A 51-year-old man presented with multiple, disseminated dark erythematous maculopapules and nodules over the body surface for more than 1 year. Initially, the patient presented with dark erythematous macules on the trunk without discomfort. Then, lesions gradually spread over the whole body surface with the development of tenderness. Physical examination revealed multiple disseminated dark erythematous, well-demarcated maculopapules, infiltrative plaques and subcutaneous nodules on the face, neck, trunk, upper and lower limbs. Some lesions were tender on palpation. An enlarged cherry-like lymph node was detected on the right inguina. Bone marrow inspiration showed that lymphocytes amounted to 32.5%, and naive lymphocytes accounted for 10%. These lymphocytes varied in size with irregular shape, moderate amount of basophilic cytoplasm, irregular nuclei and granular chromatin. Histopathological examination revealed diffuse infiltrate of numerous medium-sized atypical blastic cells with irregular nuclei in superficial dermis and subcutaneous fat tissue. The blastic cells showed sparse fine-granular chromatin, obscure nucleoli and obvious karyokinesis. Immunophenotype examination showed that tumor cells were strongly positive for CD4, CD56 and CD43, weakly positive for CD68 and terminal deoxynucleotidyl transferase, but negative for L26, CD3, CD38, granzyme B and myeloperoxidase. The diagnosis of BPDCN is confirmed based on typical clinical features, histopathology and immunohistology findings.

OBJECTIVE:To prepare epirubicin hydrochloride solid lipid nanoparticle(EPI-SLN) and investigate its physicochemical property. METHODS: EPI-SLN was prepared by ultrasonic dispersion technique with glyceryl behenate as matrix,and the appearance,particle size,? electric potential,and entrapment efficiency of the SLN were evaluated and its stability at 3 month storing at 4 ℃ was investigated. RESULTS: EPI-SLN assumed spherical shape with a particle diameter of (212.8?6.2) nm,? electric potential of (-24.7?0.3) mV and entrapment efficiency of 82 %. The EPI-SLN at 4 ℃ was stable after storing for 3 months,showing no marked change in mean diameter,? electric potential or entrapment efficiency. CONCLUSION: The prepared EPI-SLN is up to the standard.

Objective To investigate into social cognition of new subject physical education in Chinese Medicine colleges and to find out existing issues and institutes strategy to solve them. Methods Questionnaire and analysis of documents and telephonic interview were adopted. Results Society needs a large number of graduates who have solid knowledge of health protection and a good command of methods of preseving health and keeping fit and at the same time requires them to go in for teaching athletics, training and organizing games. New subject Physical Education has some advantages,and there are also lots of difficulties. Conclusions Course setting should be sptimized, practical teaching should be strengthened and publicized to ensure that the cultivation of talents meets the need of society.

A case of ulerythema ophryogenes (UO) is reported.A 12-year-old boy presented with erythema and follicular papules on the eyebrows and cheeks for 7 years.The lesions started as follicular papules surrounded by erythema,then spread symmetrically to the cheeks and forehead followed by the loss of eyebrows.There was no complaint of pruritus.Physical examination showed pinhead- to grain-sized,smooth,slightly indurated follicular hyperkeratotic papules surrounded by erythematous halo on the eyebrows,forehead and cheeks.Both eyebrows were nearly completely lost.Histological analysis of lesions from eyebrows revealed dilated follicular infundibulum with orthokeratotic plugs,sparse perivascular and perifollicular lymphohistiocytic infiltrate,widened and sclerotic collagen fibers in the dermis.According to the clinical manifestations and histopathological findings,the patient was diagnosed with ulerythema ophryogenes,and given oral vitamin A 2.5 million unit once a day,vitamin E 100 mg once a day,topical vitamine E cream twice a day,0.025％tretinoin ointment once at night.Two weeks later,the lesions improved.

Objective To develop a nested PCR for the detection of early syphilis and genotyping of Treponema pallidum (TP), and to investigate the distribution of genotypes of TP in Guangzhou. Methods Specimens were consecutively collected from genital ulcers of patients with suspected chancre during 2002-2004, and were detected by dark-field microscopy and nested PCR. The acidic repeat protein (arp) gene and the T. pallidum repeat (tpr) gene family were amplified with the positive specimens above. The number of repeats presented in the arp gene and the restriction fragment length polymorphism by Mse I in the tpr gene were analyzed by electrophoresis. The strains were genotyped according to Pillay's criteria. Results Out of 62 patients with suspected chancre, 33 cases (53.2%) were positive by dark-field microscopy and 54 cases (87.1%) by nested PCR. Of 47 TP-positive specimens genotyped by arp gene, 36 (76.6%) were type 14, while of 49 cases genotyped by tpr gene 39 (79.6%) were type d. By combining genotypes of arp and tpr genes, 7 genotypes were found, including 14d (31, 66.0%), 13d (5, 10.6%), 14b (4, 8.5%), 12b (3, 6.4%), 12d (2, 4.3%), 15d(l, 2.2%) and 14i (1, 2.2%). Conclusions Nested PCR shows a high sensitivity in early detection of TP. Genotype 14d seems the predominant type of TP in Guangzhou.

380 mmHg) while the PaCO2 increased slightly at T5 and decreased gradually. The PCWP decreased slightly at T2, T3 , T4 and increased quickly at T5 , T6, levelling with T0 at T9. PVRI was on gradual increase beginning ahepatic stage and falling to the level of T0 at T7. The changes of PAP were similar with PCWP, the value at T6 being higher than that at T3, T4 significantly. Conclusion DO2 -directed hemodynamic management protects pulmonary function from damage during LTx.

Objective To explore the effects of modified vaginal douche for preventing radiotherapy complications in patients with cervical cancer receiving radiotherapy.Methods Totally 100 patients with cervical cancer receiving radiotherapy were recruited and divided into the experimental group (n=50)and the control group (n=50). The experimental group received vaginal irrigation with modified vaginal douche. The control group received conventional vaginal irrigation.The degree of vaginal cleanliness and the incidence rate of radiotherapy complications were compared between the control group and the experimental group.Results There was a significant difference between the two groups on the degree of vaginal cleanliness (P<0.01). The incidence of vaginitis and vaginal stenosis in the experimental group was 4% and 2%, which was lower than those in the control group (22%, 16%), and the differences were statistically significant (x2=9.890,5.132;P<0.05).Conclusions Compared with traditional vaginal douche,modified vaginal douche is more effective in patients with cervical cancer receiving radiotherapy,and can significantly reduce the incidence of radiotherapy complications.

Objective:To understand the current status of fear of falling in patients receiving maintenance hemodialysis and analyze the influencing factors.Methods:The convenient sampling method was used to select maintenance hemodialysis patients admitted to BenQ Hospital Affiliated to Nanjing Medical University from August to October 2022 as the research objects. A survey was conducted on patients using the general information questionnaire, modified falls efficacy scale (MFES), fatigue, resistance, ambulation, illness, loss of weight (FRAIL), and Braden Mobility Subscale.Results:A total of 219 questionnaires were sent out, and 219 were effectively collected, with an effective recovery rate of 100.00%. Among 219 patients with maintenance hemodialysis, 96 had fear of falling, and the incidence of fear of falling was 43.84%. Binary logistic regression analysis showed that age, type of kidney disease, fall history, and score of FRAIL were the influencing factors of fear of falling in patients with maintenance hemodialysis ( P< 0.05) . Conclusions:The incidence of fear of falling in patients with maintenance hemodialysis is relatively high. Age, diabetic nephropathy, history of falls, and frailty are the risk factors for fear of falling in patients with maintenance hemodialysis. Medical staff can develop targeted intervention measures for maintenance hemodialysis patients based on risk factors to reduce their fear of falling.

Objective:To study the predictive value of BAT score for the prognosis of patients with spontaneous intracerebral hemorrhage (sICH).Methods:A retrospective analysis of 93 sICH patients in the Emergency Department of the Second Affiliated Hospital of Wannan Medical College from January 2018 to December 2020 was conducted, and the patients were classified into the good prognosis group ( n=34) and the poor prognosis group ( n=59) according to the Glasgow Outcome Score (GOS) 3 months after the discharge. Clinical data such as basic data of patients, admission vital signs, laboratory indicators, National Institute of Health stroke scale (NIHSS) score and BAT score and other clinical data of the two groups were compared. Multivariate logistic regression was used to analyze the risk factors affecting poor prognosis of sICH patients. The receiver operating characteristic (ROC) curve was drawn to analyze predictive value of BAT score for poor prognosis of sICH patients. Results:The admission systolic blood pressure, white blood cell count, hypertension complications, emergency BAT score and NIHSS score of patients in the poor prognosis group were significantly higher than those in the good prognosis group ( P<0.05). Multivariate logistic regression analysis indicated that the admission systolic blood pressure ( OR=1.024, 95% CI: 1.002~1.046, P=0.035) and emergency BAT score ( OR=2.640, 95% CI: 1.445-4.825, P=0.002) could accurately predict the poor prognosis of sICH patients. ROC curve analysis showed that the area under ROC curve (AUC) of BAT score was 0.792, the sensitivity was 79.3%, and the specificity was 76.5%. The AUC of systolic blood pressure for predicting poor prognosis of sICH patients was 0.701, and the sensitivity was 55.2%, and the specificity was 88.2%. The AUC of BAT score combined with systolic blood pressure for predicting poor prognosis of sICH patients was 0.835. Conclusions:BAT score and admission systolic blood pressure could more accurately predict poor prognosis of sICH patients. The combination of them had a higher efficacy in predicting poor prognosis of sICH patients after 3 months.

Objective:To investigate the risk factors of depression in patients with lacunar cerebral infarction 3 months after discharge, and build a risk prediction model.Methods:The clinical data of 237 patients with lacunar cerebral infarction diagnosed and treated in the Second Affiliated Hospital of Wannan Medical College from January 1, 2021 to January 1, 2022 were retrospectively analyzed. Demographic data, laboratory indicators and risk factors of cardiovascular disease were collected when the patients were admitted to hospital. The patient health questionnaire-9 (PHQ-9) score was used to assess the risk of post-stroke depression (PSD) 3 months after discharge. Univariate and multivariate logistic regression analyses were used to identify independent risk factors of depression. A predictive model was constructed based on the above risk factors. The predictive efficacy was evaluated by receiver operating characteristic (ROC) curve, and the clinical applicability of the predictive model was measured by calibration curve and decision curve.Results:Fifty-four patients with lacunar infarction (22.80%) showed symptoms of depression at 3 months after discharge. Multivariate logistic regression showed that women ( OR=2.952, 95% CI: 1.403-6.213, P=0.004), cystatin C ( OR=2.964, 95% CI: 1.222-7.191, P=0.016), apolipoprotein B ( OR=4.836, 95% CI: 1.533-15.258, P=0.007) were the independent risk factors for PSD in patients with lacunar infarction. Activity of daily living (ADL) score ( OR=0.939, 95% CI: 0.915-0.964, P<0.001) was a protective factor for PSD in patients with lacunar infarction. The area under the curve (AUC) of the prediction model was 0.779 (95% CI: 0.703-0.855, P<0.001), which was better than other predictors. Hosmer-Lemeshow H test showed that the model was well calibrated ( P=0.588). In addition, the prediction model of decision curve analysis had a good clinical applicability. Conclusions:The predictive model based on gender, laboratory indicators and daily life ability score can evaluate the risk of PSD in patients with lacunar infarction 3 months after discharge. It is good predictive efficacy and clinical applicability which worth clinical promotion and application.