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OBJECTIVE： To evaluate the efficacy and safety of apremilast in the treatment of moderate-to-severe plaque psoriasis systematically. METHODS： Retrieved from PubMed， Embase， Cochrane Library， VIP， CNKI and CBM， RCTs about apremilast or apremilast combined with other drugs （trial group） versus placebo （control group） in the treatment of moderate- to-severe plaque psoriasis were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after literature screening， data extraction and quality evaluation with bias risk evaluation tool of Cochrane System Evaluator Manual 5.1.0. RESULTS： Totally 7 studies were included， involving 2 332 patients. Results of Meta-analysis showed that case number of psoriasis assessment and severity index （PASI） decreased by 75％ （PASI 75％） [OR＝6.44，95％CI（4.90，8.45），P＜0.000 01]， PASI 90％ [OR＝8.13， 95％CI（4.65， 14.22）， P＜0.000 01] and sPGA 0 or 1 [OR＝3.89，95％CI（3.00，5.05），P＜0.000 01]， the incidence of ADR [OR＝1.87，95％CI（1.44，2.43）， P＜0.000 01] in trial group were significantly more or higher than control group. Subgroup analysis by apremilast dose showed that case number of 20 mg PASI 75％ [OR＝4.72，95％CI（2.77，8.05），P＜0.000 01]， 30 mg PASI 75％ [OR＝7.05，95％CI（5.13，9.69），P＜0.000 01]， 20 mg PASI 90％ [OR＝4.27，95％CI（1.80，10.09），P＝0.001]， 30 mg PASI 90％ [OR＝11.11，95％CI（5.27，23.43），P＜0.000 01]， 20 mg sPGA 0 or 1 [OR＝2.82，95％CI（1.51，5.26），P＝0.001]， 30 mg sPGA 0 or 1 [OR＝4.13，95％CI（3.10，5.50），P＜0.000 01]， the incidence of 30 mg ADR [OR＝1.94，95％CI（1.51，2.49），P＜0.000 01] in trial group were significantly more or higher than control group. There was no statistical significance in the incidence of serious ADR [OR＝1.27，95％CI（0.77，2.07），P＝0.35] or case number of ADR leading to withdrawal [OR＝1.48，95％CI（1.00，2.20），P＝0.05] between 2 groups. CONCLUSIONS： Apremilast is effective for moderate-to-severe plaque psoriasis in dose-dependent manner and improve the quality of life， but increase the incidence of ADR.
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Objective To detect the varicella-zoster virus (VZV) DNA load in vesicle fluid and peripheral blood,as well as plasma levels of S100β protein and neuron-specific enolase (NSE) in patients with herpes zoster before and after treatment,and to explore their correlations.Methods Vesicle fluid samples were collected before treatment,and peripheral blood samples before and after treatment from 50 inpatients with acute herpes zoster in the Department of Dermatology of the Affiliated Hospital of Southwest Medical University,and peripheral blood samplcs were also obtained from 20 heahhy controls.Real-time fluorescence-based quantitative PCR (qRT-PCR) was performed to determine the viral load in the vesicle fluid and peripheral blood samples,and enzyme-linked immunosorbent assay (ELISA) to detect the plasma levels of S100β protein and NSE.Results VZV DNA was present in all the vesicle fluid samples,as well as in peripheral blood samples from 18 patients before treatment and 5 patients after treatment,but not found in any of the healthy controls.Positive correlation was found bctween the viral load in vesicle fluid and plasma levels of S 100β protein and NSE (r =0.535,0.430,respectively,both P ＜ 0.05) in the patients with acute herpes zoster.Before treatment,patients with VZV DNA in peripheral blood showed significantly increased plasma levels of S100β protein and NSE compared with those without (both P ＜ 0.05),and the viral load in peripheral blood was positively correlated with plasma levels of S100β protein and NSE (r =0.711,0.645,respectively,both P ＜ 0.05).Conclusion VZV DNA is present in some patients with herpes zoster,and increased VZV DNA loads in the vesicle fluid and peripheral blood are related to elevated plasma levels of S100β protein and NSE before treatment.
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Objective To evaluate the efficacy and safety of allicin in patients with Behcet's disease (BD). Methods Thirty-eight patients with BD that was mainly involved skin, mucosa and joints were divided into treatment group ( 20 cases) and control group (18 cases) by randomized digital table method. Two groups of patients were respectively assigned to receive allicin tablets and identical placebo vehicles for 12 weeks, and were followed up to 16 weeks. The changes of clinical symp-toms and laboratory detection were observed in the time of pretreatment and post-treatment in two groups. Meanwhile, the ef-ficacy and side effects were compared between both groups. Results A total of 31 patients completed the experiment. The effective rate was 88.89%in treatment group, which was significantly higher than that of the control group (7.69%, P0.05). The levels of ESR and CRP were significant lower in treatment group than those in pretreatment and control group (P < 0.01). Although allicin displayed some adverse reactions, most patients could tolerate them, and these side effects tended to dissipate once the drug ceased. Conclusion Allicin is a safe and effective drug in the treatment of BD, which is significantly better than placebo, and is worth to be further researched and promoted.
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Objective To explore the therapeutic effect and the mechanism of allicin on experimental Behcet′s disease (BD) . Methods BD models were established .Then ,model mice were randomly divided into experimental group ,positive control group and negative control group ,with respectively nasogastric infusion allicin ,colchicine and saline respectively .Before and after treatment , the changes of the skin lesions were visually observed .Cytokines of IFN‐γ,TNF‐αand IL‐4 in serum were detected by ELISA anal‐ysis ,while the markers of T‐AOC ,MDA ,SOD and GSH‐PX by chemical colorimetric methods .Results After modeling ,ulcers ap‐peared on the back ,abdomen and genital of model mice with IFN‐γ,TNF‐α,IL‐4 and MDA elevation ,while T‐AOC ,SOD and GSH‐PX decrease .Twenty days of treatment later ,ulcer on mice in the experimental group and positive control group healed .After 30 days ,only two mice in the experimental group recurred ,while 6 mice in the positive control group ,which showed a significant differ‐ence between two groups (P0 .05) .Meanwhile ,T‐AOC ,SOD and GSH‐PX levels in the experimental group were significantly higher than those in the pretreatment ,but MDA was lower (P<0 .01) .In comparison with the positive control group ,levels of those markers in the experimental group changed remark‐ably (P<0 .05) .Conclusion Allicin is an effective drug in the treatment of experimental BD .The therapeutic mechanism of allicin may be the inhibition of inflammatory mediators and prevention of oxidative stress .