Compound oleum lithospermi in improving clinical symptoms of mild to moderate diaper dermatitis: a multicenter, open-labeled, randomized controlled clinical study / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of topical compound oleum lithospermi in the treatment of mild to moderate diaper dermatitis.Methods:A multicenter, randomized, positive-drug parallel-controlled clinical trial was conducted in 19 hospitals from July 2019 to August 2020. Children aged 0 - 12 months with mild to moderate diaper dermatitis were enrolled and randomly divided into 2 groups using a random number table: test group topically treated with compound oleum lithospermi, and control group topically treated with zinc oxide cream. The treatment was carried out 6 - 8 times a day for 7 days. Visits were scheduled on days 0 and 7, and total response rate and clinical healing time were evaluated. Changes in the dermatitis family impact (DFI) score were compared between the test group and control group, and adverse events were recorded. Statistical analysis was carried out by using independent-sample t test for normally distributed continuous data, Wilcoxon rank sum test for non-normally distributed continuous data, and chi-square test or Fisher′s exact test for unordered categorical data; survival curves were drawn, and log-rank test was used for comparisons between two groups. Results:A total of 343 children with diaper dermatitis were enrolled in this study. Among them, 31 children violated the protocol, so 312 were included in the per protocol set, including 157 in the test group and 155 in the control group, and all completed the visits on days 0 and 7. The total response rate was significantly higher in the test group (87.26%, 137/157) than in the control group (78.71%, 122/155; χ2 = 4.04, P = 0.044) . The clinical healing time was significantly shorter in the test group (5.33 days) than in the control group (6.13 days; χ2 = 4.67, P = 0.025) . After 7-day treatment, the DFI score significantly decreased in both the 2 groups compared with that before the treatment, but there was no significant difference in the DFI score between the 2 groups (test group: 4.02 ± 6.96, control group: 3.58 ± 5.90, Z = -0.39, P = 0.686) . The incidence of adverse events was 2.92% (5/171) and 5.45% (9/165) in the test group and control group respectively, and there was no significant difference between the 2 groups ( χ2 = 0.03, P = 0.865) . Conclusion:Compound oleum lithospermi can markedly reduce the clinical severity of diaper dermatitis, improve the total response rate, shorten the clinical treatment period, and improve the quality of life of children′s families with a favorable safety profile.

Cognitive status of Chinese acne patients and its influencing factors / 中华医学美学美容杂志

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.

Effects related to experiences of famine during early life on diabetes mellitus and impaired fasting glucose during adulthood / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the effects of famine-experience during early life on diabetes mellitus and impaired fasting glucose in the adulthood.</p><p><b>METHODS</b>In a total of 101 510 employees who took part in the health examination at the Kailuan Group between 2006 to 2007 were recruited. All the study subjects were born in Hebei province between 1956-10-01 and 1964-09-30 but those who had incomplete data were excluded. 19 347 subjects were finally included for analysis. Members from the famine-exposed group were born between Oct. 1, 1959 and Sep. 30, 1961. There was a semi-exposed group with members born between Oct. 1, 1958 and Sept. 30, 1959 and from Oct. 1, 1961 to Sept. 30, 1962 but members from the control group were born from Oct. 1, 1956 to Sept. 30, 1958 and from Oct. 1, 1962 to Sept. 30, 1964. Prevalence rates on diabetes mellitus and the detection rate of impaired fasting glucose among the three groups were compared. Logistic regression model was used to analyze the effects of famine-experience during early life with the prevalence of diabetes mellitus and the detection rate of impaired fasting glucose during adulthood.</p><p><b>RESULTS</b>Prevalence of diabetes mellitus and the detection rate of impaired fasting glucose in the famine-exposed adult-cohort groups were 8.99%, 8.96% while 8.05% and 9.35% in the semi-exposure groups, 7.71% and 8.20% in the control group. Results from the multivariate logistic regression analysis showed that experiences of famine during early life increased the risk of diabetes mellitus and impaired fasting glucose in adulthood with the odds ratios as 1.218 (95% CI: 1.056-1.404, P = 0.007) and 1.142 (95% CI: 0.994-1.312, P = 0.061). After stratification by sex, odds ratios in males were 1.163 (95% CI: 1.001-1.350, P = 0.048)and 1.213(95% CI:1.039-1.417, P = 0.015). The odds ratios in females were 1.319 (95% CI: 0.920-1.891, P = 0.132) and 0.990 (95% CI: 0.679-1.444, P = 0.959).</p><p><b>CONCLUSION</b>Experiences of famine during early life increased the risk of diabetes mellitus and impaired fasting glucose in the adulthood. However, this negative effect existed mainly in the males, according to the results from our study.</p>

Association between dietary glycemic load and severity of skin lesions in young adult males with acne vulgaris / 中华皮肤科杂志

Objective To assess dietary glycemic load (GL) in young adult males with acne vulgaris and to evaluate its association with severity of skin lesions,in hope to provide evidences for comprehensive treatment of acne vulgaris.Methods The Global Acne Grading System (GAGS) was used to evaluate the severity of acne,and food frequency questionnaire (FFQ) and 24-hour dietary recall (24-HDR) to assess GL.Differences in GL and body mass index (BMI) were assessed by t test and analysis of variance,and Logistic regression analysis was conducted to analyze the factors influencing BMI and GL.Results This study included 99 young adult males with acne vulgaris who were 19-24 years old.Logistic regression analysis revealed that GL was the risk factor of BMI,and higher GL was always associated with increased BMI (β3 =1.119,P ＜ 0.05,OR =3.062,95％ confidence intervals:1.044-8.986).No factors were found to have influences on GL.The patients with a disease duration of ＞ 6 months showed a higher GL (t =2.947,P ＜ 0.01),but similar BMI (t =0.798,P ＞0.05) compared with those with a disease duration of ≤6 months.Significant differences were observed in GL (F =76.296,P ＜ 0.01),but not in BMI (F =3.142,P ＞ 0.05),among the three groups of patients with different GAGS score.GL was higher in patients with GAGS score of ≥39 than those with GAGS score of 1-18 (P ＜0.01) and GAGS score of 19-30 (P ＜ 0.01),and higher in patients with GAGS score of 19-30 than in those with GAGS score of 1-18 (P ＜ 0.01).Conclusion GL is positively correlated with the severity of lesions and disease duration in young adult males with acne vulgaris.

Drug susceptibility testing and randomly amplified polymorphic DNA analysis of Staphylococcus aureus from 178 children with impetigo / 中华皮肤科杂志

Objective To test the antimicrobial susceptibility of Staphylococcus aureus from children with impetigo,and to assess the differences in randomly amplified polymorphic DNA profiles between sensitive and resistant Staphylococcus aureus strains.Methods Secretion specimens were obtained from the impetiginous lesions of 178 children,and subjected to bacterial culture.The susceptibility of 162 Staphylococcus aureus isolates against 21 antibiotics was tested.Randomly amplified polymorphic DNA PCR(RAPD-PCR)was performed to characterize the genotype of Staphylococcus aureus.Results Totally,180 bacterial strains were isolated from 178 children with impetigo in Chengdu,including 162(90.00％)Staphylococcus aureus strains.Of the 162 Staphylococcus aureus strains,148 were methicillin sensitive Staphylococcus aureus(MSSA),14 methicillin resistant Staphylococcus aureus(MRSA).The most active antibiotic was minocycline,followed by teicoplanin,quinupristin,vancomycin and nitrofurantoin,while the resistance rate to penicillin was highest,followed by that to erythromycin,clindamycin,compound sulfamethoxazole and tetracycline.All the Staphylococcus aureus isolates were sensitive to fusidic acid,nitrofurantoin,vancomycin,minocycline and teicoplanin.According to RAPD-PCR,the 162 Staphylococcus aureus strains were divided into 8 genotypes,with the three most prevalent genotypes being Ⅲ(31.48％),Ⅱ(26.54％)and Ⅵ(25.93％),which accounted for 65.43％(106/162)in all the strains.The 148 MSSA strains fell into 8 genotypes,with genotype Ⅲ(50 strains,33.78％),Ⅵ(39 strains,26.35％)and Ⅱ(33 strains,22.30％)being the most prevalent genotypes;the 14 MRSA strains fell into 3 genotypes,i.e.,genotype Ⅱ(10 strains,71.43％),Ⅵ(3 strains,21.43％),and Ⅲ(1 strain,7.14％).Conclusions Staphylococcus aureus is the most prevalent pathogenic bacteria in children with impetigo in Chengdu area,which is highly sensitive to minocycline,teicoplanin and quinupristin,and falls into 8 genotypes according to RAPD-PCR with genotype Ⅲ being the most common genotype.

Changes in the number and biological ability of endothelial progenitor cells from peripheral blood of patients with systemic lupus erythematosus (SLE) / 中华皮肤科杂志

Objective To analyze the changes in number and biological ability of endothelial progenitor cells (EPCs) from peripheral blood of SLE patients. Methods Mononuclear cells (MNCs) were isolated by Ficoll density gradient centrifugation from peripheral blood of 20 female SLE patients and 20 healthy female controls. EPCs were identified by double staining using antibodies to CD34 and CD133, or antibodies to CD133 and vascular endothelial growth factor receptor 2 (VEGFR2). Phycoerythrin (PE) conjugated antiCD34, fluorescein isothiocyanate (FITC) conjugated anti-CD133 and APC conjugated anti-VEGFR2 antibodies were used in a three color flow cytometric analysis to determine the percentage of EPCs in peripheral MNCs.The proliferation and migration ability of EPCs were measured by MTT assay and modified millicell chamber assay, respectively. The adhesion activity of EPCs was evaluated by counting the number of adherent cells.Results The percentage and proliferation rate of EPCs in peripheral MNCs from female SLE patients were significantly lower than those from the healthy controls(4.49% ± 1.66% vs 20.81% ± 4.14%, 23.11% ± 3.16%vs 35.65% ± 1.74%, both P ＜ 0.01 ). The migration and adhesion ability of EPCs from SLE patients was impaired compared with those from the healthy controls (12.00 ± 2.12 vs 23.60 ± 3.0 cells/field, 22.43 ± 4.43vs 36.43 ± 3.69 cells/filed, both P ＜ 0.01 ). Conclusion There is a decrease in the number and an impairment in biological ability of EPCs in SLE patients.

Emergency Call Embolization Treatment of Hemorrhage of Digestive Tract / 实用放射学杂志

Objective To discuss the value of emergency angiography and embolization treatment of hemorrhage of digestive tract.Methods Give emergency angiography and embolization treatment for 15 patients with hemorrhage of digestive tract.Male is 12.Famale is 3.Adopt to Seldinger technic and method of coaxial duct,the head of ducts accesses to the region of bleeding,with gelatin foam or suture to embolism.Results All 15 patients were sucessful embolismed and get objective of hemostasis.Angiography appeared contrast medium overflowing and the humens,mucosa development.All patients were not bleeding again.Conclusion Clinic efficiency of emergeney ;embolization treatment for hemorrhage of digestive tract is assurance and explanation the principle and events of attention.

Emergent percutaneous transhepatic embolization of gastroesophageal varices for the treatment of acute upper gastrointestinal bleeding / 中国普通外科杂志

Objective To evaluate the effect of percutaneous transhepatic embolization of gastroesophageal varices on acute upper gastrointestinal bleeding in cirrhotic portal hypertensive patients. Methods Percutaneous transhepatic embolization was performed in 37 cases of acute upper gastrointestinal bleeding until varix thrombosed. Results Bleeding stopped in all patients. No technical complications occurred. During 1～38 months follow-up, variceal bleeding recurred in two cases in 3 months. One died of heart failure, five died of hepatic carcinoma in 6 months . Conclusion Percutaneous transhepatic embolization of gastroesophageal varices is a safe and effective treatment for acute upper gastrointestinal bleeding in portal hypertensive patients.

Follow-up Study of Balloon Dilatation and Stent Implantation for Benign and Malignant Esophageal Stricture(A Report of 156 Cases) / 实用放射学杂志

Objective To evaluate the long-term results of balloon dilatation for benign esophageal stricture and stent implantation for malignant esophageal stricture.Methods Balloon dilatation and stent implantation were performed in 156 cases,of which 12 cases received balloon dilatation in benign esophageal stricture and 134 cases received metallic stents,9 cases received balloon dilatation in malignant esophageal stricture of 143 cases.Results During a follow-up period of 1～48 months,61 cases died with a mean survival period of 8.9 months(1～33 months).Recurrent stenosis occurred in 63 cases(47%)who had to receive ballon dilatation or another stent implantation procedure,the stent was obstructed due to food and mucus in 3 cases,stricture at the upper end in 19 cases and the both ends in 8 cases.Conclusion Stent implantation is an effective palliative treatment for esophageal carcinoma with severe dysphagia.Tumor and hamartoplasia are the main cause of recurrent stricture.Covered stents can reduce the rate of recurrent stricture.

A Case of Disseminated Cryptococcosis with Cutaneous Manifestations and Osteomyelitis: Clinical and Laboratory Investigations / 中华皮肤科杂志

Objective To report a case of disseminated cryptococcosis with cutaneous manifestations and osteomyelitis. Methods and Results A 33 year old female was admitted due to multiple nodules and ulcers on the upper arms, shoulders, buttocks and thighs for one year. The patient was pregnant when admitted, and gave birth to a premature baby during her illness. The nodules increased half a month after delivery, which was suspected to be hematogenously disseminated pulmonary tuberculosis and was given anti tuberculous therapy for three months but failed. Physical examination showed there were 39 nodules or ulcers on the face, gum, trunk, buttocks and extre mities. The bone structure of the left tibia and fibula destroyed and a sinus developed on the left fibula. Microbiologic examination showed that lots of spores were seen in the smear of pus and necrotic tissues, which produced yeast like colonies in culture with positive urease and caffeic acid test. Cryptococcus neoformans, serotype A was identified by API yeast reaction band and serology. Inoculation with mice and rats showed that their brains, lungs and livers were involved easily. Further identification as C.neoformans var.neoformans was obtained based on sequence analysis of ribosomal internal transcribed spacer region 2. The anti tuberculous therapy was stopped and anti fungal therapy was initiated at once. Intravenous and topical amphotericin B in combination with fluconazole were chosen in the initial therapy and itraconazole for maintenance. The nodules disappeared after 30 days and the last ulcer in the left tibia healed completely after 200 days. The anti fungal therapy was discontinued after 277 days and the patient was completely cured.

Interventional Therapy for Acute and Chronic Arterial Occlusion / 实用放射学杂志

Objective To discuss the clinic efficiency and value of intravascular infusion and PTA for treatment of acute and chronic arterial occlusion.Methods 37 patients,23 males and 14 females,aged 23～81 years,mean 52.9 years,underwent Seldinger techniqe.Percutaneous puncture femoral artery anterograde or retrocatheterism with pulsed-spray or injection thrombolysis.The concentration of urokinase was 10000 u/ml,total 300～800 thousands u,mean 550 thousands u.17 patients with chronic arterial occlusion were theated with PTA.Results The rate of success all patients with interventional therapy was 95 percent(35/37).The rate of success with acute arterial occlusion was 91 percent(21/23).In 23 cases,18 were obtained thrombolysis completely(78 percent )and thrombolysis partly were 3(13 percent )and unaffected were2(9 percent).In chronic patients thrombolysis partly was 93 percent.The rate of success with PTA was 100 percent(14/14).Conclusion The thrombolysis therapy is a first selection therapy for acute and chronic arterial occlusion and is a accessory treatment for PTA.