Granulomatous & histiocytic dermatitides

Granulomas of the skin may be classified in several ways. They are either infectious or non-infectious in character, and they contain areas of necrobiosis or necrosis, or not. Responsible infectious agents may be mycobacterial, fungal, treponemal, or parasitic organisms, and each case of granulomatous dermatitis should be assessed histochemically for those microbes. In the non-infectious group, examples of necrobiotic or necrotizing granulomas include granuloma annulare; necrobiosis lipoidica; rheumatoid nodule; and lupus miliaris disseminates faciei. Non-necrobiotic/necrotizing and non-infectious lesions are exemplified by sarcoidosis; foreign-body reactions; Melkersson-Rosenthal syndrome; Blau syndrome; elastolytic granuloma; lichenoid and granulomatous dermatitis; interstitial granulomatous dermatitis; cutaneous involvement by Crohn disease; granulomatous rosacea; and granulomatous pigmented purpura. Histiocytic dermatitides that do not feature granuloma formation are peculiar reactions to infection, such as cutaneous malakoplakia; leishmaniasis; histoplasmosis; lepromatous leprosy; rhinoscleroma; lymphogranuloma venereum; and granuloma inguinale.     

Quantification of dental plaque in oral cavity was enabled by a novel algorithm of image processing

Objectives

Quantitative analysis of the biofilm has been critical for pathogenicity of oral diseases such as caries and periodontal disease. Currently, the plaque control record (PCR) is used most frequently to evaluate the presence of plaque on teeth, but no quantification methods exist so far. The aim of this study was to establish a method to quantify plaque adhesion on teeth.

Treatment of prinzmetal's variant angina: Role of medical treatment with nifedipine and surgical coronary revascularization combined with plexectomy

This study describes three forms of treatment of Prinzmetal's variant angina. Coronary spasm, frequently found at coronary arteriography in patients with Prinzmetal's variant angina, can be treated with intravenous or intracoronary injection of nitroglycerin as well as of nifedipine. Nifedipine (0.2 mg) was injected directly into the involved artery in 12 patients and suppressed spasm in 9; in 3 patients, nifedipine increased coronary sinus flow, which had been decreased by spasm in one of the branches of the left coronary artery.Patients with Prinzmetal's variant angina who have spasm superimposed on atherosclerotic lesions can benefit from coronary arterial bypass grafting combined with partial denervation of the heart. This combination yielded acceptable results (83.4 percent favorable outcome); recurrence of attacks occurred in only 6.7 percent of this group. In those forms of angina in which spasm occurs in angiographically normal coronary arteries, therapy is essentially medical. In 13 patients treated with oral nifedipine (30 to 40 mg/day), suppression of attacks was achieved in 11 instances. During the period of treatment, the methergine provocative test, which had been consistently positive before treatment, converted to negative in 12 patients. Transient withdrawal of nifedipine caused recurrence of pain in two patients.     

Coronary arteriography and atrial thrombosis in mitral valve disease

The arteriographic findings of neovascularity and fistula formation from the coronary arteries to the left atrium have occasionally been reported in association with atrial thrombosis in patients with mitral valve disease. To establish the diagnostic value of these findings, the preoperative coronary angiograms of 507 patients who underwent open mitral valve surgery were reviewed. Atrial thrombosis was present in 76 patients (14.9 percent). In the 30 patients with angiographic neovascularity and fistula formation, the thrombi were always observed to arise from the circumflex coronary artery. None of these 30 patients had atherosclerotic coronary lesions. In 25 of these patients an atrial thrombus was found at operation.These coronary arteriographic findings, in this selected group of patients, had a predictive accuracy of 83.3 percent, a specificity of 98.8 percent and a sensitivity of 32.8 percent for the diagnosis of the presence of thrombus in the left atrium. No relation was found between these signs and the size and histologic age of the thrombl examined.     

A SYSTEMATIC REVIEW ON THE INFLUENCE OF HLA-B POLYMORPHISMS ON HIV-1 MOTHER-TO-CHILD-TRANSMISSION

Background

Mother-to-child-transmission (MTCT) is the main route of HIV-1 infection in children. Genetic studies suggest HLA-B alleles play an important role on HIV-1 transmission, progression, and control of HIV-1 infection.

经直肠超声引导下“6+X”点法前列腺穿刺活检诊断前列腺癌的临床价值分析

目的：探讨经直肠超声引导下前列腺穿刺活检诊断前列腺癌的临床价值。方法检索PubMed、Embase、Cochrane Library、SCI、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库、万方数据库等数据库,检索时间截至2015年1月。由3位研究者根据纳入与排除标准独立筛选文献、提取资料和评价质量,文献筛选严格按照纳入和排除标准,纳入研究的质量评估采用诊断性试验质量评价（QUADAS）评分量表,灵敏度合并、特异度合并、诊断比值比（DOR）及其95%CI、综合受试者工作特征（SROC）曲线下面积（AUC）和Q*指数均采用Meta-Disc 1.4软件进行统计学分析。结果最终纳入5项基于中国人群的研究。荟萃结果显示：经直肠超声引导下前列腺穿刺活检诊断前列腺癌的灵敏度合并为0.84（95％CI为0.79～0.89）,特异度合并为0.98（95％CI为0.94～0.99）,DOR 合并为170.95（95％CI为55.68～524.84）,SROC AUC为0.9625, Q*指数为0.9082。结论直肠超声引导下前列腺穿刺活检早期诊断前列腺癌具有很高的临床价值。     

炮制专家王琦论"道地药材,遵古炮制"

“道地药材,遵古炮制”是饮片生产和经营企业的行训和行规,理念和追求,是一种商业形式的广告,传播着中医药传统文化。“道地药材”它重视、强调了经营的药材是优质的,提倡遵循传统的炮制技术和方法,说明对中药材和中药炮制的重视。现代的饮片生产和经营企业已不是过去那种“前店后厂”作坊式手工加工生产经营模式,自新中国成立以来逐步发展为由中药饮片厂依据《中药炮制规范》和《中国药典》的规定和要求、质量和标准进行生产和经营。因此在当今社会条件下,王琦研究员认为再一味强调“道地药材,遵古炮制”既不准确,更不符合现实。     

前后配穴埋线治疗原发性不安腿综合征伴睡眠障碍13例

不安腿综合征伴睡眠障碍是一种严重影响患者生命质量且难以根除的中枢神经系统疾病。本文将穴位埋线与常规针刺联合治疗不安腿综合征的疗效进行观察研究,以说明穴位埋线在症状改善及远期疗效上的作用和优势。结果表明,经过2个疗程的治疗后,穴位埋线在腰膝酸软、睡眠障碍及焦虑抑郁方面较普通针刺的改善程度方面更优,且疗效维持时间更久。穴位埋线治疗在不安腿综合征伴睡眠障碍治疗中的作用值得进一步发掘和推广。     

Clinicopathological study of originally non-lupus “full-house” nephropathy

Background: Glomerular “full-house” immunofluorescence staining commonly indicates lupus nephritis. However, some non-lupus nephropathy also can present with a “full-house” immunofluorescence pattern mimicking lupus nephritis. The goal of this study is to define the clinicopathological spectrum of originally non-lupus “full-house” nephropathy. Methods: Records of 24 patients with “full-house” nephropathy in the absence of clinical or serological evidence of systemic lupus erythematosus (SLE) at the time of renal biopsy were abstracted for demographics, clinical presentation, laboratory data, renal biopsy findings, and clinical follow-up. Results: The clinicopathological diagnoses included membranous glomerulonephritis (GN) (46%), IgA nephropathy (21%), membranoproliferative GN (12.5%), postinfectious GN (12.5%), C1q nephropathy (4%), and unclassified mesangial GN (4%). No one had endothelial tubuloreticular inclusions. One patient originally diagnosed as IgA nephropathy developed anti-DNA antibody and another one patient with membranous GN developed hypocomplementemia 8 months and 10 months after renal biopsy, respectively. The two patients also developed clinical symptoms of lupus subsequently. Conclusions: There was a broad spectrum of glomerular histological findings in non-lupus “full-house” nephropathy. The possibility of “full-house” nephropathy preceding the emergence of overt systemic lupus erythematosus remained to be elucidated.