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Objective:To investigate clinicopathological features of hypopigmented mycosis fungoides (HMF) and hypopigmented interface T-cell dyscrasia (HITCD) .Methods:A total of 41 patients with cutaneous hypopigmented lymphoproliferative diseases, who had complete clinicopathological data, were collected from Department of Dermatology, the Third People′s Hospital of Hangzhou from January 2015 to September 2020, and the clinicopathological and immunophenotypic features were analyzed. Comparisons of normally distributed measurement data were carried out using t test, comparisons of categorical data using Chi-square test or Fisher′s exact test, and comparisons of ranked data between 2 groups using rank-sum test. Results:All of the 41 patients clinically presented with irregular hypopigmentation, some of which was accompanied by erythema or furfuraceous scales. In terms of pathological features, 21 patients showed infiltration and aggregation of atypical lymphoid cells in the epidermis, which was consistent with typical pathological features of mycosis fungoides, and they were diagnosed with HMF; 20 patients showed vacuolar degeneration of the basal layer, accompanied by infiltration of lymphoid cells and mild epidermotropism, and they were diagnosed with HITCD. All immune cells expressed T-cell phenotype, and epidermal lymphocytes expressed a CD8-dominated phenotype in 14 (67%) cases of HMF and 13 (65%) of HITCD. In the epidermis, the total number of lymphocytes was significantly higher in the HMF group than in the HITCD group ( t= 1.81, P= 0.012) ; in the dermis, the number of CD4 + lymphocytes and CD8 + lymphocytes, and the total number of lymphocytes were all significantly higher in the HMF group than in the HITCD group ( t= 2.64, 1.51, 2.60, P= 0.012, 0.002, 0.001, respectively) . All patients were treated with narrow-band ultraviolet B radiation. Among 34 patients who completed the follow-up, 30 achieved complete clearance of skin lesions without recurrence, including all patients with HITCD, and 4 with HMF achieved partial regression of the lesions. Conclusions:Compared with HMF, HITCD presents different pathological characteristics and benign biological behaviors. Thus, HITCD should be distinguished from HMF as an independent disease. Phototherapy alone is effective for the treatment of HITCD.
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Objective:To explore the value of series situational simulation teaching combined with symptoms-centered integrated teaching mode in clinical clerkship of obstetrics and gynecology.Methods:A total of 181 students from Batch 2016 of Clinical Medicine (experimental group) were enrolled to receive the series situational simulation teaching combined with symptoms-centered integrated teaching mode. The teaching results were evaluated by formative evaluation scores and questionnaire, compared with 195 students from Batch 2015 (control group). The statistical analysis was performed with SPSS 21.0.Results:Scores of formative evaluation in experimental group [(88.66±5.92) points] was higher than those in control group [(81.11±7.36) points], with statistically significant differences ( P<0.05). Satisfaction of students for teaching flexibility, teaching innovation, learning interest and clinical thinking in experimental group was greater than that of students in control group ( P<0.05). Meanwhile, compared with the control group, teachers from experimental group were more satisfied with teaching flexibility, teaching integration, students' participation and activity in classroom and cultivation of the clinical thinking ability and post competences ( P<0.05). Conclusion:The series situational simulation teaching combined with symptoms-centered integrated teaching mode can help students to form a systemic knowledge system, cultivate their clinical thinking ability and establish a holistic view of disease.
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Objective To investigate the curative effect of Zhizhukuanzhong capsule combined with Deanxit in the treatment of functional dyspepsia ( FD) of spleen -deficiency and qi -stagnation.Methods Seventy -six patients with FD were randomly divided into three groups .A group (24 cases)_was given Zhizhukuanzhong combined with Deanxit,B group (26 cases) was given Zhizhukuanzhong ,C group (26 cases) received trimebutine dispersible tablets treatment.After treatment for 8 weeks,the symptoms of indigestion,depressive state and therapeutic effect were observed.Results Before treatment,there were no statistically significant differences in the symptoms of dyspepsia (all P>0.05).After treatment,the symptoms of dyspepsia were improved in different degree ,the effective rates of A, B,C three groups were 91.6%,65.4% and 42.3%,respectively,there was no statistically significant difference between A group and B group(χ2 =1.579,P=0.209);there was statistically significant difference between A group and C group(χ2 =13.549,P=0.000);there was no statistically significant difference between B group and C group (χ2 =2.786,P=0.09).The FD patients complicated with varying degrees of anxiety and depression ,there was no statistically significant difference among the three groups before treatment (P>0.05).After treatment,comparison of HAMA and HAMD scores among the three groups:there were statistically significant differences between A group and B group (tHAMA =6.839,tHAMD =4.607,all P<0.05),A group and C group (tHAMA =20.069,tHAMD =15.342,all P<0.01),B group and C group (tHAMA =11.951,tHAMD =12.071,all P<0.01).After treatment,the HAMA,HAMD scores of A group and B group were significantly decreased compared with before treatment ( A group tHAMA =52.758,tHAMD=49.970,B group tHAMA =30.230,tHAMD =17.151,all P<0.01).Those in C group had no statistically significant decline compared with before treatment (tHAMA =7.845,tHAMD =3.530,all P>0.05).The adverse reactions of A group were mainly weakness ,dizziness,drowsiness,which were alleviated within 2 weeks.The adverse reactions of B group were slight stomach disease and stool frequency increased ,which not affected the treatment.The adverse reactions of C group were digestive tract symptoms ,which lasted for more than 2 weeks.Conclusion Zhizhukuanzhong capsule combined with Deanxit in the treatment of FD of spleen -deficiency and qi -stagnation can obtain good curative effect,it is safe,convenient,and with minor side effects,good compliance.