There are various kinds of antihypertensive agents with complex chemical structures. Common antihypertensive agents are divided into 5 classes, including diuretics, calcium antagonists, angiotensin-converting enzyme inhibitors, angiotensin Ⅱ receptor blockers and β-blockers, and can cause various types of drug eruptions. This review summarizes clinical characteristics, possible pathogenesis, treatment and consequences of antihypertensive agent-induced drug eruptions, including angioedema, and lupus erythematosus-like, psoriasis-like, eczematoid, herpetiform or lichen planus-like drug eruptions, in hope to facilitate their early detection, diagnosis and treatment, and to provide information and ideas for clinical and basic researches into them.

Skin microbiome maintain homeostasis with the host, and affect skin barrier and immune function. The components of skin microbiome are diverse and specific, and are affected by multiple factors. The predominance of Staphylococcus aureus and decrease in diversity of skin microbiome are a characteristic of atopic dermatitis. The overgrowth of S. aureus can aggravate inflammatory reactions in AD. S. epidermidis, although another predominant bacterium in AD, exerts an immunoprotective role by regulating skin barrier?associated immunoreactions through the dendritic cells, interleukin (IL)?17A?producing Th17 cells/IL?17 pathway, and by suppressing the overgrowth of S. aureus. Malassezia can induce and aggravate inflammatory reactions in AD through colonization, sensitization, cross reactions, and other mechanisms. Studies on skin probiotics may provide new directions for the treatment of AD.

Objective To study the expressions of survivin and caspase-9 in human primary hepatocellular carcinoma(HCC) tissues and their relationship with apoptosis.Methods Immunohistochemical staining was uesed to detect the expressions of survivin and caspase-9 in paraffin sections of 96 cases including 42 HCC tissues,42 paired adjacent noncancerous tissues and 12 normal liver tissues. Apoptosis was detected by TUNEL.Results No immunoreactivity of survivin was seen in normal liver tissues.The positive rates of survivin in HCC and paired adjacent noncancerous tissues were 73.81% and 4.76%,respectively,there was significant difference between two groups(P0.05).The expressions of survivin and caspase-9 in HCC tissues were not associated with age,sex and the size of tumor,but they were directly associated with tumor histological grade and metastasis.Conclusion High expression of survivin in HCC may inhibit apoptosis through depressing the expression of caspase-9,and it is an indicator of independent poor prognosis.

Objective To evaluate the efficacy and safety of an acne-clearing device in treating acne vulgaris.Methods A bicenter,randomized,single-blinded,placebo-controlled,parallel-group study was conducted.Seventy-three patients with mild to moderate acne vulgaris were enrolled for the trial.Two similar,clinically matched inflammatory papules were selected from each patient,and divided into a test group and a control group to be treated with an acne-clearing device with an output temperature of 46-50 ℃ and a control device without heat source respectively,for three sessions with the interval varying from 1 to 12 hours between the first two sessions and from 18 to 48 hours between the last two sessions.Every treatment lasted three minutes.Lesional color and size were recorded before and on day 1,5 and 14 after the first treatment.Side effects were also recorded for the evaluation of safety.Results Clinical improvement was observed in 66 (90.4％),73 (100.0％) and 72 (98.6％) patients,and marked improvement in 27 (37.0％),64 (87.7％) and 72 (98.6％) patients on day 1,5 and 14 after the first treatment,respectively.Significant differences existed between the control and test group in improvement rate on day 1 and 5,and in marked improvement rate on all the three time points (all P ＜ 0.01).The average time taken for erythematous swelling to begin to subside and time for lesions to completely heal were 19.51 hours and 7.15 days respectively in the test group,significantly shorter than those in the control group by 82.41 hours and 5.07 days respectively.Conclusions The acne-clearing device proves to be effective and safe for the treatment of mild to moderate acne vulgaris,which can rapidly relieve the inflammation in acne,shorten the time required for erythematous swelling to subside and for lesions to completely heal.

Objective To investigate the immunoregulatory ability of human lung-derived mesenchymal stem cells (MSCs) on T cells. Methods MSCs were isolated and cultured from human fetal lung. The immune phenotype was tested by flow cytometry and T lymphocyte proliferation assessed by thymidine incorporation. Results HLA-DR, CD86, and CD80 were not expressed in human lung-derived mesenchymal stem cells. The proliferation of peripherial blood-derived T cells was suppressed and this suppression seemed dependent on the concentration of MSCs. Conclusion Human lung-derived MSCs have been proved to possess immunomodulatory ability.

Objective To explore the diagnostic value of 18F-FDG PET/CT delayed imaging after induced diuresis for primary bladder tumor.Methods Fourteen patients (12 males,2 females; age range 35-88 years) with pathologically confirmed primary bladder tumor (clinical stage T1.3N0M0) were retrospectively analyzed.All patients underwent standard 18F-FDG PET/CT followed by a delayed (2.5-3.0 h later)pelvic imaging post intravenous injection of 20 mg furosemide and oral intake of 600 ml water.A positivelesion was defined as the uptake of 18F-FDG greater than the urine radioactivity and negative as equaled to or less than the urine radioactivity.Diagnostic efficacy of 18F-FDG PET/CT was calculated with pathology as the gold standard.Mann-Whitney u test was used to analyze data.Results There were 12 malignant (11 urothelium carcinomas and 1 squamous cell carcinoma) and 2 benign tumors (papillary epitheliomas).On standard PET/CT imaging,3 of 12 malignant lesions showed increased metabolism of 18F-FDG and the other 9 were false negative; while the 2 benign tumors showed no abnormal 18F-FDG uptake.The sensitivity,specificity,and accuracy of 18F-FDG PET/CT were 3/12,2/2 and 5/14,respectively.Sizes of the 3 18F-FDG-avid malignant lesions were greater than those of other 9 18F-FDG-negative lesions (26,30,35 mm vs (15.6±6.3) mm; Z=-2.315,P＜0.05).The sensitivity,specificity,and accuracy of delayed pelvic imaging were 11/12,2/2,13/14,respectively.Conclusion 18F-FDG PET/CT delayed imaging after diuresis has a high diagnostic efficacy for primary bladder tumor.

Objective To explore the diagnostic value of delayed 18 F?FDG PET/CT pelvic imaging after forced diuresis in detecting male patients with locally recurrent rectal cancer. Methods Thirty?two male patients ( 32-79 years) with clinically suspicious recurrences of rectal cancer were retrospectively ana?lyzed. All patients underwent a standard 18 F?FDG PET/CT followed by a delayed pelvic imaging after 2.5 h of administration of 20 mg furosemide intravenously and extra water intake of 500 ml at least. Final diagnosis was made by pathology or clinical follow?up (>10 months ) . Diagnostic efficiency of 18 F?FDG PET/CT standard and delayed pelvic images were calculated and compared. χ2 test was used for data analysis. Re?sults A total of 25 patients were diagnosed with recurrent rectal cancer, including 10 cases with invasion of surrounding tissue, and 5 cases with metastases. Among the 7 patients without local recurrences, 2 had dis?tant metastases. The sensitivity, specificity, and accuracy of standard FDG PET/CT were 92.0%(23/25), 3/7, 81.2%(26/32), respectively. The corresponding values of the delayed imaging were 96.0%(24/25), 6/7, and 93.8%(30/32), respectively. The specificity of delayed imaging was higher than that of standard FDG PET/CT (χ2=14.333, P<0.05) , but no significant differences were found in sensitivity and accuracy between the delalyed imaging and standard FDG PET/CT (χ2=0.085 and 0.966, both P>0.05) . The urina?ry bladder activity reached or approached the background during the delayed imaging. Twenty?two malignant lesions of surrounding invasion were confirmed. The positive rate of delayed imaging was higher than that of standard FDG PET/CT:95.5%(21/22) vs 63.6%(14/22);χ2=6.400, P<0.05. Conclusions 18F?FDG PET/CT delayed pelvic imaging after diuresis and hydration is useful for eliminating the artifacts from urina?ry bladder activity, and for detecting the invasion to the rectal surrounding tissue more effectively. It could be a supplement to standard FDG PET/CT.

Objective: To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. ＜br> Methods: According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. ＜br> Results: The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant (P＜0.05). After treatment, cervical range of motion (ROM) scores in both groups were statistically significantly different from those before treatment (allP＜0.05); in addition, there was a statistically significant difference in inter-group comparison of ROM score (P＜0.05). ＜br> Conclusion: Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.

10.3969/j.issn.1000-8179.2013.12.008

Objective To investigate the efficacy of proton pump inhibitors (PPI) combined with flupethixol melitracen in the treatment of non-erosive gastroesophageal reflux disease (NERD) with anxiety and depression.Methods Fifty six NERD patients with anxiety and depression were evenly divided into the positive treatment group and positive control group.Thirty NERD patients without anxiety and depression were set as negative control group.Both flupethixol melitracen (20 mg per day after breakfast) and PPI esomeprazole magnesium (20 mg per day,20 minutes before breakfast) were administrated in positive treatment group.Only esomeprazole magnesium was given in positive control group and negative control group and the dosage was same as that of positive treatment group.The treatment course of three groups was eight weeks.Before and after the treatment,the symptoms of patients were scored according to gastroesophageal reflux disease questionnaire (GERDQ),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and Pittsburgh sleep quality index (PSQI).Adverse effects were also observed.Variance analysis was performed for the comparison among three groups.Variance analysis or Post-hoc analysis were used for comparison between two groups.Results The differences of different score value before and after treatment of three groups were statistically significant in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (F=6.32,3.93,5.63,49.61,78.69 and 7.07,all P＜ 0.05).The differences of the score value before and after treatment of positive treatment group in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (4.24±2.05,3.16±1.46,1(0,3),9.32±3.21 and 8.88±2.92) were all higher than those of positive control group (2.38±2.22,1.68±1.33,0(0,2),3.72±2.95 and 3.84±1.97) and negative control group (2.32±2.18,2.48±1.34,0(0,1),2.36±1.25 and 2.36±0.79).And the differences were statistically significant (positive treatment group vs positive control group:Post-hoc analysis,P=0.002,0.022,0.003,0.002 and 0.002; positive treatment group vs negative control group:Post-hoc analysis,P=0.001,0.021,0.004,0.001 and 0.001).The difference of the score value before and after treatment of positive treatment group in PSQI (4 (2,6)) was higher than that of negative control group (2 (1,3),Post-hoc analysis,P=0.001).Two cases of positive treatment group had mild dizziness and the symptom relieved after three to four days.Conclusions For NERD patients with anxiety and depression,anti-depression drug flupenthixol melitracen can be used and the effect is superior to using PPI alone.