Lumps and bumps in neonates and infants

There are many developmental abnormalities that may appear in the neonate and in infants when critical steps in embryogenesis fail. These steps are often not fatal but can lead to significant morbidity for those patients affected. A logical approach is needed in addressing both the diagnostic and therapeutic issues that arise when caring for these patients, as various lesions will warrant an observational approach, and others may require imaging studies or definitive surgical intervention. Additionally, there are other "lumps and bumps" that are seen in the neonatal and infantile age groups that include malignancies and cutaneous neoplasms with associated systemic sequelae.     

BRAF、NRAS癌基因与恶性黑素瘤的研究

近年来,世界范围内黑素瘤的发生率正逐渐升高,发病年龄也愈来愈早,其死亡率也随之增加.环境因素和遗传易感因素是恶性黑素瘤发病的主要机制.遗传易感性的研究发现,与散发性恶性黑素瘤发病密切相关的两个遗传易感基因是位于RAS-RAF-MEK-ERK途径的BRAF、NRAS基因.其中BRAF基因是黑素瘤中突变率最高的基因,也是目前黑素瘤特异性靶向治疗研究的热点基因.概述BRAF、NRAS基因突变在恶性黑素瘤形成、发生、发展中所起的重要作用,并评述BRAF基因突变在黑素瘤临床诊治上的应用价值.     

Understanding and Evaluating Systematic Reviews and Meta-analyses

A systematic review is a summary of existing evidence that answers a specific clinical question, contains a thorough, unbiased search of the relevant literature, explicit criteria for assessing studies and structured presentation of the results. A systematic review that incorporates quantitative pooling of similar studies to produce an overall summary of treatment effects is a meta-analysis. A systematic review should have clear, focused clinical objectives containing four elements expressed through the acronym PICO (Patient, group of patients, or problem, an Intervention, a Comparison intervention and specific Outcomes). Explicit and thorough search of the literature is a pre-requisite of any good systematic review. Reviews should have pre-defined explicit criteria for what studies would be included and the analysis should include only those studies that fit the inclusion criteria. The quality (risk of bias) of the primary studies should be critically appraised. Particularly the role of publication and language bias should be acknowledged and addressed by the review, whenever possible. Structured reporting of the results with quantitative pooling of the data must be attempted, whenever appropriate. The review should include interpretation of the data, including implications for clinical practice and further research. Overall, the current quality of reporting of systematic reviews remains highly variable.     

Human T lymphocytes and mast cells differentially express and regulate extra- and intracellular CXCR1 and CXCR2

CXCL8 plays a major role in cell recruitment to sites of inflammation. Apart from neutrophils, little is known, however, about the cellular distribution and regulation of CXCL8 receptors in cells involved in acquired and adaptive immune responses. In previous studies, we have demonstrated the extracellular expression and function of CXCR1/2 on mast cells and also detected an intracellular pool of CXCR1/2. Here, we have addressed the question of receptor regulation during stimulation of human mast cells (HMC-1 cell line) and have studied T cells in comparison. Cell permeabilization was performed to detect both surface and possible intracellular receptor pools. HMC-1 cells stained positive for both receptors on the cell surface (CXCR1, 50%; CXCR2, 51%) and also after cell permeabilization (CXCR1, 86%; CXCR2, 74%). Similarly, T cells exhibited both cell-surface receptor expression (CXCR1, 30%; CXCR2, 23%) and higher total receptor expression (CXCR1, 50%; CXCR2, 36%), although overall values were lower than that in HMC-1 cells. On immunoblot, molecular weights of extra- and intracellular receptors on mast cells were the same, excluding altered receptor glycosylation. On stimulation with phorbol 12-myristate 13-acetate plus calcium ionophore, a time-dependent decrease of surface-membrane receptors was observed in both cell types, while total receptor remained the same, suggesting that receptor shedding is not involved. The kinetics of membrane receptor internalization and replenishment differed for the two cell types. Furthermore, receptor internalization was associated with decreased F-actin polymerization, a basic prerequisite for cell migration. These findings demonstrate for the first time the expression of extra- and intracellular CXCR1/2 receptors on T cells and delineate the dynamics of CXCR1/2 receptors on mast cells and T cells. Furthermore, they suggest a cell-type-specific and finely tuned regulation of chemokine responses at the receptor level in the context of inflammation.     

噬菌体疗法及其在皮肤和泌尿生殖道感染中的应用与展望

【摘要】 随着耐药菌的大量出现,给临床抗感染治疗带来严峻挑战。噬菌体疗法被认为是能够应对这种困境非常有希望的方法,已在很多学科得到探索和应用,在清除皮肤黏膜感染方面的疗效也得到证实,成为目前国际研究的热点。应用多种噬菌体混合的鸡尾酒疗法、噬菌体内溶酶以及噬菌体蛋白治疗耐药的金黄色葡萄球菌、铜绿假单胞菌、大肠杆菌、克雷伯菌、变形杆菌等获得良好的效果。本文综述噬菌体疗法的背景、特征、发展特点及其在皮肤和泌尿生殖道感染中的应用和前景。     

血管瘤与脉管畸形诊疗现状与展望

【摘要】 随着血管瘤和脉管畸形分类的不断更新,其诊断和治疗也逐步发展。婴儿血管瘤预后良好,但治疗时机和方法选择对预后至关重要,β受体阻滞剂是一线药物。而脉管畸形尤其一些发病率较低的脉管畸形相关综合征的正确诊断及鉴别诊断仍是现代医学领域面临的挑战。近年研究显示,脉管畸形致病与相关基因突变相关,这些发现为靶向药物治疗提供了理论依据。本文阐述常见的血管瘤及脉管畸形的诊断和治疗现状、存在问题及未来研究方向。     

大学生婚恋观与家庭亲密度及适应性的关系研究

目的:了解大学生婚恋观与家庭亲密度及适应性的关系,为正确引导大学生婚恋观提供帮助。方法:采用《大学生婚恋观问卷》《家庭亲密度和适应性量表中文版》(FAVESⅡ—CV)对307名陕西某高校大学生进行测量。结果:大学生婚恋观处于开放和保守的中间水平,其家庭亲密度和适应性以中间型居多;大学生婚恋观总体上存在生源地显著差异,不存在性别差异;家庭亲密度则正好相反,家庭适应性在任何方面都不存在差异;大学生婚恋观与家庭亲密度和适应性显著相关;家庭理想亲密度和实际适应性对大学生婚恋观有正向预测作用。结论:家庭理想亲密度、实际适应性能正向预测大学生婚恋观。     

Polymyositis and dermatomyositis: Disease spectrum and classification

Muscle inflammation and weakness are the key features of idiopathic inflammatory myopathies (IIMs). In addition IIMs are frequently associated with cutaneous and pulmonary involvement. In clinical practice the three common inflammatory myopathies we come across are polymyositis (PM), dermatomyositis (DM) and inclusion body myositis (IBM). The Bohan and Peter criteria combine clinical, laboratory, and pathologic features to define PM and DM. They did not recognize inclusion body myositis (IBM) or other inflammatory myopathies, such as granulomatous and eosinophilic myositis. Thus the disease spectrum is wide and IIMs are a heterogeneous group of autoimmune disorders. To address these issues in this article we have discussed the currently developing newer classifications of IIMs.     

子宫内膜样癌及卵巢浆液性癌中PR、P53、ER的表达及其临床病理学意义

目的:探究与分析传统子宫内膜样癌及卵巢浆液性癌中PR、P53、ER的表达及其临床病理学意义。方法:选取我院自2013年1月至2014年10月收治的120例子宫内膜样癌及卵巢浆液性癌患者作为研究对象进行回顾性分析,其中子宫内膜样癌患者45例,卵巢浆液性癌患者75例。采用免疫组化En Vision法分析所选的患者病理标本中PR、P53、ER的表达情况。对比在不同病理分型、组织分级、临床分期中PR、P53、ER的表达水平。结果:子宫内膜样癌PR、P53、ER的表达率与浆液性癌PR、P53、ER的表达率比较,组间差异显著(χ~2=5.49,P0.05;χ~2=4.76,P0.05;χ~2=4.23,P0.05)。中、高分化癌PR、P53、ER的表达率与低分化癌PR、P53、ER的表达率相比,组间差异显著(χ~2=5.33,P0.05;χ~2=4.23,P0.05;χ~2=4.57,P0.05)。临床分期Ⅰ~Ⅱ期患者PR、P53、ER的表达率分别与低分化癌PR、P53、ER的表达率相比,组间对比差异显著(χ~2=5.33,P0.05;χ~2=4.23,P0.05;χ~2=4.57,P0.05)。结论:子宫内膜样癌及卵巢浆液性癌中PR、P53、ER的表达存在较大差异,这对于卵巢癌病变诊断及鉴别诊断具有重要意义,值得在临床中推广PR、P53、ER的监测。     

Dermatoses in overweight and obese children and their relationship with insulin and skin color

Background/Aim

The aim of the present study was to investigate the prevalence of obesity-related dermatoses in obese children, and the association between these dermatoses and insulin resistance as well as skin color.

Methods

Obese, overweight, and normal weight children according to body mass index who were followed up and treated in the outpatient clinics were included in the study. Dermatological examinations of the participants were performed, and fasting insulin and glucose levels were checked.

Results

The obese and overweight children were evaluated as the patient group (70 girls, 41 boys, mean age: 12.37 ± 3.14 years). One hundred one healthy children with normal weight were determined as the control group (59 girls, 42 boys, mean age: 12.15 ± 2.43). The first five common dermatoses in the patient group when compared with the control group were keratosis pilaris (KP), striae distensae, hyperhidrosis, acanthosis nigricans (AN), and plantar hyperkeratosis. The first five dermatoses which were positively correlated with formation and insulin resistance were KP, striae distensae, AN, hyperhidrosis, and plantar hyperkeratosis. According to the Fitzpatrick skin scale, we found that the darker the skin color, the higher the probability of AN and KP (OR, 0.298; 95% CI, 0.106–0.834, p = 0.021; OR, 0.306; 95% CI, 0.117–0.796, p = 0.015, respectively).

Conclusion

Some dermatoses associated with obesity and insulin resistance were not found in obese children, or there was no significant association. These results indicate that many skin morbidities may be prevented by preventing and treating obesity and insulin resistance in the early period.     

Phytotherapy and psoriasis:Complementary and alternative medications

Psoriasis comprises severe skin problems affects on quality of patient's life. It affects 2% of the general population with age before 35 years old. Most potent and cheap psoriatic drugs are still largely unavailable. Recently, as aresult of the apparent side effects of chemical drugs, treatments of herbal origin gains the popularity among patients with skin disorders especially those for psoriasis. In this review, the uses of complementary and alternative medications of various topical herbal formulae with different potency against psoriasis was greatly assessed. Modified Psoriasis scoring systems were performed as evident of improvement when various topical herbal formula including traditional chinese medicine ingredients such as Camptotheca acuminate, Oleum horwathiensis, Capsaicin, furocoumarins, Curcumin, and Tars were used against psoriasis. Also, plant extracts of Aleo Vera, and green tea were reported in topical form for the treatment of psoriasis. Most studies indicated a variety of biological activities of used herbs depending on their chemical constituents. This versatile range of biological activities explaining,the apparent benefits of these herbs in monitoring of psoriasis.     

Scabies and pyodermas – diagnosis and treatment

Scabies and pyodermas are two of the commonest skin infections in tropical settings. They affect large numbers of people, particularly children, and account for a large burden of disease for peripheral health care teams. Despite this there have been significant advances in our knowledge of these diseases, their impact and their management. However there is a need to evaluate these developments in this specific setting, tropical health and in the context of communities with limited resources. This section will describe these advances and the challenges that remain.