Female ; Humans ; Hyperkeratosis, Epidermolytic ; pathology ; Infant, Newborn

[Objective] To explore the etiology and pathogenesis of rheumatoid arthritis from the perspective of the theory of Fuxie, so as to more comprehensively understand the rheumatoid arthritis, broaden the thinking of clinical diagnosis and treatment, and improve the clinical efficacy. [Methods] The theory of Fuxie theory was summarized, from the aspects of interpretation, theoretical origin, modern medical knowledge and so on, combined with the regularity of the pathogenesis of the pathogen, the etiology, pathogenesis and treatment of rheumatoid arthritis were discussed. [Results] Fuxie theory is originally derived from Huangdi Neijing, it is considered that Fuxie is divided into exogenous and endogenous Fuxie foxier, etiology of rheumatoid arthritis with hidden pathogenic objective basis, its pathogenesis with hidden pathogenic mechanism, the treatment principle and treatment method by pathogen consistentcy. [Conclusion] Understanding of rheumatoid arthritis, according to the characteristics and development of Fuxie disease transmission rules, can better grasp the nature of the disease, diagnosis and treatment of Fuxie theory of rheumatoid arthritis has important clinical significance, rheumatoid arthritis from Fuxie theory provides new ideas and methods for clinical treatment.

Objective:To analyze the characteristics of immune status in patients with different types of oral lichen planus(OLP). Methods:197 cases of OLP,61 with reticular OLP(ROLP)and 136 with hyperaemia erosion OLP(HEOLP)were included.The im-mune status of the patients were investigated by flow cytometry (FCM)for the expression of CD3 +,CD4 +,CD8 +,CD19 +,CD16 ++56 +and CD4 +/CD8 +cells,and nephelometry for the measurements of IgG,IgA,IgM,C3 and CH50 in peripheral blood.The la-brotary norm was used as the reference and the characteristics of immune status in patients with different clinical characters of OLP were analyzed by SPSS 16.0.Results:CD3 +,CD4 +,IgA and C3 decreased,CD19 +cells,IgG,IgMand CH50 increased in patients with OLP.CD16 ++56 +,CD4 +/CD8 +cells decreased in the cases with ROLP(P<0.05);CD8 +cells decreased in the cases with HE-OLP.CD3 +,CD8 +cells were fewer in HEOLP patients than that in ROLP,CD4 +/CD8 +cells were more in HEOLP than that in ROLP(P<0.05).Conclusion:There are defects of cellular immune function and increase of humoral immune in patients with OLP. The patients with different clinical types of OLP may have different immune fuction changes.

Objective To investigate the expression of p53 up-regulated modulator of apoptosis (PUMA) and p53 protein and relationship with clinicopatbological parameters in human gastric cancers. Methods Primary gastric carcinoma and adjacent normal mucosa were obtained from 84 consecutively enrolled patients undergoing gastric cancer resection at Peking University People's Hospital during the period from April 2001 to May 2003. Immunohistochemistry staining was used to measure the expression of PUMA and p53 proteins both in normal and malignant tissues. Results PUMA expression is significantly weaker in primary gastric carcinoma compared to adjacent normal mucosa (P <0. 01 ). Weak PUMA expression in gastric cancer correlates with depth of tumor invasion ( P < 0. 01 ), advanced pTNM stage ( P < 0. 05 ) and poor overall survival of patients ( P < 0. 05 ). p53 protein expression in gastric carcinoma is significantly higher than adjacent normal mucosa ( P < 0. 01 ). There was a significant negative correlation between the expression of PUMA protein and p53 protein in gastric carcinoma (P < 0. 05 ). Conclusion PUMA expression in gastric carcinoma is significantly lower compared to adjacent normal mucosa. Weak PUMA expression in gastric cancer correlates with depth of tumor invasion, later pTNM stage and poor overall patient survival.

AIM:To compare the effects of alcohol and aqueous extracts from Huiyang shengji gao(HYSJG),a Chinese medicine,on proliferation of human fibroblasts derived from normal and ulcer margin skin.METHODS:Using explant culture techniques,we obtained populations of normal human fibroblast(nHFB)and ulcer marginal fibroblast(uHFB).Alarmar blue assay was used for observing cell proliferation,and flow cytometry for cell cycle analysis.RESULTS:After cultured with aqueous extracts and alcohol extracts of HYSJG for 24 hours,the proliferation rates of the two cell lines were both elevated.For alcohol extract,obvious proliferation-promoting concentrations on nHFB and uHFB were 0.027-0.425 mg/L and 0.027-0.213 mg/L,respectively(P

Chronic pain is a common clinical disease,which brings great burden to the patients.However,the pathogenesis underlying of chronic pain is complicated,which is affected by many factors,such as physiology,psychology and society.Therefore,the treatment of chronic pain has been a problem in clinical practice.Considering its complexity,a single way of treatment usually could not reach satisfactory results,so combination therapy is often used to treat chronic pain at present.The combination therapy includes pharmacological treatment,psychological approaches,interventional treatment,self management and so on.The treatment plans are distinct for different types of chronic pain,even the individual patients with the same kind of pain.The emergence of interdisciplinary rehabilitation programs shed light upon the treatment of chronic pain recent years.This paper reviewed the research on chronic pain treatment,in order to provide theoretical basis for clinical practice.

Based on the character of the molecular structure, the prodrugs of phosphates and phosphonates were divided into two categories. The first is the drug which contained the phosphate group, introducing protected groups to increase lipophilicity and improve bioavailability. The other one is the drug which had no phosphate group, introducing the phosphate group into molecules to enhance the solubility, regulate the distribution coefficient and enhance the drug-like property. This review focuses on the application of phosphates and phosphonates in drug research and development based on improvement of physico-chemical property, drug safety and the pharmacokinetics.

Objective To establish the young rabbit models with gastroesophageal reflux (GER) and observe the effect of erythromycin in different parts of muscle segment (fundus ventriculi and lower esophageal),so as to investigate the variation after destroying the interstitial cells of Cajal (ICC).Methods Forty young rabbits of 8 weeks old were randomly divided into control group(n =20) and experimental group(n =20).In the experimental group,the fun dus ventriculus was partly ligated combined with helicobacter restriction at a level near the pylorus to establish GER young rabbit models.In the control group,the fundus ventriculi and pylorus were dissociated then the abdomen was closed.Four weeks later,10 rabbits from the experimental group and 10 rabbits from the control group were taken,2 lower esophageal segments and 2 fundus ventriculi muscle segments were split in each animal,and the ICC were destroyed at 1 lower esophageal segment and 1 fundus ventriculi muscle segment.The amplitude and frequency of lower esophageal and fundus ventriculi muscle segments were measured by using electrophysiology in vitro.Results (1) After 4 weeks of operation,the GER young rabbit models were successfully established.The data were detected by esophageal pH monitoring,general morphology observation and HE stain.Immunohistochemical staining of specific receptors protein c-kit on ICC showed that the ICC in the experimental group was reduced remarkably,and the morphological characteristics changed.(2) In the control group,the frequency and amplitude of lower esophageal muscle segments were (2.60 ± 0.70) times/min and (3.03 ± 0.59) g,the frequency and amplitude of fundus ventriculi muscle segments were (3.50 ± 0.97) times/min and (5.33 ± 1.09) g;in the experimental group,the frequency and amplitude of lower esophageal muscle segments were reduced to (0.29 ± 0.49)times/min and (0.61 ±0.43) g;the frequency of fundus ventriculi muscle segmens in the experimental group turned to (0.43 ± 0.54) times/min and the amplitude was (1.13 ± 0.41) g,and there were statistically differences compared with those of the control group (t =9.86,8.15,8.29,12.55,all P ＜ 0.05).(3) The influence of erythromycin in the lower esophageal and fundus ventriculi muscle segments:the amplitude after injecting erythromycin of lower esophageal muscle segments in the experimental group was (1.16 ± 0.83) g,the amplitude was significantly different (t =2.35,P ＜ 0.05),while the frequency had no relevance (P ＞0.05);the amplitude of fundus ventriculi muscle segments in the experimental group was (4.20 ± 1.14) g,and the difference was statistically significant(t =4.76,P ＜ 0.05),and there was no statistically more differences in the frequency (P ＞ 0.05).In the control group,the frequency and amplitude of lower esophageal muscle segments were (4.50 ±0.84)times/min and (5.13 ± 0.94) g,the frequency and amplitude of fundus ventriculi muscle segments increased to(5.40 ± 1.43) times/min and(7.50 ± 1.28) g,and the differences were statistically significant (t =3.79,5.78,3.06,6.45,all P ＜ 0.05).(4) The contraction activity of muscle segments after adding the erythromycin was prevented in the lower esophageal muscle segments or fundus ventriculi muscle segmens.Conclusions ICC plays an important role in the animal models of GER;erythromycin promotes the motility of the muscle segments in GER young rabbit models;in the sick models,erythromycin accelerates the gastrointestinal motility via ICC on muscle segments.

Objective:To estimate the probability of N2 lymph node metastasis and to assist physicians in making diagnosis and treatment decisions.Methods:We reviewed the medical records of 739 patients with computed tomography-defined stage Ⅰ non-small cell lung cancer ( NSCLC ) that had an exact tumor-node-metastasis stage after surgery.A random subset of three fourths of the patients ( n =554 ) were selected to develop the prediction model.Logistic regression analysis of the clinical characteristics was used to estimate the independent predictors of N2 lymph node metastasis.A prediction model was then built and externally validated by the remaining one fourth ( n=185 ) patients which made up the validation data set.The model was also compared with 2 previously described models.Results:We iden-tified 4 independent predictors of N2 disease:a younger age, larger tumor size, central tumor location, and adenocarcinoma or adenosquamous carcinoma pathology.The model showed good calibration ( Hos-mer-Lemeshow test:P=0.923) with an area under the receiver operating characteristic curve (AUC) of 0.748 (95%confidence interval, 0.710-0.784) .When validated with all the patients of group B, the AUC of our model was 0.781 (95% CI: 0.715 -0.839) and the VA model was 0.677 (95% CI:0.604-0.744) (P =0.04).When validated with T1 patients of group B, the AUC of our model was 0.837 (95%CI:0.760 -0.897) and Fudan model was 0.766 (95% CI: 0.681 -0.837) (P <0.01) .Conclusion:Our prediction model estimated the pretest probability of N2 disease in computed tomography-defined stageⅠNSCLC and was more accurate than the existing models.Use of our model can be of assistance when making clinical decisions about invasive or expensive mediastinal staging procedures.

Objective To explore the feasibility,safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) beneath the diaphragm.Methods Twentythree consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016.We observed the p erioperative complications and followedup long-term effect.Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation.No serious complications such as massive hemorrhage,biliary fistula and severe pleural effusion,hemopneumothorax occurred in the patients during perioperative period.CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area.Besides,the survival condition was satisfactory during follow-up period of 9-38 months.Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm.