皮下型急性发热性嗜中性皮肤病1例

报告1例皮下型急性发热性嗜中性皮肤病。患者男,47岁。颈部、躯干、四肢起疼痛性红斑、结节伴发热1周。组织病理检查示真皮、皮下脂肪中有中性粒细胞、淋巴细胞浸润,可见核碎裂像。     

并发缺血性骨坏死的系统性红斑狼疮危险因素meta分析

缺血性骨坏死(avascular necrosis,AVN)是长期血液供应不足导致的骨细胞坏死,常见于糖皮质激素治疗和过量饮酒人群,也是系统性红斑狼疮(systemic lupus erythematosus,SLE)患者常见的并发症[1]。随着SLE治疗方法的改善,预防和治疗长期并发症成了治疗SLE疾病本身的工作重点,例如:关节炎、血管炎、动脉高压、库欣体征、雷诺现象以及神经和肾脏系统受累等[2-5],这其中就包括AVN并发症。AVN的诊断取决于检查方法(如X线、CT和MRI)和在疾病筛查时发现的无症状病例。后来,一些具有潜在的与SLE特征相关的病理生理机制被认为与AVN相关,如抗磷脂抗体通过增加小血管血栓形成的风险[6],导致血管闭塞是AVN的致病过程。然而,这些与SLE相关的危险因素在AVN中的起因作用仍存在争议。同时,有研究指出类固醇治疗是AVN发生的诱导因素,糖皮质激素可直接抑制成骨细胞,从而减少骨细胞形成[7]。一项有关SLE患者AVN患病率危险因素的综述指出,合并AVN并发症的SLE患者,其合并关节炎、口腔溃疡、血管炎、动脉高血压、库欣体征以及中枢神经系统和肾脏受累的风险更高[8]。然而,该文献纳入的文章总数较少,一些危险因素的研究之间存在较大差异。在此,本研究扩展了新近发表的研究以及其他数据库的有关文献,并增加了不同群体特征中合并症之间的亚组分析以及发生风险概率推断。     

Comparison of photodynamic therapy for skin cancers and pre-cancers with δ-aminolevulinic acid

Objective  

The aim of the study was to compare the effects of photodynamic therapy (PDT) with δ-aminolevulinic acid (ALA) for patients with different kinds of skin cancers and pre-cancers.     

p27和细胞周期蛋白E在Bowen病及皮肤鳞状细胞癌中的表达

目的 探讨p27和细胞周期蛋白E在Bowen病及皮肤鳞状细胞癌（鳞癌）发病中所起的作用。方法 用免疫组化S-P法检测p27和细胞周期蛋白E在16例Bowen病、35例皮肤鳞癌和25例正常人皮肤中的表达。结果 p27在Bowen病和皮肤鳞癌中的表达均低于正常人皮肤，在Bowen病、高分化鳞癌和低分化鳞癌中的表达随肿瘤分化程度的降低呈下降趋势。细胞周期蛋白E在Bowen病和皮肤鳞癌中的表达均高于正常人皮肤，在Bowen病、高分化鳞癌和低分化鳞癌中的表达随肿瘤分化程度的降低而增强。在Bowen病和皮肤鳞癌中，p27和细胞周期蛋白E的表达呈负相关。结论 p27异常低表达和细胞周期蛋白E异常高表达可能与Bowen病和皮肤鳞癌的发病有关。     

解脲脲原体血清型1和4在雌性小鼠生殖道中的致病性研究

目的:确定解脲脲原体(UU)血清型1(UU1)和4(UU4)在小鼠生殖道中致病性。方法:将408只小鼠随机分为UU1组和UU4组,实验组阴道分别接种三种浓度UU标准株菌液。接种后不同时间点随机检测阴道、宫颈及部分上生殖道组织中UU阳性率及致病率。结果:(1)阴道和宫颈分泌物:UU1和UU4三组之间总阳性率的差异均有统计学意义(P0.01);UU1和UU4三组之间各组各时间点浓度比较差异均有统计学意义(P0.05)。(2)宫颈、子宫体与输卵管组织:UU4组阳性率、总致病率均高于UU1组,差异均有统计学意义(P0.05)。结论:(1)UU1和UU4主要在宫颈致病。(2)UU4的致病性比UU1强。     

青岛地区MSM中HIV/梅毒及尖锐湿疣的感染情况

目的了解青岛地区男男性行为人群（MSM）艾滋病病毒（HIV）/梅毒及尖锐湿疣的感染情况。方法利用中盖项目支持平台,对前来接受干预检测的MSM进行相关查体及实验室检查。结果 687名MSM共检出尖锐湿疣41例,检出率为5.97%;梅毒89例,检出率为12.95%;HIV 8例,检出率1.16%。8例HIV阳性患者中,3例合并CA,4例合并梅毒;2例CA患者同时伴有HIV、梅毒阳性;89例梅毒阳性患者中,19例合并CA。结论 MSM中HIV、梅毒及尖锐湿疣感染情况严重,提示临床医生在对MSM的梅毒、尖锐湿疣患者诊治的同时,应注重HIV的检测。     

苯丙胺类兴奋剂对梅毒患者远期预后的影响

目的观察苯丙胺类兴奋剂对梅毒患者治疗后2年内预后的影响。方法收集55例吸食苯丙胺类毒品的梅毒患者,经过规范治疗后对其定期随访,于治疗后2年时取患者外周血检测RPR滴度和免疫球蛋白水平,检测外周血单个核细胞产生IFN-γ和IL-4的水平,并与55例梅毒患者和30例正常人作比较。结果实验组治疗后2年内RPR阴转率为69.10%,明显低于对照组(P<0.05)。RPR未转阴的梅毒患者,无论是否吸毒,IFN-r水平均低于已转阴的患者和正常对照组(P<0.05),而免疫球蛋白和IL-4水平比较,差异无统计学意义(P>0.05),RPR已转阴的梅毒患者,无论是否吸毒,免疫球蛋白、IFN-γ和IL-4水平与正常对照组相比,差异均无统计学意义(P均>0.05)。结论苯丙胺类兴奋剂降低了梅毒患者的临床治愈率。     

Creating Disability-Competent Medical Students Via Community Outreach

IntroductionMedical students often have limited exposure to providing care to physically and cognitively disabled patients. To address this gap, Involvement with Disability Education and Advancement (IDEA) was started in 2015 at Rutgers New Jersey Medical School (NJMS). The organization provides NJMS students the opportunity to visit a school dedicated to disabled students and lead educational sessions on health topics.Materials and methodsWe conducted a survey study in 2018 to compare comfort levels between IDEA members and non-members in eliciting information from and providing medical attention to nonverbal, cognitively impaired, and physically disabled patients. The survey-based study utilized yes/no questions, and a Likert scale questionnaire to determine IDEA member and non-member comfort levels in working with various disabilities. Statistical analysis was performed using SAS Enterprise Guide 7.1; p value < 0.05 was considered statistically significant.Results and discussionA total of 56 responses (19 members, 37 non-members) were analyzed. Regardless of IDEA membership, medical students of all years perceived themselves to have more comfort caring for physically disabled than cognitively impaired or nonverbal patients. IDEA members also recorded higher comfort levels with eliciting information from cognitively impaired patients and lower comfort levels with providing medical attention to physically disabled patients.ImplicationsIDEA members may have increased comfort interacting with cognitively impaired individuals due to their regular experience and lower levels of comfort providing medical attention to physically disabled patients due to awareness of complex problems specific to the population. The current results warrant continued data collection and further evaluation.