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Background: The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. Aim: To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. Methods: A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Results: Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Conclusion: Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students. [ABSTRACT FROM AUTHOR]

Background: Although pulsed dye laser (PDL) has long been regarded as the gold standard in treating port-wine stain (PWS), advanced PWS with deeper coloration may display resistance because of limited penetration depth of 585 or 595-nm light. Recently, a dual-wavelength laser system has been reported to achieve pronounced fading in many patients., Objective: The objective was to evaluate the efficacy and safety of a dual-wavelength laser device in treatment of neck and facial PWS in a direct side-by-side comparison., Methods: Sixteen Chinese patients with neck and/or facial PWSs were enrolled in the study. All lesions were randomly divided into two area, treated area and adjacent untreated area. Five successive treatments using a dual-wavelength laser system (595-nm PDL combined with 1,064-nm Nd:YAG laser) were delivered on treated areas at 4- to 6-week intervals. The adjacent area was not treated as self control. Two blinded dermatologists evaluated the clinical changes by comparing the before and after photos. Erythema index (EI) values were measured with a non-invasive instrument., Results: After five sessions of treatment, over 62.5% (10/16) patients achieved more than 50% (moderate or significant) improvement. The efficacy maintained at the 3-month follow-up visit. The values of EI on treated area showed a significant decrease. Adverse effects of treated area were limited., Conclusion: Using this split-face module, the dual-wavelength laser system is proved to be effective and well tolerated in treating neck and facial PWSs in Chinese patients. Adverse effects were minimal and acceptable.

Objective: To explore the correlation between androgen-related CYP17 gene polymorphisms and female post adolescent acne in Han population in Hunan Province., Methods: The female patients with post adolescent acne and high levels of androgen (A group), those without high levels of androgen (B group) and healthy subjects (C group) were enrolled. The CYP17 gene polymorphism was investigated by PCR using DNA samples from peripheral blood lymphocytes. The T-->C transition in the risk allele (A2) produced a new recognition site for the restriction endonuclease MspA1 I. Three genotypes of androgen-related CYP17 gene (A1A1, A1A2, and A2A2) were determined and confirmed by sequencing., Results: The frequency of the A1A2 gene was similar in the cases and controls (P>0.05). The frequency of A2A2 gene was not significantly different between groups A and C (P>0.05). The frequency of A2A2 gene was significantly different between groups A and B and between groups B and C (P<0.05)., Conclusion: The presence of base substitution in androgen-related CYP17 gene at -34 bp (T-->C) increases the risk of post adolescent acne in female subjects with increased androgen levels.

Objective: To describe the etiology, clinical features and treatment of childhood acute generalized exanthematous pustulosis (AGEP)., Methods: Clinical data from 20 cases of childhood acute generalized exanthematous pustulosis from 1990 to 2008 were retrospectively reviewed., Results: Eighteen cases had a history of medication, including the use of penicillin (n=6), cephalosporins (n=3), sulphonamides (n=2), algopyrin (n=2), vaccines (n=2 ) and anti-cold drugs (n=3). Fever and generalized erythematous pustules were observed in all 20 cases. Histopathologic examination revealed spongiform superficial pustules and papillary edema. The patients were asked to stop taking suspected sensitizing drugs and received glucocorticoid treatment (1-2 mg/kg daily). After 3-5 days of the treatment, symptoms were improved and the dosage of glucocorticoid was gradually reduced. All patients were healed within 20 days after treatment., Conclusions: The cause of AGEP is mainly attributed to the use of antibiotics, sulphonamides, antipyretic analgesics and vaccines in children. AGEP is characterized by fever and widespread pustular eruption of the skin. Removal of sensitizing factors and glucocorticoid administration is important in the treatment of AGEP in children.

Objective: To establish systemic lupus erythematosus (SLE) -like murine model by immunizing BALB/C mice with Sm mimotope., Methods: Sm mimotope was identified by screening a 12-mer random peptide library with monoclonal anti-Smith antibody. Sm mimotope was initially defined with sandwich ELISA, DNA sequencing, and deduced amino acid sequence; and BALB/C mice were subcutaneously injected with mixture phages clones. Sera Sm antibody, anti-double stranded DNA (dsDNA) antibody, and antinuclear antibody (ANA) of mice were detected using direct immunofluorescence; kidney histological changes were examined by HE staining., Results: Five randomly selected peptides were sequenced and the amino acid sequences IR, SQ, and PP were detected in a higher frequency. High-titer IgG autoantibodies of dsDNA, Sm, and ANA in the sera of experiment group were detected by ELISA 28 days after having been immunized by Sm mimotope. Proteinuria was detected 33 days later; immune complex and nephritis were observed in kidney specimens., Conclusion: SLE-like murine model can be successfully induced by Sm phage mimotope.

Objective: To examine the hepatitis C virus (HCV) infection in systemic lupus erythematosus (SLE) patients, to investigate the influence of HCV infection, and to analyze the clinical appearances and experimental immunological characters of SLE., Methods: Serum of 92 SLE patients and 58 normal control people was taken, and the HCV infection and experimental immunological characters were detected. SLE patients were divided into HCV infection group and non-HCV infection group according to the detective results. The immunological characters and clinical appearances were analyzed in the two groups., Results: Thirteen of the 92 SLE patients were HCV positive, while only 2 of the 58 normal controls were positive. There were no significant differences in the clinical features including oral ulcer, arthritis, serositis, nephropathy, neural disorder, fever, as well as in the laboratory results including ANA, Anti-Ro/SSA, Anti-La/SSB, Anti-Sm, IgG and IgM in the two groups. HCV positive patients showed a lower frequency of butterfly erythema and positivity for Anti-dsDNA, and a higher frequency of cutaneous vasculitis, liver damage, positivity for RF and low C3, C4 levels., Conclusion: Patients with SLE showed a high prevalence of HCV infection, and HCV may cause some clinical and immunological changes in SLE.

Objective: To observe the photoprotective effect and possible mechanisms of resveratrol for ultraviolet A (UVA) irradiated HaCaT cells., Methods: HaCaT cells under UVA irradiation with 5J/cm(2) were interfered with 0.01 mmol/L and 0.1 mmol/L resveratrol. The testing objects were divided into a control and a UVA irradiation group, and then we detected the proliferation capacity with methylthiazdyl tetrazolium (MTT) and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, content of maleic dialdehyde (MDA) with hydroxylamine, colorimetric, thiobarbituric acid (TBA) methods. The ultrastructure was observed under electron microscope., Results: Resveratrol could enhance the proliferation activity, SOD, GSH-Px activity of HaCaT cells under UVA irradiation, decrease the content of MDA in dose-dependent manner (P<0.05). The electron microscope revealed that resveratrol could relieve the injury of HaCaT cells' ultrastructure., Conclusion: Resveratrol can relieve the inhibition to HaCaT cell proliferation,injury of their ultrastructure and oxidation by UVA irradiation. The protection is dose-dependent. That resveratrol raises the oxidase activity and clears the oxyradical may account for these results.

Objective: To investigate a possible role of CD147 in the production of matrix metalloproteinase-9 (MMP-9) by fibroblasts and the invasion of melanoma cells., Methods: We cocultured CD147-expression melanoma cells with fibroblasts and examined the MMP-9 expression of fibroblasts by zymography and the invasion of melanoma cells by transwell invasion assay., Results: MMP-9 expression was enhanced in conditioned media, while cocultured with melanoma cells in a dose-dependent manner, and CD147 antibody inhibited the production of MMP-9 in the fibroblasts. When fibroblasts were cultured at the bottom of the lower compartment of transwell invasion model, the number of melanoma cells that invaded significantly increased. Addition of anti-CD147 antibody to the upper compartment transwell invasion model resulted in the significant inhibition of the melanoma cell invasion in reconstituted basement membrane., Conclusion: CD147 expressed in melanoma cells plays an important role in the melanoma cell invasion by stimulating the production of MMP-9 by fibroblasts.

Objective: To establish a method of extracting DNA from the paraffin-embedded epidermal tissue and examine the amplification of beta-catenin gene by polymerase chain reaction (PCR) analysis., Methods: Exon 3 of the beta-catenin gene was amplified by PCR in 14 paraffin-embedded Bowen's disease (BD) of various weight and years., Results: The amplification of exon 3 of beta-catenin gene was successful in all the 10 mg and 20 mg samples, but not in the 5 mg samples. The amplification of exon 3 of beta-catenin gene was successful in 9 samples embedded within 10 years, and in only 2 of the 5 samples embedded more than 10 years., Conclusion: Epidermal tissue whose weight is 10 mg or more within 10 years of embedding can be used in the amplification of purpose gene by PCR.