Objective To evaluate the efficacy of narrow-band ultraviolet B (NB-UVB) for the treatment of early-stage mycosis fungoides (MF).Methods A retrospective study was performed on 98 patients with early-stage MF treated with NB-UVB from January 2003 to December 2013.The rate of and time to recurrence of MF were assessed,and long-term side effects were evaluated in these patients.Results Among 52 patients achieving complete remission,the median number of sessions of NB-UVB radiation was 30 (range,18-87),the median cumulative radiation dose was 24.16 J/cm2 (range,9.11-108.86 J/cm2),and the median follow-up duration was 41 months (range,11-90 months).Relapse occurred in 14 (26.9％) patients with the median time to recurrence being 8.2 months (range,3-60 months).The patients suffering from relapse achieved complete remission after treatment with NB-UVB again.Adverse reactions mainly included skin erythema and itching at the early stage of radiation,as well as temporary pigmentation after radiation.Cutaneous carcinoma occurred in none of these patients during 11-90 months of follow-up.Conclusions NB-UVB phototherapy appeared to be effective for the treatment of early-stage MF,and no cutaneous carcinoma occurred in these patients during the follow-up.Although MF may relapse in some cases,repeated NB-UVB phototherapy is still effective.

Objective To study the clinical features of follicular occlusion triad, and whether it is a hereditary disease. Methods Based on the clinical examination of a case who developed squamous cell carcinoma secondary to follicular occlusion triad, the pedigree of the patient was surveyed and analyzed. Results There were a total of thirteen patients in this pedigree, the age of onset was about 20 years old. The clinical features and laboratory examination of the proband was consistent with follicular occlusion triad. Conclusions Hereditary factor is important in the pathogenesis in follicular occlusion triad,and the disease maybe an autosomal dominant inherited disease.

ObjectiveTo investigate the significance of cerebrospinal fluid(CSF) S-100B protein and vascular endothelial growth factor (VEGF) levels in the pathogenesis of brain injury of viral encephalitis.MethodsForty-two patients with viral encephalitis (viral encephalitis group) and 40 patients with other disease at the corresponding time period(control group) were involved in this study.CSF (routine,biochemistry and cytology) was detected,and the levels of S-100B protein and VEGF in CSF were detected by ABC-ELISA method.ResultsWhite blood cell count was (0-584) × 106/L in viral encephalitis group,and (0-200) × 106/L in control group.The levels of protein and glucose in CSF had no significant difference between two groups (P＞ 0.05),and the level of chloride in CSF in viral encephalitis group was significantly lower than that in control group[ ( 110.10 ± 31.22 ) mmol/L vs.( 123.80 ± 6.32 ) mmol/L ] (P =0.006).In viral encephalitis group,cytological examination showed that mixed type cytological reaction was in 6 cases (14.3％,6/42).The level of S-100B protein in viral encephalitis group [25.04-47.97 (28.37 ± 6.09) ng/L] was significantly higher than that in control group[ 25.04-29.64(26.03 ± 0.90) ng/L ] (t =2.462,P =0.018).The level of VEGF in viral encephalitis group[88.84～143.77(96.24 ± 13.38) ng/L] was significantly higher than that in control group [89.15～96.18 (90.67 ± 1.71 ) ng/L] (t =2.673,P =0.011 ).ConclusionsThe high levels of S-100B protein and VEGF in CSF could support the viral encephalitis diagnosis.Tracking the levels of S-100B protein and VEGF in CSF dynamically have noticeable effect on checking the condition of viral encephalitis patients.

Objective To explore the application effect of the adult education theory in the nursing round. Methods 340 trainee nurses, who were trained at our surgical department between June 2008 and December 2009, were randomly divided into the experimental group(178 cases)and the control group(162cases). The adult education theory was adopted in the experimental group, whereas the traditional education method was used in the control group, a questionnaire was carried out after the nursing visit. Results The experimental group was more satisfied with the round visit than the control group. Conclusions The application of the adult education theory in the round visit is beneficial not only to the students' selection of the topics of nursing visit, but also to the improvement of the students' understanding and communicating capacity, the students' studying interests and the students' creative thinking, finally the degree of satisfaction to the round visit is increased by the adoption of this theory.

Objective To investigate changes in expressions of activation antigens CD69 and HLA-DR in CD3+T lymphocytes in peripheral blood and skin lesions in patients with psoriasis vulgaris. Methods Peripheral blood samples were obtained from 20 patients with psoriasis vulgaris and 20 healthy controls, and skin specimens from the lesions of 15 out of the 20 patients and 10 healthy controls. Flow cytometry was performed to quantify the expressions of CD69 and HLA-DR in peripheral blood CD3+T cells, and an immunohistochemical study to measure the expression of HLA-DR in skin specimens. Statistical analysis was carried out by a two-sample t-test and Pearson correlation analysis with the SPSS 19.0 software. Results Compared with the healthy controls, the patients with psoriasis vulgaris showed increased expression rates of CD69 (4.70%± 1.90%vs. 1.56%± 0.95%, t=6.629, P<0.01)and HLA-DR (8.97%± 1.79% vs. 3.02% ± 1.15%, t= 6.204, P< 0.01)in peripheral blood. Pearson correlation analysis revealed that the percentage of CD3+HLA-DR+cells in peripheral blood was positively correlated with the psoriasis area and severity index (PASI)score (r=0.5626, P<0.05). The expression rate of HLA-DR was significantly higher in the dermis (64.87%± 17.31%vs. 19.80%± 5.69%, t=7.916, P<0.01), but lower in the epidermis(11.80%± 5.55%vs. 27.40%± 8.61%, t=5.479, P<0.01)in the psoriatic specimens compared with the control specimens. Immunohistochemically, HLA-DR was widely expressed in the dermis of psoriatic lesions, but mainly distributed around blood vessels in the control skin. Conclusions There is an aberrant activation of CD3+T cells in peripheral blood and inflammatory cells in skin lesions in patients with psoriasis vulgaris, and the percentage of CD3 +HLA-DR+ cells in peripheral blood is correlated with the severity of psoriasis vulagaris.

Objective:To investigate the correlations of Lauren classification and world health organization (WHO) classification of gastric cancer (GC) with microvascular density (MVD), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 1 (VEGFR1), vascular endothelial growth factor receptor 2 (VEGFR2), and p53. Methods:The clinical data of 89 patients with GC were collected. The collected specimens were categorized on the basis of Lauren classification and WHO classification. CD34/periodic acid-Schiff (PAS) double staining was performed to validate MVD. Immunohistochemistry was conducted to investigate the expression levels of MMP-2, MMP-9, VEGF, VEGFR1, VEGFR2, and p53. Results:MVD was not correlated with Lauren classification or WHO classification (P>0.05). Lauren typing was associated with the expression levels of MMP-9, VEGFR1, and p53 (P<0.05). WHO classification was not related to any of the factors (P>0.05). Cox proportional hazards model revealed that Lauren classification and WHO classification were the prognostic factors of overall survival (P<0.05). Conclusion:This research on tumor related factors, angiogenesis, and different classifications of GC may provide new methods to treat this disease.

Objective To investigate the feasibility of subtraction coronary computed tomography angiography (Sub-CCTA) for the diagnosis of coronary heart disease in the segment with severe calcification.Methods A retrospective analysis was performed on 27 patients who underwent clinically indicated digital subtraction angiography (DSA) and CCTA using a 320-detector row CT.Compared with the results of DSA,sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Con-CCTA and Sub-CCTA were calculated.The clinical diagnostic accuracy of the two imaging methods was evaluated using the receiver operating characteristic (ROC) curve.The stenosis of coronary segments was divided into four grades (Ⅰ,Ⅱ,Ⅲ,Ⅳ).Kappa coefficient was used to measure agreement between two imaging methods.Image quality of 4-scale grade scoring method was used and t test was conducted.Results A total of 52 segments with severe calcification were evaluated.The scores of image quality in Con-CCTA and Sub-CCTA were 2.8 ± 0.5 and 3.4 ± 0.7,respectively.There was significant difference between them (t =5.9,P ＜ 0.05).Compared with the result of DSA as the golden standard,the Kappa coefficients were 0.55 and 0.81 respectively in Con-CCTA and Sub-CCTA for the quantitative evaluation of the severe calcified segments.The sensitivity,specificity,positive predictive value and negative predictive value and accuracy of Con-CCTA were 81.0％,63.1％,63.1％,81.1％ and 70.8 ％;and for Sub-CCTA they were 90.5 ％,85.2％,82.1 ％,92.0％ and 87.5 ％ respectively.Compared with Con-CCTA,the area under the ROC curve of Con-CCTA and Sub-CCTA were 0.84 (95％CI:0.70-0.93) and 0.96 (95％ CI:0.86-1.00),respectively,and the difference was statistically significant (P =0.03).Conclusions Sub-CCTA can improve the diagnostic accuracy of coronary artery stenosis in severe calcified segment.Application of subtraction technique in CCTA can reduce or even eliminate the artifacts caused by severe calcified plaque,and has a good clinical application prospect.

Objective:To explore the differences in intravascular ultrasound results in elderly coronary heart disease(CHD)patients with different uric acid levels.Methods:A total of 145 elderly patients diagnosed with CHD in our hospital from December 2017 to May 2020 were included as study subjects.Uric acid levels were measured and intravascular ultrasound examination was conducted in all patients.They were divided into different groups based on uric acid levels: Group A(uric acid≤199 μmol/L), Group B(uric acid 200~399 μmol/L)and Group C(uric acid≥400 μmol/L). Data from intravascular ultrasound-derived indexes were analyzed and compared between the three groups.Results:There was no significant difference in the degree of left main stenosis between Group A and Group B, but it was less severe in both groups than in Group C( F=5.625, P=0.039). Plaque fibrous cap thickness showed no significant difference between Group B and Group C, but it was smaller than in Group A( F=7.825, P=0.020). Group C had the largest plaque area and maximum thickness among the three groups, followed by Group B[(11.12±1.73)mm 2 and(1.76±0.24)mm]and Group A[(8.29±3.14)mm 2 and(1.38±0.09)mm]( F=6.384 and 6.827, P=0.028 and 0.015). Conclusions:Elevated uric acid levels in elderly CHD patients can increase the area and thickness of plaques, and reduce plaque fibrous cap thickness, leading to an increased risk of formation of unstable plaques, which can be life-threatening for these patients.Thus, monitoring and managing uric acid levels should be stressed in elderly CHD patients.

Objective:To compare the value of respiratory-triggered diffusion-weighted imaging with fat suppression(RTIR-DWI)and common breath-hold DWI(BH-DWI)for the differential diagnosis of pancreatic cancer and mass-like pancreatitis. Methods:A total of 30 cases of pancreatic cancer and 17 cases of mass-like pancreatitis,which were confirmed by surgical pa-thology,underwent DWI at 3.0T before operation.DWI based on SE-EPI sequence,of which b value was 600 s/mm2 ,included BH-DWI and RTIR-DWI.Apparent diffusion coefficient(ADC)value of pancreatic cancer and mass-like pancreatitis were statis-tically analyzed and compared.Receiver operating characteristic(ROC)curve was used to analyze and compare the effect of two DWI sequences in the differential diagnosis of pancreatic cancer and mass-like pancreatitis.Results:On BH-DWI,ADC value did not have significant difference between pancreatic cancer and mass-like pancreatitis(P >0.05).On RTIR-DWI,ADC value had significant difference between pancreatic cancer and mass-like pancreatitis(P <0.01).On RTIR-DWI,the sensitivity,speci-ficity,positive predictive value and negative predictive value were 86.7%,88.9%,96.3% and 66.7%,respectively,when ADC≥1.33×10-3 mm2/s was used as a cutoff for the differential diagnosis of pancreatic cancer from mass-like pancreatitis.On BH-DWI,the sensitivity,specificity,positive predictive value and negative predictive value was 73.3%,88.9%,95.7% and 50.0%,respectively,when ADC≥ 1.45 × 10-3 mm2/s was used as a cutoff for the differential diagnosis of pancreatic cancer from mass-like pancreatitis.Conclusions:Compared to BH-DWI,RTIR-DWI may be more conducive to the diagnosis and differentiation of pancreatic cancer and mass-like pancreatitis.

Objective: To investigate the clinical avalue of real time threshold manual triggering technique in the lower extremity arterial CT angiography .Methods :A total of 70 patients with clinically suspected lower extremity arterial disease underwent lower extremity arterial CT examination ,and the patients were randomly divided into two groups .In the first group 35 patients ,the automatic threshold triggering technique was used .After the threshold reached to 150 Hu ,6 s was delayed before scanning .The other group of 35 patients with manual triggering was used to observe the time density curve .When the peak value was stable ,scanning was started at once .The delay time of the two groups was analyzed and the image quality of the two groups was evaluated .The image quality evaluation included the branch level ,the smooth degree of the arterial edge , the interference of the vein and the CT value of the arterial segment .Results:There were significant differences in the starting delay time of the two trigger modes (P=0 .002 ,P<0 .05) ,and the auto trigger group was earlier than the manual triggering group .Between the two trigger modes ,there was no significant difference in the distal branches and vessel edge of abdominal‐iliac artery and femoral popliteal artery display ability .In the lower limb artery ,the image quality of manual triggering group was higher than that of the automatic trigger group ,the two groups had statistical significance (P=0 .004 , P=0 .003) .The same as to the distal branch and the edge of the vessel of the foot (P=0 .003 ,P=0 .003) .Two sets of images in the lower limb vein interference score had no significant difference ( P> 0 .05 ) .CT value had no significant difference in abdominal‐iliac artery ,femoral‐calf and popliteal arteries between the two groups ,while that in the dorsalis pedis artery had statistical significance between the two groups (P=0 .006) .Four levels of CT values in manual triggering group were higher than those in the automatic trigger group .Conclusions :Real time threshold manual triggering technique takes into account the individual differences of patients ,so the patient's delay scan time can be evaluated better and higher quality of lower extremity arterial images can be acquired .