A 36-year-old female presented with multiple dark brown papules on the chest and abdomen for more than 10 years,which had gradually increased in number.Physical examination revealed dozens of dark brown,flat papules measuring 1-3 mm in diameter in the chest and abdomen.Most of the lesions had a smooth surface,and some lesions gave a papilloma-like appearance,with no confluent trend.Biopsy of abdominal lesions showed mild hyperkeratosis of epidermis,acanthosis,extension of epidermal protrusions forming a reticulated appearance,horn pseudocysts in prickle cell layer,enhanced pigmentation of basal layer,and a sparse lymphocytic perivascular infiltrate in superficial dermis.A diagnosis of dermatosis papulosa nigra (DPN) was made.

Objective To analyze the correlations between pediatric intersive cave unit (PICU) nurses′job satisfaction and their perception of job characteristics. Method One hundred and thirty-six PICU nurses from a women and children′s hospital of Guangzhou participated in the study and the job diagnostic survey (JDS) and Minnesota satisfaction questionnaire short-form (MSQ20) were used to investigate the relationship between the job characteristics and job satisfaction. Results The average score on general satisfaction was (3.57 ± 0.41). The dimensions like skill variety, task integrity, feedback from job and feedback from others, had a significant positive impact on general satisfaction (all P<0.05). Conclusion Nurses generally have a relatively middle level of job satisfaction and measures should be taken to improve their job satisfaction as well as the quality of nursing.

Objective To explore the treatment of hemangioma associated with thrombopenia(Kasabach-Merritte syndrome,KMS) in infant.Methods The clinical manifestation and the therapy of 14 cases patients with KMS in hospital from 2003 to 2006 were collected ang analyzed,the 400 g/L urea(manufactured by ourself)combined with methylprednisolone local injection were used and followed 0.5 to 1.0 year.Results Two in 14 cases were emergency exairesis,7 cases were recurred for several times,12 cases were cured,1 case was improved,1 case was loss the connection.Conclusions It is an ideal therapy method to use the urea combined with glucocorticoid to treat infancy KMS,little trauma,definite effective,low side effect,high cure rate.

Objective: To explore the structural and functional changes of femoral and popliteal arteries in hypertension patients before and after drug therapy. Methods: A total of 201 hypertension patients treated in our hospital from 2010-03 to 2016-01 were studied. Based on blood pressure levels, the patients were divided into 3 groups: Grade-1 group,n=72, Grade-2 Group,n=68 and Grade-3 group,n=61. The patients were treated for 3 months and blood pressure was reduced below 140/90 mmHg. The intima-media thickness (IMT) of femoral and popliteal arteries was measured by two-dimensional ultrasound, blood vessel elasticity parameters of β, Ep, AC and PWV were determined by ET technology. The differences were compared between pre- and post-medication. Results: Compared with pre-medication, post-medication IMT in femoral artery was decreased in 3 groups, allP<0.05 and IMT in popliteal artery was similar,P>0.05; blood vessel elasticity parameters of β, Ep, PWV were decreased in 3 groups and AC was increased, allP<0.05. Conclusion: Drug therapy could effectively improve the elasticity of femoral and popliteal arteries in hypertension patients; two-dimensional ultrasound combining ET technology may dynamically monitor vascular elasticity of lower extremity which provides an objective basis for evaluating medication efifcacy in clinical practice.

Objective To report 6 cases of hydroa vacciniforme-like cutaneous lymphoma,and to inves- tigate the relationship between this disorder and Epstein-Barr virus(EBV)infection.Methods Pathological and immunohistochemical examinations were performed in the biopsy specimens obtained from all 6 patients. Skin lesions were subjected to EBV encoded RNA(EBER)detection by in situ hybridization.Serological assay and quantification of EBV DNA were performed.Results All the 6 patients had recurrent papules, papulovesicles,necrosis and variola-like scar with chronic intermittent fever;four of the patients also presented with edema of the face,hands and feet.Pathologically,there were multilocular vesicles in the epidermis,and large numbers of infiltrating lymphocytes through the dermis.The cells were atypical with mitotic figures. Immunohistochemical staining of the lesions of 4 patients showed large quantities of cells expressing CD56, scattered cells expressing CD3 and CD45RO,and cells expressing grazyme B and T cell intracellular antigen-1 (TIA-1);a diagnosis of hydroa vacciniforme-like cutaneous NK/T lymphoma was made in these 4 cases. In the lesions of another 2 patients,the cells expressing CD3 and CD45RO,but not CD56,were observed; the diagnosis of hydroa vacciniforme-like cutaneous T-cell lymphoma was made in them.EBER was detected in the tumor cells of all the 6 patients.The IgG titers of anti-Epstein-Barr viral capsid antigen increased in all patients(1:5120 in 2 cases,1:2560 in 2 cases,1:1280 in 2 cases).The copies of EBV DNA were increased in the peripheral blood of both the two detected cases.A chronic active EBV infection was confirmed in all patients.Conclusions Hydroa vacciniforme-like cutaneous lymphoma is clinically characterized by edema of face,hands and feet,vesicular eruptions and variola like scars;histologically,it is characterized by infiltrates of atypical cells consistent with lymphoma,and necrosis in the center of vessels.NK/T is the primary immunophenotype of this disease.There is a close association between chronic active EBV infection and hydroa vacciniforme-like cutaneous lymphoma.

Objective: To assess the reproducibility of high resolution MR imaging(MRI) in measuring the vascular wall area in atherosclerotic carotid artery. Methods: Twenty four subjects (male 18, female 6, aged 60 78 years) with 50% 79% stenosis (confirmed by Doppler ultrasound) were recruited for the study. Two independent MRI examination were conducted within 2 weeks using high resolution imaging on a 1.5 T scanner (Signa, GE Medical Systems). Three slices were selected (4 mm distal to the bifurcation, just under the bifurcation and 4 mm proximal to the bifurcation) from the bilateral carotid artery to measure the luminal, outer wall boundary and wall area. The above process was done by 2 observers blinded to each other's results. The Interscan and Interobserver variations were assessed by paired Student's t test. Results: There was no significant difference in lumen, outer wall boundary and wall area measurement for both Interscan and Interobserver comparison. Conclusion: High resolution MRI of the human carotid artery in measuring the vessel lumen and wall areas has high reproducibility. MRI can also be used to monitor the progression of atherosclerotic plaque of carotid artery.

Objective To study the effect of injured podocytes on glomerular maturation and its underlying mechanism in neonatal mice.Methods Single i.p.injection with puromycin aminonucleoside (PA,0.1 mg/g BW) was given to ICR neonatal mice at day 1 after birth (1 dpp). Littermates injected with normal saline (NS) were used as control.Animals were examined for urine protein,blood pressure,kidney weight/body weight (KW/BW),renal histology at 2,4,8,12, 30,60 and 90 dpp (n=6～9 for each group).Immunohistochemistry and quantitative RT-PCR were performed to examine the expression of WT-1,CD31,VEGF,Flk-1,Ang-1,Ang-2,Tie-1 and Tie-2.Results Mice with PA injection had lower kidney weight and body weight at all time points as well as lower KW/BW at 4,8,12 dpp when compared with NS controls.Electron microscopy revealed nearly complete foot process effacement and segmental microvillous transformation as early as 1 day after PA injection.PA-injected kidneys showed fewer capillary loops and decreased maturation index as well as less CD31-positive endothelium in cortical glomeruli at 12 dpp. Glomerular mesangial injury and developing glomerulosclerosis along with proteinuria were noted in PA-injected kidneys starting from 30 dpp.Significantly increased systolic blood pressure was detected at 60 dpp in PA mice.Compared with NS injection,PA injection significantly induced decreased mRNA expression of Flk-1 and Tie-2 as well as increased expression of Ang-1,without obvious changes of VEGF at 2 dpp.Conclusions Podocytes in neonatal kidney of ICR mice are susceptible to PA. Such podocyte injury can alter the expression of VEGF and angiopoietin system in glomeruli,leading to abnormal development of glomerular capillaries,and subsequent proteinuria,hypertension and glomerulosclerosis.

Selection and affinities of Cd binding peptides were assayed by phage random dodecapeptide library and affinity chromatography. Two Cd binding peptides were obtained, it was found that the affinities of Cu~ 2+ ,Co~ 2+ ,Zn~ 2+ ,Ni~ 2+ for Cd binding peptides were higher than that of Cd~ 2+ and Cr~ 2+ after detection of the amplified Cd binding peptides displayed phages to different heavy metal-charged resins; the detoxification of E.coli to Ni~ 2+ and Cd~ 2+ was enhanced when infected by Cd binding peptide displayed phages as compared with those of the control. The interaction of Cd binding peptide displayed phages with heavy metals charged resins was also observed under microscope. The work would be of great value and consequences for the study of interaction between heavy metals and proteins(peptides), as well as thedetoxification and bioremediation of heavy metals.

Objective To investigate the clinical efficiency of applying tibial artery perforator flap to treat anterior medial incision poor healing one-stage after Pilon fracture.Methods From June,2012 to August,2015,13 cases of anterior medial incision poor healing after Pilon fracture,with tendon or plate exposure in patients and without acute infection,treated by tibial artery perforator flap to repair wound one-stage after thorough debridement.Results All the wounds were repaired by tibial artery perforator flap after a thorough debridement.There was flap necrosis in distal 1/3 part of flap in 1 case,which gained healing after debridement and skingrafting.The remaining 12 cases of flaps survived well.All patients were followed up for 5-14 months (mean 9.8 months),the flaps or skin grafts survived well,without tissue infection,osteomyelitis and other complication,and the functional recovery of the ankle was basically normal.Conclusion It is a simple and effective method by using posterior tibial artery perforator flap to treat anterior medial incision poor healing one-stage with non-acute infection after Pilon fracture on the basis of thorough debridement,worthy of clinical application and promotion.

OBJECTIVETo compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up.

RESULTSThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036).

CONCLUSIONBoth HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.

Aged ; Holmium ; Humans ; Laser Therapy ; adverse effects ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Middle Aged ; Penile Erection ; Prostatectomy ; adverse effects ; methods ; Prostatic Hyperplasia ; surgery ; Quality of Life ; Retrospective Studies ; Thulium ; Transurethral Resection of Prostate ; Treatment Outcome ; Urine