Objective To assess the efficacy of high intensive narrow band blue light and red light combined with Cuochuangling granule,a traditional Chinese medicine (TCM),in acne vulgaris(AV).Methods Forty-two patients with mild to moderate AV were randomly divided into two groups.combination group(n=25)receiving photothempy with blue light and red light plus oral Cuochuangling granule,TCM group(n=17)treated with oral Cuochuangling granule alone.Cuochuangling granule was given thrice daily,and phototherapy was performed at a dose of 48 J/cm2 with a least interval of 48 hours.All patients were treated for 4 weeks.Before and after the treatment,sebum secretion level and water content in stratum corneum were measured by photometry and capacitance method,respectively,skin pH value was examined,and the number of lesions was counted.Results The total effective rate was 84%in the combination group,and 71%in TCM group.A significant increase was observed in the clearance rates of total lesions and inflammatory lesions in the combination group compared with the TCM group(both P＜0.01).The water content in stratum corneum increased from 210.47 to 294.70(P＜0.01)in the combination group,and the increase was greater than in the TCM group.No significant changes were noticed in the sebum secretion level or skin pH value alter the treatment in either group.Conclusions Phototherapy combined with Cuochuangling granule is highly effective in the treatment of mild to moderate acne,with an increase in the water content in stratum corneum after treatment.

Objective To analyze endoscopic histological characters and establish diagnostic standards of colorectal polyps with confocal laser endomicroscopy (CLE) examination and to explore the diagnostic value of the CLE in adenomatous polyps and non-adenomatous polyps. Methods From June to December in 2009, 90 patients were recruited in this study, which included 40 pathologically confirmed colorectal polyps patients (total 48 colon and rectal polyps) and 50 patients for prospective study (total 106 colon rectal polyps). At same time 10 spots of normal mucosa was taken for comparison. Firstly the CLE images of 48 pathologically confirmed colorectal polyps (22 adenomatous polyps and 26 non-adenomatous polyps) were analyzed, and the diagnosis criteria for distinguishing adenomatous polyps and non-adenomatous polyps was established with CLE. Then according to the criteria, 106 colorectal polyps underwent prospective diagnosis with CLE. Finally, the CLE diagnosis result was compared with pathologically result to evaluate the diagnosis efficiency of CLE. Results In the 48 colorectal polyps of 40 pathologically confirmed colorectal polyps patients, there were 22 adenomatous polyps and 26 non-adenomatous polyps. The sensitivity, specificity and accuracy of CLE in adenomatous polyps diagnosis were 94. 0%, 92. 9%, and 93. 4%, respectively. The positive predictive value was 92.2% and the negative predictive value was 94.5%. The sensitivity, specificity and accuracy of CLE in non-adenomatous polyps diagnosis were 92. 9%, 94.0%, and 93. 4%respectively, the positive predictive value was 94.5% and the negative predictive value was 92.2%.The coherence of CLE and histopathology in adenomatous polyps diagnosis was pretty good (Kappa=0. 893). Conclusion The accuracy of CLE in adenomatous polyps and non-adenomatous polyps differential diagnosis was high, and the coherence with histopathology diagnosis was good, which provided experience for further detection of early rectal precancerous.

[Object]To]explore the academic view and clinical experience of Professor MIN 's treatment based on syndrome differentiation in psoriatic arthritis. [Methods] Through the study with MIN, organising clinical medical case, discussing Professor MIN 's academic view and clinical experience in psoriatic arthritis from the etiology and pathogenesis, treatment based on syndrome differentiation, principles and methods,summing up prescription, and stating a classic case as an evidence. [Results] Professor MIN summarizes the pathogenesis of psoriatic arthritis as"dampness","stasis" and"weakness". The exogenous wind, cold, dampness and heat evils, left in the muscle and joints,leading to qi stagnation and blood stasis, meridian discord and active barrier, ultimately to liver and kidney deficiency. Professor MIN also suggests that the treatment of psoriatic arthritis should grasp the principle of sixteen words"Detect Early, Treat Simultaneously,Intervene Early, Make Confidence".[Conclusion] MIN Zhongsheng's treatment based on syndrome differentiation in psoriatic arthritisis is clinically effective and has the value of popularization and application.

Objective To investigate clinical and histopathological manifestations of cutaneous plasmacytosis.Methods The clinical and histopathological data were collected from 7 cases of cutaneous plasmacytosis and analyzed retrospectively.Results Of the 7 patients,2 were female,and 5 were male.The average age was 42.4 years,and the duration of disease ranged from 2 to 10 years.All the 7 patients presented with multiple slow progressive brown patches and plaques.No abnormality was observed in routine examinations of blood,urine and faeces,electrocardiogram and abdominal ultrasonography in the 7 patients.Three patients underwent serum IgG detection,and their serum levels of IgG were all higher than reference values.Two patients were subjected to cytological examination of bone marrow,which showed the percentage of plasma cells (mainly mature plasma cells) was up to 5％.Histopathological examination of 7 cases showed pigmentation in the basal layer of the epidermis,and infiltration mainly consisting of lymphocytes and mature plasma cells around the blood vessels in the dermis.Immunohistochemical study revealed that the ratio of κ to λ light chain was approximately 1∶ 1,and the plasma cells were strongly positive for IgG.IgG4 was positive in very few plasma cells in 1 case,and negative in the other 6 cases.Conclusion The etiology of cutaneous plasmacytosis is still unclear,but it has characteristic clinical and histopathological manifestations.

Objective:To investigate protective effect of Pinus massoniana needle extract (PMNE) against oxidative stress in human dermal papilla cells (HDPC) , and to explore its mechanisms. Methods:As research objects, some cultured HDPC were treated with H 2O 2 at different concentrations of 0 (control group) , 0.1, 0.2, 0.4, 0.8 and 1.0 mmol/L, in order to establish the optimal condition for in vitro oxidative stress in HDPC; some other HDPC were transfected with nuclear factor-erythroid 2-related factor 2 (Nrf2) specific small interfering RNAs (siRNA1, siRNA2, siRNA3) or a Nrf2-overexpressing plasmid (pCMV6-XL5-Nrf2) , the HDPC transfected with a scrambled-siRNA and an empty plasmid pCMV6-XL5 served as the control siRNA group and control plasmid group respectively, and HDPC subjected to conventional culture served as the blank group; after the above treatment, real-time fluorescence-based quantitative PCR and Western blot analysis were performed to determine Nrf2 mRNA and protein expression, respectively; cell viability and apoptosis were detected in the above transfected cells after the treatment with H 2O 2 at an optimal concentration. In the subsequent experiment, some HDPC were divided into several groups: control group subjected to conventional culture, dihydrotestosterone group treated with 0.03 μg/ml dihydrotestosterone, proanthocyanidin group treated with 0.03 μg/ml dihydrotestosterone and 6.00 μg/ml proanthocyanidin B2, PMNE groups treated with 0.03 μg/ml dihydrotestosterone and PMNE at different concentrations of 1, 5, 25 and 100 μg/ml; after the above treatment, cell viability and apoptosis were detected, relative fluorescence intensity of intracellular reactive oxygen species (ROS) , malondialdehyde (MDA) content, mRNA and protein expression of Nrf2, quinone oxidoreductase 1 (NQO1) , heme oxygenase 1 (HO-1) , Kelch-like ECH-related protein 1 (Keap1) , transforming growth factor (TGF) -β1, Sma- and Mad-related protein 2/3 (Smad2/3) , phosphorylated Smad2/3 (p-Smad2/3) were determined in HDPC. One-way analysis of variance was used for comparisons among multiple groups, and least significant difference- t test for multiple comparisons. Results:The viability of HDPC ranged from 75% to 85% after the treatment with 0.4 mmol/L H 2O 2, which was selected as the optimal condition for in vitro oxidative stress in HDPC. Compared with the blank group and control siRNA group, the Nrf2-siRNA1, Nrf2-siRNA2, Nrf2-siRNA3 groups showed significantly decreased Nrf2 mRNA and protein expression (all P < 0.05) , but significantly increased apoptosis rate (Nrf2-siRNA1, Nrf2-siRNA2, Nrf2-siRNA3 groups, blank group and control group: 12.50% ± 0.05%, 26.07% ± 0.05%, 58.44% ± 1.03%, 10.38% ± 0.64%, 13.05% ± 0.12%, respectively; all P < 0.05) . Nrf2 protein expression was the lowest in the Nrf2-siRNA2 group, so Nrf2-siRNA2 was selected as the optimal interfering fragment for subsequent experiments. Compared with the blank group and control plasmid group, the Nrf2 overexpression group showed significantly increased Nrf2 mRNA and protein expression (both P < 0.05) , but a significantly decreased apoptosis rate (all P < 0.05) . After the treatment with 0.4 mmol/L H 2O 2, the Nrf2 overexpression group showed a significantly decreased apoptosis rate, but significantly increased cell viability compared with the empty vector group ( t = 3.66, 40.40, respectively, both P < 0.001) ; the Nrf2-siRNA2 group showed a significantly increased apoptosis rate, but significantly decreased cell viability compared with the control group ( t = 13.13, 67.37, respectively, both P < 0.001) . In the PMNE treatment experiment, the proanthocyanidin group and PMNE groups showed significantly increased cell viability, but significantly decreased apoptosis rates compared with the dihydrotestosterone group (all P < 0.01) ; proanthocyanidin and PMNE at different concentrations could significantly inhibit dihydrotestosterone-induced overexpression of ROS and MDA in HDPC (all P < 0.01) ; the protein expression of Nrf2, NQO1 and HO-1 was significantly higher in the proanthocyanidin group, 5-, 25- and 100-μg/ml PMNE groups than in the dihydrotestosterone group (all P < 0.05) , while the protein expression of Keap1 and TGF-β1, and the Smad2/3 phosphorylation level were significantly lower in the proanthocyanidin group, 25- and 100-μg/ml PMNE groups than in the dihydrotestosterone group (all P < 0.05) . Conclusion:Nrf2 plays an important role in protecting against oxidative damage in HDPC, and PMNE may exert marked protective effect on HDPC by activating the Nrf2-antioxidant responsive element signaling pathway.

Objective To evaluate the efficacy and safety of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure in the treament of intrarenal and proximal ureteral stones.Methods From November 2014 to December 2016,a total of 372 patients,including 200 males and 172 females,with upper urinary tract calculi were studied.The average age of patients was 48.1 years old.The average size of stone was 5-35mm,mean 15.7mm.There were 272 cases of renal calculi,80 cases of ureteral calculi and 20 cases of renal calculi combined with ureteral calculi.There were 252 cases of single calculi and 127 cases of multiple calculi.There were 237 cases of urinary tract infection and 14 cases of bacteremia.All patients were treated by suctioning fiexible uretemscopy with automatic control of renal pelvic pressure by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath with a pressuresensitive tip.Statistical analysis was performed regarding renal pelvic pressure,operative time,stone-free rates,and complications.Results Three hundred and thirty of 372 patients only accepted one surgery to remove the stone.There were 12 cases of upper ureteral calculi were converted to ureteroscope lithotripsy.Seventeen cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis.Seven cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks.No stone was found in 6 cases,and the soft endoscope of ureter was examined.In all patients,the renal pelvic pressure of the pelvis was controlled within 20 mmHg.The average operative time was 15-180 min(mean 58.9 min).The stone-free rates was 95.55％ (322/337),the incidence of postoperative fever was 2.97％ (10/337),the sepsis rate was 1.19％ (4/337),the incidence of urinary sepsis was 0.89％ (3/337),the incidence of lumbago caused by extravasation was 0.59％ (2/337),and no peripheral viscera injury or death case.There was no statistically significant difference between preoperative and postoperative white and red blood cells (P ＞ 0.05).Conclusions This new type of suctioning flexible ureteroscopy with intelligent pressure-control has the advantages of perfusion attraction,pressure feedback,intelligent control and visualization of intracavity pressure.It could be a new type of operation with high safety,low complication and high stone free rate.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).