Malignant melanoma is the most common fatal skin tumor.Molecular targeted drugs effect on advanced and metastatic melanoma is remarkable,including mitogen-activated protein kinase (MAPK) inhibitors,phosphatidylinositide 3-kinase (PI3K) inhibitors,receptor tyrosine kinase (TKR) inhibitors and vascular endothelial growth factor (VEGF) inhibitors.Vemurafenib and Dabrafenib,as the representative of the v-Raf murine sarcoma viral oncogene homolog B1 (BARF) kinase inhibitors,play important roles for malignant melanoma.However,the primary or acquired drug resistance to this drug limits its clinical use.At present,some new molecular targeted drugs such as Trametinib,representative of mitogen-activated extracellular signalregulated kinase (MEK) inhibitors,have been used and patients can benefit from the treatment.Studies on the mechanism of drug resistance and the combination of multiple target drugs also provide more potential for individualized molecular targeted therapy of malignant melanoma.

As an important means of lung protective strategy, prone position ventilation (PPV) which can effectively shorten the time of mechanical ventilation, significantly reduce the mortality of patients with acute respiratory distress syndrome (ARDS), and is suitable for popularization and application in the ICU. However, some studies show that prolonged prone position can significantly increase the incidence of Stress injury, making it difficult to implement PPV in the practical level. In order to achieve the goal of safe and effective prevention of skin Stress injury, and to promote the correct implementation of PPV, this paper review the methods of preventing Stress injury in patients with PPV.

Objective: To investigate clinical and histopathological features of subcutaneous sarcoidosis. Methods: A retrospective analysis was performed. Clinical and pathological data were collected from 8 patients diagnosed with subcutaneous sarcoidosis in Hospital for Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College between 2012 and 2018, and analyzed retrospectively. Results: Out of the 8 patients, 1 was male and 7 were female, with an average onset age of 50.5 years. The main skin manifestations were multiple painless skin-colored subcutaneous nodules, with no history of trauma or ulceration. Other skin lesions included erythema in 1 case and dark-purple plaques in 1 case. Lung involvement was detected in 6 cases, and no other systems were involved. Histopathological findings were mainly non-caseating granulomas in the subcutaneous tissue with negative acid-fast staining. Of the 8 patients, 7 received short-term oral glucocorticoid treatment and achieved remission or subsidence of lesions, 1 patient was lost to follow-up. Conclusions Subcutaneous sarcoidosis initially manifests as painless skin-colored subcutaneous nodules, which can be complicated by erythema, plaques and so on. Histopathological findings are characterized by non-caseating granulomas. Chronic and mild systemic involvement, especially lung involvement, is common in patients with subcutaneous sarcoidosis, and the prognosis is quite favorable.

Transmembrane proteins (TMEMs) are a class of membrane proteins, also known as integral membrane proteins, that contain at least one transmembrane structure. A variety of membrane protein function has been found closely related to the proliferation, invasion and metastasis of malignant tumors: TMEM48, TMEM45A/B, TMEM14A, TMEM158 and TMEM206 have tumor promoting effects; TMEM25 and TMEM7 have antitumor effects; TMEM16A, TMEM17, TMEM97, TMEM88 and TMEM176 play heterogeneity roles in different tumors. These TMEMs can be used as potential prognostic indicators and new therapeutic targets.

Objective To analyze the CT features in the early stage of asymptomatic active pulmonary tuberculosis (PTB)in adolescence after PTB outbreak.Methods After PTB outbreak in a boarding school of a certain county in northern Jiangsu province,the clinical data, X-ray and CT findings of 47 cases with active PTB were analyzed retrospectively and compared with CT findings after treatment.Results In 47 cases,the incidence of male was higher than that of female,and 27 cases were negative on chest X-ray.The difference of X-ray and CT detection rate in the early stage of active PTB was statistically significant (P<0.001).Of 47 cases,46 patients had pulmonary parenchymal lesions and 1 had pleural effusion on CT.The lesions were found on 58 lobes and 60 lung segments,and 35 cases demonstrate lesions on the upper lobes,22 cases on the lower lobes,1 case on the middle lobe.CT images showed tree-in-bud opacities (68.1%),micronodules (89.4%) and consolidation (21.3%).All of patients got better after antituberculous therapy.Conclusion Active PTB should be considered first when CT scan shows micronodules or tree-in-bud signs in adolescences with PTB exposure.

Objective:To investigate clinical and histopathological features of mucinous nevi.Methods:Clinical and pathological data were collected from 10 patients with clinically and histopathologically confirmed mucinous nevi in Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2014 to December 2019, and retrospectively analyzed.Results:All cases developed mucinous nevi in childhood, with an average age of onset being 6.5 years. Of the 10 patients, 7 had lesions on the trunk, among whom 4 had lesions on the back; the remaining 2 had lesions on the limbs, and 1 had generalized lesions on the trunk and limbs. The skin lesions were locally arranged in lines, bands or clusters, and skin-colored, reddish or yellow in color, with the texture varying from soft to hard. Histopathological examination showed that 10 patients presented with disordered arrangement of collagen fiber bundles in the dermis and mucin deposition at varying locations and to different degrees among them, 6 with thickened and red-stained collagen fibers in the deposition area, and the remaining 4 with sparse and decreased collagen; focal liquefaction degeneration of the basal layer was observed in 2 cases, and different amounts of mature adipose tissue in the dermis were seen in 3 cases.Conclusions:Mucinous nevus pathologically manifests as mucin deposition of varying degrees among disorderedly arrangd collagen fiber bundles in the dermis, which is similar to some other diseases, and is easily misdiagnosed. Close combination of clinical and pathological features facilitates confirmed diagnosis.

Connective tissue nevi (CTN) , a kind of benign skin hamartomas, can be classified into 3 types according to the excessive components predominating in skin lesions, including collagen type, elastin type and proteoglycan type, and each type of CTN includes various inherited and acquired diseases. Therefore, genetic, clinical, and histopathological features should be considered for the confirmation of diagnosis of CTN and its subtypes. According to the latest Chinese and international literature, this review elaborates clinical classification and histopathological characteristics of CTN, aiming to further strengthen the understanding of this disease.