Objective To study the clinical characteristics of generalized pustular psoriasis (GPP) and to compare the efficacy of different remedies. Methods A total of 84 patients with GPP collected from 1995 to 2004 were analysed according to the severity of the disease. Results The patients with a history of psoriasis vulgaris and those without the history of psoriasis vulgaris accounted for 50%, 50%, respectively. Of the GPP patients, 16.6% developed complications. A secondary infection occurred in partial patients. Clinically the outbreak of GPP was earlier in patients without the history of psoriasis than those with a history of psoriasis, which often occurred following corticosteroid therapy. Sudden withdrawal of corticosteroids was also an important inducing factor of GPP. Abnormal laboratory examination results included the decrease of hemoglobin and serum albumin, the increase of peripheral blood leucocytes and liver enzymes. Considering the efficacy and side effects, acitretin was the first choice for GPP; corticosteroids were unnecessary for severe GPP unless the acute symptom could not be controlled with other drugs. Conclusion It is suggested that appropriate drug therapy be chosen based on the disease severity after the diagnosis of GPP is established.

Objective To investigate the effect of acute hyperventilation on the cerebral function of dogs with acute intracranial hypertension.Methods A total of 16 dogs with acute epidural hematoma were randomly divided into four groups.Group A,the group control,were ventilated and PETCO2 was maintained at 35-45mmHg.Groups B,C and D were hyperventilated and PETCO2 was maintained at 28-35,20-27 and below 20mmHg,respectively,for 1h.Jugular vein blood was taken to determine S100B and CRP content at preoperation(T1),2h(T2) post-ventilation,6h(T3),12h(T4),24h(T5) and 48h(T6).Results S100B and CRP contents in experimental group dogs increased,with a significant difference from that before operation(P

Objective:In this study,a prokaryotic expression of the 3-ketosteroid-Delta (1)-dehydrogenase (KSDD) which came from Arthrobacter simplex was built.Moreover,in order to investigate the catalytic mechanism of KSDD and improve its stability,the structure of KSDD was predicted by computer and the critical sites were confirmed by site-directed mutations.Methods:The recombinant plasmid was constructed by eukaryotic expression vector pET-22b and the recombinant strain was constructed and expressed in Escherichia coli BL21 (DE3).High-performance liquid chromatography was used to determine the transformation rate of 4-AD to ADD.The KSDD structure and key sites were predicted by SWISS-MODEL.Site-directed mutations for the amino acid residues of key sites were constructed and activities of the mutations were detected.Results:The recombinant strain E.coli pET-22-ksdd was successfully constructed.It was induced to express the dehydrogenase by IPTG and the conversion rate of 4-AD to ADD was 27％ at 21 ℃.The structure of 3-ketosteroid-Delta (1)-dehydrogenase and the four key sites was analyzed by SWISS-MODEL.Four mutants,Y120R,Y320L,Y488F and G492Y were constructed.Mutants Y120R and Y488F were inactivated,so they were proved to be the key active sites of KSDD.The conversion rate of mutant Y320L was consistent with that of wild type,but the stability at 37 ℃ was improved.The conversion rate of mutant G492Y was 1.2 times of the wild type and the stability has been improved at 37 ℃.Conclusions:At present,there are few studies about the structure and catalytic mechanism of dehydrogenase.The active sites of the enzyme were verified by this study,which laid the foundation for the further study of the properties of the enzyme KSDD.

Objective To describe epidemiological characteristics of scalp psoriasis in China,and to determine its influencing factors through a hospital-based,multicenter and large-scale survey.Methods An epidemiological survey was conducted on patients with scalp psoriasis in 42 hospitals in 11 provinces and 4 municipalities.A questionnaire was designed to collect general and clinical information of patients,including clinical type,lesion distribution,psoriasis scalp severity index (PSSI),aggravating factors,influence on quality of life,treatment course,degree of satisfaction with treatment,etc.Participants were asked to fill out the questionnaire with the help of well-trained dermatologists.Data were processed with the EpiData software.The WPS system and Epi Info 5.0 statistics software were used for descriptive analysis of the data.Results Totally,3 901 patients participated this study,and 3 586 valid questionaires were obtained.The mean age at onset of scalp lesions was (27.40 ± 13.34) years,and the male to female ratio was 1.6∶1 with a mean PSSI score of 13.61 ± 12.31.The hairline of the forehead was the most frequently affected area with the constituent ratio of forehead psoriasis being 74.3％ (2 663/3 586).The duration of scalp psoriasis reached 3 to 6 months every year in 1 136 (31.7％) patients,and the area affected by scalp psoriasis was less than 25％ of the total surface area of the scalp in 1 649 (46％) patients.The most frequent clinical presentation was scaling (92.1％),followed by erythema (80.6％),itching(76.7％),bunchy hairs (39.9％) and hair loss(18.0％).Disease aggravation was most frequently associated with seasons (76.7％),emotions (47.4％),stress (47.1％) and fatigue (46.6％).The quality of life (especially social,outdoor and entertainment activities) was reported to be negatively influenced by this entity to different degrees in 2 529 (70.5％) patients.Of these patients,583 (17.8％) received combination therapy (topical and systemic),with glucocorticoid ointment (27.5％),calcipotriol scalp solution (22.7％) and glucocorticoid-containing solution (11.9％) being the most commonly used topical drugs; only 38.6％ complied with medication requirements and doctors' advice for 3 to 5 weeks,and 35.2％ believed that the primary reason for poor compliance was unsatisfactory response to drugs.It was considered that an ideal drug for the treatment of scalp psoriasis should be highly effective (50.3％),safe (17.8％) and easy to apply (11％) with a rapid onset of action(11.9％).Conclusions Scalp psoriasis has a predilection for the hairline of the forehead with scaling as the main clinical presentation.Winter and spring seasons appear to be the most common aggravating factor of scalp psoriasis.The quality of life is negatively influenced to different degrees in many patients with scalp psoriasis.Topical corticosteroids plus non-hormonal drugs should be the first choice for the treatment of scalp psoriasis.Patients consider that the ideal drugs for the treatment of scalp psoriasis should be effective,safe,and easy to apply.

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 investigate the liver protective effects of Siphonostegia chinensis decoction in rats with liver fibrosis induced by carbon tetrachloride(CCl4).Methods A total of 120 male SD rats were randomly divided into six groups: a blank control group, a model group, a Siphonostegia chinensis decoction group, a Salvia miltiorrhiza decoction group, a Rhizoma polygoni cuspidati decoction group and a polyene phosphatidylcholine capsules group, with 20 rats in each group. The model of liver fibrosis in rats was induced by subcutaneous injection with CCl4, except the blank group. Except rats in the blank control group and the model group, the rats in the other four groups were treated with Siphonostegia chinensis decoction, Salvia miltiorrhiza decoction, Rhizoma polygoni cuspidati decoction and polyene phosphatidylcholine capsules(10 ml/kg). The serum level of tumor necrosis factor-α(TNF-α)was determined with enzyme-linked immunosorbent assay, the fibrosis stage assessment were determined by histopathological examination.Results Compared with the model group, Siphonostegia chinensis decoction group significantly reduced the stage of liver fibrosis(P<0.01)and there were no obvious difference in liver fibrosis stage among the Salvia miltiorrhiza decoction group, Rhizoma polygoni cuspidati decoction group and polyene phosphatidylcholine capsules group, and the Siphonostegia chinensis decoction group(allP>0.05).Compared with liver fibrosis model group(368.06±24.90)U/L, the serum level of TNF-α in the Siphonostegia chinensis decoction group(336.61± 20.20)U/L significantly reduced(P<0.01), and there were no obvious difference among the Siphonostegia chinensis decoction group, the Salvia miltiorrhiza decoction group(337.81±21.04)U/L, the Rhizoma polygoni cuspidati decoction group(338.95±24.43)U/L and the polyene phosphatidylcholine capsules group(337.11± 23.64) U/L(allP>0.05).Conclusion Siphonostegia chinensis decoction has certain liver protective effect in rats with liver fibrosis induced by CCl4.

This stued examined the effects of nutritional support in 56 patients suffer from COPD. The influence of nutritional support on lung function and arteny blood gases after infusion of an amino acid solution (7% Fan Ming) were observed. The results suggested theft PaO2, FEV1. FVC levels were increased significantry compared to the control group. PaOz decreased significantly in Fan Ming infusion group compared 100 control group.

Objective To establish a sandwich ELISA for early detection of HIV antigens using a mixture of monoclonal antibodies (McAb). Methods The ascites McAbs (anti-HIV-1 p24, anti-HIV-1 gp41, anti-HIV-1 gp120 and anti-HIV-2 gp36) were purified by the SAS and the affinity chromatography,and then were labeled with HRP by sodium metaperiodate. The establishing of sandwich ELISA for detecting the single HIV antigen and the tests of specificity and sensitivity of these systems were performed in advance.A proper ratio mixture of four screened McAbs was used as the capture antibody and a proper ratio mixture of four labeled antibodies was used as the detecting antibody. The method of using sandwich ELISA to detect HIV antigens was set up with these McAbs. Results The sensitivity of this method detecting HIV antigens are:0.625 pg/ml HIV-1 p24, 6.25 ng/ml HIV-I gp41,6.25 ng/ml HIV-I gp120 and 9.25 ng/mi HIV-2 gp36 in mixed HIV antigens. Conclusion The method of using several McAbs mixture in sandwich ELISA detecting HIV antigens was established an excellent sensitivity, which provides a novel idea for early detec-ting the HIV antigen.

Objective To evaluate the prognostic accuracy of the score of toxic epidermal necrolysis (SCORTEN) scoring system in patients with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome (SJS).Methods Clinical data were collected from 39 patients with SJS/TEN hospitalized in Peking Union Medical College Hospital during April 1992 and March 2014,and retrospectively analyzed.Among the 39 patients,13 had died,and the other 26 patients,who were matched to the dead patients in a ratio of 2:1 for age,all had a definite diagnosis and were discharged with improved conditions.The SCORTEN scoring system was used to evaluate the 39 patients with SJS/TEN and calculate expected mortality.The expected mortality and actual mortality were compared between different groups stratified by age in the 39 patients.The receiver operating characteristic (ROC) curve was drawn to assess the prognostic accuracy of the SCORTEN scoring system.Results According to the SCORTEN scoring system,15 out of the 39 patients scored 1 point,14 scored 2 points,6 scored 3 points,and 4 scored 4 points.The total number of expected deaths was 6.808,while that of actual deaths was 13.There was no significant difference between the expected mortality and actual mortality in every SCORTEN score-based group.The area under curve (AUC) was 0.832 8,indicating a good predictive ability of the SCORTEN scoring system.Conclusion The SCORTEN scoring system can predict mortality in TEN/SJS patients at early stage.

Objective To investigate the antitumor activity of the procaspase-3 activator SM-1 in BGC-823 cells in vivo and in vitro and the mechanisms.Methods The inhibitory effects of SM-1 on proliferation of BGC-823 cells were evaluated using MTT method, the cell apoptosis rate was detected by flow cytometry, and the expression of caspase-3 protein and procaspase-3 mRNA was detected by Western blotting and RT-PCR, respectively.SM-1 Antitumor activity was evaluated using the xenograft of BGC-823 cells in nude mice.Results SM-1 effectively inhibited the proliferation in vitro and in-duced apoptosis of BGC-823 cells in a dose-dependent manner.After treatment with SM-1 for 48 h, the protein expression levels of caspase-3 and mRNA expression levels of procaspase-3 were increased.SM-1 significantly inhibited growth of BGC-823 xenograft tumor at the 300 mg/kg dose and the inhibition rate was 56.3%(P<0.05).Conclusion SM-1 can significantly inhibit the tumor growth of BGC-823 cells in vivo and in vitro.The mechanism is possibly related to the activation of procaspase-3 and induced apoptosis of tumor cells.