To study the misdiagnostic reasons of valua Bowenoid papulosis. MethodTwenty-two cases of Bowenoid papulosis were retrospectively analysed. ResultsSeven cases were diagnosed as vulua Bowen's disease, 10 cases cindyloma acuminatum, 2 cases malignant melanoma and 3 cases melanocytic nevus. ConclusionsThe presence of mild to severe cytological atypia is a feature of Bowenoid papulosis. The diagnosis should be made according to both clinical and pathologic features. The disease may be spontaneously regressed.

Objective To investigate the effect of the Kolb experience learning theory applied in Surgical Nursing teaching.Methods 120 students were selected randomly and were divided into 2 groups,the observation group operated the teaching mode based on the Kolb experience learning theory,the control group operated traditional teaching.After the experiment,using the theory test,the skill test,the questionnaire survey to evaluate the teaching effectiveness.Results The two groups showed statistical difference in theory exam results,learning effect of each dimension and evaluation of teaching effect.Conclusions The teaching mode based on the Kolb experience learning theory can improve the students' interest in learning and study effect,and push forward the reform of teaching implementatiou.

[Summary] Diabetic nephropathy is one of the major chronic microvascular complications of diabetes ,which is the leading cause of end‐stage renal disease ,as well as the main cause of death in diabetic patients. Glomerular endothelial cell is an important component of the glomerular filtration barrier ,which is directly related to the materials of circulation ,and it can be easily damaged by glucose ,lipid and inflammatory factors. Under the hyperglycemia ,the PKC pathway ,the polyol pathway and oxidative stress were activated ,producing an excess of advanced glycation end products and reactive oxygen species ,which damage the endothelial nitric oxide synthase ,reduce the generation of nitric oxide ,while produce a large number of Ang Ⅱ. Ang Ⅱ damage the endothelial cell. In addition ,there are crosstalk between glomerular endothelial cells and endothelial cells ,which also cause endothelial cell injury. Here ,we reviewed the role of endothelial cell injury in the pathogenesis of diabetic nephropathy.

Objective To establish a human colon cancer multi-drug resistant cell line LS174T/5-fluorouracil(5-Fu) and to explore its biological characteristics. Methods A resistant human colon cancer line LS174T/5-Fu was established by stepwise increasing concentrations of fluorouracil selection from the parental cell line LS174T.Drug sensitivity was detected by MTT assay,and the changes of biological characteristics were determined by light microscopy,cell counting,flow cytometry and RT-PCR. Results LS174T/5-Fu cell line was developed after 6 months with stable resistance to 5-Fu and a resistance index of 40.24.The cells exhibited cross-resistance to cisplatin,etoposide,doxifluridine and hydeoxycamptothecin.LS174T/5-Fu cells grew more slowly than LS174T cells,which was longer than LS174T cell line.Cell cycle distribution of LS174T/5-Fu cells was changed compared with parental cells.The percentage of cells in G_(1) and S phase was increased,while in G_(2) phase was decreased.The level of MRP mRNA expression was increased according to the concentration of 5-Fu in resistant cell lines. Conclusion LS174T/5-Fu cells is a reliable multi-drug resistant cell subline of human colon cancer.The successful establishment of this cell subline has laid a solid foundation for further study of the multi-drug resistant mechanism of human colon cancer induced by 5-fluorouracil.

Objective To study the expression level of myostatin in the gastrocnemius muscle of cancer cachexia mice and to observe the improvement of the status and the influence on myostatin expression by use of meloxicam.(Methods The) tumor-bearing cachexia mice model was established by Lovo cell line subcutaneous inoculation.Twenty-four BALB/c mice were randomly divided into 3 groups(n=8 for each group):group A,control;group B,tumor-bearing mice plus saline;group C,tumor-bearing mice plus meloxicam(5 mg/kg).The food intake and body composition were documented.The expression of myostatin in the gastrocnemius muscle was investigated by RT-PCR and immunohistochemistry in all the animals,and the correlation analysis between serum TNF? and myostatin was conducted. Results The body weight of group B was about 60% of group A,and the average food intake was significantly declined(P

Objective To investigate the respective effects of highly concentrated amino acids, highly concentrated glucose and mixture of the above two on the proliferation and extracellular matrix synthesis of glomerular mesangial cells. Methods Mesangial cells were cultured with mannitol (13.3 mmol/L ), highly concentrated amino acids (13.3 mmol/L), highly concentrated glucose (30.5 retool/L) and the mixture of highly concentrated amino acids and highly concentrated glucose repectively. Mesangial cell proliferation was examined by MTT and flow cytometry. The mRNA expression of TGF-β1,ColⅣ and fibronectin (FN) was detected by semi- quantitative RT-PCR, and the protein expression was detected by ELISA, Western blot and radioimmunoassay. Results (1) Cellular proliferation was increased in response to amino acids and was further enhanced by increased levels of both amino acids and glucose in a time-depentent manner. And the most prominent action occured at 48 hours. (2) Among the three group, mesangial cell cycle was affected, and the number of G0/G1 mesangial cells was reduced, but the number of cycle S cells was improved. (3) In the three group, the mRNA and protein expression of TGF-β1 was improved [protein unit: ng·ml-1·(105 cells)-1, 3023±85, 3163±80, 3321+85 vs 1506±63, P< 0.05]. (4)In the three group, the mRNA and protein expression of Col Ⅳ and FN was enhanced [protein unit: ng'ml-1(105 cells)-1, Col Ⅳ:16.78±2.56, 18.65±2.56, 22.83±2.45 vs 10.22±2.54, P<0.01; FN:18.47±2.34, 13.58±3.13, 17.98±2.56 vs 8.22±2.54, P<0.05]. The expression of Col Ⅳ mRNA and protein was stronger when the cells were cultured with the mixture of highly concentrated amino acids and highly concentrated glucose. Conclusions Highly concentrated amino acid can promote cell proliferation similarly to highly concentrated glucose, which may be through increasing the activity of mesangial cells and the synthesis of extracellular matrix via TGF- β1 signaling way. Highly concentrated amino acid has the synergism with highly concentrated glucose.

Objective To explore the high-risk factors,clinical characteristics,therapy and prognosis of invasive fungal infection (IFI)in patients underwent allogeneic haemopoietic stem cell transplantation (AlloHSCT). Methods One hundred patients underwent Allo-HSCT at our department from March 2002 to July 2010 were analyzed retrospectively,among whom 26 patients had invasive fungal infection(IFI). Seven patients had pulmonary IFI before allo-HSCT, 14 patients had pulmonary IFI after allo-HSCT,3 patients had respiratory tract system IFI, and 2 patients had intestinal IFI. We observed the occurrence of Graft-versus-host disease (GVHD) ,cytomegalovirus( CMV )infection, Lymphocyte subsets and chronic basic diseases in patients with IFI. The twenty six cases were divided into two groups: experience therapy group with 12 cases and preemption therapy group with 14 cases. Results Among 26 patients with IFI,20 cases suffered from GVHD,6 cases had CMV infection,19 cases had low cellular immune function simultaneously. 1 case had diabetes,3 patients had pulmonary tuberculosis and 1 case had bronchiectasis as complications. In experience therapy groupe: 8 cases (67%)recovered completely but 1 case(8% )suffered from progressive infection. In preemption therapy groupe:3 cases ( 21% ) recovered completely but 5 cases ( 36% ) suffered from progressive infection. Conclusion Clinician should pay close attention to the patients with high-risk factors of IFI after allo-HSCT.

Objective To examine the recurrent ischemic stroke(RIS)in hospitalized patients predicted by Essen Stroke Risk Score(ESRS)and investigate the effect of intensive antiplatelet therapy in patients with high risk of RIS. Methods Retrospective analysis of patients with acute noncardioembolic ischemic stroke consecutively admitted to Peking Union Medical College Hospital(PUMCH)during 2001-2008. All 1008 patients were included in this study, 377 hospitalized in 2001-2002, 315 in 2005 and 316 in 2008. High risk of RIS was defined as ESRS ≥3. The average ESRS score in three groups and percentage of patients with high risk of RIS in each group were calculated. Risk of RIS was evaluated by comparing the average ESRS score in these three groups. Patients with high risk and taking clopidogrel treatment were also evaluated. Results Average ESRS score was 2. 67 ± 1.47,3.55 ± 1.40 and 3.93 ± 1.48(F= 150. 85,P=0.000)in groups of patients hospitalized in 2001-2002, 2005 and 2008 respectively. A significant difference was shown in percentage of high risk patients with ESRS ≥3 in three groups: as 51.64% in 2001-2002,77. 19% in 2005 and 85. 45% in 2008(X2=98.30,P=0. 000),showing a trend of increasing risk of RIS. Except for patients age, rates of having the risk factors in patients increased significantly, including hypertension, diabetes, myocardial infarction, myocardial diseases, smoking,vascular disease and stroke history. Clopidogrel usage has been increasing to 25.63% in 2008, but was far behind high ratio of high risk RIS patients(85.45%). Conclusions This retrospective study showd an increasing trend in RIS risk during 2001-2008. Identifying high risk patients and applying intensified antiplatelet therapy might play an important role in reducing the risk of RIS.

Objective Percheron artery is an uncommon anatomic variant. Percheron artery infarction with unilateral embryonic posterior cerebral artery ( PCA ) was rarely reported.The aim of this study was to characterize the clinical and imaging patterns of Percheron artery infarction with the unilateral embryonic PCA for early diagnosis and treatment.MethodsClinical and imaging data of 2 patients with Percheron artery infarction were reviewed retrospectively.ResultsTwo patients presented acute coma and one had paroxysmal blurred before coma.On neurological examinations,one patient had vertical gaze palsy besides two were unconsciousness. MRI showed symmetrical high signal intensity on diffusion weighed imaging (DWI)in bilateral paramedian thalami in two patients and a distinct pattern of V-shaped hyperintensity on DWI andFLAIR was present on the midbrain in one patient. Digital subtraction angiography and magnetic resonance angiography demonstrated unilateral embryonic PCA in two patients.ConclusionsThe classical clinical symptoms,symmetrical high signal in bilateral paramedian thalami and V-shaped sign in midbrain on DWI can improve recognition,evaluation and management of Percheron artery infarction.The unilateral embryonic PCA may be underlying risk factor of Percheron artery infarction.

Objective To assess the relationship of serum prealbumin level with the severity of acute ischemic stroke (AIS).Methods The clinical data of 2522 AIS patients who were admitted in Peking Union Medical College Hospital from 2000 to 2008 were retrospectively analyzed.The serum prealbumin and hypersensitive C-reactive protein (hs-CRP) levels were evaluated by immunoturbidimetric assay within 24 hours after admission.The AIS severity was evaluated at admission using modified Rankin Scale (mRS).Patients were divided into mild AIS group (mRS score ≤ 3 ) and severe AIS group (mRS score ＞ 3 ).The levels of serum prealbumin and hs-CRP were compared between these two groups,and the relationship between praalbumin and hs-CRP was also analyzed.Results There were 1697 patients in the mild group (average mRS score:1.67) and 825 patients in the severe group ( average mRS score:4.53 ).The severe group had significantly lower prealbumin level [ ( 191.20,82.00)versus (219.18,72.00) mg/L,P =0.000] and higher hs-CRP level [ (6.01,8.22) versus (4.15,6.93) mg/L,P =0.000 ] than the mild group,respectively.Partial regression analysis showed that the stroke severity was negatively correlated with serum prealbumin level (r =-0.115,P =0.000) and positively correlated with hs-CRP level (r =0.098,P =0.000).Serum prealbumin level was inversely correlated with hs-CRP level ( r =- 0.396,P =0.000).Conclusion The prealbumin level is relevant with the severity of AIS and inflammation.