Objective To compare the clinical efficacy of intralesional betamethasone versus triamcinolone acetonide acetate in the treatment of active alopecia areata. Methods A total of 160 patients with active alopecia areata were divided into two groups, test group (n = 100) treated with intralesional betamethasone, and control group (n = 60) treated with intralesional triamcinolone acetonide. Both injections were given once every 3 weeks for 12 consecutive weeks. Results After 12-week treatment, the cure rate, response rate, and total response rate were 60.0%, 32.0% and 92.0% in the test group, respectively, compared to 41.7%, 31.67% and 73.3% in the control group, respectively. A significant increase was observed in the cure rate and response rate in the test group compared with the control group (χ2 = 10.25, 5.06, P < 0.01 and 0.05). During the treatment course, 8 (8%) patients in the test group and 9 (15%) patients in the control group developed localized atrophy of the scalp; 8 (8%) patients in the test group and 3 (5%) patients in the control group developed localized folliculitis; no significant difference was observed between the two groups in the occurrence of adverse reactions (P> 0.05). Conclusion Intralesional use of compound betamethasone injection has a notable therapeutic effect on alopecia areata.

Objective To evaluate the role of spinal sigma-1 receptors in the maintenance of bone cancer pain (BCP) in rats and the relationship with extracellular signal-regulated kinase (ERK).Methods Part Ⅰ Twenty-four female Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups using a random number table:sham operation group (S group,n =4) and BCP group (n =20).BCP was induced by inoculating Walker 256 mammary gland carcinoma cells into the medullary cavity of the right tibia.Four rats were sacrificed on day 10 after inoculation in S group or on day 3,5,7,10 and 14 after inoculation in BCP group,and the L4-6 segments of the spinal cord were removed to measure the expression of sigma-1 receptors by Western blot.Part Ⅱ Forty female Sprague-Dawley rats,weighing 180-220 g,were randomized into 4 groups (n =10 each) using a random number table:sham operation group (S group),sigma-1 receptor inhibitor BD1047 group (BD group),BCP group,and BCP + BD1047 group (BCP + BD group).On day 10 to 14 after inoculation,normal saline 20 μl was injected intrathecally once a day in S and BCP groups,or BD1047 120 nmol/20μl was injected intrathecally once a day in BD and BCP + BD groups.Mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured one day before inoculation,on day 3,5 and 7 after inoculation,and on day 10,12 and 14 after administration.After measurement of MWT on day 14 after inoculation,the rats were sacrificed and the L4-6 segments of the spinal cord were removed to determine the expression of phosphorylated ERK (p-ERK) by Western blot.Results Part Ⅰ Compared with group S,the expression of sigma-1 was significantly up-regulated and peaked on day 10 after operation in group BCP.Part Ⅱ Compared with S group,no significant changes were found in MWT and p-ERK expression at each time point in BD group,and MWT was decreased and p-ERK expression was up-regulated in BCP and BCP + BD groups.Compared with group BCP,after intrathecal injection of BD1047,MWT was significantly increased and the expression of p-ERK was down-regulated in BCP + BD group.Conclusion Spinal sigma-1 receptors are involved in the maintenance of BCP in rats possibly through promoting phosphorylation of ERK.

Objective To provide immunological evidence for clinical transfer of chemical extracted acellular nerve allografL Methods One hundred and twenty-eight BALB/C mice were randomly divided into 4 groups of equal size according to their different treatments:negative contrast group(NC),fresh autograft group(AG),fresh allogeneic nerve group(FN)and chemical extracted aceflular allogeneic nerve group(CEN).Then we implanted various kinds of nerve grafts into the thigh muscle of BALB/C mice in corresponding groups.At 3,7,14,28 days postoperatively,8 mice from each group were killed each time to harvest their spleens,from which T lymphocytes were collected.Theu monoclonal antibodies(CD3,CD4 CD8 CD25,IL-2,IFN-γ, TNF-α)were added into the suspension.Then fluorescence.activated cell sorting(FACS)was used to determine the positive rates of cells combined with the above monoclonal antibodies. Results There were no statistically significant differences between CEN group,NC group,and AG group,but indexes of FN group were significantly higher than those of the other 3 groups at corresponding time points. Conclusion There is no obvious immune reiection of chemical extracted acellular nerve allograft when compared with fresh nerve autograft.

OBJECTIVETo investigate whether programmed death ligand 1 (PD-L1) expressed in the periodontal tissue of chronic periodontitis and the correlativity of PD-L1 and different degrees of chronic periodontitis, provide experience for immunoregulation mechanism, clinical treatment and prognosis of chronic periodontitis.

METHODSGingiva and periodontal tissue of healthy people and chronic periodontitis patients were collected. Based on clinical probing, periodontal tissue were classified into three groups: periodontal tissues of healthy people, periodontal tissue of mild chronic periodontitis, periodontal tissue of severe chronic periodontitis. Fluorescent quantitation polymerase chain reaction was applied to explore the expression of PD-L1 mRNA in the periodontal tissue of the different groups. Western blot and immunohistochemistry method were utilized to test the expression of PD-L1 protein in the periodontal tissue of the different groups. Combining with clinical image data, the relationship between differentially expressions of PD-L1 and different degrees of chronic periodontitis was analyzed.

RESULTSThe relative expression quantity of PD-L1 in the periodontal tissue of the mild chronic periodontitis was significantly higher that of the severe chronic periodontitis (P<0.01). The relative expression quantity of PD-L1 in the periodontal tissue of healthy subjects and severe chronic periodontitis had no statistical significance (P>0.05).

CONCLUSIONThe expression of PD-L1 in the periodontal tissue negativelv regulates inflammatory periodontal tissue damage.

OBJECTIVEWe detected and analyzed the clinical values of total protein (TP), albumin (ALB), globulin (GLB), and ALB/GLB ratio (A/G) of whole unstimulated saliva of healthy people to determine the time of day when saliva composition is relatively stable. We compared the protein concentration and A/G of whole unstimulated saliva of patients with chronic periodontitis with those of healthy volunteers to provide references for diagnostic methods and clinical applications of saliva.

METHODSThe whole saliva of 37 healthy subjects were collected at 8:00, 9:30, 11:30, 13:00, 16:30, and 21:00. Meanwhile, the whole saliva of 24 patients with periodontitis was collected in the morning. Bicinchoninic acid method was used to detect the TP content. Saliva ALB was detected by GF-D800 semi-automatic biochemical analyzer, and the GLB and A/G were calculated. Finally, the results were statistically analyzed using SPSS 19.0.

RESULTSSalivary protein compositions were stable in the morning on an empty stomach. Healthy people: TP, (1 354.35±389.52) µg.mL-1; ALB, (139.55±27.19) µg.mL-1; GLB, (1 211.80±360.73) µg.mL-1; A/G, 0.126 3±0.041 7. Subjects with chronic periodontitis: TP, (2 611.56±231.62) µg.mL-1; ALB, (296.27±17.34) µg.mL-1; GLB, (2 315.69±221.67) µg.mL-1; A/G, 0.156 2±0.017 3. The contents of TP, ALB, and GLB in healthy individuals at different periods within a day showed significant differences (P<0.05), which were mainly reflected in the levels before and after meals. No significant difference was detected in A/G. The concentrations of TP, ALB, and GLB were significantly increased in patients with chronic periodontitis compared with those in healthy volunteers. However, no significant difference existed in A/G.

CONCLUSIONSalivary protein compositions are more stable in the morning than in other periods. Thus, mornings can be set as the time of specimen collection in future research. The concentrations of TP, ALB, and GLB in patients with chronic periodontitis are higher than those in healthy people.

Objective: This study aimed to investigate the inhibitory effects of Brucea javanica oil oral emulsion (BJOOE) on primary liver cancer induced by diethylnitrosamine (DEN). Methods:Rats were randomly divided into the control group, model group, and BJOOE group. Rats were given free access to water. DEN was administered intragastrically to induce liver cancer in rats. Five weeks later, rats were intragastrically administered with BJOOE for five times per week. The rats were killed after 14 weeks. Abdominal aortic blood samples were collected. The contents of ALT, AST, ALP, γ-GT, and AFP of serum were detected by an automatic biochemical analyzer. The liver index, spleen index, thymus index, and changes in liver cancer nodules of the surface were observed in rats. Changes in the number of liver cancer nodules of the surface were detected by imaging. Results:Compared with the control group, the liver index, spleen index, and number of nodules of the model group significantly increased, whereas the thymus index significantly decreased (P<0.01). The levels of ALT, AFP, AST, ALP, andγ-GT of serum in the model group were significantly higher than those in the control group (P<0.01). Compared with the model group, BJOOE significantly reduced the liver index, spleen index, and number of cancer nodules, but increased the thymus index in the liver of rats with cancer (P<0.01). The levels of ALT, AFP, AST, ALP, andγ-GT of serum in rats with hepatic carcinoma significantly improved (P<0.01 or P<0.05). Conclusion:BJOOE could inhibit primary liver cancer, and the underlying mechanisms are complex.

BACKGROUND: Al ogeneic hematopoietic stem cel transplantation is the main method to cure leukemia, but the patients receiving al ogeneic hematopoietic stem cel transplantation stil have to face the risk of recurrence. Myeloid sarcoma is a rare extramedul ary relapse mode with worse clinical outcomes, so it is necessary to understand the characteristics of myeloid sarcoma and relative treatment methods. OBJECTIVE: To analyze the clinical characteristics and treatment methods of myeliod sarcomas in cardio-phrenic angle after al ogeneic peripheral blood stem cel transplantation. METHODS: One case was diagnosed as single myeloid sacoma in the cardio-phrenic angle after al ogeneic peripheral blood stem cel transplantation. The patient underwent surgical resection of the mass, chemotherapy and radiotherapy. The clinical effect, complications and survival situation were observed. RESULTS AND CONCLUSION: The patient suffered from bacteremia, fungal pneumonia and even life-threatening sepsis shock during two courses chemotherapies. Then, the patient received radiotherapy for mediastinum and the myeloid sacoma never relapsed. However, the patient suffered central nervous system leukemia after free of the disease for 25 months. Myeliod sarcoma after al ogeneic hematopoietic stem cel transplantation is rare and its manifestation is changeful. The diagnosis mainly depends on histopathology and immunohistochemistry. Surgery, chemotherapy, radiotherapy, second transplantation and molecular targeted drugs are the choices of treatment strategy. However, the optimal treatment strategy for individual patients remains to be determined.

As one of the most effective and commonly used analgesic methods during labor and delivery,epidural analgesia has been widely accepted in terms of its safety.Neurological complications following childbirth,which are most related to pregnancy and childbirth factors rather than labor analgesia,has not been well studied or recognized in China.Therefore,there are some confusions and misunderstandings of reasons for these neurological complications,and,to a certain extent,have affected the clinical implementation of epidural labor analgesia.This review analyzed the etiology and prognosis of this problem in order to help the clinicians in identifying the risk factors and causes and also to improve clinical awareness,prevention,and management for these conditions.

Objective To investigate the effects of using junior nurses in non-emergency department to take part in the training course of cardiopulmonary resuscitation (CPR) skills based on the defect situational simulation of crisis management. Methods A prospective randomly controlled test method was conducted, 66 junior nurses in non-emergency department newly-contracted in 2016 admitted to the Yuyao City People's Hospital from July 1, 2017 to Augest 30th, they were divided into a control group (n = 32) and an experimental group (n = 34) by random number table method. The nurses in control group received conventional CPR situational simulation teaching method, while the nurses in observation group received the training of using crisis management mode to direct realizing the defect situational simulation. The differences in the nurse team cooperation levels were compared between the two groups. Results After training, the team cooperation scores of the two groups of non-emergency department nurses were all higher than those before the training(control group: 99.78±12.33 vs. 92.34±12.35; experiment group:116.00±12.80 vs. 93.44±10.29, both P < 0.05), and the team cooperation score in observation group was significantly higher than that of control group (116.00±12.80 vs. 99.78±12.33, P < 0.01). Conclusion The defect situational simulation based on crisis management can effectively elevate the levels of CPR skills and team work cooperation in the non-emergency department junior nurses.