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Objective To evaluate the efficacy and safety of olopatadine hydrochloride for the treatment of chronic idiopathic urticaria (CIU). Methods A multicentre, double-blind, randomized, parallel-group, controlled clinical trial was conducted. A total of 144 patients with CIU from 3 research centers were enrolled into this study, and randomly and equally divided into a test group and a control group. The test group administrated olopatadine hydrochloride 5 mg twice a day for 28 consecutive days, while the control group administrated levocetirizine hydrochloride 5 mg in the forenoon and a placebo tablet of olopatadine hydrochloride 5 mg in the afternoon for 28 consecutive days. The symptom score reducing index(SSRI)served as the primary outcome, and global assessment score for efficacy and total response rates as the secondary outcome. Results Totally, 137 patients completed the trial, including 70 in the test group and 67 in the control group. As intention-to-treat analysis showed, there were no significant differences in the total response rate between the test group and control group on day 7 (64.29% (45/70)vs. 56.72%(38/67), P > 0.05), 14(82.86%(58/70)vs. 74.63%(50/67), P > 0.05), or 28(87.14%(61/70)vs. 77.61%(52/67), P >0.05)after start of treatment. The SSRI was significantly higher in the test group than in the control group after 4 weeks of treatment(82.67% ± 22.70% vs. 70.51% ± 32.07%, P 0.05), and adverse reactions mainly included lethargy, dry mouth, fatigue, etc. Conclusion Olopatadine hydrochloride is effective and safe for the treatment of CIU.
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Objective To observe the clinical features and to identify γ-secretase gene mutations in a Chinese family with follicular occlusion triad (FOT).Methods Clinical evaluation was carried out in a family with FOT through field investigation.Peripheral blood samples were obtained from the family members and 100 unrelated healthy controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN1,PSENEN and NCSTN genes followed by DNA sequencing and comparative analysis.Results There were 14 members over 3 generations in this family,of whom,6 (4 males and 2 females) were affected by FOT.FOT was inherited in an autosomal dominant manner in this family.Clinical manifestations varied greatly among the 4 surviving affected members.DNA sequencing revealed a novel missense mutation,c.647A > C (p.Q216P),in the exon 6 of NCSTN gene in the proband,which was cosegregated perfectly with affected,but not with unaffected,members in the family.The mutation was not found in any of the unrelated controls and had not been registered in the single nucleotide polymorphism (SNP) database in NCBI.Conclusions There is a novel heterozygous missense mutation,c.647A>C in the exon 6 of NCSTN gene,which may be the molecular basis of pathogenesis of FOT in this family.
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To report a case of retinoic acid syndrome due to tretinoin in the treatment of psoriasis.A 32-year-old male patient presented with psoriasis vulgaris for more than 10 years.In recent 10 years,he experienced erythema,plaques covered with multi-layered scales on the scalp,trunk,extremities accompanied by pruritus.The patient was diagnosed as psoriasis and given long-term treatment with oral vitamins,traditional Chinese medicine,and topical drugs,which resulted in a status of remission and exacerbation.Half a year prior to the presentation,the patient was given acitretin 10 mg twice daily due to the exacerbation of condition;20 days later,the dose increased to thrice daily;after another 30 days,the lesions were improved,and the frequency decreased to twice daily again;finally,a disappearance of the lesions was achieved after half a year of maintenance treatment with acitretin 10 mg twice daily.One week prior to the presentation,the treatment strategy was altered from acitretin to viaminate 50 mg twice daily;after three days with viaminate,the patient experienced a sudden worsening of psoriatic lesions with an obvious inflammatory reaction;subsequently,the lesions rapidly spread to the whole body surface and fused into large patches,accompanied with the following signs:marked edema,massive desquamating,high fever (>39℃),hypotension,respiratory distress,pulmonary edema,pleural and pericardial effusions,renal dysfunction,peripheral blood leukocytosis.The patient was diagnosed as retinoic acid syndrome(RAS).After given oral glucocorticoid,symptomatic and supportive treatment,he experienced a relief of symptoms.These findings indicate that RAS is an entity with an abrupt onset and poor prognosis.For patients with RAS,early diagnosis and prompt management with corticosteroids,symptomatic and supportive treatments are essential to avoid potential fatal complications.
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To observe the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with condyloma acuminatum (CA), flow cytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls (6.58% +/- 2.74% vs 14.81% +/- 6.12%, t = 5.703, P < 0.05); the average level of CD40L in CA patients was also significantly lower than that in the controls (0.73% +/- 0.54% vs 2.67% +/- 2.43%, t = 3.532, P < 0.05). Our results suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.
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To observe the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with condyloma acuminatum (CA), flow cytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls (6.58%±2.74% vs 14.81%±6.12%, t=5. 703, P<0.05); the average level of CD40L in CA patients was also significantly lower than that in the controls (0.73% ±0.54% vs 2.67%±2.43%, t=3. 532, P<0.05). Our resutls suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.
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In order to investigate the IFN-γ and IL-4 expression of CD8+ T lymphocytes in the peripheral blood from patients with recurrent genital herpes (RGH) at different clinical periods and their relationship with the pathogenesis of RGH, flow cytometry was used to detect the intracellular cytokines (IFN-γ and IL-4) of CD8+ T lymphocytes in the peripheral blood of 30 patients with RGH at acute period, 20 patients with RGH at recovery period and 15 healthy volunteers. The results showed that RGH patients at acute period had a lower percentage of Tc1 subsets in peripheral blood than that of healthy controls (P<0. 001), especially a remarkable decreased percentage of Tc1 subsets (P<0. 001) among those RGHpatients with recurrent number more than 3 in the recent half a year. Tc1/Tc2 ratio in the RGH patients at acute period was significantly decreased as compared with normal control group (P<0.05). The recurrent number of acute patients in the recent half a year was significantly correlated with the percentage of Tc1 subsets and the ratio of Tc1/Tc2 (P<0.05). A decreased percentage of Tc1 subsets was found among the RGH patients with recurrent number more than 3 in the recent half a year at recovery period in comparison with healthy volunteers (P<0.05), and it was significantly correlated with the recurrent number in the recent half a year (P<0.05). It is concluded that there are Tc1/Tc2 imbalance and a low level of Tc1 subsets in RGH patients who are relapsing repeatedly in the near period. The low level of Tc1 subsets maybe an important factor for the recurrence of RGH and the reactivation of latent herpesvirus infection.
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OBJECTIVE To investigate the epidemiological features of pregnant women with syphilis, their pregnant outcomes, and perinatal and neonatal prognosis. METHODS Fifty-eight pregnant women with syphilis were retrospectively studied from Jan 2003 to Dec 2007. RESULTS There were 3 cases in 2003, 8 in 2004, 11 in 2005, 15 in 2006 and 21 in 2007. There were 19 dominant syphilis cases and 39 latent syphilis cases among 58 pregnant women with syphilis. Pregnant outcomes: term delivery reached 92.86% in pregnant women with regular antisyphilitic treatment and only 25.00% in pregnant women without antisyphilitic treatment (P
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To compare the effects of polysaccharide nucleic acid fraction of bacillus calmette guerin (BCG-PSN) and thymopeptides on T-lymphocytes of normal and immunosuppressed mice, CD4+ and CD8+ T-lymphocyte subsets of single nucleic cell in thymus, spleen and peripheral blood were detected successively by flow cytometry after application of BCG-PSN and thymopeptides. Meanwhile, CD4+/CD8+ ratio was also calculated. The results showed that both BCG-PSN and thymopeptides could decrease the proportion of CD4+ CD8+ T-lymphocyte subsets in the thymus, at the same time increase CD4+ T-lymphocyte, CD8+ T-lymphocyte proportion in the three tissues. The fluctuation in amplitude was greater in thymopeptides group than that in BCG-PSN group. It is concluded that acting location of thymopeptides is in thymus, its stimulating action is stronger than that of BCG-PSN, while BCG-PSN not only accelerates the differentiation in thymus, but also has some direct stimulation to peripheral CD4+ T-lymphocytes, and can maintain CD4+/CD8+ ratio within normal range. So, BCG-PSN is safer.
Subject(s)
Adjuvants, Immunologic/pharmacology , Immunocompromised Host , Mycobacterium bovis/chemistry , Nucleic Acids/pharmacology , Peptide Fragments/pharmacology , Polysaccharides, Bacterial/pharmacology , T-Lymphocyte Subsets/drug effects , Thymus Gland/chemistryABSTRACT
To compare the effects of polysaccharide nucleic acid fraction of bacillus calmette guerin (BCG-PSN) and thymopeptides on T-lymphocytes of normal and immunosuppressed mice, CD4+ and CD8+ T-lymphocyte subsets of single nucleic cell in thymus, spleen and peripheral blood were detected successively by flow cytometry after application of BCG-PSN and thymopeptides. Meanwhile, CD4+/CD8+ ratio was also calculated. The results showed that both BCG-PSN and thymopeptides could decrease the proportion of CD4+ CD8+ T-lymphocyte subsets in the thymus, at the same time increase CD4+ T-lymphocyte, CD8+ T-lymphocyte proportion in the three tissues. The fluctuation in amplitude was greater in thymopeptides group than that in BCG-PSN group. It is concluded that acting location of thymopeptides is in thymus, its stimulating action is stronger than that of BCG-PSN, while BCG-PSN not only accelerates the differentiation in thymus, but also has some direct stimulation to peripheral CD4+ T-lymphocytes, and can maintain CD4+/CD8+ ratio within normal range. So, BCG-PSN is safer.
Subject(s)
Animals , Female , Male , Mice , Adjuvants, Immunologic , Pharmacology , Immunocompromised Host , Mycobacterium bovis , Chemistry , Nucleic Acids , Pharmacology , Peptide Fragments , Pharmacology , Polysaccharides, Bacterial , Pharmacology , T-Lymphocyte Subsets , Thymus Gland , ChemistryABSTRACT
To study the mechanism of Condyloma acuminatum (CA) recurrence, and the association of CA recurrence with the ability of the host derived lymphoblastoid cell lines (LCL) stimulated by LPS to produce tumor necrosis factor (TNF), EBV-transformed B LCL were used as TNF producing cells. The ability of LCL stimulated by LPS to produce TNF was measured by bioassay. The results showed that the LCL from CA patients (including recurrent and non-recurrent CA patients) produced similar level of TNF stimulated by LPS to that of normal controls (29.54% +/- 11.28% vs 34.31% +/- 11.46%, P = 0.1498). The LCL of CA recurrent patients produced significantly lower amount of TNF than that of non-recurrent CA patients (23.72% +/- 7.41% vs 37.33% +/- 11.10%, P = 0.0032). Compared with the normal controls, CA recurrent patients showed a decreased ability to produce TNF (23.72% +/- 7.41 vs 34.31% +/- 11.46, P = 0.0054), whereas CA non recurrent patients had the similar ability to the controls (37.33% +/- 11.10 vs 34.31% +/- 11.46, P = 0.4914). It was concluded that the onset of CA was not relevant to the individual's ability to produce TNF. But the recurrence of CA was associated with the ability to produce TNF. It was also indicated that the TNF involved cellular immunity might play an important role in the clearance of the residual HPV by the host after treatment.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , B-Lymphocytes , Allergy and Immunology , Metabolism , Pathology , Cell Line , Condylomata Acuminata , Allergy and Immunology , Pathology , Lipopolysaccharides , Pharmacology , Lymphocyte Activation , Allergy and Immunology , Recurrence , Tumor Necrosis Factor-alpha , GeneticsABSTRACT
Objective To investigate the correlation between the relapse of condyloma acuminatum(CA)and the potential capability of tumor necrotic factor (TNF) production of the host′s peripheral blood leukocytes. Methods Forty-two CA patients and 58 normal controls were enrolled in this study. CA relapse was diagnosed clinically. EB virus-transformed B lymphoblastoid cell line(LCL)were used as TNF producing cells. The TNF producing capability of LCL was measured by bioassay using L929 (a TNF sensitive tumor cell line) as target cells. The LCL were stimulated with LPS to produce TNF. Results The average level of TNF production of LCL from all CA patients (including recurrent and non-recurrent CA patients) was similar to that of normal controls (30.14% ? 12.27 vs 34.06% ? 12.06,P = 0.1136). However, the level of TNF production of LCs from recurrent CA patients was significantly less than that from non-recurrent CA patients (24.75% ? 7.51 vs 36.62% ? 10.96,P = 0.00016). Compared with that of normal controls, recurrent CA patients showed a lower capability to produce TNF (24.75% ? 7.51 vs 34.06% ? 12.06,P = 0.00054), whereas non-recurrent CA patients showed a similar capability to normal controls (36.62% ? 10.96 vs 34.06% ? 12.06,P = 0.3517). Conclusions These results indicate that the cellular immune mechanism might play an important role in the clearance of the residual HPV from the host, in which TNF is involved.
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Objective To investigate the role of Toll-like receptor 4 (TLR4) in the host defense against systemic candidiasis in murine model.Methods Two groups of mice,a study group (C3H/HeJ mice with mutant TLR4 gene) and a control group (C3H/HeN mice with normal TLR4 gene) were set up in cyclophosphamide-induced immuno-suppressed murine model with systemic candidiasis.Colony forming units (CFUs) of C.albicans were determined in infected kidneys and spleens with plating dilution method.Histopathological changes of infected kidneys were measured.In addition,levels of tumor necrosis factor-? (TNF-?) in kidneys were detected by enzyme-linked immunosorbent assay.Results CFUs of C.albicans were significantly higher in kidneys in the 1st day and 6th day after infection in the study group than those in the control group.Meanwhile,CFUs of C.albicans were significantly higher in spleens in the 1st day after infection in the study group than those in the control group.The scores of severity of infection,showed by histopathology,were significantly higher in kidneys in the 1st day and 6th day after infection in the study group than those in the control group(P
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Objective To investigate the expression of intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1(VCAM-1) on the surface of human vascular endothelial cells (HUVECs) stimulated by Candida albicans.Methods HUVECs were isolated from the umbilical vein of placenta of healthy parturients and cultured.The primary culture of HUVECs was stimulated with Candida albicans at different intervals.Expression of ICAM-1 and VCAM-1 mRNA were measured by reverse transcription-PCR,and the levels of secretion of IL-6 and IL-8 by enzyme-linked immunosorbent assay(ELISA).Results ICAM-1 and VCAM-1 mRNA expression in HUVECs began to increase after stimulation with C.albicans in 4 h and reached peak level in 8 h.Secretion of IL-6 and IL-8 by HUVECs began to increase after stimulation by C.albicans in 4 h and reached peak level in 24 h.Conclusion C.albicans could induce expression of ICAM-1 and VCAM-1 mRNA in HUVECs,and enhance secretion of IL-6 and IL-8 by HUVECs.
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Objective To investigate the role of HLA class II antigen of human monocytes in pathogenesis of herpes simplex virus-2 (HSV-2) infection. Methods Human monocytes were infected by HSV-2 (333 Strain). The cultured cells were collected at the first, third, 5th, and 7th days of post-infection. The expression of HLA class II antigen of the infected monocytes was measured by alkaline phosphotase anti-alkaline phosphotase method (APAAP). Results The expression of HLA class II antigen on the monocytes significantly decreased at the first day of post-infection,and then gradually increased and reached to the normal control level at the 7th day of post-infection. Conclusion HLA class Ⅱ antigen expression of monocytes was inhibited by HSV-2 infection at early stage, which may be one of means of virus escaping host immunity. The expression of HLA class Ⅱ antigen may play an important role in HSV-2 pathogenicity and immunity.
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ObjectiveTostudytheroleoffunctionalsubetsofCD4+Tlymphocytesinsyphilis.Methods40casesofsyphilis(20casesofprimaryandsecondarysyphiliseach)enteredinthisstudy,and15normalindividualsascontrols.Theperipheralbloodmononuclearcells(PBMCs)ofpatientswithsyphilisandnormalcontrolswereculturedinvitrowithphytohemagglutinin(PHA)for48hours,andtheTh2cytokineIL-4、Th1cytokineinterferon-?(IFN-?)inthesupermatantweremeasured,thechangesofIL-4,IFN-?ineachstageofsyphiliswereobserved.ResultsTheresultsshowedthattheproductionofIL-4insyphilispatientswasmarkedlyhigherthanthatinnormalcontrols,(P
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Objective To investigate the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with recurrent genital herpes (RGH). Methods Flow cytometric analysis was employed to identify the expression of CD40 and CD40L on PBMC and the T lymphocyte subgroups in the peripheral blood of 30 patients with RGH and 20 healthy controls. Results Percentage of the cells with either CD40 or CD40L expression in the patients with RGH was significantly lower than that in the controls (P = 0.0061 and 0.041, respectively). The RGH group had a significantly lower percentages of CD3+ T cells (P=0.025) and CD4+ T cells (P = 0.032) as compared to the controls. Conclusion Reduced costimulatory interaction of CD40 and CD40L in RGH patients may be one of the important factors for the recurrence.
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Objective To observe the clinical efficacy and safety of 5% imiquimod cream in topical treatment of anogenital warts. Methods A randomized, double-blind, parallel placebo-controlled clinical study was conducted. Patients with anogenital warts were instructed to apply the test drug topically and then clean the drug with water 6 ~ 8 hours later, three times a week for 8 weeks. Patients whose warts cleared completely were followed up for one month to determine recurrence rates. Results Two hundred and thirty-one patients with anogenital warts were enrolled in this trial. One hundred and sixteen patients were randomly selected to receive 5% imiquimod cream; and the other receive placebo cream. For 2, 4, 6, 8 weeks, the cure rates were 8.41%, 30.84%, 49.53%, 61.68%, respectively in the study group, and 2.68%, 7.14%, 16.07%, 24.11%, respectively in the control group (P