Objective To study the mechanism of 308 nm excimer laser combined with piperine activated the production of melanin in amelanotic melanocytes in outer root sheath of hair(AMMC) ,and promote the expression of TRP‐1、TRP‐2 protein . Methods AMMC were in incubated for 24、72、120 h in different groups(combination therapy group ,the 308 nm excimer laser group ,the piperine group ,the positive control group and the control group) .Then the melanin content was measured .The expres‐sion change of TRP‐1 and TRP‐2 in cells were observed by laser scanning confocal microscopy .Results Four groups increased the AMMC cellular melanin content .Four different groups could promote melanin content at different degrees .The combination therapy group played the strongest role in promoting function .And the function was the most obviously in 24 h ,it also was concentration dependent .0 .5 mmol/L piperine in combination group and piperine group could produce promoting effect of within 72 h on the ex‐pression of TRP‐1 ,but its role was not evident in the expression of TRP‐2 .308 nm excimer laser had effects both on TRP 1 and TRP 2 .Conclusion 308 nm excimer laser combination with piperine can increase the activation of amelanotic melanocytes in outer root sheath of hair .

OBJECTIVE: To establish the HPLC fingerprints of the freeze-dried Xueshuantong for injection.METHODS: The HPLC chromatographic column was Zorbax SB-Aq-C18(250 mm?4.6 mm,5 ?m) and the mobile phase consisted of acetonitrile-water for gradient elution.The UV detection wavelength was set at 203 nm.RESULTS: There were 13 mutual peaks in the HPLC fingerprints of the freeze-dried Xueshuantong for injection.The relative retention time and relative peak area ratio of the fingerprints in which ginsenosides Rg1 served as internal standard were obtained.The area of non-mutual peaks represented no more than 5% of total peak area.CONCLUSION: The method is simple and reliable and it is applicable for the quality control of the freeze-dried Xueshuantong for injection.

Visualization technology is more and more widely used in clinical anesthesia.Nerve block in pediatric anesthesia assisted by visual technique of ultrasound not only achieved the similar curative effect as traditional blind operation but also had lower incidence of complications,so this technology is more and more useful in pediatric anesthesia.This article reviewed the progress of the application of ultrasound guided nerve block in pediatric anesthesia.

Despite of great advances in drug management of heart failure in the past ten years,the condition remains a major public health issue,with high prevalence,poor clinical outcomes.Treatment of established systolic chronic heart failure includes agents that block the renin-angiotensin-aldosterone and sympathetic nervous systems to prevent adverse remodelling,to reduce symptoms and prolong survival.Diuretics,Vasodilator and Digoxin are often used to improve sign,with no influence on prognosis.Pharmacological agents aimed at new targets on clinically relevant endpoints are going under investigating.

Objective To observe the effect of Melodic Intonation Therapy on severe aphasia.Methods Additionally to the stimulus therapy,familiar songs were used in the treatment of listening,retelling and naming in 12 cases.Results The patients showed improvement in listening,retelling and naming.Conclusion Using familiar songs in the treatment can promote the recovery of aphasic patients.

Objective To develop self-management behavior assessment scale for chemotherapy patients with peripherally inserted central catheter (PICC),and test the validity and reliability of it.Methods In reference to Chronic Disease Self Management Study Measure and its scoring standard by patient education and study center of American Stanford University,in combination with PICC patient self-management content,with reference to the literature,expert assessment,the self-management behavior assessment scale was established.The scale included five dimensions,19 quantitative indicators,a total of 78 entries.From February 2010 to November 2011 192 cases of breast cancer chemotherapy patients with PICC participated in the survey.Results Effective questionnaire was 178 copies,scale of content validity index (CVI) was 0.906,the overall Cronbach alpha coefficient was 0.892.Using factor analysis method,4 common factors were extracted whose characteristic root was greater than 1,and could explain 41.180％ of the total variance,each item on the corresponding factor of load was above 0.3.Conclusions The evaluation scale has good validity and reliability,which can provide researchers with a tool to evaluated and intervene with self management behavior of breast cancer chemotherapy patients with PICC.

Objective To assess the association between the depth of trophoblastic penetration into the tubal wall with serum concentrations of vascular endothelial growth factor (VEGF) and β-human chorionic gonadotropin (β-HCG). Meth-ods Eighty patients with a diagnosis of tubal pregnancy in the ampullary region underwent radical surgical treatment (sal-pingectomy), were included in this study. The serum levels of VEGF andβ-HCG were detected on the day of surgery. The se-rum level of VEGF was measured by ELISA. The serum level ofβ-HCG was quantified with a two-site immunofluorimetric assay based on the direct sandwichtechnique. Histological material was stained with Masson's trichrome to identify muscular fibers. Immunohistochemical staining was used for human placental lactogen (hPL) to identify intermediate trophoblast and determine the depth of trophoblastic invasion into the tubal wall. The ampullary pregnancies were classified histologically ac-cording to the depth of trophoblastic infiltration into the tubal wall. Results The mean serum values of VEGF andβ-HCG were significantly lower in patients with stage I tubal infiltration than those of stageⅡ, and which were significantly lower in patients with stageⅡthan those in stageⅢ(P<0.05). The threshold serum value of VEGF was 308.6 ng/L, the sensitivity was 100.0%and the specificity was 92.6%for stageⅠand stageⅡ. The threshold serum value of VEGF was 431.9 ng/L, the sensitivity was 79.3%and specificity was 79.2%for stageⅡandⅢ. The threshold serum value ofβ-hCG was 2 509.6 IU/L, the sensitivity was 91.7%and specificity was 81.5%for stageⅠand stageⅡ, and levels of 13 142.6 IU/L, 72.4%and 95.8%for stageⅡand stageⅢ. Conclusion The depth of trophoblastic penetration into the tubal wall is associated with maternal serum concentrations of VEGF andβ-HCG, which can be used as the evaluation index for histological staging of trophoblas-tic tissue infiltration.

Objective To explore the mechanism of macro-reentry atrial tachycardia and to guide catheter ablation using electroanatomic mapping system in 3 patients.Methods Three patients(two females),aged 51?12 years,with atrial tachycardia were included.The mean history of symptom was 19?11 years.Conventional electrophysiological study was performed to determine the location of atrial tachycardia before the three dimensional geometry reconstruction.After voltage and activation maps were constructed,the mechanism of tachycardia was analyzed and the slow conduction areas(critical isthmus) were verified.Radiofrequency energy was delivered using irrigated-tip catheter.Results Though there was no evidence to suggest structural heart diseases,scar areas were found in the mapped atria in all the three cases.The mechanism of atrial tachycardia was found to be counter-clockwise macro-reentry around tricuspid valve,counter-clockwise macro-reentry around superior vena cava,and figure "8" reentry in left atria in the 3 patients respectively.The respective critical isthmus was found to be between the lateral scar and tricuspid valve,the lateral scar and superior vena cava,and two scars on the left atria roof.Ablation in the critical isthmus terminated all tachycardia.There were no atrial tachycardia recurrence during a follow-up of 9-10 months.Conclusion The substrate and electrophysiological mechanism of macro-reentry atrial tachycardia could be identified clearly,and navigation ablation could be performed effectively under the guidence of electroanatomic mapping.

Ovarian neoplasms,composed predominantly or exclusively of small round cells with scant cytoplasm,is relatively rare.However,there is a wide range of differentiation,and pathologists often struggle to make a correct diagnosis because of its overlapping histological features.Perhaps the best known neoplasm of this kind is ovarian small cell carcinoma of the hypercalcemic type,which may be confused with a wide range of neoplasm from sex cord-stromal tumor to neoplasm in the family of small round blue cell tumor to various undifferentiated malignancies.Small cell carcinoma of the pulmonary type may also arise from the ovary,and this may be a component of a typical ovarian surface epithelial-stromal tumor.Other small cell neoplasm that may arise within the ovary or involve the ovary includes intra-abdominal desmoplastic small round cell tumor,metastatic small cell carcinoma,peripheral primitive neuroectodermal tumor,and endometrial stromal sarcoma.In this review,the morphologic features of some of these neoplasms are described,as well the value of immunohistochemistry and other ancillary techniques in establishing a diagnosis.

Objective: To share the anti-infection experience for the patients with complicated intra-abdominal infection after operation.Methods: The whole course of drug administration participated by clinical pharmacist in one patient with complicated intra-abdominal infection after pancreatoduodenectomy were retrospectively analyzed and discussed.Results: Enterococcus was found in the blood culture and ascites.According to the results of drug sensitive tests, clinical pharmacist provided medication suggestions and performed medication mornitoring.According to the blood concentration, clinical pharmacist adjusted the dose of vancomycin, and changed the therapy regimen according to the changes of conditions.As a result, adverse reactions were controlled timely, and satisfactory treatment effects were obtained.Conclusion: The aetiology of complicated intra-abdominal infection is complex with intractable treatment, and the participation of clinical pharmacists in the treatment can improve the efficiency and safety.