A 2-month-old baby girl developed universal keratotic plaques soon after birth. Physical examination revealed well-defined, dark erythematous, keratotic plaques with thick scales and mild infiltration at the periorbital, perioral, perianal and vulvar regions, as well as deep fissures of both hands and feet covered with thick yellowish crusts. Another case was a 24-year-old female, the mother of the baby, who presented with hyperkeratotic plaques at perioral and perianal regions, congenital alopecia universalis, mutilation of fingers and toes with massive thick keratotic yellow crusts and scales. Histopathology of skin lesions from the gluteal region of the baby showed psoriasiform hyperplasia of the epidermis, slight inflammatory infiltration of dermal papillae and superficial dermal perivascular regions. Immunohistochemistry demonstrated the positive staining for acidic keratin (AE1) in the prickle cell layer and granular layer and for CK10 in the upper prickle cell layer and granular layer. Electron microscopy showed increased cell space and decreased tonofilament. Both the baby girl and her mother were diagnosed with Olmsted syndrome.

Objective To explore the value of 3‐dimensional volumetric diagnosis system in quantitative measurement of pulmona‐ry lobar volumetry using a 64 row MDCT .Methods Seventy‐seven adult volunteers were scanned twice on a 64 row MDCT at the end of the maximum inspiratory and maximum expiratory end respectively .On a volumetric computer‐aided diagnosis system ,the en‐tire lung was semiautomatically separated into 5 anatomy lobes including the right upper lobe ,right middle lobe ,right lower lobe ,left upper lobe ,and left lower lobe .Each lobar volume was measured .Results The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in male volunteers were 1 303 .90 mL and 938 .31 mL ,1 276 .90 mL and 737 .69 mL , 1 204 .47 mL and 678 .67 mL ,1 048 .49 mL and 754 .83 mL ,519 .53 mL and 407 .86 mL at the end of the inspiratory and expiratory respectively .The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in female volun‐teers were 915 .78 mL and 666 .23 mL ,913 .87 mL and 576 .62 mL ,822 .17 mL and 509 .30 mL ,734 .20 mL and 530 .23 mL ,389 .13 mL and 316 .70 mL at the end of the inspiratory and expiratory respectively .The values of each lobe volume between the full inspiration phase and expiration phase group showed significant difference the same sex group (P<0 .05) .The values of each lobe volume in the man group were significantly larger than those of female group in both respiratory phase (P<0 .05) .Of the D‐value in the each lobe volume in 5 anatomy lobe at full inspiration phase and expiration phase in both sex group ,both of the lower lobes were the largest , followed by the left upper lobe ,right upper lobe and right middle lobe .The D‐value in the each lobe volume at full inspiration phase and expiration phase in the man group were significantly larger than those of female group .Conclusion Three‐dimensional volumet‐ric diagnosis system and 64 row MDCT images can be used to assess the volume of each lung lobe .

Objective To evaluate the value of diffusion tensor imaging (DTI)in diagnosing MCI.Methods DTI and conventional MRI were performed in 26 patients with MCI and 26 age-matched normal control subjects (NC).FA were measured in the 10 select-ed white matter regions,included bilateral frontal lobe,temporal lobe,parietal lobe,parahippocampal gyrus and cingulate gyrus,in the patients with MCI (n=26)and NC (n=26).FA of each ROI (region of interest)between the patients and controls were com-pared by using independent sample t-test.The correlation between the FA values and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)scores was analyzed by using Spearman correlation analysis.Results Compared with NC,the FA values of the right frontal lobe,temporal lobe white matter and bilateral cingulate gyrus in the patients were significant-ly reduced (P <0.05).FA values of the left temporal lobe,right frontal lobe and bilateral parahippocampal gyrus were significant correlated with MoCA scores,and FA values of the bilateral parahippocampal gyrus were significant correlated with MMSE scores (P <0.05).Conclusion DTI can be used as a diagnosis index of MCI.It has important value in early intervention and improving the quality of life of patients to early diagnosing MCI.

Objective To study the finding and patterns of chronic inflammatory sinonasal disease on CT. Methods All of 93 patients with chronic inflammatory sinonasal disease by clinical observations and operation,the appearances and patterns of chronic inflammatory sinonasal disease were analyszed.Results Six radiological patterns of inflammatory sinonasal disease were identified:( 1) infundibular,16/93 or 17%;( 2) osteaomeatal unit,27/93 or 28% ; (3) sphenoethmoidal recess,5/93 or 6%;(4) sinonasal polyposis,17/93 or 18%;(5) sporadic ( unclassifiabal ) ,13/93 or 14%;(6) mixing pattern,15/93 or 16% .Conclusion Assignment of patients to radiological patterns allows tailored endoscopic sinonasal surgical approach.

Objective To explore the changes of white matter microstructure by using DTI in children with developmental delay (DD)with normal routine MRI results.Methods We performed routine MRI and DTI in 23 children with DD and 23 age-matched normal children,FA values of five deep white matters (limb of internal capsule,anterior limb,genu and knee of corpus callosum and optic radiation)and four shallow white matters (frontal lobe,temporal lobe,occipital cortex,centrum ovale)were measured.FA values of the white matter for two groups were assessed by paired t tests for each region of interest.Results FA values on the deep white matter for DD,and on the deep white matter and the shallow white matter for normal development group increased with age significantly (P <0.05).FA values on the shallow white matter for DD were lower than that for normal development group,which had no significant correlation with age (P >0.05).The FA values on the shallow white matter and deep white matter (corpus callo-sum knee,optic radiation)for children with DD were lower than that for the control group (P <0.05),and the FA values of the limb of deep white matter (genu of corpus callosum,internal capsule and anterior limb)were no difference with the contorl group (P >0.05).Conclusion DTI may detect the changes of white matter microstructure in children with developmental delay,and provides an objective basis for quantitative diagnosis.

OBJECTIVE: To explore the impact of upper airway expansion surgery on the blood pressure of hypertension patients with upper airway obstruction. METHOD: Clinical data of 45 cases of hypertension patients with nasal obstruction who were underwent upper airway expansion surgery. The morning sitting blood pressure of patients were recorded. All of the patients were underwent nasal expansion surgery and 11 cases with obstructive sleep apnea hypopnea syndrome were combined with H-uvulopalatopharyngoplasty. RESULT: Blood pressure of all 45 cases were apparently reduced in 12 months after the operations [systolic blood pressure (157.38 +/- 15.15) mmHg to (132.18 +/- 8.43) mmHg, diastolic blood pressure (95.42 +/- 9.28) mmHg to (82.31 +/- 5.88)mmHg], in which 9 cases with type I hypertension were lowered to normal pressure. Results had statistical difference between pre-operation and post-operation (P < 0.01). CONCLUSION Upper airway expansion surgery (including nasal and pharynx cav ity) can help lower blood pressure of hypertensive patients with nasal obstruction. Post-operative results were better than H-uvulopalatopharyngoplasty only.
Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; physiology ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Sleep Apnea, Obstructive ; complications ; physiopathology ; surgery

Objective To investigate the predictive value of baseline neutrophil-to-lymphocyte ratio (NLR) in the curative effect and prognosis of breast cancer patients treated with neoadjuvant chemotherapy.Methods The clinical data of 304 breast cancer patients received neoadjuvant chemotherapy in Beijing Cancer Hospital during 2010 were retrospectively analyzed.The correlations of baseline NLR with clinicopathological parameters of breast cancer patients were analyzed by Wilcox or Kruskal-Wallis tests,and the correlation of NLR with pathologic complete response (pCR) after neoadjuvant chemotherapy was analyzed by the binary logistic regression.The effect of clinic pathological parameters on the disease-free survival(DFS) of the patients was evaluated by the univariable and muhivariable Cox regression models.Results The medians of NLR in pCR + patients (n =62) and pCR-patients (n =242) were 1.76 and 1.72,respectively,and there was no significant difference between themn (P ＞ 0.05).Multivariate analysis indicated that the TNM stage (P ＜ 0.05) and pCR (P ＜ 0.05) were the independent risk factors influencing the prognosis of breast cancer patients.There was no significant correlation between NLR and 5-year DFS (HR=0.842,95％CI=0.566-1.255,P＞0.05).Condusion NLR lacks the predictive value in the curative effect and prognosis of breast cancer patients treated with neoadjuvant chemotherapy,while TNM stage and pCR are the independent risk factors influencing the prognosis of breast cancer patients.

Adult ; Aged ; Bone Transplantation ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Ilium ; surgery ; Male ; Middle Aged ; Postoperative Complications ; pathology ; prevention & control ; therapy

The changed process of bioenergy and the effects of electrode interfering on penicillin-induced epileptic brains in epileptic seizures rats were investigated. Fifty Sprague-Dawley (SD) rats were randomly divided into 4 groups, i. e. normal saline control group (group A), penicillin model group (group B), metal electrode interfere group (group C) and insulated electrode interfere group (group D). The epileptogenic potential and the expressions of the beta subunit of-ATP synthase( ATP5B) in hippocampal neurons were measured. The epileptogenic foucus potential and expressions of ATP5B in hippocampus neurons showed that the trend increased at first and decreased implantation of later, and the implantation of metal electrodes decreased the epileptogenic foucus potential at corresponding time point, but had no effect on the expressions of ATP5B. The change of epileptogenic focus potential was reduced by implantation of metal electrode, possibly due to the alteration of corrosponding bioenergy metabolism which had participated in the process of epileptic seizure.
Animals ; Electrodes ; Energy Metabolism ; Epilepsy ; chemically induced ; enzymology ; physiopathology ; Hippocampus ; enzymology ; Male ; Mitochondrial Proton-Translocating ATPases ; genetics ; metabolism ; Penicillins ; Rats ; Rats, Sprague-Dawley

Through analyzing the current situation of clinical comprehensive evaluation researches of domestic medical products from 2013 to 2023， it is found that there is a phenomenon of “four more， four less”. Specifically， there is a greater emphasis on conducting research on drug clinical comprehensive evaluation， but fewer comprehensive evaluation opinions provided； more research data come from publicly available information， but fewer derived from real world； more options for similar reference drugs， but less pre-defined research on reference drugs； the research process involves more steps， yet there are fewer studies strictly implementing quality control. Based on this， suggestions are proposed in three aspects： improving the quality of clinical comprehensive evaluation of medical products， enhancing the transformation and dissemination of results， and improving the standardization of clinical comprehensive evaluation of medical products. Regarding the current state of clinical comprehensive evaluation research on Chinese patent medicine， reflections are presented on elevating original research evidence and highlighting the characteristics and advantages of Chinese patent medicine， so as to promote better transformation and application of the results of clinical comprehensive evaluation of medical products.