Objective To evaluate the diagnostic ability of dermoscopy in facial actinic keratosis.Methods Forty patients with facial lesions suspected for actinic keratosis were enrolled from April 2009 to November 2009. There were 27 males and 13 females among these patients aged from 46 to 88 years. The disease course varied from 2 to 20 years. Lesional specimens were obtained from the subjects and underwent dermatoscopic and histopathologic examinations. The sensitivity, specificity and consistency with pathology were calculated for dermoscopy in the diagnosis of nonpigmented facial actinic keratosis. Results The sensitivity, specificity, Youden index and Kappa index of dermoscopy were 90.91%, 88.89%, 79.80% and 0.798(χ2 = 0.25, P >0.05) respectively in the diagnosis of facial nonpigmented actinic keratosis made by one dermatologist,86.36%, 94.44%, 80.80% and 0.800 (χ2 = 0.25, P > 0.05) respectively in that made by another dermatologist.Conclusion There is a high consistency between dermoscopy and histopathology in the diagnosis of facial nonpigmented actinic keratosis.

Objective To retrospectively analyze the therapeutic effect of wide surgical excision combined with low-dose adjuvant interferon-alpha 2b on cutaneous malignant melanoma.Methods A total of 32 patients with cutaneous malignant melanoma received wide surgical excision after preoperative examination and staging.The excisions were performed with a margin measuring 1-2 cm from the visible lesions or biopsy scars.Surgical modalities included direct suture after excision(4 patients),dactylolysis or toe amputation(6 patients),free skin grafting(15 patients),random skin flap transfer(3 patients)and pedicle skin flap transfer(4 patients).Lymph nodes were selectively dissected in 9 patients with regional transfer of lymph nodes,and inguinal lymph nodes were cleared away in 2 patients.One week after the operation,patients received adjuvant therapy with subcutaneous injection of interferon-alpha 2b(3 million IU,thrice per week)for one to three years.Results Preoperative tumor staging revealed 21 cases of cutaneous malignant melanoma at stage Ⅱ,and 11 cases at stage Ⅲ.The excisions healed by the first stage in all the patients.Up to June 2011,2 patients had been lost to follow up,5 patients with stage Ⅲ melanoma had died.Survival was observed in all of the 4 patients receiving 1-year follow up,12 of 13 patients receiving 1-3 year follow up,5 of 7 patients receiving 3-5 year follow up,and 4 of 6 receiving 5-year follow up.Of the 25 surviving patients,regional lymph node metastasis was observed in 8 patients,which developed within 2 years after the operation in 2 patients.The adjuvant therapy with interferon-alpha 2b lasted 3 years in 8 patients,and more than 1 year in 11 patients.Side effects were mild.Conclusion Wide surgical excision plus low-dose interferon-alpha 2b is effective for the treatment of stage Ⅱ and Ⅲ cutaneous malignant melanoma with lower local recurrence and higher survival rate.

Objective To evaluate the diagnostic ability of dermoscopy in tiny pigmented basal cell carcinoma (BCC).Methods Fifty-eight patients with lesions measuring less than 5 mm in diameter and suspected for tiny pigmented basal cell carcinoma were enrolled in this study.The patients included 19 males and 39 females aging from 16 to 82 years.The disease course varied from 3 months to 25 years.The suspected lesions were examined by dermoscopy,then,two dermatologists independently made a diagnosis according to the findings on dermoscopy.Tissue specimens were also obtained from the suspected lesions for pathological diagnosis.The sensitivity,specificity and consistency with histopathology were calculated for dermoscopy in the diagnosis of tiny pigmented basal cell carcinoma.Results Of the 58 patients,36 were diagnosed with basal cell carcinoma according to pathological findings.Based on the dermoscopic features,41 cases were diagnosed as pigmented basal cell carcinoma by the dermatologist A,and 40 by the dermatologist B.The sensitivity,specificity,Youden index and Kappa value of dermoscopy were 97.22％,72.73％,69.95％ and 0.732 (P ＞ 0.05) respectively in the diagnosis of tiny pigmented basal cell carcinoma by the dermatologist A,97.22％,77.27％,74.49％ and 0.772 (P ＞ 0.05) respectively by the dermatologist B.Conclusion There is a high consistency between dermoscopy and histopathology in the diagnosis of tiny pigmented basal cell carcinoma.

Objective　To explore the relationship between te lomerase activity and bile duct carcinoma and its significance in clinical diag nosis. Methods　Telomerase activities were examined in 23 cases of bile duct carcinoma, 5 cases of carcinoma adjacent tissues and 5 cases of nor mal bile duct tissues respectively with telomerase PCR-ELISA method. Results　Telomerase activity was detected in 18 of 23 cases (78.3%) of b ile duct carcinoma, and was not found in 5 cases of carcinoma adjacent tissues a nd 5 cases of normal bile duct tissues. The detection rate of telomerase activit y had no correlation with patients' age, sex, tumor site and size but significan tly correlated to metastasis of tumor (P<0.05). Conclusion　The level of telomerase activity was significantly higher in bile duct carcino ma and may be served as one of the clinical marker for malignant neoplasm becaus e of its spsecificity.

ObjectiveTo investigate the difference in cell apoptosis between keratoacanthoma and squamous cell carcinoma.Methods Ninety specimens were obtained from the lesions of 30 patients with regressing keratoacanthoma (rKA) and 30 patients with well-differentiated squamous cell carcinoma (wdSCC) as well as from the normal skin of 30 human controls.Immunohistochemistry was carried out to measure the expressions of B-cell leukemia/lymphoma 2(Bcl-2),cysteine-aspartic acid protease(Caspase)-3,second mitochondria-derived activator of caspase/direct inhibitor of apoptosis-binding protein with low pl (Smac/DIABLO) and inhibitor of apoptosis protein Livin.ResultsThe Bcl-2 protein expression was significantly lower in rKA specimens than in normal control specimens(t =3.1572,P ＜ 0.05).A lower expression of Caspase-3 protein was observed in rKA specimens compared with wdSCC specimens (t =2.1364,P ＜ 0.05).The expression of Smac/DIABLO protein was significantly increased in normal control specimens than in rKA and wdSCC specimens(t =7.6141,9.5666,respectively,both P ＜ 0.05).Livin was absent in normal skin,but highly expressed in rKA and wdSCC specimens,and the difference was significant between the normal skin and lesional (rKA and wdSCC) specimens ( t =4.7913,12.7737,respectively,both P ＜ 0.05).The expression of Livin protein was significantly reduced in rKA specimens than in wdSCC specimens(t =7.9824,P ＜ 0.05).Conclusions Cell apoptosis plays a certain role in the natural regression process of KA.The detection of apoptosis-regulating proteins Caspase-3 and Livin are beneficial for the differentiation between rKA and wdSCC.

Objective To investigate the effect of M-CSF and GM-CSF on migration and expression of VEGF-A in breast cancer cell line 4T1.Methods Real-time PCR was used to detect VEGF-A mRNA expression in 4T1 cells treated by 5 ng/ml or 10 ng/ml M-CSF or GM-CSF.Ability of migration and metastasis of 4T1 cells were analyzed by scratch and Transwell assays.Results The relative expression of VEGF-A mRNA at 12 h and 24 h in 4T1 cells treated by 5 ng/ml or 10 ng/ml M-CSF were 17.81±2.49 and 17.48± 5.43,5.15±2.59 and 5.45±4.28,respectively,while those treated by GM-CSF were 9.77±2.39 and 7.61±2.80,6.53±2.41 and 6.30±2.89,respectively.M-CSF and GM-CSF can promote the expression of VEGF-A in 4T1 cells (P ＜ 0.05).The relative expression of VEGF-A was higher in 4T1 cells treated for 12 h than that for 24 h (P ＜ 0.01).M-CSF,GM-CSF and VEGF-A can promote metastasis of 4T1 cells (all P ＜ 0.05),whereas no gross migration of 4T1 cells was showed by VEGF-A treatment.Conclusion M-CSF and GM-CSF can promote the migration and expression of VEGF-A in breast cancer cell line 4T1.

The present study was conducted to investigate the combined effects of recombinant human bone morphogenetic protein 2 (rhBMP 2) and dexamethasone (Dex) on the proliferation and differentiation of bone marrow stromal cells (BMSC). BMSCs were subjected to the treatment with different concentrations of rhBMP 2, Dex, or a mixture of rhBMP 2 and Dex, then proliferation and differentiation of the attached cells were measured with methylthiazol tetrazolium (MTT) method, Coomassie brilliant blue assay and alkaline phosphatase (ALP) measurement kit. The results showed that with treatment of rhBMP 2 alone could promote the proliferation of BMSCs and upregulate the expression of ALP in BMSCs. Treatment with Dex alone could also augment the expression of ALP, whereas high concentration of Dex could inhibit the proliferation of BMSC. Moreover, significantly greater differentiation of BMSCs were found in combined treatment group compared with individual treatment groups. The above results suggested that rhBMP 2 and Dex could synergistically promote the proliferation of BMSC and its differentiation to osteoblast.

Objective To assess the possibility of the transportation of patients with critical burns during shock stage. Method Data on 9 groups (63 cases) of critical burn patients, who were transferred to burn unit in 48 hours after injury, were collected and analyzed during recent 5 years. Results All of the 63 patients were transported stably and successfully. Sixty-one of them were cured and 2 were died of multiple system organ failure at the 9th and the 19th day post burn, respectively. Conclusions On principle, anti-shock treatment of the critical burn patients should be initiated immediately on the spot before transportation. For the hospitals with limited medical resources, however, it is necessary to transfer the patients to the specialized burn units with speedy and smooth vehicles after rapid fluid resuscitation, and fluid transfusion must be carried out simultaneously during transportation.

Objective:To evaluate the effects of propofol on glucose-regulated protein 78 (GRP78)-activating transcription factor-4 (ATF4)-CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) signaling pathway during apoptosis in gastric cancer cells.Methods:MGC-803 cells were cultured to the logarithmic phase and divided into 2 groups ( n=15 each) using the random number table method: control group (group C) and propofol group (group P). The cells in group C were cultured under normal conditions of 37 ℃ and 5% CO 2. In group P, propofol (final concentration 5 μg/ml) was added when the cells were attached to the wall and grown to 70%-90% confluence.At 24 h after propofol was added, the apoptosis rate of cells was determined by flow cytometry, the expression of GRP78, ATF4 and CHOP mRNA was detected by quantitative polymerase chain reaction, and the expression of GRP78, ATF4 and CHOP was determined by Wester blot, respectively. Results:Compared with group C, the apoptosis rate was significantly increased, and expression of GRP78, ATF4, CHOP and its mRNA was up-regulated in group P ( P<0.05). Conclusion:The mechanism by which propofol accelerates apoptosis is related to activating GRP78-ATF4-CHOP signaling pathway in gastric cancer cells.

Objective To investigate the efficacy of dermabrasion combined with aminolevulinic acid-based photodynamic therapy (ALA-PDT) for the treatment of nasal nodular basal cell carcinoma (nBCC).Methods Twentyfive patients who were pathologically diagnosed as nasal nBCC with lesion area ＞ 1 cm2 but no bone or cartilage involvement,were included in this study and treated with dermabrasion combined with ALA-PDT.At first,the part of tumor protruding outside the skin was removed by artherectomy,then dermabrasion was carried out.The wound surface was topically treated with 20％ aminolevulinic acid solution for 3-4 hours away from light immediately after surgery,then irradiated with LED light at a mean dose of 100 J/cm2 for 20 minutes.ALA-PDT was performed once a week for 3 consecutive weeks.The degree of and time required for wound healing were assessed,and tumor recurrence,cicatrization and appearance outcomes were observed during 1 year after surgery.Efficacy was assessed comprehensively.Results No postoperative wound infection occurred in these patients,and the average time for wound healing was (11.2 ± 1.3) days.During 1 year after the treatment,no recurrence was found,while cicatricial contracture developed in 1 case,mild proliferative scar in 3 cases,and depressed scar in 4 cases.All the patients were satisfied with the treatment outcomes,except 1 patient who was basically satisfied.Conclusions Dermabrasion combined with ALA-PDT is easy to operate with rapid wound healing,low postoperative recurrence rate and high degree of patient satisfaction,and is worthy of clinical promotion.