Objective To analyze the features of cutaneous lesions and age of onset of tuberous sclerosis(TS).Methods A total of 54 TS patients were recruited;their clinical data were analysed.Results The occurance of facial angiofibromas,periungual fibromas,hypomelanotic macules and shark macules was 72.5%,26%,70%and 48%,respectively,and the median age of onset of these lesions was 7,14,0.2 and 6 years,respectively,with a peak at 1-9,10-19,＜1 and 1-9 years,respectively.Conclusions Cutaneous lesions are commonly seen in TS,and most of them develop early in life.

Objective To investigate the value of ultrasound diagnosing for hydropneumothorax. Methods In a prospective double-blind randomized concurrent controlled trial. 213 patients doubted pneumotborax were exam-ined with CT, senography and conventional radiography. Results In 213 cases, hydropneumothorax diagnosed in 30 hemithoraces of 30 patients by CT,29 hemitboraces by ultrasound and 22 hemithoraces by X-ray. The sensitivity, nega-tive predictive value,accuracy by ultrasound and X-ray were 96.7% vs 73.3% ,99.8% vs 98.0% ,99.8 vs 98.1% respectively(P<0.05), the specificity and positive predictive value of both ultrasound and X-ray were 100%. Ultra-sound surpassed the X-ray in detecting pneumothorax ( McNemar test P<0.025 ). Conclusion If ultrasound is served to detect pneumothorax, it can make up the defects of the methods commonly used cuxrently.

Objective To compare the difference in pharmacokinetics characteristics of vancomycin in cerebrospinal fluid between administration by continuous infusion and interim infusion.Methods Twenty postoperative patients in the Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University admitted into intensive care unit (ICU) to receive vancomycin for prophylaxis of intracranial infection were enrolled, and they were randomly distributed to a continuous intravenous infusion group and a interim intravenous infusion group, each group 10 cases. In continuous intravenous infusion group, the patients received a loading dose of vancomycin (15 mg/kg) by continuous intravenous pump infusion for 1 - 2 hours followed by 30 mg/kg vancomycin in a constant pump infusion rate for 24 hours; while in interim intravenous infusion group, the patients received 15 mg/kg vancomycin administered by intravenous pump infusion for 1 - 2 hours, once every 12 hours. The concentration of vancomycin in the cerebrospinal fluid at different time points was measured by two-dimensional liquid chromatography (2D-LC) method, the parameters of pharmacokinetics were calculated in the two groups, and the adverse reaction was observed.Results The comparison between the ratio of areas under the concentration-time curves (AUC) and minimum inhibitory concentration (MIC) of the continuous and interim groups showed no significant difference (19.7±14.0 vs. 16.1±6.4,P > 0.05). However, in the continuous intravenous infusion group, the drug concentration reached the peak value (0.96± 0.77)μg/mL at 12 hours, and later revealed a plateau concentration 0.91-0.93μg/mL for 12 hours; while in the intravenous infusion interim group, the drug concentration reached the peak value (0.92±0.47)μg/mL at 16 hours, in the later 2 hours declined to (0.84±0.45)μg/mL, and afterwards still had a tendency of persistent declination. In all the patients, no any adverse reaction related to the drug occurred.Conclusion Continuous intravenous infusion and interim intravenous infusion of vancomycin for the postoperative neurosurgical patients without intracranial infection have the similar efficacy of medication, but the former can achieve the peak concentration faster and later the fluctuation of drug concentration in cerebrospinal fluid is smaller than those in the latter.

Objective To explore the role of Janus kinase/signal transduction and transcriptional activation (JAK/STAT) pathway in rat liver damaged by excessive fluorine.Methods Thirty-six healthy Sprague-Dawley (SD) rats were randomized by weight and divided into three groups (6 males and 6 females per group):a control group (drunk water containing NaF ＜1 mg/L) and two fluorosis groups (drunk water containing NaF of 5 mg/L and 50 mg/ L).After 6 months of experiment treatment,the fluorine contents of urine and bone were detected by fluorine-ion electrode method.The rats liver function was determined by automatic blood chemical analyzer.The protein expression of Janus kinase (JAK1),signal transducer and activator of transcription (STAT3),B-cell lymphoma/ leukemia-2 (Bcl-2) and Bcl-associated x protein (Bax) were detected by immunohistochemistry (IHC) and protein imprinting (Western blotting).The activity of superoxide dismutase (SOD),glutathione peroxidase (GSH-PX) and the content of lipid peroxide (LPO) in liver tissue were determined with oxidative stress kit.Results The fluorine contents in the urine and bone in low-[(1.90 ± 0.12)mg/L,(210.37 ± 15.81)mg/kg] and high-dose [(2.20 ± 0.17)mg/L,(222.84 ± 10.21)mg/kg] fluoride groups were higher than those of control group [(1.74 ± 0.11)mg/L;(165.48 ± 10.37) mg/kg,F =33.840,69.149,P ＜0.05];the activity of serum alanine aminotransferase (ALT) and aspartate transaminase (AST) in high-dose fluorosis group [(69.83 ± 11.18),(167.56 ± 50.85) U/L] was higher than those of control group [(42.67 ± 7.07),(126.31 ± 16.76)U/L,F =32.135,4.984,all P ＜0.05];the protein expression of JAK1,STAT3 and Bax (1.56 ± 0.31,1.49 ± 0.49,1.41 ± 0.55) in high-dose fluorosis group were significantly higher than those of control group(1.01 ± 0.11,1.04 ± 0.15,0.87 ± 0.21,F=10.923,5.361,5.009,all P＜0.05),and Bcl-2 (0.61 ± 0.15) was significantly lower in high-dose fluorosis group than control group (1.04 ± 0.17,F =16.017,P ＜0.05);the activities of SOD and GSH-PX [(7.22 ± 0.88),(7.23 ± 2.47)U/mg prot] were significantly lower in high-dose fluorosis group than control group [(9.52 ± 1.51),(12.01 ± 5.16)U/mg prot,F =11.627,4.824,all P ＜0.05],and the contents of LPO [(9.23 ± 2.24)μmol/g prot] was significantly higher in high-dose fluorosis group than control group [(6.09 ± 1.55)μmol/g prot,F =7.457,P ＜0.05].Conclusion JAK/STAT signaling pathway and the oxidative stress,apoptosis may be the pathogenesis of liver damage in chronic fluorosis.

Objective To explore the curative effect of modified closed negative pressure drainage on abnormal abdominal incision. Methods Sity-three patients with abnormal healing of abdominal incision in our hospital from January 2012 to June 2013 were selected as the observation group. Another 50 patients from January to December 2011 were assigned to the control group. The former was treated after debridement with human recombinant surface growth factor and modified closed negative pressure drainage,while the latter after debridement with anti-infection and dressings of ethacridine or gentamicinsolution as well as with infrared therapy. The two groups were compared in terms of the frequency,time and cost of changed dressings,and the healing time of the incisions.Results There was insignificant difference in the cost of changed dressings between the two groups(P>0.05). However,the differences were statistically significant in terms of the frequency and time of changed dressings and the healing time of the incisions(P<0.05). The observation group was significantly superior to the control group.Conclusions Modified closed negative pressure drainage is effective in accelerating the healing in abnormal abdominal incisions,reducing the frequency and the time of changed dressings,and easing the economic burdens of the patients,which is suggested to be popularized and applicable in the pimary hospitals.

Objective To compare the diagnostic performance of multi-contrast atherosclerosis characterization (MATCH) and magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for the detection of IPH with histologic analysis as the reference standard.Methods Thirty individuals were collected in this study.They were diagnosed to have carotid stenosis＞50％ by ultrasound and scheduled for carotid endarterectomy from 2014 to 2015.3 T carotid MR examinations using MPRAGE,MATCH and 3D TOF were performed in these patients.Axial images covered all plaques and centered at the bifurcation of the carotid artery.All image data sets were processed on a semi-automatic software (MRI-Plaque View,VPDiagnostics,US) to analyze the component of IPH for vulnerable plaques.The consistency between MATCH and MPRAGE was analyzed by using Cohen Kappa analysis.Comparison of the two sequences to the pathological results was performed in a similar manner.The sensitivity and specificity of the two sequences were obtained.The SNR,CNR and contrast ratio(CR) of the two regions of interest were calculated and Wilcoxon rank sum test was used to compare the difference between the two methods.Results Among 30 patients,a total of 602 available sections and 95 correponding histology specimens were included in the analysis.When all 602 available sections were included in the analysis,MATCH yielded good agreement with MPRAGE(Kappa=0.773) on the detection of IPH.With pathological specimens as the gold standard,moderate to good agreement was shown for both MATCH and MPRAGE (Kappa=0.778,0.685).The sensitivity and specificity for the detection of IPH was 93.2％ (68/73) and 90.9％ (20/22) for MATCH.For MPRAGE,the sensitivity and specificity was 87.7％(64/73) and 90.9％(20/22) respectively.The difference between MATCH and MPRAGE was statistically significant for SNR,CNR and CR.That is to say,SNR and CNR of MPRAGE were higher than those of MATCH(P＜0.05),while CR of MATCH was higher than that of MPRAGE(P＜0.05).Conclusion Compared to the MPRAGE sequence,MATCH technique demonstrates similar diagnostic performance for the detection of IPH.

Objective To determine the frequency of Th22 cells and expression of their related cytokines in peripheral blood of patients with alopecia areata(AA), to investigate their significance, and to explore the role of T lymphocytes in the occurrence of AA. Methods A total of 38 patients with AA were enrolled from Central Hospital of Minhang District in Shanghai between January 2015 and May 2016, and served as the case group. At the same time, 38 healthy people served as the control group. Peripheral blood samples were obtained from these patients and controls. Flow cytometry was performed to determine the percentage of Th22 cells, and enzyme?linked immunosorbent assay(ELISA)to measure serum levels of interleukin?22(IL?22)and IL?17. Results Compared with the control group, the case group showed significantly increased percentages of Th22 cells, Th17 cells, IL?17+IL?22+CD4+T cells and IFN?γ+IL?22+CD4+ T cells(all P < 0.01), as well as serum levels of IL?22 and IL?17(both P < 0.05). A significant increase was observed in percentages of Th22 cells, Th17 cells, IL?17+IL?22+CD4+T cells and IFN?γ+IL?22+CD4+T cells, as well as serum levels of IL?22 and IL?17, in patients with severe AA compared with those with mild AA, and in patients with active AA compared with those with stable AA (all P < 0.05). Conclusion Th22 cells and their related cytokines may participate in the occurrence, development and prognosis of AA.

Objective To observe changes of the pancreas after limb ischemia reperfusion, and the protective effect of taurine (Tau) postconditioning. Methods Twenty-four male SD rats were randomly divided into control group (Control), limb ischemia reperfusion (LIR) group, and taurine postconditioning (Tau) group (n=8 for each group). Plasma contents of xanthine oxidase (XOD), malondialdehyde (MDA), reactive oxygen species (ROS), superoxide dismutase (SOD), pancreatic amylase (AMS), pancreatic lipase (LPS) and trypsin were detected in three groups. Morphological changes of the pancreas were observed using optical microscopy. The expressions of anti-C/enhancer-binding protein homologous protein (CHOP) in pancreas were analyzed by immunohistochemistry assay. TUNEL staining was performed to estimate the apoptosis of pancre-atic cells. Results Compared with the control group and Tau group, plasma contents of MDA, XOD, ROS, AMS, LPS, and trypsin were significantly increased in LIR group, but the level of SOD was significantly lower in LIR group ( P<0.05). HE staining showed that acinar structure was disrupted , pancreatic lobule gap widened, stromal vascular dilatation and conges-tion were observed in LIR group. The perivascular infiltration of inflammatory cells appeared, islet cells were damaged with irregular islet. The immunohistochemical analysis showed the increased expression of CHOP in pancreas in LIR group than that of Tau group. And the pancreatic apoptosis was enhanced in LIR group detected by TUNEL staining. Conclusion Tau-rine postconditioning can ameliorate pancreatic injury following limb ischemia reperfusion, which may be related to the inhi-bition of oxidative stress, down-regulation of CHOP expression, thereby reducing endoplasmic reticulum stress-induced apoptosis.

In China Medical University,20-teaching-hour electron microscope technique course has been arranged for the undergraduates of Laboratory Medicine.The purpose is to let the students master the specialized skill and essential scientific research ability through studying the relative basic knowledge and operation of the electron microscope.The questionnaire results show that the attitude of students is positive and 83% of them are satisfied in general.This paper summarizes the experiences of the practice.

OBJECTIVEThe platelet membrane glycoprotein (GP) Ia/IIa plays a major part as a primary collagen receptor in platelet function. Previous studies indicated that variations of GPIa/IIa density and function are associated with the 807 C/T polymorphism of GPIa gene in American and Spanish Caucasian populations. This study investigated the correlation between acute coronary syndrome (ACS) and 807 C/T dimorphism of GPIa gene in Chinese of Han ethnicity.

METHODSA case-control study was carried out, including 75 patients with either acute myocardial infarction (AMI) or unstable angina pectoris (UAP), and 65 controls with no history of coronary heart disease, thrombogenic and hemorrhagenic diseases. Genotypes of GPIa were checked by polymerase chain reaction-sequence specific primers (PCR-SSP) technique.

RESULTSThe frequencies of both homozygotes and heterozygotes for T807 allele (TT+TC) were significantly higher in patients with AMI than in controls (62.16% vs 33.85%, P<0.01; odds ratio 3.21). The prevalence of (TT+TC) genotypes was also markedly higher in patients with UAP than in controls (65.79% vs 33.85%, P < 0.005; odds ratio 3.76). There was significant difference in the distribution of (TT+TC) genotypes not only between all patients and controls (64.00% vs 33.85%, P<0.005; odds ratio 3.47) but also between the two subgroups aged <60 years (70.00% vs 38.24%, P<0.005; odds ratio 3.77). However, there was no significant difference in the distribution of (TT+TC) genotypes between patients with AMI and with UAP. Platelet GPIa T807 allele remained significantly associated with AMI and UAP by multiple logistic regression (odds ratio 4.94).

CONCLUSIONThis study suggests a strong association between presence of GPIa T807 allele and ACS. T807 allele can be a marker of genetic susceptibility to ACS.

Aged ; Alleles ; Angina, Unstable ; genetics ; Asian Continental Ancestry Group ; Case-Control Studies ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Integrin alpha2 ; genetics ; Male ; Middle Aged ; Myocardial Infarction ; genetics ; Odds Ratio ; Polymorphism, Genetic