Objective:To evaluate the effect of Ziyin Lupus capsule on systemic lupus erythematosus patients of yin deficiency inner heat. Methods:To adopt a random,double-blind and placebo comparative research. Results:Ziyin lupus capsule cooperated with hormone group was superior to simple hormone control group(P

Objective To observe the effect of Modified Erzhi Pills (MEP) on free radicals and immunity in D-galactose-induced aging rats.Methods Sixty SD rats were randomized into 5 groups: normal group, model group, high-, middle-and low-dosage MEP groups (treated with gastric gavage of MEP 11.5, 7.0 and 3.5gkg-1d-1 respectively). Except the normal group, the rats in other groups received intraperitoneal injection of D-galactose (300mgkg-1d-1) to induce sub-acute aging rat models. After treatment for 2 months, superoxide dismutase (SOD) and malondialdehyde(MDA)levels in whole blood were detected, and the serum level of interleukin-2 (IL-2) and spleen index were examined.Results SOD level decreased, MDA increased, and IL-2 level and spleen index were decreased in the model group(P

Objective To study the mechanism of Chinese herbal capsule in the treatment of genital herpes.Methods Guinea pig model for genital herpes infection was established.HSV DNA from the cerebrum,spinal cord,cervical canal and vagina of guinea pigs was detected by fluorescent-quantitative PCR.Results The HSV DNA could be detected from all four kinds of tissues,with different copies of the virus in the different tissues,the highest in spinal cord,then in vagina,the least in cerebrum and cervical canal.There was statistical difference of HSV-DNA copies between herbal capsule group and control group(normal saline),whereas no statistical difference between herbal capsule group and aciclovir group.Conclusion The mechanism of the anti-virus herbal capsule in the treatment of experimental genital herpes might be related to blocking the latent infection and suppressing the replication of HSV.

A 47-year-old man presented with recurrent oral ulcerations for more than 1 year and generalized vesicles for 9 months.Physical examination revealed multiple oral ulcers,patchy labial erosions with yellow or dark brown crusts,maceration and blanching of the angle of mouth resulting in difficulty in mouth opening.Cinnamomeous crusts were seen on the nasal limen,palpebral margin and coronary sulcus of penis,with pale red macules after decrustation.Diffuse erythematous patches and bullae were present on the trunk and extremities.The walls of bullae tightly clung to the skin,and some bullae were ruptured,leaving an erythematous and moist surface and giving an erythema multiforme-like appearance; some bullae were turbid and covered with adherent drugcontaining white crusts or black crusts.Nikolsky's sign was negative.Shrinking,edematous dark-red patches were seen in periungual regions of all the fingers and toes.Histologic biopsy and direct immunofluorescence examination of bullous lesions confirmed a diagnosis of paraneoplastic pemphigus (PNP).Histopathological and immunohistochemical findings from the mediastinal tumor were consistent with Castleman's disease (hyalinevascular type) with proliferation of follicular dendritic cells.Laboratory examination revealed a decrease in serum complement C3 and the presence of antinuclear,anti-nucleosome and anti-dsDNA antibodies.The final diagnosis included Castleman's disease,PNP and systemic lupus erythematosus.After 2 months of treatment with low-dose prednisone and azathioprine,skin lesions completely regressed.Then,the dose of prednisone and azathioprine was tapered.Six months later,the patient himself suddenly withdrew prednisone and azathioprine,and began to take traditional Chinese medicine; thereafter,the lesions developed into toxic epidermal necrolysis (TEN),and the patient died finally.This case demonstrates that immunosuppressive therapy should be maintained for a long period of time in patients with Castleman's disease after tumor removal,otherwise,skin lesions may recur or get worse.

【Objective】To search an effective therapy for total alopecia (TA) and universal alopecia (UA) .【Methods】Nineteen cases of TA and twelve of UA were treated with combined therapy: irradiation with high-performanceelectromagnetic wave equipment, acupoint injection on Zusanli point (ST36) , external application of Yifa Tincture B andhormones, internal medication of hormones and washing with Xianglian solution.【Results】Among 31 cases of TA andUA, 17 were cured, 6 were markedly effective, 5 effective and 3 ineffective, the total effective rate being 90.3%.【Conclusion】Combined treatment with Chinese and western medicine has a certain effect for TA and UA.

Objective To observe the antibacterial and synergistic effect of Xianglian Suppository with miconazole suppository for the treatment of simple vulvovaginal candidiasis ( VVC) , and to explore the advantages of integrative Chinese and western medicine for the treatment of simple VVC. Methods According to the principle of randomized trial, 65 simple VVC patients were divided into two groups, 35 cases in test group and 30 in control group. The test group was given Xianglian suppository and miconazole suppository, and the control group was treated with miconazole suppository, the medication lasting for 7 days. The changes of symptom scores before and after treatment were observed, and the therapeutic effect and safety were also evaluated in both groups. Results ( 1) After treatment for one course, the markedly effective rate and total effective rate were 60.00%, 88.57% in the test group, and were 23.33%, 60.00% in the control group, respectively, the differences being significant between the two groups ( P<0.01). ( 2) After treatment, symptom scores were decreased in both groups ( P<0.01 compared with those before treatment) , and the decrease in the test group was superior to that in the control group (P<0.01). (3) One case of the test group had the complaint of severer pruritus vulvae after medication, and the results of physical examination showed the case had vulvovaginal flush but had no edema, blister or other discomfort. The manifestations disappeared when the medication continued, indicating that the case had no allergic reaction. No case had allergic reaction in the control group. Conclusion For the treatment of simple VVC, Xianglian suppository combined with miconazole suppository can obviously relieve the clinical symptoms, and is effective and safe.

A 41-year-old man presented with recurrent pustules and scales on both hands and feet for 1year and with neoplasm on the left toe for 4 months.On physical examination,there were multiple irregular rufous patches with lamellar white scales on bilateral thumbs,forefingers,thenar eminence,toes,and the onethird anterior part of bilateral soles.Deep-seated pustules and vesicles arising on some erythematous patches were disrupted with the formation of punctiform or patches of erosions covered by yellow brown crusts.Some toenails and fingernails were thickened and deformed.An obviously tender neoplasm measuring 4 cm × 3.5 cm× 3.5 cm was observed in the anterior part of the left fourth toe,which was a little indurated and obviously tender with superficial erosion,large amount of purulent exudates and fresh granulation tissue mixing to form black and thick blood crusts on the surface.Biopsy of the nail bed of the right index finger and neoplasm on the left toe revealed a diffuse,dense,and mixed infiltrate of small- to medium-sized atypical lymphocytes and a few inflammatory cells.Meanwhile,epidermotropism and Pautrier's microabscess were visible.Immunohistochemistry showed that the abnormal lymphocytes were positive for leukocyte common antigen (LCA),Vimentin,CD3,CD45RO,CD4,Bcl-2,partly positive for CD8,CD5,CD10,Ki-67 (＞ 80％ ),but negative for CD79a,CD20,CD30,cytokeratin,S-100,Bc1-6,anaplastic lymphoma kinase (ALK),HMBMS,CD1a or P63.Based on the above findings,a diagnosis of mycosis fungoides palmaris et plantaris was made.

Objective To observe the influence of dexamethasone on the gene expression profiling of PBMCs from patients with internal heat due to Yin deficiency-type SLE. Methods The PBMCs from 3 patients with internal heat due to Yin deficiency-type SLE were incubated with dexamethasone of 10-6 g/L for 48 hours followed by the detection of gene expression profiling of PBMCs by a GeneChip. Results The incubation with dexamethasone upregulated the expressions of 85 genes and downregulated those of 126 genes in PBMCs from the SLE patients. Conclusions Dexamethasone can regulate the expressions of numerous clusters of genes in PBMCs from patients with internal heat due to Yin deficiency-type SLE, and functional proteins encoded by these genes are located at various organelles and regions of cells. Not all the results of gene regulation by dexamethasone favor the relief of SLE. To study the regulation of genes may be beneficial to the elucidation of mechanisms underlying the therapeutic effect of dexamethasone on SLE.

Objective:To probe e ect of a Chinese compound recipe of nourishing yin and clearing heat and prednisone on nuclear protein of splenic lymphocytes in mice.Methods:MRL/LPR female lupus mice were divided into four groups respectively treated with isotonic Na chloride,traditional Chinese medicine,Western medicine and integrated Chinese and Western medicine,then nucleoproteins of splenic lymphocytes were extracted and detected by SELDI-TOF-MS method.Result:There were some proteins in control group which aggravated autoimmune course,and some proteins in Western medicine group which rivalried immunological activity;integrated Chinese and Western medicine and Western medicine showed similarly e ect on nucleoprotein of splenic lymphocytes.Conclusion:The recipe of nourishing yin and clearing heat and prednisone can treat the disease by uencing in the di erentiation of splenic lymphocytes and the expression of proteins.

Objective To explore the clinicopathologic features,diagnosis,treatment and prognosis of ACTH-independent subclinical Cushing syndrome caused by cortisol-secreting and hypo-androgen black adrenal cortical adenomas with lipomatous metaplasis.Methods The clinical and pathologic features of 1 patient presented with hypo-androgen and atypical signs and symptoms of Cushing syndrome were reported.The patient's 24 h UFC (235.62 μg) was higher than normal range,his plasma ACTH concentrations (＜1.1 pmol/L,was lower than normal range and his serum cortisol concentrations lacked diurnal rhythm.There was absence of serum cortisol suppression in overnight dexamethasone suppression tests.Serum levels of androgens (1.2 nmol/L) were lower than normal range.24 h urine catecholamine was normal,NE was 160.5 nmol/24 h (5-591 nmol/24 h),E was 23.1 nmol/24 h (0-82 nmol/24 h),DA was 1496nmol/24 h (424-2612 nmol/24 h).Aldosterone lying and standing test:ALD1 138-415 pmol/L,AT-Ⅱ1 64.54 ng/L,PRA1 0.80 μg · L-1 · h-1 Abdomen CT showed right adrenal mass (3.1 cm).131Ⅰ-MIBG scanning was normal.Adrenocortical carcinoma was considered as a possible diagnosis based on cortisol hypersecretion,hypo-androgen and the imaging characteristics.This patient accepted laparoscopic adrenal adenoma resection.Results The adrenal tumor size was 3.5 cm.Immunohistochemical (IHC) staining showed Melan-A,CgA,α-inhibin and Syn positive and Ki-67 ＜ 1％.Histopathologic results showed black adrenal cortical adenomas with myelolipomatous change.After surgery,patient's serum androgen was normal,and the signs and symptoms of Cushing syndrome and oligo-androgen disappeared.There was recurrence after 1.5 years follow-up.Conclusions Although most patients with corticotropin-independent Cushing syndrome associated with abnormal androgen proved to have adrenocortical carcinoma,the clinician should be aware of the possibility of benign,black adrenal adenoma.