Objective To analyze the clinical and histological features of drug-induced autoimmune hepatitis (DI-AIH).Methods From January 2008 to June 2011,five patients with auto-immune hepatitis (AIH),having a definitive history of medicine taking prior to the onset of disease and accepted liver biopsy were retrospectively analyzed.The general information was collected,which included gender,age,onset of the disease,medication,clinical manifestations,treatment and follow-up.The laboratory findings were also collected,which included total bilirubin (TBil),direct bilirubin (DBil),alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),gamma glutamyl transpeptidase (GGT),globulin,γ-globulin percentage,albumin (Alb),eosinophils,antinuclear antibodies,antimitochondrial antibodies,anti-smooth muscle antibodies and the type of live injury.The liver tissue sections of patients were stained with hematoxylin-eosinstaining (HE) and reticular fiber staining and then pathological changes were observed.Patients with DI-AIH were scored with AIH scoring scale.Results All five patients with DI-AIH were female,average age was 48.0--+7.5.Prior to the onset of disease,all patients had taken Chinese traditional medicine.Anorexia and fatigue were the most common clinical symptoms.Among laboratory findings,the level of ALT ((795.0+467.4) U/L),AST ((730.44-451.5) U/L),TBil ((80.3-+ 64.1) μmol/L) and DBil ((65.2 +_ 58.0) μmol/L) significantly increased.One patient was antinuclear antibody positive.One patient had drug-induced liver injury,pathological features were spotty necrosis of liver cells,liver tissue eosinophil infiltration and liver cell microbubble type degeneration.All the patients had interface hepatitis,periportal infiltration of lymphocytes or lymphocytes-plasma cells,liver cells adjacent to lesion showed rosette-like structure.All the patients received glucocorticoid treatment.After glucocorticoid withdrawal,the liver function was normal during the follow-up period.Conclusion There are no specificity of clinical manifestations,laboratory findings and histological features in patients with DI-AIH.

Background and purpose:In the primary cutaneous CD30 positive lymphoproliferative disorders, despite the common reports about the primary cutaneous anaplastic large cell lymphoma and lymphomatoid papulosis, such reports about the bordline disease-lymphomatoid papulosis (type C) were rare. This article was to introduce and discuss its clinical manifestations and morphological and immunophenotypic features. Methods:Based on the related literature, we reviewed the clinical,pathological and immunohistochemical features from one case presented in Huashan Hospital. Results:The patient, male, was 56 years old with systemic red papuloid skin lesions accompanied with pruritus, which were sporadic, chronic, recurrent and self-healing. The duration of the disease persisted more than 26 years. Recently, the multiple papuloid lesions developed to be agrias, ulcerations and black eschars. Histopathologically, besides the ulcerated epiderm exfoliation, there were medium and large atypical lymphocytes in? trating in dermis layer. These cells showed postive for CD30,TIA-1 and CD3, and negative for ALK and CD20. Conclusions:When diagnosing LyP (type C),a rare disease, we should differentiate it from the primary cutaneous anaplastic large cell lymphoma (C-ALCL) and systemic anaplastic large cell lymphoma involving the skin, and also combine the clinical and histopathological characteristics and immunophenotype to identify its defi nition and nature.

Objective To evaluate the ability of ultra-high-b-value diffusion weighted imaging (DWI) in diagnosis of the prostate cancer (PCa) at 1.5T MR.Methods 12 patients with PCa and 17 patients with benign prostate hyperplasia (BPH) proved by histopathology underwent MRI and DWI examinations (b=400, 800,1 400 s/mm2).The signal intensity and visual degree of region of interest (ROI) in all DWI with different b values were respectively measured.The signal intensity and visual degree of ROI between high-b-value DWI and ultra-high-b-value DWI were compared,respectively.Results The difference of signal intensity of PCa between high-b-value DWI and ultra-high-b-value DWI was statistically significant (χ2=220.957,P=0.000<0.05).The signal intensity of PCa was getting brighter in DWI with higher b value.The difference of visual degree between these two groups was also statistically significant (χ2=11.378,P=0.003<0.05).The difference among PCa, BPH and normal prostate peripheral zone was statistically significant in ultra-high-b-value DWI (χ2=25.913, P=0.000<0.05).The brightness of PCa in ultra-high-b-value DWI mainly was bright or grey-bright (71.4%), while the brightness of BPH and normal prostate peripheral zone were mainly dark or grey-dark (BPH 63.0%, normal prostate peripheral zone 73.3%).The difference of visual degree among PCa, BPH and normal prostate peripheral zone was statistically significant difference as well (Z=-6.908,-6.110,P=0.000<0.017).The diagnostic efficiency of the signal intensity and visual degree were highest with b=1 400 s/mm2.Conclusion DWI with ultra-high-b-value can improve the display rate of the PCa at 1.5T MR, making easier the detection and diagnosis of PCa.

This paper summarizes the key points of safety management for 15 patients with severe pulmonary arterial hypertension treated by aerosolized iloprost. All patients achieved significant improvements and none of them suffered any severe side effect. Complete safety management during the therapeutic procedure improved the patients' treatment confidence and compliance,and thereafter strengthened the efficacy of treatment.