A 24-year-old man presented with a 6-year history of pustules,atrophic scars,and alopecia of the scalp.Dermatological examinations showed generalized alopecia and atrophic scarring of the scalp.A few hairs remained at the vertex region with keratotic papules,pustules,or black sears around the hair follicles.There were also residual hairs at the forehead,temples,and occipital region near the hairline.Clusters of hairs were noted in the occipital region,and keratotic papules were observed around the hair follicles.Erythema,scales,and follicular keratotic papules were found in the superciliary arch.The eyebrows and axillary hairs partially shed and were sparse.Follicular keratotic papules were also found on both cheeks,axillae,chest,abdomen,back and limbs.Stomatological examinations revealed a large space between the upper and lower anterior teeth,anteverted upper anterior teeth,congenital absence of (+1) tooth,deep overbite and deep overjet of anterior teeth.He had a fissured tongue which lacked filiform papillae.Pathological examinations of the skin lesionsshowedathickenedspinouslayer andmassiveinfiltrationsof plasmacytes, neutrophils, and multinucleated giant cells around hair follicles.A diagnosis of folliculitis spinulosa decalvans was made based on the clinical manifestations and histopathological findings.

Objective To investigate the change in NF-κB activity in astrocytes in spinal dorsal horn in a rat model of neuropathic pain and the underlying mechanism. Methods Sixteen male SD rats aged 2-3 months weighing 220-280 g were randomly divided into 2 groups ( n = 8 each) : sham operation group (group S) and CCI group. Neuropathic pain was induced by chronic constrictive injury (CCI) . Right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 chromic catgut. In group S the right sciatic nerve was exposed but not ligated. The paw withdrawal threshold (PWT) to von Frey filament stimulation and paw withdrawal latency (PWL) to radiant heat stimulation were measured at 1 d before (baseline) and 7 d after operation. The animals were then killed and the lumbar segment of the spinal cord (L_(4-6)) was removed. The expression of NF-κB in the astrocytes in spinal dorsal horn was determined by immuno-histochemistry. Results PWT and PWL to mechanical and thermal stimuli were significantly decreased after operation as compared with the baseline before operation in group CCI. The number of NF-κBp65 immunoreaction positive cells in the spinal dorsal horn on the operated side was significantly larger in group CCI than in group S. Conclusion NF-κB signal transduction pathway in the astrocytes in the spinal dorsal hom may be involved in neuropathic pain.

Objective: To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors, so as to provide evidences for reducing stress and relieving job burnout. Methods: The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to June 2019, to understand the existence of stress and job burnout in surgical residents, and analyze the linear correlation between each dimension of stressors and each dimension of burnout. There were 132 males and 13 females, who were (26.62±1.45) years old, ranged from 22 to 30 years. SPSS19.0 software was used for statistical analysis. The measurement data of normal distribution were expressed as Mean±SD Counting data were expressed by frequency and constituent ratio. Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout. Results: The total score of surgical resident stress was 2.51±0.57. The scores of social factors and workload were higher in each dimension 3.02±0.58 and 3.00±0.62, respectively. The burnout survey showed that 7 residents (4.8%) had severe burnout. In the dimension of emotional exhaustion, there were 14 residents with severe burnout. In the dimension of cynicism, there were 21 residents (14.5%) had severe burnout. In the dimension of reduced personal accomplishment, there were 19 residents (13.1%) of mild burnout and 17 residents (11.7%) of severe burnout. Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated. In particular, emotional exhaustion and workload (r=0.411, P<0.05), reduced personal accomplishment and social factors (r=0.429, P<0.05) had a relatively large correlation coefficient. Conclusions The stress and burnout of surgical residents were at a high level. In order to reduce the stress and relieve the burnout, it is necessary to strengthen the residents′ self-management and improve the social support system.

Objective To investigate the morphologic characteristics of gonococcal inflammation of paraurethral glands in males. Methods Eleven male patients with gonococcal inflammation of paraurethral glands were examined by both real-time ultrasound imaging (Siemens Acuson X300) and 3.0 T magnetic resonance imaging (MRI, Philips Achieva). Results High-frequency ultrasound imaging revealed tubular echoic areas with well-defined borders and smooth margins in all the patients. The inside of these tubular areas was weak-echoic. These tubular echoic areas were blind in one end, but open in the other end, and ran in parallel with the urethra. The mean lumen diameter was 1.1 ± 0.2 mm (range, 0.7 - 1.3 mm) , and the mean lumen length was 8.4 ± 0.6 mm (range, 7.0 - 12.0 mm). Anechoic liquid-filled areas were seen in the tubular echoic areas in two patients. Paraurethral ducts were not detected by 3.0 T MRI in these patients. Conclusions High-frequency ultrasound imaging can clearly show the morphologic characteristics of gonococcal inflammation of paraurethral glands in males, and provide valuable ultrasound images for surgery.

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.

Objective:To investigate the satisfaction degree of surgical resident in standardized training and to explore the existing problems and influencing factors. It provides references for improving the system and quality of standardized training.Methods:The Self-designed Satisfaction scale was used to investigate the satisfaction degree of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2015 to June 2018. There were 108 males (78.8%) and 29 females (21.2%). The mean age was (26.78±1.83) years. The measurement data of normal distribution were expressed as mean ± standard deviation. Counting data was expressed by frequency and constituent ratio. The differences between groups were analyzed by t test and one-way anova.Results:The overall satisfaction score of the surgical residents to the standardized training was 3.71±0.83, among which the residents scored the highest on the working condition (4.12±0.67), while the training effect (3.53±0.85) was the last in all dimensions. The overall satisfaction of third-year residents was lower than that of first-year and second-year residents, and the differences were statistically significant ( F=3.27, P=0.04). The scores of first-year residents in standardized management was higher than that of second-year and third-year residents, and the difference was statistically significant ( F=3.30, P=0.04). The scores of professional degree postgraduate in overall satisfaction, standardized management and research training were higher than those of enrolled resident, and the differences were statistically significant ( P<0.05). The score in enrolled resident (3.78±0.85) was higher than that of professional degree postgraduate (3.44±0.63)in the dimension of salary, and the difference was statistically significant ( P=0.02). Conclusion:Surgical residents expressed satisfaction with the general condition of standardized training, training condition, research training, training effect and postgraduate salary were still need be strengthen.

Objective:To investigate the current situation of job burnout and depression among surgical residents, with a view to reduding or alleviating the burnout and depression of surgical residents.Methods:The job burnout scale and depression scale were used to investigate the burnout and depression of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to January 2019, there were 108 males and 29 females, aged (26.57±1.77) years, and the age ranged from 23 to 28 years. The distribution differences of the incidence of job burnout and depression in gender, time status and the correlation between the three dimensions of job burnout and depression were analyzed. The measurement data were expressed as mean±standard deviation ( Mean± SD). Counting data were expressed as percentage(%). The differences in the distribution of job burnout and depression in gender, time and status were analyzed by chi-square test. Pearson correlation analysis was used to analyze the correlation among the three dimensions of job burnout and depression. Results:Of the 137 surgical residents, 10 (7.3%) had severe job burnout requiring intervention . In the emotional exhaustion dimension, 67 (48.9%) had mild burnout, 53 (38.7%) had moderate burnout, and 17 (12.4%) had severe burnout. In the cynicism dimension, 86 (62.8%) had mild burnout, 37 (27.0%) had moderate burnout, and 14 (10.2%) had severe burnout. In the reduced personal accomplishment dimension, 64(46.7%) had mild burnout, 43(31.4%) had moderate burnout, 30(21.9%) had severe burnout. The results of the depression survey showed that 27 (19.7%) of the 137 surgical residents were depressed. There were no statistically significant differences in the incidence of job burnout in gender, time and status( P>0.05). There were no statistically significant differences in the incidence of depression in gender and status( P>0.05). The incidence of depression was higher among 1-year residents (14, 35.0%) than among 2-year (8, 15.7%) and 3-year(5, 10.9%) residents ( P<0.01). Depression is associated with emotional exhaustion, cynicism and reduced sense of achievement ( r=0.248, r=0.301, r=0.201, respectively, P<0.05). Conclusions:The job burnout and depression of surgical residents are not optimistic. There were differences in the time distribution of depression incidence, among which the incidence of depression is higher among the residents in the first year. The occurrence of depression is positively correlated with three dimensions of job burnout.

Objective: To observe the changes of skin lesion, neuralgia and blood pressure in hypertension patients and non-hyperension patients before and after the early formal treatment on herpes zoster in the head and face. Methods: Clinical data were collected from June 2015 to May 2018 in the Department of Dermatology, the First People＇s Hospital, Changshu, Jiangsu province. In 104 cases of hospitalized patients with herpes zoster, 46 cases had high blood pressure (hypertension group); 58 cases did not have high blood pressure (non-hypertension group). The skin lesion, numerical rating scale (NRS) and blood pressure changes were compared between the two groups before and after treatment. Results: A total of 99 patients completed treatment; 45 cases in the hypertensive group included 25 males, 20 females, aged 35 to 71 (52.40±12.51) years; 54 cases in the non-hypertensive group included 30 males and 24 females, aged 36 to 75 (52.62±12.67) years. There was no statistically significant difference in the time of control, improving and healing of skin lesion (t=-0.457, -0.607 and 1.399, P>0.05) . There was no statistically significant difference in NRS between the two groups before treatment (t=-0.009, P=0.993 >0.05). After treatment, the NRS of both groups decreased compared with those before treatment, and the difference was statistically significant (F=151.130, 181.444, P<0.05). There was no significant difference in NRS between the two groups after treatment (Z=-0.032, -0.154, -0.149 and -0.426, P>0.05). In the hypertension group, the rate of blood pressure increase before treatment was 62.22%, and the blood pressure decreased after treatment compared with that before treatment. The difference was statistically significant (P<0.05). In the non-hypertension group, the rate of increase of blood pressure before treatment was 5.56%, and the blood pressure after treatment was lower than before treatment. The difference was not statistically significant before and after treatment (P>0.05). Conclusions Blood pressure can be increased when herpes zoster occurs. After early formal treatment of herpes zoster, skin lesion healed, neuralgia reduced and blood pressure can return to normal. The history of hypertension and the increase of blood pressurd before treatment has no effect on the recovery of skin lesion and neuralgia.

Objective To investigate the healing degree of lesions of herpes zoster in the head and face and the risk factor of the discosmetic sequelae.Methods 92 case of herpes zoster in the head and face were enrolled in this study.The patients were treated in dermatological clinic of Changshu No.1 People's Hospital from Jan.2017 to Jun.2018.The clinical data were recorded,such as the time of control,improving and healing of lesion,sex,age,position,the time of therapy starting and the behavior of scratching,extrusion and divest crust.The blood glucose and serum albumin of patients were measured.We observed the remained scars and performed statistic analysis.Results In diabetes group,the control and healing time was (2.40±1.28) d and (10.38+2.47) d respectively,meanwhile the control and healing time was (1.72 ± 0.94) d and (8.32 ± 2.66) d respectively in non-diabetes group (P＜0.05).The single factor analysis indicated that the age,position,diabetes,lesion extrusion,divest crust were the correlation factors of the zoster scar in head and face (P＜0.05).Nevertheless the multifactor logistic regression indicated that the position,diabetes and divest crust were independent risk factors of the zoster scar in head and face (P＜0.05).Conclusions The healing of herpes zoster is affected by diabetes.The independent risk factors of zoster scar in head and face are non-trigeminal nerves positions,diabetes and divest crust.

Objective:To study the expression of methyltransferase-like protein 14 (METTL14) in epithelial ovarian cancer and its clinical significance, and to explore the effect of METTL14 expression on the proliferation, invasion and migration of ovarian cancer cells.Methods:Immunohistochemistry (IHC) was used to detect METTL14 expression in tumor tissue samples, and analyze the relationships among METTL14 expression, clinicopathological factors, and prognosis in ovarian cancer. Lentiviral vectors and small interfering RNA (siRNA) were used to up-regulate and down-regulate the METTL14 expression in ovarian cancer cell lines A2780 and SKOV3, respectively. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect the N6-methyladenosine (m6A) content in ovarian cancer cells. Cell counting kit-8 (CCK-8), wound healing assay, and transwell assay were used to examine the function of METTL14 expression in the cells.Results:(1) The IHC score of METTL14 protein was 6.2±3.7 in 20 samples of ovarian cancer tissues and 3.3±2.5 in 15 samples of normal ovarian tissues, and the difference was statistically significant ( t=-2.64, P=0.012). Among the patients who suffered from ovarian cancer, there were 69 cases with high expression of METTL14 protein (IHC score≥6), accounting for 57.0% (69/121), and the cases with low expression of METTL14 protein (IHC score<6) accounting for 43.0% (52/121). Compared with the patients with low expression of METTL14, the patients with high expression of METTL14 had later stages, higher rates of lymph node metastasis, abdominal metastasis, and more ascite amount. The differences were statistically significant (all P<0.05). The overall survival rate was significantly lower in patients with high METTL14 expression than the low expression ( P=0.009). (2) LC-MS/MS data showed that the relative expression of m6A in A2780 and SKOV3 cells in the lentivirus (LV)-METTL14 group were 0.213±0.024 and 0.181±0.018, which were significantly higher than those in the LV-normal control (NC) group (0.109±0.022 and 0.128±0.020; all P<0.05). While the relative expression of m6A in A2780 and SKOV3 cells in the si-METTL14 group were 0.063±0.012 and 0.069±0.015, which were significantly lower than the expression in si-NC group of 0.108±0.014 and 0.121±0.014 (all P<0.05). CCK-8 assay showed that the absorbance values were significantly lower in the si-METTL14 group compared with the si-NC group at 36, 48, 60 hours (all P<0.05); while were significantly increased in the LV-METTL14 group compared with the LV-NC group at 48, 60 hours (all P<0.01). Scratch wound assays showed that the migration rate of the si-METTL14 group was lower than those of the si-NC group, while the LV-METTL14 group were higher than the LV-NC group by 24 hours, the differences were statistically significant (all P<0.01). Cell migration and invasion were detected by transwell migration and invasion assays. After cultivated for 24 hours, the invasion cell number and the migration cell number in the si-METTL14 group were less than those in the si-NC group. While the invasion cell number and the migration cell number in the LV-METTL14 group were more than those in the LV-NC group, respectively. The differences were statistically significant (all P<0.01). Conclusion:Patients with high METTL14 expression have a worse prognosis in ovarian cancer, which may increase the m6A modification of ovarian cancer cells and promote cells proliferation, invasion and migration.