Objective:To discuss the pathogenic factors,prevention and treatment of fulminant epidemic of acute tonsillitis and acute pharyngitis.Method:We investigated and analysed the cases of twice fulminant epidemic of acute tonsillitis and acute pharyngitis.Result:In the first time,91 patients among 518 persons were attacted,the sick rate was 17.6%.In the second time,39 among 295 persons were attacted,the sick rate was 13.2%.The main symptoms were pharyngodynia and fever.Bacterial culture of throat swab of 20 cases of the first time and 17 cases of the second time were carried out.The positive rate of β-hemolytic streptococcus was 82.5% and 85.3% respectively.Conclusion:Environment and individual health condition are important factors in the fulminant epidemic of acute tonsillitis and acute pharyngitis.

The cytokine-receptor- heparin sulfate functional complex combined by cytokines, cytokine receptors, and heparin sulfate chains formed by concatenation of heparin sulfate proteoglycans (HSPG), an important component of extracellular matrix and modified by some relative enzymes, can regulate the density of cytokine receptors and their intracellular signal transduction. This article focused on the regulatory function of this complex. Many morphological abnormalities and diseases occur when the complex is dysfunctional.

To investigate the expression characteristics of fibroblast growth factor 10 (FGF10) and its receptor (Bek) underlying their effect on the formation of fetal skin appendages (SA). Expressions of FGF10, Bek, cytokeratin (CK19), Bcl-2 and proliferating cell nuclear antigen (PCNA) were detected with pathological and immunohistochemistry techniques in 130 skin specimens, which were obtained from 5 different sites (head, lower jaw, ear lobe, shoulder and presternal region) of 26 fetuses at different embryonic ages (E 8～31weeks). Results showed that FGF10, PCNA and Bcl-2 were over-expressed in interstitial cells distributed in clumps under the epidermis, and all proteins were strongly expressed in epidermal cells and pericytes at E 11weeks. In E 13weeks fetal skin, epidermal cells formed SA anlage through focal proliferation; then they developed, differentiated and migrated towards the dermis. In the skin of E 11～13weeks fetus, the expression of FGF-10, PCNA and Bcl-2 in interstitial cells in the dermis, and the expression of FGF10, Bek, PCNA, CK19, and Bcl-2 proteins in the epithelial cells in SA showed the expression characteristics of these proteins which were in accordance with growth and development of fetal SA. The results suggested that the specific binding of FGF10 from interstitial cells with Bek on the membrane of epithelial cells was the important signal to induce the proliferation and morphogenesis of embryonic SA epithelial \{cells.\ \ \ \}

Objective To explore the correlation of the formation of pseudoepitheliomatous hyperplasia (PEH) after healing of inappropriately treated wound of skin with epithelial mesenchymal cells transdifferentiation (EMT). Methods Morphological change in epithelial tissue was observed with histopathologic methods in epithelial cells from PEH lesions ( n =11) and normal skin specimens obtained adjacent to PEH (PEH N, n =6) from 11 patients with PEH. At the same time, the characteristic of expressions and distribution of type Ⅰ and Ⅲ collagen, alpha smooth muscule actin (? SMA), vimentin (Vim), desmin (Des), transforming growth factor ?1 (TGF ?1)and its receptor (TGFRI), pan cytokeratin (CKp), and type Ⅳ collagen in PEH were examined with indirect immunofluorescent double labelling method. Results In comparison with PEH N, squamous epithelium in PEH presented a picture of atypical hyperplasia, there was a derangement of basal apical polarity, disrupture in structure, and a displacement of cells foward mesenchyme. Examination under electron microscope revealed deformation of epithelial basal cells, with loose intercellular junction, and newly formed tumor like cells distingaishable from original epithelial cells. Expressions of type Ⅰ and Ⅲ collagen,? SMA,Vim and Des could be detected in the epithelial cells of PEH. However,the protein expressions of CKp, Ⅳ type collagen were significantly decreased in basal epithelial cells. Furthermore, free epithelial cells expressing CKp were found in the deep layer of mesenchyme. Conclusion It was confirmed for the first time that there was a phenomenon of EMT during the course of PEH formation. Epithelial cells in PEH lesion with granuloma and non hypertrophic scar are characteristized by de differentiation, redifferentiation and a decrement of TGF ?1 induction, which are involved in reactive hyperplasia of the epithelium.

Objective To explore the expression of c-fos gene at early stage and changes of focal cerebral blood flow (CBF) in brain tissue after intracerebral hemorrhage(ICH) in rats.Methods The rat models with ICH were made by Nath improvement method;fos protein in brain tissue and the expression of c-fos mRNA were measured by immunohistochemistry and RT-PCR method;its focal cerebral blood flow (CBF) was measured by hydrogen clearing method.Results The expression of fos protein was found at 1 h after ICH in the ipsilateral basal ganglia after ICH,it peaked at 3 h;c-fos mRNA peaked at 1 h after ICH,and had still expression of higher level after 3 h;cBF was reduced at 1 h after ICH,and returned to the level of the control group by 3 h and maintained to 24 h after ICH,and then appeared the reduction of CBF during 24 h again.Conclusion The increase and long induction expression of c-fos gene were showed in brain tissue of hematoma periperal zone and contralateral cortex one.Although focal CBF reduced after ICH in rats,it wasn't consistent with the expression of c-fos gene.

BACKGROUND:Posterior lumbar interbody fusion can thoroughly decompress the central canal, which is the common surgical technique for the central type of lumbar disc herniation with intervertebral instability at low lumbar segment. However, due to the regular traction on dural sac and nerve root in the operation, lower limb radicular pain in the early stage is inevitable. OBJECTIVE:To evaluate the effect of local use of gelatin sponge containing prednisolone acetate around the nerve roots after posterior lumbar interbody fusion on lower limb radicular pain. METHED:Sixty-three cases of lumbar disc herniation with degenerative instability were devided into treatment group (n=21) and control group (n=42) based on the type of implants. Gelatin sponge containing prednisolone acetate was implanted into patients in the treatment group after posterior lumbar interbody fusion, while pure gelatin sponge was implanted into patients in the control group. RESULTS AND CONCLUSION:Compared with the control group, radicular pain in the treatment group was significantly relieved within 1 week after surgery. The visual analog scale score and Oswestry disability index score were similar between the two groups. There were three cases of radicular pain recurrence in the control group, but no incision infection and epidural hematoma after surgery in both two groups. In conclusion, local use of gelatin sponge containing prednisolone acetate around the nerve roots can significantly relieve lower limb radicular pain in the early stage after posterior lumbar interbody fusion in lumbar disc herniation, contributing to early rehabilitation exercise and patient satisfaction outcomes.

Objective To evaluate the advantages of plasma cell enrichment combined with fluorescence in situ hybridization (FISH) based on a panel of probes by the conventional cytogenetic (CC) analysis.Methods Fresh heparinized bone marrow samples were collected by bone marrow biopsy.Plasma cells were enriched in BM samples using a magnetic cell-sorting procedure to select CD138+ cells.The common chromosome abnormalities of MM were detected by FISH based on a panel of probes and CC analysis after short-term culture of the BM cells,in order to compare the differences between these two methods for the frequency of common cytogenetic abnormalities.Results 72 of 95 (75.8％) MM patients were found to carry clonal chromosome abnormalities by FISH.And RB 1 deletion was the highest at 44.2％ (42/95) followed by CKS1B (1q21) amplification (42.1％).The frequencies of CDKN2C (1p32) deletion,TP53 deletion,IGH/CCND1 and IGH/FGFR3 were 8.4％ (8/95),12.6％ (12/95),14.7％ (14/ 95) and 14.7％ (14/95),respectively.IGH/MAF was negative.Thirty-two of 95 (33.7％) patients were found to carry clonal aberrations by CC analysis.The frequency of chromosome abnormalities detected by FISH was significantly higher than CC analysis (75.8％ vs 33.7％,P =0.000).Conclusion Plasma cell enrichment combined with FISH based on a panel of probes can greatly increase the frequency of chromosome abnormalities,which provides cytogenetic basis for risk stratification and prognosis of MM patients.

Objective To investigate correlation between the amount of interleukin-17 (IL-17) producing cells and the expression of transforming growth factor (31 (TGF-β1) in glioma,and evaluate the clinical values of IL-17 and TGF-pl in predicting the prognosis of glioma. Methods The presence of IL-17 and TGF-pl was measured by immunohistochemistry in 135 human glioma (WHO Ⅰ 18,WHO Ⅱ 45,WHO Ⅲ 53,WHO Ⅳ 19) tissues and 15 normal brain tissues. Results There was no IL-17 positive staining in normal brain tissues. Of 135 glioma specimens showed low TGF-pl expression and 77 (57. 03% ) showed high TGF-pl expression. No TGF-β1 expression was detected in normal brain tissue. Furthermore,TGF-β1 expression was positively correlated with the amount of IL-17 producing cells in glioma tissues ( r=0.285, P<0.01). Compared with the low grade,the levels of IL-17 and TGF-pl positive cells were obviously increased in high grade. The Kaplan-Meier analysis showed that there were significant differences in overall survival (OS) between the IL-17 and TGF-pl high-expression and lowexpression group (P＜0.01, P＜0.05). The 3-year OS rates of IL-17 of high expression and low expression were 33.75% and 76. 36%. Multivariate Cox proportional hazards regression analysis indicated that age,KPS score, IL-17 were independent prognostic factor for OS (P＜0.01). Conclusion Intratumoral IL-17-producing cell density and the expression of TGF-β1 was associated with the malignancy of human glioma.

Clinical teaching plan of pneumothorax and hemorrhagic shock was prepared with mind maps. The process of making this teaching plan was demonstrated as follows:relationship among all levels of subjects in this course was manifested by text and graph as belong and relevance. It is sim-ple, smooth, focused, lucid and easy to understand and remember. Application of mind mapis ex-tremely simple;it is suitable for medical education and is conducive to enhancing teaching efficiency.

Congenital bile duct cysts, which is a kind of malformation of bile duct, will lead to the inflammation in the bile duct system for a long time. Therefore, patients with cholelithiasis and cyst canceration have a risk. Surgical operation is the only treatment option for the congenital bile duct cysts patients. Resection of the cysts and complete " biliary-pancreatic duct shunt" are the key points of the standardized treatment of congenital bile duct cysts. The non-standard surgical treatment will bring the postoperative complications such as the stricture of choledochojejunostomy, the remnant cysts and even the canceration of cysts, which will seriously affect the quality of life and threaten the health of patients. Based on the retrospective study of congenital bile duct cysts patients in Eastern Hepatobiliary Hospital, the author proposed a new classification system according to the pathological and anatomical characteristics of congenital bile duct cysts. The congenital bile duct cysts can be divided into three regions and five types, i. e. localized type and diffuse type of extrahepatic bile duct cysts of hilar, trunk and terminal type; central type; and intrahepatic bile duct cysts of limited and diffuse type. It is our hope that this typing system will accurately guide the design and implementation of surgical treatment plans for congenital bile duct cysts and reduce the risk of long-term postoperative complications for patients.