Objective:To evaluate the clinical efficacy and safety of secukinumab in the treatment of moderate to severe the adults with plaque psoriasis.Methods:The clinical data from 183 adult patients with moderate to severe plaque psoriasis treated with secukinumab were collected.The patients received subcutaneous injections of secukinumab once a week at weeks 0,1,2,3,and 4,followed by an injection every 4 weeks,with each dose of 300 mg.The follow-up period was 52 weeks.The psoriasis area and severity index(PASI),body surface area(BSA),investigator global assessment(IGA),and dermatology life quality index(DLQI)scores of the patients with psoriasis were caculated.The clinical efficacy and safety of secukinumab in the treatment of moderate to severe plaque psoriasis were evaluated,and the influencing factors were analyzed.Results:Compared with week 0,the PASI、BSA、IGA and DLQI scores of the patients were significantly decreased at weeks 4,12,24,and 52 of secukinumab treatment(P<0.05).After treated with secukinumab,the percentages of the patients achieving PASI 75,PASI 90,and PASI 100 at week 4 were 95.6%,84.2%,and 47.5%,respectively;at week 12,they were 97.3%,95.6%,and 78.7%,respectively;at week 24,they were 97.8%,96.7%,and 84.2%,respectively;and at week 52,they were 98.4%,97.8%,and 83.6%,respectively.The percentages of the patients with BSA≤1%at weeks 4,12,24,and 52 were 80.9%,94.5%,95.6%,and 94.0%,respectively.The percentages of the patients with IGA score of 0/1 at week 4,12,24,and 52 were 86.3%,97.3%,96.7%,and 95.6%,respectively.The percentages of the patients with DLQI score of 0/1 at weeks 4,12,24,and 52 were 76.6%,89.1%,92.9%,and 91.8%,respectively.At week 4 of secukinumab treatment,there were significant differences in age,body mass index(BMI),disease duration,baseline PASI score,and history of previous biologic treatment between the patients in two groups(P<0.05).At week 24 of secukinumab treatment,there were significant differences in age and BMI between the patients in two groups(P<0.05).At week 4,BMI≥25 kg·m-2,disease duration≥10 years,baseline PASI score≥10,and a history of previous biologic treatment were risk factors affecting the recovery of the patient(P<0.05).At week 24,age≥40 years was a risk factor affecting the recovery of the patient(P<0.05).During the treatment period,44 out of 183 psoriasis patients reported 49 adverse reactions,and the adverse reaction rate was 24.0%.No serious adverse events or fatal adverse reactions occurred.The adverse reactions included upper respiratory tract infections in 23 cases,eczema-like skin lesions in 10 cases,skin fungal infections in 6 cases,urticaria in 3 cases,mild liver function abnormalities in 2 cases,folliculitis in 2 cases,conjunctivitis in 2 cases,and otitis media in 1 case.Conclusion:Secukinumab treatment for the adult patients with moderate to severe plaque psoriasis is rapid-acting and has lasting efficacy.The BMI,disease duration,baseline PASI score,history of previous biologic treatment,and age are the factors influencing the clinical efficacy of secukinumab.The overall safety is good,and secukinumab may be used as a first-line treatment option for moderate to severe plaque psoriasis.

Objective: To explore the effect of acupoint application combined with conventional anti-tuberculosis treatment on pulmonary tuberculosis and its effect on the immune function of patients. Methods: A total of 64 patients with pulmonary tuberculosis who visited Hangzhou Red Cross Hospital from March 2016 to September 2017 were selected in the study.The patients were randomly divided into control group (n=30) and observation group (n=34) according to the digital table.The clinical curative effect (obvious absorption, absorption, no change and deterioration), lung function (FVC, FEV₁ and FVC/FEV₁), immune function(CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺, IgC, IgA, IgM) were compared between the two groups. Results: The absorptive rate of the control group was 46.67%, which was significantly lower than that of the observation group(76.47%, χ²=6.04, P<0.05). After treatment, the levels of FVC, FEV₁ and FVC/FEV₁ of the two groups were significantly increased compared with before treatment..After treatment, the levels of FVC, FEV₁ and FVC/FEV₁ in the observation group were (2.20±0.48)L, (2.50±0.34)L, (87.44±13.60)%, respectively, which were significantly higher than those in the control group [(1.63±0.32)L, (2.02±0.44)L, (80.28±12.66)%] (t=6.607, 5.687, 2.558, all P<0.05). After treatment, the CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺, IgC, IgA, IgM levles in the observation group were significantly increased compared with before treatment (all P<0.05). After treatment, the CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺, IgC, IgA, IgM levles in the observation group were (73.25±6.17)%, (38.65±5.75)%, (36.58±3.17)%, (1.52±0.65), (15.49±1.49)g/L, (3.07±1.30)g/L, (1.94±0.50)g/L, respectively, which were significantly higher than those in the control group[(68.43±6.4)%, (34.72±5.68)%, (35.02±3.08)%, (1.16±0.78), (12.61±1.64)g/L, (2.23±0.90)g/L, (1.68±0.35)g/L] (t=3.590, 3.223, 2.340, 2.340, 8.594, 3.550, 2.846, all P<0.05). Conclusion Conventional anti-tuberculosis chemotherapy drugs combined with acupuncture has better effect than conventional anti-tuberculosis chemotherapy drugs.It can significantly improve the immune function of patients, improve the success rate of treatment, and speed up the improvement of the patients' condition.

Objective:To compare the efficacy and adverse reactions between intralesional betamethasone injection combined with botulinum toxin type A and topical hyaluronic acid and simple intralesional betamethasone injection and topical hyaluronic acid in treatment of keloid.Methods:A total of 58 patients with keloid were divided into two groups: intralesional betamethasone injection combined with botulinum toxin type A and topical hyaluronic acid group (combined group, n=28) and intralesional betamethasone injection combined with topical hyaluronic acid group (control group, n=30).In both two groups, the intralesional betamethasone injection was given once every 4 weeks for 3 times totally, and topical hyaluronic acid was applied every day.In combined group, an injection of botulinum toxin type A was given around the lesion after the first intralesional injection of betamethasone.The parameters for therapeutic efficacy and adverse reactions of the patients in two groups were recorded, and the clinical pictures were taken before and after each treatment, and they were analyzed and compared.Results:After 3 treatments, compared with control group, the lesion appearance in combined group was improved.In control group, the VAS value was reduced at 1 month, but was increased gradually at 2 and 3 months. In combined group, the VAS value was reduced gradually in 3 months. There was a significant difference in VAS value at 2 and 3 months between two groups (P<0.05).In combined group, the thickness of keloids were reduced gradually in 3 months, while the reduction was not obvious in control group (P<0.05).The recurrence of pain, itching and lesion height were observed 2 weeks after each treatment in control group, but there was no recurrence in combined group.The incidence rate of adverse reactions was 26.7% in control group, which had no significant difference compared with combined group(25.0%) (P>0.05).Conclusion:Compared with control group, the combined group shows better efficiency in the treatment of keloid and there is no increase of adverse reactions.The therapy is worthy of clinical application.

Objective To investigate the therapeutic effect of glycyrrhiza active substance on guinea pig model of vitiligo,and to clarify its mechanism on promoting synthesis of melanin,and to provide the basis for its clinical application.Methods Guinea pigs decolorized by H2O2 were used as experimental models,and normal control group was set up.After treatment of glycyrrhiza active substance in three doses groups(20,40,and 80 mg?kg-1),the therapeutic effect was observed by visual observation,macrography,histological examination as well as immunohistochemical study.Results The significant differences of skin color among control group,model group and treatment groups were observed by macrography.The total effective rates in 40 or 80 mg?kg-1 groups were higher than that in control group(P

Objective:To investigate the influence of compound glycyrrhizin on expression of HMB45,TNF-? and IL-6 in lesion of compound. using vitiligo guinea pig model induced by chemical decolorized compound.Methods:Two Guinea pig model groups were respectively treated with compound glycyrrhizin in 27.8 mg/kg and 55.6 mg/kg dosage. Immunohistochemical studies were performed to study the expression of HMB45,TNF-? and IL-6 in compound glycyrrhizin treated group,vitiligo model group and normal control group.Results:The expression of HMB45 in lesion of vitiligo model group was lower than the normal control group.The expression of HMB45 in lesion of compound treated group was higher than the vitiligo model group and the expression of HMB45 increased accompany by the increase of dosage.The expression of TNF-? and IL-6 in vitiligo model group was significantly higher than the normal control group (P