39℃)developed at the progressive stage of this disease.Physical examination showed variously sized,round or oval,atrophic and variola-like scars along with scattered erythematous patches,papules, necrosis and crusts on the face and extremities.The face was edematous,and there were some edematous and erythematous plaques with a necrotic center on the legs and arms.Histological examination revealed a massive infiltration with atypical CD8~+lymphocytes around the vessels and appendages in dermis.A diagnosis of CD8~+cutaneous T-cell lymphoma(CTCL)was made.Glucocorticoid and immunosuppressants were effective in controlling the condition.Up to the time of the writing,there has not been any definite evidence of systemic involvement.

The patient,a 11-year-old boy,presented with a 4-year history of erythema and vesicles on the face and arms as well as a 4-month history of tumor and ulcer on the extremities,accompanied by progressive fatigue and intermittent fever.The patient had a body temperature of 37.7℃.No lymph node involvement was observed.Cutaneous examination revealed minimally indurated pink-red patches on the face and nose and dusky red firm nodules and tumors of varying sizes on the extremities.The nodules ranged from 2.0 cm to 18 cm in diameter,some had necrosis and black crusts on the surface.Ulcers were observed in some of the larger nodules;many of the ulcers extended into the muscle layer.White purulent discharge was seen on the surface of many of the nodules.The lesions were sharply demarcated,firm,tender, and surrounded by small satelite nodules.Histologically,there were large quantities of irregularly shaped, middle-sized tumor cells with clear cytoplasm,large twisted nuclei and prominent chromatin,infiltrating from the epidermis to subcutaneous tissue.The tumor cells infiltrating the follicles and eccrine sweat glands were either distributed perivascularly in a nest shape,or dispersed.There were broken nuclei and reactive histio- cytic infiltration in the dermis and subcutaneous tissue.Immunohistologically,the tumor cells were positive for cytoplasmic CD3 around the nuclei,for CD56,CD45RO and T cell intracellular antigen-l,and partly for CD30,CD8 and Ki67.Epstein-Barr virus-encoded nuclear RNA was positive with in situ hybridization. TCR?-2 gene rearrangement was positive in these tumor cells.A diagnosis of hydroa vacciniforme-like primary cutaneous NK/T-cell lymphoma was made.Therefore,this is a case report of hydroa vaccini- forme-like primary cutaneous NK/T-cell lymphoma with primary involvement in the skin;the condition was slowly progressive over 51 months.

Objective To investigate the relationship between insulin resistance and erythrocyte in- sulin receptors in patients with gout associated with macroalbruminuria(MAU).Methods FBG,PBG,FINS, P2hINS,CH,TG,HDL,LDL-c,UA and erythrocyte insulin receptors were determined in 44 patients with MAU,62 patients with normal MAU(NMAU).Results In MAU,the levels of FINS,TG,LDL-c and HOMA-IR were(16?4)mU/L,(2.5?0.6)retool/L,(3.2?0.5)mmol/L and 3.6~1.2 respectively.While they were(13?3) mU/L,(2.3?0.8)mmol/L,(3.0?0.5)mmol/L and 3.0~0.4 in NMAU group.The levels of FINS,TG,LDL-c and HOMA-IR were significantly higher in the MAU patients than those in NMAU patients(P

Mean hemoglobin (Hb) concentration of about 3 500 subjects derived from 17 studies of Himalayan highlanders (Tibetans, Sherpas, and Ladakhis) was compared with lowlanders (Chinese Han, Indian Tamils) lived in the Himalayas, and European climbers during Everest expeditions as well as Andean natives. The results found that Hb concentration in Himalayan highlanders was systemically lower than those reported for Andean natives and lowland immigrants. These comparative data demonstrated that a healthy native population may successfully reside at high altitude without a significant elevation in Hb, and the lower Hb levels of Himalayan highlanders than those of migrated lowlanders and Andean natives are an example of favourable adaptation over the generations. In addition, excessive polycythemia has frequently been used as a marker of chronic mountain sickness (CMS). Altitude populations who have a higher Hb concentration also have a higher incidence of CMS. The low Hb in Himalayans suggested as showing adaptation over many generations in Tibetan stock. Recent work in Tibet, suggested that Tibetans there may have adapted to high altitude as a result of evolutionary pressure selecting for genes which give an advantage at altitude. All of the population genomic and statistical analysis indicated that EPAS1 and EGLN1 are mostly likely responsible for high altitude adaptation and closely related to low Hb concentration in Tibetans. These data supported the hypothesis that Himalayan highlanders have evolved a genetically different erythropoietic response to chronic hypoxia by virtue of their much longer exposure to high altitude.
Adaptation, Physiological ; Altitude ; Asian Continental Ancestry Group ; genetics ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Evolution, Molecular ; Hemoglobins ; genetics ; Humans ; Hypoxia-Inducible Factor-Proline Dioxygenases ; genetics ; Tibet

Objective To investigate the changes in the expression of GABAAα1, receptors in medial prefrontal cortex (mPFC) in a rat model of neuropathic pain. Methods Nine male Wistar rats weighing 200-210 g were randomly divided into 3 groups ( n = 3 each): control group (group C) , sham operation group (group S) and neuropathic pain group (group P). Neuropathic pain was induced by chronic constrictive injury. The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 3-0 chromic catgut. In group S, the right sciatic nerve was exposed but not ligated. The thermal and mechanical pain threshold was measured at 1 d before and 1,4,7, 10 and 14 d after operation. The animals were then sacrificed and the mPFC was removed. The expression of GABAAα1, receptors in mPFC was determined by Western blot. Results Compared with C and S groups, thermal and mechanical pain threshold were significantly decreased and the expression of GABAAα1, receptors was up-regulated in group P ( P ＜ 0.01) . There was no significant difference was in the thermal and mechanical pain threshold and expression of GABAAα1 receptors between C and S groups (P ＞ 0.05). Conclusion Up-regulation of GABAAα1 receptor expression in mPFC may be involved in the development and maintenance of neuropathic pain in rats.

Objective The CT features of hepatic abscess (HA) were studied to differentiate form hepatocellular carcinoma(HCC).Methods The CT and operative-pathological findings of 78 cases with HA were analyied and compared with the CT appearances of a series proven cases of HCC.Results None of 25 cases had the so-called typical findings such as the marginal"double-target sign"and the even liquidizing necrotic area and containing gas zone within the lesion,53 cases had the central even liquidizing necrotic area,the marginal "Double-target sign",and containing gas zone within the lesion.Most of a typical hepatic abscess were early HA,and the precontrast CT showed nonspecific features.There were characteristic features on contrast CT.They were peripheral multicyst sign,sharp-edged sign spider-like sign,continued enhancement sign.Conclusion The CT features of HA are very valuable for the diagnosis of HA and the differential diagnosis from HCC.

Objective To explore the clinical value of virtual touch quantification (VTQ) technique in assessing the hepatic fibrosis. Methods A total of 115 inpatients with chronic liver disease receiving liver biopsy were enrolled in this study, all patients liver tissue was checked by VTQ technique, and the results were compared with those of the control group including 80 healthy subjects. Results VTQ value was significantly different between the two groups (P = 0.0000).The VTQ value among different degree of hepatic fibrosis but between S0 and S1 had statistical significances (P = 0.0212, P = 0.0000).ROC curve displayed that VTQ value of 1.4 m/s could be used to diagnose middle-high-grade liver fibrosis, the sensitivity and specificity were 85.4 % and 64.7%, respectively. Conclusions VTQ can be used as a noninvasive and effective means for assessing the degree of hepatic fibrosis.

Objective To detect anti-M3 receptor antibodies in primary Sj(o)gren's syndrome(pSS)patients and to explore its association with clinical manifestations.Methods Anti-M3 antibodies were tested in 70 patients with pSS,50 patients with systemic lupus erythematosus(SLE)and 76 normal controls with ELISA and Western blot.The correlation between anti-M3 antibodies and other clinical manifestations was analyzed.Results (1)The positive rate of anti-M3 antibodies in pSS Was 47.14% using ELISA and 60.00% using Western blot in SLE 4.00% using ELISA and 12.00% using Western blot and in normal controls 14.47% using ELISA and 15.79% using Western blot.(2)The incidence of sehirmer test,tear break-up time(BUT),whole saliva flow rate,punctate epithelial erosions(PEE)on the corneas and external eye examination were not significantly different between the anti-M3 positive and negative groups.(3)The incidences of IgG,rheumatoid factor,SSB and fluorescence index(FI)＞3 were higher in the positive group than in the negative group using EUSA.Conclusion The positive rate of anti-M3 antibodies is higher in pSS than in SLE and normal controls and in some degree it has correlation with the lesion in salivary gland.

Objective To study the changes of inferior adjacent segmental after different segmental fixation ,and to analyze the accelerating mechanism of the adjacent segment degeneration .Methods Sixty sheep lumbar spine specimens (Waist 1 vertebral body-S5) with pedicle screws were collected ,according to the different fixed section ,they were divided into complete control group(not fixed) ,L6-L7 single segment fixed group ,L5-L7 short segmental fixed group ,L3-L7 long segmental fixed group .The biomechan-ical experiment was measured in the 6 N · m torque loading ,L7-S1 sacral vertebra clearance were measured in different fixed sec-tion .Results Applied in fixed ,beneath the adjacent segment in the stretch direction of angular displacement ,intervertebral disc pressure was increased significantly ,amplitude in creased with the increase of fixed range .The difference between groups was sta-tistically significant(P< 0 .05) .Conclusion After fixing spine in pedicle screws ,the longer the segmentation is fixed ,the more effect it has on subjacent segment degeneration .

Objectives To search for the pathogenesis of vaseular endothelial injury and its clinical significance.Methods 36 patients with acute lower respiratory trect infection(ALRI)and 30 healthy controls were envolved. Circulating endothelial cells (CEC)and nitric oxide (NO) levels were tested.Results Circulating nitrite/nitra levels,the stable metabolic products of NO,were found to be significantly higher in the patients with ALRI (44.6?22.6umol/L) than that in the controls (24.5?14.1umoI /L, P