Cutaneous dyschromia is a common problem of plastic and cosmetic surgery. There are not good methods to resolve this problem in present. The mechanisms of skin pigmentation process are not well understood. It is now recognized the correlation between melanogenesis and alpha-melanocyte-stimulating hormone. Alpha-msh enhances activity and quantity of tyrosinase as well as stimulates melanogenesis, specifically to stimulate eumelanin synthesis by activating the melanocortin-1 receptor (MC-1R) on melanocytes. Alpha-msh stimulates melanocyte prolixferation, formation of dendricity, and transfer of melanosomes to keratinocytes, It also protects melanocytes from the damaging effects by immunomodulation. Also, alpha-msh interact with other factors to affect pigmentation indirectly. Agouti signaling protein(ASIP) is a endogeneous antagonist of alpha-msh can induces pheomelanin synthesis by competing with alpha-msh for binding to the MC-1R.Follwing better understood the mechanisms of skin pigmented process, it will provide effective methods to resolve acquired human cutaneous hyperpigmentation and hypopigmentation.

Impaired ability to undergo apoptosis in response to a wide range of external stimuli acquires melanomas a selective advantage for progression and metastasis as well as their notorious resistance to therapy. Changes at genomic, transcriptional and post-translational levels of G-proteins and protein kinases (Ras) , their transcription factor effectors (c-jun,ATF2, stat3 and NF-?B) and upregulator of antiapoptosis gene (Bcl-2、Bcl-X_L、survivin、ML-IAP)affects apoptosis-induced of TNF, Fas and TRAIL receptors, which play important roles in acquiring melanoma's resistance to apoptosis. The complexity of the molecular variants involved in signal transduction along apoptotic pathways suggests that the cell may have a variety of possibilities for regulating apoptosis and generating apoptosis deficiency.

A few of patients with lumbar disk herniation having a separation of clinical symptoms and signs and imaging features, can be found in clinic, but the traditional theory of direct mechanical compression of nerve roots by herniated nucleus pulposus can't be used to explain this abnormal protrusion of lumbar intervertebral disc. The clinical symptoms and signs of the atypical lumbar disk herniation are affected by multiple factors. The indirect mechanical compression and distraction effect of spinal nerve roots may play an important role in the occurrence of the separation, and the appearance of abnormal clinical symptoms and signs is closely related to the migration of herniated nucleus pulposus tissue, transmission of injury information in the nervous system, and the complex interactions among the nucleus pulposus, dural sac and nerve roots. Moreover,the changes of microcirculation and inflammation secondary to the herniated nucleus pulposus tissue, the hyperosteogeny in the corresponding segment of the lumbar vertebrae and the posture changes all results in a diversity of symptoms and signs in patients with lumbar intervertebral disc herniation. Besides, there exist congenital variation of lumbosacral nerve roots and vertebral bodies in some patients, and the misdiagnosis or missed diagnosis of imaging finding may occur in some cases. However, the appearance of a separation of clinical symptoms and signs and imaging examination in patients may be caused by a variety of reasons in clinic. The exact mechanism involved in the interaction among nucleus pulposus tissue, dural sac and nerve root, secondary changes of pathophysiology and biomechanics around the nucleus pulposus, the determination of lesioned responsible segments, and how to overcome the limitations of imaging all need the further researches.
Humans ; Intervertebral Disc Displacement ; complications ; diagnosis ; Lumbar Vertebrae ; Nerve Compression Syndromes ; etiology

Objective To explore effective nursing intervention through clinical analysis of middle ear function of children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Tympanogram was obtained from both pre-operation and post-operation in 413 OSAHS cases(the OSAHS group).Audiogram was conducted if the tympanogram was abnormal.There were 279 cases of normal children in the control group.The incidence of middle ear function loss of two groups were compared.Results 288 cases(328 ears) had some degree of middle ear dysfunction,accounting for 69.73％.69 cases had some degree of hearing loss,accounting for 16.71％.The incidences of middle ear dysfunction and degree of hearing loss in the OSAHS group were higher than 7.53％ and 1.43％ of the control group.The hearing ability was gained after operation in both groups.Conclusions The incidence of middle ear dysfunction is higher in children with obstructive sleep apnea hypopnea syndrome.But the bad influence alleviated with age.Therefore,early detection,timely treatment and effective nursing can achieve good effect.

Objective To investigate the present situation and outcome of cardiopulmonary resuscitation (CPR) for pediatric in-hospital cardiopulmonary arrest and to analyze the prognostic risk factors.Methods Data were collected from October 2008 till October 2011 using Ustein style.Patients older than 28 days who received CPR were evaluated.Returning of spontaneous circulation(ROSC) more than 24 hours was the primary outcome.Neurological outcome was assessed by pediatric cerebral performance categories half year after discharge.Results Of the 36 patients,15 (41.7％) achieved sustained ROSC.Seven (19.4％) patients survived to discharge.Single factor analysis indicated that the beginning heart rhythm,defibrillation and original disease were significantly different between the two groups(P ＜0.05).The beginning heart rote of the patient in ROSC ＞ 24 h group was mostly sinus bradycardia.Patients who need defibrillation had bad prognosis.Patients with heart disease had a lower rate of ROSC ＞ 24 h.At half year follow-up study,4 patients had 1 or 2 score,1 patient had 4 and 1 had 5 score in the pediatric cerebral performance categories scales.Condusion The successful rate of CPR in our hospital was the same as that in developed country.The beginning heart rhythm,defibrillation and original disease were associated with the outcome.Most of the patients who survived to discharge had a good neurological outcome.

Endometriosis ; therapy ; Female ; Humans ; Infertility, Female ; therapy ; Medicine, Chinese Traditional ; Phytotherapy ; methods

To combine current situation and existing problem of sanitation equipment packaging in military area, perfect organization, special funds and package research of military special useful can be given. The high level of standardization, informationization and containerization of packaging has great significance that improves the ability to protection and pro-motes the development of sanitation equipment packaging on troops.

Teacher student relationship is the most important part in educational activities.It’s quality and quantity have a significant impact on educational and teaching effectiveness.This article aims to analyze the exiting status of the relationship between the tutors and the postgraduates in Peking Union Medical College Hospital, focusing on the some main factors which affect the said relationship, including education environment factor, tutor factor, postgrad-uate factor and etc., and combining the characteristics of Medical Colleges’studying.On the basis of the concerned survey, this article initially discusses the key issues during the establishment of the harmony relationship between tutors and postgraduates.

Child ; Cochlear Implantation ; Cochlear Implants ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss, Central ; physiopathology ; Humans ; Vestibulocochlear Nerve Diseases ; physiopathology

OBJECTIVETo observe the efficacy differences between acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture (EA) at acupoints near ear and simple EA for the treatment of nervous tinnitus.

METHODSSixty-three patients were randomly divided into an observation group (31 cases) and a control group (32 cases). The observation group was treated with acupoint catgut embedding at C4-C7 Jiaji (EXB 2) points on the affected side combined with EA at acupoints near ears, including Ermen (TE 21). Tinggong (SI 19), Tinghui (GB 2), etc.; the control group was treated with EA at regular acupoints near ears alone. The EA treatment was given five times per week, and the acupoint catgut embedding was given once every two weeks. All the treatment was given for 6 weeks. The Tinnitus severity score (TSS)was applied to assess the severity of tinnitus before the treatment, 2 weeks, 4 weeks and 6 weeks into treatment and one month after treat ment. Also the efficacy of two groups was compared.

RESULTSAfter the treatment, the severity of tinnitus was both improved in two groups at each time point (all P<0.05). which was more significant in the observation group (P<0.05, P<0.01). The cured and markedly effective rate was 77.4% (24/31) in the observation group, which was superior to 50.0% (16/32) in the control group (P<0.05).

CONCLUSIONThe short-term and long-term efficacy of acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture are both superior to those of simple electroacupuncture for treatment of nervous tinnitus.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Catgut ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Tinnitus ; therapy