异维A酸胶囊联合外用1%联苯苄唑软膏治疗马拉色菌毛囊炎的临床疗效观察

我们于2005年1月～2006年8月应用口服异维A酸胶囊联合外用1%联苯苄唑软膏或口服伊曲康唑联合外用1%联苯苄唑软膏治疗马拉色菌毛囊炎,现比较2种治疗方法的临床疗效等情况,报道如下:1资料和方法1.1一般资料入选标准具有典型的临床表现,真菌学检查符合马拉色菌毛囊炎的诊断标准[1];自愿接受观察治疗者。排除标准妊娠及哺乳期妇女、2年内计划妊娠者;心、肝、肾功能不全者系统性疾病者;糖尿病患者及血脂异常者;由于长期应用糖皮质激素、免疫抑制剂或有免疫缺陷而引起发病者。临床资料入选的50例来自我院皮肤科门诊初诊者,男33例,女17例,年龄在17…     

一例复合杂合性突变所致多发性内分泌腺瘤病1型的临床表现与基因型

目的 分析1例多发性内分泌腺瘤病1型（MEN1）患者的临床特征和基因型,以期提高临床医生对本病的认识与诊断的准确性。方法 分析患者病史、临床表现、实验室检查及影像学资料,并对MEN1基因进行扩增与测序。结果 发现1例临床症状符合典型的多发性内分泌腺瘤病1型患者,基因测序鉴定本例患者的MEN1基因第9号外显子内存在同义突变,为c.1818位T → C（rs540012）,第10号外显子存在两处复合杂合性突变,分别是c.2098位C → T（R527X,rs104894261）,造成第527位氨基酸精氨酸（CGA）突变为终止密码子TGA;和c.2140位G → A（A541T,rs2959656）,造成第541位丙氨酸（GCA）突变为苏氨酸（ACA）。结论 本例患者表现了典型的多发性内分泌腺瘤病1型的临床症状与体征,遗传学分析进一步验证了患者携带MEN1基因的致病突变,提示根据临床表现结合基因学确诊本病的可靠性。     

HPV L1衣壳蛋白和阴道微生态及酶的改变与高危人乳头瘤病毒感染、宫颈上皮内瘤变演化的关系

目的 探讨人乳头瘤病毒L1(HPV L1)衣壳蛋白及阴道微生态和酶的改变与高危人乳头瘤病毒（HRHPV）感染、宫颈上皮内瘤变（CIN）演化的关系。方法 选取2021年1月至2023年3月在我院治疗的CIN患者182例,其中CINⅠ级患者52例,CINⅡ级患者70例,CINⅢ级患者60例,分析比较不同级别CIN患者HPV L1衣壳蛋白、阴道微生态、阴道微生物代谢产物及酶的差异。结果 CINⅢ级患者HPV L1衣壳蛋白表达量为（20.00±5.92）PU,低于CINⅠ级和CINⅡ级患者（t=12.232、10.223,均P<0.05）;CINⅡ级患者HPV L1衣壳蛋白表达量为（25.10±6.04）PU,低于Ⅰ级患者（t=9.922,P<0.05）。CINⅢ级患者阴道乳杆菌阳性比例为18.33%,低于CINⅠ级患者（χ2=10.036,P<0.05）,而假丝酵母阳性比例为35.00%,高于CINⅠ级患者（χ2=6.892,P<0.05）;CINⅢ级患者β-葡萄糖醛酸酶（GUS）、唾液酸苷酶（SNA）和过氧化氢（H2O2）阳性比例分别为86.67%、90.00%和93.33%,高于Ⅰ级和Ⅱ级患者（χ2=32.044、67.608、20.394,均P<0.05）。HR-HPV感染CIN患者HPV L1衣壳蛋白表达量为（24.12±3.34）PU,低于HR-HPV未感染患者（t=-6.150,P<0.05）。HR-HPV感染CIN患者GUS、SNA、H2O2阳性率分别为65.28%、54.86%、81.25%,均高于HRHPV未感染患者（χ2=18.637、18.440、29.397,均P<0.05）。HR-HPV感染CINⅠ级患者HPV L1衣壳蛋白表达量为（28.04±3.01）PU,低于HR-HPV未感染CINⅠ级患者（t=-6.750,P<0.05）;HR-HPV感染CINⅠ级患者H2O2阳性率为70.97%,高于HR-HPV未感染CINⅠ级患者（χ2=4.109,P<0.05）。HR-HPV感染CINⅡ级患者HPV L1衣壳蛋白表达量为（28.04±3.01）PU,低于HR-HPV未感染CINⅡ级患者（t=-5.165,P<0.05）。HR-HPV感染CINⅡ级患者GUS、 H2O2阳性率为50.94%、 70.97%,均高于HR-HPV未感染CINⅡ级患者（χ2=3.920、10.758,均P<0.05）。结论 HPV L1衣壳蛋白、阴道微生态及代谢产物和酶表达与CIN严重程度有关,同时与HR-HPV感染存在一定的关系。     

宫颈癌患者高危型人乳头瘤病毒感染状况及其与阴道微环境、氧化应激水平及Th1/Th2细胞因子的关系研究

摘要 目的：探讨宫颈癌患者高危型人乳头瘤病毒（HR-HPV）感染与阴道微环境、氧化应激水平及辅助性T细胞（Th）1/Th2细胞因子的关系。方法：选择2016年1月至2021年12月石家庄市妇幼保健院收治的201例宫颈癌患者,根据是否发生HR-HPV感染将患者分为HR-HPV组（84例）和非HR-HPV组（117例）,另选择171例体检健康妇女为对照组。检测受试者阴道微环境（阴道清洁度、pH值、滴虫、霉菌、线索细胞和乳酸杆菌）,氧化应激指标[血清总氧化态（TOS）、总还原态（TAS）、氧化应激指数（OSI）]、Th1/Th2细胞因子[白细胞介素（IL）-2、IL-4、IL-6、IL-10、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）]水平,比较上述指标的差异。结果：201例宫颈癌患者,HR-HPV 感染84例,发生率为 41.79%。HR-HPV组和非HR-HPV组阴道清洁度异常、pH值异常、滴虫阳性、霉菌阳性、线索细胞阳性检出率高于对照组（P＜0.05）,乳酸杆菌阳性检出率低于对照组（P＜0.05）;HR-HPV组阴道清洁度异常、pH值异常检出率高于非HR-HPV组（P＜0.05）,乳酸杆菌阳性检出率低于非HR-HPV组（P＜0.05）。HR-HPV组血清TOS、OSI、IL-4、IL-6、IL-10水平高于对照组、非HR-HPV组（P＜0.05）,血清TAS、IL-2、TNF-α、IFN-γ低于对照组、非HR-HPV组（P＜0.05）。结论：宫颈癌患者存在较高的HR-HPV感染风险,HR-HPV感染可引起宫颈癌患者阴道微环境改变、氧化应激损伤以及Th1/Th2细胞因子紊乱,检测HR-HPV有助于评估宫颈癌患者阴道微生态和病情进展。     

青花菜萝卜硫素合成相关基因BoCYP83A1的克隆与表达分析

CYP83A1基因是萝卜硫素合成代谢中的关键基因,该试验以青花菜品种CDBY-10为材料,利用RACE和RT-PCR方法,获得BoCYP83A1基因的全长序列。该基因全长1 509bp,编码502个氨基酸,包含保守的P450结构域。通过实时荧光定量PCR分析了BoCYP83A1基因在不同品种、不同组织以及不同激素处理下的表达水平。系统进化树分析表明,BoCYP83A1与结球甘蓝亲缘关系最近。BoCYP83A1基因在不同品种间的组织特异性不同:在青花菜品种CDBY-10的根、茎、叶3个组织间表达水平差异较小,在品种CDBY-12中表现为茎叶根,在CDBY-14中则表现为根茎叶。MeJA及SA处理均能够引起BoCYP83A1基因表达量的变化:经MeJA处理后,BoCYP83A1基因表达量升高至对照的1.9倍,而后有少量下降;经SA处理后,BoCYP83A1基因表达水平迅速降低,在6h时降低至对照的0.1倍,而后逐渐回升至对照的表达水平。研究表明,BoCYP83A1基因在不同青花菜品种中的表达特性不同,其表达能够被MeJA和SA所调控。青花菜BoCYP83A1的克隆及鉴定为培育高萝卜硫素含量的青花菜新品种奠定了理论基础。     

维生素A棕榈酸酯眼用凝胶联合聚乙烯醇滴眼液对干眼症患者泪液中IL-1β与TNF-α水平的影响及其临床疗效

目的:探讨维生素A棕榈酸酯眼用凝胶联合聚乙烯醇滴眼液对干眼症患者泪液中IL-1β及临床疗效的影响。方法:选取2013年11月~2015年11月于我院治疗的干眼症患者60例,随机分为实验组和对照组,每组30例。对照组患者给予聚乙烯醇滴眼液治疗,实验组患者在对照组基础上加用维生素A棕榈酸酯眼用凝胶治疗。观察并比较两组患者治疗前后泪液中白细胞介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平、泪膜破裂时间(BUT)、泪液分泌试验(SIT)及角膜荧光素染色(FL)结果,以及临床总有效率。结果:与治疗前相比,两组患者治疗后泪液中IL-1β及TNF-α水平均降低,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后泪液中IL-1β及TNF-α水平较低,差异具有统计学意义(P0.05);与治疗前比较,两组患者治疗后BUT及SIT评分均升高,而FL评分均降低,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后BUT及SIT评分较高,而FL评分较低,差异具有统计学意义(P0.05);实验组临床总有效率高于对照组,差异具有统计学意义(P0.05)。结论:维生素A棕榈酸酯眼用凝胶联合聚乙烯醇滴眼液治疗干眼症积极有效,值得临床上大力推广。     

加强医院病理科管理与质量控制的5点建议 ——1例临床标本混淆引起的思考

病理学诊断是临床诊断和疾病治疗的重要参考依据,病理科的质量控制也是医院管理中的重要环节之一。通过回顾分析病理科发生的1例标本混淆,寻找管理流程中存在的问题,提出改进措施和意见,以达到完善病理科管理、提高病理质量控制水平的目的。     

血清GGT、CysC、ApoB/ApoA1比值与急性ST段抬高型心肌梗死合并2型糖尿病患者预后的关系

摘要 目的：探讨血清γ-谷氨酰转移酶（GGT）、胱抑素C（CysC）、载脂蛋白B/载脂蛋白A1（ApoB/ApoA1）比值与急性ST段抬高型心肌梗死（ASTEMI）合并2型糖尿病（T2DM）患者预后的关系。方法：回顾性收集175例在广东省中医院行经皮冠状动脉介入治疗（PCI）的ASTEMI合并T2DM患者的临床资料,根据PCI术后1个月的预后分为不良预后组（63例）和良好预后组（112例）,检测血清GGT、CysC水平和计算ApoB/ApoA1比值。采用多因素Logistic回归分析ASTEMI合并T2DM患者PCI术后不良预后的因素,受试者工作特征曲线（ROC）分析血清GGT、CysC、ApoB/ApoA1比值对ASTEMI合并T2DM患者PCI术后不良预后的预测价值。结果：术后随访1个月,175例ASTEMI合并T2DM患者PCI术后不良预后发生率为36.00%（63/175）。与良好预后组比较,不良预后组血清GGT、CysC、ApoB/ApoA1比值升高（P＜0.05）。Killip分级≥Ⅱ级和血清GGT、CysC、ApoB/ApoA1比值升高为ASTEMI合并T2DM患者PCI术后不良预后的独立危险因素（P＜0.05）。血清GGT、CysC、ApoB/ApoA1比值联合预测ASTEMI合并T2DM患者PCI术后不良预后的曲线下面积（AUC）为0.924,大于血清GGT、CysC、ApoB/ApoA1比值单独预测的0.776、0.778、0.785。结论：血清GGT、CysC、ApoB/ApoA1比值升高与ASTEMI合并T2DM患者PCI术后不良预后有关,血清GGT、CysC、ApoB/ApoA1比值联合检测对ASTEMI合并T2DM患者PCI术后不良预后具有较高的预测价值。     

Specific interactions of steroids, arylhydrocarbons and flavonoids with progesterone receptors from the cytosol of the fungus Rhizopus nigricans

Rhizopus nigricans (R. nigricans) transforms fungitoxic progesterone into the less toxic 11-hydroxyprogesterone which is then able to exit the mycelia into the surrounding water. Hydroxylation of progesterone is an inducible process in which cytosolic progesterone receptors could be involved. In the present study, we characterised receptors with respect to ligand specificity and to their involvement in progesterone induction of hydroxylase. EC₅₀ values of different ligands (steroids, xenobiotic arylhydrocarbons and natural flavonoids) were determined by competition studies using 40 nM (³H)progesterone. C21 and C19 3-oxo-4-ene steroids were good competitors (EC₅₀ of progesterone 2.3 ± 0.1 × 10⁻⁷ M, EC₅₀ of androsten-3,17-dione 24 ± 2 × 10⁻⁷ M). The presence of hydroxyl groups in steroids significantly decreased the affinity for receptors. The arylhydrocarbons -naphthoflavone and ketoconazole exhibited EC₅₀ values of 0.3 ± 0.01 × 10⁻⁷ M and 27 ± 5 × 10⁻⁷ M, respectively, whereas β-naphthoflavone and benzo(a)pyrene were not able to displace labelled progesterone completely. The competition curves obtained by natural flavonoids also did not reach the bottom level of non-labelled progesterone, indicating the interaction at some allosteric binding site(s) of progesterone receptors. All ligands were examined for their involvement in progesterone-hydroxylase induction. Steroid agonists induced the enzyme in a dose-dependent manner in accordance with their affinity for receptors, whereas arylhydrocarbons and natural flavonoids did not induce the enzyme. The agonistic action of steroids, together with the antagonistic action of -naphthoflavone, strongly suggests the involvement of progesterone receptors in progesterone signalling resulting in the induction of progesterone-hydroxylase.     

Isolation of Malassezia globosa and M. sympodialis from patients with pityriasis versicolor in Spain

Pityriasis versicolor is a superficial infection of the stratum corneum by several yeast species formerly collectively named Malassezia furfur. The genus Malassezia has been recently enlarged with new species. With the exception of M. pachydermatis, the remaining six species have an absolute requirement in vitro for supplementation of long-chain fatty acids in media. These lipophilic yeasts comprise six species: M. furfur, M. globosa, M. obtusa, M. restricta, M. slooffiae and M. sympodialis. The aim of this study was to establish whether there was any association between the various species of Malassezia and pityriasis versicolor lesions. Thus, we studied the isolates from 79 patients with pityriasis versicolor, both from lesions and from apparently healthy skin close to the visible lesions. In pityriasis versicolor lesions, the species most frequently isolated was M. globosa (90%), followed by M. sympodialis (41%). Almost all isolates (99%) belonged to one of these two species. The most frequent pattern was M. globosa as the sole species (58% of cases), although the association with M. sympodialis was also frequent (30%). These results confirmed M. globosa as the main agent of pityriasis versicolor and M. sympodialis as the second agent in importance. Malassezia globosa was found to be a species with high levels of esterase and lipase enzymes of probable importance in their pathogenicity. This revised version was published online in June 2006 with corrections to the Cover Date.     

一例皮下脂膜炎样T细胞淋巴瘤的报告

目的分析皮下脂膜炎样T细胞淋巴瘤的临床表现及病理组织学特征,探讨其诊断和治疗方法,提高临床医生对该病的认识。方法对1例面部和下肢浮肿及全身多发硬结1月余,发热1周的患者临床表现的演变、确诊时的组织病理学特点、免疫组织化学结果等多方面进行观察。结果皮肤活检发现组织学病变主要局限于皮下脂肪间质内见核深染的异型细胞弥漫分布或环绕脂肪细胞分布。免疫组化示CD3+,CD8+,CD68+,TiA-1+,G-B+,CD20-,CD7-,TDT-,提示为T细胞来源。治疗(环磷酰胺+长春新碱+表阿霉素)1疗程患者自动出院回家。结论皮下脂膜炎样T细胞淋巴瘤是一种特殊类型的原发性皮肤淋巴瘤,对不明原因的全身皮肤多发硬结伴发热的患者应该考虑该病的可能。病损处皮肤活检是确诊该病的主要手段。治疗常用联合化疗,如CHOP方案。本病预后较差。     

Nasopharyngeal mucoepidermoid carcinoma: A case report and review of literature

Background

Salivary gland-type tumors originating in the nasopharynx are rare, and only a few articles about mucoepidermoid carcinomas (MEC) in this location have been reported. We describe one case of nasopharyngeal MEC and, based on a review of the literature, discuss different therapeutic approaches that can be taken regarding the result of histological findings, radiological tests and extent of disease.

Case presentation

A 47-year-old woman diagnosed with mucoepidermoid carcinoma of nasopharynx, T1 N3 M0 (stage IV-B) was treated in 2007 with a combination of radiotherapy and chemotherapy to a maximum dose of 70 Gy and concomitant Cisplatin during the radiation. One year later, with the head and neck disease under control, mediastinal nodes relapse appeared which were treated with exclusive radiotherapy to a maximum dose of 65 Gy. One year after the first relapse, a second relapse was detected in the right lung, next to the previously treated mediastinal regions, and the patient initiated a treatment with exclusive chemotherapy based on TPF scheme.

Conclusion

For limited or resectable MEC, combined surgery with radiotherapy, or radiochemotherapy, should be considered the main treatment policy. On the other hand, in poorly differentiated, unresectable tumors or nasopharyngeal MEC, radiochemotherapy could be currently the main treatment approach.     

A child with anorexia nervosa presenting with severe infection with cytopenia and hemophagocytosis: a case report

Background

Patients with anorexia nervosa in the acute phase have physical complications, such as infectious disease. Although hemophagocytic syndrome due to infection is a rare complication in anorexia nervosa, early identification for hemophagocytosis is important for avoiding a life-threatening condition.

Case presentation

We report a case of a 12-year-old girl with anorexia nervosa presenting with infection with cytopenia and hemophagocytosis during initial nutritional therapy. She developed pyrexia, abdominal pain, and diarrhea during inpatient treatment. Although intravenous antibiotics were administered, the symptoms persisted. Acinetobacter baumannii was detected in blood culture. Hemophagocytosis was present in the bone marrow. Gamma globulin therapy was effective, with improvement in symptoms and cytopenia.

Conclusions

Although our case did not fulfill the criteria of hemophagocytic syndrome, clinicians should consider severe infection in anorexia nervosa with cytopenia and hemophagocytosis.

     

Rhinosporidiosis in Egypt: A case report and review of literature

Rhinosporidiosis is an infection caused by Rhinosporidium seeberi that frequently presents as a polypoidal nasal lesions. Here, we report the first indigenous case of tumoral rhinosporidiosis in Egypt. In this case, a 25-year-old male patient from a rural background of Assuit City presented with epistaxis and a nasal polyp. The patient had not traveled abroad. The diagnosis was established on the morphological basis by the identification of 5- to 10-m endospores and 50- to 1000-m sporangia. The clinicopathological and immunologic features were discussed and the literature was reviewed. To the best of our knowledge this is the first case of this disease to be reported in Egypt in the human literature.     

A rare case report of polyangiitis overlap syndrome: granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis

Background

Granulomatosis with polyangiitis (GPA) is a systemic ANCA-associated vasculitis characterized by necrotizing granulomatous inflammation and a predilection for the upper and lower respiratory tract. Eosinophilic granulomatosis with polyangiitis (EGPA) is also a systemic ANCA-associated vasculitis, but EGPA is characterized by eosinophilic as well as granulomatous inflammation and is more commonly associated with asthma and eosinophilia.Polyangiitis overlap syndrome is defined as systemic vasculitis that does not fit precisely into a single category of classical vasculitis classification and/or overlaps with more than one category. Several polyangiitis overlap syndromes have been identified, however, there are very few case reports of an overlap syndrome involving both GPA and EGPA in the medical literature.

Case presentation

We conducted a PUBMED literature review using key words ‘granulomatosis with polyangiitis,’ ‘Wegener’s,’ ‘GPA,’ ‘eosinophilic granulomatosis with polyangiitis,’ ‘Churg-Strauss,’ ‘EGPA,’ ‘overlap syndrome,’ ‘Wegener’s with eosinophilia,’ and ‘GPA with eosinophilia’ in English only journals from 1986 to 2017. Relevant case reports and review articles of overlap syndromes of GPA and EGPA were identified. We aim to report a unique case of GPA and EGPA overlap syndrome and review the cases that have been previously described.Between 1986 and 2017, we identified 15 cases that represent an overlap syndrome with compelling features of both GPA and EGPA. Patients ranged in age between 21 and 78. Of those whose gender was identified, 80 % of the patients were female. All cases described involved the lungs, 60 % reported sinus involvement, and more than 50 % displayed renal involvement. An overwhelming majority of patients were positive for c-ANCA and demonstrated eosinophilia (peripheral blood or tissue eosinophilia). A preponderance of the cases described were treated with systemic corticosteroids combined with an immunosuppressive/cytotoxic agents.

Conclusion

To our knowledge, there have been very few cases reported of an overlap syndrome of GPA and EGPA. Identification of patients with a polyangiitis overlap syndrome of GPA and EGPA is imperative as prognosis, longitudinal management and treatment modalities may differ between these entities.

     

Isolated jejunal metastasis in a patient with cervical cancer: A case report

Background

In approximately 8% of cervical carcinoma patients, gastrointestinal tract is involved, most commonly the rectosigmoid portion, because of local extension. Isolated metastases to small bowel are exceedingly rare.

Case report

We present a case of a 63-year-old woman with cervical cancer who developed isolated jejunal metastasis 8 months after postoperative chemoradiotherapy. The patient was alive with no evidence of disease 6 months after resection of metastasis. Very few cases have been reported concerning squamous cell carcinoma of the cervix with documented metastases to the small bowel. There is only one published case report of cervical cancer with multiple metastases to the small intestine and jejunum. To our knowledge, this is the first case of cervical cancer with isolated jejunal metastasis, which was initially demonstrated with positron emission tomography and confirmed histopathologically.

Conclusion

Although the exact mechanism underlying the isolated metastasis is unknown, hematogenous spread or tumor seeding during surgery may play a role.     

A case report of brucellosis with fever and abdominal pain at onset

Brucellosis is a zoonosis caused by Brucella ,with an acute or chronic clinical infection .Clinical manifestations of brucellosis are various or atypical ,and it is easily misdiagnosed and miss-diagnos...