表皮囊肿并发毛母质瘤

报告2例表皮囊肿并发毛母质瘤。例1,男,34岁。右侧大腿上方有一灰褐色肿块,直径4cm。皮损组织病理检查示表皮囊肿的囊壁不完整,囊肿中央和周边均为成片的影细胞,囊肿中央的影细胞内可见许多小而圆的嗜伊红角化中心,提示向毛母质分化,未见嗜碱性细胞。例2,女,20岁。右上臂暗蓝色、质硬的皮下结节,直径1cm。皮损组织病理检查示表皮囊肿与毛母质瘤同时存在于真皮内,相互独立,毛母质瘤内可见嗜碱性细胞和影细胞。2例患者均未出现加德纳综合征。     

浅谈皮肤科来华留学研究生培养的心得体会及建议

来华留学生培养是中国高等教育的重要组成部分,是提高中国高等教育的国际知名度、中国大学国际化程度的环节之一.皮肤科留学研究生的培养在来华留学生中有一定的需求,但大多数以东南亚来源国和非洲国家为主,其文化背景、医学基础知识差异大,很多不懂中文,缺乏统一的英文或英汉皮肤性病学教材等,这些都给带教老师带来了较大的挑战.该文分享...     

医学实习生管理现状分析与对策

我国医学院校的学生毕业后大多从事医疗工作,毕业实习是医学院或卫生学校专业教学的重要组成部分,在这一环节要完成从学生到医务工作者的过度.医学生进入临床实习是将理论知识和临床实践相结合的重要阶段,对今后的临床工作具有重要意义.因此,如何在临床实习阶段管理好学生,充分发挥临床实习应有的作用,是医学院校管理者应重点关注的问题.为此,本文针对医学实习生管理现状、实习生难管理的原因及如何改进管理措施等进行探讨. 1 医学实习生管理现状和原因 根据对皖北地区15家较大规模医院的调查,54.8％的被调查医院认为实习生管理较难,37.5％的被调查医院认为实习生管理非常难,3.2％的被调查医院不愿意接收医学临床实习生.     

系统性红斑狼疮的精神障碍

神经系统受累是系统性红斑狼疮患者残疾、死亡的重要原因之一,临床表现为一系列高度异质性的神经精神症状.其中精神症状主要包括精神病、急性意识错乱状态、情绪障碍、认知功能障碍和焦虑症.然而,当前仍缺乏相关的诊断标准和治疗准则,导致对精神狼疮患者的诊断不足和治疗不当.因此,本文围绕精神狼疮展开综述,促进患者及临床医生对其的认识...     

规范抗乙肝病毒治疗与肝癌术后肿瘤复发的关系

目的 通过肝癌多学科协作（multi-disciplinary team,MDT）诊治模式下实施规范抗乙肝病毒方案在肝癌病人中的应用,探讨抗乙肝治疗与肝癌术后生存率及肿瘤复发的关系。方法 回顾性分析2015年1月至2017年12月经我院肝癌MDT讨论后实施规范抗乙肝治疗病人（治疗组,36例）和未进行规范抗乙肝治疗病人（对照组,34例）的临床资料,比较两组病人肝癌术后肿瘤复发情况及1、3、5年内生存率。结果两组病人一般情况、实验室指标、肿瘤大小及术前HBV-DNA差异无统计学意义（P> 0.05）,手术后为期5年的随访中治疗组病人1、3、5年肿瘤复发率分别为8.3%、33.3%、41.6%;对照组1、3、5年肿瘤复发率分别为11.7%、41.1%、64.7%,差异均具有统计学意义（P <0.05）。治疗组病人1、3、5年生存率分别为91.6%、66.7%、58.3%;对照组1、3、5年生存率分别为88.2%、58.8%、29.5%,差异均具有统计学意义（P <0.05）。结论 HBV相关性肝癌病人在经过肝癌MDT制定方案,术前和术后实施规范抗乙肝病毒治疗,可有效降低肝癌...     

内皮素对黑素瘤A375细胞转化生长因子-β1及磷酸化Smad 3蛋白表达的调节

Objective To investigate the effects ofendothelin-1 (ET-1) and endothelin-3 (ET-3) on the expression of transformation growth factor-beta 1 (TGF-β1) and phosphorylation of Smad 3 in malignant melanoma cell line, A375. Methods Cultured A375 cells were classified into 5 groups, i.e. control group (no stimulation), ET-1 group (stimulated with ET-1), ET-1+BQ123 group (treated with ET-1 and BQ123),ET-1 + BQ788 group (treated with ET-1 and BQ788), ET-3 group (stimulated with ET-3), to receive different stimulation. The working concentrations were 0, 0.1, 1, 10, 100 nmol/L for ET-1 and ET-3, 10 μmol/L for BQ123 and BQ788. After another 12- and 24-hour culture, ELISA, RT-PCR and Western blot were used to detect the expression of TGF-β1 protein and mRNA as well as phosphorylated Smad 3 (P-Smad 3). Results The expression of TGF-β1 in A375 cells was up-regulated by ET-1, but down-regulated by ET-3, and both of the effects were in a concentration-dependent manner. Under the stimulation with ET-1 and ET-3 of 100 nmol/L, the level of TGF-β1 reached 1289.38 ± 89.42 ng/L per 105 cells and 85.09 ± 9.37 ng/L per 105 cells, respectively, significantly different from that in unstimulated cells (both P < 0.05). BQ123 signifi-cantly blocked the up-regnlatory effect of ET-1 on the expression TGF-β1 protein(P < 0.05), but BQ788 had no significant influence on the effect, so was the case with TGF-β1 mRNA. Western blot revealed that ET-1significantly elevated the expression of P-Smad 3 in A375 cells (P <0.05), and the elevation was significantly inhibited by BQ123, but not by BQ788. The expression of P-Smad 3 was statistically decreased by ET-3 in A375 cells (P <0.05). Conclusions The expression of TGF-β1 could be enhanced by ET-1, but suppressed by ET-3. It is likely that endothelin receptor A mediates the phosphorylation of Smad 3 induced by ET-1.     

内皮素对黑素瘤A375细胞转化生长因子-β1及磷酸化Smad 3蛋白表达的调节

Objective To investigate the effects ofendothelin-1 (ET-1) and endothelin-3 (ET-3) on the expression of transformation growth factor-beta 1 (TGF-β1) and phosphorylation of Smad 3 in malignant melanoma cell line, A375. Methods Cultured A375 cells were classified into 5 groups, i.e. control group (no stimulation), ET-1 group (stimulated with ET-1), ET-1+BQ123 group (treated with ET-1 and BQ123),ET-1 + BQ788 group (treated with ET-1 and BQ788), ET-3 group (stimulated with ET-3), to receive different stimulation. The working concentrations were 0, 0.1, 1, 10, 100 nmol/L for ET-1 and ET-3, 10 μmol/L for BQ123 and BQ788. After another 12- and 24-hour culture, ELISA, RT-PCR and Western blot were used to detect the expression of TGF-β1 protein and mRNA as well as phosphorylated Smad 3 (P-Smad 3). Results The expression of TGF-β1 in A375 cells was up-regulated by ET-1, but down-regulated by ET-3, and both of the effects were in a concentration-dependent manner. Under the stimulation with ET-1 and ET-3 of 100 nmol/L, the level of TGF-β1 reached 1289.38 ± 89.42 ng/L per 105 cells and 85.09 ± 9.37 ng/L per 105 cells, respectively, significantly different from that in unstimulated cells (both P < 0.05). BQ123 signifi-cantly blocked the up-regnlatory effect of ET-1 on the expression TGF-β1 protein(P < 0.05), but BQ788 had no significant influence on the effect, so was the case with TGF-β1 mRNA. Western blot revealed that ET-1significantly elevated the expression of P-Smad 3 in A375 cells (P <0.05), and the elevation was significantly inhibited by BQ123, but not by BQ788. The expression of P-Smad 3 was statistically decreased by ET-3 in A375 cells (P <0.05). Conclusions The expression of TGF-β1 could be enhanced by ET-1, but suppressed by ET-3. It is likely that endothelin receptor A mediates the phosphorylation of Smad 3 induced by ET-1.     

皮肤恶性黑素瘤凋亡相关基因Survivin Bax表达及其与端粒酶的关系

目的探讨凋亡相关基因Survivin,Bax及人端粒酶逆转录酶(hTERT)在皮肤恶性黑素瘤中的表达及其临床意义。方法SP免疫组化染色检测63例皮肤恶性黑素瘤和21例色素痣组织中Survivin,Bax蛋白水平;原位杂交技术检测上述组织中人端粒酶逆转录酶(hTERT)mRNA水平。结果①凋亡相关蛋白Survivin在皮肤恶性黑素瘤中的表达明显强于其在色素痣中的表达,Bax在二者中的表达无明显差异,hTERTmRNA表达与Survivin相似;②Survivin蛋白和hTERTmRNA表达均与恶性黑素瘤病理学类型、淋巴结转移、浸润深度及预后相关,Bax表达与之无相关;③hTERTmRNA在黑素瘤中的表达水平与Survivin呈高度正相关,与Bax表达无关,Survivin与Bax表达水平无明显相关性。结论皮肤恶性黑素瘤形成和发展与肿瘤细胞抗凋亡(Survivin)和促进增殖(hTERT)均密切相关;Survivin和hTERT对皮肤恶性黑素瘤的辅助诊断及预后评估具有重要的临床意义;Bax表达与皮肤恶性黑素瘤的发生发展无明显相关性。     

凋亡抑制蛋白c-FLIP在银屑病患者外周血和皮损中的表达

目的 探讨凋亡抑制蛋白c-FLIP在寻常性银屑病患者外周血和皮损中的表达和分布情况。方法 采用流式细胞仪检测30例寻常性银屑病患者和20例正常人对照组外周血T细胞和B细胞内c-FLIP蛋白表达阳性率，采用免疫组化方法检测c-FLIP蛋白在其皮损中的表达。结果 进行期银屑病患者外周血T细胞内c-FLIP表达（6.32% ± 1.17%）明显高于恢复期患者（2.64% ± 0.74%，P < 0.01）和正常人对照组（2.28% ± 0.54%，P < 0.05）。而其在外周血B细胞内的表达3组间差异无统计学意义，3组分别为0.78% ± 0.16%，0.71% ± 0.32%，0.69% ± 0.18%，P值均 > 0.05。c-FLIP蛋白在进行期银屑病患者皮损中的表达（89.73 ± 5.24）明显高于恢复期（117.40 ± 7.50，P < 0.05）和正常人对照组（121.58 ± 7.93，P < 0.01），恢复期患者和正常人对照组之间差异无统计学意义（P > 0.05）。结论 凋亡抑制蛋白c-FLIP在进行期银屑病患者的外周血T细胞和皮损内明显高表达，可能参与银屑病患者T细胞的增殖。