Five groups were assigned to include intrahepatic cholangiocarcinoma ( ICC, n=30 ) , liver cirrhosis (LC,n=30),metastatic carcinoma (MCA,n=30) and 30 healthy subjects.The serum level of GPC3 was measured by a sandwich method of enzyme-linked immunosorbent assay ( ELISA ) and alpha-fetoprotein (AFP) by microparticle enzyme immunoassay (MEIA).The serum levels of GPC3 and AFP were significantly higher than those of other groups (P<0.05).At a cut-off value of 3.5μg/L,the sensitivity and specificity of GPC3 in the diagnosis of HCC was 83.3%and 76.7%respectively.The sensitivity of combined measurement of GPC3 and AFP was better than GPC3 or AFP alone.Detectable GPC3 was significantly correlated with the presence of viral hepatitis markers and tumor size.However there was no obvious difference in tumor thrombi in portal vein ( PVTT), tumor number, age, gender or hepatic function of HCC.Thus,as a sensitive serum diagnostic marker for HCC ,GPC3 may be a good supplement to AFP in differentiating HCC from non-malignant chronic liver diseases and other liver cancers.

Objective To assess set-up errors measured with kilovoltage cone-beam CT (KV-CBCT), and the impact of online corrections on margins required to account for set-up variability during IMRT for patients with prostate cancer. Methods Seven patients with prostate cancer undergoing IMRT were enrolled onto the study. The KV-CBCT scans were acquired at least twice weekly. After initial set-up using the skin marks, a CBCT scan was acquired and registered with the planning CT to determine the setup errors using an auto grey-scale registration software. Corrections would be made by moving the table if the setup errors were considered clinically significant ( i. e. , ＞ 2 mm). A second CBCT scan was acquired immediately after the corrections to evaluate the residual error. PTV margins were derived to account for the measured set-up errors and residual errors determined for this group of patients. Results 197 KV-CBCT images in total were acquired. The random and systematic positioning errors and calculated PTV margins without correction in mm were:a) Lateral 3. 1,2. 1,9. 3;b) Longitudinal 1.5, 1.8, 5. 1 ;c) Vertical 4. 2,3.7, 13.0. The random and systematic positioning errors and calculated PTV margin with correction in mm were:a) Lateral 1.1,0. 9, 3.4;b) Longitudinal 0. 7, 1.1, 2. 5;c) Vertical 1.1, 1.3, 3.7. Conclusions With the guidance of online KV-CBCT, set-up errors could be reduced significantly for patients with prostate cancer receiving IMRT. The margin required after online CBCT correction for the patients enrolled in the study would be appoximatively 3-4 mm.

This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.

China ; Hepatitis B ; epidemiology ; Humans ; Seroepidemiologic Studies

Objective To evaluate the application value of polarized light dermoscopy in the diagnosis of vitiligo and differential diagnosis between vitiligo and other common hypopigmented diseases.Methods Dermoscopic images of lesions of 235 patients with confirmed vitiligo (130 with active vitiligo and 105 with stable vitiligo) were collected from the database in the Department of Dermatology,Xijing Hospital from January 2018 to July 2018,and retrospectively analyzed.Meanwhile,dermoscopic images of amelanotic nevus (151 cases),pityriasis alba (113 cases) and idiopathic guttate hypomelanosis (54 cases) were compared with the dermoscopic images of vitiligo.Chi-square test was used for comparison of rates among groups.Results The prevalence of perifollicular pigmentation,reticular pigmentation,starburst,Tapioca sago and micro-Koebner phenomenon was significantly higher in the patients with active vitiligo than in those with stable vitiligo (x2 =36.5,151.2,13.0,14.9,8.4 respectively,all P ＜ 0.05).The prevalence of perifollicular pigmentation,perilesional hyperpigmentation,perifollicular telangiectasia,leukotrichia was significantly higher in patients with stable vitiligo than in those with active vitiligo (x2 =91.2,166.0,54.3,41.1 respectively,all P ＜ 0.05).The prevalence of residual perifollicular pigmentation was significantly higher in patients with active (89.2％,116/130) or stable vitiligo (54.3％,57/105) than in those with amelanotic nevus (20.5％,31/151,P ＜ 0.05),pityriasis alba (12.4％,15/113,P ＜ 0.05)or idiopathic guttate hypomelanosis (9.3％,5/54,P ＜ 0.05).Conclusion Residual perifollicular pigmentation could serve as an important feature for distinguishing vitiligo from achromic nevus,pityriasis alba and idiopathic guttate hypomelanosis,and polarized light dermoscopy shows good value in the differential diagnosis between vitiligo and some hypopigmented diseases.

Objective:To investigate dermoscopic manifestations and features of melanonychia.Methods:A retrospective analysis was carried out on dermoscopic images of 4 common types of melanonychia collected in Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from January 2016 to July 2020.Results:A total of 266 cases of melanonychia were collected, including 64 (24.1%) of subungual melanoma, 52 (19.5%) of nail matrix nevi, 89 (33.5%) of subungual hemorrhage, and 61 (22.9%) of onychomycosis. Subungual melanoma and nail matrix nevi mostly occurred in the fingernails. To be specific, subungual melanoma most frequently occurred in the thumbnails (62.8%) , while nail matrix nevi mostly involved the 2 nd - 5 th fingernails (73.9%) . Subungual hemorrhage and onychomycosis mostly occurred in the toenails, and there were 51 (57.3%) cases of subungual hemorrhage of the toenails and 46 (75.4%) cases of onychomycosis of the toenails. Subungual melanoma mostly occurred in patients aged over 40 years (49 cases, 76.8%) , while the other 3 types of melanonychia mostly affected patients aged under 40 years. Dermoscopic manifestations of subungual melanoma mainly included regular longitudinal bands (35 cases, 54.7%) or irregular bands (25 cases, 39.0%) whose width was greater than 3 mm in 87.5% cases, Hutchinson sign (36 cases, 56.3%) , and ruptures (15 cases, 23.4%) which mainly were black-brown in color; dermoscopic manifestations of nail matrix nevi mainly were a single regular pigmented band (52 cases, 100%) whose width was less than 3 mm in 36 (69.2%) cases, and Hutchinson sign (26 cases, 50%) , while no ruptures were observed in nail matrix nevus lesions; subungual hemorrhage dermoscopically manifested as diffuse macules (74 cases, 83.1%) , and globular dark red or black hemorrhagic structures were observed in 85 (95.5%) cases; fungal melanonychia was dermoscopically characterized by irregular dark brown longitudinal bands (54 cases, 88.5%) . Conclusions:Subungual melanoma was dermoscopically characterized by regular longitudinal bands with a width of greater than 3 mm, nail matrix nevi by regular longitudinal bands, subungual hemorrhage by diffuse macules, and onychomycosis by irregular longitudinal bands. Dermatoscopy can be used to identify melanonychia lesions and provide a basis for auxiliary diagnosis of subungual melanoma.

Objective:To document the clinical efficacy of using electrical stimulation to guide acupuncture on the peroneal longus and the peroneal brevis of patients with functional ankle instability (FAI).Methods:Seventy FAI patients were randomly divided into an observation group and a control group, each of 35. Both groups received routine balance function training, proprioception training and manual activation of the peroneal muscles. The observation group also received acupuncture at the motor points of the peroneal longus and the peroneal brevis muscles under the guidance of electrical stimulation, once a day, for 3 weeks. Before and after the treatment, any curative effect was quantified using the CAIT ankle instability assessment questionnaire, electromyography (iEMG) of the peroneal longus and the peroneal brevis, as well as those muscles′ excitation times during simulated varus walking.Results:All of the measurements after the treatment were significantly better than before the treatment, with the improvements in the observation group significantly greater than in the control group.Conclusions:Acupuncture at the motor points of the peroneal longus and the peroneal brevis under the guidance of electrical stimulation can effectively activate the related muscles and relieve the symptoms of functional ankle instability.

Objective:To investigate the distribution of pathogenic fungi in patients with tinea capitis diagnosed in Xijing Hospital, Air Force Medical University in the past 10 years.Methods:A total of 871 outpatients or inpatients with tinea capitis were collected from the Department of Dermatology, Xijing Hospital from January 2011 to December 2020, and their clinical data and pathogen distribution were retrospectively analyzed. Pearson chi-square test was used to analyze differences in the pathogen distribution between children and adult patients with tinea capitis.Results:Of 871 patients with tinea capitis, 588 (67.5%) were males and 283 (33.5%) were females; 21 (2.40%) were aged less than 1 year, 266 (30.50%) aged 1 - 3 years, 352 (40.40%) aged 4 - 6 years, 187 (21.50%) aged 7 - 12 years, 4 (0.50%) aged 12 - 18 years, and 41 (4.70%) were aged 18 - 74 years. A total of 705 pathogenic strains were isolated from these patients, including 599 strains of Microsporum canis (85.0%) , 52 strains of Trichophyton mentagrophytes complex (7.4%) , 27 strains of Trichophyton tonsurans (3.8%) , and 18 strains of Trichophyton violaceum (2.6%) . Among the pathogenic fungi of tinea capitis, the proportion of Trichophyton violaceum was significantly higher in adults (8.8%) than in children (2.2%, P = 0.048) . Conclusions:In the past 10 years, the patients with tinea capitis in the Department of Dermatology, Xijing Hospital were mainly children aged 1 - 6 yearswhile adults, and adult patients with tinea capitis were uncommon. The main pathogen of tinea capitis was Microsporum canis, followed by Trichophyton mentagrophytes complex.

Objective:To analyze clinical manifestations, histopathological and pathogenic fungus characteristics as well as treatment of 3 cases of disseminated cutaneous alternariosis caused by Alternaria. Methods:Clinical data were collected from 3 cases of disseminated cutaneous alternariosis caused by Alternaria, who were diagnosed in Department of Dermatology, Xijing Hospital from 2019 to 2021, and clinical and histopathological features, fungal culture, strain identification and treatment results were retrospectively analyzed. Results:The 3 patients were aged 55, 41 and 46 years respectively, including 1 male and 2 females. Two patients were previously diagnosed with nephrotic syndrome and 1 with systemic lupus erythematosus. All the patients had a history of taking glucocorticoids and tacrolimus for different durations, and experienced chronic infections. Histopathological examination with hematoxylin and eosin (HE) staining showed double-contour thick-walled spores and knot-shaped thick-walled septal hyphae, but no melanin in skin lesions. Sequencing of the fungal internal transcribed spacer region confirmed that 2 cases were infected with Alternaria alternate, and 1 with Alternaria infectoria. Fungal culture at different temperatures showed that the growth ability of Alternaria markedly decreased at the temperature over 35 ℃. To treat these patients, the dose of tacrolimus was reduced to less than 1/3 of the standard dose, or tacrolimus was switched to other immunosuppressants, and systemic antifungal therapy was also given at the same time. After 7-month treatment, good clinical outcomes were achieved in the 3 patients. Conclusion:Disseminated cutaneous alternariosis is characterized by bilateral hematogenous dissemination and lymphatic distribution in unilateral limbs, and the skin lesions are characterized by verrucous plaques covered with scabs, nodules and/or sinuses.

Objective:To analyze the epidemiological distribution characteristics, influencing factors, and infection rates of pertussis in the population of Henan Province.Methods:From 2022 to 2023, a cross-sectional survey was conducted to investigate the permanent population in Henan Province. Enzyme-linked immunosorbent assay (ELISA) was used to detect anti-pertussis toxin IgG (PT-IgG), analyze the antibody positivity rate (≥20 IU/ml) and median concentration (MC), and estimate the pertussis infection rate based on PT IgG ≥40 IU/ml. The rank sum test was used to compare antibody levels among groups, and the χ2 test was used to compare antibody positive rates and infection rates among groups. Results:A total of 4 810 research subjects were included in this study. The overall positive rate of PT-IgG was 12.10% and MC was 3.04 (0.35, 10.36) IU/ml. There were significant differences both in positive rates and antibody levels of PT-IgG among different regions or age groups (region positive rate: χ2=134.06, P<0.001, MC: H=337.74, P<0.001; age group positive rate: χ2=45.27, P<0.001, MC: H=134.49, P<0.001). Both the positive rate of PT-IgG (25.26%) and MC (8.01 IU/ml) were the highest within one year after completing a full course of vaccination. There were significant differences in positive rates and antibody levels among people receiving different types of pertussis vaccines (positive rate: χ2=12.38, P=0.006, MC: H=17.93, P<0.001). The antibody positivity rate (35.71%) and MC (8.88 IU/ml) of the people who received cell-free pertussis inactivated poliomyelitis influenza type b (combined) vaccine throughout the course were higher than those who received other types of vaccines. The natural infection rate of pertussis was evaluated for individuals aged≥3 years who had no history of pertussis vaccine immunization within the year prior to sampling. With a high vaccination rate, the estimated infection rate of pertussis in the population was 5 757.22/100 000. The infection rates in the 3-year-old (1 940.16/100 000) and 4-year-old (1 765.68/100 000) populations were at a low level among the entire population, reaching their peak at the age of 6 (12 656.71/100 000). Subsequently, although the infection rate continued to decline, it remained at a high level and peaked again at the age of 40-49 years (8 740.39/100 000). There was a statistically significant difference in the estimated infection rate of pertussis among different age groups ( χ2=53.21, P<0.001). Conclusion:The PT-IgG level of pertussis in the population of Henan Province is generally at a low level. The estimated infection rate of pertussis is much higher than the reported incidence rate. A booster dose of pertussis vaccine is recommended at 6 years old.