Objective To study the production and distribution of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein 1 (MCP-1) in the skin and sera of patients with psoriasis and their roles in the pathogenesis of psoriasis. Methods Levels of VEGF and MCP-1 in sera were measured using double antibody sandwich enzyme linked immunosorbent assay(ELISA) in patients with psoriasis. The expression and distribution of VEGF and MCP-1 in psoriatic lesions, non lesional skin and normal controls were detected by immunohistochemical method. Results ①The expression of VEGF in lesional skin and non lesional skin of psoriasis patients was higher than that in normal controls. Levels of MCP-1 were increased in lesional skin than those in non lesional skin and normal controls.②Serum levels of VEGF were significantly increased in psoriasis as compared with normal control. There was no significant difference in serum levels of MCP-1 between patients and controls.③There was no correlation between the expression of MCP-1 or VEGF of psoriatic lesion and PASI index. Conclusion Overexpression of two cytokines, VEGF and MCP-1, known to promote new blood vessel formation may contribute to the pathogenesis of psoriasis.

Objective To study the association of V249I and T280M polymorphisms of fractalkine receptor CX3CR1 with carotid artery stenosis (CAS). Methods 318 patients with CAS diagnosed using color Doppler ultrasound criteria were studied and compared with 292 subjects without CAS. V249I and T280M polymorphic genotypes of CX3CR1 were determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) and sequencing analysis. Results The genotypes of MM and TM were associated with reduced risk of CAS,the frequency of genotype MM + TM in the two groups being 22. 6% and 31.2% respectively ( OR = 0. 646, 95% CI 0. 451-0. 928, P = 0. 017), the frequency of M allele was significantly lower in patients with CAS than in those without CAS ( 13.8% and 19. 2% respectively, OR = 0. 677, 95%CI 0.499--0. 918,P=0. 010). No differences were observed in the Ⅱ, Ⅵ, or VV genotype, the frequency of genotype Ⅱ + Ⅵ in the two groups being 39. 0% and 43.8% respectively ( OR = 1. 012, 95% CI 0. 731-1. 403 ,P = 0. 940), the frequency of Ⅰ allele was significantly lower in patients with CAS than in those without CAS (28. 6% and 32. 7% respectively, OR = 0. 842, 95% CI 0. 660-1. 076, P = 0. 034). The genotypes of Ⅱ and Ⅵ in patients with stable plaques were more frequent than in vulnerable plaques( OR = 0. 610, 95% CI 0. 387-0. 962, P = 0. 033 ). Multiple Logistic regression analysis revealed that the genotypes of MM and TM were an independent risk factor for CAS ( OR = 1. 847,95% CI 1. 091- 3. 127 ,P = 0. 022). Conclusion The genotypes of MM and TM are independent risk factors for carotid artery stenosis, and the genotypes of Ⅱ and Ⅵ are associated with the stability of carotid artery plaques.

Adult ; Craniotomy ; methods ; Humans ; Male ; Nasal Cavity ; pathology ; Paranasal Sinuses ; pathology ; Skull Base Neoplasms ; surgery ; Teratoma ; surgery

Objective To evaluate advantages and safety of bipolar electrodes for the treatment of submucosal myoma of uterus.Methods Three hundred patients with submucous myoma of uterus were performed with bipolar electrodes under hysteroscope,including 212 cases of type 0 submucous myoma,54 cases of type ?,and 34 cases of type Ⅱ.Results Total volumes of uterine distention fluid used during operation were 500-2000 ml(mean,626 ml);operation time was 20-50 min(mean,25 min);intraoperative blood loss was 10-20 ml.Cardio-cerebral syndrome occurred in one case and was relieved by timely treatment.There was no operation discontinuation as a consequence of pain.The diameters of resected myomas were 3-5 cm,with an average of 3.8 cm.The postoperative diagnosis showed leiomyosarcoma in 1 case and was performed by radical hysterectomy resection combined with a pelvic lymphadenectomy at 10 day postoperatively.During the follow-up period of 1-24 months in 277 cases,40 cases(type I in 12 cases;type II in 28 cases) needed hysteroscope operation again.Conclusions Hysteroscopic resection for submucosal myoma of uterus with dipolar electrodes has advantages of safety,minimal invasion,quicker recovery,higher efficiency,so it is worthy of being recommended.

Objective To explore the clinical effects of hysteroscopy combined with mifepristone on the diagnosis and treatment of abortive remnants.Methods A total of 56 patients with abortive remnants,who had undergone uterine curettage after the abortion,were treated with mifepristone combined with hysteroscopy.Before hysteroscopy,mifepristone was taken orally at a dose of 100 mg daily(50 mg,Bid) for 7 days.After the surgery,those who still had remnants in the uterus were given mifepristone at the same dose for 14 days.Results No patient had complication during and after the hysteroscopy except for one,who had abortive remnants at the uterine horn,experienced blood loss of 200 ml.In 40 patients,the abortive remnants were removed completely by hysteroscopy.Two weeks after the surgery,laboratory examination of the patients showed normal blood ?-hCG,and B-ultrasonography revealed no space-occupying mass in the uterus.In the other 16 patients,remnants were detected in the uterine horns after the hysteroscopy,and mifepristone was prescribed.These patients received reexaminations 2 months after the operation,and no abnormal blood ?-hCG or remnants in the uterus was found.Among the 56 patients,33 were followed up for 1-6 months(mean,3 months).During the follow-up,their symptoms including vaginal bleeding or drainage,amenorrhea,and abdominal pain disappeared,and the menstruation became normal.Conclusions Hysteroscopy combined with mifepristone is an effective measure to diagnose and treat abortive remnants.

Objective To investigate the relationship between sleep quality and mental health in the nurses.MethodsThree groups subjects, 53 students of nursing college, 57 advanced students receiving clinical training and 61 clinical nurses, were investigated with the Pittsburgh Sleep Quality Index (PSQI) and Self Checklist-90 (SCL-90). The standard of having sleep problem was PSQI scores ≥8.ResultsThere were 20.05% of subjects having sleep problem. The total score of PSQI was significantly different among three groups ( P<0.001), but total score of SCL-90 of three groups was not different. The total score of PSQI was correlated positively with the total score of SCL-90.ConclusionSleep quality and mental health are affected each other, and sleep quality is declining gradually from students in nursing college to clinical nurses, but there aren't obvious changes in mental status.

Objective To investigate the risk factors of chylous leakage after pancreatioduodenectomy so as to find effective measures to prevent this complication.Methods A retrospective analysis was conducted on 230 patients who underwent pancreatioduodenectomy at the First Affiliated Hospital of Zhejiang University from Jun.2012 to Jun.2014.Patients with chylous leakage were identified and a 1 ∶ 2 patients in the study and the control groups were selected.The parameters for matching included tumor volume,vascular invasion,and extent of lymph node dissection.A logistic analysis was performed to identify independent risk factors of chylous leakage.Results 15 (6.5％) patients developed chylous leakage after pancreatioduodenectomy.The average hospital stay after surgery of the study group was 20.8 days,compared to 13.5 days in the control-group (P =0.004).In the study group,chylous leakage rate increased in patients with 14th and 16th group of lymph nodes dissection (80％ vs 36.7％,P =0.006).Logistic analysis showed that 14th and 16th lymph nodes dissection was an independent risk factor of chylous leakage after pancreatioduodenectomy (P ＜ 0.05,OR =6.909,95％ CI 1.593 ～ 29.958).Conclusions Chylous leakage prolonged hospitalization after pancreatioduodenectomy.Dissection of the 14th and 16th lymph node groups was an independent risk factor of chylous leakage after pancreatioduodenectomy.Careful ligation of the gastrocolic vein near the lymphatic trunk and dissection of 14th and 16th group of lymph nodes were effective interventions to reduce postoperative chylous leakage.

The myelodysplastic syndromes (MDS), which are characterized by the presence of ineffective hematopoiesis and an increased risk of transformation to acute myeloid leukemia (AML), are a group of clonal disorders deriving from damage of the hematopoietic stem/progenitor cells. The 58th American Society of Hematology (ASH) Annual Meeting consists of 5 main subjects, includingchronic myelomonocytic leukemia (CMML) and MDS biology and treatment, higher risk MDS clinical studies, lower risk MDS clinical studies, predisposition and diagnosis of MDS, and prognostic and predictive utility of recurrent somatic mutations in MDS. This article will introduce some highlights of the oral reports in this meeting.

Objective:To study the clinical efficacy of acupuncture for ischemic stroke and its effect on ET-1 levels in IS cases.Method:The 63 cases were randomized into a treatment group (31 cases),receiving acupuncture and routine method,and control group (32 cases),receiving routine method alone.Seven days constitute a course of treatment,a 2-day interval between two courses.The clinical efficacy and ET-1 level in two groups were compared after four weeks.Result:The total effective rate in the treatment group and control group were 96.8% and 75% respectively,with a statistical significance (P＜0.05);the ET-1 level in blood plasma also with a statistical significance after the treatment (P＜0.05);the pre-treatment and post-treatment ET-1 level in the treatment group showed a statistical significance (P＜0.01),whereas the control group didn't.Conclusion:Acupuncture is effective for ischemic stroke and can lower the ET-1 level in ischemic stroke cases.

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.