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Summary Netherton's syndrome is a rare autosomal recessive disorder caused by mutations of the SPINK5 gene, which encodes the lymphoepithelial Kazal-type-related inhibitor (LEKTI) protein. We observed microstructural changes and detected LEKTI activity and SPINK5 gene mutation in three Chinese patients with Netherton's syndrome. Decreased LEKTI activity was found in the skin of patients. Lamellar bodies and foci of electron-dense material were detected in the intercellular spaces of the stratum corneum. A novel homozygous splicing mutation of 1430 + 2 TG was found in the SPINK5 gene in one proband. No mutation was found in the other family.

The epidemiological and clinical characterization data of skin malignancies and premalignancies in Chinese population is scarce and inadequate.To systematically investigate the clinical features and the trend of skin malignancies and premalignancies in 1420 Chinese cases.A total of 1398 patients (presenting 1420 skin tumours) were included. Clinical and demographic information for every individual was collected, including age, age of onset, sex, lesion location, disease duration and tumour histology, which was analyzed for each type of skin tumours.The number of skin malignancies and premalignancies increased over time, with Basal cell carcinoma (BCC) as the most common type (30.5%). The majority of the patients were above 60 years of age both at onset and at diagnosis (52.8% and 62.9%, respectively), yet around one-third of patients were between 35-59 years (35.3% and 31.2%, respectively). Skin malignancies and premalignancies were mainly located in the head and neck (58.6%), followed by the trunk (18.3%) and the extremities (15.0%). Of all BCCs, nodular BCC was the most common histologic subtype (62.8%), while 15.8% were classified as aggressive subtypes. Malignant melanoma (MM) comprised the lowest proportion of 3.7%, with 75% located on extremities. The diagnostic accordance rates varied from 49.5% to 90.4%, with BCC being 67.9%.The clinical features of skin malignancies and premalignancies in this study showed some similarities with those observed in Caucasian and other Asian populations, with several distinguished features in Chinese patients also being recognized. Closer attention to suspicious lesions in young and middle-aged people is needed.

Sustainability aims to harmonise life on Earth without compromising the essential natural resources that should be the birthright of future generations. 'Sustainable medicine' (SM) is just one component of the wide range of possible sustainable approaches to peaceful co-existence. Sustainable medicine envisions an uncomplicated system of maintaining the health of people and animals, both now and for many years to come. This type of medicine is based on ancient wisdom, knowledge and healing arts, combined with the advantages and technical achievements of modern science and other areas of medicine; it is an integrated approach to preventive, safe and affordable healing. The term sustainable medicine also implies that the main therapeutic materials used in the course of practising this type of medicine can be replaced or replenished with minimal environmental damage after harvesting. The aim of sustainable medicine is to maintain the balance of nature, allowing an estimated 7 to 100 million species of life forms to co-exist and reproduce, and to sustain the long-term future of this planet. The world is in the midst of an environmental crisis: anthropogenic environmental damage in the last century was greater than in any previous century. One of the major concerns is the misuse of medicines, and the resulting immune depletion in people and animals. Many traditional medical systems have taught that appropriate adaptation by, and of, an effective defence system is the key to health and survival. This is only possible if priority is given to a preventive rather than a curative approach to health care; the very same approach that is advocated by proponents of SM: an approach based on proper diagnosis and the use of personalised, tailor-made medicine. The authors propose SM (the combination of the advantages of modern, traditional and complementary medical systems) as the best approach to providing better health care services for people and animals. The article presents a brief history of traditional medicines and outlines strategies for developing SM. The authors highlight some important factors in the development of SM in animal health care and attempt to encourage veterinarians to adopt a sustainable approach to treating animals.

A case-control study of xerophthalmia (120 cases, two with corneal disease; 3377 children without xerophthalmia, 12 to 60 months of age) was conducted in the rural plains of Nepal. Relative household wealth (ownership of animals and goods, house quality) and social standing (parental education, nondaily laboring, more affluent castes) were inversely related to risk of xerophthalmia. Mothers of cases were more likely to have had children die than mothers of controls (odds ratio, 1.85; 95% confidence interval, 1.22 to 2.78); case households were more likely to have had a young child die in the past year (odds ratio, 2.85; 95% confidence interval, 1.43 to 5.67). Children with xerophthalmia were more wasted and stunted than controls, although these associations largely disappeared after adjusting for socioeconomic influences. Frequency of breast-feeding was highly protective against xerophthalmia in a dose-response manner (odds ratio, 0.32 for 1 to 10 times a day, 0.12 for10 times a day) after adjusting for age and other factors. The risk of xerophthalmia rose directly with reported duration of dysentery in the previous week (odds ratio, 2.13 and 5.81 for durations of 1 to 6 days andor = 7 days, respectively, vs none). Mild xerophthalmia is reflective of a lower, local standard of living within which child health, nutrition, and survival are compromised.

Patellar malalignment is difficult to diagnose, but can respond well to conservative care. This paper discusses the clinical and radiographic diagnostic features of patellar malalignment, as well as conservative care for this condition.