Invasive angiomyxoma（AAM） is characterized by unclear boundaries, non enveloped glial growth, high recurrence rate, and belongs to a benign tumor, but it is invasive and grows slowly. A patient with recurrent left vestibular invasive angiomyxoma was admitted to the Otorhinolaryngology ward of Beijing Traditional Chinese Medicine Hospital Affiliated with Capital Medical University. The patient underwent two repeated surgeries and underwent a combined internal and external nasal approach for the removal of the nasal vestibular angiomyxoma. The patient recovered well after the surgery and has not recurred since follow-up.
Humans ; Myxoma/pathology* ; Neoplasm Recurrence, Local ; Nose Neoplasms/pathology*

OBJECTIVE To optimize the drying methods of Compound Scutellaria baicalensis extract powder. METHODS Compound S. baicalensis extract powder was prepared by atmospheric pressure drying， decompression drying and spray drying respectively， and high-performance liquid chromatography （HPLC） fingerprint of the extract powder was established. The physical fingerprint of the extract powder was established by 13 secondary indexes， such as particle size， particle size distribution and bulk density. HPLC fingerprints and physical fingerprints of 3 kinds of extract powders were compared by similarity evaluation method； through the conversion of the secondary indexes， five primary indexes of homogeneity， stacking， compressibility， fluidity and stability were calculated， and the physical properties of 3 kinds of extract powder were evaluated. The compressibility parameters of 3 kinds of extract powder such as index of parameter （IP）， index of parametric profile （IPP） and index of good compression （IGC） were calculated by the secondary index to evaluate the compression formability of the powder. RESULTS The similarity means of HPLC fingerprint of the extract powder obtained by atmospheric pressure drying， decompression drying and spray drying were 0.74， 0.90 and 0.94， respectively， and the similarity means of physical fingerprint were 0.74， 0.83 and 0.92， respectively. The overall similarity of spray drying extract powder was higher. The results of physical fingerprint analysis showed that the physical properties of the extract powder obtained by different drying methods were different. The 3 kinds of extract powder showed poor stability but good stacking. The homogenity and compressibility of extract powder by spray drying and decompression drying were better than those by atmospheric pressure drying， but the fluidity was worse than that by atmospheric pressure drying. The results of further compression formability analysis showed that the IP of spray drying extract powder was 0.54， IPP was 5.23， IGG was 5.03， and the spray drying extract powder could be directly pressed after adding a small amount of lubricant. CONCLUSIONS There are differences in HPLC and physical fingerprints of Compound S. baicalensis extract powder obtained by different drying methods. The spray drying extract powder possesses better Δ 基金项目 四川省公益性科研院所基本科研项目 （No.2022- 4-720） overall quality， which is more suitable for the drying of ＊第一作者副主任药师。研究方向：临床药学、药事管理、药物研 Compound S. baicalensis extract powder. 究。E-mail：hyptotti@163.com

Objective : To investigate the effect of (exchange protein directly activated by cAMP⁃1) on inner ear hair cell injury with noise⁃induced hearing loss and its potential mechanism in rats. Methods : Twenty Specific pathogen⁃free (SPF) Sprague⁃Dawley (SD) rats were randomly divided into normal control group and noise exposure group. The rats of noise exposure were exposed to 4 kHz at 101 dB sound pressure level (SPL) for 8 h. Auditory brainstem responses(ABR) were measured in animals before noise exposure and 24 h after noise exposure. Surface preparation , transmission electron microscopy and immunohistochemistry were performed on cochlea tissuesto elucidate changes in Epac expression in rat after noise exposure. The expression levels of Epac1、Rap1、CaMK⁃ Ⅱ、Bax、Bcl⁃2、cleaved caspase3(CC3) and cleaved caspase9(CC9) were analyzed using Western blot. Results : There was found a stable temporary threshold shift after noise exposure( P < 0. 05) . The missing of outer hair cells occurred after noise exposure(P < 0. 05) . Transmission electron microscopy indicated that the epidermis plate of HCs was partially dissolved , with loss or fusion of stereocilia , some HC organelles showed serious injuries after noise exposure. Epac1 immunostaining intensities were substantially enhanced in OHCs after noise exposure( P < 0. 05) . The expression levels of Epac1 , CaMK⁃ Ⅱ and Rap1 protein were significantly up⁃regulated after noise exposure(P < 0. 05) . The expression level of Bcl⁃2 was significantly down⁃regulated after noise exposure(P < 0. 05) . The expression levels of Bax , CC3 and CC9 were significantly up⁃regulated after noise exposure(P < 0. 05) . Conclusion Epac1 ⁃Rap1 signaling pathway mediates the early pathological damage in noise⁃exposed cochlea , and participates in the regulation of inner ear hair cells apoptosis. Epac1 ⁃Rap1 pathway is expected to become a new target for intervention in noise⁃induced hearing loss.

OBJECTIVE To investigate the relationship between the distribution of eosinophils(Eos) of nasal secretion and serum specific IgE(sIgE) titer in patients with allergic rhinitis, and to evaluate the diagnostic value of Eos in nasal secretion for allergic rhinitis. METHODS A total of 60 allergic rhinitis patients from Department of Otolaryngology, Beijing Shunyi Hospital of Traditional Chinese Medicine during Jan.2016 to June 2017 were selected as treatment group, and another 60 cases of non-allergic rhinitis and 30 normal persons in the corresponding time period were chosen as control group. Eos in nasal secretions and serum sIgE were measured in all the subjects and the relationship between Eos distribution and serum sIgE level was analyzed. RESULTS The Eos distribution and serum level of sIgE was consistent(κ=0.264, P=0.000) and statistical significance was found. The area of ROC of the Eos in nasal secretion was 0.881, the standard deviation was 0.025 and 95％ confidence interval was 0.841 to 0.924. The Udden index of ROC reached the maximum when the Eos in nasal secretion smear was graded as level 3, the sensitivity was 88.5％ and specificity was 99.4％. CONCLUSION Eos cytological examination of nasal secretions has some auxiliary value in the diagnosis of allergic rhinitis. It is a cheap, simple and rapid method, which can be used as an effective reference index for diagnosing allergic rhinitis in primary hospital.

[ABSTRACT]OBJECTIVETo investigate the relationship between food allergen specific IgE, IgG and allergic rhinitis, and to explore the significance of food allergen in the diagnosis and prevention of allergic rhinitis.METHODSTen kinds of food specific IgE were detected by Western blot and 14 kinds of food specific IgG were detected by ELISA in 2860 allergic rhinitis patients. The positive results of specific IgE and specific IgG were retrospectively analyzed.RESULTSThere was no difference in positive rate of allergen in patients with different gender. Total positive rate of food specific IgE was 68.5%. The specific IgE positive rate of crab was 31.5%, shrimp 27.6%, milk 21.3%, fish assemblages 19.2%, freshwater fish assemblages 18.3% and soybean 17.2%. With the growth of age, the specific IgE positive rate of peanut increased, but eggs decreased. The total positive rate of food allergen specific IgG was 81.5%. The specific IgG positive rate of egg was 59.4%, milk 38.2%, codfish 32.6%, soybean 22.8%, rice 19% and shrimp 12.7%. With the growth of age, the specific IgG positive rate of crab increased. Specific IgE and IgG of soybean, milk, crab, shrimp and fish were correlated well.CONCLUSIONThe detection of specific food allergen antibodies is helpful for the diagnosis of allergic rhinitis.

The mechanisms of food allergy include IgE-mediated and non IgE-mediated immune responses.Food intolerance is the reaction of defected digestive function caused by many factors in which the immune system is not involved.Clinically,the cases of food intolerance are increasing and the symptoms of the disease are usually complicated.Clinicians are facing the problem of differential diagnosis of food allergy and food intolerance,this article reviews the mechanisms of these two diseases to provide the reference for differential diagnosis.

The phenylacetone monooxygenase, isolated from Thermobifida fusca, mainly catalyzes Baeyer-Villiger oxidation reaction towards aromatic compounds. Met446 plays a vital role in catalytic promiscuity, based on the structure and function of phenylacetone monooxygenase. Mutation in Met446 locus can offer enzyme new catalytic feature to activate C-H bond, oxidizing indole to finally generate indigo and indirubin, but the yield was only 1.89 mg/L. In order to further improve the biosynthesis efficiency of the whole-cell catalyst, metabolic engineering was applied to change glucose metabolism pathway of Escherichia coli. Blocking glucose isomerase gene pgi led to pentose phosphate pathway instead of the glycolytic pathway to become the major metabolic pathways of glucose, which provided more cofactor NADPH needed in enzymatic oxidation of indole. Engineering the host E. coli led to synthesis of indigo and indirubin efficiency further increased to 25 mg/L. Combination of protein and metabolic engineering to design efficient whole-cell catalysts not only improves the synthesis of indigo and indirubin, but also provides a novel strategy for whole-cell catalyst development.
Escherichia coli ; genetics ; metabolism ; Glucose ; metabolism ; Indigo Carmine ; metabolism ; Indoles ; metabolism ; Industrial Microbiology ; methods ; Metabolic Engineering ; Metabolic Networks and Pathways ; Protein Engineering

Objective To com pare and explore the application value of diatom nitric acid digestion method and plankton 16S rDNA PCR method for drow ning identification. Methods Forty drow ning cases from 2010 to 2011 were collected from Department of Forensic Medicine of Wenzhou Medical University. Sam ples including lung, kidney, liver and field water fromeach case were tested with diatom nitric acid digestion method and plankton 16S rDNAPCR method, respectively. The Diatom nitric acid digestion method and plankton 16S rDNAPCR method required 20 gand 2g of each organ,and 15 mL and 1.5 mL of field water, respectively. The inspection time and detection rate were com pared between the two methods. Results Diatom nitric acid digestion method m ainly detected two species of diatom s, Centriae and Pennatae, while plankton 16S rDNA PCR method am plified a length of 162 bp band. The average inspection time of each case of the Diatom nitric acid digestion method was (95.30±2.78) min less than (325.33±14.18)min of plankton 16S rDNA PCR method (P<0.05).The detection rates of two methods for field water and lung were both 100% . For liver and kidney, the detection rate of plankton 16S rDNA PCR method was both 80% , higher than 40% and 30% of diatom nitric acid digestion method (P<0.05), respectively. Conclusion The laboratory testing method needs to be appropriately selected according to the specific circum stances in the forensic appraisal of drow ning. Com pared with diatom nitric acid digestion method, plankton 16S rDNA PCR method has practice values with such advantages as less quantity of sam ples, huge inform ation and high specificity.

Objective To estimate the value of detection of Merkel cell carcinoma polyomavirus (MCPyV)in the diagnosis of Merkel cell carcinoma (MCC).Methods Two cases of MCC were studied using light microscopy and immunohistochemistry.PCR was performed to detect DNA sequences encoding MCPyV large T antigen(LT)and viral protein 1 (VP1) in paraffin-embedded tissue specimens from the two patients with MCC,five patients with T cell lymphoma,two normal human controls,as well as in two T cell lymphoma cell lines MAC 1 and MAC2.DNA sequencing was also carried out.Results Both of the patients with MCC were male.The patient 1 presented with a mass in the right anterior shin for more than one year,and the patient 2 had a mass in the left knee for more than six months.Skin examination revealed densely distributed pink nodules in the right anterior shin,with confluence into an indurated plaque which measured 10 cm × 8 cm with superficial erosion,exudates and crusts and was surrounded by multiple irregularly sized erythematous nodules with limited mobility in the patient 1,as well as a royal blue,hard,poorly marginated nodular mass measuring 5 cm × 4 cm in the left medial knee with limited mobility in the patient 2.Pathological manifestations were similar in the two patients.Tumor cells were uniform with large hyperchromatic nuclei,eosinophilic and sparse cytoplasm,and fine chromatin.Mitotic figures were easily seen.Immunohistochemistry revealed that the tumor cells stained positive for pan-cytokeratin,synuclein (Syn),neuron-specific enolase (NSE),chromogranin (CgA),CK20,and Ki-67 (＞ or =60％),but negative for S100 protein,HMB45,CD34,thyroid transcription factor 1 (TTT-1),CK7 and leukocyte common antigen (LCA).MCPyV DNA was detected in both MCC specimens,but absent in the other skin specimens or T cell lymphoma cell lines.Conclusions MCC has distinctive clinical and pathological appearance.Immunohistochemistry and detection of MCPyV DNA sequences using PCR may be beneficial to the definitive diagnosis of MCC.

Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) in the treatment of patients with refractory rheumatoid arthritis (RA). Methods Eighty-two patients were randomly aesigned,42 to the DFPP group and 40 to the no-DFPP group. All patients previously experienced an incomplete response to 2-3 dis-ease-modifying antirheumatic drugs (DMARDs) and 1-2 nonsteroidal anti-inflammatory drugs (NSAIDs) or predni-sene. All patients received sulphasalazine (SASP,0.75 g three times daily) plus methotrexate (MTX, 10 mg orally once weekly). DFPP was performed once a week for 2-3 sessions. A total of 121 plasmapheresis procedures were per-formed in 42 patients. Control patients did not receive sham DFPP. The efficacy measures recorded one day after the final treatment and latest month in follow up for 12～24 months included the American College of Rheumatology 20% ,50% ,and 70% improvement criteria (ACR20, ACR50, and ACR70), the Health Assessment Questionnaire estimate of disability (HAQ); and the disease activity index. Results Patients in the DFPP group had ACR 20, ACR 50 and ACR 70 improvements of 100% ,92.9% and 81.0%,as compared with the patients in no-DFPP group 17.5% ,0,and 0 (P<0.001). Significant change from baseline was observed in HAQ scores in the DFPP group but not in the no-DFPP group (P<0.001). The changes from baseline in the disease activity scores were significantlygreater than in the no-DFPP group (P<0.001). Conclusion DFPP therapy significantly alters the signs and symp-toms of refractory RA. There are significant increases in physical function and improvement in quality of life.