Clinical analysis of 1 057 patients with critical illnesses in a dermatological ward / 中华皮肤科杂志

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.

Effects and mechanism of apolipoprotein A5 on adipogenic differentiation of human adipose-derived mesenchymal stem cells / 中华心血管病杂志

Objective@#To investigate the effect and related mechanism of apolipoprotein A5 (ApoA5) on adipogenic differentiation of human adipose-derived mesenchymal stem cells (AMSC).@*Methods@#Subcutaneous adipose tissue was obtained from 40 patients undergoing abdominal surgery at our hospital from February to July 2015. After induction of human AMSC by collagenase digestion, the adipose tissue was induced to differentiate into mature adipocytes and treated with ApoA5 at 600 and 1 200 ng/ml, respectively (ApoA5 intervention groups). Cells treated without ApoA5 protein were used as control group. The cells were harvested on the 7th and 14th day of differentiation, and the following assays were performed: (1) the effect of ApoA5 on TG content was measured by a TG assay kit; (2) RT-qPCR assay was used to detect the effect of ApoA5 on aP2 and FAS mRNA expression; (3) the effect of ApoA5 on the expression of CIDEC mRNA and protein was detected by RT-qPCR and Western blot; (4) the effect of ApoA5 on the expression of C/EBPβ mRNA and protein was detected by RT-qPCR and Western blot; (5) using lentiviral transfection technique, we overexpressed the gene of CIDEC in AMSC and cells were divided into lentiviral negative control group, lentiviral over-expressed CIDEC group and lentiviral over-expressed CIDEC+ApoA5 intervention group (the ApoA5 intervention concentration was 1 200 ng/ml). Thereby, we examined the effect of ApoA5 on the above indicators in adipogenic differentiation of AMSC in the case of CIDEC overexpression.@*Results@#(1) Effect of ApoA5 on TG content in AMSC: on the 7th and 14th day after the intervention, the TG levels were lower in ApoA5 600 and 1 200 ng/ml group AMSC than those in the control group (all P<0.05). (2) The effect of ApoA5 on the expression of aP2 and FAS mRNA in AMSC: on the 7th day after intervention, the expression levels of aP2 and FAS mRNA were significantly lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). On the 14th day after intervention, the expression levels of aP2 and FAS mRNA were lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). (3) The effect of ApoA5 on the mRNA and protein expression of CIDEC in AMSC: on the 7th day after intervention, the mRNA and relative protein expression levels of CIDEC were significantly lower in AMSC of ApoA5 600 and 1 200 ng/ml group than those of the control group (all P<0.05). On the 14th day after intervention, the mRNA and relative protein levels of CIDEC were further reduced in ApoA5 600 and 1 200 ng/ml AMSC groups than those in the control group (all P<0.05). (4) The effect of ApoA5 on C/EBPβ mRNA and protein expression in AMSC: on the 7th day after intervention, C/EBPβ mRNA and relative protein expression levels were significantly lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). On the 14th day after intervention, the levels of C/EBPβ mRNA and relative protein were lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). (5) The effect of ApoA5 on the content of TG in AMSC after CIDEC overexpression: on the 7th and 14th day after intervention, the TG contents in AMSC were higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (both P<0.05). However, TG contents in AMSC were similar between the over-expressed CIDEC group and the CIDEC+ApoA5 over-expression group (both P>0.05). (6) The effect of ApoA5 on the expression of aP2 and FAS mRNA in AMSC after CIDEC overexpression: on the 7th day after intervention, the expression levels of aP2 and FAS mRNA in AMSC were higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (both P<0.05). On the 14th day after intervention, the expression level of aP2 mRNA in the AMSC was higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (P<0.05). On the 7th and 14th day after intervention, the expression levels of aP2 and FAS mRNA in AMSC were similar between the lentivirus over-expressed CIDEC group and the lentivirus over-expressed CIDEC+ApoA5 group (all P>0.05). (7) The effect of ApoA5 on the expression of C/EBPβ mRNA and protein in AMSC after CIDEC overexpression: on the 7th day after intervention, the mRNA and relative protein expressions of C/EBPβ in AMSC were higher in lentivirus-overexpressed CIDEC group than in lentivirus negative control group (both P <0.05). On the 14th day after intervention, C/EBPβ mRNA and protein expression levels in AMSC were higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (both P<0.05). On the 7th and 14th day after intervention, the expressions of C/EBPβ mRNA and protein in AMSC were similar between lentivirus over-expressed CIDEC group and lentivirus over-expression CIDEC+ApoA5 intervention group (all P>0.05).@*Conclusions@#ApoA5 can inhibit the adipogenic differentiation of AMSC,and this effect may be mediated by down-regulating the expression of CIDEC. Furthermore, our results indicate that CIDEC could be considered as a key factor in adipogenic differentiation.

Th17 cells and psoriasis / 中国医师杂志

Psoriasis is a common autoimmune disease and mainly affects skin,joints,or both.Psoriasis is also a chronic relapsing disorder that can cause physical and psychological burdens to patients.Currently it is widely accepted that the immune system is involved in the development of psoriasis.Th17 cells,a subtype of CD4 +T lymphocytes,are characterized by its ability to secrete proinflammatory cytokine IL-17.Recent studies indicate that Th17 cells play a predominant role in the pathogenesis of psoriasis and other immune-mediated inflammatory diseases.Moreover,targeted therapies have been developed and approved for the treatment of moderate-to-severe plaque psoriasis or psoriatic arthritis.This review summarizes the role of Th17 cells in the pathogenesis of psoriasis and several therapeutic biologics targeting this pathway in psoriasis.

Effect of 1, 25(OH)2D3 on the proliferative ability of and methylation levels of genomic DNA and proliferation-associated gene promoter in human HaCaT keratinocytes / 中华皮肤科杂志

Objective To estimate the influence of 1,25(OH)2D3 on the proliferative ability of and methylation levels of genomic DNA and proliferation-associated gene promoter in human HaCaT keratinocytes.Methods Some cultured HaCaT cells were treated with 1,25 (OH)2D3 of 10-6,10-7 and 10-8 mol/L for 24 hours,then,methyl thiazolyl tetrazolium (MTT) assay was carried out to evaluate the proliferative activity of cells,and a global DNA methylation quantification kit was used to determine the global DNA methylation level.Real-time PCR was conducted to quantify the mRNA expression of DNA methyl transferases (DNMTs) and methyl-DNA binding domain (MBD) proteins,and methylation-specific PCR (MS-PCR) to evaluate the methylation status of promoter region in the programmed cell death 5 (PDCD5) and tissue inhibitor of metalloproteinase 2 (TIMP2) genes,in HaCaT cells after 24-hour treatment with 1,25 (OH)2D3 of 10-6 mol/L.The HaCaT cells receiving no treatment served as the control.Results Compared with the untreated HaCaT cells,those treated with 1,25(OH)2D3 of 10-6 mol/L showed significantly down-regulated proliferative activity (0.152 ± 0.027 vs.0.290 ± 0.017,P ＜ 0.01),global DNA methylation level (0.187 ± 0.071 vs.0.316 ± 0.049,P ＜ 0.05),DNMT3a and DNMT3b mRNA expression levels (P ＜ 0.01 or 0.05),but markedly upregulated mRNA expression levels of MECP2,MBD2,PDCD5 and TIMP2 (P ＜ 0.01 or 0.05).Moreover,the DNA methylation levels within the promoter region of PDCD5 and TIMP2 genes were significantly lower in HaCaT cells treated with 1,25 (OH)2D3 of 10-6 mol/L than in the control cells (0.38 ± 0.135 vs.0.72 ± 0.121,0.46 ± 0.172 vs.0.68 ± 0.133,both P＜ 0.05).Conclusions 1,25(OH)2D3 may down-regulate the global genomic DNA methylation level of,and modulate the expression of DNA methylationmodifying genes in,HaCaT cells.Furthermore,1,25 (OH)2D3 can decrease the promoter methylation levels but induce the overexpression of PDCD5 and TIMP2 genes,and decelerate the proliferation of HaCaT cells.

RUNX3 gene methylation in a cutaneous malignant melanoma cell line A375 / 中华皮肤科杂志

Objective To investigate the relationship between the methylation of CpG island of RUNX3 gene promoter and its expression in a human cutaneous malignant melanoma cell line A375, and to assess the role of RUNX3 gene methylation in the pathogenesis of human cutaneous malignant melanoma. Methods Cultured A375 cells were treated with various concentrations (0, 1, 5, 10, 20 μmol/l) of 5-azacyti-dine for 24 or 72 hours followed by another 5 days of culture. Then, methylation-specific PCR (MSP) was performed to evaluate the methylation status of RUNX3 promoter region, and Western-blot analysis to detect the protein expression of RUNX3 in A375 cells. Results The RUNX3 gene promoter region was hypermethylated in untreated A375 cells, along with the absence of protein expression of RUNX3. However, after the treatment with 5-azacytidine, the promoter region of RUNX3 gene was demethylated partly, and the expression of RUNX3 protein was restored in A375 cells. Further, the expression intensity was directly correlated with the concentration of 5-azacytidine. Conclusions The promoter hypermethylation of RUNX3 gene may be related to the silencing of RUNX3 gene expression in A375 cells, whereas 5-azacytidine can cause the demethylation of RUNX3 gene, reactivate the gene which has been inactivated by the promoter hypermethylation, and finally induce the re-expression of RUNX3 protein.

Effect of phorbol-12-myristate-13-acetate on cyclooxygenase-2 expression in human HaCaT keratinocytes / 中华皮肤科杂志

Objective To investigate the effect of phorbol-12-myristate-13-acetate(PMA)on cyclooxygenase-2(COX-2) mRNA and protein expression in cultured human HaCaT keratinocytes,and the mechanism for cytotoxity of PMA against keratinocytes.MethodsRT-PCR and Westem blot were utilized to detect the expression of COX-2 mRNA and protein in cultured HaCaT ells at 24 hours after the treatment with various concentrations of PMA (0.1,1.0,10 mg/L).ResultsWithout any treatment,there was no or a weak expression df COX-2 mRNA and protein in HaCaT cells;incubation witll PMA resulted in the induction of the expression of COX-2 in HaCaT cells.The expression levels of COX-2 mRNA and protein in 10 mg/L PMA-pretreated HaCaT cells were significantly higher than those in 1.0 mg/L PMA-pretreated HaCaT cells,which was in turn higher than that in 0.1 mg/L PMA-pretreated cells and untreated cells;the difrerence was statistically significant (all P＜0.01).Conclusion These results suggest that PMA may be involved in keratinocyte tumorigenesis by upregulating he expression of COX-2 as well as synthesis and release of prostaglandin in keratinocytes.

Expression and methylation status of IL-13 receptor α1 gene in peripheral T lymphocytes of patients with systemic lupus erythematosus / 中华皮肤科杂志

Objective To investigate the mRNA expression and methylation status of IL-13 receptor(IL-13R)α1 gene in peripheral T lymphocytes of patients with systemic lupus erythematosus(SLE).Methods Venous blood samples were obtained from 10 SLE patients(5 in active phase,5 in inactive phase)and 6 normal human controls.CD4+ and CD8+ T cells were isolated from these samples via magnetic activated cell sorting(MACS).Real-time quantitative PCR was used to test the mRNA expression of IL-13Rα1 gene,and methylation specific PCR to detect the methylation status.Results The expression level of IL-13Rα1 mRNA was 2.224±0.251,1.712±0.132.and 1.104±0.044 in CD4+ T cells of active SLE patients,inactive SLE patients and controls,respectively;the difference between the three groups was statistically significant(all P＜0.05).The expression level of IL-13Rα1 mRNA in CD8+T cells was significantly higher in active SLE patients than that in the normal controls(1.672±0.142 vs 1.238±0.106,P＜0.05),while no difference was noted between inactive and active SLE patients or normal controls.The methylation index of IL-13Rα1 gene was 0.454±0.023.0.635±0.065.0.844±0.097 in CD4+T cells of active SLE patients,inactive SLE patients and normal controls,respectively,and the difference between the three groups was significant(all P＜0.05),while no significant difference was observed in the methylation index in CD8+T cells among these groups(P＞0.05).The IL-13Rα1 mRNA expression in CD4+T and CD8+T cells was positively correlated with SLE disease activity index(SLEDAI)score(r=0.79,0.76,P=0.007,0.02 respectively).A negative correlation was found between the methylation level Of IL-13Rα1 in CD4+T cells and SLEDAI score(r=-0.89.P＜0.0 1).as well as between the IL-13Rα1 mRNA expression and its methylation level(r=-0.84,P＜0.0 1).Conclusion The development of SLE may be related to the overexpression of IL-13Rα1 gene induced by DNA hypomethylation in T cells.

Combined high-dose intravenous immunoglobulin in the management of severe systemic lupus erythematosus / 中华皮肤科杂志

Objective To investigate the efficacy of combined high-dose intravenous immunoglobulin (IVIG) pulse therapy in patients with severe systemic lupus erythematosus (SLE). Methods Thirty-six patients were enrolled into this study, and randomly classified into WIG group (n=17) and methylprednisolone (MP) group (n=19). The treatment of patients in MG group began with a 3-day intravenous MP followed by intravenous WIG 400 mg per kilogram of body weight per day for 3-5 days, then was switched to oral prcdnisone and cyclophosphamide at routine dose. Intravenous MG was given repeatedly with an interval of 1 month for 2-5 sessions. Patients in MP group were treated with the same corticosteroids and immunosuppressants as used in WIG group but without IVIG. Patients were followed up for 3-12 months.The clinical efficacy, related serum parameters, and systemic lupus activity measurement (SLAM) were evaluated and compared between the two groups. Results Most patients in both groups showed a remission of symptoms and reduction in disease activity after treatment. The decrease in SLAM, positivity rates of antinuclear antibodies and anti-double-stranded DNA (anti-dsDNA) antibodies as well as the increase in platelets were faster in IVIG group than those in MP group (all P<0.05), but the long-term efficacy of the two groups was similar (P>0.05). Infections occurred in 11.8% of patients in WIG group and 36.8% of patients in MP group. Conclusions High-dose intravenous immunoglobulin may serve as an effective aid in the treatment of severe SLE, and is particularly beneficial to patients resistant to corticosteroids and immunosuppressants of routine dose and those accompanied by severe infections and intolerable to high dose of corticosteroids and immunosuppressants.

Effect of hydrogen sulfide on myocardial structure and function of rats with adriamycin-induced dilated cardiomyopathy / 基础医学与临床

Objective This study was designed to investigate the importance of H2S in rats with adriamycin-induced dilated cardiomyopathy.Methods Weight-matched adult male Wistar rats were randomly divided into 5 groups as follows:(1)the ADR group(n=12)where adriamycin(2.5 mg/kg)was given once a week;(2)ADR + small-dose NaHS group(n=12)where NaHS solution [2.8 ?mol/(kg?d)] was given;(3)ADR+large-dose NaHS group(n=12)where NaHS solution [14 ?mol/(kg?d)] was given;(4)the control group(n=9)where physiological saline was administered instead of adriamycin.(5)NaHS group(n=9)where NaHS solution [14 ?mol/(kg?d)]was given.Hemodynamic and echocardiographic measurements were carried out after treatment.Histological examination was implemented at the 10th week after the rats were sacrificed.Meanwhile,H2S concentrations in serum and myocardial tissues were evaluated by modified sulfide electrode method.Results The heart function of ADR rats decreased obviously.Pathological examination demonstrated that characteristics consistentwith cardiomyopathy were found in ADR group.H2S concentrations in serum and myocardial tissues of the rats in ADR group were both significantly decreased as compared with those in the control group(both P

Test of Urogenital Tract Infection With Chlamydiae Trachomatis and Mycoplasm and Drug Susceptibility Analysis in 5095 Cases / 中国医师杂志

Objective To investigate the infection of chlamydiae trachomahs(CT) and myoplasmas in urogenital tract and antibiotic susceptibility of cultured genital myoplasmas.Methods 5095 patients with urogenital tract infection were detected with mycoplasma identification susceptibility testing reagent kit,and the drug susceptibility to eight antibiotics of ureaplasma urealyticum (Uu) and mycoplasm hominid (Mh) were tested by broth microdilution method.And chlamydiae trachomatis was examined by golden standard method.Results In 5095 cases, 417cases(8 2%) were infected with chlamydiae trachomatis, and the infective rate in woman(11 2%) was statistically higher than that in man(6 2%). 1728 cases(33 9%) were infected with mycoplasma, and the infective rate in woman(43 0%) was statistically higher than that in man(28 0%).The cases infected with simple UU(1251,24 6%) were more than that in the cases infected with simple Mh(71,1 4%) and the mixed infected cases(406,8 0%). Drug sensitivity to erythromycin, roxithromycin, josamycin, azithromycin, doxycycline, minocin,ofloxacin, ciprofloxacin in Uu infection were 60 3%,67 5%,73 2%,85 3%,55 7%,40 1%,25 6%,2 7%,respectively;while the mixed infection of Mh and Uu had resistance to the eight antibiotics on the different degree.Conclusions The infective rate of chlamydiae trachomatis and myoplasma in urogential tract and the resistance rates to 8 antibiotics in Hunan province were in a higher level, compared with other area inland. It is necessary to develop antibiotic susceptibility test,in addition to the myoplasma culture for guiding the clinical therapy.

Effect of hydrogen sulfide donor on oxidative stress of myocardium in adriamycin-induced dilated cardiomyopathy rats / 中国病理生理杂志

AIM:To investigate the effect of hydrogen sulfide(H2S)donor(NAHS)on oxidative stress of adriamycin-induced dilated cardiomyopathy rats.METHODS:Weight-matched adult male Wistar rats were randomly divided into 5 groups as follows:(1)ADR group(n=12),in which 2.5 mg/kg of adriamycin was injected intraperitoneally once a week for 10 weeks(total dose of 25 mg/kg).(2)ADR+small-dose NaHS group(n=12),in which the dosage and the use of adriamycin were as mentioned above,while NaHS solution was injected to rats at a dosage of 2.8 ?mol?kg-1?d-1 at the same time.(3)ADR + large-dose NaHS group(n=12),in which the dosage and the use of adriamycin were as mentioned above,while NaHS solution was injected to rats at a dosage of 14 ?mol?kg-1?d-1 at the same time.(4)Control group(n=9),in which an equivalent volume of physiological saline was administered weekly for a total of 10 weeks.(5)NaHS group(n=9),in which 14 ?mol/kg of NaHS solution was injected to rats intraperitonealy once a week for 10 weeks.Hemodynamic and echocardiographic measurements were obtained 10 weeks after the treatment.Meanwhile,H2S and malondialdehyde(MDA)concentrations,the activities of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in serum and myocardial tissues were evaluated,respectively.RESULTS:The cardiac functions in the group of ADR rats depressed obviously.H2S concentrations,SOD and GSH-Px activities in serum and myocardial tissues of ADR group rats were all significantly decreased as compared with those in the control group(P

Protective effects of the scallop skirt-glycosaminoglycan on the vascular endothelial cells damaged by oxygen free radicals / 中国海洋药物

Objective To investigate the protective effects of the scallop skirt glycosaminoglycan (SS-GAG) in vitro on the endothelial cell damaged by oxygen free radical and the mechanism of its anti-atherosclerotic effects. Methods The endothelial cells of human umbilical vein (HUVEC)were cultured in vitro, and the damage model of endothelial cells was established by oxygen free radicals . After the damage of HUVEC by Fenton reaction, the effects of SS-GAG on the proliferative activity of HUVEC were observed by the methods of MTT chroma-tometry ,the influence of SS-GAG on lactate dehydrogenase (LDH) release was studied by chromatometry and the effects of SS-GAG on secretion of endothelins and angiotensin Ⅱ were observed by the methods of radio-immunity. Results Compared with the control group, proliferation activity of damage group cell lowered obviously ,LDH release in culture media,and the excretion of endothelins and angiotensin Ⅱ in HUVEC rised obviously. In the groups pre-treated with SS-GAG, cell proliferation activity, the LDH release and the excretions of ET and Ang Ⅱ showed obvious differences compared with model group. Conclusion SS-GAG reduce the damage of endothelial cell caused by oxygen free radicals, restrain the secretion ofendothelins and angiotensin Ⅱ . These results indicate that SS-GAG has protective effects on the endothelial cells damaged by oxygen free redicals and the anti-atherosclerotic mechanism of SS-GAG was related to its protective effects on the endothelial cells.

The effect of RNA interference on the expression of CTGF in skin fibroblasts of systemic sclerosis / 中华皮肤科杂志

Objective To study the effect of RNA interference on the expression of CTGF in skin fibroblasts of systemic sclerosis(SS). Methods Four CTGF specific siRNAs and a negative control siRNA were designed and then synthesized by in vitro transcription. siRNAs labeled with carboxyfluorescein-6-succimidyl ester (FAM) were transiently transfected into SS skin fibroblasts. Forty-eight hours after the fibroblasts were treated with siRNAs, the mRNA and protein expression of CTGF was detected by semiquantitative RT-PCR and Western blot analysis, respectively. Results The mRNA and protein expression of CTGF in fibroblasts was significantly down-regulated by 4 and 3 CTGF specific siRNAs (both P