Objective To study the role of cutaneous nerve and protease activated receptor 2 (PAR2)in the development of pruritus in atopic dermatitis(AD).Methods Dermal sheets were prepared from chronically pruritic skin lesions of 7 patients with AD,as well as from the normal skin of 7 healthy human controls.Double labeled immunofluorescence was performed using mouse anti-protein gene product 9.5(PGP9.5)monoclonal antibody and rabbit anti-substance P(SP)polyclonal antibody to observe the morphological changes in cutaneous nerve fibers,and Image-Pro Plus 6 software was used to semiquantitively assess the length,diameter of nerve fibers,integral optimal density of PAR2 and SP in dermal sheets.Results Immunofluoresence double staining showed that PAR2 co-expressed with PGP9.5 or SP in cutaneous nerve fibers.Compared with the normal control skin,both the total length and average diameter of PGP 9.5-expressing nerve fibers were increased(11051.8±1900.9 μm vs 7264.0±2659.9 μm,4.23±0.15 μm vs 3.95±0.15 μm,both P＜0.01)in pruritic lesions,while only the average diameter of SP-expressing nerve fibers was up-regulated(3.99±0.20 μm vs 3.80±0.07 μm,P＜0.05),and the total length of them remained unchanged(4304.7±1455.0 μm vs 3380.0±1735.4 μm,P＞0.05).Also,increased integral optimal density was observed for SP and PAR in pruritic lesions in comparison with the normal control skin (27.71±16.52 vs 12.63±4.31.35.99±8.63 vs 22.69±9.56.both P＜0.05).Conclusion Our results indicate a hyper-plasia of cutaneous nerve fibers in chronic itchv skin lesions of AD and an increase in the expression of PAR2 and SP in the cutaneous nerve fibers,suggesting that the signal enhancement in PAR2 pathway may be related to the mechanism of pruritus in patients with AD.

Objective To detect the expression of proteinase activated receptor 2 (PAR-2) in the skin of patients with atopic dermatitis (AD) and to evaluate the effects of tacrolimus on the expression.Methods Six patients with acute moderate or severe AD were enrolled in this study and topically treated with tacrolimus 0.1％ ointment twice daily for 3 weeks.Tissue samples were obtained from the lesions and non-lesional skin at least 10 cm away from the lesions before and after the 3-week treatment.Skin specimens from 6 normal human controls served as the control.Patients were evaluated at the baseline,1 and 3 weeks after the beginning of treatment for clinical symptoms and signs by visual analogue scale (VAS),eczema area and severity index (EASI) and investigator's global assessment (IGA).The expression of PAR-2 in tissue specimens were determined by immunohistochemistry.Results PAR-2 was expressed throughout the whole epidermis,especially in the granular layer,hair follicles,sweat glands,endothelial cells and nerve fiber-like structures.Before treatment,the expression level (mean optical density) of PAR-2 in keratinocytes was 4339.6 ± 115.8 in lesional skin of AD patients,significantly higher than that in non-lesional skin (4189.0 t 228.9,t =2.85,P ＜0.05) and in normal skin (3864.0 ± 237.3,t =4.31,P ＜ 0.05).After the 3-week treatment with tacrolimus ointment,the expression level of PAR-2 significant decreased to 3942.4 ± 176.6 in keratinocytes from lesional skin of patients with AD (t =4.55,P ＜ 0.05).The expression level of PAR-2 was positively correlated with VAS score for itch,EASI and IGA score in the patients.Conclusions The expression of PAR-2 is enhanced in keratinocytes of lesions from AD patients,and is positively correlated with itch and lesion severity.Topical tacrolimus may suppress the overexpression of PAR-2 in keratinocytes in lesional skin of AD.

OBJECTlVE To observe the effect of soybean isofIavone( SI)on the expression of nephrin and investigate its protection mechanism in the kidney of diabetic rats. METHODS A diabetic rat modeI was induced after streptozocin(STZ)60 mg·kg-1 was injected into Sprague-DawIey rats. After 72 h,SI 40,120 and 360 mg·kg-1 was ip given to rats in SI groups,respectiveIy,once daiIy,for 8 weeks. The concentration of fasting bIood gIucose( FBG)was determined by a bIood gIucose meter. Urine protein(UP)of 24 h was determined using ELISA. The concentration of serum creatinine(SCr),bIood urea nitrogen(BUN),maIondiaIdehyde(mDA)and superoxide dismutase(SOD)was determined by an automatic biochemicaI anaIyzer. The expression of nephrin,tumor necrosis factor-α(TNF-α)and NF-κB protein in renaI tissue was measured by Western bIotting,respectiveIy. RESULTS Compared with normaI controI group,the concentration of FBG,24 h UP,BUN,SCr and mDA in modeI group was aII siginificantIy increased(P﹤0.05,P﹤0.01),but SOD was decreased( P﹤0.01).Compared with modeI group,BUN in SI 40,120 and 360 mg·kg-1 groups decreased from(24.3±6.3)mmoI·L-1 to(16.8±4.9), (13.4±5.4)and(7.7±1.2)mmoI·L-1 ,respectiveIy,24 h UP in SI 360 mg·kg-1 group decreased from (1.26±0.45)mg to(0.88±0.15)mg( P﹤0.01),SCr decreased from(56.4±8.4)μmoI·L-1 to(35.3± 4.3)μmoI·L-1(P﹤0.01),mDA decreased from(8.32±1.40)μmoI·L-1 to(5.33±0.95)μmoI·L-1(P﹤0.01), but SOD in SI 120 and 360 mg·kg-1 groups increased from(125.5 ±2.4)kU·L-1 to 144.2 ±9.2 and (169.2±3.2)kU·L-1(P﹤0.01). Compared with SI 120 mg·kg-1 ,SCr,BUN and mDA in SI 360 mg·kg-1 group were aII siginificantIy Iower(P﹤0.05,P﹤0.01),but SOD was higher(P﹤0.01). Compared with normaI controI group,the expression of nephrin protein greatIy decreased(P﹤0.01),whiIe the expres-sion of TNF-α protein greatIy increased in modeI group( P ﹤0.01). Compared with modeI group,the expression of nephrin protein greatIy increased in SI 40,120 and 360 mg·kg-1 groups(P﹤0.01),whiIe the expression of TNF-α and NF-κB protein greatIy decreased in SI 120 and 360 mg·kg-1 groups(P﹤0.01). CONCLUSlON The mechanism by which SI protects the kidney may be partIy reIated to anti-infIammation,antioxidation and increasing the expression of nephrin in diabetic rats.

ObjectiveTo explore the state of misdiagnosis, missed diagnosis and excesseive diagnosis related to cerebral palsy(CP).Methods389 cases were retrospectively analyzed who were misdiagnosed, missed or escessively diagnosed related to CP as the first diagnosis in the inpatient and outpatient department from July 1999 to March 2010.ResultsAmong 389 cases, 156 cases were missed or misdiagnosed as nutritional disease, and 118 cases of other diseases were misdiagnosed as CP, while 115 cases who were normal children was excessively diagnosed as CP. The false diagnosis had relativity with children's age: doctors are more prone to make misdiagonsis when the children's age are smaller, while 293 cases were misdiagnosed before 12 months old (75.3%); 102 cases (65.4%) were misdiagnosed or missed as other diseases before September, 2004, while 87 cases (75.7%) were excessively diagnosed as CP after September, 2004. Frequency of misdiagnosis as CP reduced from 2004, and the proportion dropped from 55.9% to 44.1%.ConclusionIt is very important to master the diagnostic standard of CP. Both sides of the question are important, one side is to make early diagnosis and early treatment in order to achieve the best effect of rehabilitation, and the other side is to prevent misdiagnosis and excessive diagnosis which woud delay illness, or waste medical resources, increase the financial and psychological burden.

Objective To investigate the value of anti-HI antibody screening and identification in clinical blood transfusion . Methods 4 cases of anti-HI antibody positive in our hospital from February 2016 to November were selected as the research subjects .The irregular antibodies screening and identification were performed by adopting the anti-human globulin and saline test tube method ,then the blood transfusion effect was evaluated .Results Four cases were ABO blood group ,in which 2 cases were group A RhD positive and 2 cases were group AB RhD positive .The screening results of anti-human globulin method were weak positive , while which of saline test tube method were positive .Under the saline medium condition ,the reaction results of serum with 16 spectrum cellular reaction in 4 cases were positive ,while which with autoerythrocytes were negative ;under the anti-human globulin medium condition ,the reaction results of serum with 16 spectrum cellular reaction in 4 cases were negative except 1 case of weak positive ,while which with autoerythrocytes were negative .After blood transfusion in 2 cases of treatment blood use ,Hb increase reached the expected effect without blood transfusion adverse reactions occurrence .Conclusion In blood transfusion for the patients with anti-HI antibody positive ,the blood of same type ABO and compatible results in both saline test tube method and anti-human globulin tests should be selected .

Objective: To explore the management effects of health knowledge-attitude-practice education on phosphorous control in peritoneal dialysis patients with hyperphosphatemia. Methods: A total of 64 peritoneal dialysis patients with hyperphosphatemia with long-term stable follow-up in the People’s Hospital of Quzhou from 2016 to 2018 were selected, and randomly divided into control and intervention groups. The groups received regular health education and health knowledge-attitude-practice education for 3 months, respectively. T-test and paired t-test were used to analyze the difference in the two groups, before and after intervention, in the score of knowledge-attitude-practice, serum phosphorus level, daily dietary phosphorous, and dosage of phosphate binder. Results: Before the health education intervention,there was no significant difference between the two groups’ questionnaire score of knowledge-attitude-practice of hyperphosphatemia, serum phosphorus, intact parathyroid hormone (iPTH), daily dietary phosphorous, dosage of phosphorus binder, and weekly urea clearance index in gender, age, and other general information. After 3 months of health education, the total score, knowledge, and behavior scores were higher in both groups than before intervention, and the scores of the intervention group were significantly higher than the control group. The scores increased by 16.64, 6.15, and 9.52 points respectively in the control group, and by 26.26, 11.67, and 13.56 points respectively in the intervention group. There was no significant difference in attitudes and beliefs between the groups before and after the intervention. After the intervention, the serum phosphorus level decreased, dosage of phosphate binder increased in both groups, the daily dietary phosphorous and iPTH decreased in the intervention group. These differences were statistically significant. The serum phosphorus level of the intervention group (1.86±0.42) mmol/L was lower than the control group (1.97±0.33) mmol/L, and the daily dietary phosphorous of the intervention group (831.22±187.85) mg/d was lower than the control group (928.23±192.81) mg/d. The difference in dosage of phosphate binder and iPTH of the groups was not statistically significant. Conclusions Health knowledge-attitude-practice education in peritoneal dialysis patients with hyperphosphatemia can improve their level of knowledge-attitude-practice, and promote the reduction of serum phosphorus.

Skin microbiota is associated with various skin diseases. Scalp hair follicles penetrate deeply into the skin, and carry complex microbial communities distinct from those on the skin surface. Local imbalance of microbial communities may impair the skin barrier function, leading to a variety of hair and scalp diseases. This review discusses changes in microbial diversity and colonization by specific microorganisms in various hair diseases, including dandruff, folliculitis decalvans, etc., and provides new ideas for exploring the pathogenesis of and therapeutic strategies for various hair and scalp diseases.

Objective To summarize and analyze the pathological data of 431 cases of renal biopsy from Quzhou, Zhe-jiang and to discuss the epidemiological characters via pathological distribution in Quzhou. Methods A total of 431 patients with kidney diseases hospitalized between January 2012 and December 2014 by our hospital were reviewed and their epidemiological characters and distribution of pathological patterns were analyzed. Results Among the 431 speci-mens, 181 cases were from males (42.0%), and 250 were females (58.0%, male/female=1:1.38). As to the clinical types of disease, the most common disease was nephrotic syndrome (NS, 178 cases, 41.3%), followed by chronic glomeru-lonephritis (CGN, 142 cases, 32.9%). As to the etiologic classification, a majority of 342 cases were primary glomeru-lonephritis (PGN, 79.3%), 77 cases were secondary glomerulonephritis (SGN, 17.9%), 11 cases were tubulo-interstitial disease(TID, 2.6%), and 1 case was renal transplantation disease(0.2%). Among the PGN patients, IgA nephropathy (IgAN) and membranous nephropathy(MN) were most commonly observed, accounting for 32.7%and 24.5%, respectively. Of the SGN patients, lupus nephritis(LN) was most common, accounting for 40.2%, which was followed by Henoch-Schonlein purpura nephritis (HSPGN, 18.2%) and hepatitis b virus-associated glomerulonephritis (HBVGN, 13.0%). Conclusion PGN is the most common etiological factor of kidney biopsy, with IgAN and MN at most. LN is the main type of SGN, followed by HSPGN and HBVGN. In Quzhou, Zhejiang, the incidence rate is higher in young adults, indi-cating that special attention should be paid on IgAN, MN and LN in prevention and treatment of kidney diseases.

In recent years,an increasing body of research has reported that the gut microbiota can modulate host immune responses and is associated with a variety of immune-related diseases.The gut microbiota plays a pivotal role in maintaining immune homeostasis.In numerous immune-related inflammatory diseases,significant alterations have been observed in both the gut microbiota and its derived metabolites,short-chain fatty acids(SCFAs).These microbial communities and metabolites play a crucial role in the pathogenesis of immune-related inflammatory diseases such as inflammatory bowel disease,diabetes,rheumatoid arthritis,and systemic lupus erythematosus.In this review,we discuss the latest developments in the human gut microbiome's association with autoimmune diseases(ADs)and the feasibility of developing novel diagnostics based on microbiome profiling.We aim to provide new drug targets for the treatment of autoimmune diseases,thereby paving a way for drug research and development.

Objective:To explore the application effect of new whole-course closed sputum specimen collection technology in intensive care unit patients.Methods:From April 2020 to January 2022, the convenient sampling was used to select 442 ICU mechanical ventilation patients admitted to 6 hospitals in Jiaxing City as the research objects. According to the order of admission time, the patients were divided into the control group ( n=221) and the experimental group ( n=221) . The control group adopted the traditional open sputum specimen collection technology, while the experimental group adopted the new whole-course closed sputum specimen collection technology. The heart rate, the incidence of hypooxygen saturation and the incidence of sputum spatter were compared between the two groups after sputum sample sampling. Results:The incidences of hypooxygen saturation and sputum spatter in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The new whole-course closed sputum specimen collection technology can effectively stabilize the oxygen saturation of ICU patients in the process of sputum specimen collection, reduce the incidence of sputum spatter and promote the safety of both patients and medical staff, which is worthy of clinical promotion and application.