Objective To evaluate the in vitro effect of heat shock protein 70(HSP70)on interleukin-6 (IL-6)expression by cultured fibroblasts from psoriasis vulgaris lesions(PFbs).Methods Fibroblasts were isolated from the lesions of patients with psoriasis vulgaris and subjected to a primary culture.After 3 to 5 passages of culture,the fibroblasts were collected and used in the next experiment.Some PFbs were cultured with different concentrations(5,10,20,30 mg/L)of HSP70 for 48 hours,or with HSP70 of 30 mg/L for different durations(3,6,12,24,48,72 hours);some PFbs were incubated with HSP70 of 30 mg/L for 24 hours after pretreatment with pyrrolidine dithiocarbamate(PDTC,a specific inhibitor of nuclear factor-kappa B)for 30 minutes.PFbs receiving no treatment served as the control.Enzyme-linked immunosorbent assay(ELISA)and semi-quantitative reverse transcription PCR were performed to measure the IL-6 protein expression in culture supematant and IL-6 mRNA expression by PFbs,respectively.Differences in the expression of IL-6 protein and mRNA between PFbs receiving different treatment were analyzed by using t test and Dunnett's t test.Results HSP70 significantly increased both protein production and mRNA expression of IL-6 in a time(0-48 h)-and dose(5-30 mg/L)-dependent manner.The expression levels of supernatant IL-6 protein and IL-6 mRNA were significantly higher in the PFbs treated with HSP70 of 10 mg/L for 48 hours than untreated PFbs((75.2 ± 15.4)ng/L vs.(47.2 ± 10.6)ng/L,0.439 ± 0.093 vs.0.249 ± 0.069,both P ＜ 0.05).A significant increase was observed as early as 6 hours in the level of IL-6 mRNA after the treatment with HSP70 of 30 mg/L,and 12 hours in the level of supematant IL-6 protein.Decreased supernatant IL-6 protein and IL-6 mRNA were noted for PFbs treated with PDTC and HSP70 of 30 mg/L compared with untreated PFbs((42.23 ± 9.41)ng/L vs.(68.40 ± 14.43)ng/L,0.144 ± 0.048 vs.0.295 ± 0.081,both P ＜ 0.05).Conclusion HSP70 may increase the expression of IL-6 mRNA and protein by cultured PFbs via the nuclear factor-kappa B pathway.

Objective:To analyze the clinical features and auxiliary examination results of sporadic Creutzfeldt-Jakob disease (sCJD) with restless leg syndrome (RLS) as the first symptom.Methods:The clinical features and auxiliary examination results of one case of sCJD who received treatment in Sichuan Mianyang 404 Hospital were analyzed based on relevant literature.Results:A 59-year-old woman of Han nationality who had sCJD with restless leg-like manifestation of the left lower limb for 18 days was included in this study. The patient was first treated in orthopedic department, but her symptom did not improve after treatment. Twenty days later, she was transferred to neurology department for further treatment. Her daily life and activities were not affected. Head magnetic resonance imaging, electroencephalography, cerebrospinal fluid routine examination and biochemical test results were normal. Five days later, the patient had mild left-sided ataxia, which then progressed rapidly, followed by right-sided ataxia, left-leg spasticity and adduction, involuntary movement, myoclonia, cognitive decline, akinetic mutism, repeated hyperthermia, repeated complex partial seizures. Two weeks later, head magnetic resonance imaging examination revealed hyperintense signal of the cingulate gyrus, frontal cortex and right island cortex on DWI, with cerebellar atrophy and three-phase electroencephalography wave. Four weeks later, CSF14-3-3 protein was positive, and no related genetic mutation in the prion protein gene was found. The duration from onset to death was about 8 months.Conclusion:sCJD is a common subtype of prion protein disease, and the condition can be stabilized for more than 1 month after the onset of RLS. There is no specificity in early clinical and auxiliary examinations, and neither dobutazine treatment nor neurotrophic treatment is effective. The disease progresses rapidly after 1 month, head MRI and EEG reexamination can reveal clues, and CSF14-3-3 protein can assist clinical diagnosis.