Basal cell carcinoma (BCC) is the most common malignant tumor in dermatology with incidence rising rapidly. Expert consensus on diagnosis and treatment of cutaneous basal cell carcinoma (2021) was published in September 2021 by Skin Tumor Research Center, Chinese Society of Dermatology and Subcommittee on Skin Tumor, China Dermatologist Association. This consensus comprehensively describes the epidemiology, pathogenesis, clinical manifestations, auxiliary examination, pathology, pretreatment assessment, treatment, prognosis, and follow-up education. It offers an important guideline for promoting the standardized diagnosis and treatment of skin BCC in China. In this work, multidisciplinary experts interpreted the main contents of the consensus, including clinicopathological findings, pretreatment assessment, and treatment advance.

OBJECTIVETo examine whether calcineurin/NFAT signaling pathway mediates endothelin-1 (ET-1)-induced proliferation of pulmonary artery smooth muscle cells (PASMCs) by regulating phosphodiesterase-5 (PDE5) and the effect of the selective calcineurin inhibitor cyclosporine A and PDE5 inhibitor sildenafil on ET-1-induced PASMC proliferation.

METHODSPASMCs were treated with ET-1 to stimulate their proliferation with or without prior treatment of the cells with CsA or sildenafil. Calcineurin activity in the cells was measured using a calcineurin activity assay kit, PDE5 expression examined using immunoblotting, and cGMP level detected using a cGMP direct immunoassay kit. PASMC proliferation following the treatments was determined using [(3)H]thymidine incorporation assay.

RESULTSET-1 caused a 2.05-fold increase in the cellular calcineurin activity, a 1.80-fold increase in PDE5 expression, and a 3.20-fold increase in the DNA synthesis rate, and reduced the cGMP level by 67%. Pretreatment of the cells with Cyclosporine blocked the effects of ET-1, and PDE5 inhibition by sildenafil pretreatment also abolished ET-1-induced reduction of cGMP level in the cells. Both Cyclosporine and sildenafil suppressed ET-1-stimulated PASMC proliferation.

CONCLUSIONActivation of calcineurin/NFAT signaling pathway mediates ET-1-induced PASMC proliferation by stimulating PDE5 expression, which further degrades cGMP. Both Cyclosporine and sildenafil can suppress ET-1-stimulated PASMC proliferation in vitro.

Animals ; Calcineurin ; metabolism ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclic GMP ; metabolism ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; metabolism ; Cyclosporine ; DNA ; biosynthesis ; Endothelin-1 ; pharmacology ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; enzymology ; NFATC Transcription Factors ; metabolism ; Piperazines ; Pulmonary Artery ; cytology ; Purines ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Sildenafil Citrate ; Sulfones

OBJECTIVETo identify the immunological characteristics of the recombinant major pollen allergen pTSX2 of Humulus scandens and evaluate its safety in immunotherapy of allergic asthma in mice.

METHODSWestern blotting was used to characterize the immunological properties of pTSX2, and its immunogenicity in normal mice was evaluated by detecting sIgG and sIgE levels. The mouse models of allergic asthma were immunized with pTSX2 and examined for sIgE and sIgG levels, total cells and eosinophils percentage in BALF, interleukin-4 (IL-4) and interferon-γ (IFN-γ) levels in BALF and spleen homogenate, and changes in lung pathologies.

RESULTSWestern blotting showed that pTSX2 reacted with the majority (about 70%) of sera from patients allergic to Humulus pollen. In normal mice, pTSX2 mainly induced the production of sIgG. In mouse models of allergic asthma, intervention with pTSX2 caused a significant reduction of sIgE and an increase of sIgG (P<0.05), significantly decreased the total cells and eosinophils in BALF (P<0.05), obviously lowered IL-4 but increased IFN-γ in BALF and spleen homogenate (P<0.05), and diminished inflammatory cell infiltration and percentage of eosinophils in the lung tissues.

CONCLUSIONSpTSX2 shows a definite therapeutic effect and safety in the treatment of allergic asthma in mice possibly by inhibiting sIgE and inducing sIgG production, suppressing airway allergic inflammation and regulating the balance between Thl and Th2.

Allergens ; immunology ; Animals ; Asthma ; immunology ; therapy ; Bronchoalveolar Lavage Fluid ; immunology ; Disease Models, Animal ; Female ; Humans ; Humulus ; immunology ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Immunotherapy ; Interferon-gamma ; analysis ; Interleukin-4 ; analysis ; Mice ; Mice, Inbred BALB C ; Pollen ; immunology ; Th1 Cells ; cytology ; immunology ; Th2 Cells ; cytology ; immunology

A total of 189 stool samples from swine with diarrhea, collected in various porcine farms in the central region of China were tested for porcine enteric caliciviruses (PEC) member porcine sapoviruses (SaV) by reverse transcription polymerase chain reaction (RT-PCR) amplification using primers designed to detect porcine SaV. Selected amplicons were sequenced to establish phylogenetic relationships with reference strains. Porcine SaV were detected in 12.70% (24/189) of the samples. Phylogenetic studies based on partial RNA polymerase gene sequences indicated that the field strains of viruses isolated in China were closely related (75.6 88.3% identity) to the porcine SaV Cowden reference strain. These results provide evidence that caliciviruses of the genus sapovirus circulate in piglets in China, but further studies are needed to clarify their importance as cause of diarrhea. This is the first report of PEC in China.

Objective To investigate the clinicopathological characteristics and treatment effect of patients with non-small cell lung cancer (NSCLC) and uncommon epidermal growth factor receptor (EGFR) gene mutations. Methods Real-time fluorescence quantitative PCR was used to detect the mutation of EGFR in 674 samples of patients with NSCLC.The correlation between uncommon EGFR mutations and clinicopathological characteristics was analyzed. Results The EGFR mutation rate was 47.92%, of which the incidence of uncommon EGFR mutations was 5.19%, showed the presence of ex18 G719 A/S/C (G719X)(1.63%), ex20ins (1.04%), ex21 L861Q (0.74%), and compound mutations (1.78%).Correlation analysis showed that uncommon EGFR mutations were more common in women, non-smokers, patients with high-medium differentiation and adenocarcinoma, and patients were more prone to brain and bone metastasis (all P < 0.05).NSCLC with uncommon EGFR mutations showed no significant differences in clinical and pathological features compared with those with common sensitive mutations (all P > 0.05).Follow-up information was available on 31 patients, with a median follow-up time of 10 months, of which 23 were in advanced stage.Among eight patients with G719X mutation in late stage, seven patients used EGFR tyrosine kinase inhibitor (EGFR TKIs)(five of them used afatinib) in the first line and had a median PFS of 12 months; one patient received chemotherapy with pemetrexed and carboplatin and had PFS of seven months, which was lower than that of the TKI group.Among four patients with L861Q mutation in late stage, one patient was untreated and the three remaining were treated with TKI in the first line and had a median PFS of eight months.The patient who was treated with afatinib and bevacizumab was still stable after 11 months of follow-up.Two patients with EGFR ex20ins in advanced stage were treated with chemotherapy and bevacizumab.Nine patients with compound mutations in advanced stage were treated with TKI; among which, five patients harboring T790M compound mutations were treated with third-generation TKI and had a median PFS of more than 10 months. Conclusion The correlation between specific uncommon EGFR mutation and clinical pathological characteristics varies.For advanced patients with uncommon EGFR mutations (except for ex20ins), TKI is generally chosen as the first-line clinical treatment.Afatinib is recommended for advanced NSCLC patients with G719X and L861Q mutations.Third-generation TKI has significant efficacy in patients with complex mutations containing T790M.

Objective To evaluate the clinical efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis (TEN),and to investigate its adverse reactions.Methods Patients with TEN receiving single-session plasmapheresis therapy alone were collected from the Second Affiliated Hospital of Xi'an Jiaotong University between September 2010 and December 2017.Clinical data on the disease severity,clinical efficacy,hospitalization duration and adverse reactions were analyzed.Results A total of 17 patients with TEN were enrolled into this study,including 9 males and 8 female,with an average age of 36.1 ± 25.4 years.Their initial SCORTEN and STENS scores were 2.1 ± 1.24 and 29.9 ± 6.6 respectively.After treatment,the STENS score decreased to 3.5 ± 1.8.Of the 17 patients,15 were cured after single-session plasmapheresis therapy,1 showed response to the treatment,and 1 died.The duration of intensive care unit stay was 6.4 ± 1.8 days,and the total hospitalization duration was 12.1 ± 5.7 days.There was no significant difference in the STENS score among the day 1,4,7,10 and 20 after hospital admission (F =18.569,P ＜ 0.05).No severe adverse reactions were observed,except 2 cases of plasma allergy.Conclusion Single-session plasmapheresis therapy alone is effective for the treatment of TEN without obvious adverse reactions.

Pulmonary hypertension (PAH) is a common clinical syndrome characterized by elevated pulmonary arterial pressure. The pathological changes in PAH include increased vasoconstrictor tone, thrombosis in situ and pulmonary vascular remodeling. Pulmonary arterial smooth muscle cell (PASMC) proliferation is a hallmark of pulmonary vascular remodeling, and exploration of the molecular mechanisms of PASMC proliferation and intervention of the involved signaling pathways is therefore of great importance for prevention and treatment of PAH. This review focus primarily on the current understanding of the molecular mechanisms involved in the proliferation of PASMCs.
Cell Proliferation ; Humans ; Hypertension, Pulmonary ; Lung ; Myocytes, Smooth Muscle ; cytology ; Pulmonary Artery ; cytology ; Signal Transduction ; Vascular Remodeling

OBJECTIVETo examine the correlation of the changes in the serum markers (C-reactive protein, endothelin-1, interleukin-6, and brain natriuretic peptide) with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension secondary to COPD.

METHODSA total of 174 COPD patients with acute exacerbation, admitted between February 2011 and February, 2013, were enrolled in this study, with 43 volunteers with normal pulmonary functions as controls. Pulmonary arterial pressure was determined by Doppler echocardiograph, and the severities (mild, moderate and severe) of PH secondary to COPD was evaluated. The levels of serum markers were determined using ELISA kits.

RESULTSThe levels of serum markers in patients with COPD was significantly elevated compared with those of the control subjects (P<0.05), and further increased in patients with pulmonary hypertension secondary to COPD (P<0.05). A positive correlation was found between these serum markers and pulmonary artery pressure in COPD patients with mild and moderate pulmonary hypertension. In patients with severe pulmonary hypertension, only the serum level of brain natriuretic peptide continued to increase with pulmonary artery pressure (P<0.05), and the other markers did not further increase.

CONCLUSIONSEarly and combined examination of these serum markers in patients with COPD can help to identify pulmonary hypertension in early stage and estimate the severity of pulmonary hypertension. Hemodynamic monitoring of the changes of these serum markers can be of important clinical value in the treatment of pulmonary hypertension secondary to COPD and in evaluation of the prognosis of COPD.

Aged ; Biomarkers ; blood ; Blood Pressure ; C-Reactive Protein ; metabolism ; Endothelin-1 ; blood ; Female ; Humans ; Hypertension, Pulmonary ; blood ; complications ; physiopathology ; Interleukin-6 ; blood ; Male ; Natriuretic Peptide, Brain ; blood ; Pulmonary Disease, Chronic Obstructive ; blood ; complications ; physiopathology

OBJECTIVETo systematically review whether statins can reduce the risk of infection and infection-related mortality.

METHODSWe searched the Cochrane Library, MEDLINE, EMBASE, PubMed, Elsevier and CBM databases for randomized placebo-controlled trials of statins published by September 2013, and each trial enrolled at least 100 participants with follow-up for at least 4 weeks. Two reviewers independently assessed the quality of the included studies and extracted the relevant data for analysis using Stata 12.0 software.

RESULTSSixteen trails involving a total of 48973 patients were included in our meta-analysis. The results showed that statins significantly reduced the risk of infection (OR=0.93, 95% CI 0.89 to 0.98, P=0.004) compared to placebo but did not significantly lower infection-related mortality (OR=0.96, 95% CI 0.82 to 1.12, P=0.592).

CONCLUSIONStatins can significantly reduce the risk of infection but does not lower infection-related mortality.

Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Infection ; epidemiology ; mortality ; Randomized Controlled Trials as Topic ; Risk Factors

Objective To examine the correlation of the changes in the serum markers (C-reactive protein, endothelin-1, interleukin-6, and brain natriuretic peptide) with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension secondary to COPD. Methods A total of 174 COPD patients with acute exacerbation, admitted between February 2011 and February, 2013, were enrolled in this study, with 43 volunteers with normal pulmonary functions as controls. Pulmonary arterial pressure was determined by Doppler echocardiograph, and the severities (mild, moderate and severe) of PH secondary to COPD was evaluated. The levels of serum markers were determined using ELISA kits. Results The levels of serum markers in patients with COPD was significantly elevated compared with those of the control subjects (P<0.05), and further increased in patients with pulmonary hypertension secondary to COPD (P<0.05). A positive correlation was found between these serum markers and pulmonary artery pressure in COPD patients with mild and moderate pulmonary hypertension. In patients with severe pulmonary hypertension, only the serum level of brain natriuretic peptide continued to increase with pulmonary artery pressure (P<0.05), and the other markers did not further increase. Conclusions Early and combined examination of these serum markers in patients with COPD can help to identify pulmonary hypertension in early stage and estimate the severity of pulmonary hypertension. Hemodynamic monitoring of the changes of these serum markers can be of important clinical value in the treatment of pulmonary hypertension secondary to COPD and in evaluation of the prognosis of COPD.