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Objective:To investigate changes in skin microecological structures and functions between acute and remission phases in adult patients with severe atopic dermatitis (AD) .Methods:From October 2019 to November 2020, skin scale specimens were collected from 5 body sites (cheeks, cubital fossa, back of the hand, abdomen, lower limbs) of 4 adult patients with severe AD in the acute and remission phases, who visited the outpatient clinic of Guangzhou Institute of Dermatology. The next-generation high-throughput sequencing was performed for metagenomic sequencing to construct the microbial gene catalogue of these specimens, followed by gene annotation and bioinformatics analysis for each sample.Results:A total of 18 phyla, 37 classes, 73 orders, 142 families, 237 genera, and 331 species were identified in the skin specimens from the 4 patients with severe AD. The patients with AD in the remission phase showed significantly increased diversity of skin microbiota and markedly different relative abundance of skin microorganisms compared with those in the acute phase (both P < 0.05). At the microbial species level, Staphylococcus aureus showed the highest impact on the acute phase of AD, while Staphylococcus epidermidis, Moraxella osloensis, Francisella sp., Staphylococcus cohnii, Staphylococcus warneri, Malassezia globosa and Malassezia restricta were enriched in the remission phase of AD with the absolute value of the common logarithm of the linear discriminant analysis score > 2 (Kruksal-Wallis test, all P < 0.05). As KEGG pathway enrichment analysis showed, the differentially abundant genes were annotated into a total of 355 functional pathways, of which 38 pathways were significantly enriched (all P < 0.05), mainly involving Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism, nitrogen metabolism, metabolism of arginine and proline, biosynthesis and degradation of valine, leucine and isoleucine, fatty acid degradation, peroxisome proliferator-activated receptor signaling pathway, etc. Conclusion:The skin microecological structure significantly differed between the acute and remission phases among the patients with severe AD, which may be related to multiple functional pathways, such as Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism and nitrogen metabolism.
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Primary aldosteronism(PA) is one of the most common secondary hypertension, the pathogenesis is still not fully understood. Aldosterone synthase(CYP11B2) was thought to be continuously expressed in the zona glomerulosa of the adrenal cortex. In recent years, it is found that there were discontinuous CYP11B2 positive cell clusters in adrenal cortex via immunohistochemical staining, and proposed the concept of aldosterone-producing cell clusters(APCC). Thenceforwarding a growing body of studies suggest that there may be a potential causal link between APCC and PA. This article summarizes the latest studies on APCC and provide an update on the potential role of APCC in the pathogenesis of PA.
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Teratoma is a rare tumor, mainly occurring in the ovary, sacrococcygeal region, testis, central nervous system and mediastinum, rarely occurring in the kidney, and adult immature teratoma originating in the kidney is extremely rare. A case of adult left renal immature teratoma was reported in this paper. After radical nephrectomy, pathological examination found that the tumor tissue contains malignant epithelial tissue and a small number of brain tissue. BEP regimen chemotherapy was performed after operation.The patient was followed up for 26 months, and died of organ failure caused by systemic metastasis.
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Objective:The optimal allocation of resources is the focus of hospital administrators, and how to improve efficiency is one of the key problems. This paper aims to establish the new mechanism of hospital equipment sharing to optimize the resource allocation.Methods:Taking large-scale general hospital as an example, set up rules for sharing the scientific research equipment in the hospital, establish information management platform to assure the unify and smart management of large-scale scientific research instruments.Results:Through hospital policy-making, information system construction, reward-punishment mechanism updating, a tailored opening and sharing construction scheme of scientific research instruments and equipment in the hospital was established.Conclusions:The construction of equipment sharing platform plays important role in optimize resource allocation, improves the efficiency of existing equipment, and avoids redundant and inefficient use and repeated purchases, which provides strong support for the sustainable development of scientific research in the whole hospital.
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Objective:In a relatively "loose" macro policy environment, formulate highly operational implementation management methods for scientific research at institutional level to optimize the research management services, improve risk prevention and control, and at the same time play a role of "relaxing" scientific researchers.Methods:Combining with practical management issues, this article takes Southwest Hospital affiliated to The Third Medical University as an example, focuses on the existing problems and risk points in the institutionalization of scientific research management in hospitals. Discussions are carried out, including establishment and improvement of labor charge management, scientific research financial assistant system through labor dispatching service, catalogued reagents and consumable procurement mode, and out-put and in-put of warehouse management. In addition, specific solutions pertinent to the potential problems arising in institutionalization are proposed, especially in the ambiguity zone of higher-level policies.Results:Based on the analysis of problems existed in the practice, we puts forward some concrete solutions, and suggests " institutionalization" should replace the " inertia" management to make sure compliance. Improve labor management practices, more refined payment range on the basis of relevant national policies, specifically issuing qualifications of different categories of staff and set according to the local yearbooks a more appropriate standard for payment; explore research finance assistant institutional foundation dispatch mode, in order to make up the shortcomings of financial assistants include low salaries and the short employment periods. Establish a cataloged reagent and consumables procurement management mode and storage system. It is recommended to use information management measures to achieve visual management of procurement and use of various links.Conclusions:The institutional reform and innovation can stimulate the vitality of scientific research and improve academic integrity.
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Metagenomic analyses of humans and animals have showed that atopic dermatitis (AD) is associated with microbiome dysbiosis in the gut and skin. Decrease of microbial diversity can cause damage to skin barrier and aggravation of AD, and gut microbiome may be involved in the occurrence and development of AD through immune, metabolic and neuroendocrine pathways. This review summarizes the latest advances in the application of metagenomics in tmicrobiological research in and treatment of AD, possible mechanisms underlying microbiome-mediated pathogenesis of AD, and provides a theoretical reference for the microecological therapy of AD.