1.Pathophysiological Evolution and Syndrome-Based Stratified Treatment of Qi Deficiency with Stagnation in Chemotherapy-Induced Myelosuppression
Jing LONG ; Hengzhou LAI ; Wenbo HUANG ; Feng YU ; Yifang JIANG ; Zhuoling DAI ; Chong XIAO ; Fengming YOU
Journal of Traditional Chinese Medicine 2025;66(11):1109-1113
The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi, impaired qi transformation, and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology, chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi, blood, and essence, while "stagnation" refers to the accumulation of phlegm, turbid dampness, and blood stasis. These two components interact reciprocally, forming a vicious cycle where deficiency leads to stagnation, and stagnation further damages the healthy qi. In the early stage of mild myelosuppression, chemotoxicity begins to accumulate in the bone marrow, leading to qi consumption, blood deficiency, yin injury, and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression, the accumulation of toxicity causes qi sinking, exhaustion of essence, and marrow depletion, along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation, with an emphasis on assessing the severity of the condition, balancing deficiency and excess, and achieving both symptomatic relief and root cause resolution.
2.Isolation and identification of mosquito-borne viruses in Huachuan county and Huanan county, Heilongjiang province, China
Han CHEN ; Fengming LIU ; Liqin YU ; Fan LI ; Shihong FU ; Qikai YIN ; Qianqian CUI ; Ruichen WANG ; Kai NIE ; Mingjia BAO ; Huanyu WANG ; Songtao XU
Chinese Journal of Experimental and Clinical Virology 2025;39(2):182-188
Objective:To investigate the mosquito-borne viruses carried by mosquito specimens collected from Huachuan county and Huanan county in Heilongjiang province.Methods:Mosquito samples were collected locally in 2023 and processed in the laboratory. Homogenates of the mosquitoes were inoculated into cells for virus isolation, followed by molecular and bioinformatics analyses of the viral isolates.Results:In 2023, ten viral isolates were obtained from Anopheles sinensis specimens collected in Heilongjiang province, China. Among these isolates, one was identified as Culex flavivirus (CxFV), one as Menghai rhabdovirus (MRV), and eight as Nam Dinh virus (NDiV). The phylogenetic analysis showed that CxFV belongs to genotype I and is clustered with the strains isolated from Liaoning province in 2011 and Ningxia Hui autonomous Region in 2019 in the same evolutionary branch, with amino acid similarity ranging from 98.2% to 99.2% and nucleotide similarity ranging from 98.8% to 99.2%. The MRV strain belongs to the same evolutionary subclade as the strain detected in Guangdong, with both nucleotide and amino acid similarity of 98.0%. Eight NDiV isolates clustered with the South Korean isolates on the same evolutionary branch, forming an independent evolutionary sub-branch. The nucleotide similarity among these eight isolates ranged from 98.5% to 99.7%, while the amino acid similarity ranged from 98.1% to 99.7%. In comparison, when matched with other NDiV isolates from China, the nucleotide similarity of these eight isolates ranged from 94.1% to 97.8%, and the amino acid similarity ranged from 93.5% to 97.7%.Conclusions:This study represents the first isolation of CxFV, MRV, and NDiV in Heilongjiang province, China, and the findings provide fundamental data for the prevention and control of mosquito-borne viral diseases in this region.
3.Efficacy and safety of high-frequency repetitive transcranial magnetic stimulation in postherpetic neuralgia
Yu ZHAO ; Xiangyang TANG ; Zuosheng CHEN ; Fengming YAO ; Wei JIANG ; Fei XU
Chinese Journal of Neuromedicine 2025;24(8):799-805
Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.
4.Exploration and Practice of Talent Cultivation in Allied Health in the Context of the Integration of Medicine and Engineering
Zhenrong WANG ; Fengming LUO ; Zongan LIANG ; Guopeng LIANG ; Tingting LIU ; Yuemeng XU ; Zheng QU ; He YU
Journal of Sichuan University (Medical Sciences) 2025;56(4):1165-1170
The discipline of allied health sciences provides vital support to clinical diagnosis and treatment while promoting the translation of medical research into practice.As the integration of medicine and engineering deepens,talent cultivation in allied health faces new opportunities and challenges.Herein,we reviewed representative cases from domestic and international universities that have implemented interdisciplinary training in fields related to allied health,including exploration and practices concerning the development of cross-disciplinary platform,dual-degree programs,and collaborative education mechanisms involving the academia,industry,and research.We highlight the efforts of the School of Allied Health,West China School of Medicine,Sichuan University,which has continuously improved its disciplinary system and training programs through top-level planning and platform construction.The School of Allied Health Sciences has accelerated platform construction and established a new model for multidisciplinary collaborative education.At the practical level,the school has promoted curriculum reform through initiatives in ideological and political theories education,instructional system design,and the development of textbook systems.The school has created courses focused on the integration of medicine and engineering,interdisciplinary project-based modules,and specialized project-based curricula.These initiatives aim to strengthen the foundation for training high-level interdisciplinary professionals in allied health sciences under the evolving landscape of medicine-engineering integration.This articile also highlights other prospects,such as establishing a collaborative education model integrating medicine and engineering through industry-university-research collaboration,optimizing academic program structures,and enhancing professional certification systems,to inform policy-making and optimize practice.
5.Biological Role of RNF41 in Regulating Proliferation and Metastasis of Cholangiocarcinoma Cells
Qijie WU ; Yong LI ; Yu ZHANG ; Fengming RAN ; Rong DING ; Qi ZHANG ; Yinshan YANG
Journal of Kunming Medical University 2025;46(7):10-17
Objective To explore the role of ring finger protein 41(RNF41)in the initiation and progression of cholangiocarcinoma.Methods The expression levels of RNF41 mRNA and protein in tumor tissues and adjacent normal tissues from 84 CHOL patients who underwent total surgical resection at the Second Affiliated Hospital of Kunming Medical University and Kunming Ganmei Hospital between January 2010 and December 2016 were analyzed using bioinformatics,Western blot,and immunohistochemistry.The TIMER 2.0 database was used to analyze the impact of RNF41 on the prognosis and survival of CHOL patients and the relationship between RNF41 and tumor clinical characteristics.RNF41 siRNA was transfected into HCC9810,RBE,and HUCCT1 cells.CCK-8,Edu,colony formation,and Western blot assays were conducted to evaluate the changes in proliferation of cholangiocarcinoma cells between the RNF41 knockdown group and the control group.Transwell assays and detection of EMT and migration markers were performed to assess changes in the invasion ability of cholangiocarcinoma cells between the RNF41 knockdown and control groups.Western blot was used to examine the effect of RNF41 knockdown on epithelial-mesenchymal transition in cholangiocarcinoma cells.Twelve BALB/c mice were randomly divided into two groups:a control group and an RNF41 knockdown group,with six mice in each group.Tumor formation assays,Western blot assays,and immunohistochemistry staining were carried out to investigate the effect of RNF41 knockdown on tumor growth in nude mice.Results Real-time quantitative fluorescence PCR analysis revealed that the expression level of RNF41 mRNA in cholangiocarcinoma tissues was significantly higher than that in the corresponding adjacent non-tumor tissues(P<0.01),and this trend was corroborated at the protein level by immunohistochemical staining.Using the TIMER 2.0 database,we further analyzed the correlation between RNF41 expression and clinicopathological features,including histological grade,tumor stage,lymph node metastasis,and patient survival.The results indicated that elevated RNF41 expression was significantly associated with advanced histological grade and lymph node metastasis in cholangiocarcinoma(P<0.01).Survival analysis demonstrated that high RNF41 expression was closely linked to poor prognosis in patients with cholangiocarcinoma(CHOL).Functional assays,including CCK-8,EdU incorporation,and colony formation,showed that RNF41 knockdown significantly inhibited the proliferation of cholangiocarcinoma cells compared with the control group.Western blot analysis revealed that,following RNF41 silencing,the expression of the epithelial-mesenchymal transition(EMT)marker E-cadherin was markedly upregulated,whereas the levels of mesenchymal markers N-cadherin and MMP9 were significantly reduced(P<0.05).These findings were consistent with the results obtained from in vitro experiments(P<0.01).Moreover,in vivo studies showed that RNF41 knockdown suppressed subcutaneous tumor formation in nude mice(P<0.05).Conclusion RNF41 plays a critical role in promoting the occurrence and progression of cholangiocarcinoma and is closely associated with adverse clinicopathological features and poor prognosis in patients.The knockdown of RNF41 effectively suppresses the proliferation,invasion,epithelial-mesenchymal transition(EMT),and tumorigenicity of cholangiocarcinoma cells.
6.Isolation and identification of mosquito-borne viruses in Huachuan county and Huanan county, Heilongjiang province, China
Han CHEN ; Fengming LIU ; Liqin YU ; Fan LI ; Shihong FU ; Qikai YIN ; Qianqian CUI ; Ruichen WANG ; Kai NIE ; Mingjia BAO ; Huanyu WANG ; Songtao XU
Chinese Journal of Experimental and Clinical Virology 2025;39(2):182-188
Objective:To investigate the mosquito-borne viruses carried by mosquito specimens collected from Huachuan county and Huanan county in Heilongjiang province.Methods:Mosquito samples were collected locally in 2023 and processed in the laboratory. Homogenates of the mosquitoes were inoculated into cells for virus isolation, followed by molecular and bioinformatics analyses of the viral isolates.Results:In 2023, ten viral isolates were obtained from Anopheles sinensis specimens collected in Heilongjiang province, China. Among these isolates, one was identified as Culex flavivirus (CxFV), one as Menghai rhabdovirus (MRV), and eight as Nam Dinh virus (NDiV). The phylogenetic analysis showed that CxFV belongs to genotype I and is clustered with the strains isolated from Liaoning province in 2011 and Ningxia Hui autonomous Region in 2019 in the same evolutionary branch, with amino acid similarity ranging from 98.2% to 99.2% and nucleotide similarity ranging from 98.8% to 99.2%. The MRV strain belongs to the same evolutionary subclade as the strain detected in Guangdong, with both nucleotide and amino acid similarity of 98.0%. Eight NDiV isolates clustered with the South Korean isolates on the same evolutionary branch, forming an independent evolutionary sub-branch. The nucleotide similarity among these eight isolates ranged from 98.5% to 99.7%, while the amino acid similarity ranged from 98.1% to 99.7%. In comparison, when matched with other NDiV isolates from China, the nucleotide similarity of these eight isolates ranged from 94.1% to 97.8%, and the amino acid similarity ranged from 93.5% to 97.7%.Conclusions:This study represents the first isolation of CxFV, MRV, and NDiV in Heilongjiang province, China, and the findings provide fundamental data for the prevention and control of mosquito-borne viral diseases in this region.
7.Efficacy and safety of high-frequency repetitive transcranial magnetic stimulation in postherpetic neuralgia
Yu ZHAO ; Xiangyang TANG ; Zuosheng CHEN ; Fengming YAO ; Wei JIANG ; Fei XU
Chinese Journal of Neuromedicine 2025;24(8):799-805
Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.
8.Mingshi Formula (明视方) for Low Myopia in Children with Heart Yang Insufficiency Syndrome: A Multicentre, Double-Blind, Randomised Placebo-Controlled Study
Jianquan WANG ; Xinyue HOU ; Zefeng KANG ; Yingxin YANG ; Xinquan LIU ; Zhihua SHEN ; Xiaoyi YU ; Jing YAO ; Fengming LIANG ; Fengmei ZHANG ; Jingsheng YU ; Ningli WANG ; Man SONG ; Hongrui SUN ; Xin YAN
Journal of Traditional Chinese Medicine 2024;65(6):587-593
ObjectiveTo observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules (明视方颗粒) for low myopia in children with heart yang insufficiency. MethodsA multicentre, prospective, double-blind randomised controlled study was conducted, in which 290 children with low myopia from 8 centres were randomly divided into 145 cases in the treatment group and 145 cases in the control group, and the treatment group was given education, dispensing glasses, and Chinese herbal medicine Mingshi Granules, while the control group was given education, dispensing glasses, and granules placebo. Both Mingshi Granules and placebo granules were taken orally, 1 bag each time, twice daily, 4 weeks of oral intake and 2 weeks of rest as 1 course of treatment, a total of 4 courses of treatment (24 weeks). Equivalent spherical lenses, best naked-eye distance visual acuity, ocular axis, corneal curvature K1, adjustment amplitude, traditional Chinese medicine (TCM) symptom scores, calculate the amount of progression of equivalent spherical lenses, were observed at the 12th and the 24th week of treatment, at the 36th week and 48th week of follow-up, resectively, the control rate of myopia progression was evaluated at the 24th week, and safety indexes were observed before treatment. ResultsThe amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up (P<0.05). The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher (57.60%, 72/125) than that in the control group (44.63%, 54/121) (P<0.05). The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group (P<0.05). Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment (P<0.05), and were higher in the treatment group than in the control group at the 48-week follow-up (P<0.05). The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment (P<0.05). The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up (P<0.05). Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment (P<0.05). The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treatment (P<0.05). The scores of white/dark complexion, white coating thin pulse, fatigue and total TCM symptom scores of children in both groups at the 12th, 24th, 36th and 48th weeks of follow-up were significantly lower than those before treatment (P<0.05); the scores of blurred vision at the 24th and 36th weeks of follow-up were significantly lower than those before treatment (P<0.05); and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment (P<0.05). In the treatment group, the score of fatigue was higher than that of the control group at the 36-week follow-up, and the score of blurred vision was lower than that of the control group at the 48-week follow-up (P<0.05). No adverse reactions or obvious abnormalities of the safety indexes were observed of the two groups during the treatment. ConclusionChinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia, improving the best naked eye distance visual acuity, slowing down the growth of the eye axis, improving some of the TCM symptoms, with good safety.
9.A retrospective study on the prevalence and risk factors of neurogenic lower urinary tract dysfunction for acute ischemic stroke in China: A case-control study
Fengming HAO ; Shuxian LI ; Lanlan YU ; Yingjie HU ; Ling CHEN ; Wenzhi CAI
Investigative and Clinical Urology 2024;65(4):368-377
Purpose:
This study identified risk factors for neurogenic lower urinary tract dysfunction (NLUTD) in patients with acute ischemic stroke (AIS) through multidimensional analysis of the medical records of patients, aiming to reduce the incidence of NLUTD, improve prognosis, and facilitate rehabilitation.
Materials and Methods:
In this case-control study, patients with AIS were recruited from two tertiary general hospitals in Shenzhen, China, from March 2021 to October 2023. Patients were divided into NLUTD and non-NLUTD groups based on the presence and absence of NLUTD, respectively. Comparative analysis was performed using the Mann–Whitney U and chi-square tests, with significant variables being included in logistic regression analysis.
Results:
Of the 652 participants enrolled in this study, 119 participants (18.3%) developed NLUTD. Bivariate analysis showed that 39 of 54 screened factors exhibited a significant correlation (p<0.05) with the incidence of NLUTD after AIS. Significant variables identified through logistic regression analysis included Glasgow coma scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) scores, anemia, aphasia, pneumonia, brainstem involvement, multiple lesions, urine clarity (CLA), random venous blood glucose (GLU) and hemoglobin (HGB) levels, and white blood cell (WBC) count.
Conclusions
A total of 11 risk factors for NLUTD were identified in this study. This finding provides valuable guidance for reducing the incidence of NLUTD after AIS and improving the quality of life of patients.
10.Clinical and pathological analysis of 98 cases of malignant transformation of congenital melanocytic nevi
Fengming CHEN ; Lei WANG ; Tianwen GAO ; Yu LIU
Chinese Journal of Dermatology 2023;56(11):1028-1034
Objective:To analyze clinical and histopathological features of malignant transformation of congenital melanocytic nevi (CMN) .Methods:From January 2010 to September 2020, 98 patients with clinically and pathologically confirmed malignant transformation of CMN were enrolled from Xijing Hospital, Air Force Medical University, and their clinical and histopathological features as well as immunohistochemical staining and genetic testing results were retrospectively analyzed.Results:Among the 98 patients with malignant transformation of CMN, 45 (45.9%) were males and 53 (54.1%) were females. Their ages ranged from 4 months to 86 years, with a median age of 47 years. The lesions were located on the trunk (34 cases, 34.7%), limbs (25 cases, 25.5%), acra (24 cases, 24.5%), head, face and neck (13 cases, 13.3%), and mucosa (2 cases, 2.0%). Among the 98 patients, 95 (96.9%) had a history of obvious changes in lesions (sudden enlargement, newly developed papules, ulceration, itching, or pain), and the interval time from obvious changes in lesions to diagnosis varied from 2 weeks to 5 years; among the 95 cases, the average age at the onset of obvious changes in lesions was 46 years, and the changes of lesions occurred before the age of 18 years in 4 cases (4.1%), occurred between the age of 18 and 40 years in 35 (35.7%), and occurred after the age of 40 years in 56 (57.1%). In addition, 55 (57.9%) patients experienced a sudden enlargement of primary lesions, 52 (54.7%) developed ulcers in the primary lesions, 21 (22.1%) developed red or black papules or nodules on the surface of primary lesions, 4 (4.2%) developed subcutaneous masses, 2 (2.1%) had itching, and 1 (1.1%) only had pain. The remaining 3 (3.1%) patients experienced slow enlargement of primary lesions. Among the 98 cases of melanoma originating from CMN, 85 (86.7%) arose from small CMN, 11 (11.2%) from medium CMN, and 2 (2.0%) from large CMN. Histopathological examination showed no residual nevus cells in 86 (87.8%) cases, which only had characteristics of typical melanoma; residual nevus cells were only seen in 12 (12.2%) cases, and melanoma cells in the 12 cases all expressed HMB45, while residual nevus cells did not express HMB45 in 11 of 12 cases. Immunohistochemical staining for 5-hydroxymethylcytosine (5hmC) was conducted in 7 cases, and 6 showed negative staining in tumor cells and positive staining in residual nevus cells. BRAF gene detection was conducted in lesional tissue specimens from 22 patients, and it was negative in 1 case of melanoma originating from large CMN and 10 (47.6%) cases of melanoma from small CMN, and positive in 11 (52.4%) cases of melanoma from small CMN.Conclusion:The malignant transformation of CMN mostly occurred on the trunk, and was commonly observed in patients aged over 40 years; most patients had a history of obvious changes (sudden enlargement, newly developed papules, ulceration, etc.) in lesions before diagnosis, and a few patients only felt itching or pain in lesions; immunohistochemical staining of HMB45 and 5hmC could help to distinguish melanoma cells from dermal nevus cells; confirmation of the diagnosis of malignant transformation in CMN should be closely combined with clinical and histopathological results.

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