Efficacy and safety of CM310 in moderate-to-severe atopic dermatitis: A multicenter, randomized, double-blind, placebo-controlled phase 2b trial / 中华医学杂志(英文版)

BACKGROUND@#Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.@*METHODS@#This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.@*RESULTS@#At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs . placebo, 95% CI 31%-69%) and 45% (low vs . placebo, 95% CI 26%-64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator's Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310.@*CONCLUSION@#CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.

Establishment and application of a prospective follow-up research method for acute infectious diseases in Shanghai community residents / 上海预防医学

ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations， using COVID-19 infection as an example， and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai， with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects， and COVID-19 antigen test kits were distributed. From December 21， 2022 to September 30， 2023， prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects， comprising 6 098 males （47.3%） and 6 783 females （52.7%）. The baseline survey revealed that 35.2% （4 540/12 881） of the subjects had a history of COVID-19 infection. During the follow-up period from December 21， 2022 to September 30， 2023， the average incidence density in the cohort was 0.61/person-year， with a higher incidence density in females （0.63/person-year） compared to males （0.59/person-year）. Individuals aged 60 and above （0.64/person-year） and those with underlying health conditions （0.67/person-year） had a higher incidence density. Healthcare workers showed a notably higher incidence density （0.84/person-year） than that in other occupational groups. As of September 30， 2023， a total of 340 subjects in the cohort experienced secondary infections， with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance， providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.

Four-stitch cholangiojejunostomy / 中华肝胆外科杂志

Objective:To evaluate the clinical application efficacy of four-stitch cholangiojejunostomy.Methods:Of 38 patients who received four-needle biliary and enterointestinal anastomosis in the Department of Hepatobiliary Surgery, Yuebei People's Hospital Affiliated to Shantou University Medical College from November 2016 to April 2020 were included, and the diseases, surgical methods and postoperative complications of four-needle biliary and enterointestinal anastomosis were analyzed.Results:There were 26 males and 12 females with an average of 57.3(44-77) years. Among 38 patients, there were 12 hilar cholangiocarcinoma patients, 10 pancreatic head cancer, 9 duodenal papillary cancer, 4 intrahepatic and extrahepatic bile duct stones, 1 pancreatic cystic adenoma, 1 gastric cancer invading pancreatic head and 1 gallbladder carcinoma. The procedure included pancreatoduodenectomy in 20, radical resection of hilar cholangiocarcinoma in 12, hepatectomy with biliary-enteric anastomosis in 4, radical resection of gastric cancer combined with pancreaticoduodenectomy in 1, radical resection of gallbladder carcinoma in 1. One, two and three ductal openings were anastomosed in 27, 7 and 4 patients, respectively. 10 patients have bile duct diameter <6 mm. Postoperative anastomotic leakage occurred in 1, and all patients were received followed-up visit for 2 months to 4 years without anastomotic stenosis.Conclusion:Four-stitch cholangiojejunostomy is simple, safe, effective, and convenient for small biliary ductal surgeries.

The outcome predicted value of enhanced MRI for prolapsed or sequestrated lumbar disc herniation / 中华骨科杂志

Objective:To analyze the predictive value of enhanced MRI in the outcome of prolapsed and sequestrated lumbar disc herniation through a retrospective analysis.Methods:A retrospective analysis of the data of 64 patients with prolapsed and sequestrated lumbar disc herniation from January 2015 to December 2018, including 38 males and 26 females; age 35.72±12.44 years (range, 22-64 years) ; 43 cases of prolapsed type, 21 cases of sequestrated type. Conservative treatment was the first choice for all patients, in case of surgical indications during the treatment, percutaneous endoscopic lumbar discectomy or fenestration discectomy will be performed. Enhanced MRI was performed at the first and last inspections, the volume of the protrusion, the thickness of rim enhancement (Tr), and the extent of rim enhancement (Er) were measured and calculated at the same time. According to the ring around the protrusion, the size of the rim-enhancement area was divided into type I-III; then compared the relationship between the rim-enhancement signal differentiation and the resorption rate of protrusions, and the correlation between Tr, Er values and the resorption rate of protrusions during the initial inspection.Results:Among the 64 patients, 42 patients completed conservative treatment, and 22 received surgical treatment. According to the rim-enhancement signal differentiation, 23 cases were treated conservatively for type I, 3 cases were treated by surgery; 16 cases were treated for type II conservatively, 7 cases were treated by surgery; 3 cases were treated for type III conservatively, and 12 cases were treated by surgery. All patients were followed up for 12 to 34 months. Among 42 conservatively treated patients, The volume of the protrusion before treatment was 2 645.67±690.86 mm 3, and the volume of the protrusion after treatment was 842.76±573.35 mm 3. The volume of protrusions before and after treatment was statistical significance ( t=11.897, P<0.001), Tr was 1.38±0.83 mm, and Er was 73.08%±34.39%, the resorption rate of protrusions was 65.10%±24.50%, and 39 cases (92.86%, 39/42) reached the standard for protrusion resorption (resorption rate ≥30%); 23 cases of type I , the resorption rate was 76.54%±18.62%; 16 cases of type II had an resorption rate of 56.81%±21.44%; 3 cases of type III had an resorption rate of 21.58%±12.19%. The resorption rate of type III were compared by single factor analysis of variance, and the difference was statistically significant ( F=12.885, P<0.001); 32 cases of both type I and II (82.05%, 32/39) had significant resorption (resorption rate ≥50%), and no case of type Ⅲ had significant resorption, comparing with type I and II, the difference was statistically significant ( P=0.010); Tr was positively correlated with resorption rate ( r=0.569, P<0.001), Er was positively correlated with resorption rate ( r=0.677, P<0.001). Conclusion:Under close clinical observation, parts of the prolapsed or sequestrated lumbar disc herniations can be conservatively treated, and the herniated disc can be resorption in many people and the clinical symptoms were alleviated. Rim-enhancement signal differentiation by enhanced MR has a better predictive value for the outcome of the herniation, type I is more prone to resorption, preferred conservative treatment, type Ⅲ is not easy to resorption, preferred surgery treatment, and the higher thickness of rim enhancement, the greater extend the rim-enhancement, the more prone to resorption phenomenon.

Clinic observation of bone metastasis treated with apatinib combined with radiotherapy / 国际肿瘤学杂志

Objective To evaluate the clinical efficacy and safety of apatinib combined with radiotherapy in patients with bone metastasis.Methods Thirty-one patients admitted to Radiation Oncology of the First Affiliated Hospital of Anhui Medical University with bone metastasis were recruited from April 2016 to February 2017.All patients were received apatinib 500 mg/d orally combined with radiotherapy (30 ～40 Gy/10 ～20 F).until disease progression or intolerable toxicity occurred.Clinical efficacy and safety were observed.Results The total response rate was 93.55％ (29/31),25.81％ (8/31) had complete response,58.06％ (18/31) had moderate response,9.68％ (3/31) had mild response,and 6.45％ (2/31) had no response;The time to exert its effect after the treatment was 6 days,and its median maintenance time was 7 months.The lesions complete response was 3.23％ (1/31),partial response was 51.61％ (16/31),became stable in 13 patients (41.94％),and deteriorated in 1 patient (3.23％),and the total control rate was 96.78％.The patients Karnofsky score increased obviously after the treatment (83.71 ± 5.77 vs.78.87 ± 7.49),and the difference was statistically significant (t =4.23,P =0.006).The median local progression-free survival and median overall survival were 6 months and 7 months,respectively.The main adverse reactions were hypertension,hand-foot syndrome,proteinuria and bone marrow depression.The rates of hypertension,hand-foot syndrome,proteinttria and bone marrow depression were 35.48％ (11/31),25.81％ (8/31),16.13％ (5/31),and 16.13％ (5/31),respectively.Conclusion Radiotherapy combined with apatinib is effective and tolerable for bone metastasis patients.

Peri-operative Management and Result of Pulmonary Endarterectomy in 56 Patients / 中国循环杂志

Objective: To summarize the peri-operative management experience of pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A total of 56 CTEPH patients received PEA in our hospital from 2015-01 to 2016-11 were retrospectively analyzed. Our study was focused on the medication in respiratory and circulatory system during ICU stay, peri-operative application of vasoactive drug and target drug to pulmonary hypertension (HP), usage of ventilators, mechanical assisted devices and other management experiences. Results: No peri-operative death occurred. There were 2/56 (3.6%) patients with lung reperfusion, 2 (3.6%) with PH crisis. Compared with pre-operation, the post-operative pulmonary artery hemodynamics parameters were improved as right heart catheter measured pulmonary artery systolic pressure (PASP) decreased from (85.05±22.40) mmHg to (36.83 ±17.21) mmHg and pulmonary vascular resistance decreased from (773.84±342.95) dyn·s·cm-5 to (293.59±214.95) dyn·s·cm-5. Post-operative oxygen saturation was maintained at (95-100) % in all patients. Echocardiography found that PASP from pre-operation (85.03±25.78) mmHg decreased to (39.44±19.24) mmHg at follow-up period, P<0.01.Conclusion: A comprehensive peri-operative management of PEA was helpful to improve pulmonary hemodynamics in CTEPH patients; meanwhile, effective prevention and treatment of severe complication could obviously reduce peri-operative mortality.

Effects of three suture techniques on complications after choledochojejunostomy / 临床肝胆病杂志

ObjectiveTo observe the effects of different suture techniques on complications after choledochojejunostomy. MethodsA retrospective analysis was performed on the clinical data of 162 patients who underwent choledochojejunostomy from January 2005 to December 2014 in our hospital. The patients were divided into group A undergoing simple interrupted suture (n=68), group B undergoing simple continuous suture (n=45), and group C undergoing parachute type continuous suture (n=49). The intraoperative conditions and postoperative complications were compared between the three groups. Comparison of continuous data between the three groups was made by ANOVA and pairwise comparison between any two groups was made by LSD t-tests; comparison of categorical data between the groups was made by chi-square test. ResultsThe anastomosis time and the rate of T-tube insertion showed significant differences between the three groups (P＜0.05). Groups B and C had significantly shorter anastomosis time than group A(P＜0.001), but there was no significant difference in the anastomosis time between groups B and C (P＞0.05). Among the three groups, group A had the highest rate of T-tube insertion; group B had the second highest rate; group C had the lowest rate. Significant differences were found between any two groups in the rate of T-tube insertion by pairwise comparison (P＜0.05). However, there were no significant differences between the three groups in the incidence rates of postoperative bile leakage and choleperitonitis (P＞0.05). There was significant difference in biliary stricture between the three groups in the follow-up examination 6 months after surgery (P＜0.001) and the differences analyzed by pairwise comparison were also significant (P＜0.05). Among the three groups, the degree of biliary stricture in the group A was the highest and that in the group C was the lowest. ConclusionParachute-type continuous suture is a fine suture technique for choledochojejunostomy, which can reduce the anastomosis time, the rate of T-tube insertion, and the degree of biliary stricture.

Effects of three suture techniques on complications after choledochojejunostomy / 临床肝胆病杂志

ObjectiveTo observe the effects of different suture techniques on complications after choledochojejunostomy. MethodsA retrospective analysis was performed on the clinical data of 162 patients who underwent choledochojejunostomy from January 2005 to December 2014 in our hospital. The patients were divided into group A undergoing simple interrupted suture (n=68), group B undergoing simple continuous suture (n=45), and group C undergoing parachute type continuous suture (n=49). The intraoperative conditions and postoperative complications were compared between the three groups. Comparison of continuous data between the three groups was made by ANOVA and pairwise comparison between any two groups was made by LSD t-tests; comparison of categorical data between the groups was made by chi-square test. ResultsThe anastomosis time and the rate of T-tube insertion showed significant differences between the three groups (P＜0.05). Groups B and C had significantly shorter anastomosis time than group A(P＜0.001), but there was no significant difference in the anastomosis time between groups B and C (P＞0.05). Among the three groups, group A had the highest rate of T-tube insertion; group B had the second highest rate; group C had the lowest rate. Significant differences were found between any two groups in the rate of T-tube insertion by pairwise comparison (P＜0.05). However, there were no significant differences between the three groups in the incidence rates of postoperative bile leakage and choleperitonitis (P＞0.05). There was significant difference in biliary stricture between the three groups in the follow-up examination 6 months after surgery (P＜0.001) and the differences analyzed by pairwise comparison were also significant (P＜0.05). Among the three groups, the degree of biliary stricture in the group A was the highest and that in the group C was the lowest. ConclusionParachute-type continuous suture is a fine suture technique for choledochojejunostomy, which can reduce the anastomosis time, the rate of T-tube insertion, and the degree of biliary stricture.

Postoperative complications of laparoscopic splenectomy in patients with portal hypertension / 临床肝胆病杂志

ObjectiveTo investigate the incidence rate and risk factors for the complications after laparoscopic splenectomy in patients with portal hypertension. MethodsThe clinical data of 83 patients with portal hypertension, who were admitted to our hospital and underwent laparoscopic splenectomy from June 2009 to December 2014, were analyzed retrospectively. The incidence rate of the complications was analyzed using the Clavien-Dindo classification system and the risk factors for the complications were analyzed using chi-square test and logistic regression method. ResultsThe incidence rate of postoperative complications was 24.10% (20/83). According to the Clavien-Dindo classification system, the numbers of patients with grade Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ complications were 5, 3, 10, 2, and 0, respectively. The patients undergoing total laparoscopic splenectomy had a significantly higher incidence rate of postoperative complications than those undergoing hand-assisted laparoscopic splenectomy (32.59% vs 15.00%, χ2=3.966, P=0.046). According to the univariate analysis, the Child-Pugh class, application of the hand-assisted device, gastroesophageal vein ligation, and American Society of Anesthesiologists (ASA) grade were all risks factors for the postoperative complications (all P＜0.05). Further analysis using multiple logistic regression illustrated that Child-Pugh class B and ASA grade Ⅲ were independent risk factors for the postoperative complications (OR=0.328, 95%CI: 0.129~0.834, P＜0.05; OR=0.294, 95%CI: 0.150~0.573, P＜0.05). ConclusionPatients with portal hypertension undergoing laparoscopic splenectomy have a high incidence of postoperative complications and the occurrence of the complications is closely associated with the Child-Pugh class and the ASA grade.

The clinical value of serum procalcitonin in diagnosis and treatment of community acquired pneumonia / 中国基层医药

Objective To investigate the clinical significance of serum level of the diagnosis and treatment of community acquired pneumonia.Methods 42 hospital patients with pneumonia obtained from community were slect-ed as the observation group.According to patient outcome,they were divided into improvement group and aggravated group.Another selection during the same period in hospital for treatment of acute upper respiratory tract infection in patients with 30 cases was the control group.Respectively,in the 1 day,3 days,7 days the results of serum calcitonin angiotensinogen (PCT)and CRP were compared and analyzed.Results In observation group,PCT of first day,third days and seventh days were respectively (1.18 ±0.32)μg/L,(0.78 ±0.12)μg/L and (0.18 ±0.04)μg/L;CRP were respectively (154.15 ±21.58)mg/L,(67.42 ±20.35)mg/L and (15.43 ±7.76)mg/L.In the control group, PCT of first days,third days and seventh days were respectively (0.05 ±0.01 )μg/L,(0.04 ±0.02)μg/L and (0.05 ±0.02)μg/L,while CRP were respectively (9.39 ±2.22)mg/L,(8.83 ±2.91 )mg/L and (7.06 ± 3.03)mg/L.There were significant differences between the two groups (t =6.15,10.85,4.86,58.69,16.79,11.99,all P <0.05).In the aggravated group,PCT levels of first days,third days and seventh days were significantly higher than that of the improved group,the differences were statistically significant (t =17.86,18.21,20.65,all P <0.05). Conclusion As a monitoring marker,PCT showed higher sensibility and specificity than CRP in diagnosis and treat-ment of CAP,and it would be helpful to make early diagnosis and certain the therapeutic schedule to use antibiotics.

The relationship between adipocyte fatty acid binding protein and lower limb vascular disease in the elderly with type 2 diabetes / 中华老年医学杂志

Objective To explore the relationship between adipocyte fatty acid binding protein (A-FABP) and lower limb vascular disease (LLVD) in the elderly with type 2 diabetes(T2DM).Methods Bilateral lower limb vessels were checked by the High Resolution Color Doppler in all the subjects,including 40 healthy subjects as control (group A),126 T2DM patients.42 T2DM patients had no LLVD (group B),40 had mild LLVD (group C),and 44 had severe LLVD (group D).The levels of plasma A-FABP,blood glucose,lipid profiles,HOMA-IR,hypersensitive C reactive protein (hs CRP),and e-glomerular filtration rate were determined.Results The levels of plasma A-FABP were in the following ascending order of group A(4.5± 1.7)μg/L＜group B(6.1±2.1)μg/L＜group C (7.2 ± 2.3)μg/L ＜ group D (8.4 ± 3.2)μg/L (P＜ 0.01).A-FABP levels elevated along with the decrease of ABI and the increase of L IMT.Multiple logistic regression analysis showed that A FABP levels was main influencing factor of lower limb vascular disease (LLVD) in the elderly with type 2 diabetes.LDL C,HbA1c,HOMR-IR,hs-CRP were the predictive factors for the plasma A-FABP levels in the elderly with T2DM after multiple stepwise regression analysis.Conclusions For elder T2DM patients,the level of plasma A FABP is correlated with the degree of LLVD,and plays an important role in the progress of LLVD.

Comparison of the prognosis between male and female patients with hepatocellular carcinoma after hepatectomy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Hepatocellular carcinoma (HCC) is sexually dimorphic, with a significantly higher incidence in male. But it is not clear whether the women have a better prognosis than the men. The present study aimed to compare the short and long-term outcomes, postoperative recurrence and survival in female and male patients with HCC after hepatectomy.</p><p><b>METHODS</b>Clinicopathological data of retrospective analysis was performed on 40 female and matched 40 male HCC patients treated by hepatectomy in Cancer Hospital of Chinese Academy of Medical Sciences between May 2006 and May 2012 were retrospectively reviewed in this study. Patients were paired in terms of age, chronic hepatitis, Child-Pugh class, tumor size, histological differentiation, presence of satellite nodules and resection margin.</p><p><b>RESULTS</b>Hepatectomy was successfully performed in all 80 cases. There was no significant difference in intraoperative variables and postoperative outcomes between the female and male groups except the level of total bilirubin. The 1-, 3- and 5-year recurrence-free survival rates were 76.7%, 47.4% and 29.7% in the female group and 63.8%, 30.0% and 25.0% in the male group (P = 0.12). Corresponding overall survival rates were 92.2%, 81.5% and 55.4% in the female group and 97.4%, 55.2% and 39.0% in the male group (P = 0.04).</p><p><b>CONCLUSION</b>Certain gender differences might exist in HCC patients after hepatecomy, favoring females in the overall survival and the tolerance for liver injury.</p>

Observation of effect of IFN-αcombined with ATRA in liver cancer therapy in perioperative phase of intervention * / 重庆医学

Objective To study the effect of IFN-αcombined with ATRA in liver cancer therapy in perioperative phase of inter-vention .Methods An animal model of liver cancer CBRH7919 was established by implanting 28 Wistar rats with tumor tissue .The hepatic artery was tied off in one month after formation of tumor .All the rats were randomly divided into the experimental group (14 cases) and the control group(14 cases) .The control group accepted peritoneal injection with normal saline while the experimen-tal group accepted IFN-αcombined with ATRA .10 days later ,all the rats were sacrificed .And the level of expression of VEGF ,bF-GF ,mirovessel density ,and apoptotic index of tumor cells were measured .Results Serum VEGF level ,MVD and apoptotic index of tumor cells of the experimental group were statistically lower than that of the control group [(91 .8 ± 12 .7) pg/mL ,(115 .7 ± 11 .8)/HP ,(12 .29 ± 4 .53)% vs .(67 .4 ± 18 .3)pg/mL ,(65 .3 ± 7 .2)/HP ,(3 .81 ± 1 .52)% ,t=4 .099、13 .642、6 .640 ,P<0 .05)] , results of RT-PCR and immunohistochemistry detection both showed that the levels of expression of VEGF and bFGF of the exper-imental group was lower than that of the control group .Conclusion IFN-αcombined with ATRA in liver cancer therapy in periop-erative phase of intervention could suppress the generation of neoplastic vascular and improve the effect of the intervention .So it is worth promoting .

Expression of human papillomavirus L1 protein in lesions of condyloma acuminatum / 中华皮肤科杂志

Objective To investigate the expression of human papillomavirus (HPV) L1 protein in lesional tissue of condyloma acuminatum and its clinical significance.Methods Forty-three patients with condyloma acuminatum were included in this study,and received CO2 laser therapy.Tissue samples were resected from the lesions of these patients at their first visit before treatment.Immunohistochemistry was used to determine the expression of HPV L1 protein in these samples.Follow up was carried out once every 2 weeks for 3 months to assess the recurrence rate and frequency in these patients after treatment.Results HPV L1 protein was detected in 83.72％ (36/43) of these tissue samples.The expression rate of HPV L1 protein decreased sequentially from patients infected with HPV 6/11,patients with both HPV 6/11 and 16/18,to those with HPV16/18 (x2 =17.90,P ＜ 0.01).During the 12 weeks of follow up,the recurrence rate was 69.77％ (30/43) with the average number of recurrence of 2.16.There was a sequential reduction in the recurrence rate and number from patients with strong expression of HPV L1 protein,to those with moderate expression,slight expression and negative expression (x2 =8.02,46.92,P ＜ 0.05 and 0.01,respectively).The expression intensity of HPV L1 protein was negatively correlated with the recurrence rate and frequency (rs =-0.429,-0.696,respectively,both P ＜ 0.01).Conclusion HPV L1 protein may serve as a helpful molecular biomarker for the prediction of prognosis and recurrence of condyloma acuminatum.

Expression of CD133 protein in hepatocellular carcinoma tissues and its clinical significance / 肿瘤研究与临床

Objective To investigate the expression of CD133 protein in primary lesions of hepatocellular carcinoma (HCC) and its clinical significance.Methods The expression of CD133 protein in 190 patients with HCC was detected by immunohistochemical staining ABC method.The correlation of CD133 protein expression with the clinicopathologic parameters and features after operation was analyzed.Results The expression positive rate of CD133 protein in cancer tissues was 22.1％ (42/190).There was significant correlation between the expression of CD133 protein and tumor differentiation (P ＜ 0.001),micro vessel invasion (P =0.016) and hepatitis B virus infection (P =0.024).Univariate analysis of factors demonstrated that differentiation level,lymph node,macro vessel invasion,micro vessel invasion,TNM stage and CD133 expression were correlated with disease-free survival after surgery (all P ＜ 0.05).Multivariate analysis of factors demonstrated that both CD133 expression and micro vessel invasion were independent prognostic factors of disease-free survival after surgery.Prognostic analysis demonstrated that the disease-free survival of CD133 positive group was significantly lower than that of CD133 negative group.Conclusion The CD133 protein expression in HCC tissues is related with development,metastasis and prognosis of HCC.

Detection of Th17 cells and interleukin-17 expression in peripheral blood from patients with atopic dermatitis / 中华皮肤科杂志

ObjectiveTo determine the protein and mRNA expression levels of interleukin-17 (IL-17) and proportions of Th17 cells in peripheral blood of patients with atopic dermatitis (AD),and to analyze their clinical significance.MethodsVenous blood samples were obtained from 63 patients with AD and 30 normal human controls.Enzyme linked immunosorbent assay was performed to measure the plasma level of IL-17 protein,real time fluorescence reverse transcription (RT)-PCR to detect the mRNA expression level of IL-17 in peripheral blood,flow cytometry to determine the percentage of Th17 cells in peripheral blood mononuclear cells(PBMCs).Spearman's rank correlation analysis was performed to assess the relationship of peripheral blood Th17 cell percentage and IL-17 levels with disease severity in patients with AD.Results The percentage of Th17 cells in PBMCs was 1.83％ ± 0.47％ in patients with acute AD,significantly higher than that in normal human controls (0.85％ ± 0.45％,t =4.128,P ＜ 0.01 ) and in patients with chronic AD ( 1.12％ ± 0.69％,t =2.439,P ＜ 0.05).There was a significant increase in the plasma level (98.37 vs.63.75 ng/L,U =168,P ＜ 0.05) and mRNA expression level of IL-17 in peripheral blood in patients with AD compared with normal controls.Both the Th17 cell percentage and plasma IL-17 level were positively correlated with eczema area and severity index(EASI) score in patients with AD (r =0.681,P ＜ 0.01;r =0.427,P ＜ 0.05).ConclusionsThere is an elevated proportion of Th17 cells and an abnormal expression of IL-17 protein and mRNA in peripheral blood from patients with acute AD,which are positively correlated with disease severity,implicating the possible roles of IL-17 and Th17 cells in the pathogenesis of AD.

Bacille calmette-guerin polysaccharide nucleic acid and mizolastine for the treatment of patients with chronic idiopathic urticaria:clinical efficacy and effect on skin prick test reactions / 中华皮肤科杂志

Objective To estimate the effect of bacille calmette-guerin polysaccharide nucleic acid(BCG-PSN)on skin prick test(SPT)reactions,and to assess the clinical efficacy and therapeutic mechanism of BCG-PSN combined with mizolastine,in patients with chronic idiopathic urticaria.Methods A non-randomized,openlabel clinical trial was carried out.Totally,168 patients with chronic idiopathic urticaria were divided into 2 groups to be treated with mizolastine 10 mg once a day combined with BCG-PSN injection at a dose of 2 ml every other day(experiment group,n =85)or mizolastine 10 mg once a day only(control group,n =83).All the patients underwent SPT,and were evaluated by symptom score at the baseline and after 12 weeks of treatment.Statistical analysis was performed by using the SPSS 10.0 software,t test and Chi-square test were used to analyze the intra-and inter-group differences in symptom score reducing index(SSRI)and SPT results.Results After 12-week treatment,SSRI was significandy higher in the experiment group than in the control group(0.92 ± 0.33 vs.0.74 ± 0.35,t =2.39,P ＜ 0.05).In the experiment group,50 patients were cured,28 patients received a marked response,with a total response rate of 92.0％;meanwhile,32 patients were cured and 30 patients received a marked response in the control group with a total response rate of 74.6％;there was a significant difference in the total response rate between the experiment group and control group(x2 =5.62,P ＜ 0.05).The percentage of positive SPT to Dermatophagoides pteronyssinus and Dermatophagoides farinae was 24.7％ and 17.6％ respectively at the baseline,9.4％ and 5.9％ respectively after treatment,in the experiment group,24.1％ and 16.9％ respectively at the baseline,24.1％ and 15.7％ respectively after treatment,in the control group.Significant differences were observed in the percentage of positive SPT between the control group and experiment group after treatment(x2 =5.82,P ＜0.05),but not at the baseline.A statistical decrease in the percentage of positive SPT was induced by the combined therapy with BCG-PSN and mizolastine(x2 =4.56,P＜ 0.05),but not by mizolastine alone.Conclusions BCG-PSN combined with mizolastine appears superior to mizolastine alone in the treatment of chronic idiopathic urticaria,with a decrease in the percentage of positive SPT reactions and in the sensitivity to allergens.

Application of an improved skin prick test in infantile eczema / 中华皮肤科杂志

Objective To evaluate the performance of an improved skin prick test in infantile eczema.Methods A self-controlled study was carried out in 248 infants with eczema.Improved and conventional skin prick tests were conducted with 8 allergens on the left and right flexural forearm of the subjects,respectively.Results Positive results of skin prick test were found in the left flexural forearm of 38.3％ of the infants,and in the right flexural forearm of 38.7％ of the infants,with no significant difference between the two methods in the detection rate of allergens (P ＞ 0.05).The most common sensitizing allergens were house dust mite and Dermatophagoides culinae as shown by both methods.Conclusions The improved skin prick test displays an acceptable performance with simple and safe procedure in the detection of allergens in infants with eczema,and can provide reliable evidence for clinical diagnosis.

Scar sarcoidosis: first case report in China / 中华皮肤科杂志

A 54-year-old woman presented with a five-year history of malaise with weight loss and arthralgia of both knee joints. Six months prior to the presentation, an indurated nodule developed at the site of an old scar on the temporal side of left eyebrow. Subsequently, erythema and nodules spread over the trunk and extremities, especially at the sites of old scars on the hands. Physical examination showed bilateral axillary lymphadenectasis, a plaque at the site of an old scar on the temporal side of left eyebrow, a subcutaneous mass at the extensor aspect of the right upper arm, multiple dark-erythematous nodules at the site of scars on the left hand and both soles, few small erythematous papules scattered on the left forearm and trunk. The serum angiotensin converting enzyme concentration was high (82 kU/L). Computer tomography of thorax showed multiple obscure tubercles in both lungs and swollen lymph nodes in mediastina and axillary fossa, but no hilum pulmonis lymphadenectasis was observed. Histopathology revealed non-caseating granulomas with multinucleated giant cells. Neither acid-fast bacilli nor PAS staining was positive. A diagnosis of scar sarcoidosis was established. The lesions obviously improved after one-month treatment with oral methylprednisolone. This case represents a rare subtype of sarcoidosis that arose in old sears and clinically manifests as scar, nodules,plaques, subcutaneous masses and papules. The reactivation of old scars, which manifests as erythematous swelling and nodules, may highly suggest the diagnosis of sarcoidosis.

Clinical analysis of 24 cases of Kaposi's varicelliform eruption / 中华皮肤科杂志

Objective To investigate the clinical features and treatment of Kaposi's varicelliform eruption. Methods Clinical data on 24 cases of Kaposi's varicelliform eruption were retrospectively analyzed.Results All the 24 patients were accompanied by different underlying skin diseases, including eczema in 17 cases and atopic dermatitis in 7 cases. PCR of vesicle fluid was positive for herpes simplex virus type 1 (HSV 1 ) in 16 (66.67%) patients, and culture of vesicle fluid or lesional exudates grew Staphylococcus aureus in 12 (50%) patients. Conclusion Infants with atopic dermatitis or eczema are rather susceptible to Kaposi's varicelliform eruption, which may be partly caused by herpes simplex virus infection.