Dermatitis herpetiformis is an autoimmune bullous disease associated with celiac disease, which occurs mostly in Caucasians carrying HLA-DQ2 or HLA-DQ8 alleles. Studies have shown a variety of antibodies against transglutaminase and other antigens in the serum of patients with dermatitis herpetiformis, and epidermal transglutaminase is an autoantigen. The occurrence of dermatitis herpetiformis not only is associated with genetics and gluten sensitivity, but also may be related to the imbalance of intestinal microbiome. Gluten-free diet and dapsone are still the main therapies for dermatitis herpetiformis. This review summarizes epidemiological features, pathogenesis, clinical manifestations, laboratory features, diagnosis and treatment of dermatitis herpetiformis.

Clinical characteristics, treatments and prognosis of 10 primary Sj?gren syndrome (pSS) patients with lymphoma were retrospectively analyzed. All 10 patients were female. Dry mouth, dry eyes and lymph node enlargement were common. Laboratory tests showed positive antinuclear antibody(ANA), anti-SSA antibody, anti-SSB antibody and rheumatoid factor(RF); lower lymphocyte counts and high IgG level. All patients were not treated regularly after pSS was diagnosed; 9 cases of non-Hodgkin lymphoma (NHL) and 1 case of Hodgkin lymphoma (HL) were finally diagnosed. The main histological types of NHL were mucosa-associated lymphoid tissue marginal zone lymphoma (MALT) and diffuse large B cell lymphoma (DLBCL). Both intranodal and extranodal involvement was common. Patients were followed up for 1-144 months, 8 patients were treated with R-CHOP regime, CHOP regime or rituximab; 5 patients were stable, 4 patients died, and 1 case lost to follow up. Patients with pSS are closely associated with an enhanced risk of lymphoma, especially NHL. The clinical manifestations were complicated and varied.

Objective To explore the effect of virtual reality video games on gross motor skills of children with cerebral palsy.Methods The 56 patients with cerebral palsy treated in the Fifth Affiliated Hospital of Zhengzhou University from April 2015 to April 2017 were selected as the subjects.The age of the patients was (5.4 ± 1.2) years old (5-7 years old).According to the results of Gross Motor Function Classification System (GMFCS) assessment,all patients belonged to level Ⅰ-Ⅱ.All patients were randomly divided-into 2 groups:video-game group and conventional exercise group for 6 weeks of functional exercise.The evaluation criteria included the average exercise time,the 6-minute walk test (6MWT) and general motion function challenge module (GMFMS-CM) measurement and evaluation.Results The average exercise time of video games in video game group was (44.2 ± 6.1) minutes.The encouragement from the therapists in the intervention process was very important.The technical problems also had a relatively high proportion,and the technical guidance and training should be emphasized at the beginning of the study.The average score of the Likert scale showed that the practice program was suitable for the patients;GMFMS-CM in video game group was significantly higher [mean difference was 4.8,the quartile (IQP) was 4.68,Z =-2.025,P =0.035],while conventional exercise group showed an increasing trend which was not significantly different;6MWTshowed a significant increase in the mean level of video-game group (mean difference was 69.1 m,IQR was 40.2 m,Z =-2.108,P =0.045),conventional exercise group was significantly lower than the average level of subjects in video-game group and there was no significant change in the study period.Conclusion For children with cerebral palsy,routine functional rehabilitation exercise plus family-style virtual reality video game practice,on the one hand to improve patient compliance with the treatment,on the other hand can significantly improve their physical movement function,which is conducive for the patients' quality of life and self-care ability.

Objective To evaluate the efficacy and safety of Qingpeng ointment for the treatment of localized eczema in children.Methods A multicenter,randomized,open-labeled,tacrolimus 0.03％ ointment-controlled clinical trial was conducted.A total of 442 children with localized eczema were enrolled into this study,and divided into 2 groups to topically apply Qingpeng ointment (Qingpeng group) and tacrolimus 0.03％ ointment (tacrolimus group) respectively twice a day for 2 weeks.The children were followed up before the treatment and 1,2 weeks after the treatment,and the efficacy and safety were evaluated at the same time.Results Clinical data from 426 children were included in the efficacy analysis.At 1,2 weeks after the treatment,there were no significant differences in the response rate between the Qingpeng group and tacrolimus group (1 week after the treatment:78.92％ vs.81.77％,x2 =0.545,P =0.460;2 weeks after the treatment:98.65％ vs.97.54％,x2 =0.721,P =0.396).However,the pruritus scores at 1,2 weeks after the treatment were both significantly lower in the Qingpeng group than in the tacrolimus group (1 week:F =14.001,P =0.000;2 weeks:F =11.252,P =0.001).At 1 week after the treatment,the incidence rate of adverse reactions was significantly lower in the Qingpeng group than in the tacrolimus group (P ＜ 0.05).Mild itching,burning sensation and other local irritant sensations were the most common adverse reactions.Conclusion Qingpeng ointment is safe and effective for the treatment of localized eczema in children with good tolerability.

Objective To investigate the voicing acoustic characteristics of sulcus vocalis patients with mini-mum glottal area(MGA) .Methods 60 normal subjects (30 male ,30 female) ,and 62 subjects with sulcus vocalis (33 male and 29 female)were recruited .They all had stroboscopic laryngoscopy ,and had MGA measured when say-ing /i:/using software supporting KIPS .The acoustic parameters consisted of vocal cord fundamental frequency (F0) ,jitter and shimmer ,normalized noise energy ( NNE) ,harmony to noise ratio (HNR) and signal noise ratio (SNR) ,maximum phonation time(MPT) and respectively make correlation analysis with voice MGA .Results The voicing MGA of male patients with sulcus vocalis was 434 .74 ± 112 .83 ,larger than the males with normal vocalis 298 .25 ± 93 .63 .This was statistically significant (P<0 .05) .The voicing MGA of females with sulcus vocalis was (484 .75 ± 143 .91) ,significantly larger than those of females with normal vocalis (293 .43 ± 93 .73) and the differ-ence was statistically significant (P<0 .05) .The voicing MGA on both males and females with sulcus vocalis was noticeably relation to the F0 (r=0 .972 ,P<0 .05) and (r=0 .928 ,P<0 .05) ,Jitter (r=0 .978 ,P<0 .05) and (r=0 .910 ,P<0 .910) and Shimmer (r=0 .973 ,P<0 .05) and (r=0 .921 ,P<0 .05) ,normalized noise energy(r=0 .883 ,P<0 .05) and (r=0 .960 ,P<0 .05) ;and negative relation to the signal noise ratio (r= -0 .947 ,P<0 .05) and (r = -0 .957 ,P<0 .05) ,signal noise ratio (r= -0 .959 ,P<0 .05) and (r= -0 .944 ,P<0 .05) ,max-imum phonation time (r= -0 .891 ,P<0 .05) and (r= -0 .936 ,P<0 .05) .Conclusion Patients with pathological sulcus vocalis have glottal areas larger than normal .Acoustic analysis of the voices of the sulcus vocalis can be used as an objective laboratory examination .

with PsA in Chinese Han population from Shandong Province.

OBJECTIVE To analyze the complications of the CO2 laser-assisted laryngeal microsurgery for laryngeal tumors. METHODS The clinical data of 520 patients who underwent CO2 laser assisted laryngeal microsurgery for laryngeal tumors were retrospectively analyzed. The complications were recorded. RESULTS Complications caused by CO2 laser were found in 61 case(11.73 %) and those caused by suspended laryngoscope in 71 case(13.65 %). CONCLUSION The complications of the CO2 laser-assisted laryngeal microsurgery for laryngeal tumors may be caused by CO2 laser or suspended laryngoscope.

Objective To evaluate the results of the Groningen valve voice prosthesis in China.Methods The Groningen valve was used to date in 10 patients with a mean age at insertion of 60.2 years from January 2003 to January 2004. Seven patients underwent primary valve insertion at the time of surgery and in three patients the prosthesis was inserted at a later date. The speech quality of this group was assessed.Results The median score was 4.6(range 3.3～6.9)which compared favourably with a similar analysis of other valve.Conclusion The Groningen valve provides a highly acceptable means of obtaining vocalization after total laryngectomy in patients.

ObjectiveTo study the relation of phonation and respiration in normal subjects. MethodsUsing Aerophone Ⅱ Model 6800 and Visipitch 6097, vital capacity was recorded first , then the simultaneous phonation volume, maximum sustain phonation time,mean airflow rate,sound pressure level and average pitch were recorded in order to induce the relation of phonation and respiration in normal subjects. ResultsThere was a linear correlation between phonation volume and vital capacity. Maximum sustain phonation time varied with changes of mean airflow rate and phonation volume and mean airflow rate varied little in different subjects and had no relation with average pitch and sound intensity. ConclusionMaximum phonation time, the mean airflow rate and ratio of phonation volume to vital capacity can be used as indicator in clinical application.