Telangiectasia macularis eruptiva perstans: diagnóstico dermatoscópico

IntroductionTelangiectasia macularis eruptiva perstans (TMEP) is a rare cutaneous mastocytosis, characterised by erythematous and/or brown macula in which telangiectasia are identified. The diagnosis is based on the clinical state of the lesions and on histopathology; however dermoscopy is an important diagnostic tool, revealing a very characteristic reticular vascular pattern.MethodologyA clinical examination, dermatoscopy, photographic follow-up, and histological study were performed on 5 patients with erythematous brown spots on the neck and V of the neckline, and were seen in this Centre between 2008 and 2018. A polarised light dermatoscope was used on lesion and the skin around it. All patients had a 4 mm punch biopsy of the affected skin, and the slices were stained with haematoxylin-eosin and Giemsa.ResultsThe dermatoscopy of the 5 patients showed a retiform vascular pattern with surrounding and crossing yellow spots corresponding to the follicular sebaceous glands, with few hairs. The skin around the lesion did not show any of these changes. In all patients, biopsy with haematoxylin-eosin corroborated the diagnosis of mastocytosis type TMEP. The location of the disease in the 5 patients was in the neck and V of the neckline.ConclusionsDermatoscopy helps in the diagnosis of TMEP by demonstrating that the retiform telangiectatic vascular pattern is a constant finding in all affected patients, and this is supported by the dermoscopic-histological findings. It also makes it possible to differentiate with other erythematous skin disease, and with other disorders that dermatoscopically exhibit retiform patterns.     

全国著名骨伤专家梁铁民教授学术思想和正骨经验

总结了全国著名骨伤专家梁铁民教授的学术思想和正骨经验,简述了梁老生平。梁老学术思想表现在突出整体观念,主张辨证施术;注重调理气血,强调药物接续;重视望问切触量法五诊结合等三个方面。对于梁老正骨经验先进行了综合论述,进一步佐证其学术思想;后分别从小儿桡骨头半脱位、颈椎错位、胸腰椎小关节错位、肋骨骨折等梁老研究较深入和比较擅长的几个方面进行了阐述。特别是颈椎错位这种高难度高风险的手法操作,体现出梁老高超的手法技艺。     

幼儿不同跑步着地方式的生物力学特征

文题释义：跑：跑是双脚交替接触地面的周期性运动，但跑有一个双脚都离开地面的腾空期。幼儿在 1 岁多开始学习跑步，最初是走跑结合的移动方式，由于身体发育不完善，下肢力量弱，平衡能力差，容易摔倒；到 2.5岁，幼儿跑步的腾空阶段明显；到 6岁，早期跑步的特点基本消失。 着地方式：指的是人体在跑步着地阶段足部接触地面的方式，一般分为3种方式：分别为足跟着地(fore foot strike)，跟骨先接触地面；全足着地(mid foot strike)，全脚掌着地，即足跟与前足同时接触地面；前足着地(rear foot strike)：前足部首先接触地面。 背景：成年人跑步着地方式一直是国内外学者研究的重点，而幼儿跑步的着地方式也是不容忽视的内容。 目的：运用生物力学方法探究幼儿在跑步过程中，不同着地方式下的运动学和动力学指标的差异，为幼儿正确的跑步着地方式提供科学依据。 方法：在北京市海淀区某公立幼儿园中随机抽取幼儿74名，按年龄分为3岁组、4岁组、5岁组，采用BTS红外动作捕捉系统、Kistler三维测力台和VIXTA录像解析系统同步采集幼儿跑步过程中不同着地方式下的运动学、动力学数据；运用Anybody 5.2仿真建模软件计算下肢肌肉力量指标。试验前向受试者父母详细解释并签署知情同意书，试验方案符合北京师范大学的相关伦理要求。 结果与结论：①3岁组全足着地的比例最高，足跟着地的比例最低，5岁组全足着地的比例最低，足跟着地的比例最高；前足着地者的蹬伸时间大于足跟着地(P < 0.01)和全足着地(P < 0.05)；②着地时刻，踝屈曲角度足跟着地者大于前足着地(P < 0.01)和全足着地者(P < 0.05)，全足着地者大于前足着地(P < 0.05)；前足着地者髋内收-外展角度、最大髋内收-外展角、髋内-收外展的关节变化量及最大膝内收-外展角速度大于足跟着地(P < 0.01)和全足着地者(P < 0.05)；前足着地者的踝屈伸最小值大于足跟着地者(P < 0.05)，而最大髋内收-外展角速度小于足跟着地者(P < 0.05)；③足跟着地和全足着地者的腓骨短肌、腓骨长肌、第三腓骨肌的肌力大于前足着地者(P < 0.05)，前足着地者的股中间肌、股外侧肌下束、股外侧肌上束、股内侧肌下束、股内侧肌上束、股内侧肌中束肌力均大于足跟着地(P < 0.01)和全足着地者(P < 0.05)；④结果提示：在3-6岁阶段，幼儿多采用足跟或全足着地模式进行奔跑，以满足自己在跑步过程的稳定性，随着年龄的增长，逐渐出现前足着地方式的跑步模式；前足着地能够动用更多髋关节和膝关节额状面的运动来维持人体运动中的稳定，足跟着地和全足着地能够动用更多的小腿前侧和后侧的肌力，而前足着地动用更多的大腿前侧肌力。 ORCID: 0000-0002-8337-3931(赵盼超) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程     

Sequential Therapy Based on Evolvement of Patterns: A New Model for Treatment of Alzheimer’s Disease

In order to solve the problem of long-term (>9 months) efficacy in the treatment of Alzheimer''s disease (AD) by conventional therapy (CT), a staged and multiply-targeted sequential therapy based on the evolvement of patterns (STEP) was developed. Its main innovations include: (1) the time order of evolution of patterns defined by Chinese medicine (CM) in AD was found, that is, "the orderly pattern evolution starting from Shen (Kidney) deficiency, progressing to phlegm, stasis and fire, and worsening to severe toxin as well as functional collapse"; (2) the cascade hypothesis of Shen deficiency in AD and its sequential therapy based on Shen-reinforcing was proposed, that is, "reinforcing Shen in the early stage and throughout the whole process, resolving phlegm, activating blood and purging fire in the middle stage, detoxifying and replenishing vitality to stop the collapse in the advanced stage", and through meta-analysis, clinical drug use was optimized, thus the leap from "inferential selection" to "evidence-based selection" was realized; (3) the STEP regimen combined with CT maintained cognitive and behavioral stability in AD patients for at least 12 months, with cognitive enhancement and behavioral synergy after 9 months, and cognitive benefit was superior to CT at 9, 12, 15, 18, 21, and 24 months, respectively. The 2-year cognitive improvement rate was increased by 25.64% (P=0.020) and the cognitive deterioration rate was decreased by 48.71% (P=0.000). Among them, the cognitive and functional benefits of Shen-reinforcing therapy for very early AD (350 cases) for 1 year were better than the placebo (P<0.001), and the dementia conversion rate was reduced by 8.85% (P=0.002). The behavioral symptomatic relief of patients with vascular dementia received fire-purging therapy (540 cases) was superior to those received CT (P=0.016). These data suggested that the STEP regimen has synergistic effects on CTs at least in terms of cognitive benefit, and the earlier the use, the greater the benefit will have. Therefore, the STEP regimen should be considered as one of the clinical options, particularly for the dearth of effective pharmaceutical or immunological interventions that are currently available for AD.     

去势后大鼠海马结构一氧化氮合酶阳性神经元的变化

目的：观察去势后大鼠海马结构一氧化氮合酶（NOS）阳性神经元的变化。方法：用黄递酶组织化学染色方法观察切除双侧卵巢后雌后SD大鼠海马结构NOS阳性神经元的形态，分布的变化，并进行计算机图像分析。结果：去势后海马结构NOS阳性神经元分布变化有区域差异性；NOS阳性神经元在下托、海马（CA）一区邻近下托的部分、CA三区、CA四区（CA4）和齿状回（DG）数目明显减少，而在CA二区数目明显明显增多，CA4和DG的NOS阳性神经元平均密度降低，胞体的平均周长和平均截面积都明显减少。结论：雌激素可能通过影响海马结构NOS的表达来影响学习和记忆。     

Development of the blood-testis barrier in the domestic fowl (Gallus domesticus)

The formation of the blood-testis barrier (BTB) in the domestic fowl was studied at the electronmicroscopic level employing lanthanum as a tracer. No effective barrier could be demonstrated in testes before puberty, although several components of the Sertoli junctional complex such as focal tight junctions and desmosomes were already existent. The time of onset of meiosis after hatching showed great individual variation and meiosis did not occur synchronously in the tubules of a given testis. An effective barrier could first be detected in tubules containing early spermatids, and in which spermatogonia and primary spermatocytes at the leptotene stage were still within the open compartment. Thus, barrier formation was correlated with the occurrence of haploid germ cells. Complete compartmentation of seminiferous tubules, leaving only spermatogonia within the open compartment, was attained in tubules containing elongated spermatids of the maturation phase. In these tubules, primary spermatocytes at the leptotene stage were situated in an intermediate compartment.