易与花斑糠疹混淆的融合性网状乳头瘤病合并黑棘皮病1例

融合性网状乳头瘤病为一种少见的原因不明的皮肤病,不易诊断。多见于青少年,好发于躯干部和腋窝,为褐色鳞屑性斑片或斑块。临床易误诊而被延误治疗。报告1例融合性网状乳头瘤病合并黑棘皮病,曾被多次拟诊为"花斑糠疹",有较典型的临床表现和组织病理改变。口服及外用异维A酸治疗有效。     

绿慕安治疗脂膜炎1例

脂膜炎是一种少见病,目前尚无特效疗法,我们用绿慕 安治疗１例,效果良好,现报道如下。 　　病例　患者,女,５９岁,全身散在凹陷性硬斑１年多。 检查：双下肢股外侧各有一处掌大硬性斑片,局部轻度凹 陷,臀部及上臂亦见指甲大上述皮损,伴轻度疼痛,不发烧。 曾在省级皮肤病专科医院治疗无效,遂于１９９８年６月２０ 日来我院就诊。即予绿慕安皮下注射,隔４天１支,４０天 后硬性斑块变软,范围缩小,未再出现新的病损,２０支后 病损缩小过半,触之已无硬感,继续治疗观察中。 　　讨论　皮下脂肪层有…     

不同方法治疗皮肤型孢子丝菌病

皮肤型孢子丝菌病首选口服抗真菌药物治疗,如碘化钾、伊曲康唑、特比萘芬和氟康唑等[1].由于个体差异及疾病情况的复杂性,患者对每种抗真菌药物治疗的反应不同,最近我们应用不同的方法治愈了4例皮肤型孢子丝菌病患者,报道如下.1临床资料1.1病例1患者男,68岁,北京市延庆县农民.因右侧面部皮损8个月于2008年12月8日就诊.8个月前患者右侧面部出现米粒大小皮损,之后皮损破溃、增多,伴疼痛.否认外伤史.皮肤科情况:右面颊部可见8个1 ～1.5 cm大小皮损,基底红肿,其上有厚的结痂,无脓液渗出,可触及多数皮下结节(见图1a).皮损痂屑KOH湿片真菌镜检阴性,皮损组织真菌培养为申克孢子丝菌.皮损组织病理显示表皮角化不全,有脓痂,表皮呈假上皮瘤样增生;真皮全层弥漫淋巴细胞、组织细胞、多核巨细胞、浆细胞、嗜中性粒细胞浸润,伴少许嗜酸粒细胞;PAS染色未见真菌成分.诊断:皮肤淋巴管型孢子丝菌病.     

缓解性血清阴性对称性滑膜炎伴凹陷性水肿22例临床回顾

目的:总结缓解性血清阴性对称性滑膜炎伴凹陷性水肿(RS3PE)的临床特点及转归,为该病的诊治提供更多的参考依据。方法:回顾性分析我院2004年1月至2016年2月的22例我院收治的RS3PE住院病例的临床数据和随访资料,总结该病的特点。结果:本研究纳入男性13例(59.1%),女性9例(40.9%),平均发病年龄(65.6±10.0)岁(40.0～79.0岁),发病至确诊时间12天至2年,均为急性起病,并伴有不同程度的对称性多关节炎及肢端水肿。发热6例(27.3%)。主要实验室指标:血红蛋白(109.1±16.0)g·L~(-1),血小板计数(277.0±91.8)×109·L~(-1),血清白蛋白(36.1±5.0)g·L~(-1),C反应蛋白(62.5±67.4)mg·L~(-1),血沉(58.1±33.9)mm/h。测血清铁蛋白的6例中有5例(83.3%)升高,测肿瘤标记的10例均正常。18例(81.8%)行关节影像学检查,均未见骨破坏。5例行唇腺粘膜活检、2例行骨髓穿刺活检均无异常。住院期间治疗后症状均明显好转,4例(18.2%)单用糖皮质激素,18例(81.8%)在激素基础上联用慢作用药物。电话随访4.0月～8.0年(中位随访时间5.0年),有5例(22.7%)关节症状和肢端水肿持续缓解,4例(18.2%)症状减轻,1例(4.5%)反复,3例(13.6%)发展为类风湿关节炎,9例(40.9%)失访,确诊淋巴瘤1例(4.5%)。老年组RS3PE患者红细胞计数、血红蛋白、血清总蛋白及白蛋白低于非老年组。结论:RS3PE多为老年患者,急性起病,为对称性多关节炎伴肢端水肿,常伴贫血及低蛋白血症,对糖皮质激素敏感,有时可伴肿瘤,关于RS3PE的随访观察病例数迄今仍不足。     

痤疮严重程度与影响因素分析及经非那雄胺片治疗后的临床观察

目的:通过对痤疮患者资料的回顾性分析,将痤疮与影响因素的关系进行总结,并对非那雄胺片治疗不同程度痤疮的疗效进行比较,为痤疮有效治疗奠定基础.方法:对166例痤疮患者进行性别、年龄、家族史、BMI、皮损分值与痤疮严重程度等资料的搜集,分析上述各因素与痤疮严重程度的关系,记录非那雄胺片对不同程度痤疮的疗效.结果:166例患者中女性140例(84.34％),男性26例(15.66％);年龄11～59岁;(平均25.19±8.07岁);4例(2.41％)为初次发病,162例(97.59％)既往有痤疮病史;随着年龄升高轻度痤疮患者的比例升高,中重度痤疮以16～25岁为主;BMI18.5～23.9组不同严重程度痤疮患者BMI差异显著(P＜0.05);痤疮Ⅰ度、Ⅱ度严重患者,无家族史的例数较多,而Ⅲ度严重患者有家族史的例数较多(P＜0.05);痤疮Ⅰ度严重组中,治疗4、12周及痤疮Ⅱ、Ⅲ度严重组治疗4、8、12周时的皮损综合分值与治疗前相比差异显著(P＜0.01),治疗后皮损综合分值明显减低;痤疮Ⅰ度、Ⅱ度、Ⅲ度严重组好转率分别为47.2％、62.9％、64.0％,三组好转程度无显著差异(P＞0.05).复发率分别为:16.7％、15.2％、4.0％,三组复发程度也无显著差异(P＞0.05).结论:痤疮患者的初发年龄男性平均17岁,女性平均20岁,随着年龄增长痤疮以轻度为主;轻中度痤疮患者多不伴有家族史,而重度痤疮患者多有家族史;非那雄胺片可有效抑制不同严重程度的痤疮的复发,在治疗过程中,其对中重度痤疮的疗效优于轻度痤疮.     

两个弥漫性掌跖角化病家系的病理特征与基因突变分析

为了明确两个弥漫性掌跖角化病家系的临床、病理特征、角蛋白9在局部组织中的表达情况及KRT9基因的突变, 对2名先证者的手掌皮肤进行组织病理学、免疫组织化学分析, 并用聚合酶链反应技术及直接测序分析的方法, 对家系中46名成员的KRT9基因进行突变分析。发现两名先证者的表皮都呈显著的角化过度, 颗粒层和棘层明显增厚, 真皮浅层有轻度的炎症细胞浸润, 上基底的棘层和颗粒层的角质形成细胞中都有特征性的空泡变性存在; 角蛋白9只在棘层和颗粒层的角质形成细胞中特异性表达; 两个家系患者分别存在KRT9基因的点突变N160S和L167S; 说明这两个家系都属于表皮松解性掌跖角化病家系, KRT9基因N160S和L167S突变分别导致这两个家系发病。     

以皮肤受累为首发表现的播散性念珠菌病1例并文献复习

目的：播散性念珠菌病是一种致命性真菌感染性疾病,在免疫缺陷患者中发病率逐年增多,报道1例以双下肢多发皮下结节为首发表现,伴有肺及脑受累的播散性念珠菌病,并文献复习播散性念珠菌病的皮肤受累临床表现。方法患者女,37岁。因双下肢多发皮下结节6个月余就诊。有局灶节段性肾小球硬化病史,口服强的松及他克莫司2a余。取患者皮损组织行病理学检查,皮损组织、脓液、血、痰、尿、粪、脑脊液进行真菌镜检及真菌培养,并文献检索统计播散性念珠菌病皮肤受累患者临床特点。结果皮损组织病理见假菌丝,皮损组织、脓液、痰、尿、粪标本直接涂片均见假菌丝并培养出白念珠菌,CT显示肺受累,诊断为播散性念珠菌病,予抗真菌治疗,患者皮损愈合及肺部病灶部分吸收,但因自行停药,最终出现颅内播散。结论以皮损为首发表现的播散性念珠菌病临床罕见,临床诊疗中应重视应用免疫抑制剂患者皮损的组织病理及微生物检查,及早进行诊断和治疗,防止出现系统性播散,从而降低死亡率。     

实验准备工作对马拉色菌直接镜检的影响

目的探讨实验准备工作对马拉色菌直接镜检的影响,旨为提高直接镜检的检出率,为花斑癣诊断和鉴别诊断提供病原学证据。方法对217例花斑癣患者皮损处的皮屑进行直接镜检。结果取材方法、标本处理方式等实验准备工作,大大影响直接镜检的效果。用透明胶布粘贴法取材,制成的湿片外观能看到患者皮损的原始形状,镜下马拉色菌分布按体表状态自然分布,无明显角化皮损镜检的阳性率高达94．5％～100．0％,有明显角化皮损镜检的阳性率仅为45．8％。用锉刀刮取法取材,无明显角化皮损镜检的阳性率〈90．0％,有明显角化皮损镜检的阳性率达87．5％。不同的载液处理标本以及载液作用标本的时间长短都影响皮屑直接镜检的阳性率。结论不同的皮损采用不同的取材方法及标本处理方式,将大大提高直接镜检的阳性率和准确率。     

五个家族货币状掌蹠角化病的遗传调查

自Wachters等1983年提出货币状掌蹠角化病的命名以来,迄今国内尚未见此病以独 调查方法及内容 发现先证者,询问现病史、既往史、家族史及身体检查。调查内容包括:病史、发病年龄、皮损发展过程、皮损数目、皮损部位、家族中有     

掌跖角化病41例调查报告

掌跖角化病(keratosis palmaris et plantarls) 是一种较少见的角化过度性遗传病Ll,。我院皮肤科自1980年一1984年所见4例,并对此4 个先证者进行了家族系谱的追访调查,经追访又发现41例发病者（不包括先证者）,兹将调查结果报告如下。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.