Objective To have a general picture the history and existing problems of independent clinical labs in China, for the purpose of building a supervision mechanism for such novel clinical institutions-clinical labs. Methods By way of the nationwide network of clinical labs, ICLs in China were surveyed with written questionnaires and field check. Results ICLs have grown into a greater and diversified scale thanks to the development of China's economy and laboratory technology. However,such vulnerabilities as unbalanced staff ratio, full-range quality control bugs, cutthroat competition,asymmetrical information disclosure, and bio-safety have loomed large in the meantime. Conclsion It is time to formulate a stricter industry access system and appropriate regulatory modes; ICLs should take a good care of the "Four relations" in their development, and health regulators should play a tighter role in the "Four supervisions". All these aim at better sharing medical resources, and building a win-win environment for the people, hospitals and ICLs.

Objective To treat a group of patients with port wine stains (PWS) using a variable pulse width (VPW) frequency doubled Nd:YAG 532nm with high energy long pulse green (HELP G) laser and to evaluate the clinical efficacy, side effects and different histological changes between VPW and HELP G. Methods Thirty two patients with PWS were treated in order to study the clinical improvement by transforming from 11～16 J/cm 2 at 3 mm spot size (VPW,7～10 ms) gradually to 16～24 J/cm 2 at 4～5 mm spot size (HELP G,15～50 ms). Two patients were biopsied before and after the laser treatment.Results After treatment of 1～8 times(3.19 average), very good results were achieved in 7 PWS, and excellent results were achieved in 15 PWS.Improvement was found in 68.75 % of the patients.Conclusion VPW with HELP G laser at 532 nm appears to be an effective treatment for PWS.

Objective To investigate the dose-effect relationship between Q-switch ruby laser and skin pigmentation in Guinea pigs. Methods Ten Guinea pigs were included in this study, and the back of each pig was divided into 5 areas, negative control area receiving no UVB irradiation or laser treatment, positive control area receiving UVB irradiation but no laser treatment, low-, middle- and high-dose areas receiving UVB irradiation followed by the treatment with laser at an energy density of 1.5, 3.0 and 6.0 J/cm2 for 4, 2, and 1 session, respectively, with an interval of 1 week. Melanin content index (MCI) was determined, and confocal laser scanning microscopy (CLSM) and histopathology were performed to observe melanin granules and melanocytes in the skin tissue from Guinea pigs before the initial laser treatment, 2 and 4 weeks after the final laser treatment. Results The best response was observed in the low-dose areas, and there was a complete clearance of hyperpigmentation in these areas, which maintained 8 weeks without recurrence, while different degrees of skin pigmentation recurred in the middle- and high-dose areas. Moreover, the low-dose areas showed a significantly lower melanin content index (MCI) compared with the middle- and high-dose areas (F = 4.2,P < 0.05), together with a marked reduction in the extent of pigment deposition, melanin granules, melanocyte number and density. Conclusions The efficacy of Q-switched ruby laser on skin pigmentation in Guinea pigs is correlated with the energy density and treatment frequency, and, low intensity and high frequency are often associated with a better treatment outcome.

ObjectiveTo compare the accelerating effect of topical recombinant human epidermal growth factor (rhEGF) and recombinant bovine basic fibroblast growth factor (rb-bFGF) on wound healing after fractional CO2 laser therapy.MethodsTwenty male guinea pigs were included in this study.After hair removal and irradiation with fractional CO2 laser,the back of each guinea pig was divided into 4 regions to be topically treated with rhEGF of 10 μg/cm2 (rhEGF group),rb-bFGF of 262.51 IU/cm2 (rb-bFGF group),the combination of rhEGF and rb-bFGF (combination group),or normal saline (control group),twice daily until the healing of wound.Skin physiology parameters including elasticity index and melanin index were detected before the irradiation,7,14 and 28 days after the irradiation,and compared between the 4 groups by analysis of variance.Tissue specimens were obtained from 4 mice at the above time points and subjected to pathological examination for the observation of collagen fibers and quantification of fibroblasts.ResultsAfter fractional CO2 laser therapy,the crusts fall off completely in growth factor-treated regions,while partly in the control regions,within 3 to 7 days; the wounds healed completely in 14 to 28 days in all the groups,with the regenerating tissue being more tender and redder compared with the surrounding unirradiated tissue.The wound surface was smaller in area and redder in color in the 3 growth factor-treated groups than in the control group.At 28 days after the irradiation,the elasticity index was 262.29 ± 62.40 in the combination group,202.00 ± 65.62 in the rhEGF group,188.86 ± 35.02 in the rb-bFGF group,167.14 ± 42.49 in the control group.Statistical difference was observed in elasticity index,but not in skin melanin index among the 4 groups.Pathological examination showed a dense and organized arrangement of collagen fibers in the combination group but a sparse and disorganized arrangement of collagen fibers in the control group.ConclusionThe combined application of rhEGF and rbbFGF can accelerate the healing of wound and increase the elasticity of regenerating tissue after fractional CO2 laser therapy.

Two cases of nevus of Ota resistant to multiple sessions of Q-switched laser treatment are reported.Both of the patients were females,who developed beige or blue patches on the left side of the face (zygomatic region,cheek)several months after birth.No conjunctiva or sclera was involved.The lesions spread to the left retroauricular region and posterior neck during pregnancy in one patient.Histopathological examination of the lesions showed scattered melanocytes and melanophages in lower dermis and subcutaneous adipose tissue as well as apparent proliferation of collagen.Immunostaining for CD34 showed no abnormality in the distribution of vascular endothelial cells in these tissues.No obvious improvement was observed in either of the patient after more than 10 sessions(12 sessions in 1 case,and 13 sessions in the other case)of treatments with Q-switched alexandrite(755 nm)or Q-switched Nd:YAG laser(1064 nm).The immediate response of lesions to laser irradiation was unusual.Purpura or errhysis was absent in the lesions after repetitive irradiation with high-energy laser,but both were visible in the adjacent normal skin even after irradiation with low-energy laser.

Objective To summarize our experience in the diagnosis and management of popliteal artery entrapment syndrome (PAES). Methods This is a retrospective study on 10 patients (13 limbs)who were admitted for symptoms of claudication and the diagnosis of popliteal entrapment was established either with angiography,computed tomographic angiography,magnetic resonance angiogram or during the operation in recent 7 years (2002-2009).All patients were treated surgically. Results The mean age at the time of presentation was (25 ±7) years old (range,17-41 years).Claudication was the most frequent presenting symptom (12 limbs).The surgical procedures consisted of simple musculotendinous dissociation in 1 limb,thrombectomy with balloon angioplasty in 1 limb,musculotendinous dissociation plus thromboendarterectomy with autogenous saphenous vein (ASV)patch angioplasty in 2 limbs,ASV graft interposition or bypass in 6 limbs and graft interposition or bypass in 3 limbs.At a median follow-up of (35 ±27) months (range,2 months-7 years),there were no intraoperative or long-term postoperative complications and all the patients were cured. Conclusions PAES is an unusual but important cause of peripheral vascular insufficiency especially in young patients.A combined approach is necessary for diagnosis.Popliteal artery release alone or with vein bypass or reconstruction is the treatment of choice.

Objective To observe the preventive and therapeutic effects of L-carnitine on the metabolic disorder and cardiac remodeling in alcoholic cardiomyopathy. Methods Experimental animals were divided into three groups: alcohol-fed group(A), an alcohol/L-carnitine fed group(B) and a control group(C). Free fatty acid(FFA) and earnitine were detected in the blood serum at different time. mRNA and protein expressions of peroxisome proliferator-activated receptors (PPARα and PPARγ), retinoic acid receptor retinoid X receptor alpha (RXRα), earnitine palmitoyl transferase isoform and medium-chain acyl-CoA dehydrogenase (MCAD) were observed with RT-PCR and Western blotting methods. Results (1) When group A and B were compared with group C, FFA was increased and carnitine was decreased;mRNA and protein expressions of PPARα, RXRα, CPT-Ⅰ and MCAD were decreased with the development of alcoholic cardiomyopathy (ACM), being more significantly in group A than group B (P < 0.05). (2) mRNA and protein expressions of PPARγ had no statistical significance between these three groups at the end of 2 and 4 months(P>0.05), but after 6 months, they were increased in group B and decreased in group A (A vs. C,P<0.01;B vs. C,P<0.05). Conclusion Metabolic disorder and cardiac remodeling occur in the development process of ACM; they are partly prevented by L-carnitine through downregulating mRNA and protein expressions of PPARct, RXRα, CPT-Ⅰ, MCAD and PPARγ.

Objective To analyze the skin barrier function in patients with facial steroid dermatitis.Methods Ninety-five patients with facial steroid dermatitis were enrolled into this study along with 25 healthy volunteers as controls.Transepidermal water loss(TEWL)and skin hydration were measured in 8 facial regions.including lesional skin in forehead,nasal tip,submaxilla,both cheeks and angulus oris,and non-lesional skin in the left posteior ear.Results Compared with the healthy group,the patients with steroid dermatitis had a significant higher value of TEWL on lower mandible,both angulus oris and cheeks(t:4.90,2.60,2.57,2.54,3.77,respectively,P＜0.01),while a significant lower level of skin hydration was noted on both angulus otis,right cheek and forehead(t=3.27,3.81,2.02,2.78,respectively,P＜0.05).Among the 8 test sites in both patients and controls,TEWL value decreased in the following order:submaxilla and both angulus oris＞both cheeks and forehead＞non lesional skin on the posteroir ear,and the decrease in skin water content was highest in submaxilla and both angnlus oris,followed by cheeks and forehead,and finally by left posterior ear.Conclusions In patients with facial steroid dermatitis,skin barrier function is disturbed on submaxilla,both angnlus oris and cheeks,and TEWL value is found to be higher in perioral area,while cheeks have a lower level of skin hydration.

AIM:To determine the function of peritoneal mesothelial cells on the inflammatory microenvironment by administration of endometrial cells,and further define the pathogenesis of endometriosis.METHODS:Homogenous mouse endometrial epithelial and stromal cells were injected into the peritoneal cavities of Swiss Webster mice.After 4,24,and 72 h,a number of endpoints evaluated:protein concentrations of cytokine MCP-1,IL-1 ?,IL-6 in peritoneal lavage and gene expressions of MCP-1,IL-1 ?,IL-6 in peritoneal mesothelial cells and macrophages.RESULTS:The intraperitoneal administration of endometrial cells increased the protein expressions of cytokines in the peritoneal lavage of the recipient mice,which increased at 4-hour points and subsequently decreased with time.Gene expressions of cytokines in peritoneal mesothelial cells paralleled with the protein quantities in peritoneal lavage.The peak time of gene expression of cytokines in peritoneal macrophages was at the 24-hour point.The endometrial epithelial cells stimulated stronger inflammatory responses in the peritoneal cavity than the endometrial stromal cells.CONCLUSION:The recipient mice have a non-specific inflammatory response to the presence of endometrial cells in the peritoneal cavity.Mesothelial cells may be the targets of early inflammatory stress initiated in the presence of endometrial cells.

Objective To study effect of rubescens on inflammatory cytokines and liver function of alcoholic liver injury rat model.Methods 120 SD rats were chosed for studied, randomly divided into control group, model group and treatment group,40 rats per group.Alcoholic liver injury rat model was made by ethanol feeding approach, rubescens were given for treatment.Then serum AST, ALT, α-GST, GLDH content and liver tissue NF-κB, TNF-α, IL-6, IL-8 levels were detected by electrochemiluminescence and fluorescent quantitation PCR,respectively.Results Model group serum AST, ALT,α-GST, GLDH contents and NF-κB, TNF-α, IL-6, IL-8 contents in liver tissue were higher than control group(t=12.030~37.417, P<0.05). Treatment group serum AST,ALT, α-GST, GLDH contents and NF-κB, TNF-α, IL-6, IL-8 contents in liver tissue were lower than model group (t=5.128~32.325, P<0.05).Conclusion Alcohol feeding can cause liver damage, rubescens therapy can reduce liver injury, relieve inflammation.