摘要
BACKGROUND@#This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability.@*METHODS@#This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability.@*RESULTS@#STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min.@*CONCLUSION@#The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Subject(s)
Humans , Reproducibility of Results , Surveys and Questionnaires , Practice Guidelines as Topic摘要
A 3-year-old male patient was diagnosed with neurofibromatosis type 1(NF1) for two years. The patient has multiple neurofibromas in retroperitoneum, lumbococcygeal paravertebral, lumbosacral spinal canal, and foramina. Due to retroperitoneal mass compression, the child suffered from urological complications such as hydronephrosis, ureterdilation, neurogenic bladder, etc., which seriously affected the urination function and resulted in multiple surgical treatments. Currently, the patient has been treated with mitogen activates extracelluar signal-regulated kinases(MEK) inhibitor selumetinib targeted therapy, and has voluntarily urinated, and his general state is better than before medication. The diagnosis and treatment of this case reflects the importance of multidisciplinary collaboration in the diagnosis and treatment of rare diseases.
摘要
In recent years, the number of guidelines/consensus in the field of dermatology has increased in China, but the quality is variable. This article proposes to describe the specific process of guideline/consensus development in 10 steps, focusing on the initiation phase, advancement phase, as well as dissemination, implementation and update phases, with the aim to improve the quality of guidelines/consensus in the field of dermatology.
摘要
In order to further standardize the diagnosis and treatment of atopic dermatitis by health-care professionals, as well as to enhance the awareness of atopic dermatitis among patients and promote doctor-patient communication, Chinese Society of Dermatology and China Dermatologist Association jointly initiated the development of guidelines on the diagnosis and treatment of atopic dermatitis (specialist version, general practitioner version and patient version). The development working group had planned the development process of the 3 versions of guidelines with reference to relevant development manuals and methodological articles. It is also intended to expound the details of registration, working group establishment, clinical question collection, evidence search and grading, recommendation formation and consensus through this protocol, aiming to enhance the transparency of guideline development.
摘要
Objective:To investigate the correlation between food-specific IgG (sIgG) antibodies and phenotypes of chronic spontaneous urticaria (CSU) .Methods:Serum samples were collected from outpatients with active CSU, symptomatic dermographism (SD) , or acute urticaria (AU) , and healthy controls from 5 third-grade class-A hospitals such as the First Hospital of China Medical University between April 2014 and March 2015. Enzyme-linked immunosorbent assay was conducted to detect serum levels of 90 food-sIgG antibodies and total IgE, Western blot analysis to detect levels of 20 allergen-specific IgE antibodies, and chemiluminescent microparticle immunoassay to detect levels of anti-thyroid peroxidase IgG antibodies and anti-thyroglobulin IgG antibodies. Comparisons of normally distributed quantitative data between two groups and among several groups were performed by t test and one-way analysis of variance, respectively; comparisons of non-normally distributed quantitative data between two groups were performed by Mann-Whitney U test; for comparisons of proportions, chi-square test and Fisher′s exact test were used. Results:A total of 248 patients with CSU, 22 with SD, 15 with AU and 13 healthy controls were recruited. The cut-off level for sIgG positivity was 100 U/ml (at least 2+) , and the positive rate of food-sIgG antibodies was slightly higher in the patients with CSU (176/248, 70.97%) , SD (15/22, 68.18%) and AU (11/15) than in the healthy controls (7/13; χ2 = 1.80, P = 0.615) . Among the 248 CSU patients, the proportion of patients with family history of allergic diseases was significantly higher in the sIgG-positive group (71/176, 40.34%) than in the sIgG-negative group (19/72, 26.39%; χ2 = 4.30, P = 0.042) , while no significant difference was observed in the 1-day urticaria activity score (UASday) between the two groups ( Z = 0.18, P = 0.859) . Totally, 177 CSU patients completed 12- to 40-week treatment; their condition could be completely controlled by second-generation H1-antihistamines, and there was no significant difference in the required dosage of second-generation H1-antihistamines between the sIgG-positive group (128 cases) and sIgG-negative group (49 cases; Z = -1.06, P = 0.298) . Conclusions:The prevalence of family history of allergic diseases was relatively high in food-sIgG-positive patients with CSU. However, food-sIgG could not be used as an indicator to reflect the disease activity of CSU and treatment response.
摘要
Objective To evaluate the clinical efficacy and safety of compound polymyxin B ointment combined with desonide cream for the treatment of subacute or chronic eczema. Methods A multicenter, randomized, double?blind, parallel?group, controlled clinical study was conducted. Totally, 144 patients with subacute eczema and 144 patients with chronic eczema were enrolled into this study, and both randomly and equally divided into the test group and control group. The test group and control group firstly topically applied compound polymyxin B ointment and its vehicle respectively, then both topically applied desonide cream 3 hours later. The drugs or vehicle were applied twice a day in all the patients. Patients′ symptoms and signs (including degree of itching, inflammation, erosion/exudation and infiltration/thickening, as well as area of target lesions) were evaluated, and the time to onset and duration of itching?alleviating effect were recorded. The clinical efficacy and safety of treatments were analyzed and compared between the test group and control group. Results The total symptom and sign scores significantly decreased to different extents on days 7 and 14 in the test group(subacute eczema patients:6.09 ± 2.78 and 3.68 ± 3.18 vs. 13.44 ± 1.66; chronic eczema patients: 6.56 ± 2.68 and 4.38 ± 3.27 vs. 12.96 ± 1.16)and control group(subacute eczema patients:8.26 ± 3.17 and 5.28 ± 4.05 vs. 13.60 ± 1.75;chronic eczema patients: 8.84 ± 2.90 and 6.25 ± 3.78 and vs. 12.64 ± 1.18)compared with those at baseline. Moreover, the total symptom and sign score of patients with subacute or chronic eczema was significantly lower in the test group than in the control group on days 7 and 14(all P<0.05). A significant increment was observed in the degree of decrease in scores for itch, infiltration/thickening in patients with subacute eczema in the test group compared with that in the control group(all P<0.01), as well as in scores for itch, infiltration/thickening and area of target lesions in patients with chronic eczema in the test group compared with those in the control group (all P < 0.05). In addition, patients with subacute eczema in the test group showed significantly shorter onset and longer duration of itching?alleviating effect than those in the control group(both P<0.05). The time to onset of itching?alleviating effect was also significantly shorter in patients with chronic eczema in the test group than in those in the control group(P<0.000 1), but there was no significant difference in the duration of it between the two groups of patients with chronic eczema. Clinicians and patients were both more satisfied with therapeutic effects in the test group than in the control group(all P<0.05). Conclusions Topical compound polymyxin B ointment can increase the efficacy of topical desonide cream for the treatment of subacute or chronic eczema, especially subacute eczema. Compound polymyxin B ointment also shows a favorable therapeutic effect on itching and infiltration/thickening in patients with eczema.
摘要
BACKGROUND:Different structures of matrix models, such as grating, holes and pil ars make different effects on the differentiation of neural stem cel s. OBJECTIVE:To explore the effects of the diameter and spacing, known as physical signals of micro pil ars on neural stem cel differentiation. METHODS:Micro pil ars with different diameters and spacing, both of which had four dimensions of 2.5, 5, 10 and 20μm, were fabricated on silicon substrates by photolithographic method. Purified primary neural stem cel s were incubated on the each micro pil ar for 7 days in vitro. Then the differentiation of neural stem cel s into neuron-like cel s was observed using immunofluorescence staining and quantitative real-time PCR. RESULTS AND CONCLUSION:When the diameters of the micro pil ars were constant and the spacing of micro pil ars varied in the range of 2.5-10μm, the differentiation rate of neural stem cel s increased with the spacing increase. When the spacing was invariable and the diameters changed in the range of 2.5-20μm, the differentiation rate of neural stem cel s declined with the diameter increase. Especial y, the micro pil ars with 2.5μm diameter and 10μm spacing significantly promoted the differentiation of neural stem cel s into neuron-like cel s. These results show that specific micro pil ars with smal diameters and large spacing facilitate the differentiation of neural stem cel s, thus providing guidance for developing tissue-engineered scaffolds.
摘要
Objective To observe the distribution of circum-patella nerve fibers in the soft tissue to provide experimental evidence,which is significant in denervation for Total Knee Arthroplasty (TKA).Methods Patella specimens were collected from 4 cadavers (2 cases of diabetic foot,lcase of lower extremity arterial occlusive,and 1case of car accident),all 4 of which were resected soft tissue with a dimension of 0.5cm × 0.5cm and full depth thickness around patella more than 0.5cm for histology and morphology observation.The nerve fibers histology and morphology were observed in all resected specimens with HE staining and silver-gilt glycine staining in the same field of microscopic vision.Results Anatomy found that the vascular network form skins directly involved in the patella nourish hole area and in the 10,2,4,7 clock point have found that blood vessels into the patella.There have a large number of nerve fibers near to the patella under the microscope,but there were no significant difference in the nerve fibers region distribution of all specimens.There were some into patella nerve fiber paths in side of patella soft tissue,which lied in 7,11 and 13 clock point,but outside no this phenomenon.The distribution of circum-patellar nerve fibers were described as distribution of regional concentration,which lied in much more 5,6,7 clock points and 10,11,12,1,2,clock points,in which the quadriceps tendon and patellar tendon have more than the others.In the 13 clock point,the fascia and periosteum of nourish hole area were also found in a large number of nerve fibers,and there were laminar distribution in different soft tissue layers,which were collected much more in synovial layer,fat pad,tendon near to patella.Conclusion There are much more nerve fibers near to the patella and some into patella nerve fiber paths in the medial side and nourish hole area.Nerve fibers distribution of circum-patella can be described as laminar distribution and regional concentration ,which is more in the centre,bottom more than top,outside more than inside,the bipolar more than the others.The patella denervation operation by reducing the number of peripheral nociceptors to achieve desensitization is feasible in TKA.
摘要
Objective To investigate technical points,risks and advantages of primary total knee arthroplasty (TKA) through subvastus approach.Methods The study involved 68 patients of similar basic conditions who were treated by TKA between September 2008 and August 2010,including 34 patients treated through subvastus approach (Group A) and 34 patients treated through traditional medial parapatella approach (Group B).Clinical parameters between groups were comparatively studied after operation.Results All patients were followed up for 6-25 months (mean 8.7 months).Alignment of lower extremities in both groups was restored.Group A showed significant differences from Group B in aspects of postoperative drainage volume [(124 ± 32.4) ml vs (182 ± 41.3) ml,P < 0.05],requirement of lateral retinacular release (7% vs 23%,P <0.01),time before patients being capable of having active straight-leg-raising movement [(1.3 ± 0.7) d vs (3.2 ± 0.6) d,P < 0.05],and time away from patients being able to bend their leg up to 90° [(3.1 ± 0.6) d vs (5.3 ± 0.5) d,P < 0.05].Conclusion Primary total knee arthroplasty through subvastus approach can hardly intervene in extension knee apparatus and in blood circulation around patellas,promote rapid recovery of knee function and achieve satisfactory early outcomes.
摘要
Objective To explore the distribution and their characteristics of contact allergens in patients with eczema and dermatitis in Shenyang.Methods Patients who were clinically diagnosed as eczema or dermatitis in the Department of Dermatology,No.1 Affiliated Hospital of China Medical Univer sity between March 2008 to November 2008 were enrolled in this study.They were tested with a standardized screening antigen kit on their back or inner part of upper arm,and interpreted 72 hours after patching.Results Patch test was completed in 89 patients and 25 (28.09 %) showed at least one positive allergen of 20 standardized screening antigens.Twenty-one patients had one positive allergen (23.60 %) while 3 patients had two positive antigens (3.37 %).No one showed three positive antigens,and four or more than 4 antigens were positive in 1 patient (1.12 %).All antigens were negative in 30 patients (33.71%).The top four allergens were nickel sulfate,para-phenylenediamine,thimerosal,and fragrant mix in all 89 patients.There was no statistical difference between male group and female group.The top three allergens were nickel sulfate,thimerosal,formaldehyde in male group while para-phenylenediamine,nickel sulfate,fragrant mix were top three in female group (the last two were same).The positive rate of nickel sulfate and thimerosal was obviously higher in male group than female group,and the difference was statistically significant.No statistical significance of positive rate occurred between the youth group and the old group.Conclusions Patchtest is helpful in identifying the property of contact allergens in para eczema and dermatitis,and it is of significance in clinical prevention and treatment of such diseases.
摘要
Objective To investigate the effect of local hyperthermia on the morphology and quantity of Langerhans cells (LCs)at challenged skin sites of a mouse model of contact hypersensitivity.Methods Sixty mice were equally divided into 3 groups to be treated with local hyperthermia (37℃,39℃,41℃and 43℃)for 20 minutes at sensitization sites on the back of mice 3 days before (pre-heat group),concurrently with (concurrent-heat group)or 2 days after(post-heat group)sensitization respectively.Five mice which remained unsensitized and untreated served as the controls.Five days after the sensitization,the mice were challenged on the dorsal surface of right ears.Two days after the elicitation,the right ears were resected and immunohistochemistry was performed to observe the morphology and determine the quantity of LCs at challenged sites.Results With the rise in temperature,the number of LCs in the epidermis of ear skin decreased in pre-heat group(321.83±41.81,251.12±16.29,191.41±28.7,128.33±77.61 per square millimeter at 37 ℃,39 ℃,41℃and 43℃,respectively,P0.05)and in the post-heat group(320.83±113.6,398.33±31.91,437.83±29.78,477.25±86.79 per square millimeter at 37℃,39 ℃,41℃and 43℃,respectively,P<0.01).The dendrites of LCs increased in number and length when the temperature lose from 37 ℃ to 41℃,but slightly declined at 43℃.Conclusions Local hyperthermia at sensitization sites could affect the morphology and density of LCs at challenged sites,and the effect is likely associated with the severity of contact hypersensitivity.
摘要
Objective To study the expression and significance of cyclin A1 in the skin of wild-type mice at RNA level.Methods Thirty 6-12-week old wild-type Kunming mice(15 male and 15 female)were included in this study.In situ hybridization was used to detect the expression of cyclin A1 mRNA in the skin of head and neck of the mice.The skin treated without probe was regarded as negative control and the testis of male mice was taken as positive contr01.Results The expression of cyclin A1 mRNA was found in sebaceous glands of 25 mice and in epidermis of 12 mice.Strong positive staining of sebaceous glands was seen in 50% and positive staining in 33.3% of sections,whereas strong positive and positive staining of epidermis was seen in 13.3% and 20% of sections.respectively.The positive rate of sebaceous glands was 83.3%,much higher than that of epidermis(33.3%).Conclusions There is a quite high expression of eyelin A1 mRNA in the skin sebaceous gland and epidermis of head and neck of wild-type mice.Especially a strong expression is in the sebaceous glands.It indicates that cyclin A1 mRNA may play a certain role in the physiological function of sebaceous glands and epidermis of the skin.
摘要
Objective:To investigate the expression of Th1 chemokine CXCL9,CXCL10,CXCL11,Th2 chemokine CCL22 and their receptors in the lesions of bullous pemphigoid (BP).Methods:Immunohistochemical assay was performed to detect the expression of CXCL9,CXCL10,CXCL11,CCL22 and their receptors CXCR3 and CCR4 in BP lesions and normal control skin.Results:CXCL9,CXCL10,CXCL11,CCL22,CXCR3 and CCR4 were overexpressed in BP lesions than those in normal control skin (P<0.01).The positive rates of CXCL9,CXCL10,CXCL11 and CXCR3 in BP lesions were 50%(15/30),46.7%(14/30),46.7%(14/30) and 53.3%(16/30),respectively.The positive rates of CCL22 and CCR4 were 66.7% (20/30) and 56.7% (17/30).Conclusion:The overexpression of Th1 chemokine CXCL9,CXCL10,CXCL11,Th2 chemokine CCL22 and their receptors may play important roles in the pathogenesis of BP.
摘要
Objective To assess the changes in frequency of peripheral T lymphocytes expressing different cytokines in patients with atopic dermatitis (AD) before and after treatment with BCG-PSN and their relationship with disease severity. Methods A randomized, double blinded and placebo cross-over control study was conducted. A total of 8 patients with AD were recruited in this study. Intramuscular BCG-PSN or placebo was given to patients every other day for 36 days. Flow cytometry was performed to measure the frequency of IL4-, IL5-, IFN-γ- and TNFα-expressing peripheral CD4+ T cells and CD8+ T cells before and after the therapy. Disease severity was evaluated by atopic dermatitis area and severity index score (ADASIS). Results The difference value in IFN-γ+CD8+ T cell frequency before and after therapy was significantly higher in patients treated with BCG-PSN than in those with placebo (8.056 ± 13.962 vs -6.549 ± 10.491, U = 2.26, P< 0.05). There was no statistical difference in the frequency of IL4-, IL5-, TNFa-expressing CD8+ T cells between BCG-PSN- and placebo-treated patients (all P > 0.05). The decrease in ADASIS was 1.56 ± 1.49 in patients treated with BCG-PSN, which was statistically higher than that in placebo-treated patients (-0.05 ± 1.54, U = 2.00, P< 0.05). Conclusion As an immunomodulator, BCG-PSN may control AD by restoring the balance of T-cell subsets.
摘要
Objective To investigate the effect of local hyperthermia on the mRNA expression of phosphatidylinositol 3-kinase(P13-K)in Langerhans cells(LCs)transmigrating from HPV-infected skin.Methods Tissue samples were collected from 5 female patients with condyloma acuminatum(CA)and 5 normal human controls.then equally divided into three parts to receive local hyoerthermia treatment at 37℃,42 ℃ and 45℃,respectively,for 30 minutes.After another 12-hour incubation in RPMI 1640 culture medium,transmigrating cells were collected and LCs were purified.Real-time quantitative reverse transcription-PCR was performed to detect the mRNA expressions of P13-K p85a and p110α in purified CD1a~+ LCs from these tissue samples.Results In CD1a~+ LCs transmigrating from normal skin and lesions of CA.the expressions of P13-K p85a and P110α mRNA decreased with the increase of temperature.Atier local hyperthermia treatment of normal skin at 37℃,42℃,45℃,the relative mRNA expression level was 1.00±0.00,0.78±0.13,0.54±0.17,respectively.for P13-K p85α in transmigrating LCs,1.00±0.00,0.80±0.11,0.61±0.12,respectively.for P13-K P110α;there was a significant difierence among the three temperatures in bOth parameters(both P<0.01).In the case of lesions of CA.the relative mRNA expression level of P13-K p85αand p110α was 1.00±0.00 and 1.00±0.00 under treatment at 37℃,0.20±0.11 and 0.49±0.21 at 42℃.0.1±0.08 and 0.09±0.03 at 45℃.respectively;significant difierence was also noted among the three treatment temperatures(both P<0.01).The decrease in P13-K P110α mRNA expressions under hyperthermia treatment at 42 ℃ and 45℃ compared with those at 37℃was greater in LCs from CA lesions than that from normal skin.Conclusions Local hyoerthermia could remarkably inhibit the expression of P13-K genes.which may enhance immunity and favor elimination of HPV.
摘要
Objective To investigate the effect of hyperthermia on the expression of E6 and E7 genes of human papillomavirus (HPV) type 6 and 11 in HPV-infected human skin. Methods Tissue samples were obtained from the lesions of condyloma accuminatum (CA) in 6 patients after informed consent. Each sample was divided into 4 parts: one was embedded and directly stored at -80 ℃; the other 3 parts were placed in culture medium and the surface of the samples was irradiated for 30 minutes with a thermotherapy apparatus at 37℃, 42 ℃, 45 ℃, respectively, then the samples were taken out and stored at -80 ℃. RNA was extracted from the specimens, real time quantitative PCR (qPCR) was performed to detect the expression of E6 and E7 genes of HPV-6 and -11. Results Of the 6 patients, 2 were infected with HPV-6 and -11 respectively, 4 with both HPV-6 and HPV-11. The expression of E6 and E7 mRNA decreased with the increase in irradiation temperature. The relative mRNA expression levels at 37 ℃, 42 ℃ and 45 ℃ were 1.00 ± 0.00, 0.61 ± 0.17, 0.27 ± 0.15, respectively, for HPV-6 E6 gene, 1.00 ± 0.00, 0.56 ± 0.21, 0.16 ± 0.11 respectively, for HPV-6 E7 gene, 1.00 ± 0.00, 0.60 ± 0.22, 0.16 ± 0.08, respectively, for HPV-I1 E6 gene, 1.00 ± 0.00, 0.55 ± 0.15, 0.24 ± 0.06, respectively, for HPV-11 E7 gene; statistical difference was noted among them between the specimens irradiated at different temperature (all P < 0.01). Conclusion Hyperthermia can remarkably suppress the expression of HPV-6/I 1 E6 and E7 genes, which may be a possible mechanism under the regression of warts induced by local hyperthermia.
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Objective To observe the efficacy of intense pulsed light(IPL)incorporated with optimal pulse technology (OPT)in the treatment of rosacea.Methods Thiris-two patients with erythematotelangiectatic rosacea and 53 patients with papulopustular rosacea were treated with IPL-OPT for 4 sessions with an interval of 3 weeks.Patients were assessed clinically and photographically by physicians before each treatment.Skin melanin index,erythema index,sebum secretion level and water content in stratum corneum were tested at the baseline,3 weeks after each treatment,and 6 months after the last treatment.Results Three weeks after the last treatment,the effective(more than 60%improvement)rate WaS 81.18%in total,75%in erythematotelangiectatic rosacea,and 84.91%in papulopustular rosacea;there WaS no significant difference between erythematotelangiectatic rosacea and papulopustular rosacea (x2=1.28,P>0.05).Six months after the last treatment,the total effective rate still remained at 78.82%with no significant difierence from that observed at 3 weeks after the treatment(x2=1.62,P>0.05).The value of melanin index,erythema index and sebum secretion level decreased significantly after the final treatment,however,water content in stratum corneum remained at the salne level as that before treatment.After 6-month follow-up,no significant change was noticed in the above 4 parameters compared with those obtained at 3 weeks after the treatment.Neither hyperpigmentation nor hypopigmentation was observed during the treatment and follow-up.Conclusion This study demonstrates that IPL-OPT is an effective treatment for rosacea with relatively few side effects.
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Objective To investigate the protective effect of green tea-based cream at different con- centrations on photoaging and photo-immunosuppression. Methods Twenty healthy female volunteers were enrolled into this study with informed consent. Green tea-based cream with a mass fraction of 2%-5% (pre- pared by adding green tea extracts to an emollient formulation), excipient or green tea extracts alone were applied to six unexposed sites on the back of these volunteers. Thirty minutes later, these treated sites were subjected to solar-simulated ultraviolet irradiation (ssUVR) with a 1.5-fold minimal erythema dose once a day for 4 days. At 6, 24 and 48 hours after the last irradiation, green tea-based cream were applied repeatedly to the corresponding sites. Biopsy specimens were obtained from the seven sites 72 hours following the last irradiation, and immunohistochemical staining was performed to detect cytokeratin 5/6 and 16 expression, as well as the densities of CDla- or HLA-DR-positive cells. Resttlts Green tea-based cream at a mass fraction of 2% to 3% could effectively prevent ssUVR-induced obvious erythema and hyperpigmentation. The posi- tivity (+) rates plus strong positivity (++) rates reached 50% and 25% for CK5/6 in the sites treated with ssUVR only and those irradiated and protected with green tea cream at a mass fraction of 3%, respectively, 69% and 31% in the sites treated with ssUVR only and those irradiated and protected with green tea-based cream at a mass fraction of 2%, respectively. Compared with the control site without irradiation or protec- tion, a decrease over 75% was noticed in the density of epidermal CD1a- or HLA-DR- positive Langerhans cells in the irradiated sites without protection, and green tea-based cream, especially those at a mass fraction of 3%, could effectively inhibit the density decrease. Conclusion Green tea extracts could effectively pro- tect skin from photoaging and photo-immunosuppression with the optimal mass fraction at 2% or 3%.
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Objective To investigate the influence of polysaccharide and nucleoside extract from bacille Calmett-Gueiin (PNCG) on the frequency of peripheral cutaneous lymphocyte-associated antigen positive (CLA~+) T lymphocyte derived lymphokines in atopic dermatitis (AD) and to explore their associations with the disease severity. Methods A randomized,double blind and placebo cross-over control method was used to treat the AD patients. Before and after the treatment,flow cytometry was used to measure the frequencies of IL-4,IL-5, IFN-γ,TNFα positive CLA~+T cells. Disease severity was evaluated by atopic dermatitis area and severity index score (ADASIS). Results After the PNCG treatment,the frequency of IL-5~+ CLA~+T cell decreased significantly,while IFN-γ increased,compared with the placebo con-trol group. PNCG could improve the ADASIS. Conclusion PNCG may treat AD through restoring the immune balance of CLA~+T cells.