A 51-year-old man presented with multiple, disseminated dark erythematous maculopapules and nodules over the body surface for more than 1 year. Initially, the patient presented with dark erythematous macules on the trunk without discomfort. Then, lesions gradually spread over the whole body surface with the development of tenderness. Physical examination revealed multiple disseminated dark erythematous, well-demarcated maculopapules, infiltrative plaques and subcutaneous nodules on the face, neck, trunk, upper and lower limbs. Some lesions were tender on palpation. An enlarged cherry-like lymph node was detected on the right inguina. Bone marrow inspiration showed that lymphocytes amounted to 32.5%, and naive lymphocytes accounted for 10%. These lymphocytes varied in size with irregular shape, moderate amount of basophilic cytoplasm, irregular nuclei and granular chromatin. Histopathological examination revealed diffuse infiltrate of numerous medium-sized atypical blastic cells with irregular nuclei in superficial dermis and subcutaneous fat tissue. The blastic cells showed sparse fine-granular chromatin, obscure nucleoli and obvious karyokinesis. Immunophenotype examination showed that tumor cells were strongly positive for CD4, CD56 and CD43, weakly positive for CD68 and terminal deoxynucleotidyl transferase, but negative for L26, CD3, CD38, granzyme B and myeloperoxidase. The diagnosis of BPDCN is confirmed based on typical clinical features, histopathology and immunohistology findings.

Objective To investigate the application of 3D reconstruction system in the clinical departments of the hospital.Methods 3D reconstruction system had its architecture,main features,working flow and principle of auto preprocessing software introduced,and then applied to auto preprocessing of PACS images to realize auto reconstruction,which had the function of 3D post processing.Results 3D reconstruction system gifted the doctor in clinical departments with the access to the images and after treatment,and changed the traditional working mode in imaging department.Conclusion Fusion imaging has 3D reconstruction as the main technique,which eliminates the deficiency in reading radiological images and innovates medical service mode.

Objective To know the efficacy and safety of the blood sugar control by double-pump a-mong severe patients with duodenectomy. Methods Divided 60 severe patients with doudenectomy into the experimental group and the,control group randomly, there were 30 cases in each group. In the control group, pa-tients received intravenous infusion with the liquid containing glucose and neutral insulin (4g: 1 U), intravenous injection of 50U neutral insulin added into 50ml normal saline by micro-pump, the pump speed was In the ex-perimental group, sugar-containing liquid without insulin was infused within 24 hours by infusion pump with u-niform speed, a neutral insulin 50U mixed with 5Oral normal saline were injected by micro-pump according to the ratio fo glucose 4g: 1U neutral insulin through the same vein. Which also adjusted the pump speed according to maintaining blood sugar in the range of 4.4～8.3mmol/L. Compared the level of blood sugar control, treatment safety, efficacy and the workload of nurses between the two groups. Results The highperglycemic index and the time to achieve target values of blood sugar in the experimental group was shorter than in the control group respectively, while the time of keep blood sugar in idea level in the experimental group was longer than in the control group. There were no significant difference about incidence rale of hypoglycemia and workload of nurses between the two groups. Conclusions Double-pump can effective control blood sugar for severe patients with duodenectomy without burden nurses' workload, which is more reasonable than the traditional method.

Objective To determine the frequency of T helper type 22 (Th22) cells and expression level of interleukin-22 (IL-22) in peripheral blood of patients with psoriasis vulgaris,and to investigate their relationship with disease severity and clinical course.Methods Peripheral blood samples were obtained from 40 patients with psoriasis vulgaris and 30 healthy human controls.Five-color flow cytometry was performed to determine the percentage of Th22 cells in peripheral blood,and enzyme-linked immunosorbent assay (ELISA) to measure the expression of serum IL-22.Statistical analysis was carried out by t test and Pearson correlation analysis.Results Both the percentage of Th22 cells and serum level of IL-22 in peripheral blood were significantly higher in patients with psoriasis vulgaris than in healthy human controls (Th22 cells:0.65％ ± 0.48％ vs.0.33％ ± 0.15％,t =3.89,P ＜ 0.01; IL-22:(67.96 ± 14.32) vs.(40.59 ± 9.91) ng/L,t =9.45,P ＜ 0.01).Further more,Th22 cell percentage and IL-22 serum level in peripheral blood were both positively correlated with psoriasis area and severity index (PASI) in these patients (r =0.38,0.94,P ＜ 0.05 and 0.01,respectively),but neither of them correlated with clinical course of psoriasis vulgaris (r =0.20,0.10,respectively,both P ＞ 0.05).Conclusions The percentage of Th22 cells and level of IL-22 are increased in peripheral blood of patients with psoriasis vulgaris,and both of them are correlated with disease severity.

Objective To establish and evaluate unstable atherosclerotic plaque model in abdominal aorta induced by cold stress. Methods Sixty male New Zealand white rabbits were randomly divided into three groups:cold stress group fed with high fat diet and followed by balloon induced arterial wall injury of abdominal aorta at week 2 and exposed to cold (4℃) for 1 h per day except for the first postoperative week,balloon-injury group treated by high fat diet plus balloon-injury, control group fed a normal chow without any treatment. Pathological changes of atherosclerotic plaques among these groups were evaluated at 20 weeks. Meanwhile, serum concentrations of blood lipid,oxidized low density protein(ox-LDL),hypersensitive C-reaction protein (hs-CRP)and interleukin (IL)-8 were determined. Results There was no difference in blood lipid level between cold-stress and balloon-injury groups.Serum concentrations of ox-LDL[(56.1 +14.3)mg/L vs.(42.9± 13.8)mg/L],hs-CRP[(149.1+78.3)mg/L vs. (94.5±57.3)mg/L],IL-8 [(97.6±17.9)μg/L vs.(57.5±18.3)μg/L]and macrophage infiltration[(30.9±5.6)％ vs,(18.7±4.8) ％] were significantly higher in cold stress group than in balloon-injury group (t =2.78,6.91,14.94,6.88,all P＜0.05). Higher angiogenesis rate of atherosclerotic plaque in cold-stress group (23/31,74.1％) was observed in comparison with group balloon-injury(5/25,20,0％)(x2=16.26,P＜0.05). Conclusions Establishment of rabbit unstable atherosclerotic plaque model induced by cold stress in synergy with high fat diet and balloon-injury is feasible, which is superior to conventional method through high fat diet plus balloon-injury surgery.

Objective:To evaluate the value of endovascular recanalization and hybrid recanalization for chronic internal carotid artery occlusion(COICA), and to evaluate its feasibility, safety, success rate, and clinical outcomes.Methods:Totally 35 patients who received endovascular recanalization or hybrid recanalization with symptomatic COICA were enrolled from January 2019 to December 2019 in Department of Cerebrovascular Disease,Zhengzhou University People′s Hospital. The clinical characteristics, treatment strategies, success rate, and major events of the patients were analyzed retrospectively.Results:Thirty of 35 patients were successfully recanalized. Among them, hybrid recanalization was performed in 3 cases, carotid endarterectomy was performed in 1 case, and endovascular recanalization was performed in 26 cases, 5 patients failed because they could not reach the distal true cavity. Among the successful patients, 5 patients had operation-related complications, 3 patients had embolism cerebral infarction, 1 patient had hyperperfusion cerebral hemorrhage, 1 patient still had transient ischemic attack after operation. All patients were followed up clinically, 2 patients had reoccurrence of obstruction, 2 patient had restenosis, the remaining patients had no hemodynamic stenosis or reocclusion.Conclusion:In highly-selected cases, intracavitary recanalization for symptomatic COICA is feasible, relatively safe and effective.

OBJECTIVETo study the dynamic changes of dry material accumulation and platycodin D content in Platycodon grandiflorum in different planting densities.

METHODFive different planting densities M1 (4 cm x 25 cm), M2 (6 cm x 25 cm), M3 (8 cm x 25 cm), M4 (10 cm x 25 cm) and M5 (12 cm x 25 cm) were designed in the plot experiment. The individual and colony biomass accumulation, dry material distribution, root yield and platycodin D content were measured in different stage.

RESULTIn a certain density range the individual biomass in P. grandiflorum obviously declined with increasing density with the exception of biomass M2 > biomass M3. On the contrary, the colony biomass increased with the increasing density. Dry material accumulation in each organ in P. grandiflorum in different planting densities showed significance (P<0.05). The dry material distribution in organs in the different planting densities showed significance (P<0.05), and the dry material distribution in flower and fruit reached the minimal level in M2, in the same planting density the distribution in root reached the maximal; The dry material in stem, flower and fruit obviously declined with the increasing density, while the dry material in leaf increased. The individual root output increased with the increasing density, and it reached the highest in M2. The colony root yield increased with the increasing density. The platycodin D content in P. grandiflorum reached the highest in M2.

CONCLUSIONThe result showed that a suitable planting density is very important to P. grandiflorum dry material accumulation and distribution, root yield, platycodin D content and colony yield.

Plant Structures ; growth & development ; metabolism ; Platycodon ; growth & development ; metabolism ; Saponins ; metabolism ; Seasons ; Triterpenes ; metabolism

Objective To establish a noninvasive prenatal testing(NIPT) method based on the chromosome specific site sequencing instead of the conventional whole genome sequencing.Methods Blood plasma samples from 200 pregnant women with known fetus karyotypes were collected.First,the specific loci on chromosome 13,18 and 21 were selected by the database filter.Then,these specific loci were captured by probes,and were performed sequencing.Finally,chromosome aneuploidy was identified by the Z-score.ResultsSeven fetuses with 21-trisomy syndrome,3 with 18-trisomy syndrome and 1 with 13-trisomy syndrome were detected by the chromosome specific site sequencing,and the results were accordant with those of the whole genome sequencing method.Conclusion The NIPT method based on the chromosome specific site sequencing has the advantages of low cost and high throughput,which may replace the NIPT method based on the whole genome sequencing.

Objective To compare the perioperative complications of prophylactic use of three antiplatelet strategies in unruptured intracranial aneurysms treated by stent assisted coiling. Methods A total of 203 consecutive patients were brought into this retrospective study including the following three groups:the loading group (n=54), with a loading dose of 300 mg to 600 mg clopidogrel at 2 h to 24h before the stenting; tirofiban group (n=50), a loading dosage of tirofiban (8 μg/kg/min over 3 min) followed by a 0.1μg/kg/min maintenance dosage; dual antiplatelet group (n=99), dual oral antiplatelet drugs (clopidogrel 75 mg + aspirin 100 mg) pretreated for 3-5 days before the operation. Events of hemorrhage and thromboembolism were recorded and the complications were compared to assess the safety and efficacy of various antiplatelet strategies. Chi-square or Fisher exact tests were used for categorical variables. Results The hemorrhagic rates were 11.1% in loading group, 2.0% in dual antiplatelet group, and 0% in tirofiban group, respectively, while the thromboembolic rates were 7.4% in loading group, 4.0% in dual antiplatelet group, and 0% in tirofiban group, respectively. For total complications, significant difference (P<0.05) existed among the three groups, and the complication rate in loading group was significantly higher than that of the dual group (P=0.016) and tirofiban group (P=0.001), while there was no significant difference between tirofiban group and dual antiplatelet group(P>0.05). The hemorrhagic rate in loading group was significantly higher than that of the dual group (P=0.023) and tirofiban group (P=0.027), while there was no significant difference between tirofiban group and dual antiplatelet group (P>0.05). In subgroup analysis of the loading group, the postoperative thromboembolic rate was significantly higher in those exposed to low molecular weight heparin than those not (P=0.039) with no increase of hemorrhagic events (P>0.05). Conclusions When compared with the dual antiplatelet strategy, tirofiban strategy may be used as a new prophylactic protocol in unruptured intracranial aneurysms treated by stent assisted coiling. Those treated by low molecular weight heparin postoperatively after receiving dual antiplatelet therapy may increase the hemorrhagic risk, although there was a significant decrease in thromboembolic events postoperatively.

Objective To explore the diagnostic value of color Doppler ultrasound for fetal intrauterine distress(FIUD)in high-risk puerperae in plateau areas.Methods A total of 130 puerperae in plateau areas and 130 puerperae in plain areas were enrolled.According to presence or absence of FIUD in different areas,they were divided into the plateau distress group(47 cases),the plateau normal group(83 cases),the plain distress group(31 cases)and the plain normal group(99 cases).All cases underwent blood flow detection of middle cerebral artery(MCA)and umbilical artery(UA)before delivery,and cerebral-placental ratio(CPR)was calculated.The incidence of FIUD was compared between high-risk puerperae in plateau area and in plain area.Gestational age,birth weight,cesarean section rate and blood spectrum parameters of MCA and UA were compared between the four groups.The predictive value of color Doppler ultrasound parameters for FIUD was analyzed by receiver operating characteristic(ROC)curves.Results The incidence rates of FIUD and severe FIUD were higher in patients of plateau areas than those in plain areas(36.15%,13.85%vs.23.85%,4.62%,P＜0.05).Compared with the plateau distress group,gestational age and birth weight were increased in the plateau normal group and the plain distress group(P＜0.05).Compared with the plateau distress group,PI,RI,S/D and CPR of MCA were increased,while PI,RI and S/D of UA were decreased in the plateau normal group and the plain distress group(P＜0.05).Results of ROC curve analysis showed that overall performance advantage of S/D of UA was the most obvious in the diagnosis of FIUD in high-risk puerperae in plateau areas.The diagnostic sensitivity of RI of MCA was the highest,and the diagnostic specificity of CPR was the highest(P＜0.05).Conclusion Color Doppler ultrasound has good diagnostic value for FIUD in high-risk puerperae in plateau areas,which can be applied as an effective clinical screening means for FIUD.