A case of the H syndrome was reported.An 18-year-old man presented with an 8-year history of progressive cutaneous sclerosis,skin hyperpigmentation,and hypertrichosis on the trunk and extremities.In addition,he suffered from short stature,hearing loss,cardiac anomaly,hepatosplenomegaly,and scrotal masses.Laboratory examination revealed hypogonadism.Cutaneous histopathologic examination showed hyperpigmentation of the basal layer with acanthosis,widespread fibrosis (moderate in dermis and severe in subcutis) and an infiltrate composed of histiocytes and plasma cells.A perivascular lymphocyte infiltrate was also observed throughout the dermis and subcutaneous fat tissue.These findings were consistent with the H syndrome.Differential diagnosis must be made with Winchester syndrome and polyneuropathy, organomegaly,endocrinopathy,M-protein and skin change (POEMS) syndrome.

Objective To assess the value of high-frequency color Doppler ultrasound technique combined with hemorheology in detecting early atherosclerosis and monitoring its progression.Methods Twenty-four white big ear rabbits were divided into two groups randomly.Group A (6 rabbits) was fed normal rabbit chow,while group B (18 rabbits) was fed high cholesterol diet and was divided into three subgroups: B1(6 rabbits) with high cholesterol diet for 4 weeks,B2(6 rabbits) for 8 weeks,B3(6 rabbits) for 12 weeks.Intima-media thickness (IMT),diameter of common carotid artery and hemorheology index were observed dynamically and compared with the findings of histological examination.Results IMT of common carotid artery increased gradually in group B at different phases of atherosclerosis.Diameter compensationally enlarged at the early stage,and then stenosed with the progression of atherosclerosis.RBC deformation index of group B began reducing in the second week,but blood viscosity,plasma viscosity,RBC aggregation index and rigidity index gradually increased from the fourth week( P

Objective: To observe the efifcacy and safety of bivalirudin on primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI).
Methods: A total of 159 patients with acute STEMI treated by emergent PCI in our hospital from 2011-09 to 2014-01 were retrospectively studied. The patients were divided into 2 groups according to procedural bivalirudin application as Bivalirudin group and Heparin group, and the application of GPI (glycoprotein IIb/IIIa inhibitor) was decided by the operator. The baseline condition, coronary artery imaging condition, peri-operative and 30-day post-operative bleeding, the occurrence rate of MACE were compared between 2 groups.
Results: There were 153 patients completed the follow-up study including 72 in Bivalirudin group and 81 in Heparin group. The peri-operative bleeding rates in Bivalirudin group and Heparin group were 6.5% vs 11.0%, the in-stent thrombosis rates were 0% vs 1.2%, 30-day post-operative bleeding rates were 9.7% vs 13.5% and the occurrence of MACE were 1.4% vs 7.4% allP>0.05.
Conclusion: THE application of bivalirudin in emergent PCI is safe and effective in patients with acute STEMI, it has certain trend to reduce bleeding in relevant patients.

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of immunosuppressive cells derived from bone marrow stem cells.MDSCs can not only strongly inhibit the anti-tumor immune reactions mediated by T cells,but also directly accelerate angiogenesis,tumor progression and metastasis.Nonresolving inflammation (NRI),a major driving factor in the occurrence and development of tumor,and MDSCs are present in tumor microenvironment and become hot topics in recent years.However,the relationships between MDSCs and NRI,especially in the relevant molecular regulatory networks,have not been fully elucidated.The relationships between MDSCs and NRI,the molecular regulatory networks,the key regulatory points and the strategies for targeted treatment are reviewed in this paper based on the current literatures and the work achieved by our research team.

BACKGROUND: Diabetes causes abnormal insulin like growth factor-1 (IGF-1) gene expression, which contributes to initiation and development of peripheral neuropathy.OBJECTIVE: To investigate the efficacy of a single dose of methylcabalamin on prevention of experimental diabetic neuropathy and the possible molecular mechanism of its involvement in IGF-1 gene expression.DESIGN: Completely randomized and controlled experiment.SETTING: Endocrinology Department of the First Affiliated Hospital of Nanjing Medical University.MATERIALS: The study was carried out in an Animal Center of Nanjing Medical University. Totally 80 male Sprague Dawley rats (sanitary degree)were randomly selected.METHODS: ① Totally 64 rats were chosen to be induced diabetic. They were injected intravenously with alloxan dissolved in saline solutions, at the dose of 240 mg/kg. ② Of 16 rats were chosen as normal control group who were injected intravenously with equivalent volume of saline solution. ③ Of 64 established diabetic rats were treated with daily subcutaneous injection of pork regular insulin in combination of protamine zinc insulin (2:1) then further divided into 2 groups as insulin-treatment diabetic control groups based on different blood glucose levels: group 1 with relatively better control of diabetes, group 2 with relatively worse control of diabetes, with 32 rats in each group. Totally 16 rats of each group were treated with methylcobalamin injection intramuscularly with 500 μg/kg body weight, thus correspondingly divided into insulin +methylcobalamin group 1 and insulin+methylcobalamin group 2. The remaining 16 rats of each group as respective insulin-treatment diabetic control groups were treated with equivalent volume of saline. ④ Initiate weight and end weight were measured at beginning of the experiment and after diabetic model was established. Glucose oxidase was used to detect glucose level. 1-deoxy-1-malin was used to detect fructose level. ⑤ Parameters were measured as follows: Sensory/motor nerve conduction velocity (SNCV, MNCV) and evoked potential amplitude (EPA) of sciatic nerves detected by evoked electromyogram; IGF-I mRNA by reverse-transcriptase polymerase chain reaction (RT-PCR); IGF-1 peptide by enzyme-linked immunosorbent assay (ELISA). ⑥ One-way analysis of variance was used to analyze the Significance of differences among groups.MAIN OUTCOME MEASURES: ① Tissue IGF-1 mRNA/ IGF-1 peptide, electrophysiological data of individual groups at different points of the experiment. ② Comparison between individual groups in glucose metabolic parameters and body weights at different points of the experiment.RESULTS: Three rats died for diabetic infection or other acute complications and only 77 rats were included in the final statistical analysis.① Body weight and glucose metabolic parameter changes: After diabetic model, glucose, fructose level and body weight change between methylcobalamin+insulin treated groups and insulin treated groups were not significant. ② IGF-1 mRNA/peptide changes: Tissue IGF-1 mRNA increased significantly in methylcobalamin + insulin treated groups than that in insulin treated groups, respectively (P ＜ 0.05-0.01). Two weeks after diabetic model was established, the sciatic tissue IGF-1 mRNA contents were obviously higher in methylcobalamin + insulin treated group 1 than that in insulin treated group 1 (P ＜ 0.05), but not significantly different from that in NC group; Similarly, tissue IGF-1 mRNA contents were obviously higher in methylcobalamin + insulin treated group 2 than that in insulin treated group 2 (P ＜ 0.05), but lower than that in NC group (P ＜ 0.01); Month 2, tissue IGF-1 contents in methylcobalamin+ insulin treated groups were lower signiiicantly than NC groups, but higher than insulin treated groups (P ＜ 0.05-0.01). By month 3, IGF-1 mRNA level in methylcobalamin+ insulin treated group 2 was not significantly different from that in insulin treated group 2. The IGF-1 peptide levels in nerve tissue changed approximately parallel to IGF-1 mRNA level over time course. ③ Nerve electrophysiological data changes: Month 2 and 3, SNCV, MNCV and EPA were significantly higher in methylcobal-amin+ insulin treated group 1 than in insulin treated group 1 (P ＜ 0.05);Month 2, SNCV and EPA were higher in methylcobalamin+ insulin treated group 2 than in insulin treated group 2 (P ＜ 0.05); Month 3, SNCV, MNCV and EPA were significantly lower in methylcobalamin + insulin treated group 2 than in control group (P ＜ 0.05-0.01), whereas no difference was observed between methylcobalamin + insulin treated group 2 and insulin treated group 2.CONCLUSION: ① Methylcobal has not effect on blood glucose. ②Methylcobal could prevent occurrence of experimental neuropathy through its effect on nerve IGF-1 gene expression of diabetic rats. ③ A better efficacy could be achieved by Methylcobal with a good control of blood glucose level in prevention of diabetic peripheral neuropathy.

Biological chemistry of Chinese herbal germplasm resources (BCCHGR) is a new cross-discipline formed from rapid development of modern science and technology and its application in the area of Chinese herbal resources. BCCHGR was defined as probing and understanding biological processes like heredity, gene transcription, expression and metabolism of Chinese herbal germplasm, at the interface of biochemistry, molecular biology and chemistry, elu-cidating the nature of Chinese herbal germplasm using as TCM medicine as well as the forming mechanism thereof. In this paper, the scientific background, definition, significance and contents of BCCHGR were discussed to depict a preliminary picture of BCCHGR and arouse popular consideration and discussions.

Objective To explore the effect of Tuina combined with Traditional Chinese exercise (TCE) on nonspecific chronic neck pain (NCNP). Methods 80 eligible patients were recruited in our hospital from October, 2014 to October, 2015. They were randomized to observation group (n=40) and control group (n=40). The observation group received Tuina combined with TCE, and the control group re-ceived intermittent cervical traction, 5 times a week for 2 weeks. They were assessed with Visual Analog Scale (VAS) and Neck Disability Index (NDI) before, immediately after intervention, and at 1 month follow-up. Results 77 patients completed the treatment and follow-up. The scores of VAS and NDI significantly decreased after a 2-week intervention (t>9.330, P<0.001) in both groups. The VAS score were sig-nificantly lower in the observation group than in the control group immediately after intervention and at 1-month follow-up (F>8.338, P<0.01). The NDI score was significantly lower in the observation group than in the control group at 1-month follow-up (F=9.053, P=0.004). Conclusion Tuina combined with TCE could relieve pain and improve cervical function in patients with NCNP, which was superior to inter-mittent cervical traction.

Two cases of frontal fibrosing alopecia (FFA) were reported.Case 1,a 44-year-old woman,presented with progressive recession of the frontotemporal hairline for 4 years and multiple skincolored facial papules for 2 years.Skin examination showed that the frontotemporal hairline was receded,the local skin was smooth and thin,and a few remaining fine hairs could be seen.Additionally,eyebrows,axillary and pubic hairs were partly shed,and plenty of millet-sized skin-colored papules were diffusedly distributed on the frontotemporal region and bilateral mandibular angles.Dermatoscopy showed reduced hair follicular openings,different hair shaft diameters,cicatricial white patches and perifollicular erythema.Case 2,a 55-year-old woman,presented with progressive frontotemporal hair loss for 2 years.Skin examination revealed the recession of bilateral frontotemporal hairline and partial loss of eyebrows,axillary and pubic hairs.Histopathological examinations of the 2 patients both revealed perifollicular infiltration of lymphocytes,liquefaction degeneration of basal cells and perifollicular lamellar fibrosis.Clinical manifestations and histopathological features of the 2 patients both confirmed the diagnosis of FFA.

OBJECTIVE:Tosum up the condition of theoretical teaching and experimental teaching of the Processing of Chinese Materia,and to provide referencefor the reform of teaching model of the Processing of Chinese Materia. METHODS:Teaching soft-ware,teaching video and other modelrn teaching methods were used to enrich the content in theory teaching;linking theory with practice was used to stimulate students'interest in learning;scientific research achievement was introduced in teaching to train stu-dents' scientific research thinking;the teaching model of traditional confirmative experiment teaching was reformed by increasing de-signing experiment hours and score;the traditional usual performance evaluation method was changed by replacing with evaluation method of formative,and it was used for evaluation. RESULTS:The students not only learned theoretical knowledge,but also cul-tivated their ability to analyze and solve problems,changing from passive learning to active learning,so that it has made satisfacto-ry teaching effect. CONCLUSIONS:The traditional concept should be changed in teaching of the Processing of Chinese Materia, paying attention to the combination of scientific research and teaching;improve the situation of the designing experiment in the present undergraduate experimental teachingto stimulate students interest in learning,enhance students'practical ability,and im-prove the quality of teaching.

Objective To investigate the clinical value of 64-slice spiral computed tomography(64-MSCT)triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters de-termined metastatic perigastric lymph node as follows:①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters (①+②)in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters (①+②+③)were 98.2% and 1 9.4%,respec-tively.The sensitivity and specificity of combining four parameters (①+②+③+④)were 99.7% and 13.2%,respectively.In ad-dition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.