Objective To investigate characteristic skin lesions and typical histopathological changes of adult-onset Still's disease(AOSD) for its early diagnosis and treatment.Methods Clinical data were collected from 8 patients with AOSD,and analyzed retrospectively.Results All the patients had transient rashes and persistent papules/plaques during the course of disease.Of the 8 patients,1 had urticaria-like rashes,3 had dermatomyositis-like rashes,and 1 had prurigo pigmentosa-like rashes.Biopsies were carried out at the sites where transient rashes or persistent papules/plaques occurred.Histopathological findings showed necrotic keratinocytes in the upper prickle cell layer,and perivascular infiltration of neutrophils and lymphocytes in the upper dermis.Conclusion The skin lesions and histopathological changes of AOSD are characteristic,which can provide clues to the early diagnosis of AOSD.

Objective To investigate the effect of propofol on nNOS expression after focal cerebral ischemia-reperfusion in rats and the possible mechanism of protective effect of propofol on brain. Method Seventy-eight male Wistar rats, weighting 250 ~ 300 g, were randomly divided into 3 groups:(1)Sham operation group (S group, n=6) was performed with scham operation; (2) Ischemia-reperfusion group (group I-R, n=36) was subjected to 2-hour right middle cerebral artery occlusion and then reperfusion was followed, saline (1 mg/kg) was injected into the right lateral cerebral ventricle using microsyringe before reperfusion;(3) Propefol group (group P, n=36) was injected with propofol (1mg/kg) into the right lateral cerebral ventricle using microsyringe right after ischemia. Group I-R and group P were divided into 3 subgroups according to the reperfusion time: 1 h, 3 h and 6 h. The neurological function of all rats were tested before reperfusion. The cerebral infarction area of the whole brain was calculated with TIC staining (n=6). The pathological change of brain was observed from HE staining (n=6) and the nNOS protein expression was obtained by immuno- histochemical method (n=6). Results Compared with I-R group, the neurological function was better in group P(P

Objective To study the expressions of keratin 10, 14 and 17 (KI0, K14, K17) in psoriatic lesions before and after the treatment with acitretin. Methods Thirty patients with moderate or severe plaque psoriasis were included in this study. The cohort consisted of 19 males and 11 females with an average age of 33.9 years, and disease course of 4 months to 30 years. Patients were treated with acitretin for 8 weeks which started with an initial dose of 20 mg per day for 1 week, then switched to 0.5-0.75 mg per kilogramme of body weight per day until symptom improvement, finally maintained at a dose of 10-30 mg per day. The expression of K10, K14 and K17 was detected by immunohistochemical technique before and after treatment with acitretin. The relationship between the disease severity and levels of keratins was evaluated. Results Prior to the treatment, increased expression of K14 and K17 was observed in lesions of patients along with the decreased expression of K10 compared with the normal controls. After treatment, the expression of K14 and KI7 significantly decreased (both P < 0.01), while that of K10 increased (P < 0.01), and there was still a statistical difference between the patients and normal controls (P < 0.01). A significant decrease was observed in the PASI score of patients (P < 0.01). The changes in the expression levels of K10, K14 and KI7 before and after treatment were somewhat correlated with the clinical course and severity of psoriasis. Conclusions Systemic aeitretin can affect the expression of K10, K14 and K17 in psoriatic lesions, but the extent of changes in their expression is not always consistent with the improvement of clinical manifestations.

AIM and METHODS: The effects of angiotensin II(AngII) on the activation of three transcription factors were investigated by using EMSA and western-blot methods in endothelial cells respectively. RESULTS: The EMSA results showed that AngII stimulation could increase NF-κB, SP-1 and AP-1 activation in ECV304, which suggested that activity changes in these three transcription factors could partly contribute to the dysfunction of endothelial cells.The binding affinity of NF-κB, SP-1 and AP-1 with corresponding oligonucleotides in AngII-treated ECV-304 were respectively 10.98,3.89,1.33 times as large as in control. The nuclear appearance of AngII-activated NF-κB was examined by western-blot, which corroborates our results from EMSA analysis. While as the protein appearance of AP-1 and SP-1 in nucleus, were little higher than the control group. The result of western-blot suggested that AngII-induced EC activation of these three transcription factors maybe mainly due to the enhanced binding ability to its corresponding cis-acting factors. CONCLUSION: NF-κB, a ubiquitously exposed nuclear transcription factor, is involved, together with SP-1,AP-1, in the regulation of endothelial cell dysfunction related to cardiovascular diseases such as atherosclerosis and hypertension.

Objective To analyze the prevalence,risk factors of kidney disease in type 2 diabetic patients with KDIGO classification of chronic kidney disease,also to study cardiovascular and cerebrovascular diseases and death in these patients,so as to investigate the significance of the KDIGO classification system.Methods One thousand six hundred and forty-five type 2 diabetic patients who were in hospitalization from June 2008 to December 2012 were grouped according to the KDIGO classification of chronic kidney disease and the incidence of vascular disease was analyzed based on the classification.Clinical features were compared between patients with or without kidney disease.The risk factors of kidney disease and the death of diabetic patients were also investigated.Results There were 915 male and 730 female,aged a median (57.86±12.54) years with (6.35±6.30) years duration of diabetes mellitus among the 1645 cases,and 37.2％ of patients had concomitant kidney disease.According to the classi fi cation of CKD,patients in CKD group 3a,group 3b and CKD group 4-5 accounted for 5.7％,3.5％ and 7.6％,while 33.4％ of patients had proteinuria,among which 19.5％ with microalbuminuria,13.5％ with macroalbuminuria.On complications,patients with hypertension accounted for 49.5％,hyperlipidemia 67.7％,diabetic retinopathy 27.4％,cardiovascular and cerebrovascular diseases 18.5％ (coronary artery disease 16.5％,cerebrovascular diseases 8.8％).Statistical difference was detected in the incidence of diabetic retinopathy,coronary artery disease and cerebrovascular diseases between CKD group 3a and 3b (P ＜ 0.05).The duration of diabetes,concomitant hypertention especially with elevated systolic blood pressure,diabetic retinopathy and hyperuricemia were the independent risk factors for type 2 diabetic patients with kidney disease.Age,Scr,complicating cardiovascular and cerebrovascular diseases and advanced CKD stage were the independent risk factors for the death of type 2 diabetic patients with kidney disease.Conclusion KDIGO classification of chronic kidney disease enables better staging of kidney diseases in diabetic patients for management and prognosis.Diabetic patients have a higher prevalence of renal diseases and cardiovascular and cerebrovascular events than the general population.Early control of factors such as blood pressure and serum uric acid can delay the progression of kidney disease,and the predictive role of diabetic retinopathy should be emphasized.

?AlM: To observe the effect of Qingguang'an on elastic fiber, MMP-7, TlMP-1 in scarring area of filtration canal after glaucoma surgery through the four Qingguang'an effective groups and Qingguang'an granules, to discuss and compare their mechanism of action on scarring area of filtration canal.?METHODS:Four effective components of Qingguang'an were used in groups D, E, F, G and H after glaucoma surgery, compared with group A ( blank ) , group B (model) and group C ( MMC) to observe the effect of elastic fiber, MMP-7, TlMP-1 in scarring filtration canal.?RESULTS:Compared with the preoperative basic lOP and 2d , 1, 2, 4wk postoperative lOP of groups C, E and H, the lOP of three group rose up slower than other groups, and kept the lowest data at 28d. There was significant difference compared with the rest of A, B, D, F, G groups (P<0. 05). The area and density of elastic fiber in surgery group were significantly different with that of black control group ( P<0. 05 ), but there were no statistical differences between groups C and H, groups C and F, groups H and E (P>0. 05). The difference was statistically significant among other groups (P<0. 01).?CONCLUSlON:The scarring area of filtration canal after glaucoma surgery is the major reason which lead to the failure of surgery. Qingguang'an effective group 2, Qingguang'an granules and MMC could reduced the scar tissue by restrained the elastic fiber, TlMP - 1 and increased the MMP-7. By observing the experimental results that both Qingguang'an effective group 2 and Qingguang'an granules could restrained the scarring area of filtration canal, the effects were unbiased, Qingguang'an granules group is better than effective group 2.

Objective To investigate and assess the clinical effect of treatment of children′s fractures at distal radial or radial-ulna through incision and Kirschner wire′s interior fixation without coursing epiphysis.Methods The treatment of children′s fractures at distal radial or radial-ulna in our hospital between 1996 and 2005 were reviewed,91 cases via Kirsehner-wire′s internal fixation were dealt.According to the way of placing Kirschner wire,the patients were divided into 2 groups.Group A of 53 cases eschewing epiphysis and passed bone-cortex.Group B of 38 cases got intramedullary fixation and passed epiphysis for 38 cases.After 6-100 months′ follow-up investigation,the 2 groups were comporred by analyzing statistics and the number of cases which involved repeatedly setting of Kirschner wire during operation,anatomical restoration,replacement,Kirschner-wire moving,infection,wrist′s dysfunction and bridge between the epiphysis.Results The fractures in both groups were recovering well.Besides,both were at the low rate of repeated replacement,Kirschner wire moving and infection.However,there were significant differences on repeated setting of Kirschner wire during operation,wrist′s dysfunction and bridge between the epiphysis,of which group B were higher than those in group A.Conclusions While the children′s fractures at distal radial or radial-ulna will be reduced by incision and fixing with Kirschner wire,the way of eschewing epiphyses and passing bone-cortex is better because it accords with anatomic character of children.It can not only fix reliably and bring satisfying clinical treatment effect,but also cause little complication.Thus,it is superior to the way of intramedullary fixation and passed epihysis.

Diagnosis, Differential ; Esophageal Neoplasms ; pathology ; surgery ; Granuloma, Pyogenic ; pathology ; surgery ; Hemangioma, Capillary ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; pathology

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects

Objective To analyze the impact factors for early renal damage in type 2 diabetic patients by the classification tree model.Methods A total of 601 patients with type 2 diabetes were enrolled.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 2 diabetes group (418 cases) and early diabetic renal damage group (183 cases).The clinical data of the patients were recorded to analyze the main influential factors for the microalbuminuria of type 2 diabetic patients using the Exhaustive CHAID classification tree algorithm.Results Six important explanatory variables were screened out by the classification tree model from the 34 candidate variables related to early renal damage,including fibrinogen,history of hypertension,retinopathy,Cys C levels,SBP and peripheral neuropathy.Elevated fibrinogen was the main factor.Conclusion The classification tree model can analyze the major influential factors of early renal damage in type 2 diabetic patients effectively,and it can help develop the prevention and treatment methods.