Microfocused ultrasound (MFU),as a new approach for facial skin tightening and lifting,has been widely applied in recent years.Its action mechanism is that heat can be transmitted to the deep dermis and superficial musculoaponeurotic system through precise and depth-consistent microcoagulation zones,leading to the contraction and remodeling of skin collagen without damage to the epidermis.MFU has high safety with few serious adverse reactions.However,there are still doubts whether it can lead to subcutaneous scar formation,the risk of lipolysis,or nerve,vessel and eye injuries,etc.Appropriate use and selection of patients can minimize the occurrence of these rare adverse reactions as much as possible.

目的:本文旨在探讨整合医学美容的概念并阐述其发展方向.方法:根据整合医学的发展史以及医学美容学科发展的特点提出了整合医学美容的概念,医学美容尤其需要树立"以人为本"和"以求美者为中心"的理念,医学美容的发展不仅需要将各个相关学科的先进治疗方法进行横向整合,同时需要对求美者实行全程充满人文关爱的纵向整合,做到医护并重、身心并重、防治并重.结果:医学美容唯有通过"整合"才能达到疗效更佳、副反应更小、体验度更好的效果,从而使求美者实现医美价值最大化.结论:整合医学美容将成为医学美容新的发展方向.

目的:探讨应用埋线加固面部韧带改善中面部松弛下垂的作用.方法:明确中面部颧弓韧带、颊上颌韧带、下颌韧带、颈阔肌耳韧带以及咬肌皮肤韧带的解剖位置,从韧带根部至真皮层多层次置入平滑线,固定和加强韧带.结果:本组共30例患者,术后随访6个月发现平滑线置入可加强韧带支撑作用,使中面部松弛下垂状况得到改善,治疗恢复期短、并发症少、皮肤平整,表情自然.结论:置入平滑线固定和加强中面部韧带改善中面部松弛下垂是一种有效易行的治疗方式.

黄褐斑（Melasma）是一种发生于颜面部的获得性色素性疾病，多见于中青年女性，是临床常见的皮肤病之一。其确切病因尚不清楚，与日光因素、遗传因素、内分泌因素、药物因素、精神因素、化妆品不当及皮肤屏障功能受损等有关。目前的治疗方法主要包括全身和局部治疗，如：内服药物、外用脱色剂、皮肤磨削术、化学换肤术等[1]，但疗效均不理想。随着激光美容技术的发展，Q开关Nd：YAG激光越来越广泛地被用于黄褐斑的治疗，为黄褐斑的治疗提供了新方法，该方法虽然短期效果较好，却易出现色素沉着、色素减退甚至脱失、皮肤敏感、易复发等副作用。近年来，笔者科室采用长脉冲800nm半导体激光对黄褐斑患者进行治疗观察，取得了较满意疗效，现报道如下。

OBJECTIVE:Increasing evidence suggests that, when used in combination, tumor necrosis factor-α (TNF-α) synergizes with traditional chemotherapeutic drugs to exert a heightened antitumor effect. The present study investigated the antitumor efficacy of recombinant mutated human TNF-α specifically targeted to the tumor vasculature (RGD-rmhTNF-α) combined with the chemotherapeutic agent doxorubicin in 2 murine allografted tumor models.METHODS:Mice bearing hepatoma or sarcoma allografted tumors were treated with various doses of RGD-rmhTNF-α alone or in combination with doxorubicin (2 mg/kg). We then evaluated tumor growth and tumor vessel permeability as well as intratumoral levels of RGD-rmhTNF-α and doxorubicin.RESULTS:RGD-rmhTNF-α treatment enhanced the permeability of the tumor vessels and increased intratumoral doxorubicin levels. In addition, intratumoral RGD-rmhTNF-α levels were significantly higher than that of rmhTNF-α. In both of the tested tumor models, administering RGD-rmhTNF-α in combination with doxorubicin resulted in an enhanced antitumor response compared to either treatment alone. Double-agent combination treatment of doxorubicin with 50,000 IU/kg RGD-rmhTNF-α induced stronger antitumor effects on H22 allografted tumor-bearing mice than the single doxorubicin agent alone. Moreover, doxorubicin with 10,000 IU/kg RGD-rmhTNF-α synergized to inhibit tumor growth in S180 allografted tumor-bearing mice.CONCLUSIONS:These results suggest that targeted delivery of low doses of RGD-rmhTNF-α into the tumor vasculature increases the antitumor efficacy of chemotherapeutic drugs.

目的 探讨血清胱抑素C (CysC)对高血压患者早期肾损害的诊断价值.方法 采用免疫比浊法测定244例高血压患者与314例对照者(无高血压、糖尿病、肾病和其他慢性病史)的血清CysC,肌氨酸氧化酶法测定血清肌酐(CREA),酶偶联速率法测定血清尿素(BUN),并进行相关分析.结果 高血压组血清Cys C的阳性率(59.43%)明显高于对照组(6.37%)(P<0.01).高血压患者血清Cys C的阳性率(59.43%)明显高于其血尿素(40.16%)和血肌酐阳性率(20.90%)(P<0.01).此外,高血压患者血清Cys C的升高早于血尿素和血肌酐.结论 血清CysC是反映高血压早期肾功能损害的敏感指标,其敏感度高于血尿素和血肌酐,在诊断高血压早期肾损害方面有重要的临床价值.

The forkhead transcription factor Foxp3 is the only definitive marker of CD4+CD25+ regulatory T cells (Tregs) and has been identified as a key regulator in the development and function of Tregs. Foxp3 expression has been reported in a variety of solid tumors, including melanoma. In this study, we validated Foxp3 expression in both tumor-infiltrating Tregs and melanoma cells by performing immunohistochemical analysis of human melanoma tissue sections. Further, we assessed Foxp3 expression in melanoma cell lines by performing flow cytometry, confocal microscopic analysis, reverse transcription-polymerase chain reaction (RT–PCR), and Western blotting. Inhibition of Foxp3 expression in melanoma cells using small interfering RNA (siRNA) resulted in downregulation of B7-H1 and transforming growth factor (TGF)-β expression; in contrast, Foxp3 overexpression resulted in the upregulation of the expression of these proteins. Coculture of Foxp3-expressing melanoma cells with naive CD4+CD25− T cells resulted in strong inhibition of T-cell proliferation. This antiproliferative effect was partially abrogated by specific inhibition of Foxp3 expression and was effectively enhanced by overexpression of Foxp3. We observed an attenuated antiproliferative effect even when melanoma cells and T cells in the coculture were separated using Transwell inserts. These findings indicated that melanoma cells could have Foxp3-dependent Treg-like suppressive effects on T cells and suggested that the mimicking of Treg function by melanoma cells may represent a possible mechanism of tumor resistance to immune destruction in the melanoma tumor microenvironment.

报告1例寻常性银屑病并发成人型线状IgA大疱性皮病。患者男,36岁。因全身红色斑疹伴白色鳞屑反复发生20年,躯干、双上肢出现环状排列的水疱10 d伴瘙痒就诊。皮损组织病理检查:表皮下水疱,疱内、真皮浅层和真皮乳头见中性粒细胞、嗜酸性粒细胞浸润;皮损周围皮肤直接免疫荧光显示基膜带IgA、IgG呈带状沉积;取患者血清行BP180NC16A（大疱性类天疱疮18 000抗原的近膜片段）-ELISA检查显示阴性;以盐裂正常人皮肤为底物,取患者血清行间接免疫荧光检查显示IgA、IgG呈带状沉积在真皮侧。诊断为寻常性银屑病并发成人型线状IgA大疱性皮病。

ObjectiveTo clone,express,purify and verify human Dickkopf1(Dkk1).MethodsFibroblasts from metatarsus were cultured,and mRNA was harvested from the fifth generation.The dkk1 gene was acquired via RT-PCR and cloned in PQE30 plasmid containing the 6His tag to construct the recombinant plasmid PQE30-dkk1.The E.coli was amplified and induced via IPTG after the PQE30-dkk1 translated in.The E.coli was split ultrasound.The product of expression was purified with NI-agarose chromatography and verified via SDS-PAGE and Western Blot.ResultsThe product of RT-PCR was coincide with what we preconceived.Double restriction enzyme cutting and sequence-analysis proved the recombinant plasmid to be PQE30-DKK1.The product of expression was verified properly via SDS-PAGE electrophoresis and Western Blot with special anti-DKK1 antibody.ConclusionThe successful cloning of dkk1 gene and expression of Dkk1 protein lay a basis for studying the effects on the biologic activity of melanocyte.

Objective To investigate the effect of DKK1 protein on melanocytes,which is human and expressed by prokaryon expression system.Methods MTT method,NaOH-assay and DOPA-hydrocarbonylation method were employed to measure the proliferation,melanin synthesis,tyrosinase activity of melanocytes.The change of melanocyte cell morphology was observed via light microscope.Results DKK1 protein induced a mild effect on melanocytic proliferation(P0.05),While it showed a statistically significant decrease in the melanin synthesis(P 0.05),and tryosinase activity(P0.05).The melanocyte affected by DKK1 protein showed cell body bigger,shape polygon,dendrite shorter and thicker.Conclusion DKK1 protein inhibits melanocytic proliferation,melanin synthesis and tryosinase activity,which may be the foundation that make it valid in clinical treatment of the pigmented skin diseases.

A case of paraneoplastic pemphigus associated with follicular dendritic cell sarcoma is reported. The 16-year-old man suffered from oral and genital ulceration with a fever for 2 months and the rash on his whole body for 20 days. He had oral and genital ulceration with vesicles, erosion, and crusts on his whole body. Skin biopsy suggested paraneoplastic pemphigus. Computerized tomography suggested a mass in his right adrenal gland. A follicular dendritic cell sarcoma was detected and excised. With the administration of high-dose intravenous immunoglobulin, prednisone and immunosuppressants, almost complete remission of rash on his trunk occurred 7 weeks after tumor resection, but leaving rash on mucosa and extremities.