Objective:To evaluate the efficacy of Liangxue-Xiaofeng Decoction combined with acitretin A capsule in the treatment of psoriasis vulgaris. Methods:A total of 80 patients with psoriasis vulgaris from March 2015 to June 2019 in our hospital, who met the inclusion criteria, were divided into two groups according to the random number table method, 40 patients in each group. The control group was given acitretin A capsules on the basis of conventional western medicine treatment, and the study group was given Liangxue-Xiaofeng Decoction on the basis of the control group. Both groups were treated for 2 months and followed up for 6 months. The skin lesion area and Psoriasis Area and Severity Index (PASI) scores were performed before and after treatment. The levels of IL-8, IL-6 and TNF-α were detected by real time PCR amplification, and the levels of histone acetyltransferase (HATs) and histone deacetylase (HDACs) by ELISA. The adverse reactions and recurrence during the follow-up period were recorded and the clinical efficacywas evaluated. Results:The total effective rate of the study group was 82.5% (33/40) and that of the control group was 62.5% (25/40). The difference between the two groups was statistically significant ( χ2=4.012, P=0.045). After treatment, the PASI score of the study group was significantly lower than that of the control group ( t=7.921, P<0.01), and the serum levels of IL-8, IL-6 and TNF-α were significantly lower than those in the control group ( t=12.749, 13.933, 10.856, all Ps<0.01); the activity of HATs [(35.03 ± 3.79) g/L vs. (29.26 ± 2.41) g/L, t=8.125] of the study group was significantly higher than that of the control group ( P<0.01), and HDACs activity [(31.00 ± 2.71) g/L vs. (37.55 ± 3.08) g/L, t=10.098] of the study group was significantly lower than that of the control group ( P<0.01). Conclusions:Acitretin A capsule combined with Liangxue-Xiaofeng Decoction can reduce the level of inflammatory cytokines in patients with psoriasis vulgaris, and prevent the disease progression. The mechanism may be related to the regulation of homeostasis balance in acetylation.

Objective: To investigate the changes of the intestinal mucosa-associated microbiota in the patients with ulcerative colitis (UC), and to explore their correlation with the clinical manifestations. Methods: From June to October 2016, at Gastrointestinal Endoscopy Center, the Second Affiliated Hospital of Xi′an Jiaotong University, 28 patients with UC and 16 healthy individuals who underwent colonoscopy examination were enrolled. The mucosa specimens of them were collected for fluorescent in situ hybridization (FISH). The bacterial flora were observed and counted, the correlation between the bacterial flora and the clinical manifestations were analyzed. Kruskal-Wallis test and Spearman rank correlation analysis were performed for statistical analysis. Results: Among 28 patients with UC, 16 were at active phase and 12 at remission phase. The number of total bacteria flora, Escherichia coli, Clostridium and Bacteroides of the active UC group and remission UC group were all more than those of healthy control group; however the number of Lactobacillus and Bifidobacteria were less than those of healthy control group, and the differences were statistically significant (χ²=23.34, 19.94; 23.40, 12.96; 23.39, 19.16; 23.32, 10.46; 23.19, 4.25; 18.94, 12.33; all P<0.05). The number of total bacteria flora, Escherichia coli and Bacteroides of the active UC group were more than those of the remission UC group, however the number of Lactobacillus and Bifidobacteria were less than those of the remission UC group, and the differences were statistically significant (χ²=7.32, 5.63, 5.62, 20.38 and 4.82; all P<0.05). In the patients with UC, the defecation frequency was positively correlated with the count of Bacteroides (r=0.459, P=0.014) and was negatively correlated with the count of Lactobacillus (r=-0.634, P<0.01). In UC patients, bloody stool, endoscopic appearance and total Mayo score were positively correlated with the counts of universal bacteria, Escherichia coli and Bacteroides (r=0.469, 0.403, 0.376; 0.604, 0.562, 0.475; 0.551, 0.463, 0.461; all P <0.05); and which were negatively correlated with Lactobacillus and Bifidobacteria (r=-0.570, -0.413; -0.899, -0.458; -0.862, -0.480; all P<0.05). The evaluation by the doctors was positively correlated with the counts of Escherichia coli (r=0.415, P=0.028), however was negatively correlated with Lactobacillus and Bifidobacteri (r=-0.841, -0.529; both P<0.01). Conclusion The intestinal microbiota have sigificantly changed in patients with UC which are correlated with some clinical manifestations of UC.

Objective To explore clinical efficacy of elephantiasis myogenic cream for treatment of chronic refractory skin ulcer. Methods A total of 91 chronic refractory skin ulcer patients were randomized into the treatment group (n=46) and the control group (n=45) by random number table method. Patients of control group were treated with conventional debridement, while the treatment group were treated with elephantiasis myogenic cream. The two groups were treated for 4 weeks. Clinical curative effect was evaluated after treatment. The pain score at the times of debridement and ulcer wound healing time of the two groups were compared. The FGF-2, VEGF and fiber connection (Fn) of wound secretion of the two groups before and after treatment were compared. Results Total effective rate of treatment group was 87.0％ (40/46), which was significantly higher than the control group 66.7％ (30/45), and the difference was statistically significant (χ2=5.275, P=0.022). The pain score at the time of 2 w and 4 w after treatment in the treatment group were significantly lower than those in the control group (t value were 10.456, 12.266, all Ps<0.01). After treatment, ulcer wound healing time in the treatment group were significantly lower than those in the control group (t=2.911, P=0.002). After treatment, the FGF-2 (7.72 ± 0.58 ng/ml vs. 6.37 ± 0.50 ng/ml, t=11.881), VEGF (24.85 ± 5.63 ng/ml vs. 18.75 ± 4.51 ng/ml, t=5.697) and Fn (4.15 ± 0.42 ng/ml vs. 3.47 ± 0.38 ng/ml, t=8.093) of wound secretion in the treatment group were significantly higher than those in the control group (P<0.05).There were no serious adverse reaction of the two groups during treatment. Conclusions The elephantiasis myogenic cream for treatment of chronic refractory skin ulcer has a good efficacy and low adverse reactions, can relieve patients' pain, improve the wound heal, reduce heal times.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.