Objective To investigate the value of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the patients with pancreaticobiliary diseases and the methods to manage complications. Methods 100 cases treated with ERCP were analyzed retrospectively. Compared with hepatobiliary diseases were examined with ERCP,abdominal B-ultrasound and CT simultaneously. Results 100 cases underwent ERCP,the success and failure were 95 cases and 5 cases respectively;64 cases with simple diagnostic in ERCP,36 cases in EST;EST was performed on 36 patients with hepatobiliary stones. Stones were removed from 14 patients with single common bile duct stones and 19 patients with multiple duct stones;The diagnostic rate of ERCP、abdominal B ultrasound、CT were 96.0%、39. 0% and 64.0% respectively. The rate of diagnosis in ERCP were higher than the B ultrasound and CT(x2 =7. 05 ,P ＜ 0. 01 ,x2 = 3.83, P ＜ 0. 05); The complication of gastro-intestinal tract bleeds in 2 cases (2.0%)、 acute cholangitis in 1 case (1.0%) 、acute pancreatitis in 2 cases(2.0)%, pass through the internal medicine to treat conservatively completely recovers from an illness after treatment. Conclusion Therapeutic ERCP was effective and minimally invasive treatment for pancreaticobiliary diseases.

Mycosis fungoides (MF) is the most common subtype of primary cutaneous T-cell lymphoma, and its pathogenesis remains unclear. Recent studies have uncovered high-frequency chromosomal copy number variations in MF, such as gain of chromosomes7q,1q,17q and loss of 9p21,10q,17p, which lead to the gain of proto-oncogenes and loss of tumor suppressor genes, and finally result in tumor development and progression. Moreover, low-frequency single-nucleotide variants have been found in MF, and these mutated genes are mostly enriched in the pathways associated with cell cycle regulation, cell apoptosis, chromatin remodeling as well as T cell activation. Gene-fusion variation is rarely reported in MF. In addition, large cell transformation may occur in some MF cases, and often indicates poor prognoses such as disease progression and drug resistance. In conclusion, MF is a complex disease with highly molecular genetic heterogeneity, and more extensive and intensive researches on its pathogenesis are needed in the future.

Objective To estimate the application value of dermoscopy in the differential diagnosis of basal cell carcinoma (BCC).Methods Patients who underwent dermoscopic examination and had been definitely diagnosed by pathological examination in the Peking University First Hospital were enrolled in this study.In a blind study,dermoscopic images of 86 BCC lesions from 81 patients (case group) and 68 non-BCC hyperpigmented lesions with similar degree of hyperpigmentation and location from 61 patients (control group) were evaluated for features suggestive of BCC and melanocytic lesions.The diagnostic capability of dermoscopy in patients with BCC was evaluated by diagnostic test.Pathology served as the gold standard method for diagnosis.The frequency of features suggestive of melanocytic lesions was calculated in BCC lesions,and dermatoscopic findings were compared between heavily and lightly pigmented BCC lesions.Results The sensitivity,specificity,positive predictive value,negative predictive value of the classic dermoscopic pattern for the diagnosis of BCC were 98.84％,89.71％,92.39％,98.39％ respectively,with a Youden index of 0.88.The coincidence rate was 94.81％ between pathologic and microscopic diagnosis.Pigment network,multiple brown to black globules/dots,pigmentation around hair follicle openings were observed more frequently in melanocytic lesions compared with BCC lesions (all P ＜0.05).Blue-whitish veil-like structures were observed in 61.63％ of the BCC lesions.The presence of blue-black blotch and blue-whitish veil-like structures was significantly more frequent in heavily pigmented BCC lesions than in lightly pigmented BCC lesions (both P ＜0.01).Conclusions The classic dermoscopic pattern of BCC shows a favorable diagnostic capacity in Chinese population.Large-scale studies are needed to estimate the value of some features proposed in this study,such as peripheral pigment in palisade arrangement,peripheral hyperpigmentation and hypo-or hyperpigrnentation around hair follicle openings,in the differential diagnosis of pigmented diseases.

OBJECTIVETo investigate the protective effect and mechanism of Xingnaojing(Traditional Chinese Medicine) injection on brain injury in rats.

METHODSSixty-three healthy adult male SD rats were randomly divided into 3 groups (n = 21): sham operation group, model group, xingnaojing group. The model of traumatic brain injury model group and Xingnaojing group used the free fall impact injury method, the sham operation group underwent craniotomy, did not cause brain damage. Xingnaojing group in rats after 10 min by tail vein injection Xingnaojing injection 10 ml/(kg x d), model group and sham operation group were intravenously injected with 0.9% sodium chloride solution, three groups were administered continuously for 7 days. At administration of the seventh days compared the S-100B protein in the serum and neuro specific enolase (NSE) level, the water content of brain tissue, serum superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) content, and neurological function of rats among groups.

RESULTSCompared with the sham operation group, the nerve defect, brain water content, MDA, S100B protein and NSE levels were obvigusly increased in Xingnaojing group and model group; SOD, GSH-Px content decreased significantly; In Xingnaojing group nerve impairment and brain moisture were significantly lower than those of model group, the serum MDA, S-100B protein and NSE levels were significantly lower than those in the model group, the SOD, GSH-Px activity was significantly higher than that in the model group.

CONCLUSIONXingnaojing injection has protective effects on rat brain injury, and its mechanism may be related to reduce brain edema after traumatic brain injury and inhibit the reaction of oxygen free radical, protect nerve cells.

Animals ; Brain Injuries ; metabolism ; prevention & control ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Glutathione Peroxidase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Phosphopyruvate Hydratase ; metabolism ; Rats ; Rats, Sprague-Dawley ; S100 Calcium Binding Protein beta Subunit ; blood ; S100 Proteins ; metabolism ; Superoxide Dismutase ; metabolism

Objective To investigate the dermoscopic features of palmoplantar melanocytic lesions.Methods The dermoscopic images of palmoplantar melanocytic lesions that underwent examination in the Department of Dermatology in Peking University First Hospital from September 2009 to October 2011,were retrospectively analyzed.Results Totally,155 benign acral melanocytic lesions in 121 patients and 23 acral melanomas in 22 patients were analysed in this study.Among the benign acral melanocytic lesions,the parallel furrow pattern and its variations (34.2％) were the most common,followed by the fibrillar pattern (22.6％).Two benign lesions (1.3％) showed a parallel ridge pattern.Of 23 melanoma lesions,12 (52.2％) exhibited parallel ridge pattern,and 14 (60.9％) showed irregular diffuse pigmentation that was present in all of the invasive melanoma lesions.The fibrillar pattern,as a common benign acral dermoscopic pattern,was also present in 39.1％ of melanoma specimens.Conclusions Dermoscopy is valuable to some extent in the differential diagnosis of benign melanocytic nevi and malignant melanoma in palmoplantar region,and may facilitate the secreening for early melanoma.

A 19-year-old Chinese woman presented with progressive ulcers and recurrent fever for 1 year.The lesions originally began with purplish red maculopapules,then rapidly developed into ulcer with severe pain and spread to the trunk and extremities accompanied by intermittent fever.Histopathology revealed lymphoid infiltration of middle and large atypical T cells throughout the dermis and subcutaneous fat laver along with focal epidermotropism.The lymphoid infiltrates were positive for CD3,CD8,T-cell intercellular antigen(TLA)and T-cell receptor β(TCR-β).Gene analysis showed the rearrangement of T-cell receptor gene.According to the above findings,the patient was diagnosed as primary cutaneous aggressive epidermotropic CD8-positive cytotoxic T-cell lymphoma. Combined thempy with cyclophosphamide,vincristine,prednisone and bleomycin resulted in partial remission of skin lesions,but she eventually died 22 months after the onset of disease.

Objective To determine XPAC gene mutation in a Chinese pedigree with xeroderma pigmentosum group A.Methods All exons of XPAC gene were analyzed by PCR-DNA sequencing in the pedigree.The mutations were confirmed by restriction fragment length polymorphism(RFLP).Results By PCR-DNA sequencing,a nonsense mutation of C631T was identified which caused R211X substitution in exon5of XPAC gene.The mutated gene encoded a defective XPA protein truncated by63amino acids in C-terminus.The parents were all heterozygotes.The results were confirmed by RFLP.Conclusions A nonsense mutation is found in XPAC gene of a pedigree of xeroderma pigmentosum group A.This mutation may impair XPA protein function of DNA repair,and as a consequence,cause skin aging and carcinogenesis.

Objective To study the effect of Chinese herbs on human scalp hair growth in vitro. Methods Organ culture of human scalp hair follicles was used to study the effects of extracts of Crataegus cuneata, Ligustrum lucidum, Polyporus umbelatus and Bletilla striata mixture and ginseng saponin on hair growth. Results Low doses of mixture extracts(1.28 ?g/mL and 6.4 ?g/mL) markedly enhanced the hair growth and lengthened the period of hair growth, while high doses of mixture extracts(4 mg/mL and 20 mg/mL) sharply inhibited hair growth and shortened the period of hair growth. High doses of ginseng saponin (40 ?g/mL and 200 ?g/mL) also had an inhibiting effect on hair growth. Conclusion This observation suggests that extracts of Crataegus cuneata, Ligustrum lucidum, Polyporus umbelatus and Bletilla striata mixture can promote hair growth in vitro.

Objective To find out households consumption of iodized salt in Xinjian county, and to provide scientific basis for prevention and treatment of iodine deficiency disorders(IDD). Methods From 2006 - 2010 in Jiangxi province, according to the direction of east, west, south, and north, nine townships(streets) were selected,in each township (street), 4 administrative villages (committees) were selected, in each administrative village(committee) 8 households were selected to collect their edible salt each year, direct titration method was adopted to detect salt iodine. Results From 2006 - 2010 a total of 1440 salt samples were collected, of which 1379 were qualified iodized salt, 34 unqualified, 27 non-iodized salt; iodized salt coverage rate, qualified iodized salt and iodized salt consumption rates were 98.13% (1413/1440), 97.59% (1379/1413) and 95.76% (1379/1440),respectively, and the rate of non-iodized salt was 1.88% (27/1440). Conclusions The intake rate of qualified iodized salt in Xinjian county have reached the standards of eliminating IDD. The quality of iodized salt should be improved in few counties. In the future, we should also increase the use of various forms advocacy of IDD prevention and treatment, and educate the masses to enhance self-protection awareness, so that they can consciously resist the salt smuggling, and refuse to buy non-iodized salt.

Objective_To guide students to better adapt to the life of medical learning phase, and to plan a good profession design, while eliminate candidates do not meet the characteristics of medical school.Methods_Develop and Implement of seven stations of multiple mini-interview in 3-grave medical students.Results_The score of each station shows a normal distribute, and reliability Cronbach’sαcoefficient is 0.629.Conclusions_The design and implementation of multiple mini-interview f to link with the pre-med phase and Basic medical learning phase for 8-year program of clinical medicine is successful, and meet the purpose of ‘ examination promotes learning’ .