Dermatology and venerology is a clinical discipline characterized by morphology.With the development of the internet and the application of internet in education,the features and advantages of internet teaching are gradually recognized including high flexibility,rich information and good student-teacher interaction.This article focused on the establishment and practice of internet teaching to improve teaching quality.

Objective To evaluate the long-term effectiveness of different-dose of botulinum toxin A (BTXA) therapy on axillary hyperhidrosis.Methods Total 86 patients with axillary hyperhidrosis were self-controlled.One group of left axillary was injected with a low-dose of BTXA,50U.Another group of right axillary was injected with a high-dose of BTXA.A total dose of 200 U of BTXA was used per axilla.Patients were followed-up for 29 months.To investigate the effect of two methods,we analyzed two ranked data by rank sum test and x2 test to judge the disparities of the therapeutic effect.Results The results showed that the relapse-free interval of two groups with axillary hyperhidrosis was significant difference through the statistical analysis (P ＜ 0.05).Conclusions High-dose of BTXA treatment is capable of prolonging the antihidrotic effect on axillary hyperhidrosis.

Objective To evaluate antibacterial and antifungal effect of the composite chitosan artificial skin in vitro. Methods The standard strains were used in the experiment, including Staphylococcus aureus (ATCC25923), Escherichia coli (ATCC25922), Pseudomonas aeruginosa (ATCC27853) and Candida albicans (ATCC10231). Twelve agar plates were prepared for each standard strain, which were equally divided into the trial and the control groups. In the trial groups, 50 ?L composite chitosan dermal substitute was added to each prepared agar plate, two samples for each plate. In the control groups, composite collagen-gelatin dermal substitute was used. After the plates were incubated at 35 ℃ for 18 ~ 24 h, the antibacterial or antifungal rings of every sample were measured. Results The composite chitosan dermal substitute showed the antibacterial effect on Staphylococcus aureus (ATCC25923), Escherichia coli (ATCC25922), and Pseudomonas aeruginosa (ATCC27853) (P

Objective To rapidly isolate and culture sweat gland epithelial cells in vitro and to observe the characteristics of the cells. Methods The secretory coils of sweat glands were dissected and picked out under an anatomical microscope, then digested by collagenase. The harvested epithelial cells of sweat gland were observed for their growth characteristics and identified by immunohistochemistry. Results The cultured epithelial cells grew very well. About 3 weeks later, a distinctive cobblestone appearance was observed in the culture. The antibody-staining showed the cells were positive for epithelial membrane antigen and cytokeratin, but negative for actin, which confirmed that the cells were sweat gland epithelial cells. Conclusion A method is established for rapid isolation and culure of sweat gland epithelial cells in vitro.

Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group (40 cases) and control group (40 cases).The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0％ (36/40) and 72.5％ (29/40) for the control group,the difference was statistically significant (P＜0.05).There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.

Objective To analyze retrospectively the HRCT signs in the patients with invasive pulmonary aspergillosis and evaluate the value of HRCT in the diagnosis of invasive pulmonary aspergillosis.Methods The cilinical and HRCT images of 30 cases with invasive pulmonary aspergillosis diagnosed by fiber bronchoscopy, CT guided biopsy or sputum culture were collected.HRCT images were analyzed and the HRCT signs were summarized by two experienced chest imaging radiologists.Results 19 patients had a variety of CT signs, the sign of tree in bud was seen in 8 cases, bronchial stenosis 6 cases, bronchiectasis 8 cases, ground-glass opacity 8 cases, acinic nodules 10 cases, nodular lesions 12 cases, acinar nodules with halo sign 4 cases, nodules with halo sign 9 cases, cavity 10 cases.11 cases only had a single CT sign, the sign of tree in bud was seen in 2 cases, bronchiectasis 2 cases, ground-glass opacity 1 case, acinar nodules 2 cases, nodules with halo sign 2 cases, cavity 2 cases.The occurrence rates of various signs in 30 cases were as follows, the sign of tree in bud was 33.3%, bronchial stenosis 20%, bronchiectasis 33.3%, ground-glass opacity 30%, acinar nodule 40%, nodular lesion 46.6%, halo sign 53.3%,cavity 40%.Conclusion The main HRCT signs in the patients with invasive pulmonary aspergillosis includes tree in bud, bronchial stenosis, bronchiectasis, ground-glass opacity, acinar nodules, nodal lesions,pulmonary cavity and halo sign.The signs of bronchiectasis with tree in bud sign, acinar nodule and halo sign in the HRCT images are highly specific in the diagnosis of invasive pulmonary aspergillosis.

OBJECTIVE:To prepare and characterize Ibuprofen (IBU) nano-powder,and to investigate its transdermal ability in vitro. METHODS:Using chloroform-ethanol(7:3,V/V)as organic phase,deionized water as aqueous phase and polysorbate 80 as surfactant,the emulsification method was used to prepare IBU nano-powder. Laser granulometric analysis,Fourier transform in-frared spectroscopy(FT-IR),X-ray diffraction(XRD),differential scanning calorimetry(DSC)were used to characterize IBU na-no-powder. IBU nano-powder was compared with bulk drug in respects of saturation solubility,dissolution rate and transdermal rate in vitro. RESULTS:The optimum condition was as follows that the concentration of polysorbate 80 was 5 mg/mL;the volume ra-tio of water phase-organic phase was 40:1;the concentration of IBU was 250 mg/mL;homogenate speed was 5000 r/min;homog-enate time was 2 min. Prepared IBU nano-powder was polyporous crumbly coralliform,and its chemical structure kept stable;the nano-powder changed from crystal to amorphous state;the particle size was 179.6 nm,and drug-loading amount was 8.99%;satu-ration solubility,dissolution rate and transdermal rate of IBU nano-powder were 148,1.23 and 4.08 times of bulk drug. CONCLU-SIONS:The prepared IBU nano-powder shows good water-solubility and percutaneous permeability.

Purpose To explore the Relationship between expression of apoptosis-modulating proteins amdmultidrug resistance in K562/VCR cells. Methods Irnmunocytochemical methol and western blot wereused to analyze the expression of apoptosis-modulating proteins (Bcl - 2, Bcl-XL, Bax, Bak ) in multidrugresistant cell line K562/VCR and drugsensitive cell line K562. Results The positive cell rates ofapoptosis-suppressing protein Bcl-2 and Bcl-XL in K562/VCR were (40.0 ± 8.0) % and (60.0 ± 10.0) % .While the rates in K562 were (1.0 ± 0.3) % and (20.0 ± 4.0) %. There was significant difference in thepositive cell rates of Bcl - 2 and Bcl - XL between K562/VCR and K562 ( n = 3, P ＜ 0.05 ). It was alsofound there was no significant difference in expression of Bax between K562/VCR and K562. Furthemore,Bak was not expressed in both K562/VCR and K562 or the expression was very low. Conclusions Wesuggest that Bcl-2 and Bcl-XL play important roles in multidrug resistance in K562/VCR, while Bax and Bakmight not be important.

Objective To explore the effect of intraoperative tension adjustment and postoperative scar formation in the treatment of circular skin defects using modified purse-string suture.Methods Twenty-eight cases of circular lesions in the face region were selected and resected along the edge.We first used purse-string suture technique to reduce the circular defect area,and then closed the wound with linear suture in random direction.After 7 days,the stitches were removed and longterm follow-up effects were observed.Results All patients had no facial organ deformation and displacement,the length of the linear scar lesions was shorter than the preoperative length.In 28 cases,one patient's surgical wound was dehisced after removal of stitches in 24 h,and the rest of the skin defects healed after operation in stage Ⅰ.All cases were followed up for 3 months to 1 year,and had a satisfactory therapeutic effect.Conclusions Modified purse-string suture can linearly close the dicision in stage Ⅰ,reduce the scar area and maintain the normal morphology and relative position of the nearby organs.

Objective To compare the epidermal shape built by different passages of keratinocytes and its ability of proliferation and differentiation in three-dimensional conditions.Methods Different passages of keratinocytes were used to construct tissue-engineered skin.The morphology of the tissue-engineered skin was observed with HE and PAS staining,while CK1/CK10,CK5/CK14,Ki67 were detected by immunohistochemical assays.Results All the tissue-engineered skin had a significant dermoepidermal structure.The stratification of 1st and 2nd passage skins were better,and 2nd passage epidermis was thicker than that in other passages (P＜0.05).Dermoepidermal structure in collagen type Ⅳ group binded more tightly,but collagen type Ⅳ had little effect on the thickness of the epidermis (P＞0.05).In collagen type Ⅳ group PAS stain was negative,indicating type Ⅳ collagen was unable to promote the reconstruction of BM in vitro.The Ki-67 proliferation index of the 2nd keratinocyte was similar to the normal skin,the remaining passages keratinocyte proliferation gradually decreased (P＜0.05) ; the 1st and 2nd passage skins expressed CK1/CK10 and CK5/CK14.Conclusions Keratinocytes before the 3rd passage have a better ability in the proliferation and differentiation,and so they are more suitable as seed cells for tissue-engineered skin.