Role of different melanocyte populations in the reconstitution of pigmented hair follicles / 中华皮肤科杂志

Objective:To observe whether hair follicle cells from mice of different species can integrate to generate new pigmented hair follicles, and to explore the role of different melanocyte populations in pigmented hair follicle reconstruction in mice.Methods:The epidermal cell population, hair follicle epithelial cell population and dermal cell population were isolated from the skin of fetal or neonatal C57BL/6J and BALB/C mice, and epidermal melanocytes were obtained by culture and purification of the epidermal cell population. The experiments were divided into 3 parts: (1) hair follicle reconstruction experiment in neonatal C57BL/6J mice, which included 2 groups: epidermal cells + hair follicle epithelial cells group and dermal cells group; (2) chimeric hair follicle reconstruction experiment, which included 4 groups: dermal cells of neonatal C57BL/6J mice group, dermal cells of neonatal BALB/C mice group, dermal cells of neonatal BALB/C mice + dermal cells of neonatal C57BL/6J mice group, and dermal cells of fetal BALB/C mice + dermal cells of fetal C57BL/6J mice group; (3) pigmented hair follicle reconstruction experiment, which included 3 groups: dermal cells of neonatal BALB/C mice + epidermal cells of neonatal C57BL/6J mice group, dermal cells of neonatal BALB/C mice + hair follicle epithelial cells of neonatal C57BL/6J mice group, and dermal cells of neonatal BALB/C mice + cultured C57BL/6J epidermal melanocytes group. Different cells were implanted into dorsal skin fold chambers of the nude mice, and there were 4 mice in each group. At weeks 4 and 8 after inoculation, hair follicle reconstruction was assessed by gross observation, histological examination and immunofluorescence assay.Results:Among the 8 BALB/C nude mice in the 2 groups in the hair follicle reconstruction experiment, 7 survived and 1 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, no hair growth was observed in the epidermal cells + hair follicle epithelial cells group (3 mice) , while normal hair grew out in the dermal cells group (4 mice) mixed with epithelial components. Among the 16 BALB/C nude mice in the 4 groups in the chimeric hair follicle reconstruction experiment, 14 survived and 2 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, brown-grey hair grew well in the dermal cells of neonatal BALB/C mice + dermal cells of neonatal C57BL/6J mice group (4 mice) , and dermal cells of fetal BALB/C mice + dermal cells of fetal C57BL/6J mice group (3 mice) . Among the 12 BALB/C nude mice in the 3 groups in the pigmented hair follicle reconstruction experiment, 10 survived and 2 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, only white hair grew out in the dermal cells of neonatal BALB/C mice + cultured C57BL/6J epidermal melanocytes group (3 mice) , and no hair follicle melanocytes were observed by immunofluorescence assay, while brown-grey hair grew well in the dermal cells of neonatal BALB/C mice + epidermal cells of neonatal C57BL/6J mice group (4 mice) , and dermal cells of neonatal BALB/C mice + hair follicle epithelial cells of neonatal C57BL/6J mice group (3 mice) .Conclusions:The interaction between mesenchymal cells and hair follicle epithelial cells is a necessary condition for hair follicle reconstruction. The hair follicle cells from different species of mice can integrate to generate new pigmented hair follicles. Both hair follicle melanocytes and epidermal melanocytes can participate in the formation of pigmented hair follicles, but differentiated melanocytes have no such ability.

Several rare nail unit tumors / 中华皮肤科杂志

Nail unit tumors are a group of rare tumors only occurring in the nail unit, including onychopapilloma, onychomatricoma, onychocytic matricoma, onycholemmal carcinoma, and so on. These tumors have specific clinical manifestations and pathological features due to their special anatomical locations. This review focuses on clinical manifestations, histopathological characteristics and treatment of the above tumors.

Considerations in the diagnosis and treatment of several nail diseases / 中华皮肤科杂志

In recent years, some progress has been made in the diagnosis and treatment of nail diseases, but there are still many challenges, such as longitudinal melanonychia, rare nail unit-specific tumors and nail dystrophy. Longitudinal melanonychia may develop into melanoma. Besides, biopsy and surgery are triggering factors for acral melanoma, so it is important to decide whether to operate and how to apply operating principles in clinic. In addition, the diagnosis and treatment should be based on patients′ age, clinical evaluation results, dermoscopic findings and pathological examinations, so as to avoid missed diagnosis of malignant melanonychia and deformities from treatment of benign melanonychia as far as possible. There are few summaries of clinical manifestations and pathological features of rare nail unit-specific tumors, and their diagnosis is difficult. In particular, onychocytic carcinoma and onycholemmal carcinoma are malignant tumors with great harm, so this article focuses on the two kinds of tumors to remind clinicians to avoid missed diagnoses. The etiology of nail dystrophy is complex. Nail dystrophy caused by inflammatory diseases can be treated with topical or systemic drugs, while various nail deformities caused by genetic factors, toe deformities, improper walking posture, mechanical injuries, and chronic inflammation of the nail groove are in need of physical or surgical correction. This article gives insight into challenges and strategies for the diagnosis and treatment of the above nail diseases.

Efficacy of collagen implant in the treatment of lacrimal groove deformity / 中华医学美学美容杂志

Objective:To observe the therapeutic effect of collagen complant filling in the correction of lacrimal groove deformity.Methods:Twenty-five patients with lacrimal groove deformity in our hospital from July 2018 to October 2019 were injected with collagen complant under local nerve block anesthesia or local topical anesthesia to improve local aging. The effects and adverse reactions after injection were evaluated.Results:The lacrimal groove depression was significantly improved in twenty-five patients in this study after injection of collagen implant. The lower eyelid to zygomatic-cheek region presented a natural and smooth, youthful profile curve. The shadow of lacrimal sulcus and palpebral sulcus depression and the pigmentation of lower eyelid were obviously improved. All the patients had mild swelling and skin reddening after the injection immediately. Two patients had local bruise. One patient had a small local strip bulge after injection. The effective rate was 88%. The overall satisfactory rate was 92%. During the follow-up for 3 months, the effect remained satisfactory within 1 month.Conclusions:Collagen complant filling can improve lacrimal groove deformity and achieve the goal of facial rejuvenation.

Surgical repair for deformities of the nail unit / 中华皮肤科杂志

Nail unit is an important structure for both aesthetic appearance and functional capability of the fingers and toes, and any defect or lesion at this anatomical site would lead to nail unit deformity. Surgical repair is the main treatment for such deformity. According to etiological and anatomical classification, appropriate surgical procedures can be chosen to repair the nail unit deformity, including autologous fat grafting, split-thickness nail bed grafting, full-thickness nail matrix grafting, nail bed elongation, palmar V-Y advanced flap reconstruction and so on. This review systematically summarizes classification of the nail unit deformity and associated surgical repair techniques.

Treatment of pincer nails / 中华皮肤科杂志

Pincer nails are a kind of nail deformity characterized by abnormal thickening and distal transverse overcurvature of the nail plate,whose etiology and pathogenesis are still unclear.According to the morphology of the nail plate,pincer nails can be divided into three subtypes:common pincer nail (trumpet nail),tile-shaped nail,and plicated nail.Width index,height index and curvature index are objective indicators to evaluate the severity and therapeutic effect of the pincer nails.According to the classification and severity of the pincer nails,appropriate treatment methods can be adopted to improve the appearance of the nail plate and relieve clinical symptoms of patients.This review systematically summarizes the classification of,evaluation of the severity of and several therapeutic methods for pincer nails.

Surgical repair for deformities of the nail unit / 中华皮肤科杂志

Nail unit is an important structure for both aesthetic appearance and functional capability of the fingers and toes,and any defect or lesion at this anatomical site would lead to nail unit deformity.Surgical repair is the main treatment for such deformity.According to etiological and anatomical classification,appropriate surgical procedures can be chosen to repair the nail unit deformity,including autologous fat grafting,split-thickness nail bed grafting,full-thickness nail matrix grafting,nail bed elongation,palmar V-Y advanced flap reconstruction and so on.This review systematically summarizes classification of the nail unit deformity and associated surgical repair techniques.

The application of IFCC reference methods in methodological evaluation of glycated hemoglobin measurement systems / 中华检验医学杂志

Objective To perform a methodological evaluation study of 4 HPLC based systems and a capillary electrophoresis based system , with the International Federation of Clinical Chemistry and Laboratory Medicine ( IFCC) glycated hemoglobin reference method as a comparative method .Methods 40 hemolysis samples of variety concentrations were prepared .The samples were measured by IFCC reference method and 5 glycated hemoglobin testing systems , respectively and trueness verification was performed according to the Clinical &Laboratory Standards Institute (CLSI) guideline EP9-A3.Whole blood samples were used to test the systems'precision, linearity and analytical interferences .Results The average CV of IFCC reference method results of 40 hemolysis samples was 1.4％( range from 0.2％to 2.5％).No outlier was found in the results of the 5 testing system.The slopes ranged from 0.9902 to 1.0267, and intercepts from -0.1526 mmol/mol to +0.1512 mmol/mol, squared correlation coefficient from 0.9962-0.9971, biases at two medical decision level were less than 0.3％HbA1c.Within-laboratory precisions were less than 2％ (NGSP unit).Bias between all test results and predicted results were less than 5％.High concentration of glucose showed certain interference to glycated Hemoglobin tests but had little influence in clinical practice.Conclusions The results of the 5 testing system are comparable to the IFCC reference method , the results of precision and linearity evaluation meet the requirements of related guidelines .

Association between frailty and serum biomarkers in older adults / 中华老年医学杂志

Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P＜0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P＞0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.

Anatomical ideas on infrapyloric lymphadenectomy in sagittal view of laparoscopic radical gastrectomy for gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To preliminarily discuss the anatomical ideas on infrapyloric lymphadenectomy in the sagittal view of laparoscopic radical gastrectomy for gastric cancer.</p><p><b>METHODS</b>A retrospective review was performed on the clinical data of 98 patients of lower-middle stomach cancer who underwent D2 radical gastrectomy in Department of Gastrointestinal Surgery of The First Hospital of Jilin University from June 2015 to December 2016. There were 56 males and 42 females with an average age of 59 years. TNM staging of gastric cancer revealed 22 cases of stage I, 37 cases of stage II, and 39 cases of stage III. All the patients underwent standardized No.6 lymph node dissection. Patients in stage II and above also received dissection of No.14v lymph nodes. During operation, sub-regional lymph node dissection was performed in the infrapyloric region according to sagittal anatomy. The dissection of each sub-region was to expose the corresponding anatomical landmarks as quality control standards. The region under the stomach pylorus was divided into the upper and lower parts by the pancreatic anterior plane and the gastroduodenal artery. The lower part was 6v region, and the upper part was 6a and 6i region. The lower part was further divided into front region and rear region by right vein of gastric omentum. The upper part was further divided into front, middle and posterior parts by right vein of gastric omentum and inferior pyloric artery. A total of 5 regions were established. Lymph node dissection in the lower pyloric region was performed at these five regions. Photographs were taken during operation and statistics was carried out in operation time and harvested lymph nodes from infrapyloric lymphadenectomy.</p><p><b>RESULTS</b>The time to complete No.6 lymph node dissection was (38±6) minutes for the 22 patients with stage I gastric cancer, and to finish No.6 and No.14v lymph node dissection was (49±8) minutes for the 76 patients with stage II and stage III gastric cancer. The mean number of harvested No.6 lymph nodes was 5.4±2.9, including 2.9±1.8 in No.6a,1.3±0.9 in No.6v, and 1.2±0.7 in No.6i. No.6 lymph node metastasis was found in 29 cases (29.6%), and No.14v lymph node metastasis in 19 patients (9.2%).</p><p><b>CONCLUSION</b>Sub-regional lymphadenectomy for infrapyloric region based on embryology and membrane anatomy may achieve complete dissection of No.6 lymph nodes.</p>

Study of introperitoneal hyperthermic perfusion chemotherapy combined with systemic neoadjuvent chemotherapy in treatment of gastric cancer patients with peritoneal carcinomatosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>The aim of this study is to discuss the curative effect of introperitoneal hyperthermic perfusion chemotherapy(IHPC) combined with systemic neoadjuvant chemotherapy on the gastric cancer patients with peritoneal carcinomatosis.</p><p><b>METHODS</b>Sixty-four patients with gastric cancer and peritoneal carcinomatosis who were hospitalized in the Department of Gastrointestinal Surgery of First Hospital of Jilin University from December 2006 to December 2013. After peritoneal carcinomatosis was confirmed during laparoscopic exploration, FOLFOX6 (oxaliplatin and calcium folinate and 5-Fu) was performed for systemic chemotherapy. One course was 14 days and a complete treatment includes four courses. At the same time, patients underwent peritoneal catheter insertion and received IHPC(5-Fu 1 500 mg/m(2) and Cisplatin 35 mg/m(2) were added into 0.9% NaCl solution 2 000 ml, the infusion velocity was 35-45 ml/min, infusion time was 45-60 minutes, the temperature was controlled to 41°C). A comprehensive evaluation was taken after the fourth course of treatment before operation. Further surgical therapy was performed according to the assessment result.</p><p><b>RESULTS</b>Sixty-four patients received IHPC combined with systemic chemotherapy. Thirty-two patients(50.0%) had partial response, 18(28.1%) stable disease, and 14(21.9%) progressive disease after chemotherapy. No severe complications or death occurred during the neoadjuvant chemotherapy. Thirty-two patients(50.0%) received radical resection, 10(15.6%) palliative operation, and another 22 patients(37.4%) didn't comply with inclusion criteria of operation. Patients receiving operation had a median survival time of 678 days, which was significantly longer than patients without operation, with a median survival time of 251(χ(2)=23.34, P=0.02).</p><p><b>CONCLUSIONS</b>IHPC combined with systemic chemotherapy is an effective therapeutic method for gastric cancer patients with peritoneal carcinomatosis in terms of reducing preoperative tumor load and achieving radical resection.</p>

Effects of omega-3 polyunsaturated fatty acids on postoperative inflammatory reaction and clinical efficacy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of omega-3 polyunsaturated fatty acids (PUFA) on postoperative inflammatory response and clinical efficacy in gastric cancer patients with nutritional risk.</p><p><b>METHODS</b>All patients with gastric cancer in our department from June 2013 to January 2014 undergoing radical gastrectomy were prospectively enrolled in the study. Patients who matched the selection criteria were randomly divided into two groups: trial group (with omega-3 PUFA in parenteral nutrition) and control group (without omega-3 PUFA in parenteral nutrition). Levels of inflammatory factors (serum CRP, TNF-α, IL-1, IL-6, IL-10) and nutrition-related proteins (prealbumin, retinol conjugated protein and transferrin) were compared between the two groups before operation and 2, 4 and 6 days after operation. Incidence of postoperative systemic inflammatory response syndrome (SIRS) and other indicators associated with efficacy were compared between the two groups as well.</p><p><b>RESULTS</b>Forty-seven patients were finally included in this study with 21 patients in the trial group and other 26 in the control group. There were no significant differences of inflammatory factors and nutrition-related proteins between the two groups before operation (all P>0.05). In the 6th days after operation, the levels of proinflammatory cytokines, including CRP, IL-1 and IL-6 were significantly lower in the trial group as compared to the control group, while the level of IL-10 (inhibiting inflammatory cytokine) was higher in the trial group, as well as levels of nutrition proteins(all P<0.05). The trial group had significantly lower rate of SIRS than the control group [57.1%(12/21) vs. 84.6% (22/26), P=0.036]. Compared with the control group, patients in the trial group had shorter bowel sound recovery time [(12.3±1.1) d vs. (3.1±1.3) d, P=0.025], earlier passage of flatus [(3.1±1.0) d vs. (3.9±1.2) d, P=0.025] and shorter hospital stay [(9.4±2.1) d vs. (10.9±2.5) d, P=0.038], but there was no difference in postoperative complication rate between the two groups (P=0.678).</p><p><b>CONCLUSIONS</b>Omega-3 PUFA can reduce the release of inflammatory promoters, promote the release of inhibiting inflammatory cytokine IL-10, decrease the incidence of SIRS, improve patients' nutritional state, expedite the recovery of gastrointestinal function and shorten patients' recovery time.</p>

β-catenin and PCNA expression in gastric cancer tissues and their correlation with clinical prognosis / 中华普通外科杂志

Objective To investigate the expression of β-catenin and PCNA,and its relationship with clinical parameters and prognosis.Methods Tissue microarray technology and immunohistochemical method were used to detect the expression of β-catenin and PCNA in gastric carcinoma and normal tissue collected from January 2000 to December 2006.Data were analyzed by SPSS 19.0.Results The percentage of expression of β-catenin and PCNA in gastric carcinoma is 96.7％,99.2％,respectively,and higher than the normal gastric tissue (x2 =41.082,P =0;x2 =97.692,P =0).ROC curve was used to find that PCNA was better than β-catenin to discriminate gastric carcinoma from normal gastric tissue in sensitivity,specificity,coincidence rate(84.4％,87.5％,84.6％).The expression of β-catenin is related to lymph node metastasis in gastric cancer (x2 =6.107,P =0.04).The expression of PCNA is related to pathological type (x2 =9.71,P =0.02).The expression of β-catenin and PCNA in gastric carcinoma were positively correlated (r =0.24,P =0.005).Multivariate analysis showed that TNM staging and both positive β-catenin and PCNA were independent factors impacting on the overall survival rate of patient with gastric cancer.Conclusions The expression of β-catenin and PCNA in gastric carcinoma is signifrcandy high.PCNA is more important than β-catenin in discriminating gastric carcinoma from normal gastric tissue.Combined detection of the two kinds of protein have some clinical significance in predicting the prognosis of patients with early gastric cancer.

Reconstruction of hair follicles in mice: a pilot study / 中华皮肤科杂志

Objective To reconstitute hair follicles in mice using graft chambers,and to study the effect of different cell types on hair follicle regeneration.Methods Full-thickness skin was obtained from the back of C57BL/6 neonatal mice.Then,epidermal cell suspensions were prepared by shredding epidermis after trypsinization,hair follicles and dermal cells were collected by filtration,low-speed centrifugation and density gradient centrifugation,and hair follicle epithelial cells were obtained via trypsinization of hair follicles followed by filtration.Nude mice were classified into four groups to be transplanted with epidermal cells + follicular buds,dermal cells alone,epidermal cells + follicular buds + dermal cells,follicular epithelial cells + dermal cells,respectively.The cells were implanted into the dorsal skin of nude mice using fold chambers.After the grafting,the growth of skin and hairs was observed at the grafted sites on week 1,2,4 and 8,and skin specimens were obtained on week 2,4,and 8 for histological study of hair follicles using hematoxylin-eosin staining.Results After grafting,the chambers on the back of nude mice began to shed with crust formation on week 1; stunted hairs came out and follicle-like structures were seen under the microscope on week 2 at the grafted sites,normal hairs were observed on week 4 and 8 in all the mice except for those transplanted with epidermal cells + follicular buds,and the growth of hairs in mice grafted with epidermal cells + follicular buds + dermal cells and mice grafted with follicular epithelial cells +dermal cells was superior to that in mice grafted with dermal cells alone.Conclusions Hair follicles can regenerate after hair follicle cell transplantation into dorsal chambers in nude mice.Both epidermal cells and dermal cells play indispensable roles in hair follicle reconstitution.

Techniques and feasibility of laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy / 中华消化外科杂志

Laparoscopic curative gastrectomy has been widely adopted because it is minimal invasiveness.The efficacy of laparoscopic gastrectomy is comparable to that of open gastrectomy for patients with early or advanced gastric cancer,but few studies of laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy for patients with advanced gastric cancer have been reported.Seven patients with advanced gastric cancer received laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy at the First Hospital of Jilin University from September 2010 to September 2011.The mean operation time,blood loss,postoperative hospital stay and the nunber of lymph nodes resected were (218 ± 24) minutes,(366 ± 174) ml,( 14.6 ± 2.8 ) days and 32 ± 15,respectively.Two patients were complicated by pancreatic juice leakage and were cured with drainage. No anastomotic leakage,abdominal bleeding or mortality was observed. With the development of techniques and equipments,laparoscopic total gastrectony combined with distal pancreatectomy and splenectomy is safe and feasible in selected patients.

The application of hemoglobin and transferrin immunoassay in detection of digestive tract bleeding / 中华全科医师杂志

Fecal samples were collected from 81 patients with digestive tract bleeding (including 32 cases of upper digestive tract bleeding, 6 gastric cancer, 34 lower digestive tract ulcer and 9 colorectal cancer) and 40 healthy subjects. Fecal occult blood was detected with hemoglobin and/or transferrin monoclonal immunoassay. The positive rate with hemoglobin immunoassay for upper digestive tract bleeding, gastric cancer, lower digestive tract ulcer and colorectal cancer was 46.9%, 66.7%, 32.3% and 77.8% respectively;the positive rate with transferrin imrnunoassay was 71.9%, 83.3%, 47.1% and 88.9% respectively. When two methods were combined, the positive rate increased to 87.5%, 100%, 55.9% and 100% respectively showing a higher sensitivity.

Ultrastructural Characteristics of Amelanotic Melanocytes from Human Hair Follicles / 中华皮肤科杂志

Objective To investigate the ultrastructural characteristics of amelanotic melanocytes (AMMCs). Methods Individual hair follicles from normal human scalp were digested with collagenase type V, then washed in phosphate buffer saline. Hair-follicle cell suspensions were prepared by trypsin and cultured in a medium suitable for melanocyte growth. The keratinocytes were removed by differential trypsinization. Geneticin (100?g/mL) was used to eliminate contaminating fibroblasts. After 3 passages the cells were trypsinized, washed in phosphate buffer saline, and finally processed for transmission electron microscopy. Results Under transmission electron microscope, the cultured cells were round or oval-shaped with a single large nucleus and double-layered karyotheca. Abundant euchromosome but sparse heterochromosome was observed within the nucleus. There were various organelles in the cytoplasm, including mitochondria, rough endoplasmic reticulum (RER), ribosomes and abundant melanosomes of nearly uniform size. The electronic density granules distributed in a concentric pattern in most of the melanosomes. Colgi complexes were inconspicuous in the cells. Conclusions Compared to epidermal melanocytes, AMMCs from human hair follicles have different ultrastructural characteristics which implies their functional immaturity. AMMCs may serve as the depot for mature melanocytes.

The Impact of Severity of Psoriasis on Quality of Life in Psoriatic Patients / 中华皮肤科杂志

Objective To investigate the impact of severity of psoriasis on quality of life in patients with psoriasis vulgaris.Methods A questionnaire interview was carried out to the outpatients with psoriasis vulgaris(n=504)from Dec.2000to Sept.2001.All the patients were more than18years old.The content of questionnaire included daily life and activities,work and school performance,social activities and personal relationships,and psychologic status.Disease severity was assessed with psoriasis area and severity index(PASI).498patients were included for the final analysis.Statistical analysis was performed with SPSS software package.Results63.3%patients were restricted in their food selection.40.2%had bad sleep,59.0%could not dress short clothes in the summer.26.5%were restricted in use of public traffic and services.15.1%were rejected in haircut and cosmetic service.31.2%had decreased income along with severity of the disease.58.8%felt uncomfortable in social activities and public places.25.8%avoided handshaking with others.43.3%were reluctant in social intercourse.29.0%were not willing to take part in social activities,especially for moderate and severe cases.54.9%felt that their self-esteem was injured.26.6%thought that other peoples always avoided to meet them.64.4%felt anxiety for their disease.83.1%often worried about relapse or exacerbation of psoriasis.15.9%showed a tendency to commit suicide.Conclusions The more severe the disease is the more impact it may have on the daily life,work and school performance,social activities and personal relationship,and psychologic status in patients with psoriasis vulgaris.It is reccommended that besides the conventional treatment bio-psychic and social medical management be given to the patients especially for moderate and severe cases.