A patient diagnosed with myoepithelial carcinoma was recently treated in our department. The neoplasm was huge, located in the left maxillofacial region, blocking both eyes, impeding feeding. About one month before admission, the tumor began to bleed frequently, about 100 ml each time, causing headache, dizziness, fatigue, and cold sweats. CT showed the maximum diameter of the tumor was about 23 cm, with uneven density, and maxillofacial bone destruction. MRI revealed internal bleeding and necrosis inside the tumor. After admission, blood routine test showed erythrocyte count 3.64 x 10(12)/L(↓), hemoglobin 106 g/L(↓), hematocrit 0.320 (↓), serum iron 6.2 μmol/L(↓). After surgery, the patient recovered smoothly.
Carcinoma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Myoepithelioma ; diagnosis ; surgery ; Nasal Cavity ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; pathology

ObjectiveTo observe the effect of the ambulation training on the typical hemiplegic gait in community.Methods50 stroke patients with typical hemiplegic gait were divided into two groups: treatment group was treated with systematic rehabilitation training, 5 times each week for 3 months, and control group accepted self-walking training. The follow-up was performed every week at home. The two groups were assessed by the timed "up & go" test, the Fugl-Meyer Assessment(FMA) and Satisfaction with Life Scale(SWLS).ResultsThe scores of the timed "up & go" test, FMA, and SWLS showed that there weren't significant difference between the treatment group and the control group 1 month after treatment; but the scores in the treatment group were obviously higher than those in the control group 3 months after treatment.ConclusionAmbulation training could improve the typical hemiplegic gait and quality of walking of stroke patients with hemiplegic gait in community.

Objective To compare the effect of 3 models of rehabilitation service on stroke patients following hemiplegia in community.Methods 87 stroke patients were randomly divided into rehabilitation training group (n=29), intensive training group (n=30) and followed-up group (n=28). Fugl-Meyer Assessment (FMA) was used to evaluate the limbs motor function and Modified Barthel Index (MBI) was used to evaluate the activities of daily living before, 3 months and 6 months after intervention. Results There was no significantly difference in scores of FMA and MBI among the groups. Both the rehabilitation training group and the intensive training group improved in scores of FMA and MBI 3 months after intervention (P<0.01). The intensive training group and the rehabilitation training group improved further 6 months after intervention, while follow-up group had no improvement. Conclusion Stroke patients following hemiplegia can improvemotor function and activities of daily living through systematic, standard, and ongoing rehabilitation training from professionals in community.

Objective To examine the application value of reticulocyte hemoglobin content (CHr)for diagnosing iron deficiency in premenopausal women.Methods The levels of CHr,hemoglobin (Hb), mean cellular volume(MCV),red cell distribution width (RDW) were measured on the ADVIA 120 (Bayer Diagnostics) automated hematology analyzer.Transferrin saturation (TS) and ferritin (SF) were measured on chemistry analyzer.Results CHr in iron deficiency without anemia group were significantly lower than that in the healthy control group (P＜0.01)and significantly higher than that in iron deficiency anemia group(P＜0.01).CHr in anemia of chronic disease group were significantly higher than that in iron deficiency anemia group(P＜0.01).Receiver operator characteristic curve (ROC) analysis in diagnosis of iron dificiency without anemia demonstrated that the area under the curve for CHr,SF,RDW,MCV,Hb were 0.872,0.798,0.721,0.713,0.677,respectively (P＜0.01).So CHr has a better overall sensitivity than SF,Hb,MCV and RDW in the diagnosis of iron deficiency without anemia.ROC also showed that the area under the curve for Hb,RDW,CHr,SF and MCV was 1.000,0.969,0.958,0.953 and 0.926,respectively (P＜0.01) in iron deficiency anemia.Conclusion CHr is the early and sensitive predictor of iron deficiency in premenopausal women,especially for the diagnosis of iron deficiency without anemia.

Objective:To observe the effect of Gegen Qinlian decoction on serum high sensitive C-reactive protein(hs-CRP)expres-sion of rats with periodontitis and atherosclerosis(P-AS).Methods:40 male Wistar rats were randomly divided into 2 groups:control group(A,n=1 0),P-AS group(B,n=30).5 rats in group A and B were used for the identification of P-AS model.Then rats with P-AS in group B were randomly divided into 5 groups(n=5)and administered with saline(B1 ),atorvastatin(B2),metronidazole (B3),atorvastatin+metronidazole(B4)and Gegen Qinlian decoction(B5)respectively for 4 weeks.Serum hs-CRP level was assayed by ELISA.Periodontal attachment loss(AL)and artery change were examined by pathology.Results:Serum hs-CRP level in group B1-5 was higher than that of group A(P<0.01 ).Serum hs-CRP level of group B4 and B5 was lower than that of group B1-3(P<0.01 ),B4 vs B5,P>0.05.The inflammation of periodontal tissues in group B2-5 was improved more than that in group B1 .AL in group B4 and B5 were lower than that in other groups(P<0.01 ),B4 vs B5,P>0.05.Histopathological observation of arteries re-vealed that there was no foam cell in group B4 and B5 ,the artery wall in group B4 and B5 was more even and muscle fibers were ar-ranged more regular.Conclusion:Gegen Qinlian decoction may decreas serum hs-CRP expression and depress the development of pe-riodontitis and atherosclerosis.

Objective:To observe the effect of Gegen Qinlian decoction on high sensitive C-reactive protein(hs-CRP)and interleu-kin-6(IL-6)in serum of the rats with periodontitis and the IL-6 expression level in periodontal tissues.Methods:45 Wistar rats were randomly divided into 2 groups:control group N(n =1 0),periodontitis model group P(n =35).After periodontitis model was identi-fied by the examination of 5 rats,the rest rats were randomly divided into 3 groups(n =1 0)and treated by gavage of saline(group P0 ), metronidazole(group P1 )and Gegen Qinlian decoction(group P2 )respectively for 4 weeks.Then all the rats were sacrificed.Serum was immediately harvested for the test of serum hs-CRP and IL-6 levels by ELISA.Attachment loss level(AL)was examined by pa-thology.IL-6 expression in periodontal tissues was examined by S-P immunohistochemistry.Results:The inflammation of periodontal tissues in P1 ,P2 were improved more than that in P0 .AL in group P2 were lower than that in other groups(P <0.05).The IL-6 expres-sion in periodontal tissues and the levels of serum hs-CRP and IL-6 of group P2 were lower than those of other groups(P <0.05).Ser-um hs-CRP level was positively correlated with IL-6 level.Conclusion:Gegen Qinlian decoction may inhibit the development of peri-odontitis by depressing the expression of serum hs-CRP and IL-6.

Objective To reconstitute hair follicles in mice using graft chambers,and to study the effect of different cell types on hair follicle regeneration.Methods Full-thickness skin was obtained from the back of C57BL/6 neonatal mice.Then,epidermal cell suspensions were prepared by shredding epidermis after trypsinization,hair follicles and dermal cells were collected by filtration,low-speed centrifugation and density gradient centrifugation,and hair follicle epithelial cells were obtained via trypsinization of hair follicles followed by filtration.Nude mice were classified into four groups to be transplanted with epidermal cells + follicular buds,dermal cells alone,epidermal cells + follicular buds + dermal cells,follicular epithelial cells + dermal cells,respectively.The cells were implanted into the dorsal skin of nude mice using fold chambers.After the grafting,the growth of skin and hairs was observed at the grafted sites on week 1,2,4 and 8,and skin specimens were obtained on week 2,4,and 8 for histological study of hair follicles using hematoxylin-eosin staining.Results After grafting,the chambers on the back of nude mice began to shed with crust formation on week 1; stunted hairs came out and follicle-like structures were seen under the microscope on week 2 at the grafted sites,normal hairs were observed on week 4 and 8 in all the mice except for those transplanted with epidermal cells + follicular buds,and the growth of hairs in mice grafted with epidermal cells + follicular buds + dermal cells and mice grafted with follicular epithelial cells +dermal cells was superior to that in mice grafted with dermal cells alone.Conclusions Hair follicles can regenerate after hair follicle cell transplantation into dorsal chambers in nude mice.Both epidermal cells and dermal cells play indispensable roles in hair follicle reconstitution.

目的探索康复治疗专业学生社区实习基地规范带教方法和教学管理模式。方法对43名康复治疗专业学生进行问卷调查。结果绝大多数学生对社区康复教学的必要性表示肯定。超过半数学生对教学模式、内容比较满意，但教学效果的满意度低于教学模式及内容。社区康复教学在培养学生服务态度、沟通能力、操作能力方面有优势，在培养学生创造性思维能力、分析归纳能力、激发兴趣性存在明显不足。结论需要将三级医院康复的技术力量与社区康复教学纵向整合，摸索社区康复教学模式，不断提高社区康复师资水平。

An 81-year-old male presented with an 8-year history of recurrent ulcer on the left dorsal foot which gradually spread to involve both lower limbs. Physical examination revealed no abnormality of any organ systems and no palpable superficial lymph nodes. Skin examination showed erythematous swelling of the left dorsal foot with an ulcer sized 7 cm × 10 cm on the surface. Tendon was visible at the base of the ulcer, and the ulcer margin was elevated giving a dyke-like appearance. The perilesional skin was purple-brown. There were several millet-like papuloid lesions circularly arranged at the inner side of the right foot as well as dark erythematous or brown nodules and pigmented patches with tenderness on both lower limbs. Histopathology of the ulcer of the left dorsal foot and papuloid lesions on the right foot revealed a visible epidermotropic infiltrate in the epidermis as well as an infiltration throughout the entire dermis with medium-sized atypical lymphoid cells with obvious mitoses. Immunohistochemical examination showed the coexpression of both T cell markers (including CD3, CD45RO, CD43) and B cell marker (CD20), with scatted positive staining for PAX-5and negative staining for CD79α or CD1 9. PCR confirmed the rearrangement of T cell receptor (TCR)-γgene. A diagnosis of peripheral T cell lymphoma unspecified was made in view of the rearrangement of TCR-γgene and above findings. The patient was treated with the following modified CHOP regimen: intravenous cyclophosphamide 0.8 g, leurocristine 2 mg and epirubicin hydrochloride 60 mg, as well as oral prednisone 15 mg twice daily for 5 days every 3 weeks (one treatment session). After 3 treatment sessions, the lesions improved markedly.

Objective To investigate the influence of murine cytomegalovirus(MCMV) infection on differentiation and differentiation gene expression of neural stem cells (NSCs) in vitro for studying the mechanisms of brain abnormalities calmed by congenital cytomegalovirns infection. Methods NSCs were separated from fetal BALB/c mouse and cultured and identified in vitro. The differentiation potency of NSCs was observed by immunnfluorescence. The NSCs infected by MCMV at dosage of multiplicity of infection (MOI) equaled to 5, I and 0. 1, respectively, were cultured in differentiation medium. The morphological changes of the cells were observed by inverted microscope. The ratios of NSCs and its differentiated cells were detected by flow cytometry. The expression changes of nestin, GFAP and NSE, markers of NSCs and its differentiated cells, were studied by immunofluorescence ( MOI = 1 ). The expression of early antigen (EA) of MCMV was detected to observe the infection process. Real-time RT-PCR method was employed to measure the expression levels of the key differentiation genes Wnt-3 and Wnt-7a in Wnt signal pathway of NSCs at early phage of differentiation culture. Results NSCs isolated from embryonic mouse brains could proliferate to form neurnspheres and strongly express Nestin and differentiate into NF-200 positive neurons or GFAP positive astrocytes. The NSCs of the infected groups couldn't adhere to the wall and appear differentia-tion growth, but showed swollen gradually after differentiation culture. The nostin expression of the infected groups downregulated slowly and was higher than that of the control groups ( P < 0.05 ). The GFAP and NSE expression of the infected groups were lower than that of the control groups (P <0.05). The EA of MCMV could be always detected in the cells of the infected groups. The ratios of nestin positive cells of the infected groups were higher than that of the control groups, but the ratios of GFAP and NSE positive cells of the for-mer were lower than that of the latter from 3rd to 9th day after differentiation culture ( P < 0.05 ). The levels of Wnt-3 mRNA and Wnt-7a mRNA of the infected groups were markedly lower than that of the control groups from 1st to 2nd clay and from 12th hour to 2nd day after differentiation culture respectively ( P < 0.05 ) . These changes of the infected groups became more obvious as MCMV MOI increased . Conclusion MCMV could inhibit significantly NSCs differentiate to neurons and astrocytes and lead to the decrease of dif-ferentiated cells. MCMV could inhibit or interfere with the gene expression of Wnt-3 and Wnt-7a in Wnt sig-nal pathway of NSCs. The effect that MCMV inhibited the differentiation and the differentiation gene expres-sion of NSCs showed dose-dependent with MCMV MOI. The inhibitory effect of MCMV on the differentiation of NSCs might be induced by interfering the differentiation gene expression of NSCs, which is possibly the one of primary causes of brain development disorders caused by congenital CMV infection.