Objective To investigate the expression of cellular chemokine CCL22 and its receptor CCR4, as well as its clinical significance in systemic lupus erythematosus (SLE), along with its roles in the pathogenesis of this disease. Methods Forty-eight patients with SLE and 26 normal human controls were recruited into this study. The patient cohort included 2 males and 46 females with an average age of 33.98± 12.73 years and disease course of 1 month to 20 years. Blood samples were collected from the subjects. ELISA and flow cytometry were used to examine the plasma concentration of CCL22 together with the CCR4 expression on peripheral blood cells. SLEDAI was applied to evaluate the severity of SLE patients. Results The plasma concentration of CCL22 was 227.03±122.84 ng/L in SLE group, 369.53±79.10 ng/L in the control group, 168.09±61.83 ng/L in patients with lupus nephritis and 292.77±163.45 ng/L in patients without lupus nephritis; there was a significant difference between the SLE patients and normal con-trols (P < 0.05) as well as between patients with lupus nephritis and those without (P < 0.05). Increased percentage of CCR4-expressing cells were observed in the peripheral blood of patients with SLE compared with the controls (20.24%±13.86% vs 10.44%±3.07%, P < 0.01), and the percentage of CD3+CCR4+ cells was significantly higher than that of CD3-CCR4+ cells. Moreover, a decrease was noted in the plasma con-centration of CCL22 in severe patients (P < 0.05). In SLE patients, the percentage of CCR4 increased with the rise in SLEDAI score, whereas the plasma concentration of CCL22 negatively correlated with SLEDAI score (r = -0.308, P < 0.05). Conclusion CCL22/CCR4 may play a certain role in the development, pro-gression and organ involvement in SLE.

Objective To estimate the significance of E-selectin and P-selectin in nodular vasculitis.Methods The EnVision two-step method was used to measure the expression of E-selectin and P-selectin in skin samples from the lesions of 70 patients with nodular vasculitis and normal skin of 24 human controls. The differences between the patients and controls in the expression of E-selectin and P-selectin and relationship between their expression levels in nodular vasculitis lesions were assessed. Results The expression of E-selectin was detected in all the specimens of nodular vasculitis, and most of the expression level was moderately intensive (++); while E-selectin was absent in all of the control specimens. All the specimens of nodular vasculitis stained postivive for P-selectin, which was strongly (+++) expressed in most of the specimens; while only 2 control specimens stained weakly positive for P-selectin. A significant difference was observed in the expression of E-selectin and P-selectin between the specimens from the patients and controls (both P< 0.01), but not among specimens from patients at different ages and between specimens from female and male patients (all P > 0.05). In addition, the expression of E-selectin and P-selectin was well correlated with each other in lesions of nodular vasculitis (P < 0.01). Conclusions The expression of E-selectin and P-selectin is correlated with each other in lesions of acute nodular vasculitis, and is associated with the development of nodular vasculitis.

Objective To assess the histopathological characteristics of tumors arising in nevus sebaceous.Methods The clinical and pathological data on 16 patients with tumors arising in nevus sebaceous were collected and retrospectively reviewed.Histopathological characteristics were analyzed.Results Of the 16 patients,12 aged ≥ 18 years,4 aged 11 to 17 years; 7 had syringocystadenoma papilliferum(SCAP),4 tubular apocrine adenoma (TAA),3 trichilemmoma,2 basal cell carcinoma (BCC),1 porokeratotic eccrine ostial and dermal duct nevus,and 1 nevus flammeus.Six patients suffered from more than one kind of tumor,of these tumors,concurrent syringocystadenoma papilliferum and apocrine adenoma predominated and were observed in 4 of these patients.Conclusion Any tumor arising from nevus sebaceous should be closely followed up.

Objective To evaluate the efficacy of 0.1% tacrolimus ointment and 0.1% mometasone furoate cream in the treatment of chronic actinic dermatitis (CAD). Methods Forty male patients with CAD were recruited and divided into two groups randomly.Twenty cases were treated with 0.1%tacrolimus ointment (Group A), and the other 20 cases were treated with 0.1% mometasone furoate cream (Group B) . The medications mentioned were applied topically to the lesions on the face twice a day and mizolastine tablet 10 mg per day given orally for 4 weeks. The therapeutic efficacy and side effects of medications were observed. The enzyme linked immunosorbent assay (ELISA) method was used to measure the serum levels of IFN-γ, IL-2 and IL12 in CAD patients before and after treatment with topical tacrolimus ointment and mometasone furoate cream. Results (1) Both groups had overall response rates of 100%, with no statistically significant difference ( > 0.05) . (2) Serum levels of IFN-γ,IL-2 and IL-12 were down-regulated after treatment in both treatment groups respectively ( < 0.01) . No statistically significant difference was found between the two treatment groups ( > 0.05) . Conclusion 0.1%tacrolimus ointment is effective in the treatment of CAD. Its therapeutic efficacy is equivalent to that of 0.1%mometasone furoate cream. It can be used as a possible steroid sparing equivalent.

Objective To investigate the association of imbalance of Tc1 and Tc2 cells with chronic actinic dermatitis (CAD). Methods Immunohistochemistry (S-P method) was used to test the subgroups of infiltrating cells and the expression of receptors of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-12 (IL-12) and interferon-? (IFN-?) in these cells of the eruptions from 28 patients with CAD and 7 normal controls. The serum levels of IL-4, IL-10, IL-12 and IFN-? from 33 patients with CAD and 32 normal controls were tested by ELISA. Results The major infiltrating cells in the eruptions of patients with CAD were T cells, which were significantly more than B cells (P

Objective To observe the effect of different ultraviolet on HaCaT and offer experimental evidences for further studies of the pathogenesis of photodermatitis. Methods Using different dose of UVA and UVB to irradiate HaCaT cell line respectively. 12 hours later, the morphology of HaCaT cells was observed and the sum was calculated. Results The cell linkage was loose and the refraction was weak with some dead cells. The effect of large dosage of UVB was more obvious. Conclusions the effects on keratinocyte after UV exposure are different according to the dose of irradiation, which offers experimental evidences for the further study of the pathogenesis of photodermatitis.

Objective To explore the mechanism underlying the effects of gypenosides (GP) against photodamage. Methods Eighty BALB/c mice were equally divided into 8 groups, i.e., blank control group (untreated), UVB model group (irradiated with UVB), GP I group (irradiated with UVB before topical application of GP), GPⅡ group (irradiated with UVB followed by topical application of GP), VitE I group (irradiated with UVB after topical application of Vitamine E cream), VitE Ⅱ group (irradiated with UVB followed by topical application of Vitamine E cream), Vehicle group Ⅰ (irradiated with UVB after application of the drug vehicle),and Vehicle group Ⅱ (irradiated with UVB before application of the drug vehicle). UVB irradiation was performed once every other day for 14 days. Mice were sacrificed after the last irradiation and skin specimens were obtained from the irradiated sites, and the levels of p53 and p21 protein were measured by Western blot in the specimens. Results The expression level of p53 protein was significantly lower in the blank control group than in the UVB model group (0.11 ± 0.08 vs. 0.22 ± 0.12) and GP Ⅰ group (0.44 ± 0.23, P < 0.01),in the blank control group and UVB model group than in the GP Ⅱ group (0.48 ± 0.24, P < 0.01, 0.05). VitE Ⅰ group (0.49 ± 0.29) and VitE II group (0.50 ± 0.27) were similar to the GP groups in the expression of p53 protein. No statistical difference was observed in the expression of p21 protein between the eight groups. Conclusion The upregulation of p53 protein expression in epidermal cells may be related to the mechanisms underlying the protective effect of 1.5% GP cream against photodamage.

Objective To investigate the clinical and histological characteristics of trichilemmal carcinoma (TLC). Methods A clinicopathological analysis of 13 cases of TLC was carried out. Results There were 9 males and 4 females among the 13 patients with TLC who were aged from 34 to 87 years (mean: 70 years). Clinically, the tumor presented as an exophytic mass; histologically, it was characterized by the proliferation of epithelial cells and keratinization of outer root sheath. Cytologically atypical clear cells predominated in the tumor tissue. Microscopy revealed different growth patterns of tumor cells, which included solid growth pattern, tobular pattern and trabecular pattern. Periodic acid Schiff (PAS) stain demonstrated clear cells in all the tumor tissues from the 13 patients. Immunohistochemistry was performed in tissue samples from 6 patients, and showed that these samples were positive to high molecular weight cytokeratin (CK-HMW) and epithelial membrane antigen (EMA), but negative to carcinomebrynic antigen (CEA), S-100, cytokeratin 8 (CK8)and epithelial antigen(Ber-Ep4). Follow-up over 4 months to 5 years revealed neither recurrence nor metastasis in 9 cases.Conclusions TLC is a low-grade malignancy of skin adnexal tumor without distinctive clinical features, and should be differentiated from other malignant clear cell tumors of the skin.

Objective To explore the effects of case method teaching in the medical postgraduate student of dermatology English teaching. Methods The experiment group was taught by case method teaching, and the control group was taught by traditional teaching model. The quantitative research and questionnaire investigation were used to evaluate the teaching methods. Results (1) There were significant differences in professional English test scores of Dermatology between the two groups;(2) The questionnaire investigation revealed that the case method teaching have achieved a higher evaluation from students in stimulating their enthusiasm of learning English,cultivating their ability of using language and improving capability of resolving clinical problem. Conclusion Case method teaching could help students cultivate the abilities to interpersonal communication and cooperation, raise the sense of innovation and innovation capacity,strengthen the relation between skills and theoretical knowledge, and improve the ability of self-management, learn cooperation and information literacy. But we should improve the case-based teaching and evaluation methods,in order to improve the teaching method of case teaching quality.

Objective To observe the effects of gypenosides (GP) on nuclear factor κB (NF-κB) and p38 mitogen activated protein kinase (p38MAPK) signaling pathways in photodamaged skin of mice,and to explore the mechanisms underlying the protective effects of GP against photodamage.Methods Eighty Balb/C female mice were randomly divided into 8 groups: blank control group receiving no treatment,ultraviolet B (UVB) model group receiving UVB irradiation for 60 seconds,GP group Ⅰ receiving topical GP treatment followed by UVB irradiation,GP group Ⅱ receiving UVB irradiation followed by topical GP treatment,VitE group Ⅰ receiving topical VitE treatment followed by UVB irradiation,VitE group Ⅱ receiving UVB irradiation followed by topical VitE treatment,matrix group Ⅰ receiving topical matrix treatment followed by UVB irradiation,matrix group Ⅱ receiving UVB irradiation followed by topical matrix treatment.UVB irradiation lasted 60 seconds at one time,and was given once every other day for 7 times to establish a skin model of photodamage.The interval between irradiation and topical treatment was 30 minutes in all the groups except the control group and UVB model group.After the last treatment,mice were sacrificed.Western blot was performed to measure the protein expressions of inhibitor of NF-κB(IκB),inhibitor of NF-κB kinase (IKK),p38MAPK as well as phosphorylated p38MAPK (pp38) in skin tissue from the mice.Results No expressions of IκB or IKK were observed in the blank control group.The expression level of IκB was 0.40 ± 0.07 in UVB model group,significantly lower than that in GP group Ⅰ (1.63 ± 0.85,P ＜ 0.05) and GP group Ⅱ (0.90 ± 0.40,P ＜ 0.05),whereas the level of IKK protein was higher in UVB model group than in the GP group Ⅰ and Ⅱ (2.01 ± 1.75vs.0.23 ± 0.12 and 0.45 ± 0.29,both P ＜ 0.05).No significant difference was observed in the expression of IκB or IKK proteins between the GP group Ⅰ,Ⅱ,VitE group Ⅰ and Ⅱ or in the expression of p38MAPK between the 8 groups.The phosphorylated p38MAPK expression in UVB model group was significantly higher than that in GP group Ⅰ and Ⅱ (0.835 ± 0.049 vs.0.425 ± 0.054 and 0.571 ± 0.090,both P＜ 0.05),but similar to that in VitE groups.Conclusions UVB can activate NF-κB and phosphorylated p38MAPK signaling pathways; GP 1.5％ cream can inhibit UVB-induced activation of NF-κB and p38MAPK pathways,which may be one of the mechanisms underlying its protective effects against inflammation and photodamage.