Characteristics and risk factors for hyperglycemia in Chinese female patients with systemic lupus erythematosus.

The aim of the study was to investigate the characteristics and risk factors for hyperglycemia in Chinese female patients with systemic lupus erythematosus (SLE). One hundred and forty-six female SLE patients without a history of diabetes underwent a 75 g oral glucose tolerance test to evaluate glucose tolerance, insulin sensitivity and pancreatic beta cell function. According to the 1999 World Health Organization criteria, all patients were divided into three groups: normal glucose regulation, impaired glucose tolerance and diabetes mellitus. Glucocorticoid doses, insulin sensitivity and pancreatic beta cell function were compared among these groups. Risk factors for hyperglycemia were analyzed by univariate and multi-variate regression analysis. Our results showed that 46 of the 146 female SLE patients (31.5 %) were hyperglycemic, including 21 (14.4%) diabetes mellitus patients and 25 (17.1%) impaired glucose tolerance patients. These female SLE patients with hyperglycemia were characterized by insulin resistance and reduced pancreatic beta cell function, and they were relatively young. Age ≥35 years and high glucocorticoid doses were risk factors for hyperglycemia in Chinese female SLE patients. The prevalence of diabetes mellitus and impaired glucose tolerance are quite high in Chinese female SLE patients. It is suggested that plasma glucose concentration should be monitored regularly and oral glucose tolerance test should be recommended for SLE patients who have risk factors for hyperglycemia.

Diallyl trisulphide-induced apoptosis in human melanoma cells involves downregulation of Bcl-2 and Bcl-xL expression and activation of caspases.

BACKGROUND: Although diallyl trisulphide (DATS) has been found to induce apoptosis in various tumour cells, its cytotoxicity in melanoma cells has not yet been defined and the molecular pathway by which DATS induces apoptosis is not well understood. OBJECTIVES: To determine growth inhibition of DATS in human melanoma cells (A375 and M14) by inducing apoptosis, and to investigate the mechanism underlying such effects. METHODS: Growth inhibition by DATS was estimated by the tetrazolium assay. Apoptosis induction in DATS-treated cells was assessed by staining with 4',6-diamidino-2-phenylindole (DAPI) and double staining with annexin V and propidium iodide. Expression of Bcl-2, Bax, Bcl-xL/Bcl-xS, cytochrome c release, activation of caspase-9 and poly(ADP-ribose) polymerase (PARP) were determined by western blotting. The activity of caspase-3 was measured using a colorimetric assay. RESULTS: DATS exerted its cytotoxic effect in a time-dependent and dose-dependent manner by inducing apoptosis in A375 and M14 cells. Expression of Bcl-2 and Bcl-xL was downregulated. Release of cytochrome c and activation of the downstream effectors caspase-3, caspase-9 and PARP were detected after DATS sensitization. CONCLUSIONS: DATS inhibits growth of melanoma cells by inducing apoptosis in association with downregulation of Bcl-2 and Bcl-xL and activation of caspases.

Skin colonization by Staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial.

BACKGROUND: Staphylococcus aureus has a peculiar ability to colonize the skin of patients with eczema and atopic dermatitis (AD), and is consistently found in eczematous skin lesions in these patients. A correlation between the severity of the eczema and colonization with S. aureus has been demonstrated, and it has been determined that bacterial colonization is an important factor aggravating skin lesions. Patients colonized with S. aureus have been treated with antibiotics in several open and double-blind placebo-controlled studies, with conflicting results. OBJECTIVES: To investigate the colonizing features of S. aureus in the lesional and nonlesional skin of patients with eczema and AD in China and to compare the therapeutic effect of mupirocin plus hydrocortisone butyrate with vehicle ointment plus hydrocortisone butyrate. METHODS: A multicentre, double-blind randomized trial was conducted. Eczema Area and Severity Index (EASI) scores were evaluated before the start of the trial and on the 7th, 14th and 28th day of treatment. Swabs for bacterial isolation were taken from lesional skin before the start of the trial and on the 7th, 14th and 28th day of treatment, and from nonlesional skin only before the start of the trial. A combination topical therapy with mupirocin plus hydrocortisone butyrate ointment was used in the experimental group, with vehicle ointment plus hydrocortisone butyrate ointment as a control. RESULTS: Of 327 patients enrolled in the study, 208 had eczema and 119 had AD. Bacteria were isolated from 70.2% of lesional and 32.7% of nonlesional skin samples from patients with eczema, of which S. aureus accounted for 47.3% and 27.9%, respectively. Bacteria were isolated from 74.8% of lesional and 34.5% of nonlesional skin samples from patients with AD, of which S. aureus accounted for 79.8% and 80.5%, respectively. The colonization density of S. aureus was markedly higher in lesional than in nonlesional skin, both in patients with eczema and with AD (P < 0.01, P < 0.05), and was positively correlated with lesion severity. Considering the EASI scores before and after treatment and the final effective rate, good therapeutic effects were obtained in both the combination experimental groups and the control groups (P < 0.01), and there were no differences in the global therapeutic effect between the two groups in patients with eczema and with AD (P > 0.05). However, in patients with eczema with a clinical score of > 8 or in patients with AD with a clinical score of > 7, the therapeutic effect in the experimental groups was superior to that in the control groups (P < 0.05) on the 7th day of treatment. There were no differences between the two groups on the 14th and 28th days of treatment (P > 0.05). Following the improvement of symptoms and signs of eczema and AD, the positive rates of bacteria and S. aureus were reduced on the 7th day of treatment. CONCLUSIONS: This study confirmed that lesional skin of patients with eczema and AD was more frequently colonized with S. aureus than was nonlesional skin. The more severe the eczema, the higher the colonization rate of S. aureus, and S. aureus was also more often present in lesional and nonlesional skin in patients with AD than in those with eczema. Staphylococcus aureus infection is related to the pathogenesis of eczema and AD. An antibiotic-corticosteroid combination and corticosteroid alone both gave good therapeutic effect in eczema and in AD, and both reduced colonization by S. aureus. Early combined topical therapy is beneficial to patients with moderate to severe eczema and AD, and it is unnecessary to use antibiotics at later stages of disease or in mild eczema or AD.

In vitro susceptibility testing of amorolfine in pathogenic fungi isolated from dermatomycosis patients in China.

The antifungal susceptibility of isolates from Chinese dermatomycosis patients to amorolfine was investigated following National Committee for Clinical Laboratory Standards (NCCLS) protocols. In total, 383 isolates were tested, including 132 strains from tinea pedis, 148 strains from tinea corporis/cruris, and 103 strains from onychomycosis. The minimum inhibitory concentration (MIC) of amorolfine against dermatophytes ranged from 0.01 to 0.08 microg ml(-1). The MIC(50) and MIC(90) of amorolfine for Trichophyton rubrum were both equal to 0.04 micro ml(-1); for T. mentagrophytes these MICs were 0.04 microg ml(-1) and 0.08 microg ml(-1) respectively; and for Epidermophyton floccosum they were 0.02 microg ml(-1) and 0.04 microg ml(-1) respectively. The MIC range of amorolfine against Candida parapsilosis was 0.5-16 microg ml(-1). MIC(50) and MIC(90) for C. parapsilosis were 0.5 and 2 microg ml(-1). MIC ranges of amorolfine against Scopulariopsis spp. and Acremonium spp. were 0.5-4 and 2-8 microg ml(-1), respectively. Candida albicans, Fusarium solani and Aspergillus flavus required relatively higher concentrations of amorolfine to inhibit their growth (MIC 0.125-64 microg ml(-1), MIC(50) and MIC(90) were 4 and 64 microg ml(-1)). The results demonstrated that amorolfine is the only topical agent that has such a potent antifungal activity and a broad spectrum against a wide range of pathogenic fungi.

Anti-HIV triterpene acids from Geum japonicum.

The methanol extract from the whole plant of Geum japonicum was found to inhibit the human immunodeficiency virus (HIV-1) protease. Through bioassay-directed fractionation of the extract, a new triterpene acid along with five known triterpene acids, ursolic acid, epipomolic acid, maslinic acid, euscaphic acid, and tormentic acid, were isolated. The structure of the new compound was determined by spectral means including 1H-1H COSY, HMQC, HMBC, and NOE experiments to be 2 alpha, 19 alpha-dihydroxy-3-oxo-12-ursen-28-oic acid (1). Of these compounds, 1, ursolic acid, and maslinic acid showed potent inhibitory activity against HIV-1 protease.