Total Glucosides of Paeony Regulate Immune Imbalance Mediated by Dermal Mesenchymal Stem Cells in Psoriasis Mice.

OBJECTIVE: To investigate the therapeutic effects of total glucosides of paeony (TGP) on psoriasis based on the immunomodulatory effect of dermal mesenchymal stem cells (DMSCs). METHODS: A total of 30 male BALB/c mice were divided into 6 groups (n=5 in each) by a random number table method, including control, psoriasis model (model, 5% imiquimod cream 42 mg/d), low-, medium- and high-dose TGP (50, 100, and 200 mg/kg, L, M-, and H-TGP, respectively), and positive control group (2.5 mg/kg acitretin). After 14 days of continuous administration, the skin's histopathological changes, apoptosis, secretion of inflammatory cytokines, and proportion of regulatory T cells (Treg) and T helper cell 17 (Th17) were evaluated using hematoxylin-eosin (HE) staining, TdT-mediated dUTP nick end labeling staining, enzyme-linked immunosorbent assay, and flow cytometry, respectively. DMSCs were further isolated from the skin tissues of normal and psoriatic mice, and the cell morphology, phenotype, and cycle were observed. Furthermore, TGP was used to treat psoriatic DMSCs to analyze the effects on the DMSCs immune regulation. RESULTS: TGP alleviated skin pathological injury, reduced epidermis layer thickness, inhibited apoptosis, and regulated the secretion of inflammatory cytokines and the proportion of Treg and Th17 in the skin tissues of psoriatic mice (P<0.05 or P<0.01). There was no significant difference in cell morphology and phenotype between control and psoriatic DMSCs (P>0.05), however, more psoriatic DMSCs remained in G0/G1 phase compared with the normal DMSCs (P<0.01). TGP treatment of psoriatic DMSCs significantly increased cell viability, decreased apoptosis, relieved inflammatory response, and inhibited the expression of toll-like receptor 4 and P65 (P<0.05 or P<0.01). CONCLUSION: TGP may exert a good therapeutic effect on psoriasis by regulating the immune imbalance of DMSCs.

Enhanced Effect of Qing-Ying Decoction Concurrent with Secukinumab in the Treatment of Plaque Psoriasis.

Both Qing-Ying decoction (QYD), a Traditional Chinese Medicine (TCM), and secukinumab, a fully humanized anti-interleukin-17A monoclonal antibody, have been used to treat patients with plaque psoriasis. The combined application of TCM and biologics in the treatment of psoriasis, however, has not been investigated. We enrolled a total of 68 patients with plaque psoriasis in our prospective study, and randomly assigned them to either the study group (treated with secukinumab plus QYD), or the control group (treated with secukinumab alone). After 12- and 16-week treatment, the Psoriasis Area and Severity Index (PASI) score and the TCM score were significantly reduced in both the study and the control groups. However, the reduction in PASI and TCM scores was more significant in the study group than in the control group (12-week: PASI: 5.29 ± 0.27 vs 8.87 ± 0.38, respectively; P < .01; TCM: 5.83 ± 0.21 vs 12.39 ± 1.23, respectively; P < .01; 16-week: PASI score: 4.76 ± 0.18 vs 8.36 ± 0.31, respectively; TCM score: 4.98 ± 0.19 vs 11.27 ± 1.13, respectively; P < .01). The total treatment efficacy rate was significantly higher in the study group (97.1%) than the control group (76.5%; P = .012). The number of CD3+ and CD4+ T cells was increased, while the number of CD8+ T cells was decreased after treatment in both groups, with more significant changes in the study group (P < .01). QYD may enhance the therapeutic outcome of secukinumab in the treatment of plaque psoriasis by further suppressing chronic skin inflammation, as well as reducing adverse events and patients' psychological stress.

Efficacy and Safety of the Bushen-Shugan Method in Pregnancy Outcomes in Patients with Recurrent Miscarriage Complicated by Anxiety and Depression: A Prospective Randomized Trial.

Objective: This study aimed to investigate the effect of the Bushen-Shugan (BSSG) method on pregnancy outcomes, serum D-dimer (D-D), platelet aggregation rate, homocysteine (Hcy) and antithrombin III (AT-III) in patients with recurrent miscarriage complicated by anxiety and depression. Methods: From December 2016 to December 2019, 100 patients with recurrent miscarriage combined with anxiety and depression were enrolled in our study, and a prospective randomized trial was carried out. Patients were randomly assigned to either the control group or the BSSG group via the random number table method. Traditional Chinese medicine (TCM) syndrome scores, laboratory indicators and psychological changes were compared in the 2 groups before and after treatment. Results: After treatment, the primary, secondary and total TCM syndrome scores in the 2 groups were lower, and the scores in the BSSG group were significantly lower than in the control group. The clinical curative effect in the BSSG group was significantly higher (92% vs 76%) than in the control group. The levels of ß-HCG, P, E2 and AT-III in the 2 groups were higher, while levels of D-D, platelet aggregation rate and Hcy were lower than before treatment. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were lower after treatment in both groups, and the scores in the BSSG group were significantly lower than in the control group. Conclusions: The BSSG method may be worthy of consideration because it improves pregnancy outcomes in patients with recurrent miscarriage complicated by anxiety and depression.

The Curative Effect of Pregabalin in the Treatment of Postherpetic Neuralgia Analyzed by Deep Learning-Based Brain Resting-State Functional Magnetic Resonance Images.

This work aimed to investigate the brain resting-state functional magnetic resonance imaging (fMRI) technology based on the depth autoencoders algorithm and to evaluate the clinically curative effect of pregabalin in the treatment of postherpetic neuralgia (PHN). In this study, 40 patients with PHN were selected and rolled randomly into a treatment group and a control group (20 cases in each group). Then, a depth autoencoders algorithm was constructed and applied in the brain resting-state fMRI technology. The brains of 40 patients with PHN treated with pregabalin were scanned, and the time curve extracted from MRI images was convolved by linear drift removal bandpass filtering to reduce low-frequency drift and high-frequency noise, so the low-frequency amplitude was calculated. Based on the low-frequency amplitude method, the calculated low-frequency signal energy was eventually divided by the total power of the entire frequency band to obtain the low-frequency amplitude rate value. The amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (f-ALFF) before and after treatment were compared between the treatment group and the control group, and the visual analog scale (VAS) after treatment was also observed. After 4 weeks of taking the drug, the VAS scores of patients from the treatment group in the first week (6.5 ± 0.8 points), the second week (6.5 ± 0.8 points), the third week (3.1 ± 0.3 points), and the fourth week (2.3 ± 0.4 points) after treatment were lower steeply than the scores before treatment (8.3 ± 1.1 points) (P < 0.05). Resting-state fMRI images showed that the f-ALFF of the 4 brain areas in the treatment group was higher than that of the control group, mainly including the bilateral frontal lobes, bilateral parietal lobes, left parietal lobes, and right posterior cerebellar lobes. Besides, the f-ALFF of the 6 brain areas in the treatment group was lower than that of the control group, mainly including the right frontal lobe, right parietal lobe, right middle frontal gyrus, precuneus, left frontal lobe, and superior frontal gyrus. In conclusion, the resting-state fMRI technology based on the depth autoencoders algorithm could efficiently display the brain area characteristic changes of patients with PHN before and after treatment, thereby providing a reference for the diagnosis of the patient's condition.

Balneotherapy with Chinese herbal medicine prolongs the remission period in patients with psoriasis vulgaris.

This study aimed to evaluate whether the supplementary balneotherapy with Chinese herbal medicine (CHM) could facilitate the treatment of psoriasis vulgaris and thus be beneficial for long-term remission from the symptoms. Two hundred psoriasis vulgaris patients with moderate-to-severe plaque psoriasis from January 2013 to June 2014 were evenly divided into two groups: the consolidated therapy group (CTG) and unconsolidated therapy group (UTG); the remission period of the two groups was compared. There was no significant difference in Psoriasis Area Severity Index (PASI) score between the two groups at the beginning and the end of the treatment. However, the average remission time in CTG was 10.99 months, which was significantly longer than that of 7.94 months in UTG (P = .001). After a correction of age, course of disease, skin type as well as PASI baseline value using a COX model, we found that the risk of recurrence of psoriasis vulgaris in UTG was higher than that in the CTG (P < .001). No adverse reactions were discovered when combing the two treatments together. The combined treatment of CHM balneotherapy and narrowband ultraviolet B could significantly prolong the remission time in patients with psoriasis vulgaris.