And the diseased tongue demonstration was a crucial diagnostic basis.

This study was aimed to discuss the connotation of congenital constitution in medical books before Qing dynasty. By searching the character Bing as a keyword in the Encyclopedia of Traditional Chinese Medicine (TCM), 6 480 articles were retrieved. Through reading each of the articles, 9 congenital constitution terms were con-cluded. A total of 1 041 valid entries involved in 165 medical books were retrieved. The results showed that congen-ital constitution was affected by parent heredity and region factors. Parent heredity factor includes the influence of both parents and the influence of mother during pregnancy where the influence of both parents includes both parents' habits and conditions when having sex; the influence from the mother includes habits and medication during her pregnancy. Congenital constitution embodiment includes the body's growth and development, body structure and vis-cera, qi and blood, pulse and forefinger blood vessels (of young children), mental state and life span. In three other factors of congenital constitution (i.e. qi and blood, body structure and life span), both body structure and life span depend on the endowment of qi and blood. It was concluded that TCM practitioners before Qing dynasty judged one's congenital constitution through observing the speed of its growth and development, appearance, mental state, strength of visceral functions, condition of its mind, forefinger blood vessels, pulse, susceptible to types of disease and etc. Therefore, body structure is an important factor of congenital constitution judgment. TCM practitioners before Qing dynasty paid attention to the effect on mother to her offspring's health.

This study was aimed to investigate the congenital constitution terms consist of Bing and connotation in medical books before Qing dynasty. By searching the character Bing as a keyword in the Encyclopedia of Tradi-tional Chinese Medicine (TCM), 6480 articles were retrieved. Through reading each of the articles, 9 congenital con-stitution terms were concluded. The results showed that Sui dynasty recorded the earliest congenital constitution term. And till the end of Ming dynasty, altogether 9 terms, which were Bing Qi, Bing Zhi, Bing Shou, Bing Fu, Suo Bing, Fu Bing, Qi Bing, Bing Ti and Su Bing, appeared in sequence. The terms appeared with high frequency were Bing Shou ( 33 . 27%) and Bing Fu ( 32 . 99%) . There were 5 congenital constitution relat-ed factors altogether , which were physique , parental heredity , life span , qi and blood as well as region , ap-peared in sequence . And the term appeared with high frequency was physique ( 32.11%) . It was concluded that before Qing dynasty, all congenital constitution terms occurred with the character of Bing (endowment). The usage of different terms to state congenital constitution was intended to describe different associated factors . It reflected the understanding of congenital constitution process. The first known congenital constitution factor was not parental heredity but physique . Qi and blood was the second most appeared factor . This indicated that con-genital constitution does not only involve the structure of the body ( physique ) , but also the function of the body (qi and blood). The investigation about congenital constitution of ancient TCM brings a positive practical signifi-cance for the modern health cognition and health maintenance .

Objective To analyze the correlation of real-time fluorescent quantitation PCR(FQ-PCR)for detecting HCV-RNA loading and the chemiluminescence immunoassay(CLIA)for detecting anti-HCV antibody.Methods 587 samples of anti-HCV an-tibody positive detected by CLIA were furteher detected HCV-RNA by FQ-PCR.Results Among 587 samples of anti-HCV anti-body positive by the CLIA screening,225 samples were HCV-RNA negative and 362 samples were HCV-RNA positive detected by FQ-PCR,and the positive rate was 61 .67%,moreover,which was positively correlated with the S/CO ratio detected by CLIA.Con-clusion The positive rate of HCV-RNA is positively correlated with the S/CO ratio detected by CLIA.The result of HCV-RNA can be predicted according to the S/CO ratio.

Objective To measure the chromatic differences of the tongue tip and tongue side and provide quantitative evidence for tongue color diagnosis. Methods Totally 683 healthy people were recruited, and their tongue photos were taken. Then ICC specific documents were used for the correction of all tongue photos, and chromatic values (L*, a*, b*, C*and h°) of tongue tip and tongue side were obtained for further statistical analysis. CIEDE2000 was used for calculating the color differences. Results The average color difference of tongue tip and tongue side in normal pink tongue was 5.4. When pink tongue has abnormal red tongue tip, the average color difference of tongue tip and tongue side was 10.85. Compared with normal tongue tip, the average color difference of tongue tip and tongue side in abnormal color tongue with abnormal red tongue tip increased from 5.4-7.0 to 11.23. Conclusion Red tongue tip is a sensitive sign indicating abnormal heat in the body. Tongue tip quantitative diagnosis is valuable in the determination of heat sign in TCM preventive treatment of disease, and reveal the diagnosis meaning and scientific connotation of red tongue tip.

Objective:To explore the clinical characteristics, chest imaging manifestations, RAPID score and therapeutic situation in patients with parapneumonic pleural effusion (PPE) caused by streptococcus anginosus group (SAG), in order to provide help for the early diagnosis and treatment in clinical practices. Methods:The clinical data of 39 patients with PPE caused by SAG from January 2015 to May 2020 in Affiliated Hospital of Jining Medical University and Jining First People′s Hospital were retrospectively analyzed. The patients were classified by RAPID score.Results:Among 39 cases, males was in 31 cases (79.5%), females in 8 cases (20.5%), and aged 46 to 89 (65.31±10.53) years old. Fever was in 27 cases (69.2%), chest pain in 19 cases (48.7%), and dyspnea in 18 cases (46.2%). The chest CT findings showed consolidation shadows was in 30 cases (76.9%), encapsulated pleural effusion in 21 cases (53.8%), ground glass shadow in 18 cases (46.2%), nodules in 12 cases (30.8%), atelectasis in 8 cases (20.5%), and pneumothorax in 5 cases (12.8%). The complexity PPE was in 23 cases (59.0%), and empyema in 16 cases (41.0%). The microbiological culture results showed that streptococcus constellatus was detected in 25 cases (64.1%), streptococcus anginosus in 13 cases (33.3%), and streptococcus intermadius in 1 case (2.6%). After comprehensive treatment, 36 cases (92.3%) were improved, 3 cases (7.7%) died. According to the RAPID score, low-risk was in 13 cases (33.3%), intermediate-risk in 16 cases (41.0%), and high-risk in 10 cases (25.7%). The RAPID score in patients with low-risk, intermediate-risk and high-risk was (1.85 ± 0.38), (3.43 ± 0.51) and (5.30 ± 0.67) scores, and there was statistical difference ( F = 124.88, P<0.05). the length of stay in patients with low-risk, intermediate-risk and high-risk of RAPID score was (16.84 ± 5.57), (16.56 ± 7.05) and (28.20 ± 17.97) d, and there was statistical difference ( F = 4.41, P<0.05); the length of stay in patients with high-risk was significantly longer than that in patients with low-risk and intermediate-risk, and there was statistical difference ( P<0.05), there was no statistical difference between intermediate-risk patients and low-risk patients ( P>0.05). Conclusions:SAG, as important pathogens for the PPE, tends to induce CPPE and even pyopneumothorax. Clinical manifestations and imaging are not specific, which should be payed attention in clinical work. The patients with high-risk of RAPID score have more serious condition and worse prognosis.