Objective To evaluate and explore the Patients with acute cerebral infarction P-selectin and C-reactive protein (CRP) clinical significance.Methods According to the degree of neurological deficit scores were divided into light group (38 cases),medium group (35 cases) and severe group (25 cases),30healthy subjects were selected as the control group,measured at different time levels of P-selectin and CRP.Results Light group,medium group,severe group admitted 24 h P-selectin levels were higher,the difference was statistically significant (P ＜ 0.05).Light group,medium group,severe group admission decreased after 3 d P-selectin levels were highest; mild group admitted 24 h,7 d P-selectin levels and medium-sized group and severe group differences were statistically significant (P ＜ 0.05).Light group,medium group,severe group admission 3 d P-selectin levels were statistically significant differences (P ＜ 0.05) among the three groups.Light group,medium group admitted 14 d P-selectin levels and heavy group differences were statistically significant (P ＜ 0.05).Light group,medium group,severe group admitted 24 h CRP levels were higher,the difference was statistically significant (P ＜ 0.05).Light group,medium group,severe group admitted 24 h,3 d,7 d,14 d CRP levels decreased,comparing the differences among the three groups were statistically significant (P ＜ 0.05) at the same time point.Linear correlation analysis showed that P-selectin hormone levels and CRP levels were positively correlated (r =0.493,P ＜ 0.05).Conclusions Serum P-selectin and C reactive protein may be involved in the pathological process of ACI.The changes of serum P-selectin and C reactive protein levels were contributed to judge severity of pathological changes,focus range and prognosis assessment.It is an important biochemical observational indicator,and it's worthy recommending in clinic.

Objective:To investigate whether febuxostat with stepwise dose increase is as useful as colchicine prophylaxis in comparison with febuxostat with no dose titration when initial introduction of urate-lowering therapy in patients with gout. And to determine the effect of urate-lowering therapy in the treat to target by febuxostat with stepwise dose increase.Methods:In this prospective, multicentre, randomized open-label comparative study, patients were randomized to group A (stepwise dose increase of febuxostat from 10 to 40 mg/d), group B (fixed-dose febuxostat 40 mg/d plus colchicine 0.5 mg/d) or group C (fixed-dosefebu-xostat 40 mg/d) and were followed-up for 24 weeks. Non-steroidal anti-inflammatory drug was used to control symptoms when acute flare occurred. Patients were follow-up every 4 weeks. The comparison between groups was made by single factor analysis of variance (ANOVA). χ2 test was used to compare groups. Results:A total of 276 patients were randomized, and 253 patients were treated. 211 patients completed the study and were follow-up. Among the treated patients, gout flares were experienced by 12/84(25.0%) in group A, 20/85(23.5%) in group B and 26/42 (61.9%) in group C. There was no significant difference between group A and group B ( χ2=0.050, P=0.824) in gout flares. There was significantly higher frequency in gout flares in group C than that in group A and group B ( χ2=22.040, P<0.01). The proportion of patients reaching the target of urate-lowering therapy in group A at 4 and 8 weeks was significantly lower than that in group B and C. And there was no significant difference among the three groups after 12 weeks. Conclusion:Stepwise dose increase of febuxostat and low-dose colchicine has the same prophylaxis effectiveness in reducing gout flares but are more effective in prevent acute flare when compared with fixed-dose febuxostat alone. Stepwise dose increase of febuxostat may be an effective alternative to low-dose colchicine prophylaxis during the introduction of urate-lowering therapy.

ObjectiveTo investigate the mechanism of topical treatment of allergic contact dermatitis （ACD） mice with Portulacae Herba based on the nuclear factor E₂-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）/nuclear factor-κB （NF-κB） signaling pathway. MethodsA total of 70 6-week-old specific pathogen free （SPF） female Kunming mice were adaptively fed for 1 week and randomly divided into blank group， model group， compound dexamethasone acetate cream group （2.075×10^-2 g·g^-1）， blank matrix cream group， low-dose Portulacae Herba cream group （0.1 g·g^-1）， high-dose Portulacae Herba cream group （0.2 g·g^-1）， and Portulacae Herba + inhibitor group （0.2 g·g^-1 + 30 mg·kg^-1 ML385）， with 10 mice in each group. One day before the experiment， the mice were shaved on the neck and back. Except for the blank group， the mice in the other groups were treated with 2，4-dinitrochlorobenzene （DNCB） to establish an ACD model. After respective administration， the skin lesion of the mice was scored， and the histopathological changes of the skin were stained with hematoxylin-eosin （HE）. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of interleukin-6 （IL-6）， interleukin-1β （IL-1β）， reactive oxygen species （ROS）， superoxide dismutase （SOD） activity， and malondialdehyde （MDA） in serum of mice. The expression of Nrf2/HO-1/NF-κB signaling pathway-related proteins in mouse skin tissue was detected by immunohistochemistry （IHC）， Western blot， and real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultsCompared with the blank group， the mice in the model group had an increased skin lesion score （P<0.01）， severe pathological damage to skin tissue， increased content of IL-1β， IL-6， ROS， and MDA in their serum （P<0.01）， and decreased content of SOD （P<0.01）. In addition， the mRNA and protein expression levels of Nrf2， HO-1， and nuclear factor-κB inhibitor α （IκBα） in skin tissue were up-regulated （P<0.01）， while the protein expression levels of phosphorylated （p）-IκBα and p-NF-κB p65 and the mRNA expression of NF-κB p65 were down-regulated （P<0.01）. Compared with the model group and the blank matrix cream group， the mice treated with Portulacae Herba had a decreased skin lesion score （P<0.01）， reduced pathological damage to skin tissue， decreased content of IL-1β， IL-6， ROS， and MDA in their serum （P<0.01）， and increased content of SOD （P<0.01）. Additionally， the mRNA and protein expression levels of Nrf2， HO-1， and IκBα in skin tissue were down-regulated （P<0.05，P<0.01）， and the protein expression levels of p-IκBα and p-NF-κB p65 and the mRNA expression of NF-κB p65 were up-regulated （P<0.05，P<0.01）. Compared with the Portulacae Herba + inhibitor group， the high-dose Portulacae Herba cream group had a decreased skin lesion score （P<0.01）， alleviated pathological damage to skin tissue， decreased content of IL-1β， IL-6， ROS， and MDA in the serum of mice （P<0.05，P<0.01）， and increased content of SOD （P<0.01）. The protein expression levels of Nrf2， HO-1， and IκBα and the mRNA expression of Nrf2 and HO-1 in skin tissue were up-regulated （P<0.05，P<0.01）， and the protein expression levels of p-IκBα and p-NF-κB p65 and the mRNA expression of NF-κB p65 were down-regulated （P<0.05）. ConclusionPortulacae Herba can improve DNCB-induced ACD skin damage in mice by regulating the Nrf2/HO-1/NF-κB signaling pathway.