A 54-year-old woman presented with a five-year history of malaise with weight loss and arthralgia of both knee joints. Six months prior to the presentation, an indurated nodule developed at the site of an old scar on the temporal side of left eyebrow. Subsequently, erythema and nodules spread over the trunk and extremities, especially at the sites of old scars on the hands. Physical examination showed bilateral axillary lymphadenectasis, a plaque at the site of an old scar on the temporal side of left eyebrow, a subcutaneous mass at the extensor aspect of the right upper arm, multiple dark-erythematous nodules at the site of scars on the left hand and both soles, few small erythematous papules scattered on the left forearm and trunk. The serum angiotensin converting enzyme concentration was high (82 kU/L). Computer tomography of thorax showed multiple obscure tubercles in both lungs and swollen lymph nodes in mediastina and axillary fossa, but no hilum pulmonis lymphadenectasis was observed. Histopathology revealed non-caseating granulomas with multinucleated giant cells. Neither acid-fast bacilli nor PAS staining was positive. A diagnosis of scar sarcoidosis was established. The lesions obviously improved after one-month treatment with oral methylprednisolone. This case represents a rare subtype of sarcoidosis that arose in old sears and clinically manifests as scar, nodules,plaques, subcutaneous masses and papules. The reactivation of old scars, which manifests as erythematous swelling and nodules, may highly suggest the diagnosis of sarcoidosis.

Delphian lymph node is a part of Ⅵlymph node.According to the latest research ,the metasta-sis rate in papillary thyroid carcinoma ( PTC) is up to nearly 20%.Meanwhile ,the Ⅵlymph node is usually con-sidered as the sentinel lymph node of PTC metastasis .Most scholars believe that .Delphian lymph nodes may have certain clinical significance in the development process of PTC .This article aims to summarize the research pro-gress in clinical relations between the Delphian node and papillary thyroid carcinoma .

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

ObjectiveTo determine the protein and mRNA expression levels of interleukin-17 (IL-17) and proportions of Th17 cells in peripheral blood of patients with atopic dermatitis (AD),and to analyze their clinical significance.MethodsVenous blood samples were obtained from 63 patients with AD and 30 normal human controls.Enzyme linked immunosorbent assay was performed to measure the plasma level of IL-17 protein,real time fluorescence reverse transcription (RT)-PCR to detect the mRNA expression level of IL-17 in peripheral blood,flow cytometry to determine the percentage of Th17 cells in peripheral blood mononuclear cells(PBMCs).Spearman's rank correlation analysis was performed to assess the relationship of peripheral blood Th17 cell percentage and IL-17 levels with disease severity in patients with AD.Results The percentage of Th17 cells in PBMCs was 1.83％ ± 0.47％ in patients with acute AD,significantly higher than that in normal human controls (0.85％ ± 0.45％,t =4.128,P ＜ 0.01 ) and in patients with chronic AD ( 1.12％ ± 0.69％,t =2.439,P ＜ 0.05).There was a significant increase in the plasma level (98.37 vs.63.75 ng/L,U =168,P ＜ 0.05) and mRNA expression level of IL-17 in peripheral blood in patients with AD compared with normal controls.Both the Th17 cell percentage and plasma IL-17 level were positively correlated with eczema area and severity index(EASI) score in patients with AD (r =0.681,P ＜ 0.01;r =0.427,P ＜ 0.05).ConclusionsThere is an elevated proportion of Th17 cells and an abnormal expression of IL-17 protein and mRNA in peripheral blood from patients with acute AD,which are positively correlated with disease severity,implicating the possible roles of IL-17 and Th17 cells in the pathogenesis of AD.

Breast cancer is one of the most common malignancies happened in female patients.The incidence of breast cancer in Chinese females has increased in recently years.Human epidermal growth factor receptor-2 (HER-2) exhibits gene amplification or high expression of receptor protein in about one third of breast cancer patients.HER-2 positive breast cancer patients has poor prognosis,high risk of recurrence and short survival.Trastuzumab is a specific inhibitor of human epidermal growth factor receptor-2 [1],which has been widely used in the treatment of HER-2-positive breast cancer patients,and trastuzumab molecular targeting therapy compared with the traditional chemotherapy,with the advantages of high specificity and low toxicity.It changes the natural disease progression of patients with HER-2-positive breast cancer and prolongs the patient's survival time.This article will review the researches on the four aspects,which including the development and the application of trastuzumab in the treatment of HER-2 positive breast cancer.

Objective To observe the impact of diabetes and stress hyperglycemia on thrombolytic effect and short-term prognosis in patients with acute cerebral infarction. Methods A total of 127 patients with acute cerebral infarction (≤4. 5 h) who received thrombolytic therapy with alteplase at General Hospital of Beijing Military Command from January 2012 to August 2013 were enrolled retrospectively. They were divided into three groups:Diabetes group (n=35),stress hyperglycemia group (n=49),and normal glucose group (n=43) according to whether they had a history of diabetes,random glucose on admission, and oral glucose tolerance test at day 7. At 24 h after thrombolysis,the National Institute of Health Stroke Scale (NIHSS) scores,recanalization rate,and the modified Rankin Scale (mRS) scores at day 90 were compared between the 2 groups. Results Before thrombolysis,the NIHSS scores of the diabetic group, stress hyperglycemia group,and normal glucose group were 14. 2 ± 5. 1,12. 8 ± 5. 6,and 13. 0 ± 4. 6,respectively (P>0.05);at 24 h after thrombolysis,they were 14.7 ±6.0,11.9 ±4.9,and 8.0 ±2.9,respectively (P<0.05);compared with before thrombolysis,the NIHSS scores of the diabetes group and the stress hyperglycemia group had no significant change (P>0. 05);the NIHSS score of the normal glucose group was lower than before thrombolysis. There was significant difference (P <0. 05). After thrombolysis,the patients with good recanalization were 54. 3% (n=19),57. 1% (n=28),and 67. 4% (n=29),respectively in the three groups;the hemorrhagic conversion rate was 14. 3% (n=5),6. 1% (n=3),and 2. 3% (n=1),respectively. There were no significant differences. At day 90 after thrombolysis,the mRS scores in the 3 groups showed that the good prognosis rate of the normal glucose group was 72. 1% (n=31);it was significantly higher than 51. 0% (n=25) of the stress hyperglycemia group and 29. 6% (n=10) of the diabetes group. There were significant differences (P<0. 05,P<0. 01). There was also significant difference between the stress hyperglycemia group and the diabetes group. Conclusion Diabetes and stress hyperglycemia have varying degrees of adverse effects on the efficacy and prognosis of the thrombolytic therapy for acute cerebral infarction.

Objective To investigate the bioactivities of controlled release bFGF microspheres (Ms) and their effects on the cultured osteoblasts. Methods The secondary cultured osteoblasts were divided into four groups according to the different ingredients being added to the DMEM culture medium, ie, control group,bFGF group, bFGF-PLGA-Ms group and bFGF-PELA-Ms group. The proliferation of the cultured osteoblasts was measured with cell counting method, MTT method and flow cytometry. The content of bone BGP secreted by osteoblast was also measured with RIA method. Results The in vitro cellular study showed no significant difference in the cell number and cell viability of four groups one day after plate culture.The cell number and cell viability in the bFGF-PLGA -Ms group were more than those in other three groups four and six days after plate culture. The cell number and cell viabilitythose in the bFGF group were more than those in the bFGF-PELA-Ms group six and eight days after plate culture with insignificant difference. The flow cytometrical examination showed that the G 2/M+S percentage in the bFGF group reached the highest two days after plate culture and the G 2/M+S percentage in the bFGF-PLGA-Ms group went the highest four and eight days after plate culture. Among four groups, the content of BGP in the bFGF-PLGA-Ms group was the highest and the bFGF-PELA-Ms group the next. Conclusions The effect of bFGF-PELA-Ms is not satisfactory,as indicates that the manufacturing method needs improving. However,the bFGF-PLGA-Ms can promote the proliferation and differentiation of the osteoblasts through a long period of controlled release of bFGF.

Objective To clone and express the mouse acidic mammalian chitinase ( AMCase ) gene and protein, and to analyze the hydrolysis of the cell walls of Trichophyton rubrum and Candida a/ft/cans by this enzyme. Methods Total RNA was isolated from the stomach of BALB/c mouse, and AMCase gene was amplified by RT-PCR. The recombinant fusion expression vector of pET28a ( + ) -AMCase was constructed. AMCase protein was expressed in prokaryotic system and purified. After incubation of AMCase with the cell wall extracts, the level of N- acetylglucosamine was measured. Results AMCase gene was cloned and expressed successfully. Purified AMCase protein can hydrolyse the chitin in the cell walls of T. rubrum and C. albicans. Conclusion The AMCase expressed in prokaryotic system can hydrolyse chitin in the cell walls of T. rubrum and C. albicans, which implies its antifungal potential.

Objective To explore the expression of Ezrin in hepatocellular carcinoma(HCC),and the relation of Ezrin expression to E-cadherin,proliferating cell nuclear antigen(PCNA) and clinical features of HCC.Methods Forty-nine cases of HCC were divided into high and low invasive groups according to tumor size,disseminated lesions,distant metastasis,tumor capsule and portal vein tumor thrombus.The expression of Ezrin,E-cadherin and PCNA in normal liver tissues,HCC and adjacent tissues were determined by immunohistochemistry,and the relation of the expression to clinical features was analyzed.Results The Ezrin expression was found in normal liver tissues,HCC and adjacent tissues,and was significantly higher in HCC tissues than in adjacent and normal liver tissues(P

Objective To evaluate the effect of continuous adenosine infusion on mesentery microcirculation during cardiopulmonary resuscitation in rats with asphyxia. Methods Rat model of asphyxia was established in 22 healthy Wistar rats. The animals were then randomly divided into normal saline group (group A, n=10), epinephrine group (group B, n=6) and epinephrine plus adenosine group (group C, n=6). After a 3-min asphyxia without intervention, cardiopulmonary resuscitation (CPR) was started. The cardiac compression was carried out with an electric cardio-pulmonary resuscitation machine (200 times/min). Respiration was restored and maintained with a ventilator with tidal volume of 4ml, breathing rate 50times/min and FiO2 100%. After a 4-min CPR, rats in group A and group B were given normal saline and epinephrine (bolus of 90?g/kg) respectively, and in group C epinephrine (bolus of 90?g/kg) plus 70?g/kg adenosine were given. Electric defibrillation would be initiated if there was ventricular fibrillation. The reperfusion rate of mesentery arterioles and venules, diameter of blood vessels and relative blood velocity were observed. Results The reperfusion rate of mesentery arterioles and venules was significantly higher in group C than in group B (P