Objective To characterize the natural history of psoriasis vulgaris.Methods A retrospective study was carried out.Totally,245 patients admitted to hospitals within three months after the first episode of psoriasis vulgaris were selected from 1136 patients with psoriasis vulgaris who had been followed up for more than 20 years.Changes in disease severity during the long-term follow-up were traced,and information on the shape and distribution of skin lesions,family history,use of anticancer drugs,vitamins and traditional Chinese medicines was collected and analyzed.SPSS13.0 software package was utilized to assess factors associated with the evolution of psoriasis vulgaris.Results The natural course of psoriasis vulgaris could be classified into six types:immediate healing,slow healing,intermittent relapse,frequent mild relapse,frequent moderate relapse,and frequent severe relapse.The immediate healing type and slow healing type amounted to 30％ of these patients,and the frequent severe relapse type to less than 10％.Statistical analysis revealed that the clinical severity of psoriasis was associated with the age of onset and family history,and was negatively correlated with the use of anticancer drugs.Conclusions The long-term follow-up study reveals the natural course of psoriasis vulgaris,which may be helpful in guiding the prediction of prognosis,prevention of recurrence and selection of treatment.

Objective To explore the clinical manifestations, electroencephalographic characteristics and therapeutic effect of drugs in children with Jeavons syndrome. Methods The clinical and electroencephalographic characteristics and thera-peutic effect of drugs were analyzed in 4 children with Jeavons syndrome. Results Among the four children there were 3 female and 1 male. The age at the onset of the disease was from 1 to 6 years. The typical clinical manifestations of this disease were brief, fast and repeated eyelid myoclonia (EM) with or without absence seizure. The typical electroencephalography (EEG) in two patients showed 3-6 Hz generalized spike and waves and polyspikes burst, and the eye closure and intermittent photic stimu-lation helped to induce discharges and clinical events. The typictal EEG in the other two patients showed 3.0-3.5 Hz generalizedδslow wave rhythm burst. The drugs of choice for treatment was sodium valproate monotherapy in two cases, levetiracetam in one case, sodium valproate combined with levetiracetam in one case. During the follow-up, seizures were controlled in one case, decreased in frequency in two cases and were still frequent in one case. Conclusions Jeavons syndrome is one of the idiopathic and generalized epileptic syndromes and characterized by EM with or without absence seizure. Video EEG monitoring plays an important role in the diagnosis of this disease. Sodium valproate and levetiracetam were effective for this disease.

Objective To observe the effect of the different bore diameter membranes on technological parameters of Radix Polygoni Multiflori Granula and to optimize the process of membrane filtration.Methods Three different membranes were tested under different parameters of operation to observe the changes in membrane flux and the content of effective components by Radix Polygoni Multiflori Granula.Results The membrane(50 nm)had the great flux,the transfering rate of stilbene glucoside was the highest;The optimum conditions:the operation differential pressure was 0.8-1.2 MPa;The operation temperature was 50-60 ℃;the membrane surface flow rate was 3.0 m/s.When the volume of filtration solution was condensed to 1/10 of former,entering the same volume deionized water into it,and when the effective components transfering rate reached 80%,the filtration was finished.Using the strong acid and strong alkali to wash it in turn,the flux could revive above 90%.Conclusion It can be obtained a good result that adopts the technology of ceramic membranes microfiltration to refine Radix Polygoni Multiflori Granula.This can provide the foundation for the application of ceramic membrane microfiltration in the refinement of water extraction of other Chinese materia medica.

AIM:To observe the influence of the different bore diameter ceramic membranes on the processing parameters of Jinlida Granules(Radix et Rhizoma Salviae miltiorrhizae,Radix Sophorae flavescentis,Rhizoma Polygonati,etc.) and optimize the process of membrane filtration. METHODS: Three different membranes were tested to observe the changes in membrane flux and the content of effective components by Jinlida Granules extract. RESULTS: The 50 nm membrane had the great flux,the transfer rates of matrine and salvianolic acid were the highest;The optimum conditions: the operation differential pressure was 0.08～0.12MPa;the operation temperature was 50～60℃;the membrane surface flow rate was 3.0 m/s.When the volume of filtration solution was condensed to one tenth,adding the same volume aeionized water,and the effective components transfer rate reached 80%.Using the strong acid and strong alkali to wash it in turn,the flux can revivify above 90%. CONCLUSION: Applying the ceramic membrane to ultrafiltrate Jinlida Granule is good and useful to herb purification.

OBJECTIVE: To establish a RP-HPLC method for the determination of the content of hesperidin in Yangweishu tablets.METHODS: The samples were separated on octadecyl silane bonded gel silica column(150 mm?4.6 mm,5 ?m) with the mobile phase consisted of methanol-7% acetic acid solution(32∶68) under a detection wavelength of 283nm.RESULTS: The linear range of hesperidin was 49.6～892.8 ng(r=0.999 9) with an average recovery rate of 99.02%(RSD=0.45%,n=9).CONCLUSION:The method is simple,accurate,reproducible and applicable for the quality control of Yangweishu tablets.

Objective To investigate the role of human herpesvirus type 7 (HHV-7) in the development of drug eruptions.Methods Venous blood samples were collected from 35 patients with mild drug eruptions at acute stage,15 patients with severe drug eruptions at both acute stage and remission stage,as well as 50 healthy human controls.PCR was performed to detect HHV-7 DNA in peripheral blood mononuclear cells (PBMCs),and enzymelinked immunosorbent assay (ELISA) to determine the titer of anti-HHV-7 IgM antibody in serum.Statistical analysis was carried out by t test,one way analysis of variance,Chi-square test and q test.Results The detection rate of HHV-7 DNA was significantly higher in these patients with drug eruptions than in the healthy controls (82.00％ (41/50) vs.62.00％ (31/50),x2 =4.96,P ＜ 0.05),different among patients with severe drug eruptions (93.33％ (14/15)),patients with mild drug eruptions (77.14％ (27/35)) and the healthy controls (x2 =6.32,P ＜ 0.05),higher in the patients with severe drug eruptions than in the healthy controls (q =3.50,P ＜ 0.05),but not significantly different between the patients with severe drug eruptions at acute stage and those at remission stage (73.33％(11/15),P ＞ 0.05).The anti-HHV-7 IgM antibody titer was significantly increased in the patients with drug eruptions compared with the healthy controls ((69.319 0 ± 25.289 7) ng/L vs.(59.785 3 ± 22.438 2) ng/L,t =1.99,P ＜ 0.05),but no significant difference was observed among the patients with severe drug eruptions (74.340 7 ±31.411 2) ng/L),patients with mild drug eruptions ((65.479 1 ± 21.326 1) ng/L) and healthy controls (P ＞ 0.05) or between HHV-7 DNA-positive patients ((63.748 1 ± 27.239 1) ng/L) and-negative patients ((65.580 2 ± 36.258 4) ng/L,P ＞ 0.05).Conclusions Active HHV-7 infection exists in patients with drug eruptions,and may be associated with the development and aggravation of this entity.

Objective To detect the mutations of COL7A1 gene in three cases of dystrophic epidermolysis bullosa pruriginosa (DEBP). Methods Clinical data were collected from 3 patients with DEBP. Skin lesions were obtained from these patients and subjected to transmission electron microscopy. DNA was extracted from the peripheral blood of the 3 patients, their 16 relatives, and 150 unrelated normal human controls, and PCR was performed to amplify all the exons and flanking sequences of COL7A1 gene followed by sequencing.Results The patient 1 and 2 had family history, whereas the case 3 was sporadic. Transmission electron microscopy showed tissue cleavage beneath lamina densa in case 1 and slightly decreased anchoring fibrils in some areas of the lesions in case 1 and 3. Three heterozygous mutations of COL7A1 gene, i.e., c. G6734T, c.G6859A and c. G5318T, which leaded to three amino acid mutations, i.e., p. G2245V, p. G1773V and p. G2287R, were found in patient 1, 2 and 3 respectively. Of them, p. G2245V and p. G1773V were novel mutations. The mutations strictly cosegregated with the phenotype in the patients of family 1 and 2. No mutation was detected in the unaffected parents of patient 3 or the 150 unrelated healthy controls. Conclusions The p. G2245V, p. G2287Rand p. G1773V mutations of COL7A1 gene may be responsible for the phenotype of DEBP in the three cases,and of them, p. G2245V and p. G1773V have never been reported.

Aim To explore the effect of survivin in PC12 cells against injuries induced by cobalt chloride(CoCl_2).Methods PC12 cells were exposed to CoCl_2 at different doses in different time to set up the chemical hypoxia induced PC12 cells injuries model.Cell viability was tested by using cell counter kit-8.Dose-effect(200～1 000 μmol·L~(-1))and time-effect(0～48 h)relationship between hypoxia induced by CoCl_2 and the expression of survivin was evaluated by western blot.Results PC12 cells viability was inhibited significantly by CoCl_2 in a dose and time dependent manners;At the concentrations from 200 to 600 μmol·L~(-1) CoCl_2 for 24 h,survivin expression was upregulated in a dose dependent manner,peaking at 600 μmol·L~(-1) CoCl_2 treatment,exceeding this concentration of CoCl_2,with dose increasing,survivin expression decreased.At the dose of CoCl_2 up to 1 000 μmol·L~(-1),survivin did not express basically;Treatment with 600 μmol·L~(-1) CoCl_2 in different time,within the range of 0～36 h,the expression of survivin enhanced in time dependent manner.But with the extension of time,survivin expression was declining; 17-allylamino-17-demethoxygeldanamycin (2 μmol·L~(-1)),an inhibitor of Hsp90,not only decreased survivin overexpression but also obviously enhanced the injuries of PC12 cells induced by CoCl_2,which didn't damage PC12 cells alone.Conclusion Upregulation of survivin expression may be one of the endogenous defense mechanisms for PC12 cells against chemical hypoxia.

Purpose To explore the value of spectral coronary CT angiography (CCTA) in reducing radiation dose and contrast dose using individualized optimal monochromatic imaging.Materials and Methods Sixty patients with suspected coronary disease were recruited in the study,who were randomly divided into two groups:group A (n=30) using conventional CT protocol with 350 mgI/ml contrast agent;group B (n=30) using low dose spectral CT imaging mode with 300 mgI/ml contrast agent.The images of group A were reconstructed with conventional process,and the images of group B were reconstructed with Optimal CNR to obtain the optimal monochromatic energy images.The images of both groups were transferred to an Advanced Workstation for analysis.Double-blinded method was carried out to qualify the images.CT values of coronary artery segments,as well as standard deviations (SD),the signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) of aortic sinus were measured.Radiation doses and iodine intake were compared between the two groups.The optimal keV distribution in group B was analyzed.Results There was no significant difference for the subjective scoring of image quality,CT value of each coronary artery segment,SD,SNR,and CNR values between the two groups (P＞0.05).The effective radiation dose and total iodine load in group B were less than that in group A (P＜0.05).The optimal energy distribution for group B was 60-75 keV,average at (66.50+3.91) keV.Conclusion Compared with the conventional CT protocol,spectral CT imaging at optimal energy levels combined with iterative reconstruction can effectively reduce the radiation dose and iodine load,and obtain better images than usual protocol.

Objective To explore the application of low dose of radiation combined with low concentration of contrast medium in the energy spectrum CT of the coronary artery angiography.Methods 60 patients with suspected diagnosis of coronary heart disease were randomly divided into A,B two groups,30 cases in each group.Group A with 350 mg I/mL contrast agent,undergoing conventional CT scanning;Group B using 300 mg I/mL contrast agent,the gems energy spectrum CT scanning with low-dose.Two groups both adopted forward-looking heart switch control scanning mode.After scanning,group A reconstructed conventional images of 40% ASiR sequence,group B rebuilded axial surface images of single energy 65 keV and 40% ASiR sequence,all the reconstruction images were introduced to AW4.6 workstations used for analysis.Double-blind subjective rating was done by two experienced doctors to measure CT values and SD of aortic sinus (AS),left main (LMA),the left anterior descending branch proximal (LAD-p),left circumflex branch proximal (LCX-p), right coronary artery proximal (RCA-p)and pericardial fat,AS the noise (SD),to calculate the signal-to-noise ratio (SNR)and contrast to noise ratio (CNR),to calculate the effective doses of radiation(ED)by recording CTDI and DLP,and to record iodine intake.By using two independent samples t test to compare two groups of patients’the effective radiation doses,iodine intake,the average CT value,SD,SNR and CNR.Results The subjective image quality score differences and coronary measuring section CT values between the two groups had no statistical significance.In the aspects of effective radiation dose,group B reduced about 29% compared to group A,the difference was statistically significant.Iodine intake in group B decreased about 16% than in group A.Conclusion In coronary artery CT imaging, spectral scanning with low dose of radiation and reconstruction images with single energy can effectively reduce the radiation dose and iodine intake,at the same time it can obtain the approximate image quality like conventional scanning.