恶性肿瘤患者的皮肤转移（附50例报告）

恶性肿瘤的皮肤转移确与患者的病种、病理类型、术前后淋巴结转移情况、临床分期、手术类型、放疗及化疗的剂量、遗传因素有关。其出现于任何部位均提示预后不佳。     

IgE and atopy in perinatally HIV-infected children

Elevated serum immunoglobulin E (IgE) and increased prevalence of atopy is reported in patients infected with human immunodeficiency virus (HIV). The elevated serum IgE may be attributed to polyclonal stimulation of B cells or IgE production against allergens, viruses, fungi and bacteria. This study investigates the prevalence of atopy in perinatally HIV-infected children, and the relationships between serum IgE (and other serum immunoglobulins) with atopy, CD4+ cell count and HIV-disease stage. Serum immunoglobulin levels, epicutaneous skin test for common aeroallergens, clinical Centers for Disease Control and Prevention (CDC) classification, CD4+ cell counts and allergy history were extracted from the charts of perinatally HIV-infected children on highly active antiretroviral therapy. The prevalence of atopy (52%) and the pattern of aeroallergen sensitivity were comparable with the US pediatric population. Serum IgE levels did not correlate with clinical disease stage. However, in non-atopic patients, serum IgE levels increased with disease progression (p = 0.02). There was an inverse relationship between the prevalence of elevated serum IgE levels and atopy with progression of disease (p = 0.019). Serum IgE did not correlate with atopy, CD4+ cell count, or duration of HIV infection or levels of serum immunoglobulins. This is the first study to show no increased prevalence of atopy in perinatally HIV-infected children compared with the general population. In advanced stages of HIV, elevated serum IgE may be specific for antigens other than those known as allergens.     

组织工程皮肤中黑色素细胞的培养纯化

目的探讨如何以简便快速的方法获得大量高纯度的黑色素细胞。方法以包皮组织作为细胞来源,用消化法获得表皮细胞悬液,用该实验室设计的方法对细胞进行纯化,Dopa染色、S100免疫组化和透射电镜鉴定细胞来源。结果用该实验室的纯化方法培养的黑色素细胞贴壁快,细胞产量高,未见角朊细胞和成纤维细胞污染。结论结果表明该实验方法可以快速获得大量高纯度的黑色素细胞。     

人体蠕形螨感染的皮肤组织病理学观察

目的:观察人体蠕形螨感染所致皮肤组织病理学改变。方法:收集7例面部皮肤标本经HE染色后在显微镜下观察。结果:在患者面部皮损处扩大的毛囊和增生的皮脂腺中检查出大量蠕形螨成虫、若虫和虫卵。人体毛囊蠕形螨多寄生于毛囊的根部或毛囊周围组织内,被寄生的毛囊均有不同程度的扩张,虫体周围常可见淋巴细胞为主的慢性炎症细胞浸润,毛根角质化较常见。人体皮脂蠕形螨寄生部位为皮脂腺体及导管部,可见腺细胞增生而失去正常结构,但较少有炎症细胞浸润,导管部有轻度扩张。结论:人体蠕形螨寄生与皮肤组织病理学改变有密切关系。     

防晒制剂皮肤安全性的实验研究

目的 :探讨同一系列不同SPF(sunprotectionfactor)防晒制剂对皮肤的安全性 ,筛选安全有效的防晒制剂配方。方法 :选用白化豚鼠背部去毛 ,分别涂抹SPF值为 15、2 8、30 +三种防晒制剂 ,以UV光源照射 ,波长为 32 0～4 0 0nm ,强度为 ( 16 8± 2 )mW/cm2 。结果 :三种不同SPF防晒制品对实验动物皮肤各时相点反应积分为 ,SPF15组为0 ;SPF2 8组为 1;SPF30 +组为 3。结论 :三种不同SPF值产品对皮肤的光毒性有一定差异 ,提示SPF值在 2 8以内的防晒制剂皮肤安全性较好 ,SPF30 +的防晒制剂对皮肤有一定光毒刺激反应。     

皮肤交界性平滑肌瘤的复发与恶性转化

目的探讨皮肤交界性平滑肌瘤的复发与恶性转化。方法复习2例皮肤交界性平滑肌瘤及其复发恶性转化的临床病理特征、免疫组化表型及相关文献。结果2例病变位于下肢和额部，肉瘤组织平滑肌标记阳性。结论少数病理诊断为皮肤平滑肌瘤的病例，虽然浅表且组织形态良性，但其生物学恶性潜能尚不能确定，部分病例复发后可转变为典型的平滑肌肉瘤。     

Biological characterization of glutaraldehyde-modified Parietaria judaica pollen extracts

BACKGROUND: Allergoids are widely used in specific immunotherapy (SIT) for the treatment of IgE-mediated allergic diseases, but all techniques for standardization of conventional allergic extracts may not be appropriate for standardization of a glutaraldehyde (GA)-modified extract because of the unique characteristics of these extracts. OBJECTIVE: To assess an accurate methodology for standardization of chemically modified extracts. METHODS: GA-modified extracts from Parietaria judaica pollen were purified by diafiltration. Biochemical properties were investigated by determination of amino groups, chromatography, and SDS-PAGE. The IgE-binding activity was determined by skin prick test, enzyme allergosorbent test inhibition, basophil activation, and histamine release tests. Peripheral blood mononuclear cells (PBMCs) from P. judaica pollen-allergic subjects were stimulated with either native or allergoid extracts, and proliferation was measured. RESULTS: Biochemical data indicated a high degree of allergen polymerization resulting in extract components higher than 100 kDa. IgE-binding activity, both in vivo and in vitro, was reduced by more than 99.8%. Both allergen and allergoid induced PBMC proliferation and synthesis of blocking IgG antibodies at similar rates. Moreover, no evidence of introduction of new determinants by chemical modification was found. CONCLUSIONS: The preparation of GA-modified extracts by diafiltration is faster and more reliable than previous chromatographic methods. These modified extracts have drastically reduced their allergenicity while maintaining their immunogenicity, and therefore they can be used in safer and shortened schedules of SIT.     

烧伤创面细菌分布对植皮存活率的影响

目的　通过对烧伤病人不同时间的痂下组织细菌定量培养及种类检测 ,探讨手术时间、菌量和菌种与植皮存活率的关系。方法　选择 3 65例病人于手术时取痂下组织以组织匀浆行细菌定量并鉴定菌种。结果　 45 0份标本中 3 90份为阳性 ,共培养出细菌 5 80株 ,以铜绿假单胞菌(2 7.93 %)及金黄色葡萄球菌 (16.2 0 %)为最常见种类 ;手术时间、菌量和菌种对植皮存活率均有不同程度的影响 (P <0 .0 1)。结论　手术时间越早 ,痂下组织细菌含量越少 ,菌种较单一 ,植皮存活率越高 (P <0 .0 1) ;金黄色葡萄球菌感染对植皮存活率影响较大 (P <0 .0 1)。     

Calciphylaxis – a topical overview

'Calciphylaxis', a calcification syndrome associated with ischaemic cutaneous necrosis, is acquired naturally in humans in disease states. It is a life and limb-threatening complication, usually observed in patients with renal disease and secondary hyperparathyroidism, but known to occur in the absence of renal or parathyroid disease. The reported mortality rate, which ranges from 60-80%, relates to wound infection, sepsis and organ failure. It is a small-vessel vasculopathy, which is estimated to occur in about 4% of haemodialysis patients. Clinically, violaceous, reticulate areas of cutaneous necrosis and eschar may be evident, particularly in the extremities. In addition to the clinical picture, a raised calcium phosphorous product, an elevated parathyroid hormone level, radiographic evidence of vessel and soft-tissue calcification and the finding of mural calcification affecting small arteries and arterioles on histopathology help to confirm the diagnosis of this entity which generally has a poor prognosis. A high index of suspicion and an active multidisciplinary management approach, with rigorous attention to wound care and prevention of sepsis, are vital in the management of these patients. In this overview, we discuss the pathophysiology, clinical features and associations, risk factors, diagnosis and management issues relating to calciphylaxis.     

几种评价保湿产品无创性测试方法的相关性评价

目的:对测量皮肤角质层含水量和屏障功能的几种无创性皮肤测试方法进行相关性评价。方法:采用SKICON-200测定皮肤电导法、皮肤保水功能测定、TEWL测定、受试者主观评价的方法,比较某种保湿霜/精华素使用前、后皮肤角质层含水量和屏障功能的变化,并分析这些方法之间的相关性。结果:保湿霜的效果优于精华素,SKICON-200测定皮肤电导法、皮肤保水功能测定以及部分受试者临床症状和主观评价指标(如红斑、脱屑情况,皮肤滋润度的改善、皮肤细纹数量变化和皮肤弹性改善)有很好的平行关系。TEWL结果在本试验中变化不大,与上述指标没有平行关系。结论:SKICON-200测定皮肤电导法、皮肤保水功能测定适合用于保湿化妆品的功效评价。TEWL测定对于屏障功能受损的皮肤可能更敏感,对于健康皮肤使用前、后比较可作为参考指标。