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Olmsted syndrome (OS) is an extremely rare hereditary skin disease, that is usually characterized by mutilating palmoplantar keratoderma (PPK) and periorificial keratotic plaques. The diagnosis of this disease depends primarily on the clinical presentation and OS has to be differentiated from other disorders associated with hyperkeratosis. In recent years, there have been many advances in molecular genetic research on the pathogenesis of the disease. The genes that can cause disease after specific mutations include TRPV3, MBTPS2/S2P and PERP. Therefore, genetic testing has become one of the important methods for the diagnosis of this disease.OS treatment is difficult, and conventional therapy uses topical drugs to soften the cuticle of the skin, or oral Avi A.Excision of palmoplantar keratosis may also be used for constricting rings that severely restrict movement, but they often reoccur after initial improvement. In terms of precision treatment, researchers have tried the small molecule drugs erlotinib and sirolimus and have achieved some results. This paper summarizes the etiology, pathogenesis, clinical manifestations, diagnosis, treatment and prognosis of OS, in order to improve the clinicans' awareness of OS.
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Research progress in the establishment of long-term control goals and treat-to-target in the treatment of atopic dermatitis (AD) was searched and summarized in this review. The TREatment of ATopic eczema (TREAT) Registry Taskforce defined a minimum follow-up frequency of initially 4 weeks after commencing treatment, then every 3 months while on treatment and every 6 months while off treatment; the international Harmonising Outcome Measures for Eczema (HOME) group recommended that the long-term control of AD should be measured by either the Recap of Atopic Eczema (RECAP) instrument or the Atopic Dermatitis Control Tool (ADCT) . In order to achieve the treat-to-target in AD, a panel comprising 87 participants from 28 countries developed and published "Treat-to-target in atopic dermatitis: an international consensus on a set of core decision points for systemic therapies" in early 2021, which recommended 3 months and 6 months as two evaluation time points, and various disease outcome domains spanning symptoms, signs, quality of life plus patient global assessment as the target. By setting the time-specific outcome thresholds, the consensus provided a framework for shared decision-making on systemic treatment adjustment for AD patients. This review summarizes concepts and indicators related to the assessment of long-term control of and treat-to-target in AD, in the hope of providing some ideas for clinical management, especially the long-term control, of AD in China.
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High-dose intravenous immunoglobulin (IVIG) has emerged as an effective treatment option for some refractory and severe dermatoses with few adverse reactions. The Fab and Fc fragments of IgG can exert anti-inflammatory effect by mediating specific downstream reactions via binding to a variety of autoantigens, autoantibodies and complements. This review summarizes action mechanisms of IVIG, focuses on the progress towards its application in severe dermatoses (such as severe drug eruption, refractory dermatomyositis and autoimmune bullous diseases) and special populations, as well as its adverse reactions.
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@#A novel allicin pro-drug tablet containing antacid pellets was developed to realize pH-regulated allicin release and to guarantee allicin yield in stomach environment.Firstly, allicin precursor pellets containing antacid pellet were prepared and artificial gastric juice was used as the medium to determine the yield of the allicin.Then, the total lipid cholesterol (TC), triglyceride cholesterol (TG), high density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) were used as indicators to study the hypolipidemic effect of allicin precursor pellets in rats.The dissolution test showed that in artificial gastric juice, the yield of allicin-containing antacid pellets exceeded 90%.In pharmacodynamic studies, it was found that antacid pellets showed the expected hypolipidemic effect on hyperlipidemia rats compared without antacid pellets.There was a very significant difference in blood lipid levels between the two test groups (P < 0.05).The allicin pro-drug tablets containing antacid pellets can effectively lower blood lipids.
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Melanoma is a highly malignant immunogenic tumor. Although immunotherapy represented by immune checkpoint inhibitors can markedly improve the survival rate of patients with metastatic melanoma, nearly half of patients are still tolerant or resistant to immunotherapy, with high incidence of immune-related adverse reactions. This review focuses on the key difficulties in tolerance, resistance and immune-related adverse reactions to current melanoma immunotherapy, and summarizes corresponding strategies and research advances. By intervening in the immunosuppressive microenvironment in melanoma, screening precise biomarkers, and optimizing immunotherapy-based combination strategies, the problem of tolerance and resistance to immunotherapy can be solved. Moreover, the combination of traditional immunotherapy and nanotechnology can also greatly reduce the occurrence of immune-related adverse reactions. In the future, more extensive and in-depth research on the tumor immune microenvironment will help to explore the best immunotherapy regimens for melanoma.
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Colon cancer-related anemia (CCRA) is mainly caused by systemic inflammation, intestinal bleeding, iron deficiency and chemotherapy-induced myelosuppression in colon cancer. However, the best therapeutic schedule and related mechanism on CCRA were still uncertain. Studies on blood enrichment and anti-tumor effects of combined Danggui Buxue Decoction (DBD), Fe and rhEPO based on CCRA and gut microbiota modulation were conducted in this paper. Here, CCRA model was successfully induced by subcutaneous inoculation of CT-26 and i.p. oxaliplatin, rhEPO + DBD high dosage + Fe (EDF) and rhEPO + DBD high dosage (ED) groups had the best blood enrichment effect. Attractively, EDF group also showed antitumor activity. The sequencing results of gut microbiota showed that compared to P group, the relative abundances of Lachnospiraceae and opportunistic pathogen (Odoribacter) in ED and EDF groups were decreased. Interestingly, EDF also decreased the relative abundances of cancer-related bacteria (Helicobacter, Lactococcus, Alloprevotella) and imbalance-inducing bacteria (Escherichia-Shigella and Parabacteroides) and increased the relative abundances of butyrate-producing bacteria (Ruminococcaceae_UCG-014), however, ED showed the opposite effects to EDF, this might be the reason of the smaller tumor volume in EDF group. Our findings proposed the best treatment combination of DBD, rhEPO and Fe in CCRA and provided theoretical basis and literature reference for CCRA-induced intestinal flora disorder and the regulatory mechanism of EDF.
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Recently, the 2019 novel coronavirus has rapidly spread throughout China. The medical staff at dermatology departments of some hospitals in Hubei province also participated in the fight against coronavirus disease 2019. However, many problems emerged during this period. Some medical staff at dermatology departments lacked abilities to deal with emergencies, self-protect, and to conduct surveys on skin diseases occurring in this period. In this article, the authors highlight common problems in and give advice on dermatology teaching about national public health emergencies to healthcare workers, undergraduate students, graduate students and senior residents, hoping that healthcare workers at dermatology departments will calmly deal with public health emergencies in the future.
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The combination of ginkgo ketoester tablet - donepezil (GD) is a popular combination commonly used in clinic for the treatment of Alzheimer's disease. To evaluate the learning and memory improving ability of different proportions of the two drugs. We optimized the ratio of GD for treatment of dementia using a mouse model. Dementia was induced by multiple neuronal damages in mice. The experimental protocols were approved by the Animal Experimental Ethical Committee of Nanjing University of Chinese Medicine and all the procedures were strictly conducted in accordance with ethical principle of animal use and care. Morris water maze, brain hematosylin-eosin staining and the changes of the neurotransmitters and related enzymes in the plasma or brain tissues were tested to determine the effect of GD on dementia mice. The results showed that the dementia mice were significantly different from the normal group in terms of behavior, pathological sections and related indicators. Compared to the dementia mice, partial administration groups could improve learning and memory ability as well as indexes in the blood and brain tissues. Both the principal component analysis and multi-attribute comprehensive index methods were used to comprehensively evaluate the total effect of GD on anti-dementia. The results showed that the combination of two drugs at the dose of 0.5 to 1 times was in a dose-effect relationship, and the dose of 1 (the clinical equivalent) had the best treatment effect. Then based on the optimal dose, GD 1∶1 had best effect, which was consistent with the clinical use of two drugs. This provides scientific basis for more effective application of the compatibility between ketoester tablet and donepezil for modern clinic medicine.
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Objective@#To evaluate the accuracy of automated fluorescence microscopic imaging and computer-aided diagnosis system (AFMICADS) in the auxiliary diagnosis of superficial cutaneous fungal infections.@*Methods@#Totally, 106 outpatients and inpatients with suspected superficial fungal infections were enrolled from clinical departments of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between July 2018 and September 2018. A total of 126 specimens were collected, including 83 skin scales and 43 nail parings. Each specimen was divided into 3 groups to be examined by conventional fungal microscopy, culture with modified Sabouraud dextrose agar and fluorescence microscopy (artificial fluorescence microscopy and AFMICADS-based fluorescence microscopy) respectively. A positive result was defined as that conventional fungal microscopy and/or fungal culture was positive. Consistency rate, sensitivity and specificity of the 3 microscopic methods were calculated. Statistical analysis was carried out with SPSS 10.0 software by using McNemar test and Kappa test for analyzing difference in the positive rate, as well as consistency, between the 3 microscopic methods and the positive standard, and by using efficiency test for comparing the consistency rate among the 3 microscopic methods.@*Results@#Of 126 specimens, 124 (98.4%) were positive for artificial fluorescence microscopy, and 123 (97.6%) for AFMICADS-based fluorescence microscopy. Both positive rates of the above 2 microscopic methods were significantly higher than the positive rate of the positive standard (77.8%, both P < 0.001) . The sensitivity, specificity and consistency rate of AFMICADS-based fluorescence microscopy were 100%, 10.7% and 80.2% respectively, and those of artificial fluorescence microscopy were 100%, 7.1% and 79.4% respectively. Additionally, no significant difference in the consistency was observed between the AFMICADS-based and artificial fluorescence microscopy (P > 0.05) .@*Conclusion@#The accuracy of AFMICADS-based fluorescence microscopy in the diagnosis of superficial cutaneous fungal infections is similar to that of artificial fluorescence microscopy.
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Objective To evaluate the accuracy of automated fluorescence microscopic imaging and computer-aided diagnosis system (AFMICADS) in the auxiliary diagnosis of superficial cutaneous fungal infections.Methods Totally,106 outpatients and inpatients with suspected superficial fungal infections were enrolled from clinical departments of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology between July 2018 and September 2018.A total of 126 specimens were collected,including 83 skin scales and 43 nail parings.Each specimen was divided into 3 groups to be examined by conventional fungal microscopy,culture with modified Sabouraud dextrose agar and fluorescence microscopy (artificial fluorescence microscopy and AFMICADS-based fluorescence microscopy) respectively.A positive result was defined as that conventional fungal microscopy and/or fungal culture was positive.Consistency rate,sensitivity and specificity of the 3 microscopic methods were calculated.Statistical analysis was carried out with SPSS 10.0 software by using McNemar test and Kappa test for analyzing difference in the positive rate,as well as consistency,between the 3 microscopic methods and the positive standard,and by using efficiency test for comparing the consistency rate among the 3 microscopic methods.Results Of 126 specimens,124 (98.4％) were positive for artificial fluorescence microscopy,and 123 (97.6％) for AFMICADS-based fluorescence microscopy.Both positive rates of the above 2 microscopic methods were significantly higher than the positive rate of the positive standard (77.8％,both P ＜ 0.001).The sensitivity,specificity and consistency rate of AFMICADS-based fluorescence microscopy were 100％,10.7％ and 80.2％ respectively,and those of artificial fluorescence microscopy were 100％,7.1％ and 79.4％ respectively.Additionally,no significant difference in the consistency was observed between the AFMICADS-based and artificial fluorescence microscopy (P ＞0.05).Conclusion The accuracy of AFMICADS-based fluorescence microscopy in the diagnosis of superficial cutaneous fungal infections is similar to that of artificial fluorescence microscopy.
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Aim To compare high-content cell imaging system and other methods in detecting cell proliferation, including the traditional thymidine ( 3H-TdR) incorporation method, methyl thiazolyl tetrazolium ( MTT ) method and cell counting kit-8 (CCK-8) method. Methods The fibroblast-like synovial cells (FLS) were used as the study object to observe the sensitivity and stability of FLS proliferation in different methods by using the usual proliferative stimulant tumor necrosis factor-α ( TNF-α) and the known proliferation inhibitor methotrexate at different concentrations. Results The 3H-TdR method and high-content cell imaging could detect a significant inhibitory effect of 1 nmol ·L-1 MTX on FLS cell proliferation, MTT assay and CCK-8 method could detect the significant inhibitory effect of 10 nmol· L-1 MTX on FLS cell proliferation. 3H-TdR method was found to have a large degree of discretization in the data set, with a standard deviation of 32.61% ~61.36% , and the MTT method was 11.9% ~ 17.8% , the CCK-8 method was 17.15% ~32.88% , and the high-content cell imaging system method was 12.66% ~26.54%. Conclusion The method of high-content cell imaging system is more accurate and stable for detecting cell proliferation.
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AIM:To investigate the long-term clinical effect of modified frontalis tendon flap suspension in the treatment of severe blepharoptosis in children.METHODS:A total of 83 cases (114 eyes) of modified frontalis tendon flap suspension for children severe blepharoptosis correction were analyzed between January 2009 to December 2011 for the efficacy and complications of this surgery.Follow-up observation for 5a.RESULTS:In the fifth year after operation,there were 84 eyes (73.7％) with correction and satisfactory correction,30 eyes (26.3％) were corrected,and the operation was satisfactory.Postoperative complications included 4 eyes (3.5％) of inverted eyelashes,of which 3 eyes were given suture traction at 1/3 interior of the gray line,1wk later inverted eyelashes disappeared,1 eye of secondary surgery.Conjunctival prolapse was in 2 eyes (1.8％),the application of corticosteroids eye drops,pressure bandage were used for 1 wk and conjunctival prolapse disappeared.There was no recurrence of keratitis,eyelid ectropion,septum separation,eyelid angular deformity,hematoma formation,infection and other complications.Postoperative retrograde retrogression and lateral eyelid folds disappear were the most common problems of long-term follow-up.CONCLUSION:The study shows that this surgical technique is a satisfied method to treat severe blepharoptosis and predictable with few complications.
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Objective To analyze common complications of arm port and chest port using meta-analysis and to investigate the safety of ann port.Methods Randomized controlled trials,cohort studies and well-designed casecontrol trials published in CNKI,Wanfang,VIP,PubMed,CINAHL and Embase regarding complication comparison between arm port and chest port were searched.Review Manager 5.3 software was applied to analyze outcome indicators.Results Nine retrospective cohort studies and 2511 patients were included.The results of meta-analysis showed that the incidence of thrombosis in ann port group was lower than that in chest port group,and the difference was statistically significant [0R=0.51,95％CI (0.28,0.92),P=0.03].However,there was no significant difference in incidence of infection[OR=0.85,95％CI(0.53,1.38),P=0.52],incidence of obstruction[OR=1.05,95％CI(0.37,3.01),P=0.92],incidence of sepsis [OR =0.44,95％ CI (0.10,1.87),P=0.27],incidence of skin incision [OR =0.28,95％ CI (0.07,1.17),P=0.08].Conclusion The incidence of thrombosis in ann port was lower than that in chest port,and there was no obvious advantage in the incidence of infection,obstruction,sepsis and skin incision.
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<p><b>OBJECTIVE</b>To study the association of the risk factors during maternal pregnancy and the neonatal period with childhood bronchial asthma.</p><p><b>METHODS</b>A total of 306 children with asthma (asthma group) and 250 healthy children (control group) were enrolled. Their clinical data during the neonatal period and the maternal data during pregnancy were retrospectively studied.</p><p><b>RESULTS</b>The univariate analysis showed that there were significant differences in the rates of maternal use of antibiotics during pregnancy, use of antibiotics and probiotics during the neonatal period, preterm birth, cesarean section, low birth weight, and breast feeding (>6 months) between the asthma and control groups (P<0.05). The multivariate logistic regression analysis showed that use of antibiotics during pregnancy (OR=3.908, 95%CI: 1.277-11.962), use of antibiotics during neonatal period (OR=24.154, 95%CI: 7.864-74.183), preterm birth (OR=8.535, 95%CI: 2.733-26.652), and cesarean section (OR=4.588, 95%CI: 2.887-7.291) were independent risk factors for childhood asthma. The use of probiotics during the neonatal period (OR=0.014, 95%CI: 0.004-0.046) and breast feeding (>6 months) (OR=0.161, 95%CI: 0.103-0.253) were protective factors for childhood asthma.</p><p><b>CONCLUSIONS</b>The early prevention of childhood asthma can be improved by reducing the use of antibiotics during pregnancy, reducing cesarean section, avoiding abuse of antibiotics during the neonatal period, trying breast feeding and taking probiotics in early stage.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Pregnancy , Anti-Bacterial Agents , Asthma , Breast Feeding , Logistic Models , Probiotics , Therapeutic Uses , Retrospective Studies , Risk FactorsABSTRACT
Purpose To investigate the multi-slice spiral CT (MSCT) features ofchromophobe renal cell carcinoma (CCRC),renal oncocytoma (RO) and clear-cell renal cell carcinoma (CCRCC) for the improvement of its diagnostic accuracy.Materials and Methods The MSCT data of 15 CCRC cases,8 RO cases,and 29 CCRCC cases confirmed by surgery or pathology at Dong H ua Hospital from October 2012 to April 2016 were retrospectively studied.The CT signs of different tumors were compared.Results Most CCRCC cases had cystic degenerations,which showed significant difference with CCRC and RO cases (P＜0.05);RO cases were found mostly with star-shaped scars,which had significant difference with CCRCC cases (P＜0.05);the enhanced scanning showed most of CCRC were enhanced homogeneously,which presented significant difference from CCRCC (P＜0.05).The lesion-kidney-ration (LKR) of CCRCC at cortical phase,parenchymal phase or excretory phase was significantly different from that of CCRC (P＜0.05);the LKR of CCRCC at cortical phase was significantly different from that of RO (P＜0.05);the LKR of CCRC at the three phases were all significantly different from that of RO (P＜0.05).The average △ LKR value of CCRCC was significantly different from that of CCRC and RO (P＜0.05);there was a certain degree of difference distribution of their △ LKR among the three kinds of cases.Taking CCRCC as object,when the LKR at cortical phase was 0.693 or △ LKR was 0.068,the sensitivity reached 93.3％ and the specificity reached 72.2％ or 88.9％ respectively in evaluating the differential diagnosis of CCRC and RO.Taking RO as object,when the LKR was 0.656 at cortical phase or was 0.595 at parenchymal phase,the sensitivity reached 83.3％ and 91.7％ respectively,and the specificity was 75.0％ and 58.3％ respectively,in evaluating the differential diagnosis of CCRC.Conclusion Enhanced MSCT at different phases,especially the calculation of LKR and △ LKR value,can benefit the diagnosis of CCRC,RO and CCRCC.
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AIM:To evaluate the regulatory effect of microRNA-132 ( miR - 132 ) in human umbilical vein endothelial cell ( HUVEC) . ●METHODS: ln vitro cultured human umbilical vein endothelia cells in hypoxic environment for 6h, then maintained under normal oxygen condition for 3h, 6h, 12h, 24h. miR-132 and peroxisome-proliferator-activated receptor-γ coactivator-1α ( PGC-1α) expression was detected by quantitative Real - time polymerase chain reaction and Western blot analysis. Human umbilical vein endothelial cells transfected miR-132 mimic and miR-132 inhibitor( anti-miR-132 ) were measured by quantitative Real-time polymerase chain reaction and Western blot. ●RESULTS: miR - 132 and PGC - 1α expression was significantly ( P ●CONCLUSION:miR-132 level is highly expressed in the HUVEC under hypoxia and may be an effect of regulation for PGC-1α.
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?AlM:To study the relationship between blood lead level and abnormal eye blinking in children. ? METHODS: The patients with chief complaint of frequent eye blinking, whose diagnosis of abnormal eye blinking, were randomized to experimental group. The patients in this group carried out vision and the slit-lamp examination, detected corneal fluorescein staining and tear break-up time, and improved the level of blood lead and trace elements examination. The patients in control group with chief complaint of health physical examination in our hospital, excepted of blood lead level, the other body check results were normal and were divided into boys group and girls group according to the gender. The changes of the experimental group and control group in blood lead level were compared. ?RESULTS: Totally 371 cases ( male:295 cases; female:76 cases) with mean age was 6. 56±2. 41 years and 6. 08±2. 82 years respectively were in experimental groupe. ln control group, there were 300 cases ( male: 186 cases;female:114 cases) with mean age was 6. 99±3. 01 years and 6. 56±2. 80 years respectively. The average of blood lead level of boys in experimental group was 63. 82 ±24. 56μg/L and 53. 98±15. 42μg/L in control group. The average of blood lead level in experimental group was higher than that in control group. The difference between of the two group was statistically significant (χ2=16. 96, P6 years children were 48. 73±11. 67μg/L, 51. 39 ± 14. 87μg/L, 52. 98 ± 14. 45μg/L respectively. ln expirement group, the results were 56. 57±17. 89μg/L, 59. 92±18. 46μg/L and 67. 00±32. 55μg/L in 6 children, respectively. There was no significant difference with 6 years children were statistically significant (χ2 = 9. 62, P = 0. 008 ) and (χ2 = 19. 22, P = 0. 000 ) respectively. The blood lead level were divided into three grades: 100μg/L, and relative risk (RR) were 0. 65, 1. 22, and 10. 11 respectively. ?CONCLUSlON: Blood lead level of experimental group is higher than that of control group. The relationship between blood lead level and abnormal eye blinking in children is positive correlation.
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Abnormal eye blinking in children is a disease of frequent eye blinking in children, more than 15 times per minute, without facial spasms and neurological diseases, with relatively independent clinical symptoms. If combining with organic or neurological disease, we consider it as children eye blinking syndrome. It's a common and frequently encountered disease in pediatric ophthalmology. The etiologies include body and psychological disorders, such as refractive errors, ocular surface and ocular adnexal disease, bad habits, lead pollution, tic disorders and so on. We think that most of abnormal eye blinking in children firstly caused by oculopathy, neurological disorders and psychological illness are the important factors for increasing or making it repeatedly happen. Recognizing and identifying the etiologies of abnormal eye blinking in children, so as to take a targeted theray and avoid misdiagnosis and delayed treatment.
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AIM:To observe the incidence of ocular fundus disease in preschool children examined by non-mydriatic fundus camera and evaluate its effectiveness compared with direct inspection shadow mirror. METHODS: Three thousand eight hundred and ninety-six preschool children from April 2012 to October 2013 were examined by Topcon TRC-NW300 color fluorescence fundus camera and direct inspection shadow mirror, and images were saved immediately. RESULTS: Detection rate of non - mydriatic fundus photography was higher than that of direct inspection shadow mirror. In 3 896 cases, 41 eyes were detected abnormal fundus accounting for 1. 05%. The retinal myelinated nerve fibers, morning glory syndrome, retinitis pigmentosa, congenital retinoschisis were common, accounted for 24. 39%, 21. 95%, 14. 63%, 12-20% respectively. The children eye diseases were often accompanied by abnormal vision (68. 30%), ametropia (63. 41%), strabismus (19. 51%). CONCLUSION:Non-mydriatic fundus photography is a mydriatic method without medicine, so it is easy for preschool children to accept. Image results could directly display the fundus lesions. It shows important significance in the screening for preschool children eye diseases.
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<p><b>OBJECTIVE</b>To observe the therapeutic effect of Yangxue Tongluo Recipe (YTR) combined with immunosuppressive agents in the treatment of rheumatoid arthritis (RA).</p><p><b>METHODS</b>Totally 88 RA patients were randomly assigned to the treatment group [47 cases, YTR combined Methotrexate (MTX) + Leflunomide (LEF) treatment] and the control group (41 cases, MTX + LEF therapy). All patients received 12-week treatment. Clinical symptoms and signs, laboratory tests [erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and C reactive protein (CRP)], and adverse reactions were observed before and after treatment.</p><p><b>RESULTS</b>The total effective rate was 91.5% (43/47 cases) in the treatment group, and the total effective rate was 75.6% (31/41 cases) in the control group. There was statistical difference between the two groups (P < 0.05). The morning stiffness, the rest pain, the number of tender joints, the number of swollen joints, tender joint index, swollen joint index, ESR, RF, and CRP were significantly improved in the two groups after treatment (P < 0.01). Besides, clinical symptoms and signs, ESR, RF, and CRP were more improved in the treatment group after treatment, when compared with those in the control group (P < 0.05). Gastrointestinal discomfort was the main adverse reaction in the two groups, but the occurrence was lower in the treatment group than in the control group (P > 0.05).</p><p><b>CONCLUSIONS</b>The clinical efficacy of YTR combined MTX + LEF in the treatment of RA was better than using Western medicine alone. It was more safe with less adverse reactions.</p>