Objective To observe the effect of lidocaine gargle,gentamicin,dexamethasone mixture on degree and cure time of oral mucositis caused by paraquat poisoning.Methods 61 patients with paraquat poisoning were randomly divided into the experimental group (31 cases) and the control group (30 cases); the experimental group was given lidocaine,gentamicin,dexamethasone mixture gargle,the control group was given dexamethasone dilution as gargle.The degree of oral mucositis and healing time were compared between two groups.Results There was significant difference in degree of oral mucositis and healing time between the experimental group and the control group.Conclusions Lidocaine gargle,gentamicin,dexamethasone mixture gargle can reduce degree of oral mucositis and hasten healing in patients with paraquat poisoning.It can alleviate the suffering of patients,and is worthy of clinical application.

Autoimmune blistering skin diseases are a group of organ-specific autoimmune disorders that are characterized by autoantibodies against desmosome and hemidesmosome which are structural proteins of the epidermis or the dermal-epidermal junction and clinically by blisters and erosions on skin and/or mucous membranes.According to the skin level at which the blister occurs and the structural proteins that the autoantibodies target,autoimmune blistering diseases can be categorized into intraepithelial blister group and subepidermal blister group.The treatment options and prognosis are different among the various diseases.Since clinical criteria and histopathological characteristics are not sufficient for an accurate diagnosis of autoimmune blistering skin diseases,direct immunofluorescence microscopy,indirect immunofluorescence microscopy,ELISA,immunoblotting and immunoprecipitation are needed for exact diagnosis.The detection of serum autoantibodies have been shown to correlate with disease activity and thus may be helpful in deciding treatment options for the patients.

A 66-year-old female patient presented with blisters on the scalp and neck for 1 month. She had a history of type 2 diabetes for 6 years, and started taking the dipeptidyl peptidase-4 inhibitor linagliptin at a dose of 5 mg once a day 6 months before the onset of eruption. Skin examination showed scattered mung bean- to peanut-sized blisters on the scalp, and some blisters broke with exudation and crusts. There was a pigeon egg-sized bulla and two mung bean-sized blisters on the left neck, with tense blister walls, clear blister fluids, non-erythematous base, and Nikolsky′s sign was negative. Enzyme-linked immunosorbent assay revealed that the serum levels of anti-BP180 NC16A and anti-BP230 antibodies were 5.81 and 139.76 kU/L respectively. Histopathological examination of the blister on the neck showed subepidermal blister formation, and infiltration with neutrophils and a few eosinophils in the blister. The patient was finally diagnosed with localized anti-BP230-type bullous pemphigoid. This case of anti-BP230-type bullous pemphigoid associated with the dipeptidyl peptidase-4 inhibitor linagliptin was firstly reported in China.

This study is to investigate the effects of concentration, intestinal section, pH, paracellular route, substrate/inhibitor of enzyme (CYP3A) and proteins (P-gp, MRP2, SGL1) on the absorption of forsythoside A. The absorption of three concentrations (2.6, 5.2, and 10.4 microg x mL(-1)) of forsythoside A in different intestinal segments was studied with phenol red as the marker by rat circulation in situ. The results showed that the residue of forsythoside A with different concentrations had little significant difference from that obtained after perfusing via duodenum, jejunum, ileum and colon, which indicated that the absorption of forsythoside A was passive diffusion and had no difference in different segments of rat intestine. The residue of forsythoside A increased to 466.160 and 463.429 microg respectively when cyclosporine (4 microg x mL(-1)) or midazolam (50 micromol x L(-1)) was added to the circulation fluid, which showed significant difference compared to the control group (P < 0.05). Moreover, the residue of forsythoside A showed a tendency of increase with the increase of cyclosporine or midazolam. When digoxin (50 micromol x L(-1)) or EDTA (10 microg x mL(-1)) was added to the circulation fluid, the residue of forsythoside A decreased to 325.110 and 369.888 microg respectively, which showed significant difference as compared to the control group (P < 0.05). Besides, the residue of forsythoside A showed a tendency of reduction with the increase of digoxin or EDTA. However, there is no significant change in the absorption of forsythoside A when the different concentrations of mannitol were added to the circulation fluid. The results above indicated that the absorption of forsythoside A was mainly passive diffusion and involved paracellular route at the same time. In addition, the substrates of P-gp or CYP3A had dose-dependent effect on the absorption of forsythoside A.

Objective To understand the cleaning status of hospital environment,and evaluate the effect of fluo-rescence labeling method plus feedback and training on hospital environmental cleaning effectiveness.Methods A total of 27 departments in a hospital were investigated,1 cleaning staff and 2 inpatients were selected from each de-partment,cleaning staff’s knowledge about cleaning and disinfection of environmental object surfaces,as well as cleaning status of inpatients’wards were surveyed,cleaning efficacy of hospital environmental object surfaces were detected with fluorescence labeling method,the surveyed results were performed timely feedback to clinical depart-ments,training on cleaning and disinfection knowledge was conducted,the effective cleaning rate of environmental object surface before and after the training was compared.Results A total of 27 cleaning staff were surveyed,the correct response rate for cleaning frequency was 96.30% ,awareness rate for section concept was 96.30% ,accuracy rate of cleaning order was 92.59% ,accuracy rate of post-cleaning immersion time of sanitary wares in disinfectant was 85.19% ,accuracy rates of replacing,drying,and repeated immersing wiping cloths were 81.48% ,48.15% ,and 25.93% respectively,rates of correct disinfectant formulating method and mop drying time were both 0. Among 54 investigated patients,bed units and ground of wards of 28 patients were cleaned both 1-2 times/day;bed units of 8 patients had never been wiped,18 patients in 9 departments cannot be conducted statistics due to completely in-consistent responses with the other patients of the same departments. The effective cleaning rates of environmental object surfaces before and after the training were 34.62% and 64.96% respectively,difference was significant(χ2=21.81,P<0.01).Conclusion Fluorescence labeling method plus feedback and training can improve cleaning efficacy of hospital environmental object surfaces.

Objective To discuss the correlation between the joint detection of BA,EMAb,ACA and unexplained recurrent spontaneous abortion(URSA).Methods Selected 144 URSA cases,166 SA(sporadic abortion)cases,188 normal pregnant women,and detected their BA,EMAb,ACA and statistical analysis of parallelism.Results Comparing URSA group with SA group and control group respectively,there were significant statistical difference between BA negative rate (74.31%, 25.30% and 50.53%),EMAb positive rate (35.42%,7.23% and 6.91%)and ACA positive rate (26.39%,5.42% and 5.32%)(χ2 = 19.344 ~ 74.180;P < 0.05;χ2 = 37.837 ~ 42.586,P < 0.05),(χ2 = 26.355 ~ 29.270,P < 0.05).URSA group’s BA,ACA and EMAb joint detection rate of positive (84.72%)was significantly higher than SA group and the con-trol group (χ2 =35.532~93.076,P <0.05).Conclusion There was a close relationship between the lack of BA,the genera-tion of EMAb,ACA and unexplained recurrent spontaneous abortion.Joint detection has important clinical significance in auxiliary diagnosis of unexplained recurrent spontaneous abortion and prognosis judgement.

Objective Discussing the correlation between joint detection of procalcitonin(PCT) ,hypersensitive c‐reactive protein (hs‐CRP) ,WBC and bronchopneumonia in children .Methods Choosing 89 bacterial infection bronchopneumonia children ,92 virus infection bronchopneumonia children ,90 mycoplasma infection bronchopneumonia children and 100 normal children ,detecting their PCT ,hs‐CRP ,WBC and statistical analysis of the level of parallelism .Results There is a positive correlation between bacterial in‐fection group′s PCT and hs‐CRP ,WBC(r=0 .807 ,0 .764 ,P<0 .05) .The joint detection of PCT ,hs‐CRP ,WBC positive rate in bac‐terial infection group is significantly higher than the rest group(P<0 .05) .Conclusion PCT ,hs‐CRP and WBC is a sensitive indica‐tor of bacterial infection .There is important clinical reference value in joint detection to the diagnosis of bacterial infection broncho‐pneumonia in children ,in dynamic monitoring the disease progression ,and in prognosis judgement .

Objective To identify the gene locus and the mutation of DSRAD (double-stranded RNA adenosine deaminase) in a Chinese dyschromatosis symmetrica hereditaria(DSH) family. Methods After confirming the diagnosis of the DSH proband, the genomic DNA was extracted from the whole blood samples of every members of the pedigree. The DSRAD gene intervals were localized by linkage analysis and haplotype reconstruction. The mutation of DSRAD was detected by direct sequencing. Results The candidate gene was localized at the 1q region, consistent with the reported region. The direct sequencing results showed that there was a CAA→TAA transition at exon 2 of DSRAD in all affected family members, which consequently led to a nonsense mutation of Gln517Ter. Conclusion A nonsense mutation is found in the Chinese DSH family.

Objective To investigate the expression of HINT1 mRNA in the tissue of malignant melanoma and nevocellular nevus. Methods Half-quantitative RT-PCR was used to measure the expression of HINT1/PKCI-1 mRNA in fresh and archival tissues of 25 patients with malignant melanoma and 25 patients with nevus. Results In the case of the same specimen, the expression of HINT/PKCI-1 mRNA showed no difference in the tissue treated with formalin fixation and paraffin embedment with that in the fresh tissue. The expression level of HINT/PKCI1 mRNA was 0.49 ? 0.04 in nevus and 0.31 ? 0.07 in malignant melanoma, and the difference was significant (P

Objective:To assess the application value of reflectance confocal microscopy (RCM) in evaluating clinical efficacy of hemoporfin-mediated photodynamic therapy for purple-type port-wine stain.Methods:From April 2018 to January 2020, a total of 39 patients with centrofacial purple-type port-wine stains were enrolled from Department of Dermatology, Wuhan No.1 Hospital, and received 3 sessions of hemoporfin-mediated photodynamic therapy. Before the first treatment, and 3- 6 months after 3 sessions of hemoporfin-mediated photodynamic therapy, skin lesions were photographed, and RCM was conducted to measure the diameter and density of blood vessels at a depth of 100 μm in the lesions. Clinical efficacy was evaluated based on the clinical photos, and the average diameter of blood vessels and density of blood vessels per square millimeter of lesion area were calculated. Measurement data were compared among different groups by using one-way analysis of variance, multiple comparisons were performed using least significant difference test, and comparisons of parameters before and after treatment were conducted by using paired t test. Results:After 3 sessions of hemoporfin-mediated photodynamic therapy, 1 (2.56%) patient was nearly completely cured, 16 (41.03%) received marked improvement, 20 (51.28%) received improvement, and 2 (5.13%) showed no response to the treatment. In the patients receiving marked improvement or improvement, the average diameter and density of blood vessels significantly decreased after treatment compared with those before treatment (all P < 0.05) , while no significant difference was observed before and after treatment in the patients with no response (both P > 0.05) . The average difference in the blood vessel diameter before and after treatment was significantly higher in the patients receiving marked improvement (48.56 ± 17.87 μm) than in those receiving improvement (31.15 ± 21.09 μm, P < 0.05) and those with no response (12.00 ± 2.83 μm, P < 0.05) . The average difference in the blood vessel density before and after treatment was 7.13 ± 3.44, 5.00 ± 2.22 and -0.50 ± 3.54 vessels/mm 2, respectively, in the patients receiving marked improvement, improvement and those with no response, and pairwise comparisons between the 3 groups all showed significant differences (all P < 0.05) . Conclusion:RCM can be used to assess the average diameter and density of blood vessels in the port-wine stain lesions before and after hemoporfin-mediated photodynamic therapy, and is helpful in quantitatively evaluating the therapeutic effect of hemoporfin-mediated photodynamic therapy.