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.

Objective To investigate the relationship between truncating mutations of APC gene and sporadic colorectal cancer,and analyze the feasibility of non-radioactive protein truncation test (PTT) in the detection of mutations of APC gene.Methods Ninety-six samples of sporadic colorectal cancer tissues ( including 44 patients with colonic cancer and 52 patients with rectal cancer) were obtained from the General Hospital of Ningxia Medical University from September 2008 to September 2010.The mutation cluster region of the APC gene was screened using digital PTT labeled with fluorescent Lys-t-RNA,with a polymerase chain reaction fragment amplified from genomic DNA serving as a tenplate for in vitro translation.The occurrence of gene mutation was determined according to the emergence of truncated peptides.The mutation cluster region of the APC gene in 46 samples of colorectal cancer tissues was analyzed by direct sequencing.The detection rates of the 2 methods were compared by chi-square test.Results Thirteen (26％) truncated peptides were detected in the 50 samples of colorectal cancer tissues.The mutation type of 4 samples is nonsense mutation,which resulted in emergence of truncated gene products.Eleven (24％) truncated peptides were detected in the 46 samples of colorectal cancer tissues.There was no significant difference in the detection rates between PTT and direct sequencing ( x2 =0.033,P ＞ 0.05 ).Conclusions Truncating mutations of APC gene are common alterations in sporadic colorectal cancer in the Chinese.Digital PTT labeled with fluorescent Lys-t-RNA is rapid and high-sensitive in screening gene mutations.

Objective To study the mechanism of tear trough deformity and palabromalar groove deformity.Methods Four old cadavers (2 male,2 female,an average age of 67.2 years) with obvious tear trough deformity and palpbromalar groove deformity and 4 young cadavers (2 male,2 female,an average age of 23.5 years) without tear trough deformity and palpbromalar groove deformity were selected and dissected and histological observation were performed on lower eyelid and periorbital region.Results Compared to young specimens,the skin and orbicularis oculi muscle of old specimens were atrophy and relaxed.Tear trough deformity and palabromalar groove deformity overlaid the junction of thinner eyelid skin and thicker cheek skin.The superior border of the malar fat pad covered the junction of the palpebral and orbital portions of the orbicularis muscle,and correlated with the tear trough and palpbromalar groove,but the superior border of the malar fat pad in young cadavers was found above the tear trough and palpbromalar groove line.The orbicularis retaining ligament arose from the orbital rim and caudal to the junction of the palpebral and orbital portions of the orbicularis muscle,and it was relaxed in old group than that in young group.Conclusions Tear trough deformity and palabromalar groove deformity result from combination of age-related relaxation,atrophy and descent of layers of tissues.The orbital septal and the orbicularis retaining ligament prevent tissues from descending,which makes tear trough deformity and palabromalar groove deformity more visible.