INTRODUCTION: Pemphigus is a chronic, relapsing immunobullous disease. There is limited data on the clinical course and prognostic factors of pemphigus in Asian patients. MATERIALS AND METHODS: We conducted a retrospective cohort study of all newly diagnosed pemphigus vulgaris (PV) and pemphigus foliaceus (PF) patients seen at the National Skin Centre from 1 January 2004 to 31 December 2009. Demographic and clinical data on comorbidities, treatment and remission were recorded. Mortality information was obtained from the National Registry of Diseases. Prognostic endpoint was overall remission at last visit. RESULTS: Sixty- one patients (36 PV and 25 PF) were recruited. Among PV patients, higher initial prednisolone dose ( = 0.017) and the use of azathioprine ( = 0.028) were significantly associated with overall remission at last visit. However, higher desmoglein 1 antibody titres at diagnosis ( = 0.024) and the use of dapsone ( = 0.008) were negatively associated with overall remission at last visit. Among PF patients, only higher desmoglein 1 antibody titre at diagnosis ( = 0.041) was found to be associated with lower overall remission at last visit. There was no mortality during the 3-year follow-up period in both PV and PF. CONCLUSION Higher initial prednisolone dose and the use of azathioprine in PV desmoglein 1 antibody titre at diagnosis in PV and PF might be prognostic markers for achieving remission. Use of dapsone was associated with lower overall remission in PV, but this might be confounded because dapsone was used as an adjuvant therapy in recalcitrant cases. Owing to study methodology and limitations, further evaluation is needed for better prognostication of pemphigus.

Objective To investigate the improvement of ischemic hypoxic injury of brain after the transplantation of bone marrow mesenchymal stem cells (BMSCs).Methods Rats were randomly (random number) divided into sham operation group,cardiac arrest group and BMSCs treatment group (n =10 in each group).The model of cardiac arrest was induced by asphyxia.One hour after restoration of spontaneous circulation (ROSC),green fluorescent protein labeled BMSCs were transplanted via tail vein injection.At 3 and 7 days after transplantation,frozen sections of hippocampus was stained with hematoxylin-eosin (HE).The rest of brain tissue was weighed by an electronic balance.Brain water content (％) was calculated as (wet weight-dry weight) / wet weight × 100％.Results ①BMSCs were observed in hippocampus at 3 and 7 days after transplantation under fluorescent microscopy.②Compared with sham operation group and BMSCs treatment group,brain water content in cardiac arrest group was higher (all P ＜ 0.05).HE staining results showed that BMSCs transplantation could lessen hypoxia ischemia damage on brain.Conclusions BMSCs reduced the neurons damage induced by cardiac arrest and promoted neurological function recovery.

OBJECTIVE: To purify and identify HMGB1 secreted by liver cells HepG2 and immune cells U937. METHODS: We cultured the liver cell lines HepG2 and immune cell lines U937, and stimulated them with HMGB1 (400 ng/mL) for 20 h. Then the supernatant was collected. Ultrafiltration centrifugation, CM-Sepharose cation, DEAE-Sepharose anion exchange chromatography, Sephadex G75-gel filtration chromatography, and immunoprecipitation were used for purification. The molecular weight and identity of HMGB1 was confirmed by SDS-PAGE and Western blot. RESULTS: A sharp stained protein band with a molecular weight of about 26 kD was obtained by SDS-PAGE analysis and shown to be HMGB1 confirmed by Western blot. CONCLUSION High purified HMGB1 can be separated from these two cell lines.
Cell Culture Techniques ; Electrophoresis, Polyacrylamide Gel ; methods ; HMGB1 Protein ; isolation & purification ; metabolism ; Hep G2 Cells ; Hepatocytes ; metabolism ; Humans ; Monocytes ; metabolism ; U937 Cells

INTRODUCTION: Nail psoriasis treatment is challenging due to difficult drug delivery and systemic therapy toxicities. Self-dissolvable microneedle patches embedded with corticosteroids offers a potentially rapid, minimally invasive drug delivery platform with good efficacy and minimal adverse side effects. METHODS: We conducted a 4-month prospective randomised controlled trial. Subjects with psoriatic nails were randomised to receive microneedle device delivered topical steroids on one hand and control treatment (topical Daivobet gel) on the other. Two independent dermatologists blinded to the treatment assignment scored their Nail Psoriasis Severity Index (NAPSI) during visits at baseline, 2 and 4 months. All treatment was discontinued after 2 months. Average NAPSI score on each hand was analysed. RESULTS: A total of 25 participants were recruited, aged 22 to 73 years. Majority were Chinese (72%), followed by Indian and Malay. There was equal randomisation of treatment to the left and right nail. While there was a rapid significant improvement in average NAPSI score for the control arm at 2 months, the treatment arm had a greater, more sustained improvement of the NAPSI score at 4 months. The average NAPSI score improved for both treatment and control group at 4 months compared to baseline. However, only the NAPSI value improvement in the controls at 2 months compared to baseline was statistically significant (P=0.0039). No severe adverse effects were reported. CONCLUSION To the best of our knowledge, this is the first prospective randomised control trial comparing microneedle technology against conventional topical steroids in nail psoriasis treatment. Our findings demonstrate microneedle technology is as efficacious as topical therapy.
Humans ; Nail Diseases/drug therapy* ; Nails ; Prospective Studies ; Psoriasis/drug therapy* ; Triamcinolone

Objective:To explore the influencing factors for serum concentration of oxcarbazepine active metabolite 10, 11-dihydro-10-hydroxyl carbazepine (MHD), and the effecacy of clinical pharmacists' intervention in administration scheme through serum concentration monitoring.Methods:A total of 96 patients with epilepsy who were treated with oxcarbazepine or oxcarbazepine combined with other drugs in our hospital from August 2017 to December 2021 were selected. Blood samples with monitored MHD concentration during treatment in our hospital in these patients were used as the research objects. Univariate analysis and multivariate linear regression analysis were used to analyze the influence of gender, age, body weight, daily dose of oxcarbamide, liver and kidney functions and medication in serum MHD concentration. For patients with substandard serum MHD concentration or ineffective treatment, clinical pharmacists would intervene the medication regimen and lifestyle; the differences of compliance rate of serum MHD concentration and incidence of adverse reactions were compared between the intervention group and non-intervention group.Results:A total of 190 blood samples were collected from these 96 patients. There was significant difference in serum MHD concentration among samples with different daily doses of oxcarbazepine, different creatinine clearance rate (Ccr), and different medications ( P<0.05). Correlation analysis showed that daily dose of oxcarbazepine was positively correlated with serum MHD concentration ( r=0.655, P<0.001). Multivariate linear regression analysis showed that daily dose of oxcarbazepine ( 95%CI: 0.009-0.014, P<0.001), Ccr ( 95%CI: -0.037-0.007, P=0.005), and combined use of oxcarbazepine with lamotrigine ( 95%CI: 0.526-8.790, P=0.027) or atorvastatin ( 95%CI: 0.213-5.168, P=0.033) were independent influencing factors for serum MHD concentration. For patients whose blood concentration was monitored for the first time, the serum MHD concentration in patients with somnolence and/or dizziness (10.9 [6.7, 14.0] μg/mL) was significantly higher than that in patients without somnolence and/or dizziness (7.5 [5.2, 9.4] μg/mL, P<0.05). The compliance rate of serum MHD in the intervention group (83/85[97.6%]) was statistically higher than that in the non-intervention group (95/105[90.5%]), and the incidence of adverse reactions (11/85[12.9%]) was statistically lower than that in the non-intervention group (28/105[26.7%], P<0.05). Conclusions:The serum MHD concentration is affected by daily dose of oxcarbamide, Ccr, and combined use of oxcarbazepine with lamotrigine or atorvastatin. Clinical pharmacists should be encouraged to participate in clinical drug treatment to achieve better effectiveness and safety of drug treatment.

INTRODUCTION: Melanomas in Asians have different clinicopathological characteristics and prognosis from melanomas in Caucasians. This study reviewed the epidemiology and treatment outcomes of cutaneous melanoma diagnosed at a tertiary referral dermatology centre in Singapore, which has a multiracial population. The study also determined whether Asians had comparable relapse-free and overall survival periods to Caucasians in Singapore. METHOD: This is a retrospective review of cutaneous melanoma cases in our centre between 1996 and 2015. RESULTS: Sixty-two cases of melanoma were diagnosed in 61 patients: 72.6% occurred in Chinese, 19.4% in Caucasians and 3.2% in Indians, with an over-representation of Caucasians. Superficial spreading melanoma, acral lentiginous melanoma and nodular melanoma comprised 37.1%, 35.5% and 22.6% of the cases, respectively. The median time interval to diagnosis was longer in Asians than Caucasians; median Breslow's thickness in Asians were significantly thicker than in Caucasians (2.6mm versus 0.9mm, CONCLUSION More physician and patient education on skin cancer awareness is needed in our Asian-predominant population for better outcomes.
Humans ; Melanoma/therapy* ; Prognosis ; Retrospective Studies ; Singapore/epidemiology* ; Skin Neoplasms/therapy* ; Treatment Outcome

INTRODUCTIONThis study aimed to determine if disposable filtering facepiece respirators (FFRs) that come with an exhalation valve (EV) and a novel active venting system (AVS) provided greater perceived comfort and exertion when compared to standard N95 FFRs without these features among male military personnel performing prolonged essential outdoor duties.

METHODSWe used a randomised open-label controlled crossover study design to compare three FFR options: (a) standard FFR; (b) FFR with EV; and (c) FFR with EV+AVS. Male military personnel aged between 18 and 20 years completed a questionnaire at the start of outdoor duty (baseline), after two hours of standardised non-strenuous outdoor duty and after 12 hours of duty divided into two-hour work-rest cycles. Participants rated the degree of discomfort, exertion and symptoms using a five-point Likert scale. The association between outcomes and types of FFR was assessed using a multivariate ordered probit mixed-effects model.

RESULTSFor a majority of the symptoms, study participants gave FFR with EV and FFR EV+AVS significantly better scores than standard FFR. Both FFR with EV and FFR with EV+AVS had significantly less discomfort (FFR with EV+AVS: 91.1%; FFR with EV: 57.6%) and exertion (FFR with EV+AVS: 83.5%; FFR with EV: 34.4%) than standard FFR. FFR with EV+AVS also had significantly better scores for exertion (53.4%) and comfort (39.4%) when compared to FFR with EV.

CONCLUSIONUsage of FFR with EV+AVS resulted in significantly reduced symptoms, discomfort and exertion when compared to FFR with EV and standard FFR.