A 1-year-old boy developed multiple skin-colored nodules on the forehead and extremities when he was 4 months old.Physical examination revealed that his general condition was well with no hepatomegaly,splenomegaly,lymphadenectasis,testicle abnormality or gingival hypertrophy.Pathologically,the epidermis was normal,while the dermis and subcutaneous tissue were diffusely infiltrated with medium-to large-sized deformed cells,which had a small amount of cytoplasm,oval nucleus,irregular shape and fine chromatin.Some infiltrating cells had nuclear groove and nucleoli.Immunohistochemical studies showed that the tumor cells were positive for S-100 protein,CD56,CD123,CD163,CD68,Ki-67 (40％),weakly positive for CD4 (some),but negative for myeloperoxidase,CD1,CD21.Bone marrow smears showed a 24.5％ infltration by monoblasts and promonocytes.A diagnosis of monoblastic sarcoma cutis preceding acute monoblastic leukemia was made.

Objective To explore the expression of COX-2 and p38MAPK in patients with trauma MODS. Methods Forty MODS patients were evaluated. The levels of peripheral blood mononuclear cells COX-2 and p38MAPK in MODS patients and 40 normal controls was detected by enzyme linked immunosor-bent assay (ELISA). RT-PCR was used to measure the COX-2 mRNA and p38MAPK mRNA expression of in PBMCs. ANOV and correlation analysis were used in statistical analysis. Results The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in MODS group were higher than in control group (all P <0.05). The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in dead group were higher than in survival group( all P <0.05). The levels of COX-2 and p38MAPK of PBMCs were positively correlated, (r =0.6 147, P<0.01). The expression of COX-2 mRNA, p38MAPK mRNA of PBMCs and APACHE I scoring were positively correlated (r1 =0.5 009, P1 <0.05,r2 =0. 5 316, P2 <0. 05). Conclusions COX-2 and p38MAPK of PBMCs take part in the onset of MODS, and may service as index to judge the prognosis of MODS.

Objective To investigate the clinical features of Kawasaki disease.Methods A retrospective analysis was performed in 272 children diagnosed as Kawasaki disease from 2002 to 2006.Clinical data,laboratory findings and auxiliary examination results were collected for these patients.Results The male-to-female ratio Was 2.58:1.Onset ages between 1 to 3 years accounted for 59.2%of patients.Of these patients,100%had a fever for more than 5 days,76.1%transient polymorphous exanthema,74.6% bilateral conjunctival hyperemia,47.8%flare and fissure on the oral lip,58.5%strawberry tongue,22.8% firm swelling of hands and feet as well as flushing of palms and soles,3 1.2%subacute desquamation at the junctional site between nail bed and skin,36%cervical lymphadenopathy.Laboratory findings showed a significant increase in the count of peripheral blood leukocytes and pefipheral blood platelets as well as erythrocyte sedimentation rate in 80.5%,87.5%and 96.2% of Patients,respectively.Additionally,81.6%of these patients were positive for C reactive protein and the frequency of coronary aaery involvement was 54.3%.All patients were treated with aspirin,and high-dose intravenous immunoglobulin was given to 258 patients.Fever relieved and the condition was controlled in all patients with an average hospitalization period of 8.9 days.Conclusions Kawasaki disease should be suspected in Patients with exanthematous lesions,fever lasting for more than 5 days and poor response to antibiotic therapy.Peripheral blood platelet count and cardiac ultrasound are of great value in the diagnosis of Kawasaki disease.Aspirin iS the first choice in treating Kawasaki disease,and adjunctive high-dose intravennous immunoglobulin treatment may facilitate the quick control offever.

BACKGROUND: Eye acupuncture therapy is a technique used to adjust qi-blood circulation, relax muscles and tendons, and activate col aterals by acupuncture at the acupoints around the eye bal s and in the orbital border. This therapy has been widely used in the clinic because it exhibits remarkable therapeutic effects on many ischemic cerebrovascular diseases. However, the precise mechanism behind this therapy remains poorly understood. Neurotrophic factors are a protein family including neurotrophic factors and brain-derived neurotrophic factors that can regulate neuronal survival, development and functioning.
OBJECTIVE: To investigate the effects of eye acupuncture therapy on neurological function and nerve growth factor and brain-derived neurotrophic factor expression in the brain tissue of rat models of cerebral ischemia/reperfusion injury.
METHODS: Fifty-four male Sprague-Dawley rats were randomly divided into three groups with 18 rats per group: sham-operated, model and eye acupuncture therapy groups. Rat models of middle cerebral artery occlusion were established by the intraluminal suture method in the model and eye acupuncture therapy groups. Eye acupuncture was performed at the fol owing acupoints liver area, upper-jiao area, lower-jiao area and kidney area located at the internal orbital margin at 2 hours after cerebral ischemia/reperfusion injury. Rat neurological function was evaluated at 3, 7, and 14 days after injury. Nerve growth factor and brain-derived neurotrophic factor expression in the rat brain tissue was detected using immunohistochemical staining method at 1 and 2 weeks after treatment. Cerebral infarct size was determined using TTC staining at 2 weeks after treatment.
RESULTS AND CONCLUSION: (1) At 1 and 2 weeks after injury, nerve growth factor and brain-derived neurotrophic factor expression was significantly greater in the eye acupuncture therapy group than in the model group (P < 0.05), but nerve growth factor and brain-derived neurotrophic factor expression in the eye acupuncture therapy group was decreased at 2 weeks after injury compared to that at 1 week after injury. (2) At 7 and 14 days after treatment, neurological function scores in the eye acupuncture therapy group were significantly lowered, and there was significant difference between eye acupuncture therapy and model groups (P < 0.05), but they were significantly higher than those in the sham-operated group (P< 0.05). (3) At 2 weeks after treatment, cerebral infarct size was significantly greater in the eye acupuncture therapy and model groups than in the sham-operated group (P < 0.01), and it was significantly smal er in the eye acupuncture therapy group than in the model group (P < 0.05). (4)These results indicate that eye acupuncture therapy shows neuroprotective effects on ischemic cerebral injury by increasing nerve growth factor and brain-derived neurotrophic factor expression, improving neurological function, and reducing cerebral infarct size.

Objective: To explore the relationship between serum level of high-sensitivity cardiac troponin T (hs-cTnT) and atrial ifbrillation (AF) occurrence in patients with stable coronary artery disease (CAD).
Methods: A total of 1011 patients with stable CAD treated in our hospital from 2013-01 to 2015-09 were retrospectively studied. According to quartiles of hs-cTnT, the patients were divided into 4 groups: Group① the patients with hs-cTnT≤7ng/L, n=283, Group② hs-cTnT 7-10ng/L,n=238, Group③ hs-cTnT 10-15ng/L,n=272 and Group④ hs-cTnT>15ng/L,n=218. The relationship between hs-cTnT level and AF occurrence rate was studied; the risk factors for AF occurrence were explored by multi stepwise Logistic regression analysis.
Results: There were 127/1011 (12.6%) patients combining AF and 884 (87.4%) with simple type stable CAD. AF patients had the higher serum level of hs-cTnT than non-AF patients 17.0 (12.0, 25.0) ng/L vs 10.0 (7.0, 13.0) ng/L,P<0.01. With baseline hs-cTnT level increasing, AF occurrence rates were elevated from group① to Group④ as 4.6% (13/283), 4.6% (11/238), 11.0% (30/272) and 33.5% (73/218), Ptrend<0.05. Multi stepwise Logistic regression analysis revealed that with adjusted common risk factors of age and gender, the risk for stable CAD patients suffering from AF in Group④ was 5.324 times higher than group① (95% CI 2.285-12.405,P<0.01).
Conclusion: Increased serum level of hs-cTnT was closely related to AF occurrence in patients with stable CAD.

Objective To study the function of the nano-molecular polyamide-amine (PAMAM) as microRNA(miR) carrier targeting gastric adenocarcinoma, and the foundation of developing an efficient delivery of small molecule drugs tar-geting gastric cancer thereof. Methods The folic acid (FA)/PAMAM comoles compound was prepared by dialysis method. After transfection of miR-7 or liposomes into SGC-7901 cell line, fluorescence microscope was used to detect the gene trans-fect efficiency. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the miR-7 level. The immu-nocytochemistry assay was used to test the protein expressions of epidermal growth factor receptor (EGFR), protein kinase B (PKB) and proliferating cell nuclearantigen (PCNA). The transwell system was utilized to explore the migration ability of tu-mor cells. Results Compared with liposme, FA/PAMAN complex compound can significantly improve the level of miR-7 in SGC-7901 cells,reduce the protein levels of EGFR, PKB and PCNA in SGC-7901 cells, and also reduce the percentage of cancer cell migration (P<0.05). Conclusion PAMAM can effectively transfect miR into gastric cancer cells, which is expected to become an efficient delivery of small molecule drugs.

ObjectiveTo investigate the ratios of peripheral blood CD4+CD25highFoxp3+ regulatory T cells of systemic lupus erythematosus(SLE) patients,and explore its association with disease activity and nephropathy.MethodsPBMC lymphocytes in 42 patients with SLE and PBMC in 40 normal healthy donors were evaluated for the proportion of Treg cells,as a percentage of the total CD4+ cells,by flow cytometric analysis.Levels of mRNA for Foxp3 were measured with a real-time quantitative PCR.The proportion of Treg cells and its association with SLEDAI,nephropathy,serum anti-dsDNA antibody,and C3 levels were analyzed.Statistical analysis was conducted with t-test and Spearman's correlation analysis.ResultsPatients with active disease had statistically significantly lower levels of CD4+CD25highFoxp3+ Treg than normal controls [(4±3)％ vs (7±4)％,P＜0.05],while no significant difference could be found between patients with nonactive disease and normal controls(P＞0.05).The percentage of peripheral blood CD4+CD25highFoxp3+ Treg/CD4+ in patients with active disease was significantly lower when compared to patients with non-active disease [(9±6)％ vs (10±6)％,P＜0.05],and it was related to the disease activity.SLE patients with nephropathy had significantly lower levels of CD4+CD25highFoxp3+ Treg and CD4+CD25highFoxp3+ Treg/CD4+ than patients without nephropathy(P＜0.05).Foxp3 mRNA levels were lower in PBMC from active disease patients than those in non-active disease.In addition,there was a negative correlation between the populations of CD4+CD25highFoxp3+ and SLEDAI(r=-0.5892,P＜0.05).There was a negative correlation between the percentage of CD4+CD25highFoxp3+/CD4+ and SLEDAI (r=-0.4962,P＜0.05),while there was a positive correlation between the percentage of CD4+CD25highFoxp3+/CD4+ and C3(r=0.3867,P＜0.05).There was a positive correlation between the populations of CD4+CD25highFoxp3+ and Foxp3 mRNA(r=0.6142,P＜0.01 ).ConclusionThese suggest that the decrease of CD4+CD25highFoxp3+ Treg and Foxp3 mRNA expression may play a crucial role in the pathogenesis of SLE.

Humans ; Maxillofacial Injuries ; therapy ; Patient Care Team

Objective To investigate the effects of miRNA-146a on the differentiations and functions of CD4+ T lymphocytes in patients with psoriasis vulgaris.Metbods Thirty patients with psoriasis vulgaris and twenty heathy subjects were enrolled in this study.Quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of miRNA-146a in CD4+ T lymphocytes isolated from the peripheral blood samples.The levels of IFN-γ and IL-4 in serum samples were determined by using enzyme-linked immunosorbent assay (ELISA).Mononuclear cells were isolated from human peripheral blood samples by using Ficoll-Hypaque density-gradients centrifugation,from which the CD4+ T lymphocytes were separated by magnetic-activated cell sorting.The CD4+ T cells (2× 106/ml) were seeded in culture plates with 6 wells.The CD4+ T lymphocytes were divided into 3 groups including the control group,miRNA-146a group and miRNA-146a inhibitor group.The numbers of Th1 and Th2 cells were measured by flow cytometry analysis (FACS).The expression of IFN-γRα,T-bet and GATA-3 at mRNA and protein levels were measured by using RT-PCR and Western blot assay,respectively.The levels of IFN-γ and IL-4 in culture supernatants of CD4+ T lymphocytes were detected by using ELISA.Results In comparison with the normal control group,there were significant increases in the expression of miRNA-146a in CD4+ T lymphocytes and the level of IFN-γin serum samples from patients with psoriasis vulgaris [(2.43±0.94) vs (1.05±0.23),(27.69±7.64) ng/L vs (9.75±2.81) ng/L,all P＜0.01].A positive correlation between the expression of miRNA-146a and the level of IFN-γ in serum was observed (r=0.837,P＜0.01).Results of the in vitro culture of CD4+ T lymphocytes showed that the number of Th1 cells,the expression of T-bet at mRNA and protein levels and the level of IFN-γin culture supernatant were significantly increased,while the expression of IFN-γRα protein was decreased in the miRNA-146a group in comparison with those of the control group (all P＜0.01).No significant differences in the number of Th2 cells,the expression of GATA-3 protein,the expression of GATA-3 and IFN-γRα at mRNA level and the level of IL-4 in culture supernatants were found between the control and miRNA-146a groups (all P＞0.05).The miRNA-146a inhibitor could effectively attenuate the effects of miRNA-146a on Th1 cells.Conclusion The miRNA-146a could promote the differentiation and enhance the function of Th1 cells.It might play an important role in the pathogenesis of psoriasis vulgaris.

Objective To study the quantity change and significance of myeloid‐derived suppressor cells(MDSCs) in patients withpost‐traumaticmultipleorgandysfunctionsyndrome(MODS).Methods 66patientswithMODS,34patientswithnon‐system‐ic inflammatory response syndrome(SIRS)and 37 healthy volunteers were enrolled in this study .Peripheral blood was collected and CD14-CD11b+ CD33+ were used as markers of MDSCs .The percentage of MDSCs was determined by flow cytometry and serum interleukin‐10(IL‐10) and tumor necrosis factor‐α(TNF‐α) levels were determined by ELISA .The MODS scoring system was used to assess patients′disease severity .The relationship was analyzed between MDSCs and TNF‐αand MODS score .Results The per‐centage of MDSCs in peripheral blood of healthy volunteers was(1 .18 ± 0 .22)% .after MODS ,the percentage of MDSCs in periph‐eral blood was(11 .84 ± 2 .18)% and(6 .52 ± 0 .37)% in patients with non‐MODS ,the percentages of MDSCs in three groups showed significant differences(P<0 .05) .Serum IL‐10 and TNF‐αin patients with MODS group and non‐MODS group were signif‐icant differences(P<0 .05) .The correlation was found between MDSCs percentage in peripheral blood and MODS score and TNF‐α(r=0 .342 6 ,0 .387 9 respectively ,P<0 .05) .Conclusion The increase proportion of MDSCs in peripheral blood correlates with the onset of infection in patients with MODS ,indicating that the expansion of MDSCs in peripheral blood may play important roles in immune dysfunction after MODS .