Effect of Yinxieling decoction on PASI, TNF-α and IL-8 in patients with psoriasis vulgaris.

OBJECTIVE: To study the effect of Yinxieling decoction on PASI, TNF-α and IL-8 in patients with psoriasis vulgaris. METHODS: A total of 120 cases of psoriasis vulgaris were divided into 4 groups according to syndrome differentiation of TCM and randomized controlled method: wind heat syndrome group (group A), blood stasis syndrome group (group B), blood dryness syndrome group (group C) and control group (group D) (n=30 per group). Patients in observation groups were treated with Yinxieling decoction, while patients in control group were treated by placebo for 8 weeks. Levels of TNF-α and IL-8 were determined before treatment, 4 and 8 weeks after treatment. psoriasis area and severity index score was also performed before and after treatment. RESULTS: psoriasis area and severity index score and serum level of TNF-α, IL-8 were significantly decreased in all groups. The decrease in three observation groups was more significant (P<0.05 or P<0.01), and the decrease in wind heat syndrome group was the most significant (P<0.01). psoriasis area and severity index was positively correlated with TNF-α and IL-8, respectively (P<0.05). CONCLUSIONS: Yinxieling decoction has therapeutical effect on psoriasis vulgaris via regulating TNF-α and IL-8.

Effect of pharmacological intervention on MIP-1α, MIP-1ß and MCP-1 expression in patients with psoriasis vulgaris.

OBJECTIVE: To detect the expression level of macrophage inflammatory protein-1 (MIP-1)α, MIP-1ß and monocyte chemoattractant protein-1 (MCP-1) in with psoriasis vulgaris and explore the role in the pathogenesis of psoriasis vulgaris. METHODS: The level of MIP-1α, MIP-1ß and MCP-1 in peripheral blood from 50 patients with psoriasis vulgaris and 50 normal controls were measured by enzyme linked immunosorbent assay. The correlation with psoriasis area and severity index (PASI) was analyzed. The level of MIP-1α, MIP-1ß and MCP-1 was compared between psoriasis vulgaris patients at active stage and resting stage. And the change in MIP-1α, MIP-1ß and MCP-1 before and after therapy was also observed. RESULTS: The content of MIP-1α, MIP-1ß and MCP-1 in patients with psoriasis vulgaris was (1342.78 ± 210.30), (175.28 ± 28.18) and (266.86 ± 32.75) ng/L, respectively, significantly higher than those in control group (P<0.05). The expression level of MIP-1α, MIP-1ß and MCP-1 in peripheral blood of patients with psoriasis vulgaris was positively correlated with PASI (P<0.01). After acitretin therapy, expression level of MIP-1α, MIP-1ß and MCP-1 in peripheral blood of patients with psoriasis vulgaris was significantly decreased. CONCLUSIONS: Chemokine factor MIP-1α, MIP-1ß and MCP-1 may be involved in the pathogenesis of psoriasis vulgaris.

[Efficacy analysis of laparoscopic sleeve gastrectomy in the treatment of obesity-related comorbidities].

OBJECTIVE: To investigate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity and related diseases. METHODS: Clinical data of 67 patients who underwent LSG between December 2006 and July 2011 were analyzed retrospectively. Improvements in body mass index(BMI), percentage of excess weight loss(EWL), type 2 diabetes mellitus, hypertension and other comorbidities were observed at one year postoperatively. RESULTS: Laparoscopic procedures were completed in 67 patients without conversion. The operative time was(78±17) min. The postoperative hospital stay was(5.0±1.7) d. The postoperative recovery was uneventful and there were no perioperative death or severe postoperative complication. Sixty-four patients(95.5%) had a postoperative follow up of 1 year. One year after LSG, BMI decreased by(10.4±3.7) kg/m(2) from (37.7±4.1) kg/m(2) preoperatively and EWL was(80.2±27.7)%. In 13 cases of type 2 diabetes mellitus, 7 patients (53.8%, 7/13) were weaned off hypoglycemic agents or insulin. In 11 cases of hypertension, 5 required no medications(45.5%, 5/11). The remission rate was both 100%. There was significant resolution or improvement of other obesity-related comorbidiities, including hyper-triglyceridemia(n=51), hyperuricemia(n=42), sleep apnea syndrome (n=2), osteoarticular disease (n=9), and acanthosis (n=8). CONCLUSIONS: LSG is safe and feasible for the treatment of obesity and can cure or improve type 2 diabetes mellitus, hypertension and other obesity related comorbidities.

[Expression of Oct-4 transcription factor in squamous cell skin carcinoma and seborrheic keratosis].

OBJECTIVE: To detect the expression of stem cell transcription factor Oct-4 in squamous cell carcinoma (SCC) and seborrheic keratosis (SK) and its association with cancer stem cells. METHODS: Immunohistochemistry was used to detect Oct-4 expression in 35 SCC cases, 21 SK cases and 15 normal control skin tissues. RESULTS: Oct-4 expression was negative in normal skin and showed a significant difference between SCC and SK tissues (P<0.05). CONCLUSION: The Oct-4-positive cells in SCC and SK are probably tumor stem cells. Oct-4 expression may provide an important evidence for isolation and identification of human SCC and SK stem cells.

Laparoscopic versus open splenectomy for hypersplenism secondary to liver cirrhosis.

BACKGROUND: Since the first laparoscopic splenectomy (LS) in 1991, LS has become the gold standard for the removal of normal-to-moderately enlarged spleens in benign conditions. Compared with open splenectomy (OS), fewer postsurgical complications and better postoperative recovery were observed, but it is contraindicated for hypersplenism secondary to liver cirrhosis owing to technical difficulties associated with splenomegaly, well-developed collateral circulation, and increased risk of bleeding. With the improvements of laparoscopic technique, the concept is changing. METHODS: OS and LS performed for hypersplenism secondary to liver cirrhosis at our institution were analyzed. Relationships between postoperative increases in platelet counts, white blood cell counts, hemoglobin, and liver function were examined. Perioperative data of LSs were compared with those of OSs, including operative time, blood loss, excised spleen weight, complications, and hospital stays. RESULTS: A total of 216 splenectomies (135 OS and 81 LS) were performed from April 1999 to March 2007. Five laparoscopic cases were converted to open surgery owing to operative bleeding or bleeding of splenic fossa. The other 76 patients were performed LSs successfully. No major operative complications occurred. There was no operative death. Excised spleen weight >400 g was present in 56% of cases in this series. At 7 days postoperatively, the platelet counts, white blood cell counts, and hemoglobin significantly increased after open and laparoscopic surgeries, and increase of alanine aminotransferase, aspartate aminotransferase, total bilirubin, and directed bilirubin of LS were significantly different with open cases. Operation times of LS and OS were 2.9+/-0.7 hours and 2.6+/-0.6 hours, respectively. Blood losses were 150.6+/-135.4 mL and 633.8+/-340.3 mL (P<0.01), excised spleen weights were 585.7+/-184.6 g and 591.1+/-153.4 g (P>0.05), and hospital stay were 8.2+/-2.0 days and 11.9+/-3.8 days (P<0.01). Operative associated complications were noted in both LS and OS. Less blood loss, shorter hospital stay, and less impairment of liver function were observed in LS than OS. CONCLUSIONS: LS is feasible, effective, and safe procedures for hypersplenism secondary to liver cirrhosis and contributes to less impairment of liver function, less blood loss, and shorter hospital stay.

[The influence of the application of cytotoxic lymphocyte antigen 4-Ig adenovirus on the burn wounds with alloskin grafting on the murine immune function].

OBJECTIVE: To investigate the influence of local application of cytotoxic lymphocyte antigen 4-Ig (CTLA4-Ig) adenovirus on the burn wound with alloskin grafting upon the murine immune function. METHODS: Sixty BALB/c mice were randomly divided into A (operation control), B (CTLA4-Ig transfection) and C (normal control) groups, with 20 mice in each group. Skin wounds (full-thickness loss) sized 1.5 cm x 1.5 cm were created on the backs of mice in A and B groups. Then the skin grafts of the same size obtained from C57BL mice were grafted into the skin wounds. 0.1 g of cross-linking polyacrylic resin (carbomer cream) without adenovirus was daubed onto the wounds in A group, and the same amount of carbomer cream with adenovirus in titers of 5 x 10(9)/L was daubed onto the wounds in B group, while no treatment was given in C group. 1 ml of 10% SRBC (sheep red blood cell) was injected intraperitoneally to all the mice of the three groups on the 1st post injury day (PID). Splenocytes from BALB/c, C57BL and Kunming mice were harvested for mixed lymphocyte culture on 7, 14, 21 and 28 PIDs. Agglutination assay was used in the same time to detect the SRBC antibody titers. RESULTS: The reaction of murine splenocytes in B group to the donor (C57BL) splenocytes was suppressed in a specific way (P < 0.05) within 14 PIDs. There was no difference in the titers of anti-SRBC antibody among the 3 groups (P > 0.05). CONCLUSION: Local application of CTLA4-Ig recombinant adenovirus exhibited no influence on the murine humoral immunity, but might induce systemic and specific T cell tolerance in immunity system.

Enteral nutrition in treatment of severe acute pancreatitis.

OBJECTIVE: To observe the role and the timing of EN in the treatment of patients with severe acute pancreatitis (SAP). METHODS: Eleven patients with severe acute pancreatitis underwent systemic nutrition support were studied. EN was given through jejunostomy tube (or Bengmark tube) after a period of PN maintenance. EN started when serum and urine amylase activity returned to normal with regular peristaltic sound, defecation or break wind. The sequence of preparation was as follows: saline glucose-->chemically defined diet-->polymeric diet-->normal diet. RESULTS: In all the patients, none died. The rate of late complications was lower, and the levels of serum albumin and transferritin significantly increased in the post-EN period as compared with the pre-EN period, although the count of lymphocytes was less changed. CONCLUSIONS: Nutritional support should be transformed from PN to EN as early as possible during the treatment of patients with severe acute pancreatitis. EN could not only continue sufficient nutritional support, but also avoid the unfavorable effects of long-time PN, thus reducing complications as well as mortality.