Objective To report 2 cases of Epstein-Barr virus-associated cutaneous lymphoproliferative disease (LPD) and to evaluate their relationship with chronic active Epstein-Barr virus (CAEBV) infection.Methods The clinical data on, laboratory examination findings in, treatment and therapeutic response of 2cases of LPD were analyzed. Results Both the patients had chronic intermittent fever, lymphadenopathy, recurrent lesions including papules, papulovesicles, necrosis and variola-like scar in light-exposed and unexposed areas. Pathologically, there was a dermal infiltrate of pleomorphic lymphoid cells with the involvement of perivascular area and some subcutaneous tissue. Immunohistochemical staining showed that most of the infiltrating lymphoid cells were positive for CD8, PCR revealed no TCR-γ gene rearrangement, and in situ hybridization for EBV was positive. The copy of EBV DNA was above the normal range in the peripheral blood from both patients. Clinical status was improved after glucocorticoid treatment. Conclusion The biologic behavior of LPD appears to be a chronic and indolent course and is closely associated with CAEBV.

Adult ; Diagnosis, Differential ; Endometriosis ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; pathology ; Lumbar Vertebrae ; pathology ; Magnetic Resonance Imaging ; Spinal Canal ; pathology ; surgery ; Spinal Diseases ; pathology ; surgery

Objective To explore the clinicopathological characteristics as prognostic factors in patients with colorectal signet-ring cell carcinoma. Methods Clinical data of 62 patients of colorectal signet-ring cell carcinoma and 281 patients of colorectal low-differentiated adenocarcinoma were retrospectively analyzed. COX Proportional Hazards Model was used in multivariate analysis. Results Colorectal signet-ring cell carcinoma occurred more frequently in young patients and most of them located in the rectum. Gender, preoperative CEA, pathological type and liver metastasis were not statistically different from low-differentiated adenocarcinoma (X2=0.07,0.04,0.06,1.79,P>0.05).Bowel obstruction, operative modalities, tumor embolism, infiltration depth, lymph node metastasis were statistically different from low-differentiated adenocarcinoma (X2=8.96,75.1,18.5,72.0,7.44,P<0.05). Median survival time was 28 months in patients of colorectal signet-ring cell carcinoma and 49 months in patients of colorectal low-differentiated adenocarcinoma. The difference was statistically significant (X2=12.51,P<0.05). Infiltration depth, lymph node metastasis, operative modalities and postoperative adjunctive therapy were independent prognostic factors based on a multivariate analysis of the COX Proportional Hazards Model. Conclusions The biological malignancy of colorectal signet-ring cell carcinoma is higher than that of low-differentiated adenocarcinoma in colorectal carcinoma. Radical resection and postoperative adjunctive therapy were effective treatment methods.

Objective This study aimed to survey students' satisfaction and cognitive attitude of elaborate course of social medicine to provide a basis for exploring appropriate teaching mode. Methods Purposive sampling was used with questionnaire to survey 646 students who had learned social medicine in 5 universities in Guangdong province. The survey included the social medicine curriculum, teaching situation, students' satisfaction and cognitive attitude of elaborate course of so-cial medicine. Descriptive statistical analysis was used to describe the demographic characteristics and curriculum. The t test and one-way ANOVA were used to compare the means of students' satisfaction and cognitive attitude of elaborate course in different universities, using the test level of 0.05. Results The lecture-based learning was the main teaching mode. 335(52.7%) students thought it necessary to learn social medicine, but only 27.2%of the students(173 students) were interested in social medicine and 65(10.2%) students could take the initiative to read about extracurricular books. Overall satisfac-tion with using network resources of elaborate course in two universities that had university-level elab-orate course of social medicine were (2.78 ± 0.55) and (3.01 ± 0.30) respectively and the difference was statistically significant(t=-3.97,P<0.01). The cognitive attitude of the students in 5 universities with using network resources of elaborate course was (3.09±0.66) and the difference was statistically significant(F=3.70,P<0.01). Conclusion Social medicine teaching has been paid attention to in 5 universities, but there were some common problems: ①putting emphasis on theory and ignoring prac-tice in teaching mode; ②putting emphasis on credit and ignoring effectiveness in learning; ③and putting emphasis on construction and ignoring using in network resources of elaborate course of social medicine.

A research combined trickling filter system and active sludge aeration system was applied in the treatment of industrial wastewater from gas-generating with heavy oil. The wastewater contained both high contents of NH+4-N and mixed hydrocarbons including various PAHs. Its BOD5/COD ratio was less than 0.3 and belongs to recalcitrant, toxic wastewater. The results showed a touch-growth biofilms system was formed on the porous packing material and it played a key role in the decrease of toxicity of the influent. It could also improve the biodegradability of the wastewater.

A laboratory scale combination process of anaerobic baffled reactor(ABR) with sequencing batch reactor(SBR) for treatment of real dyeing wastewater was studied.The effects of operational conditions were investigated.The results demonstrated that removal rates of COD,colour and aniline were 32%~95%,89%~99% and 50%~98%,respectively,the effluents of COD were 30.0 ~97.1mg/L,colour were 8 ~40 times dilution ratio,concentration of aniline were 0.20 ~0.95 mg/L,which could meet the National Discharge Criteria(GradeⅠ) under the operational conditions of HRTs of 24~36 h,organic loading rates of 0.43 ~2.46 kg COD/(m~(3)?d),the influent pH values of 6.5~8.0,ambient temperatures of 20℃~35℃ at the ABR stage and DOs of 2 mg/L,reaction times of 3~10h,settle times of 2 h at the SBR stage.

Objective:To retrospectively analyze the early mortality and related risk factors in adult patients with maintenance hemodialysis (MHD).Methods:Adult MHD patients from 2008 to 2018 were enrolled and divided into training data group and validation data group. In training data group, multivariate logistic regression was used to analyze the risk factors of early death within 120 days after hemodialysis and establish a prediction model. The receiver operating characteristic (ROC) curve was applied to evaluate the prediction ability of the model.Results:A total of 4 885 patients were included. The cumulative mortality within 120 days was 20.97/100 person years, and that within 365 days was 12.25/100 person years. A total of 3 603 patients in the training data group were analyzed. The following risk factors were correlated with early mortality (all P<0.05), including age at start of dialysis over 60 years old ( OR=1.792), non-chronic glomerulonephritis ( OR=2.214), cardio-cerebrovascular disease ( OR=2.695), plasma albumin less than 35 g/L ( OR=1.358), platelet count less than 120×10 9/L ( OR=2.194), serum creatinine less than 600 μmol/L ( OR=1.652), blood urea nitrogen over 30 mmol/L ( OR=1.887), blood phosphorus less than 1.13 mmol/L ( OR=1.783), pulse pressure over 55 mmHg(1 mmHg=0.133 kPa) ( OR=1.656), low density lipoprotein less than 1.5 mmol/L ( OR=1.873), and blood calcium over 2.5 mmol/L ( OR=1.876). Risk prediction model was established. The other 1 282 cases in the validation data group were verified. The area under ROC curve was 0.810, with sensitivity 85.7%, and specificity 62.5%. Conclusion:The mortality rate of adult MHD patients within 120 days after dialysis is high. The established prediction model can effectively predict the risk of early death.

Objective:To explore the relationship between end-dialysis over-weight (edOW) in initial stage of hemodialysis and long-term prognosis in maintenance hemodialysis patients.Methods:The data of initial uremia patients receiving hemodialysis in the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017 were retrospectively analyzed. The end point of follow-up was death or until April 30, 2018. The general data including age, gender, body mass index, primary disease, complications and laboratory indicators of the patients and the related parameters of dialysis from four to twelve months were collected. Kaplan-Meier method was used to analyze survival rate. Cox multivariate regression was used to analyze the relationship between edOW and all-cause mortality and cardiovascular disease (CVD) mortality.Results:A total of 469 patients (300 males, 64.0%) were enrolled, with age of (56.9±17.1)years old. During the follow-up period of (4.1±2.4) years (1.0-10.3 years), 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.1% (45/102). The value of edOW was (0.28±0.02) kg. The patients were divided into edOW<0.28 kg group ( n=292) and edOW≥0.28 kg group ( n=177) according to the mean value of edOW. Kaplan-Meier survival analysis showed that the long-term survival rate in edOW<0.28 kg group was higher than that in edOW≥0.28 kg group (Log-rank χ2=4.134, P=0.043), and the CVD mortality in edOW≥0.28 kg group was significantly higher than that in edOW<0.28 kg group (Log-rank χ2=11.136, P=0.001). Cox multivariate regression analysis showed that high edOW was an independent influencing factor for all-cause death and CVD death in hemodialysis patients ( HR=1.541, 95% CI 1.057-2.249, P=0.025; HR=1.930, 95% CI 1.198-3.107, P=0.007). Conclusion:High edOW in early phase is an independent influencing factor of all-cause and CVD death in hemodialysis patients.

Objective To assess the treatment effects of As_2O_3-PLGA microspheres on VX2 rabbits liver tumor models.Methods Thirty-two New Zealand white rabbits were involved with formation of VX2 rabbits liver tumor models,and randomly divided into 4 groups of 8 each.(a)As_2O_3 plus 0.9% NaCl solution group:3 F co-catheter was plugged into hepatic artery,and then As_2O_3(3 mg/kg)plus 10 ml 0.9%NaCl solution was injected into the tumor through the feeding artery;(b)As_2O_3-PLGA microspheres group :As_2O_3- PLGA microspheres(3 mg/kg)was injected into the tumor through the feeding artery;(c)PLGA mierospheres group:Injection of PLGA microspheres(3 mg/kg)injected into the tumor through the feeding artery;(d) control group:0.9% NaCl solution(10 ml)was injected into the feeding artery.Dual phase helical CT scans were performed the day before treatment,20 days after treatment and finally the rabbits were sacrificed.The sizes of the tumor were measured and followed by histopathological analysis and HE staining.Results The volumes of tumors post operatively of group a,b,c and d were(31.08?11.15)cm~3,(3.82?2.537)cm~3, (13.22?4.665)cm~3 and(115.8?62.01)cm~3 respectively.The most significant treatment effect was available in group b,with more coagulation necrosis and fibrotic tissue formation.Statistical analysis indicated that the treatment effects of group a,b,c were better than that of group d with significant difference which can be also seen between group a and b,group b and c.Conclusion As_2O_3-PLGA microspheres shows rather excellent chemoembolization effects on VX2 rabbit liver tumor model with safely.

Objective: To observe the changes in numbers and degranulation status of local mast cells (MCs) of the complementary acupionts, as well as the concentrations of serum histamine and bradykinin after acupuncture at rat's complementary acupionts of Yanglingquan (GB 34) and Yinlingquan (SP 10), for exploring the mechanisms of the synergistic effect of complementary acupionts. Methods: Using random number table method, 40 Wistar rats were randomly divided into a blank control group (group K), an acupuncture at Yanglingquan (GB 34) group (group A), an acupuncture at Yinlingquan (SP 9) group (group B), an acupuncture at Yanglingquan (GB 34) and Yinlingquan (SP 9) group (group AB), and an acupuncture at points near Yanglingquan (GB 34) and Yinlingquan (SP 9) group (group CD), 8 rats in each group. Group A received acupuncture at Yanglingquan (GB 34); group B received acupuncture at Yinlingquan (SP 9); group AB received acupuncture at Yanglingquan (GB 34) and Yinlingquan (SP 9); group CD received acupuncture at the control points [points 3 mm away from Yanglingquan (GB 34) and Yinlingquan (SP 9) respectively]. Acupuncture was performed at bilateral points in each group. Rats in group K were fixed using the same method as rats in the other 4 groups without acupuncture stimulation. Needles of 0.35 mm in diameter and 40 mm in length were used for acupuncture. Needle handle was connected to the G6805-Ⅱ mode electroacupuncture (EA) device after needling qi was obtained, with sparse-dense wave, frequency of 2 Hz/100 Hz and current of 1 mA to keep the needle handles slightly tremulous while the rats kept quiet. Rats were continuously stimulated by EA for 20 min each time. Experimental interventions were conducted on the 1st, 3rd, 5th and 7th days when the experiment started, for 4 times in total. Specimens from rats in each group were collected 2 h after the 7th day. The levels of histamine and bradykinin in serum were detected by enzyme-linked immunosorbent assay (ELISA). Local tissues of the points were used to prepare cryosections. The changes of MCs were observed after toluidine blue staining. Results: Compared with group K, the numbers and degranulation rates of MCs in group A, group B, group AB and group CD were significantly increased (all P<0.05). The number and degranulation rate of MCs in group AB were significantly higher than those in group A, group B and group CD (all P<0.05). The order of histamine levels from high to low was: group AB >group B > group A > group CD > group K, and the differences were statistically significant (all P<0.05); the levels of bradykinin in group AB, group A and group B were significantly higher than those in group K and group CD (all P<0.05). There was no significant difference in the bradykinin level between group A and group B, nor between group CD and group K (all P>0.05). Conclusion: The number and degranulation rate of MCs of the complementary acupionts are significantly increased after acupuncture at complementary acupionts of Yanglingquan (GB 34) and Yinlingquan (SP 9) of rats, and the serum levels of histamine and bradykinin are increased, which may be one of the mechanisms of the synergism produced by the combination of complementary acupionts.