Investigation of clinical factors influencing the response to systemic glucocorticoid treatment in patients with progressive non-segmental vitiligo / 中华皮肤科杂志

Objective:To compare the clinical data and peripheral blood levels of CXC chemokine ligand (CXCL) 9 and CXCL10 between patients with progressive non-segmental vitiligo who were sensitive to systemic glucocorticoid treatment and those who were resistant, and to clarify key clinical factors influencing the sensitivity to systemic glucocorticoid treatment.Methods:From May 2021 to May 2023, a cohort of patients with progressive non-segmental vitiligo receiving systemic glucocorticoid treatment was established in Huashan Hospital, Fudan University. Clinical data and peripheral blood samples were prospectively collected from all enrolled patients. Standard treatment, i.e., intramuscular injections of 1 ml of compound betamethasone once a month, was administered. After 3-month treatment, the improvement of patients′ skin lesions was estimated, and the vitiligo area and severity index (VASI) score and the Vitiligo European Task Force assessment tool (VETFa) were used to evaluate the efficacy. Patients with VASI changes ≥ 0 and VETFa progression scores ≤ 0 point were included in the glucocorticoid-sensitive group (i.e., the patients′ condition was stable or improved), otherwise those with VASI changes < 0 and VETFa progression scores of 1 point were included in the glucocorticoid-resistant group. Associations of lesion locations, specific clinical markers (trichrome lesions, confetti-like depigmentation, and Koebner phenomenon), previous medication history, family history of vitiligo, etc. with the response to systemic glucocorticoid treatment were analyzed. At baseline and after 3-month treatment, peripheral blood samples were collected from the patients, and enzyme-linked immunosorbent assay was performed to detect the plasma levels of CXCL9 and CXCL10. Statistical analysis was carried out by using the chi-square test, Fisher′s exact test, binary logistic regression analysis, Mann-Whitney U test, and Wilcoxon signed-rank test. Results:A total of 142 patients with vitiligo were enrolled, and 127 completed 3-month treatment, including 77 males and 50 females. Their age at diagnosis was 18 to 65 (36.6 ± 11.4) years, and the disease duration ranged from 2 months to 58 (13.5 ± 10.7) years; 25 (19.7%) had a family history of vitiligo; the percentage of lesion area to total body surface area before treatment ranged from 1% to 70% (11.5% ± 12.7%), and the VASI score was 1% to 70% (10.8% ± 11.6%). Multivariate logistic regression analysis showed that the absence of specific clinical markers (odds ratio [ OR] = 6.900, 95% confidence interval [ CI]: 1.228, 38.757, P = 0.028), carrying a single specific clinical marker ( OR = 2.579, 95% CI: 1.012, 6.574, P = 0.047), having a history of topical glucocorticoid treatment ( OR = 2.643, 95% CI: 1.019, 6.850, P = 0.041), the absence of family history of vitiligo ( OR = 5.090, 95% CI: 1.070, 24.215, P = 0.030), and lesions on the proximal extremities ( OR = 3.767, 95% CI: 1.315, 10.793, P = 0.037) were risk factors for the resistance to systemic glucocorticoid treatment in the patients with vitiligo. After 3-month treatment, the glucocorticoid-sensitive group showed a significant decrease in plasma CXCL10 levels compared with those before treatment ( W = 571.00, P < 0.001), while there was no significant difference between the pre- and post-treatment CXCL10 levels in the glucocorticoid-resistant group ( W = 48.00, P = 0.524). Additionally, no significant difference was observed in changes of the plasma CXCL9 level before and after treatment between the glucocorticoid-sensitive and glucocorticoid-resistant groups ( P > 0.05) . Conclusions:Carrying no or a single specific clinical marker, having a history of topical glucocorticoid treatment, the absence of family history of vitiligo, and lesions on the proximal extremities appeared to be risk factors for the resistance to systemic glucocorticoid treatment in patients with progressive non-segmental vitiligo. Changes in CXCL10 levels after treatment may be used as an important evaluation indicator for determining whether patients with progressive vitiligo were resistant to systemic glucocorticoid treatment.

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.

Efficacy of soluble hyaluronic acid microneedle on removing suborbital wrinkles / 中华医学美学美容杂志

Objective@#To investigate the clinical efficacy and safety of soluble hyaluronic acid microneedle eye patch on infraorbital wrinkles.@*Methods@#Seventy-five female subjects in Beijing and Shanghai were recruited and treated with soluble hyaluronic acid microneedle patch two days a week at the left lower eyelid (experimental side) and at least 30 minutes each time for 12 weeks. Investigator visual assessment, instrumentation measurement for skin moisture, elasticity, wrinkle area and depth were performed at week 0 (pre-treatment) and week 4 and week 12 and compared to the right (control side). The safety was assessed by documenting adverse reactions occurring during the study. Subject satisfaction was assessed at week 12.@*Results@#After 12 weeks of treatment, the visual assessment of skin wrinkles on experimental side (n=41, 54.67%) was significantly improved as comparied with that on control side (n=14, 18.67%). The skin hydration of treatment side skin increased with treatment time (t=-0.488 at week4, t=-3.054 at week 12, P<0.05). After 12 weeks of treatment, skin elasticity of the experimental side improved significantly. The improvement rate of the experimental side was more than that of the control side (t=2.724, P<0.05). The wrinkle area was significantly decreased in 4 and 12 weeks compared with pre-treatment (t=4.442 at week 4 and t=3.802 at week 12, P<0.001). The depth of wrinkles of the experimental side shallowed with the treatment (t=-2.435 at week 4 and t=-3.433 at week 12, P<0.05). Only 8% (n=6) of the subjects had temporary slight pruritus or acupuncture sensation on the treatment side, and no other adverse reactions occurred. The overall subject satisfaction rate was 88%(n=66).@*Conclusions@#Soluble hyaluronic acid microneedle eye patch is effective in improving wrinkles, skin elasticity and hydrating, and has no obvious adverse reaction.

Cellular senescence-mediated skin aging / 中华皮肤科杂志

Aging is age-related degeneration of the whole body,and skin aging is one of the most visualized changes in aging.Cellular senescence is a stress response to stable cell cycle arrest,and it is both the hallmark of aging and the important mechanism of the occurrence and development of aging.With the development of skin aging,senescent cells gradually accumulate in both the epidermis and dennis,and further exacerbate aging.Thus,when these senescent cells are eliminated,the aging skin seems to be rejuvenated.Cellular senescence is involved in the process of skin aging,which may be related to activation of DNA damage response pathway,up-regulation of regulatory proteins blocking cell cycle,and increase of senescence-associated secretory phenotypes.Cellular senescence is expected to be a novel target for preventing skin aging in the future.

Increased Circulating CXCL10 in Non-Segmental Vitiligo Concomitant with Autoimmune Thyroid Disease and Alopecia Areata

BACKGROUND: Vitiligo is a common acquired pigmentary disease caused by destruction of epidermal melanocytes in underlying autoimmune response. Few studies have been focused on the role of chemokines in non-segmental vitiligo (NSV) concomitant with autoimmune thyroid disease (AITD) and alopecia areata (AA). OBJECTIVE: The aim of this study was to determine the best serum biomarker for predictive role in the progression of vitiligo and to evaluate the influence of AA and/or AITD on vitiligo by using the biomarker. METHODS: This prospective cohort study recruited 45 NSV patients: 14 without either AITD or AA, 12 with AITD, 11 with AA, and 8 with both AITD and AA. Serum levels of CXCL1, CXCL8, CXCL9, CXCL10, CXCL12, CXCL13, and CXCL16 were analyzed by ELISA. CXCR3 mRNA expression was detected on PBMCs by RT-PCR. Improvement was evaluated using repigmentation scales. RESULTS: Serum CXCL10 levels, along with the expression of CXCR3 mRNA were higher in NSV patients with AITD or AA alone than in those without AITD or AA. Moreover, serum CXCL10 levels, along with the expression of CXCR3 mRNA were higher in NSV patients with both AITD and AA than in those with AITD or AA alone. Poorer repigmentation was observed in NSV patients with both AA and AITD than in those with AA or AITD alone. CONCLUSION: CXCL10 could be a biomarker to predict the progression of NSV. Dermatologists should pay much attention to those NSV patients concomitant with AITD and/or AA, for comorbidity might lead to more active autoimmune reaction.

A clinician's reference guide for the management of atopic dermatitis in Asians

BACKGROUND: Atopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD. OBJECTIVE: The Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians. METHODS: Electronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017. RESULTS: The Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included. CONCLUSION: The management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.

Application of fractional radiofrequency in cosmetic dermatology / 中华皮肤科杂志

Fractional radiofrequency(FRF)is an aesthetic technique that utilizes electric current emanating from electrode or microneedle arrays to heat the dermis in a fractional pattern, with only little damage to the epidermis. The recovery process following the heat damage involves multiple heat shock proteins, matrix metalloproteinases, cytokines, etc, which can stimulate the proliferation of collagen and elastic fibers in the dermis. It has been applied to treat wrinkles, skin laxity, acne scars and other aesthetic skin problems, and has proved to be a safe and effective cosmetic method for the improvement of atrophic acne scars, inflammatory acnes and postinflammatory erythema. It has few adverse effects, including tolerable pain, transient erythema, edema and mild crusting, so the downtime is short. FRF is more suitable for populations with dark complexions because of low risks of postinflammatory hyper?pigmentation. Recently, it has been used in combination with other devices such as lasers, or been used to assist transdermal drug delivery, and has shown remarkable therapeutic effects and favorable application prospects.

Short-term efficacy of high-intensity ultraviolet B versus 308-nm excimer laser for the treatment of vitiligo / 中华皮肤科杂志

Objective To compare the short-term efficacy of high-intensity ultraviolet B (UVB) versus 308-nm excimer laser for the treatment of vitiligo.Methods Eighty patients with vitiligo were equally divided into two groups to be treated with high-intensity UVB twice a week or 308-nm excimer laser once a week for eight weeks.Repigmentation was evaluated at the end of the treatment.Results After eight weeks of treatment,repigmentation of different degrees was observed in 83.6％ and 86.1％,and marked repigmentation in 42.1％ and 50％,of the UVB-and excimer laser-treated lesions,respectively.The response rate was significantly lower in facial lesions receiving high-intensity UVB radiation than in those receiving excimer laser radiation (49.1％ vs.68.4％,x2 =4.32,P ＜ 0.05),but similar at the other body sites between the two treatment (all P ＞ 0.05).The cumulative dosage required for initial repigmentation was similar between high-intensity UVB and 308-nm excimer laser (t =0.89,P ＞ 0.05),while the treatment sessions and cumulative dosage required for marked or better repigmentation were significantly increased in UVB-compared with excimer laser-treated lesions (both P ＜ 0.01).In addition,both high-intensity UVB and 308-nm excimer laser were suitable for childhood and active vitiligo.Conclusions Both high-intensity UVB and 308-nm excimer laser are safe and effective in the treatment of vitiligo with rapid onset of action,and the latter appears to be superior to the former in efficacy.

In vitro evaluation of antibacterial activity of fusidic acid against Propionbacterium acnes / 中华皮肤科杂志

Objective To evaluate the in vitro antibacterial activity of fusidic acid against P.acnes.Methods Fifty strains of P.acnes were clinically isolated from Huashan Hospital,Fudan University from March to September 2013.The minimum inhibitory concentrations (MICs) of several antibacterial agents including fusidic acid against these P.aches isolates were determined by using the agar dilution method according to the recommendations of Clinical and Laboratory Standards Institute (CLSI).Data were analyzed using the WHONET 5.4 software.Results Among the 50 P.acnes isolates,90％ were sensitive to fusidic acid,90％ to moxifloxacin,54％ to clindamycin,46％ to erythromycin,but 100％ were resistant to metronidazole.The minimum concentration required to inhibit the growth of 50％ organisms (MIC50) and 90％ organisms (MIC90) were 0.5 and 1.0 mg/L respectively for fusidic acid,whereas clindamycin and erythromycin both showed higher MIC90 values (＞ 128 mg/L).At the concentration of 128 mg/L,clindamycin inhibited the growth of 70％ of the P.acnes isolates,and erythromycin inhibited the growth of 48％ of them,while the growth of all the isolates was inhibited by fusidic acid at 2 mg/L.Conclusion Fusidic acid exhibits excellent antibacterial activity against clinical isolates of P.acnes in vitro.

Effects of sun protection education on the severity and treatment of polymorphous light eruption / 中华皮肤科杂志

Objective To estimate the effect of sun protection education on the severity and treatment of polymorphous light eruption (PLE).Methods Sixty-two patients with PLE were enrolled in this study,and randomly assigned into the control group (n =31) and intervention group (n =31) by using a random number table.Routine therapy was provided to all the subjects at their visits.The intervention group attended two lectures on sun protection at the beginning of spring and summer,and was given an education manual after each lecture.All the subjects completed a face to face interview and a questionnaire on the severity and therapy of PLE at the baseline and 12 months after enrollment.SPSS 11.5 software was used for data processing.Rank sum test,t test and chi-square test were carried out to assess the differences in the severity and treatment of PLE between the control group and intervention group as well as between pre-and post-intervention.Results The patients receiving sun protection education showed a significant decrease in the severity of PLE,including the number of months affected by PLE (t =4.611,P ＜ 0.01),number of PLE episodes (t =3.569,P ＜ 0.01),frequency of facial involvement (Z =2.369,P ＜ 0.05) and the time taken for lesions to appear after sun exposure (Z =2.650,P ＜0.01) in the year after enrollment compared with that before enrollment.Significant differences were also observed between the intervention group and control group in the number of months affected by PLE (t =3.679,P ＜ 0.01),number of PLE episodes (t =2.995,P ＜ 0.05),frequency of facial involvement (Z =2.169,P ＜ 0.05),the time taken for lesions to appear after sun exposure (Z =2.169,P ＜ 0.05) in the year after enrollment.The percentage of patients applying highly potent topical glucocorticosteroids (x2 =10.928,P ＜ 0.01)and administrating antihistamines (x2 =18.723,P ＜ 0.01) as well as the cumulative time of treatment with oral antihistamines (Z =2.656,P ＜ 0.01) were significantly reduced in the intervention group in the year after enrollment than in that before enrollment.Further more,a marked decrease was found in the percentage of patients applying topical highly potent glucocorticosteroids (x2 =4.521,P ＜ 0.05) and administrating antihistamines (x2 =10.949,P ＜0.01) as well as the cumulative time of treatment with oral antihistamines (Z =3.353,P ＜ 0.01).Conclusions Sun protection education through lectures and manuals appears to be an efficient adjuvant for the relief of PLE severity as well as for the reduction in the use of antihistamines and glucocorticosteroids,suggesting that dermatologists should pay more attention to sun protection education in the treatment of photosensitive diseases.

Topical 5-aminolevulinic acid with intense pulsed light versus intense pulsed light for photodamage in Chinese patients.

BACKGROUND: It has been suggested that the adjunctive use of 5-aminolevulinic acid (ALA) with intense pulsed light (IPL), known as ALA-IPL photodynamic therapy (PDT), increases the benefits of IPL therapy for photoaging. OBJECTIVE: To evaluate the efficacy and safety of ALA-IPL PDT for photoaging in Chinese subjects with Fitzpatrick skin types III and IV. METHOD: This was a prospective, controlled, split-face study with 26 subjects. Subjects received three split-face treatments 4 weeks apart. A blinded investigator assessed the signs of photodamage. Satisfaction was also assessed. RESULT: Twenty-four subjects completed the trial. Better results were achieved for global score, fine lines, and coarse wrinkles on the PDT/IPL treated side than on the IPL-only side at the final visit (50% vs 12.5%p=.005 for global score, 70.8% vs 33.3%p=.009 for fine lines, 50% vs. 12.5%, p=.005 for coarse wrinkles). Phototoxic reactions such as erythema and edema were the primary side effects, as well as an increase in postinflammatory hyperpigmentation. CONCLUSION: ALA-IPL PDT has superior rejuvenation effects over IPL alone in Chinese subjects. Taking reasonable precaution to prevent the postinflammatory hyperpigmentation is the most important point in making ALA-IPL PDT a successful therapy.

Clinical, histopathologic and ultrastructural characteristics of achromic naevus / 中华皮肤科杂志

Objective To study the clinical, histopathologic and ultrastructural characteristics of achromic naevus (AN). Methods Clinical data, including sex, age, age of onset, pattern of lesions, involved sites, shape and number of lesions and associated systemic diseases, were collected from 85 patients with AN. Skin melanin index was detected in 34 lesions of 19 patients with AN, 30 lesions of 12 patients with vitiligo and 64 contralateral normal skin islands of the 31 patients. Reflectance confocal microscopy (RCM) was performed to analyze the lesion, normal skin and junctional area between lesional and normal skin of 62 patients with AN. Tissue samples were obtained from lesions and perilesional normal skin of 17 patients with AN and subjected to pathological examination as well as ultrastructural study with transmission electron microscopy; also, skin biopsy specimens were immunostained for tyrosinase, HMB45, tyrosinase-related protein-1 (TRP-1), TRP-2 and CD117. Results Of the 85 patients with AN, 23 (27.1%) developed lesions at birth, and 21 (24.7%) after 3 years of age; 72 (84.7%) had irregularly shaped lesions, 54 (63.5%) had only a single lesion. The mean melanin index and relative melanin index of AN lesions were 186.56 ± 52.86 and 80 ± 11, respectively, significantly lower than those in normal skin islands (223.88 ± 63.19 and 100, both P < 0.01), but higher than those in depigmented lesions from 12 patients with vitiligo (128.57 ± 64.31 and 60 ± 20, both P < 0.01). RCM revealed a decline in the number of melanocytes and brightness of melanin caps, even distribution of melanin in lesions, as well as obscure demarcation between lesions and normal skin from patients with AN. Fontana-Masson stain showed that the melanin content was lower in lesions than in perilesional skin (1810.12 ± 327.96 vs 2064.24 ± 260.41) from patients with AN. Microscopic examination demonstrated a decrease in melanocyte and melanosome number, presence of immature melanocytes at stage Ⅱ and Ⅲ in cytoplasm and dendrites of melanocytes and keratinocytes, aggregated melanosomes in affected keratinocytes in lesions of AN. In 17 patients with AN, the relative expression levels of tyrosinase and TRP-1 were 1827.35 ± 307.09 and 6102.54 ± 1642.64, respectively, in normal skin specimens, significantly higher than those in lesional skin (1477.35 ± 224.05, 5322.33 ± 1565.26, both P< 0.01); no statistical difference was observed in the expression levels of HMB45, TRP-2 or CD117 between lesional and normal skin. Conclusions AN is an early-onset, nonfamilial aggregated, stable leukoderma with irregular margins, and in lesions of AN, the number of both melanocytes and melanosomes is decreased with the presence of immature melanosomes. The measurement of relative melanin index and reflectance confocal microscopy may offer a non-invasive approach to the diagnosis of AN.

Effects of 5-azacytidine and estradiol on the methylation of CpG motifs and expression of DNA methyltransferase 1 in patients with SLE / 中华皮肤科杂志

Objective To investigate the effects of 5-azacytidine and estradiol on the methylation of CpG motifs and expression of DNA methyltransferasel (DNMT1) mRNA in patients with systemic lupus erythematosus (SLE) and normal controls.Methods Peripheral blood lymphocytes isolated from 12 patients with SLE and 11 normal human controls were stimulated with phytohaemagglutinin for one day followed by additional 3-day culture with or without the presence of 5-azacytidine of 1 μmol/L or estradiol of 30μg/L respectively.Then.the methylation of CpG motifs was detected by flow cytometry using anti-5-methylcytosine antibody,and DNMT1 mRNA expression by real time reverse transcription-PCR Results After treatment with 5-azacytidine,a decrease wag observed in the methylation of CpG motifs, but not in the expression of DNMT1 mRNA in peripheral lymphocytes from patients with SLE (1=18.60,P<0.01;t=1.56.P>0.05) and in those from the normal controls (t=5.63,P<0.01;t=2.17,P>0.05) compared with untreated lymphocytes.Nevertheless,there were no significant changes in the methylation of CpG motifs or expression of DNMT1 mRNA in lymphocytes from patients with SLE (t=1.53,0.93,respectively,both P>0.05) and normal controls (t=1.93,0.11,respectively,both P>0.05) after the treatment with estradiol.Conclusions The methylation of CpG motifs is suppressed efficiently by 5-azacytidine,and the suppression is unlikely to be associated with the decrease of DNMT1 mRNA.Estradiol has no significant impact on the methylation of CpG motifs and expression of DNMT1 mRNA in lymphocytes.

Relationship of severity of chronic actinic dermatitis with photosensitivity profile of patients / 中华皮肤科杂志

ED are correlated with the severity of CAD in a degree.

The study of DNA CpG methylation and lymphocyte function-associated antigen-1 expression in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To study the methylation of CpG motifs and expression of lymphocyte function-associated antigen-1 (LFA-1) mRNA in patients with systemic lupus erythematosus (SLE), and evaluate their associations. Methods The peripheral blood lymphocytes were collected from 26 patients with SLE and 17 normal individuals. The methylation of CpG motifs was detected by the 5-methylcytosine antibody and flow eytometry, and the expression of LFA-1 mRNA was analyzed by RT-PCR. Results Methylation of CpG motifs in patients with SLE was lower than the control subjects (P<0.05), and a negative correlation existed between methylation of CpG motifs and SLEDAI (P<0.05). While expression of LFA-1 mRNA in patients with SLE was higher than that in the control group (P<0.05), and a positive correlation could be detected between the expression of LFA-1 mRNA and SLEDAI (P<0.05). There was a negative correlation between methylation of CpG motifs and expression of LFA-1 mRNA (P<0.05) in patients with SLE. Conclusion Hypomethylation of CpG motifs does exist in patients with SI,E, and is correlated with high expression of LFA-1, therefore, epige-netics plays an important role in the pathogenesis of SLE.

Narrow-band ultraviolet-B(311 nm)regulates dendrite formation in cultured B16 melanoma cells / 中华皮肤科杂志

Objective To investigate the effect ofnarrow-band ultraviolet-B(NB-UVB)(311 nm)on dendrite formation in B16 melanoma cells.Methods B16 melanoma cells were irradiated with various doses of NB-UVB(0,25,50,100,200,300 mJ/cm2).Atier additional culture of varying durations,irradiated cells were harvested and subjected to the observation of morphological changes and cell cytoskeleton F-actin microfilaments by phase contrast microscopy and laser scanning confocal microscopy(LSCM).respectively,and to the detection of cell proliferation bv MTT colorimetric assay.Pull down assay was performed to detect the activity of GTP-RhoAA and GTP-Rac1 in B16 cells before and after UVB irradiation.Results Twenty-four hours after irradiation with UVB of 100 mJ/cm2.an increase was observed in the cell body of B16 cells which appeared in sphericity,as well as in the number of dendrites(P＜0.01)which showed a branch-like appearance.compared with non-irradiated cells which had 2-3 dendrites and obscure branches.LSCM revealed that F-actin microfilaments in B16 cells were well organized with clear textures before irradiation;after irradiation wim NB-UVB of 100 mJ/cm2.stress fibers were disassembled and disrupted and the texture became unclear,which was observed as early as 30 minutes and became more and more evident,and at 6 hours the stress fibers displayed a clumping appearance with obscure textures.Following the irradiation with NB-UVB of 100 mJ/cm2,the expression level of GTP-Rac 1 protein increased at l 5 minutes,and.at 30minutes,reached 2 times of that observed in nonirradiated cells,then decreased a liale,but still remained elevated at 60 minutes and 120 minutes,compared to unirradiated cells;meanwhile.the level of GTP-RhoA dropped a little at 30 minutes,then gradually increased and,at 120 minutes.reached 1.6 times of that observed in unirradiated cells.Conclusion Narrow-band UVB(311 nm)can promote dendrite formation.likely via regulating the expression of GTP-Racl and GTP-RhoA in B16 melanoma cells.

Photodynamic therapy with 5% 5-aminolevulinic acid in the treatment of acne: a randomized, controlled trial / 中华皮肤科杂志

Objective To investigate the clinical efficacy of photodynamic therapy using low concentration of photosensitizer, short incubation time and red light source in the treatment of ache. Methods Thirty patients with facial ache were equally randomized into two groups, one group applying 5% 5-aminolevulinic acid (ALA) to the facial lesions on the right side and placebo agent on the left side as control, the other applying the same concentration of ALA to the facial lesions on the left side and placebo agent on the right side as control. The whole face of every subject was irradiated with red light once a week for 4 sessions. The lesions were counted by a dermatologist, sebum production was measured by a sebum meter (SHP88) and pigmentation index by Mexameter MX 18, at the baseline and on week 2, 4, 8 after the last treatment. Adverse effects were also recorded at each visit. Results Two weeks after the last treatment, a sixty percent or more clinical improvement was achieved in the ALA-treated side of 25.9% patients, but no patients experienced sixty or more percent clinical improvement in control side, and the efficacy of ALA was superior to that of the placebo (P<0.05). A significant reduction was noticed in the count of every kind of lesions, including comedo, papules, pustules, cysts/nodules, as well as the total count of these lesions compared with the baseline (all P<0.05); meanwhile, only the pustule count and total count of lesions were decreased in the control side (both P<0.05). Conclusions Both ALA (5%)-PDT and red light-irradiation alone can reduce the number of acne lesions, but the former is more effective than the latter with few side reactions.

Transglutaminase 1 gene mutation in a family with lamellar ichthyosis / 中华皮肤科杂志

Objective To report a consanguineous family with lamellar ichthyosis and to detect the mutations in transglutaminase 1 (TGM1) gene in this family. Methods Genomic DNA was extracted from the blood samples of a 19-year-old male patient with lamellar ichthyosis, his family members and 100 normal human controls. PCR was carried out to amplify all the encoding sequences (15 exons) and adjacent flanking sequences of TGM1 gene followed by bidirectional sequencing. Results A C1666T mutation in the 11th exon in TGM1 gene, which resulted in the substitution of ACA (threonine) by ATA (isoleucine) at codon 529, was detected in the proband, while both his parents carried the C1666T mutation in heterozygous form, and his sister was a C/C homozygote. None of the 100 normal control individuals carried the mutation in TGMlgene. Conclusions The de novo mutation from ACA (threonine) to ATA (isoleucine) at codon 529, may contribute to the development of lamellar ichthyosis. Consanguineous marriage can increase the risk for lamellar ichthyosis by raising the probability of homozygosis of C 1666T mutation in TGM 1 gene.

Prokaryotic expression, purification and identification of tetrameric-protein of methyl-CpG-binding domain / 复旦学报（医学版）

Objective To express, purify and identify tetrameric protein of methyl-CpG-binding domain in E. coli. Methods The recombinant plasmid 4 × MBD-pET30b + were transformed into E. coli DH5a for clonal expansion and sequenced, then the tetrameric-proteins were expressed in E. coli BL21 (DE_3) under the induction of IPTG. Moreover, the expression products were purified by Ni-NTA chromatography, and were determined by SDS-PAGE and Western blot. Immunostain 293T cells with the proteins were analyzed by fluorescence microscope. Results The sequence analysis showed orientation right and was identical with the expectation. SDS-PAGE and Western blot demonstrated that the molecular weight of the tetrameric- protein was 46 0110 with the N-terminal His-tag and the C-terminal HA-tag. The MBD proteins can bind to the intracellular CpG DNA specifically.Conclusions The tetrameric-proteins of methyl-CpG-binding domain are successfully expressed and purified in E. coli. This results establish a groundwork for the further researches on DNA methylation.

Treatment of port wine stains with photodynamie therapy in Chinese patients / 复旦学报（医学版）

Port wine stains affect patients on either cosmetic or functional, and even psychological aspects. Although many therapeutic modalities have been applied, the effective clearance rate of this bothersome problem is still limited to some extent. Photodynamic therapy is a state-of -the-art option for patients with port wine stains. In this article, clearance rates and adverse effects of different photo-dynamic therapy measures (including photosensitizers and light sources) for Chinese patients were re-viewed.