Objective:To investigate clinical and dermoscopic manifestations of nail damage secondary to hand, foot and mouth disease.Methods:Clinical data were collected from 12 patients with nail damage secondary to hand, foot and mouth disease in Department of Dermatology, Shandong Provincial Hospital from June to November 2015, and characteristics of nail damage were analyzed.Results:The clinical manifestations of nail damage following hand, foot and mouth disease included dryness of periungual skin (12 cases) , nail plate cavities (11 cases) , nail fractures (11cases) and Beau′s lines (4 cases) . Dermoscopy showed nail discoloration (12 cases) , nail delamination (12 cases) , horizontal streaks (10 cases) , longitudinal streaks (8 cases) , brown background of the nail matrix (11 cases) , telangiectasia (7 cases) , periungual desquamation (12 cases) and red background (10 cases) .Conclusion:The clinical manifestations of nail damage following hand, foot and mouth disease are mainly dryness of periungual skin, nail plate cavities and fractures, and its dermoscopic manifestations include nail discoloration, delamination, horizontal and longitudinal streaks, brown background of the nail matrix, telangiectasia, periungual desquamation and red background.

Objective:To screen for peptides that specifically bind to PreS1 antigen from a phage-displayed peptide library.Methods: The PreS1 antigen was used as the target molecule to screen the binding peptide from the Ph.D.-7 peptide library with phage display technique,and the positive clones were identified by ELISA.Results: After three rounds of biopanning,the binding peptides were screened from the peptide library by ELISA and competitive inhibiting ELISA.Sequencing result showed that the binding peptides had high affinity and specificity.Conclusion: A peptide binding PreS1 antigen has been successfully obtained by screening the phage display library,which paves a way for the diagnosis and treatment of hepatitis B infection.

Objective To investigate the feasibility of internal mammary sentinel node(SN) biopsy and internal mammary lymph chain excision under thoracoscope. Methods Six small pigs were used for the experiment.The small pigs were intubated using a double lumen endotracheal tube and kept anesthetized with ketamine.Methylene blue(4 ml) was injected subdermally into both of the first pair of breast.The sentinel node biopsy and internal mammary lymph chain dissection was performed thoracoscopically using a harmonic scalpel.Time of the appearance of the first blue-stained node and the dissection procedure were recorded respectively.Results Thoracoscopic internal mammary sentinel node dissection and internal mammary lymph chain excision was performed successfully in all the 6 pigs(12 sides).The time of the appearance of the first blue-stained sentinel node was 5~15 min(mean,8.9 min),the time of thoracoscopic biopsy was 15~50 min(mean,30.4 min),and the time of internal mammary lymph chain excision was 30~56 min on the left side and 22~48 min on the right side(mean,38.2 min),respectively.No bleeding,lung injuries,and other surgical complications occurred. Conclusions Thoracoscopic internal mammary sentinel node dissection and internal mammary lymph chain excision is feasible,easy to perform,and minimally invasive.

Objective To analyze the features of dynamic contrast-enhanced CT of blunt hepatic injury in rabbits. Methods The model of blunt hepatic injury was established in 40 New Zealand white rabbits with a steel ball falling down to the xiphoid process of the animals. Plain CT scan and dynamic contrast-enhanced CT scan (Hispeed spiral CT/2i, GE, America) of the liver were performed. Arterial,portal and balanced phases were respectively at 8-10 s, 35-40 s and 120-150 s after initiation of the contrast medium injection. The non-enhanced and enhanced images were compared in aspects of location and range of injury, tear of the liver capsule, active bleeding, involvement of the main hepatic veins and CT features of abdominal hemorrhage, which was further compared with the results of gross anatomy. Results The rate of plain CT scan was obviously lower than that of dynamic contrast-enhanced CT scan,which defined single tear in 13 patients, multiple lacerations in 18, liver subcapsular hematoma in seven,liver hematoma in nine, liver coated gap in 17, active bleeding in nine and main hepatic vein injury in five, with coincidence rates with the results of gross observation for 13/13,18/18,7/9,9/9,25/30,9/5and 5/4 respectively. According to Moore' s classification, CT/Laparotomy performed from grade Ⅰ to grade Ⅵ were 5/4 patients at grade Ⅰ , 15/13 at grade Ⅱ, 9/11 at grade, 5/6 at grade Ⅳ, 1/2 at grade Ⅴ, O at grade respectively. Conclusion Dynamic contrast-enhanced CT scan, especially at portal and balanced phases, is of great value for diagnoses of liver injuries and determination of injury severity.

Objective To understand the status of tobacco epidemic among adults in Zhejiang province in 2013.Methods A total of 2 779 residents aged 15-69 years from 15 counties were selected using stratified multi-stage cluster sampling method and surveyed by face to face interview to complete questionnaire.Results The current smoking prevalence was 25.62％ among the adults 15-69 years old in Zhejiang province,50.88％ among males and 0.78％ among females.The daily smoking prevalence was 21.85％;40.56％ of the current daily smokers smoked within 30 minutes after waking;95.19％ of current smokers were not willing to quit;64.04％ of all respondents reported someone smoked in their own homes;67.48％ smokers thought they would continue to smoke even if the price of tobacco rises;21.09％ of all respondents saw tobacco AD at shops and on TV;42.00％ of people were aware that smoking could cause stroke,heart attack and lung cancer;89.69％ smokers still believed that low-tar cigarettes were less harmful than regular cigarettes;73.92％ of people agreed with completely no-smoking in public places.Conclusions Male smoking prevalence in Zhejiang remains at a high level,coupled with low rate of quitting,second hand smoke exposure remains a serious issue in household,low awareness of the harms of smoking for people,suggesting that the task of controlling smoking needs to be strengthened.

Objective:To screen for simulation peptide binding specifically to the first and the second extra-cellular domain of CC chemokine receptor 5(CCR5),and to observe their therapeutic effect on mice with experimental autoimmune encephalomyelitis(EAE).Methods:Phage display peptide library was used to screen for peptide sequence binding specifically to CCR5;ELISA was used to identify its binding activity and analyze its DNA sequence.The simulation peptide was synthesized and was injected into abdominal cavity of the EAE mice.Spinal cord tissues were obtained and the pathologic changes were studied by H-E staining in EAE control group and simulation peptide group.Results:Twenty phage clones were randomly chosen for identification and ELISA showed that there were eighteen clones had a strong binding activity with CCR5.The positive clones were sequenced and four peptides of high frequency were obtained:STFTTTL,TPIPQLL,SLPLPKP,and QTSSAAL.Mean clinical score of mice in the EAE model group was 3 and that of the simulation peptide group was 1.H-E staining found that the spinal cord tissues in EAE model group had great number of inflammatory cells and evident demyelination changes;the simulation peptide group had less inflammatory cells and no demyelination changes.The four short peptides had an effect of suppressing and delaying the development of EAE,with the average inhibition rate being 43%(P

Objective:To explore the correlation among serum cardiac troponin I (cTnI),N terminal pro brain natri-uretic peptide (NT-proBNP)and main endpoint events of heart in patients with chronic stable heart failure.Meth-ods:The present study enrolled 95 patients with NYHA cardiac function class III~IV from Feb 2010 to Feb 2011.According to levels of cTnI and NT-proBNP,the patients were divided into cTnI negative group (n=60)and cTnI positive group (n=35);NT-proBNP negative group (n=40)and NT-proBNP positive group (n=55),all patients were followed up for two years,and the main endpoint events were cardiogenic sudden death and rehospitalization caused by acute aggravation of heart failure.Results:Compared with negative group,the hazard ratio (HR)of end-point events was 2.69 and confidence interval (CI)was 1.54~ 4.72,P = 0.002 in cTnI positive group;HR was 2.54 and CI was 1.35~4.78,P =0.003 in NT-proBNP positive group;further interclass crossover analysis found that,when patients'cTnI and NT-proBNP were both positive,the hazard ratio of cardiac endpoint events was the highest (HR=6.34,CI 2.26~17.9,P <0.001).Conclusion:In patients with chronic stable heart failure,serum elevated levels of cardiac troponin I and N terminal pro brain natriuretic peptide are important predictors reflecting prognosis of patients with heart failure.

BACKGROUND:The success of cell therapy will depend on the ability to monitor the fate of transplanted cells in vivo.Superparamagnetic iron oxide(SPIO)labeling is an ideal magnetic resonance contrast medium,and it offers the potential for non-invasive tracking of implanted cells.The chlormethylbenzamido-1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine (CM-Dil)labeling does not have cytotoxicity,so it cannot influence cell growth.OBJECTIVE:To investigate the effects of SPIO and CM-Dil labeling and tracking on bone marrow mesenchymal stem cells(BMSCs).METHODS:Porcine BMSCs were isolated and cultured by the whole bone marrow method.BMSCs were labeled with SPIO containing 50 mg/L Ferrum and CM-Dil.The labeled BMSCs were transplanted into porcine myocardial infarction model via intracoronary infusion.The frozen sections of the cardiac tissues were obtained after 4 weeks.RESULTS AND CONCLUSION:Efficiency of SPIO and CM-Dil labeling BMSCs was nearly 100%.The SPIO and CM-Dil labeled BMSCs could be found in the cardiac muscle tissues at 4 weeks after transplantation.SPIO and CM-Dil labeling BMSCs were efficiently tracked in vivo.

Objective To explore surgical approach for internal mammary node biopsy in patients with breast cancer. Methods Modified radical mastectomy and incised intercostal muscles for internal mammary node biopsy was performed on 113 patients. The distance from the internal mammary artery to the lateral sternal border, and the intercostal distance between the two costal cartilage were measured. Anatomical location and maximal diameter of the excised nodes were recorded. Results The internal mammary artery runs through intercostal space along the lateral sternal border. The distance from the internal mammary artery to the lateral sternal border was (10. 9?4. 5) mm, (11.6?2.9) mm, (9.6?3.6) mm and (4.5?3.5) mm in the first, second, third and fourth intercostal space, respectively. The distance between the two costal cartilage was (14. 2?4. 1) mm, (16. 2?4. 2) mm, (13. 9?4. 3) mm and (9.9?3. 6) mm in the first,second, third and fourth intercostal space, respectively. Two hundred and seventy-nine internal mammary nodes were excised from 113 patients. The anatomical location of the internal mammary nodes which embedded in the fatty tissue surrounding internal mammary artery were 41. 2% at the medial side, 51. 6% at the lateral side and 7. 2% in an anterior plane to the internal mammary artery. Metastases in the internal mammary node were detected in 26 patients. The lymph nodes metastasis were detected only in the internal mammary nodes in 5 cases. Conclusion Internal mammary node biopsy via intercostal space is a feasible, minimally traumatic, low-risk procedure.

Objective To discuss the possible reasons of contrast agent reflux during transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy),and in order to provide scientific evidences for reducing the contrast agent reflux.Methods The sonographic features of contrast reflux were observed in the images of 167 infertile patients who underwent TVS RT-3D-HyCoSy, and the association of the incidence rate of the reflux with tubal patency,the types of infertility,endometrial thickness,menstrual clean days,abnormal uterine cavity,the history of intrauterine operations,pelvic operations and ectopic pregnancies were analyzed.Results The incidence rate of the reflux during TVS RT-3D-HyCoSy was 41 .3%.The incidence rates of reflux in unilateral patency and bilateral obstruction were 4.929 and 9.21 5 times of that of bilateral patency respectively.The incidence rate of reflux in the secondary infertility cases was significantly higher than that of primary ones(P <0.05).Logistic regression analysis demonstrated that the reflux is associated with the tubal patency,the endometrial thickness and the history of intrauterine operations,and none of the other factors.Conclusions TVS RT-3D-HyCoSy could differentiate the images of reflux better;the proper timing of the contrast examination and avoiding the damage of endometrium would reduce the incidence of the reflux.