Objective To investigate the criteria for assessing the clinical therapeutic effect of chronic urticaria in China.Methods The application of criteria for assessing the clinical therapeutic effect of chronic urticaria in China and their applicable scope were analyzed by frequency analysis and K-means clustering analysis, respectively.Results The criteria for assessing symptoms and therapeutic effect were different in the 857 papers included in this study. SSRI was used in 549 (64.17) out of the 857 papers included in this study.K-means clustering analysis showed that the applicable scope of SSRI with curative rate ( 100%≥SSRI>90%) , improvement rate ( 90%≥SSR<60%) , Significant effect rate (60%≥SSRI>20%) , and no response rate (20%≥SSR≥0%) as its criteria was wider than that of frequency analysis.Conclusion The criteria for the clinical assessment of chronic urticaria and its drug treatment effect should be unified and standardized.

Objective To evaluate effects of daily average temperature on the occurrence of urticaria in Lanzhou city,and to analyze differences in the effects between different populations.Methods Time-series data on daily outpatient visits for urticaria between January 1,2007 and December 31,2013 were collected from the First Hospital of Lanzhou University and Lanzhou University Second Hospital.Daily meteorological data during this peroid were obtained from the Gansu Meteorological Bureau.Distributed lag non-linear models were used to analyze the association between daily average temperature and occurrence of urticaria,and the analysis was stratified by age and gender.Results The association between daily average temperature and daily number of outpatient visits for urticaria was nonlinear.Low temperature had significant lag effects on the daily number of outpatient visits for urticaria,with the maximum relative risk (RR) value (1.014 [95％ CI 1.000-1.023]) observed at 6 ℃ on lag day 18.Stratification analysis demonstrated that the effects of high temperature on the number of outpatient visits for urticaria were apparent on the day of exposure in age groups of 0-18 and 19-64 years,but decreased on the day of exposure in the age group ≥ 65 years.The effects of low temperature,which showed similar trends along with the increment of lag days in all groups,were relatively delayed and occurred 2 to 4 days after exposure.Conclusions Air temperature affects the occurrence of urticaria in Lanzhou city.Low temperature has evident lag effects on the occurrence of urticaria,while high temperature does not have.

Objective To evaluate effects of the daily average temperature on the daily number of outpatient visits for eczema in Lanzhou city.Methods Clinical data were obtained from outpatients with eczema in the Department of Dermatology of 2 third-grade class-A hospitals in Lanzhou city from January 1st 2007 to December 31st 2015,and meteorological data during this period were also collected.Controlling for confounding factors like long-term trends and day of the week,a distributed lag non-linear model (DLNM) fitted with quasi-Poisson link function was used to assess the effects of daily average temperature on the daily number of outpatient visits for eczema,and the analysis was stratified by season,age and gender.Results The exposure-response relationship between the daily average temperature and daily number of outpatient visits for eczema could be roughly described by a W-shaped curve.Stratification analysis showed that the effect of the daily average temperature on outpatient visits for eczema was strongest in autumn and winter,followed by summer,and weakest in spring.Low temperature may have lagged,cumulative and persistent effects on the daily number of outpatient visits for eczema,with the maximum relative risk (RR) value (1.12 [95％ CI:1.03-1.22]) observed at-9 ℃ on lag day 14.With a 1 ℃decrease in the temperature,16％ (RR =1.16,95％ CI:1.00-1.03),14％ (RR =1.14,95％ CI:1.02-1.26) and 13％ (RR =1.13,95％ CI:1.02-1.25) increases in the daily number of outpatient visits for eczema were observed in men,teenagers and middle-aged adults respectively (P ＜ 0.05).However,low temperature had no significant effects on outpatient visits for eczema among women or the elderly (P ＞0.05).The effect of high temperature usually occurred following exposure without lag periods,and was gradually weakened over lag time (P ＞ 0.05).Conclusions In Lanzhou,the effect of daily average temperature on outpatient visits for eczema was strongest in autumn and winter.Changes of the daily temperature may be one of risk factors for eczema.Low temperature had lagged effects on the daily number of outpatient visits for eczema,and the effects were strongest on lag day 14.

Objective To explore the role of peripheral blood CD4+CD25+CD127low Treg cells,interleukin-17A (IL-17A) and IL-27 in the pathogenesis of chronic spontaneous urticaria (CSU).Methods Peripheral blood samples were obtained from 37 patients with CSU (CSU group)and 40 healthy controls (control group).Flow cytometry was performed to determine the percentage of CD4+CD25+CD127low Treg cells in the peripheral blood,and enzyme-linked immunosorbent assay (ELISA) to detect the serum levels of IL-17A and IL-27.Results The percentage of CD4+CD25+CD127low Treg cells in the peripheral blood (5.99％ ± 2.72％ vs.9.07％ ± 3.44 ％,t =4.325,P ＜ 0.01) and the serum level of IL-27 (20.54 ± 7.65 ng/L vs.26.63 ± 9.72 ng/L,t =3.039,P =0.003) were both significantly lower in the CSU group than in the control group.However,there was no significant difference in the serum level of IL-17A between the 2 groups (P =0.529).Among the patients with CSU,the level of IL-17A was negatively correlated with the percentage of CD4+CD25+CD127low Treg cells (r =-0.359,P =0.029),while the urticaria activity score (UAS) was uncorrelated with the levels of IL-17A and IL-27 as well as the percentage of CD4+CD25+ CD127low Treg cells (r =-0.076,-0.083,-0.053 respectively,all P ＞ 0.05).Conclusion There may be Th17/Treg imbalance in the peripheral blood of patients with CSU,and IL-27 may be involved in the occurrence of CSU.

Objective To evaluate the effect of penehyclidine hydrochloride on the expression of airway mucin 5AC(MUC5AC)during ventilator-induced lung injury(VILI)and the relationship with Toll-like receptor 4/myeloid differentiation factor 88(TLR4/MyD88)signaling pathway in rats.Methods Thir-ty-six clean-grade healthy male Sprague-Dawley rats,aged 6-8 weeks,weighing 200-250 g,were divided into 3 groups(n＝12 each)using a random number table method: sham operation group(group S),VILI group(group VILI),and penehyclidine hydrochloride group(group P).The rats were tracheotomized in group S.The rats were tracheotomized,connected to a small animal ventilator and mechanically ventilated for 4 h with the tidal volume of 20 ml/kg,respiratory rate 80 breaths/min,inspiratory/expiratory ratio 1 ∶1,and inspired oxygen fraction ratio 21％in VILI and P groups.At 30 min before mechanical ventilation,penehyclidine hydrochloride 2 mg/kg was injected via the tail vein in group P,and the equal volume of nor-mal saline was given instead in S and VILI groups.At 4 h of mechanical ventilation,the arterial blood sam-ples were taken for measurement of PaO2.The rats were then sacrificed,and broncho-alveolar lavage fluid(BALF)was collected for determination of interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)concentrations by enzyme-linked immunosorbent assay.The lung specimens were collected for calculation of the wet/dry weight ratio(W/D ratio),for examination of pathological changes which were scored after haematoxylin and eosin staining(under a light microscope),and for determination of the ex-pression of MUC5AC(by immunohistochemistry),expression of TLR4,MyD88,p38 mitogen-activated protein kinase(p38MAPK)and nuclear factor-kappa B(NF-κB)in lung tissues(by Western blot),and expression of MUC5AC mRNA in lung tissues(by real-time polymerase chain reaction).Results Com-pared with group S,PaO2 was significantly decreased,the W/D ratio and lung injury score were increased,the expression of MUC5AC protein and mRNA was up-regulated,the concentrations of IL-1β,IL-6 and TNF-α in BALF were increased,and the expression of TLR4,p38MAPK,MyD88 and NF-κB was up-reg-ulated in VILI and P groups(P＜0.01).Compared with group VILI,PaO2 was significantly increased,the W/D ratio and lung injury score were decreased,the expression of MUC5AC protein and mRNA was down-regulated,the concentrations of IL-1β,IL-6 and TNF-α in BALF were decreased,and the expression of TLR4,p38MAPK,MyD88 and NF-κB was down-regulated in group P(P＜0.05).Conclusion Penehy-clidine hydrochloride can decrease the expression of airway MUC5AC during VILI,and the mechanism may be related to inhibiting activation of TLR4/MyD88 signaling pathway in rats.

Objective To analyze the correlation between air pollutants and pediatric atopic dermatitis outpatient visits in Lanzhou,and provide scientific insights for the life guidance of the affected children and dis-ease prevention by relevant departments.Methods A generalized additive model was employed to analyze the effects and lagged effects of air pollutants on pediatric atopic dermatitis outpatient visits in Lanzhou while control-ling for confounding factors such as long-term trends,holiday effects,day of the week effects and meteorological factors.Results The effects of NO2,PM2.5,PM10,and SO2 on pediatric atopic dermatitis outpatient visits were most significant on the current day(Lag0),but were not statistically significant(all P＞0.05);CO also had the most significant effect on Lag0,and for every 10 μg/m3 increase in its concentration,the excess risk(ER)for pediatric atopic dermatitis outpatient visits was 0.05％(95％CI=0-0.10％,P=0.049);and O3 exhibi-ted the most significant effect on day 7 of the cumulative lag(Lag07),with a statistically significant increase in the ER for each 10 μg/m3 increase in its concentration of 7.40％(95％CI=5.31％-9.53％,P＜0.001)for pediatric atopic dermatitis outpatient visits.Age stratification showed that children aged 0-3 years with atopic dermatitis were the most sensitive to CO,with an increased ER of 0.09％(95％CI=0.04％-0.15％,P＜0.001)for every 10 μg/m3 increase in concentration,and children aged 7-14 years with atopic dermatitis were the most sensitive to O3,with an increased ER of 8.26％(95％CI=4.99％-11.64％,P＜0.001)for every 10 μg/m3 increase in concentration.Seasonal stratification showed that CO exerted a stronger effect on pediatric atopic dermatitis outpatient visits in summer and fall,with ER values of 0.45％and 0.16％(both P＜0.001),respectively,while O3 had a significant effect on outpatient visits in winter,with an ER value of 20.48％(P＜0.001).Conclusion Elevated daily average concentrations of air pollutants CO and O3 in Lanzhou were posi-tively correlated with the number of outpatient visits for atopic dermatitis in children,with significant seasonal effects and age-stratified sensitivities.

Background::Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection.Methods::A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2.Results::Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685–11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068–2.343), traditional systemic (adjusted OR = 1.887, 95% CI= 1.263–2.818), and nonsystemic treatment (adjusted OR= 1.602, 95% CI= 1.117–2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680–1.274, compared to no treatment), according to multivariable logistic regression analysis. Conclusions::A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension.

Objective: To evaluate the effect of penehyclidine hydrochloride on the expression of airway mucin 5AC (MUC5AC) during ventilator-induced lung injury (VILI) and the relationship with Toll-like receptor 4/myeloid differentiation factor 88 (TLR4/MyD88) signaling pathway in rats. Methods: Thirty-six clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 3 groups (n=12 each) using a random number table method: sham operation group (group S), VILI group (group VILI), and penehyclidine hydrochloride group (group P). The rats were tracheotomized in group S. The rats were tracheotomized, connected to a small animal ventilator and mechanically ventilated for 4 h with the tidal volume of 20 ml/kg, respiratory rate 80 breaths/min, inspiratory/expiratory ratio 1∶1, and inspired oxygen fraction ratio 21% in VILI and P groups.At 30 min before mechanical ventilation, penehyclidine hydrochloride 2 mg/kg was injected via the tail vein in group P, and the equal volume of normal saline was given instead in S and VILI groups.At 4 h of mechanical ventilation, the arterial blood samples were taken for measurement of PaO₂.The rats were then sacrificed, and broncho-alveolar lavage fluid (BALF) was collected for determination of interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) concentrations by enzyme-linked immunosorbent assay.The lung specimens were collected for calculation of the wet/dry weight ratio (W/D ratio), for examination of pathological changes which were scored after haematoxylin and eosin staining (under a light microscope), and for determination of the expression of MUC5AC (by immunohistochemistry), expression of TLR4, MyD88, p38 mitogen-activated protein kinase (p38MAPK) and nuclear factor-kappa B (NF-κB) in lung tissues (by Western blot), and expression of MUC5AC mRNA in lung tissues (by real-time polymerase chain reaction). Results: Compared with group S, PaO₂ was significantly decreased, the W/D ratio and lung injury score were increased, the expression of MUC5AC protein and mRNA was up-regulated, the concentrations of IL-1β, IL-6 and TNF-α in BALF were increased, and the expression of TLR4, p38MAPK, MyD88 and NF-κB was up-regulated in VILI and P groups (P<0.01). Compared with group VILI, PaO₂ was significantly increased, the W/D ratio and lung injury score were decreased, the expression of MUC5AC protein and mRNA was down-regulated, the concentrations of IL-1β, IL-6 and TNF-α in BALF were decreased, and the expression of TLR4, p38MAPK, MyD88 and NF-κB was down-regulated in group P (P<0.05). Conclusion Penehyclidine hydrochloride can decrease the expression of airway MUC5AC during VILI, and the mechanism may be related to inhibiting activation of TLR4/MyD88 signaling pathway in rats.