A 4-year-old girl presented with generalized papules, erythema, desquamation, subcuta-neousnodules around large joints, as well as a 3-year-history of progressive eye damage. Three months after her birth, papules developed on the lower limbs, and gradually spread to involve the whole body. Eye damage appeared after a high fever and she was diagnosed with keratoleukoma, old iritis, and posterior synechia. Physical examination revealed sharply demarcated corneal opacity, shallow anterior chamber, obscure irides, and posterior synechia; pupils were not round. No superficial lymphadenectasis was observed. Dermatological examination showed ichthyosis-like coarse skin with generalized papules, erythema and desquamation, increased wrinkles and absence of sweat. Skin temperature was higher than normal. There were soft, irregu-larly sized, non-tender, movable subcutaneous masses at the wrist, ankle and knee joints without inflamma-tion or warmth. Type-B uitrasonography of both eyes disclosed vitreous opacification, posterior detachment of vitreous, extravasation at the posterior vitreous membrane, and decreased intraocular pressure. Histopathology of lesions on the back, waist, and back of hands as well as subcutaneous nodules on the wrists showed epidermal acanthosis and infiltration with a large number of histiocytes, foam cells and multi-nucleated giant cells in the dermis. No abnormal findings were observed from other examinations. This case was diagnosed as Blau syndrome, which is an autosomal dominant inherited disease; currently, there is no effective therapy for it.

Objective To analyze the clinical data of henoch-schonlein purpura(HSP)in children and to conclude the clinieal featrues of HSP.Methods The clinieal features of 60 children with HSP were analyzed.Results(1)The age of onset of all the 60 children with HSP was from 3 to 14 yearn old,especially from 5 to 10 years and the female patients were more than the male patients(the ratewas 2:1).Of the 60 children,they developed HSP in the four seasons,especially in the spring and winter;most of the HSP patients revealed evident predisposing factors,mainly upper respiratory infection.(2)All the patients had typical purpura.80% had typical purpura as the presenting contancous sign.The distribution of rash in the lower extremitiees,buttock upper extremities and face was 100%,30%,13% and 7%.30% occurre,repeatedly.(3)Gastrointestinal involvement and arthritis occurred rate is 47% and 60%,respectively.Of all the patients,13% devdoped HSP nephritis manifested as isolated hematuria and/or protcinuria.Conclusion HSP has its own clinical and episodic features.It is not difficult to diagnose the typical case.HSPN is its serious syndrome,it should be long-term foflow-up of kidney conditions.

Aerospace nutrition and food hygiene is a subject elucidating the effect of aerospace envi-ronment on nutrition and food hygiene which is closely related to health of flight personnel. The teaching work should be in the aim of raising battle effectiveness and enforcing the primary professional capability of students. The most required theory and techniques in both peacetime and wartime was the priority of teach-ing fulfilling mainly through practical or in-site learning. The examination was composed of test paper, ex-periments and health propaganda. The teaching evaluation relied on feed-back of the army on which the teaching plan was revised. Survey in three straight years indicated the exploration enhanced teaching quality significantly.

0.05). The LDL-C and apoB concentrations in fasting serum in men with 54T allele were significantly higher than those with 54A allele (2.38?0.63 vs 2.21?0.57mmol/L, P

Objective To study the mechanism of effects of estrogen receptor (ER) on T and B lymphocytes in patients with SLE and synergistic effect of T and B lymphocytes in the pathogenesis of SLE.Methods Real-time fluorescence quantitative PCR was performed to detect the mRNA expressions of ER-α,interleukin 10 (IL-10) and B lymphocyte stimulator (BLyS) in peripheral blood mononuclear cells (PBMCs)from 40 SLE patients and 40 normal human controls. The clinical and laboratory correlation with the levels of these parameters was analyzed. Results A significant increase was observed in the relative expression levels of ER-α, IL-10 and BLyS mRNA in SLE patients compared with the normal human controls (P ＜ 0.05 or 0.01 ), in active SLE patients compared with inactive SLE patients (P ＜ 0.05 or 0.01 ). Additionally, the mRNA expression levels of the 3 parameters were significantly correlated with the presence of renal damage, proteinuria, arthritis, etc. No statistical difference was observed in the mRNA expression levels of these parameters between female and male patients or between female and male normal controls. Conclusions IL-10 and BLyS appear to be correlated with the disease activity and severity of SLE, and ER-α may play an important role in the action mechanism of T and B lymphocytes in SLE.

Objective To explore the feasibility of team-based learning (TBL) for practice teaching of the aerospace nutrition and food hygiene.Methods A total of 90 students were investigated,and were divided into the TBL group (n=46) and the TL group (n=44) by simple random sampling.After the experiment teaching,a test and questionnaire were used to compare the teaching effect of TBL group and TL group.SPSS 18.0 was used for date and the data was analyzed by Independent-Samples t test and Chi-square test.Results Students in TBL group achieved higher mean test scores (85.70 ± 3.47) compared with students (74.10±2.41) in TL group and the difference was statistically significant (t=8.703,P=0.000).The results of the questionnaire showed that,compared with the TL group,TBL group students more agreed with the positive impact of the teaching methods on their team work ability,interpersonal skills,communication ability,problem-solving and self-learning and other aspects,and the differences between two groups were statistically significant (P＜0.05).In addition,the majority of the respondents in TBL group [93.5％ (43/46)] were satisfied with TBL.Conclusions TBL teaching is better than the TL teaching,and it can significantly improve students' comprehension of knowledge and enhance their learning effect.

BACKGROUND: In clinical practice, delayed brain injury after carbon monoxide (CO) poisoning occurs in 3% to 30% of the persons who suffered carbon monoxide poisoning and is in the main presence of dementia, psychiatric symptom and extrapyramidal symptoms. At present, its pathogenesis is unclear.OBJECTIVE: To investigate the pathological damage mechanism of delayed brain injury after CO poisoning and the protective effect of hyperbaric oxygen on delayed brain injury.DESIGN: A randomized controlled animal experiment.SETTING: Staff Room of Aviation Health, Department of Aerospace Medicine, the Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was carried out in the Laboratory of Aviation Pathology and Molecular Biology, Department of Aerospace Medicine, the Fourth Military Medical University of Chinese PLA in March 2004. Totally 80 healthy male Sprague-Dawley, of clean grade, were used in this experiment. The animals were randomized into 3 groups: normal control group (n=10), model group (n=35) and hyperbaric oxygen group (n=35).The latter two groups were separately divided into 7 time points: poisoning 6 hours, 1,3,5,7,14 and 21 days, 5 rats at each time point.METHODS: In the model group, acute CO poisoning rat models were developed by placing the rats in the poisoning jar which contained the mixture of CO and air for 60 minutes. The volume faction of CO was kept at 2 500×10-6. In the hyperbaric oxygen group, modeling was the same as that in the model group. Three hours after poisoning, the rats were given 115-minute hyperbaric oxygen treatment. Pressure was 0.2 Mpa and the volume fraction of oxygen was over 0.90. The first three days after poisoning, hyperbaric oxygen treatment was conducted twice per day, then once per day, with one day of non-administration in a week. There was no intervention in the normal control group. MAIN OUTCOME MEASURES: ① The characters of pathological changes in brain tissue of rats at each time point after poisoning were detected with histopathological and immunohistochemical methods; ② Neuronal apoptosis was detected with electron microscopy and in situ TdT-mediated-dUTP nick end labeling(TUNEL).RESULTS: After rats were modeled, the rate of death was about 10%. ① In the model group, general pathological injury occurred in the brains of rats. Denatured necrosis appeared in the neurons of cerebral cortex, hippocampus, corpus striatum, cerebellum and other regions. Injuries in cerebral cortex, hippocampus and other regions were severe. Results of haematoxylin-eosin and TUNEL staining and electron microscope observation demonstrated that apoptosis occurred in hippocampal neurons. The apop totic neurons increased on the 3rd day after poisoning, reached the peak on the 7th day (P ＜ 0.01), then gradually decreased. In the hyperbaric oxygen group, the denatured necrosis of neurons in the brains was significantly lightened, and the injuries of hippocampal region of rats at each time point were significantly attenuated in comparison with model group; The number of necrotic neurons was decreased, especially on the 5th and 7th days after poisoning (P ＜ 0.01). Hyperbaric oxygen promoted the expression of Bcl-2 in hippocampus of modeled rats, especially on the 3rd and 5th days after Coexposure (P ＜ 0.01).CONCLUSION: General delayed neuronal injury is found in the acute CO poisoning rat, with the presence of delayed neuronal necrosis and apoptosis. Hyperbaric oxygen treatment can effectively reduce denatured and necrotic neurons and promote the expression of apoptosis-inhibiting gene bcl-2, then inhibit neuronal necrosis and apoptosis.

Objective To evaluate the diagnostic and prognostic value of serum CA19-9,CA125 and CP2 in mucinous ovarian tumors.Methods In this retrospective study,the serum CA19-9,CA125 and CP2 levels of 273 hospitalized patients with ovarian tumors of either mucinous or non-mucinous type were analyzed.Results(1)CA19-9 had the biggest area under chive(AUC)in mucinous tumors followed with CA125 while CA125 and CP2 had bigger AUC in non-mucinous tumor.(2)For the diagnosis of mucinous tumors,CA19-9 and CA125 combination showed a greatly increased sensitivity compared with CA19-9 or CA125 alone(93.8%versus 75.0%and 66.7%,P＜0.05)with no significant improvement of the specificity(P＞0.05).For the diagnosis of non-mucinous tumors,CA125 and CP2 combination showed an increased sensitivity compared with CA125 or CP2 alone(85.0%versus 80.7%,P＞0.05,85.0%versus 70.6%,P＜0.05)with no significant improvement of the specificity(P＞0.05).(3)Seventy percent of tumor marker-positive patients could undergo cytoreductive surgery.Compared with those who could not undergo cytoreductive surgery,they were more likely to have normal tumor marker two months after surgery (P＜0.05)and longer interval to re-elevation of tumor markers(P＞0.05),with lower reeurrence and death rate (P＜0.05).All of the 20 tumor marker-negative patients could have eytoreduetive surgery with only 10%recurrence.(4)CA19-9 inereased mainly in recurrent mucinous tumor,while CA125 increased dominantly in recurrent non-mueinous tumor.(5)The survival rate of CA125 and CP2 positive patients was much lower than CA125 and CP2 negative patients(P＜0.05),while the survival rate was similar between CA19-9 positive and CA19-9 negative patients.Conclusions CA19-9 is a sensitive index for diagnosis of mucinous ovarian tumors.Combination of CA19-9 with CA125 can improve the sensitivity of diagnosis and postoperative monitoring of mucinous ovarian tumors.Combination of CA125 with CP2 is more valuable in the diagnosis of non-mucinous ovarian tumors.

Objective TO evaluate the efficacy and safety of three adjuvant chemotherapy regimens after curative resection for stage III colorectal cancer,and present clinical evidence for proper choice.Methods 256 cases with stage Ⅲ colorectal cancer randomized to receive de Gramont,modified FOLFOX4(mFOLFOX4) and XELOX regimens.3-year disease-free survival(DFS) and overall survival(OS) were compared within the three groups and subgroups.Therapeutic adverse events were recorded and analyzed with Kaplan-Meier.Results Compared with de Gramont regimen,mFOLFOX4 and XELOX had superior efficacy.The two former could significantly improve 3-year DFS(79.7% vs.66.2%,P=0.015;81.5% vs.66.2%,P=0.004) and medium survival time(40.2 mon vs.37.8 mon,P=0.024;41.4 mon vs.37.8 mon,P=0.014).Meanwhile they could respectively decrease the ratio of recurrence risk 18%(P=0.024) and 21%(P=0.003).The relative benefit of mFOLFOX4 versus XELOX didn't differ for 3-year DFS [hazard ratio(HR): 0.84,95% confidence interval(CI): 0.79～1.12,P=0.13] and OS(HR: 0.87,95%CI: 0.84~1.06,P=0.54).In advanced analysis of DFS in subgroup,XELOX had better trend of survival advantage.mFOLFOX4 had higher adverse events within these regimens,especially in grade 3 or 4 neutropenia and peripheral neurologic adverse events.Conclusion XELOX maintains its efficacy and safety ratio in advanced colorectal cancer.Patients have good tolerance and compliance.The regiment is deserved to be applied in clinic.

The glutamate transporter EAAT 2 ( rodent nomencla-ture GLT-1:glutamate transporter 1), which is a predominantly astroglial glutamate transporter in the hippocampus and the pre-frontal cortex , is responsible for the majority of extracellular glu-tamate uptake .The glutamate transporter EAAT 2 can decrease the high levels of glutamate in the synaptic cleft , avoiding gluta-matergic excitotoxicity to damage the glial cells and neurons . Currently, the transporter EAAT2 has become a research hotspot of depression .This article aims to summarize roles of glutamate transporter EAAT2 in the occurrence and treatment of depres-sion.