A 69-year-old man with fever,pulmonary nodules,joint pain and superficial lymphadenopathy was admitted to our hospital.The patient had a history of ten year hypertension.She smoked a pack of cigarettes daily for forty years and quitted for fifteen years.Family history of coronary heart disease,diabetes,cancer or other diseases was negative.Chest CT showed a nodule in the left lung lower lobe.Percutaneous lung biopsy revealed a large number of atypical B cell proliferation and infiltration which involved the vessel wall.The atypical B-cell phenotype and genotype was EBERs (+),CD20 (+),CD30 (+),CD15 (-).The patient was diagnosed as pulmonary lymphomatoid granulomatosis (LYG),an angiodestructive and angioinvasive lymphoproliferative disorder which is an Epstein-Barr virus associated B cell disorder with reactive T lymphocytes.The patient received six courses of chemotherapy.In this rare case,misdiagnosis of LYG often occurred due to the complex clinical presentation and non-specific imaging.Percutaneous or open lung biopsy is the main choice in the diagnosis of LYG.

Objective To investigate the causes of hypothermia in severe trauma patients as well as the effects of warming nursing.Methods Toally 100 severe trauma patients with hypothermia were engaged in the study during January to December 2014.Their temperature was monitored and recorded,the causes analyzed so that the warming nursing measures were done to them.Results Among the 100 patients,59 contracted hypothermia,with the rate of 59.0％ before operation,28 contracted hypothermia during operation,with the incidence rate of 28.0％.The causes of hypothermia included injury,anaesthesia,exposure and fluid resuscitation.The nursing measures included pre-treatment before anaesthesia,avoidance of more exposure and intraoperative warming.Conclusions For the patients with severe trauma,the hypothermia during the operation can be caused by injury,anaesthesia,exposure and fluid resuscitation.The warming nursing can reduce the incidence of hypothermia so as to increase their survival rate.

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

ObjectiveTo study the effects of early rehabilitation on symptom, range of motion (ROM) and motor function of upper extremity of patients with shoulder-hand syndrome after stroke.Methods47 patients were divided into two groups,early rehabilitation group and non-early rehabilitation group.Two groups were treated with comprehensive rehabilitation. The passive ROM, the pain and motor function of affected limb was assessed by Fugl-Meyer Assessment.The evalution was done in pre-treatment and post-treatment respectively. Results1.The passive ROM decreased and the pain of affected limb of the early rehabilitation group were less than the non-early rehabilitation gronp when the shoulder-hand syndrome occour.2.After comprehensive rehabilitation treatment,their clinical symptom ROM and motor function of upper extremity impoved significantly in patients with shoulder-hand syndrome after stroke( P<0.05).The early rehabilitation treatment has better effects. Conclusions The early rehabilitation treatment could decrease the degree of their passive ROM decrease and the pain of affected limb in patients with shoulder-hand syndrome after stroke,and the patients who accepted earlyrehabilitation seemed easly to improve by comprehensive treatment.

ObjectiveTo determine the impact of lupus flares on maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus(SLE).MethodsData was obtained from 46 pregnancies of 44 pregnant women with SLE.The relationship between lupus flares and pregnant outcomes,and the risk factors for adverse maternal and fetal prognosis were analyzed.T-test,X2 test or Fisher's exact test and Logistic regression were used for statistical analysis.Results① Lupus flares occurred in19(41％)pregnancies(group A) and stable lupus disease was observed in 27(59％) pregnancies(group B) during pregnancy.Compared to pregnancies in patients with stable lupus disease at the conception(n=32),pregnancies in patients with unstable lupus disease at the conception(n=8) had higher lupus flare during pregnancy( 100％ vs 16％,P＜0.05).(②) The common manifestations of lupus flares during pregnancy were lupus nephritis (LN) (11 cases),skin rashes (10 cases),arthritis (7 cases),and the common complication was infection ( 11 cases).(③) The incidence of premature labor,fetal growth retardation (FGR) and fetal loss in group A was 42％,47％ and 26％ respectively,which was significantly higher than that of the group B (7％,15％ and 0 respectively)(P＜0.05).There was no difference in the incidence of preeclampsia,fetal distress and neonatal asphyxia between the two groups ( 16％ vs 7％,16％ vs 19％,5％ vs O,respectively,P＞0.05).The incidence of premature labor and FGR in patients with active LN was higher than that of patients without active LN (55％ vs 11％,64％ vs 17％,respectively,P＜0.05).(④)The binary Logistic regression analysis showed that renal impairment,hypocomplementemia,aPL and serum urea nitrogen level were independent risk factors for premature delivery,FGR,fetal loss and fetal distress.Conclusion(①) Lupus flares during pregnancy increase the incidence of premature labor,FGR and fetal loss.Active LN during pregnancy can increase the incidence of premature labor and FGR.② Renal impairment,hypocomplementemia,aPL and serum urea nitrogen level are associated with adverse fetal outcomes in pregnant patients with SLE.

Objective:To evaluate the effect of short-time group psychological guidance on mental quality of college students. Methods:Designed the content of one day's psychological coach.600 college students received psychological coach successively.60 students were randomly chosen as the intervened group,who were treated with one-day group psychological guidance,while 60 students,who never attended the group psychological guidance,were chosen as control.Assessed and compared the mental quality of the intervened group and the control group with the Faith in People Scale (FPS),Personal Evaluation Inventory (PEI),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale (SDS) on the day before or 1 and 12 weeks after coach.Results:There were no significant differences of the scale of FPS,PEI,SAS,and SDS between two groups before coach and there were significant differences between two groups after coach.Conclusion:Short-time group guidance is helpful to developing college students' ability in interpersonal contact and self-confidence and improving depression and anxiety.

To have a better understanding on the evolution of Metallosphaera sedula-mediated precipitation and the properties of the precipitate synthesized by this species，a newly identified extremely thermophilic strain (YN23) of Metallosphaera sedula was cultured in the medium containing Fe2+ as energy resouTce under optimal condidons (pH1.5，65℃,0.2g·1-1 yeast extract,30g·1-1 Fe2SO4·7H2O and 170rpm)．XRD，EDS，ETIR and SEM reveal the precipitate obtained from YN23-inoculated flasks to be a mixture of potassium jarosite and ammoniojarosite，with morphological features similar to the latter．Precipitation Was first detected once over 90％ of Fe2+ was oxidized at hour 25 with a peak pH value of 1.92，and was ended when precipitate reached the highest point of 7.9g·1-1 at hour 95 with the lowest pH value of 1.32 in solution．Microbial density underwent a rapid increase along with Fe2+ oxidation and a gradual decrease with precipitate piling up.

Adult ; Antidotes ; administration & dosage ; therapeutic use ; Female ; Humans ; Insecticides ; poisoning ; Parathion ; poisoning ; Poisoning ; drug therapy ; Pralidoxime Compounds ; administration & dosage ; therapeutic use ; Treatment Outcome

OBJECTIVETo compare the clinical effects and safety of dynamic external fixtor combined with limited internal fixation and cross K-wires fixation for the treatment of close Pilon fractures of the proximal interphalangeal joint.

METHODSFrom June 2012 to June 2014, totally 41 patients (45 fingers) with close interphalangeal joint Pilon fracture were treated by dynamic external fixtor combined with limited internal fixation or cross K-wires fixation, and all the patients were followed up. In the dynamic external fixtor combined with limited internal fixation group (group A), there were 21 patients with 22 fingers, including 12 males and 9 females, with an average of (30.6±5.6) years old. In the cross K-wires fixation group (group B), there were 20 patients with 23 fingers, including 11 males and 9 females, with an average of (30.1±5.3) years old. Regular re-examination of X-ray was performed to evaluate the active range of joint motion, fracture healing time, infection rate and postoperative joint motion pain.

RESULTSAccording to the evaluation criteria of upper extremity function issued by the Hand Surgery Society of Chinese Medical Association, the excellent and good cases of group A was up to 19 and 13 for group B. The evaluation results has significant differences (Z=2.558, P=0.011). The excellent and good rate of group A was obviously higher than that of group B. The average bone union time of group A was (7.9±2.1) weeks, and (8.1±2.3) weeks for group B. There was no significant difference on the mean healing time (t=-0.304, P=0.762). The infection fingers of group A was 5, and 1 for group B. The difference between the results was statistically significant (χ2=3.287, P<0.05). The infection rate of group A was higher than that of group B. The postoperative joint motion pain was evaluated by VAS score, the mean score was 0.18±0.50 in group A, and 0.65±0.88 in group B. The difference between the results was statistically significant (t=-2.207, P<0.05). The postoperative joint motion pain was lower than that of group B.

CONCLUSIONDynamic external fixtor combined with limited internal fixation is a reliable and effective method to treat Pilon fractures of the proximal interphalangeal joint. It allows early postoperative functional rehabilitation and restores the joint function.

Adolescent ; Adult ; Bone Wires ; Case-Control Studies ; External Fixators ; Female ; Finger Joint ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

AIM:To investigate the feasibility of using human amniotic epithelial cells(HAECs) sheets,which are cultured by using a biodegradable fibrin sealant to re-establish corneal surface layer.METHODS:Human amniotic membrane(AM) harvested at the time of elective caesarean section was digested by collagenase and trypsin respectively to obtain HAECs.The HAECs were planted on Millicell culture dishes coated with biodegradable fibrin glue,and cultured by using the air-lifting cultivation.The HAECs sheets were investigated morphologically by Hematoxylin-Eosin staining,scanning electron microscopy(SEM) and were identified by cytokeratin immunohistochemistry.RESULTS:HAECs sheets were transparent and successfully cultured by using a biodegradable fibrin sealant.Most of the cultured cells were round or polygon and typical slabstone-like appearance.Many microvilli were observed on cell surfaces by SEM.Cytokeratin staining was positive.HAECs had stratificated growth tendency and became corneal-like stratificating epithelial cells.CONCLUSION:A commercially available fibrin sealant was an effective means of tissue engineering to create a carrier-free,transplantable HAECs sheets.The sheets were potential graft to re-establish corneal surface layer.