To explore the clinical effect of ganglioside sodium in the treatment of acute cerebral infarction and its influ-ence on hs-CRP and TNF-α in serum. Methods:A total of 216 patients with acute cerebral infarction were randomly divided into the observation group and the control group. The control group (108 cases) was given regular treatment, and the observation group (108 cases) was given 100 mg ganglioside in 250 ml 0. 9% sodium chloride, ivd, qd additionally, and the treatment course was 14d. The clinical effect of the two groups was compared, and the change of hs-CRP and TNF-αin serum was also researched in both groups. Re-sults:The total effective rate of the observation group was 90. 7%, which was obviously higher than that of the control group (71. 3%, P<0. 05). After the treatment, the NDS score of the observation group was lower than that before the treatment, while the ADL score was higher than that before the treatment (P<0. 05). After the treatment, the level of hs-CRP and TNF-α in serum was higher than that before the treatment in the two groups (P<0. 05), and that in the observation group was higher than that in the control group (P<0. 05). During the treatment, no adverse reaction was shown in the two groups. Conclusion:The clinical effect of ganglioside sodi-um in the treatment of acute cerebral infarction is promising, which can reduce the level of hs-CRP and TNF-αin serum of the patients and improve the scores of NDS and ADL with good safety, and is worthy of further clinical application.

Objective To evaluate the relationship of serum levels of interleukin (IL)-36α,IL-36β and IL-36γas well as their receptor antagonist IL-36Ra with disease severity in patients with psoriasis.Methods Venous blood samples were collected from 45 patients with generalized pustular psoriasis (GPP),34 patients with psoriasis vulgaris (PV),and 37 healthy human controls.Enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum levels of IL-36α,IL-36β,IL-36γ and IL-36Ra.Nonparametric Mann-Whitney test was conducted to compare the levels of IL-36 and IL-36Ra among these groups,and Spearman's rank correlation analysis to assess the relationship between the serum levels of IL-36 and IL-36Ra and disease severity.Results No statistical difference was observed in the serum levels of IL-36 or IL-36Ra among the patients with GPP,patients with PV,and healthy human controls.The serum levels of IL-36β and IL-36γ (given as the median ± interquartile range) were significantly higher in 27 patients with GPP during episodes of pustules ((12.101 ± 11.315) ng/L and (34.541 ± 15.580) ng/L respectively) and in 7 patients with severe GPP ((11.218 ± 9.318) ng/L and (38.536 ± 17.332) ng/L respectively) than in the healthy human controls ((5.355 ± 9.020) ng/L and (23.052 ± 22.410) ng/L respectively,P ＜ 0.05 or 0.01).The serum level of IL-36γwas positively correlated with that of IL-36β in patients with GPP,patients with PV,and the healthy human controls (r =0.85,0.86,0.91,respectively,all P ＜ 0.01),and both IL-36β and IL-36γserum levels were lowly and positively correlated with the severity of GPP (r =0.33,0.41,respectively,both P ＜ 0.05).A positive correlation was also observed between the serum level of IL-36β and psoriasis area and severity index (PASI) scores in patients with PV (r =0.54,P ＜ 0.01).Conclusions The serum levels of IL-363 and IL-36γ are lowly and positively correlated with disease severity in patients with GPP,suggesting that IL-36β and IL-36γplay an important role in the pathogenesis of GPP.

Objective To analyze the clinical characteristics and treatment of acne inversa.Methods Seventeen outpatients with acne inversa were collected in the Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College from January l,2012 to December 31,2012.The general condition,clinical feature and treatment of these patients were retrospectively analyzed.Results All the patients were male with the age at onset being about 20 years and disease duration varying from 2 to 50 years.Characteristic clinical manifestations were recurrent tender inflammatory papules,nodules,abscesses,fistulae and sinus tracts in the neck,axillary fossa,groin,perineum and buttocks.Among these patients,10 had a family history and seven were sporadic with mild symptoms.Oral tretinoin combined with antibiotics were the main treatment,and surgical treatment was usually used for severe patients.Conclusions Acne inversa is mainly manifested as abscess,sinus and scars in areas bearing apocrine sweat glands,and therapeutic regimen should be selected according to the severity of lesions.

ObjectiveTo evaluate the efficacy and safety of bepotastine besilate in the treatment of chronic urticaria.MethodsA randomized,double-blind,parallel-controlled clinical study was conducted in 5 centers.Patients were randomly assigned to 2 groups to be treated with bepotastine besilate 20 mg or loratadine 10 mg once a day,respectively,for 4 weeks.Visits were scheduled before and after 1,2 and 4 weeks of treatment.Itching degree,number of wheals and diameter of the largest wheal were recorded for efficacy evaluation.ResultsTotally,240 patients were enrolled and 227 patients completed the study.The response rate was 74.6％ and 77.9％ respectively in bepotastine besilate- and loratadine-treated patients,respectively(P ＞0.05).No significant difference was observed in the incidence of adverse reactions between bepotastine besilate- and loratadine-treated patients(12.8％ vs.17.9％,P ＞ 0.05).The main side effects were mild to moderate drowsiness,dry mouth,dizziness.ConclusionBepotastine besilate is effective and safe for the treatment of chronic urticaria,with an efficacy and safety profile similar to that of loratadine.

Objective To evaluate the performance of anti-type Ⅶ collagen antibody detection using enzyme-linked immunosorbent assay (ELISA) in the auxiliary diagnosis of a case of epidermolysis bullosa acquisita (EBA),and to analyze its sensitivity and specificity for the diagnosis of EBA in large-scale studies by review of relevant literature.Methods Serum samples were collected from a patient with typical clinical,histological and immunological manifestations of EBA,4 healthy human controls,5 patients with bullous pemphigoid and 3 patients with pemphigus vulgaris.ELISA was performed to determine the serum levels of anti-type Ⅶ collagen antibodies.Literature regarding the diagnosis of EBA using ELISA was reviewed with a summary of inclusion criteria for patient enrollment,coating antigens,sensitivity and specificity.A comparison was carried out between ELISA and the other serological methods.Results Anti-type Ⅶ collagen antibodies were detected by ELISA in the serum of the patient with EBA (136 U/ml),but not in the other serum samples.The sensitivity and specificity of ELISA in the diagnosis of EBA differed in different studies,but in general,the accuracy of ELISA was higher than that of immunoblotting.Conclusion ELISA is a simple and convenient tool for the diagnosis of EBA with high accuracy.

A 55-year-old male patient presented with tense bullae on the extremities and trunk.Histological examination revealed subepidermal vesicles and superficial dermal infiltration of eosinophils and lymphocytes.The patient was primarily diagnosed with bullous pemphigoid.However,serum autoantibodies of the patient bound to the dermal side of salt-split skin,and no serum antibodies against BP180,BP230 or type Ⅶ collagen were detected by enzyme-linked immunosorbent assay.Hence,the diagnoses of bullous pemphigoid and epidermolysis bullosa acquisita were excluded.As Western blot and immunoprecipitation analysis showed,there existed antibodies capable of binding to a dermal antigen with a relative molecular mass of 200 000 in the serum of the patient.Based on the above findings,the patient was diagnosed as anti-laminin γ1 (p200) pemphigoid.

Objective To evaluate the reversal effect of a cholinergic receptor agonist on acantholysis in pemphigus,and to investigate its mechanism.Methods Human HaCaT keratinocytes were co-cultured with pemphigus vulgaris immunoglobulin G (PV-IgG) to establish a cell model of pemphigus,then classified into two groups to be incubated with the cholinergic receptor agonist carbachol for 12 hours (test group) or remain untreated (control group).Cell dissociation assay was performed to quantitatively estimate the reversal effect of carbachol on acantholysis,and immunofluorescence assay to qualitatively assess the changes of desmosomal proteins.Radio-immunoprecipitation assay (RIPA) lysis buffer and Triton X-100 were used to lyse HaCaT cells to obtain total proteins and cytoplasmic proteins,and Western blot was conducted to determine the expression levels of adhesion-related proteins desmoglein 3 (Dsg3) and plakoglobin (PG) on the surface of HaCaT cells,as well as the phosphorylation levels of p38 mitogen activated protein kinase (p38 MAPK) and epidermal growth factor receptor (EGFR) at different time points.Quantitative polymerase chain reaction (qPCR) was performed to detect the mRNA expressions of the above surface proteins,and coimmunoprecipitation assay to qualitatively evaluate the interaction between Dsg3 and PG.Results The number of cell debris was significantly lower in the test group than in the control group (18.67 ± 2.52 vs.46.67 ± 2.03,t =11.22,P＜0.01).Immunofluorescence assay showed that carbachol could reverse the internalization of desmosomal molecules induced by PV-IgG.In the pemphigus cell model,the levels of total Dsg3 and PG as well as non-desmosomal Dsg3 were decreased,while the level of non-desmosomal PG increased,and the interaction between Dsg3 and PG was attenuated.When the pemphigus cell model was co-cultured with carbachol,these above changes were reversed.Carbachol also increased the mRNA levels (expressed as 2-△△Ct) of Dsg3 and PG from 1.428 ± 0.215 and 1.563 ± 0.247 in the control group to 4.974 ± 0.948 (t =3.65,P =0.01) and 13.420 ± 1.715 (t =6.85,P ＜ 0.01) in the test group respectively.In phosphorylation assay,carbachol inhibited the phosphorylation of EGFR,but had no significant effect on that of p38 MAPK.Conclusions The cholinergic receptor agonist carbachol can reverse acantholysis in pemphigus,likely by inhibiting the internalization of Dsg3 and PG,enhancing their expressions and interaction,and suppressing the phosphorylation of the key signaling molecule for acantholysis,EGFR.

Objective To establish two nested PCR assays for detection of Trichomonas vaginalis in urine samples from male patients with urethritis,and to evaluate their diagnostic value.Methods One thousand and eighty-eight male patients with urethritis were enrolled from sexually transmitted disease (STD) clinic in the Hospital of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College between April 2011 and December 2013.Urethral swabs were collected followed by smear testing,wet mount microscopic examination of Trichomonas vaginalis,and cultivation of Neisseria gonorrhoeae.Urine specimens were also obtained from these patients followed by DNA extraction.Two nested PCR assays were developed and performed to amplify the repeat genomic sequence and β-tubulin gene of Trichomonas vaginalis.Results Trichomonas vaginalis was detected in none of these swab specimens by wet mount microscopy,but in 29 (2.67％) of the urine specimens by either of the two nested PCR assays.Moreover,the positive specimens detected by the two nested PCR assays were completely consistent.Conclusion Compared with wet mount microscopy,nested PCR has higher sensitivity and specificity in detection of Trichomonas vaginalis in urine samples from male patients.

Objective To analyze γ?secretase gene mutations in a pedigree with acne inversa. Methods Clinical data were collected from a pedigree with acne inversa, which contained 30 members spanning 4 generations. Of these members, 12 were affected by acne inversa, and 9 of the affected members were alive. Peripheral blood DNA was obtained from the proband, his seven relatives (including 4 affected and 3 unaffected members), and 100 unrelatedhealthy human controls. PCR was performed to amplify all the coding exons and their flanking sequences of the NCSTN, PSEN1, PSENEN, Aph1 genes followed by DNA sequencing. Results A heterozygous insertion mutation (c.229_230insCACC)of the PSENEN gene, which led to translational frameshifting and resulted in dysfunciton of the PSENEN protein, was detected in all the 5 patients, but not in unaffected members or healthy controls. Conclusion There is a novel heterozygous insertion mutation c.229_230insCACC in the PSENEN gene, which may be the molecular basis of acne inversa in this family.

Objective To investigate the feasibility of transplantation of mesenchymal stem cell (aisc) into expanion skin. Methods MSCs were isolated from porker's bone marrow and cultured in vitro. Pigs were randomly divided into four groups: Group A was injected with MSCs on the local expansion; Group B was injected with MSCs from ear vein; Group C was planted expander only; Group D was the contronl group. Each side of pig's spinal column was implanted with three expander in groups A, B and C. The same volume of NS was injected at the fixed time, the marked area measured after 7, 14, 28 days of expansion, the difference of those area was compared between groups. The differentiation of BM-MSC was detected by immunofluorescence. Results Flow-cytometric analysis showed that these BMSCs expressed CD90 and CD29 highly but did not express CD34 or CD45. The expansion area (cm2) of groups A, B, C and D was 34.05±0. 92, 31.83±l. 07,30. 10±0.79, and 18. 27±0.25, respectively (P＜0. 01). Immunofluorescence showed that the positive expression rate of CD31, PCNA in groups A and B was higher than that in groups C and D, in which the expression was the highest in group A. Conclusions Allogeneic transplantation of BM-MSC can promote skin expansion and the effect of local transplantation group is most significant.