晕痣与白癜风的相关性及祛除晕痣中央痣对疗效的影响

 目的 探讨晕痣与白癜风的相关性及祛除晕痣中央痣对疗效的影响。方法 收集2010-07至2017-10就诊于武警特色医学中心白癜风门诊的晕痣患者的临床资料进行统计学分析。结果 144例晕痣患者平均发病年龄(20.69±12.73)岁,皮损单发118例(81.94%),多发26例(18.06%),好发于躯干部(48.62%)及面颈部(41.44%)。125例合并白癜风,其中非节段型占108例(86.40%),节段型占17例(13.60%),与单纯晕痣患者相比就诊时病程较长(P=0.014)。随访106例合并白癜风患者的临床转归情况,祛除晕痣中央痣的疗效明显好于非手术治疗组(P=0.001),而采取CO₂激光或者手术祛除晕痣中央痣两种方式之间差异无统计学意义(P=0.694)。17例单纯晕痣患者祛除晕痣中央痣组总体有效率为91.67%,明显好于非手术治疗组。结论 晕痣好发于青少年,皮损以单发多见,以躯干、面颈部好发。大部分晕痣合并白癜风,且以非节段型为主。祛除晕痣中央痣对于晕痣本身及伴发白癜风均可加快其消退。     

新生儿呼吸道合胞病毒肺炎的临床特征及干扰素的干预效果

目的 研究新生儿呼吸道合胞病毒(RSV)肺炎的临床特征及干扰素的干预效果.方法 将我院儿科2014年5月至2015年7月收治的96例RSV肺炎新生患儿纳入研究对象.经随机数字法分为观察组和对照组,每组48例.对照组入院后进行常规治疗,观察组在此基础上增加重组人干扰素α1b的使用.比较观察组与对照组肺部哕音消失时间、吸氧天数、住院时间,并于治疗1周后评估两组临床疗效,治疗期间观察药物不良反应.另随机抽取医院同期出生的RSV检查阴性新生儿90例为阴性对照组,比较RSV阳性患儿与RSV阴性新生儿的一般资料、临床特征差异.结果 RSV阳性组纯母乳喂养率为35.42％,明显低于RSV阴性组53.33％ (P ＜0.05),咳嗽、鼻塞、细湿鸣音、哮鸣音发生率分别为76.04％、71.88％、54.17％、30.21％,均明显高于RSV阴性组(P＜0.05);观察组肺部哕音消失时间、吸氧天数及住院时间分别为(6.44 ±2.13)d、(5.67±1.75)d、(9.28±2.89)d,均明显少于对照组(7.58±3.29)d、(6.83±2.02)d、(10.85±3.60) d(P ＜0.05);观察组治疗1周后有效率为81.25％,较对照组明显升高(P＜0.05).结论 咳嗽、鼻塞、细湿鸣音、哮鸣音、纯母乳喂养率低为新生儿RSV肺炎的主要特征,以干扰素治疗该病,可有效改善治疗效果,促进肺部功能恢复,是值得推广的治疗方式.     

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??Objective To study the clinical features??treatment and prognosis of multiple sclerosis??MS?? in children in order to improve the the diagnosis and treatment level. Methods The clinical data of 84 MS children hospitalized from Nov. 1993 to Dec. 2014 in Department of Pediatrics??Peking University First Hospital were analyzed retrospectively and the follow-ups were summarized. Results Main clinical manifestations included visual acuity decrease??weakness??headache?? fever?? encephalopathy and seizure. CSF oligoclonal band was positive in 22/78 cases ??28.2%????and CSF myelin-oligodendrocytes glycoprotein antibody was positive in 16/49 cases ??32.7%??. Lesions on MRI were frequently observed in subcortical white matter ??92.9%?? and ventricular white matter ??86.9%???? then in cerebellum??47.6%?? in brainstem ??36.9%???? basal ganglia ??29.8%???? thalamus ??21.4%???? and corpus callosum ??16.7%??. All cases were treated with glucocorticoids at acute stage??combined with intravenous immune globulin ??IVIG?? in 53 cases ??63.1%??. Complete remission was achieved in 69 cases ??82.1%?? after treatment. The cases were followed-up for ??0.7—22.0?? years. The average relapse times were ??4.71±3.18??. The annual relapse rate was ??0.65±0.52?? times/year. A total of 61 cases ??72.6%?? relapsed within the first year after the onset of MS. Fifty-seven cases were followed up to December 2014?? and 17/57 cases ??12.3%?? had movement disorder?? and 17/57 cases ??29.8%?? had visual acuity decrease?? and 21/53 ??39.6%?? had learning disabilities. Conclusion MS with early onset ??younger than 10 years?? is not rare. The common presentation symptoms include visual acuity decrease?? weakness?? headache?? fever?? encephalopathy and seizure. The positive rate of CSF oligoclonal bands is low. MRI shows the lesions are frequently located in subcortical and ventricular white matter. Glucocorticoids are effective in the acute period. Relapse usually occurrs in the first year after onset. DMT can prolong the relapse interval.Visual acuity decrease and learning disabilities are the common sequelae of the children with MS.     

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??Objective To explore the epidemiological features of NV and RV infection and to investigate the clinical features and prognosis of NV infection. Methods Stool specimens??without pus??mucus or blood?? were collected from children less than 3 years old with acute diarrhea within 7 days admitted from November 2012 to October 2013 in Beijing Children’s Hospital??Capital Medical University. Stool specimens were screened for NV and RV using immunochromatographic test??ICG??. History was investigated and the severity was evaluated by Vesikari scale. Follow-ups were conducted via phone calls. The epidemiological features?? clinical manifestations and prognosis of children infected with NV were analyzed and compared with those infected with RV. Results Among the total 942 samples??RV was detected in 329??34.9%?? samples??while NV was detected in 137??14.5%?? samples. Rate of co-infection was 9.7%??91/942??. The seasonal distribution of RV detection showed a peak of incidence from September to February the following year??but NV detection showed sporadic distribution. The times and duration of diarrhea and vomiting were similar in two kinds of infection??but fever??vomiting??severe diarrhea??with fatigue??sleepiness or lethargy?? were significantly more common in RV infection??P??0.05??. NV infection had a higher incidence of respiratory symptoms??such as cough and rhinorrhea. Mean Vesikari severity score was ??8.98±2.94?? in NV infection??remarkably lower than??10.45±3.04??in RV infection??P??0.05??. Most patients recovered in??7 days??but NV infection was likely to have longer duration. Conclusion RV is still the leading cause of acute viral diarrhea??and NV is also a significant cause. NV infection occurs year-round??while RV infection shows a peak in autumn and winter. Fever??vomiting and severe diarrhea with dehydration are more common in RV infection. NV infection has a higher rate of respiratory symptoms and longer recovery period.     

ACTL8的表达与乳腺癌临床病理特征及预后的关系

目的:探讨肌动蛋白样蛋白8(ACTL8)在乳腺癌中的表达及其与乳腺癌临床病理特征及预后的关系。方法:采用Western blot方法检测人正常乳腺上皮细胞株MCF-10A和5种乳腺癌细胞株中ACTL8蛋白的表达;采用免疫组织化学方法检测6例乳腺癌标本及其对应的癌旁组织中ACTL8蛋白的表达;收集TCGA乳腺癌数据集,将488例乳腺标本纳入,分析ACTL8的mRNA表达水平与乳腺癌患者临床病理特征及预后的关系。结果:ACTL8蛋白在乳腺癌细胞株T47D、BT474、HCC1954和SKBR3中表达显著高于乳腺上皮细胞株MCF-10A;ACTL8蛋白在乳腺癌组织中的表达也显著高于癌旁组织;ACTL8 mRNA表达与乳腺癌患者年龄、肿瘤大小、临床TNM分期和淋巴结转移相关(P0.05)。ACTL8 mRNA高表达的乳腺癌患者5年内生存率低、预后差。结论:ACTL8在乳腺癌组织中高表达并与乳腺癌临床病理特征及预后密切相关,提示ACTL8可作为判断乳腺癌预后的标志物。     

Design and conduct of occupational epidemiology studies: I. Design aspects of cohort studies

Cohort and case-control studies are two standard approaches for investigating the etiology of occupational diseases. This paper, which is the first of a four-part series, contains a review of the design features of occupational cohort studies. Topics discussed include the basic features of prospective and historical cohort studies, options for defining the cohort, disease incidence ascertainment, and considerations involved in planning an occupational cohort study. Subsequent papers in this series will focus on data analysis of occupational cohort studies and the design and analysis of occupational case-control studies.     

Differences in aerodynamic characteristics of new and dysfunctional Provox®2 voice prostheses in vivo

Tracheoesophageal voice prostheses need to be replaced due to increased airflow resistance or retrograde leakage of fluid into the trachea as a consequence of biofilm formation. Previous in vitro studies show a change of aerodynamic features of biofilm covered voice prostheses after removal of the prostheses out of the patient. To assess these changes in an in situ situation, aerodynamic characteristics were measured within 45 patients at the beginning and at the end of the wearing process of the Provox 2 voice prosthesis. As a consequence, the influence of biofilm formation on aerodynamic characteristics can be evaluated. In the majority of cases, leakage through the prosthesis was the reason for replacement. No differences were found in the total flow, volume range and intratracheal pressure (ITP) of the voice prostheses measured. The airflow resistance of biofilm covered prostheses was significantly reduced compared to new clean prostheses. However, no correlation was found between the extent of biofilm and the different aerodynamic features measured. Biofilm formation on the Provox 2 is responsible for both reduction in airflow resistance and leakage through the prosthesis by deterioration of the silicone rubber material.     

Bilateral malignant phyllodes tumours.

We report a rare example of bilateral primary malignant phyllodes tumours. The diagnosis was supported by the identification of a benign epithelial element in each lesion. The case illustrates the typical dimorphic features of malignant phyllodes tumours. A contralateral tumour should not be regarded as metastatic without histological confirmation.     

海洛因依赖者支气管哮喘的临床特点及防治

目的：探讨海洛因依赖者支气管哮喘临床特点，为防治和治疗提供科学根据。方法：2004年1月至2005年1月1752例海洛因依赖者中伴发哮喘40例与随机抽取同期戒毒的100例患者进行回顾性分析与对照。结果：研究组病例的日滥用量、吸毒方式、吸毒年限与对照组病例相比均呈显著差异（P〈0．01）。研究组中：轻度发作24例（60％）；中度发作12例（30％）；重度发作3例（7．5％）；危重度1例（2．5％），哮喘多出现在脱毒中期；在有效脱毒的基础上，抗炎平喘，结合心理治疗与干预，轻度发作者多在4小时内缓解，中度发作者多在48小时内缓解，重度及危重度发作者多在3～5天内缓解。结论：长期大剂量烫吸海洛因是支气管哮喘发作的危险因素。应完善相关检查、及时发现，积极有效抗炎平喘，制定合理治疗方案，注意心理因素的影响。更重要的是，对海洛因依赖者进行教育，使他们了解哮喘知识、戒除毒品，才能从根本上预防和治疗此类并发症。