Anti-Bacterial Agents ; therapeutic use ; Communicable Diseases ; drug therapy ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fever ; drug therapy ; etiology ; Humans ; Medicine, Chinese Traditional ; Meningitis, Meningococcal ; drug therapy ; Phytotherapy

Objective To summarize the experience with adapalene in the treatment of ache vulgaris and to provide a clue to improve the clinical use of adapalene in ache vulgaris. Methods Chinese literature over the past ten years related to the evaluation of efficacy and safety of 0.1% adapalene gel in acne vulgaris were searched and assessed. Results Combination therapy with 0.1% adapalene was more effective than monotherapy with it. The efficacy of adapalene gel was higher than that of non-tretinoin topical agents, but equivalent to that of other tretinoins. Furthermore, the incidence of adverse events was lower for adapalene than for other tretinoin formulations. Conclusions Adapalene is safe and effective for the treatment of mild to moderate acne vulgaris, and can be used as monotherapy, maintenance treatment, or in combination therapy of acne vulgaris.

Objective To study the effects of different stimulators on the production of matrix metalloproteinases (MMPs) by peripheral blood mononuclear cells (PBMCs),and to evaluate the effects of the culture supernatant of activated PBMCs,named conditioned media (CM),on the proliferation of and production of MMPs by cultured human fibroblasts.Methods PBMCs were isolated from the venous blood samples of healthy volunteers and divided into three groups to be stimulated by phytohemagglutinin (PHA group),the combination of antibodies against CD3 and CD28 (double-antibody group),or the RPMI 1640 medium containing 10％ fetal calf serum (control group).After 72-hour stimulation,CM was collected from all the three groups,diluted to several different degrees.Cultured human fibroblasts were classified into several groups to be treated with different dilutions of CM from the three groups for 48 or 24 hours,with the fibroblasts untreated with CM serving as the control group.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity,semi-quantitative reverse transcription (RT)-PCR to detect the expressions of MMP-1,MMP-3 and MMP-9 mRNAs in cells,and enzyme-linked immunosorbent assay (ELISA) to measure the levels of interleukin (IL)-6,MMP-1,MMP-3 and MMP-9 proteins in the culture supernatant of cells.Statistical analysis was carried out mainly by using one-way analysis of variance (ANOVA),Tukey HSD test,and GamesHowell test.Results Compared with the control group,the PHA group showed increased cellular proliferative activity,IL-6 and MMP-3 protein levels in the culture supernatant of activated PBMCs (all P ＜ 0.05).Significant differences were observed among the PHA group,double-antibody group and control group in the relative mRNA expression level (expressed as the ratio of target mRNA to β-actin mRNA) of MMP-1 in activated PBMCs (0.083 ± 0.016 vs.0.188 ± 0.030 vs.0.714 ± 0.104,F =85.905,P ＜ 0.05),but neither MMP-3 nor MMP-9 mRNA was expressed by activated PBMCs.MMP-3 protein was detectable in the culture supernatant of fibroblasts after the treatment with CM,and the level of MMP-3 protein was highest in that of fibroblasts treated with undiluted CM,and lowest with 1/10 diluted CM;at the same dilutions,the level of MMP-3 protein was highest in the culture supernatant of fibroblasts treated with CM from the PHA group,but lowest with that from the control group.Neither MMP-1 nor MMP-9 protein was detected in the culture supernatant of activated PBMCs or treated fibroblasts.There were no significant differences in cellular proliferative activity of and mRNA expressions of MMP-1 or MMP-3 in fibroblasts among these groups (all P ＞ 0.05),and MMP-9 mRNA expression was undetected in the treated fibroblasts.Conclusions PBMCs can be induced to express MMP-1 mRNA and secret MMP-3 protein after activation.However,the culture supernatant of activated PBMCs has no capacity to stimulate the expressions of MMP-1,MMP-3 and MMP-9 mRNAs or proteins by fibroblasts,suggesting that inflammatory cells may function through self-production of MMPs.

Objective To study the expression of matrix metalloproteinase(MMP)-1,-3 and-9 in sun-exposed and-unexposed skin as weil as its significance in the mechanism of skin photoaging.Methods Skin samples were resected from the exmnsor side of forearm(sun-exposed area)and flexor side of upper arm(sun-unexposed area)of 23 healthy female volunteers.The expression of MMP-1,-3 and-9 was detected by immunohistochemical staining in 46 skin samples.Immunoreactive intensity distribution index (IRIDI)was calculated to assess the expression of MMP-1,-3 and-9.Wilcoxon signed ranks test,Mann-Whitney U-test and Spearman rank correlation analysis were performed.Results MMP-1,-3 and-9 were expressed in both sun-exposed and -unexposed skin.The average IRIDI value for MMP-1,-3 and-9 was 7.70(range,3 to 12).9.22(range,6 to 12),8.30(range,6 to 12)in sun-exposed skin,and 4.26 (range,2 to 6),5.39(range,2 to 9),4.04(range,1 to 6)in sun-unexposed skin,respectively;significant difierence existed between sun.exposed and-unexposed skin in the three parameters(all P＜0.01).A significant inerease was observed in the average IRIDI value for MMP-1,-3 and-9 in sun-exposed skin vs.sun-unexposed skin in women above 50 years of age (9.17 vs 4.75,10.58 vs 6.42,8.92 vs 4.33,respectively,all P＜0.05).In women younger than 50 years,the average IRIDI value for MMP-1,-3 and-9 was 6.09(range,3 to 8),7.73(range,6 to 9),7.64(range,6 to 12)in sun-exposed skin,significantly higher than that in sun-unexposed skin[3.73(range,2 to 6),4.27(range,2 to 8),3.73(range,1 to 6),all P＜0.05].Increased IRIDI scores of MMP-1,-3 and -9 were noticed in sun-exposed skin in women above 50 years of age vs.those younger than 50 years.but there was no statistical difrerence in MMP-I or MMP-9 between the two aged groups in sun-unexposed skin(all P＞0.05).The IRIDI scores of MMP-1,MMP-3 and MMP-9 were positively correlated with age(r=0.66,0.69,0.74,all P＜0.01)in sun-exposed skin,but the IRIDI scores of MMP-1 and MMP-9 uncorrelated with age in sun-unexposed skin.Conclusions There isan elevated expression of MMP-1,-3 and.9 in sun-exposed skin VS.SUn.unexposed skin.hinting that these three MMPs play a role in the occurrence and development of photoaging,but their biological mechanism may be different.

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.

No abstract available.
Lung Neoplasms* ; Lung*

Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 :1, with a mean age of onset at 59.79±15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles' plaques" wheals, nodules,or erythema muitiforme-like lesions, with the most common lesions being erythematous papules and plaques (occumng in 35.29% of these patients). Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.

Objective: To explore the relationship between blood levels of cyclophilin A (CyPA) and chronic heart failure (CHF).
Methods: A total of 166 CHF patients were enrolled as CHF group, according to NYHA classiifcation, it was further divided into 4 sub-groups: Class I,n=37, Class II,n=39, Class III,n=46 and Class IV,n=44. In addition, there was a Normal control group,n=52. Blood levels of CyPA, B-type natriuretic peptide (BNP) and high sensitivity C-reactive protein (hs-CRP) were examined and compared among different groups.
Results: Compared with Normal control group, CHF group had elevated CyPA (5.11 ± 2.43) ng/ml vs (2.28 ± 0.61) ng/ml, BNP (385.65 ± 184.06) pg/ml vs (90.37 ± 18.44) pg/ml and hs-CRP (11.74 ± 5.44) mg/L vs (5.99 ± 1.14) mg/L, all P<0.05. As increased severity of NYHA classiifcation, blood levels of CyPA, BNP and hs-CRP between 2 subgroups had the increasing trend accordingly, allP<0.05; while there was an exception: blood levels of CyPA and hs-CRP were similar between Class I subgroup and Normal control group, allP>0.05. Pearson correlation analysis indicated that blood levels of CyPA were positively related to BNP and hs-CRP in CHF patients (r=0.838,P<0.01 and r=0.755,P<0.01).
Conclusion: Blood levels of CyPA were elevated in CHF patients and it’s obviously related to NYHA classiifcation, which might have certain effects on CHF diagnosis and evaluation.

Objective To identify risk factors associated with the severity of acute kidney injury (AKI) in-duced by crush syndrome and whether the patient required hemodialysis (HD). Method A retrospective study was designed. Within 19 days after the Chinese Wenchuan earthquake (May 12, 2008), 63 victims (33 men, 30women) of 2139 cases were hospitalized at Mianyang Central Hospital (Siehuau, China) because of crush syn-drome caused by crush injuries. The patients with renal dysfimcfion before the earthquake were excluded. Totally 63 patients with AKI associated with crush syndrome were included in this study and were divided into two groups: group 1, 25 patients, requiring HD (when urine volume <250 mL/d;serum potassium> 6 mmol/L) ; and group 2, 38 patients, without HD. The following data were collected retrospectively for all patients: (1) epidemiological parameters: age, gender, race, time under the rubble, liquid treatmem before being rescued; (2) clinical param-eters: blood pressure, body area crushed, amputation, fasciotomy, blood transfusion, quantity of fluid infusion, urine output in the first 24 hours; (3) initial laboratory data: complete blood count, urine analysis, serum chem-istry, arterial blood gas analysis. Comparisons between the two groups were made using SPSS 10.0. The quantita-tive data and categorical data were analyzed using t tests and χ2 tests, respectively. P -values < 0.05 were consid-ered to indicate significant differences. The significant variables were entered into logistic regression models to de-termine the risk factors for the severity of AK1 in patients with crush syndrome and whether the patient required HD. Results Four significant risk factors with P -values < 0.05 were identified: fasciotomy, cystatin C (Cys C)level, myoglobin (MB) level and lactic acidosis. The odds ratios (95% confidence intervals) were 8.641 (3.027～76.479), 6.956 (3.027～76.479), 5.379 (3.027～76.479) and 4.833 (2.569～32.764), respectively. Conclusions In addition to urine output and potassium levels, we found that four risk factors, namely faseiotomy, Cys C and MB levels, and lactic acidosis, were significanfly associated with the severity of AKI and whether the patient required hemodialysis.

BACKGROUND: Recentry, the prevalence of HBsAg in children has been gradually decreased in Korea may be due to extensive vaccination. The object of this study is to identify the HbsAg positive rate in 6 to 7 year-old school children in Seoul and to outline the surveilance status of the HBsAg positive subjects. METHODS: We analyzed HBV mass screening results of 120,106 6 to 7-year-old school children in Seoul. For 188 HBsAg positive children who complied with the follow up visit, we tested HBeAg, LFT and interviewed their parents. We also compared the questionnaire results of HbsAg positive group with those of 694 random-sampled HBsAg negative controls. RESULTS: The overall HBsAg positive rate was 0.79%(0.81% in boys and 0.76% in girls). Children in poverty area showed significantly higher rate(1.04%) of HBsAg positivity than those in non-poverty area(0.77%). Among HbsAg positive children, 86.7% was also HBeAg positive and had higher ALT levels than those with negative HBeAg. More than 70% of parents of HBsAg positive children was not aware of their children's HBsAg status before the screening and 28.7% of mothers did not know their own HbsAg status. The complete vaccination rate of the HBsAg positive and HBsAg negative group were 75.5% and 77.4% respectively, which shows no significant difference. Having family history of HBV infection was significantly associated with HBsAg positive status(OR=32. 8). CONCLUSIONS: The HBsAg positive rate in 6- to 7-year-old school children has decreased in Korea compared to the data from previous studies. However in the aspects of public awareness and health care compliance, there are much room for quality improvement. Above all, more rigorous and continuous surveilance system is required for antenatal and postpartum care.
Child* ; Compliance ; Delivery of Health Care ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Mass Screening ; Mothers ; Parents ; Pilot Projects* ; Postnatal Care ; Poverty Areas ; Prevalence ; Quality Improvement ; Seoul* ; Vaccination ; Surveys and Questionnaires