A 36-year-old woman presented with a 3-year history of pruritic erythema and scaling on the trunk and extremities.Dermatological examination revealed ill-defined light pink macules with white lamellar scales on the chest,abdomen and buttocks.Histologically,there was a focal mononuclear cell infiltrate in the superficial dermis,with the epidermotropism of some cells and mild atypia of epidermotropic cells,as well as an interstitial mononuclear cell infiltrate and mild deposition of mucin between the collagen fibers in the middle dermis.CD3 and CD4 were expressed by scattered mononuclear cells infiltrating the upper and middle dermis.Based on these data,the patient was diagnosed with interstitial granuloma fungoides.

Patients with gastrointestinal diseases are more likely to exhibit malnutrition. Nutritional support is needed for those who are with malnutrition or at risk. Nutritional support can be categorized into enteral nutrition and parenteral nutrition. With the widely application of nutritional support,more and more attention has been paid on its role in gastrointestinal diseases. It not only can improve the nutritional status,but also can alleviate the clinical symptoms to some extent and improve prognosis,which makes it a kind of extremely important treatment modality for gastrointestinal diseases. In this article,the advances in study on nutritional support of gastrointestinal diseases were reviewed.

Objective To investigate the application of electronic bronchoscopy in diagnosis of recurrent tracheoe-sophageal fistula of type Ⅲ esophageal atresia. Methods 5 patients were reviewed who were suspected postopera-tive tracheoesophageal fistula recurrence of type Ⅲ esophageal atresia and examined through electronic bron-choscopy combined with injecting Methylene blue into stomach tube from Jan 2010 to Aug 2014. Male to female ra-tio was 4:1. The age was 2~15 months, median age was 7.4 months. Results The 5 cases were found trachea mem-brane fistula by electronic bronchoscope, recurrent tracheoesophageal fistula was diagnosed with Methylene blue in-jected into stomach tube and overflowed from trachea membrane fistula. Examination time is 3~7 minutes, the aver-age is 4.2 minutes. The 5 cases were confirmed by operation. Conclusion Electronic bronchoscopy combined with injecting Methylene blue into stomach tube to diagnose recurrent tracheoesophageal fistula is safe and feasible, the time is short and the diagnosis rate is high.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnosis ; epidemiology ; virology ; Child ; China ; epidemiology ; Female ; Genes, Viral ; Genotype ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; diagnosis ; epidemiology ; virology ; Male ; Middle Aged ; Viral Load ; Young Adult

Objective The light and electron-microscopic examination was utilized to study the tissue from middle ears diagnosed as having tympanosclerosis. The main purpose of this article is to understand the clinicopathologic and electron-microscopic characteristics of 68 patients with tympanosclerosis. Methods The material for histopathologic and electron-microscopic studies were taken from the tympanic mucosa in various localities, especially from the whitish sclerotic masses in the tympanum of the patients with tympanosclerosis, during middle ear surgeries between 2006 and 2008. Specimens were divided into two groups: one group of 68 specimens was fixed and stained for light microscopic study with hematoxylin-eosin; the second group of 12 specimens was viewed in the electron microscope. Results The specimens from tympanic mucosa showed granulation tissue with infiltration of chronic inflammatory cells, and slight fibrosis in the submucosal layer. The histopathology of the plaques after haemaoxylin and eosin staining revealed dense bundles of collagen with hyaline degeneration and scattered areas of calcification. An ultrastructural examination of these specimens revealed fibrocytes that were irregularly shaped, elongated, and degenerating. The osmiophilic cytoplasm contained vesicles and collagen bundles. There were clusters of mitochondria in perinuclear cytoplasm and lots of electron dense calcareous deposits within lysosomes and degenerated mitochondria in fibrocyte cells. Conclusion The histopathologic examinations of tympanosclerosis revealed dense fibrous and collagenous connective tissues, poor in cell, with hyaline degeneration and occasional calcification in the tympanic mucosa. Electron-microscopic studies further revealed marked proliferation of collagen fibers and electron dense calcareous deposits within lysosomes and degenerated mitochondria in fibrocyte cells.

Objective To investigate the distribution of genotypes in chronic HBV infection (CHB) and acute HBV infection (AHB) patients in Shanghai. Methods Sixty-two patients with AHB and 73 patients with CHB admitted to ('hanghai Hospital of Shanghai between 2003 and 2007 were studied. Viral genotypes of all the patients were determined by direct gene sequencing.Meanwhile, epidemiological, clinical and biochemical parameters of all patients were collected. Mean values of different groups were compared by t test while frequency was compared by chi square test. Results The major prevalent genotypes in both AHB and CHB patients were genotype B and C (48.4% vs 51.6% in AHB patients and 26.0% vs 74.0% in CHB patients). The proportion of genotype B was higher in AHB patients compared to CHB patients (P= 0.02). Epidemiological factors and clinical outcomes were not statistically different among patients with different viral genotypes. The proportion of genotype C was much higher in CHB patients compared to AHB patients (P=0.006). The main transmission route of AHB was heterosexual interaction which was 18 out of 62 (29.0%), but in CHB patients, it was prenatal transmission which was 38 out of 73 (52.1%). Conclusions In shanghai, the main HBV genotypes in both AHB and CHB patients are genotype B and C. The proportion of genotype B is relatively high in AHB patients while proportion of genotype C is more common in CHB patients. There is no significant relationship between genotypes and the clinical outcomes of AI-IB patients.

Objective To analyze the expression feature and function of microRNAs in exosomes secreted by leukemia cells (LCEX). Methods The mice leukemia cell line L1210 was taken as the example, and LCEXL1210 was obtained by isolating supernate of L1210 cells through density gradient centrifugation. MicroRNAs isolated from LCEXL1210 were analyzed by microarray analysis, compared with miRNA from L1210 cell line, and then some of miRNAs with different expression were verified by real-time PCR and were analyzed by Gene Ontology (GO) database. Results The number of miRNAs identified in LCEXL1210 was 1 044, and that in L1210 cell line was 872. The number of shared miRNAs between LCEXL1210 and L1210 cell line was 732, accounting for 70.1 % of LCEXL1210 and 83.9 % of L1210 cell line, respectively, which indicated that 70 % of LCEXL1210 was derived from the parental cells. Interestingly, 312 miRNAs in LCEXL1210 were found to be underrepresented in the parental cells, indicating their specificity in LCEXL1210. Some miRNAs were significantly highly expressed in LCEXL1210 compared with those in L1210 cell line, including miR-16-1, miR-210, miR-195 and so on, which showed that miRNAs isolated from LCEXL1210 were differentially expressed with those from the parental cells. Some differentially expressed miRNAs from LCEXL1210 were verified by real-time PCR, and then were analyzed by GO database, which demonstrated that these highly expressed miRNAs participated in the processes of various biological function and signal transduction. Conclusions MiRNAs isolated from LCEXL1210 show a high similarity to miRNAs isolated from L1210 cells, whereas of which one-third are specific. The highly expressed miRNAs participate in the processes of various biological function and signal transduction.

Objective To compare the spine intensity modulated radiation therapy (IMRT) and the conventional radiation therapy on the beagle spinal cord neurons,in order to prove the biological safety of IMRT of the spinal cord.Methods Twelve selected purebred beagles were randomly divided into 2 groups.A beagle clinical model of tumor was mimiced in the ninth and tenth thoracic vertebrae.Then the beagles were irradiated by 2 different models of intensity modulated radiotherapy and conventional radiation therapy,with the total irradiation doses of 50 and 70 Gy.The samples of spinal cord were taken out from the same position of the nine and tenth thoracic vertebrae at the third month after radiation.All the samples were observed by the electron microscope,and the Fas and HSP70 expression in spinal cord neurons were evaluated by immunohistochemistry method.Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spinal cord.Results The neurons in the spinal cord of IMRT group were mainly reversible injury,and those in the conventional radiation therapy were mainly apoptosis.Compared with the conventional radiation therapy group [50 Gy group,(7.3±1.1)% ;70 Gy group,(11.3 ±.4)%],the apoptosis rate of the spinal cord neurons of the intensity modulated radiotherapy group[50 Gy group,(1.2 ±0.7)%;70 Gy group(2.5 ±0.8)%] was much lower[(50 Gy group,t＝0.022,P＜0.05;70 Gy group,t＝0.017,P＜0.05)].The expression levels of Fas in the IMPT group(50 Gy group,4.6 ±0.8;70 Gy group,7.4 ±1.1)were also much lowerthan those in the other group(50 Gy group,15.1 4-6.4;70 Gy group,19.3 ±7.6.50 Gy group,t＝0.231,P＜0.05;70 Gy group,t:0.457,P＜0.05),while the expression levels of HSP70 in the IMPT group(50 Gy group,9.1 ±0.8;70 Gy group,7.3±1.4)were much higher than those in the conventional radiation therapy group(50 Gy group,2.1 ±0.9;70 Gy group,1.7±0.3;50 Gy group,t＝0.153,P＜0.05;70 Gy group,t＝0.223,P＜0.05).The expression of Fas/HSP70 was positively correlated with the apoptosis rate of the spinal cord neurons(r＝0.996,t＝1.14.P＜0.05).Conclusions The late radiotherapy response of the spinal cord neurons was obviously observed on the third month.Comparison of the morphology and apoptosis rate of the spinal cord neurons after radiotherapy,the expression of Fas and HSP70 indicated that the biological safety in the 1MRT might be much better than that the conventional radiation therapy.

Objective To assess the effectiveness of treatment of meniscal injuries of knee joints by arthroscopy.Methods 33 patients 35 joints were followed up and the parts,types and treatment under arthroscopy were analysed.Results 33 patients were followed up from six months to six years,the mean preoperative Lysholm score was 60.5 points,and the mean postoperative one was 86.7 points.Conclusion The advantage of treating meniscal injuries by arthroscopy was the result of correct examination and little wound of arthroscopy operation,and arthroscopic repair or partial menisectomy could effectively restore the function of the injured knee.

Objective To explore the effect of transplanting poly (lactic-co-glycolic acid) (PLGA) scaffolds seeded with neural stemcells (NSCs) and Schwann cells (SCs) on spinal cord injured rats and the mechanism. Methods NSCs and SCs were cultured in vitro andthen seeded into the directional PLGA scaffolds. Then PLGA-cell complexes were implanted into the spinal cord hemisected rats, whichwere divided into PLGA group, PLGA+NSCs group and PLGA+ NSC+SCs group. The rats were tested with cortical motor evoked potentials(CMEPs) and Basso-Beattle-Bresnahan (BBB) score. Then, the rats were further ipsilaterally or contralateral hemisected at T6 and testedwith CMEPs and BBB score again. Results The incidence of recovery and the amplitudes of CMEPs were the highest in PLGA+NSCs+SCs group. The rats exhibited a gradual improvement in hindlimb locomotor function in score. The BBB score was the least in the PLGAgroup in the 2nd week or later. After retransected ipsilaterally, the CMEPs disappeared again and the BBB score improved quickly. But afterretransected contralaterally, the rats were completely paraplegia. Conclusion The directional PLGA scaffolds seeded with NSCs and SCs facilitatethe recovery in spinal cord injured rats, which may associate with axonal regeneration and functional connections, but play a limitedrole.