Objective To explore the therapeutic mechanism of narrow-band ultraviolet B (NB-UVB)in psoriasis. Methods Forty-two patients with psoriasis vulgaris and 20 healthy controls were enrolled into this study. All the patients received 20 sessions of NB-UVB radiation. Psoriasis area severity index (PASI)was used to evaluate the severity of psoriasis. Blood samples were collected from all the patients before and 15 cured patients after the treatment as well as from 20 healthy controls, and skin samples from 10 patients before and after the treatment as well as from 10 healthy controls. Enzyme-linked immunosorbent assay (ELISA)was performed to determine the serum levels of IL-17 and IL-22, and real-time fluorescence-based quantitative PCR to measure the mRNA expressions of IL-17 and IL-22 in skin specimens. Statistical analysis was carried out by using the two-sample t-test, paired t-test and Pearson correlation analysis. Results After 20 sessions of NB-UVB radiation, 15 out of the 42 patients were cured with a significant decrease in PASI. Compared with the healthy controls, the 15 cured patients showed a significant elevation in the levels of IL-17and IL-22 proteins(IL-17: 34.26 ± 10.05 ng/L vs. 16.34 ± 4.73 ng/L, t = 7.016, P < 0.01; IL-22: 13.72 ± 4.45 ng/L vs. 5.03 ± 1.84 ng/L, t = 8.282, P < 0.01)and mRNAs (IL-17: 13.43 ± 2.12 vs. 5.26 ± 0.87, t = 6.312, P < 0.01; IL-22:16.53 ± 2.65 vs. 7.72 ± 2.13, t = 6.823, P < 0.01)before the treatment. The PASI score was positively correlated with the levels of IL-17 and IL-22 proteins in sera (r = 0.76, 0.70, respectively, both P < 0.05)and their mRNAs in skin lesions (r = 0.65, 0.68, respectively, both P < 0.05)in these patients. The serum levels and mRNA expressions of IL-17 and IL-22 all significantly reduced in the cured patients after the treatment compared with those before the treatment(all P < 0.05). Conclusion NB-UVB may treat psoriasis by downregulating the levels of IL-17 and IL-22 in peripheral blood and skin lesions in patients with psoriasis.

A 74-year-old man presented with yellowish red nodules and plaques on the trunk for more than one year.Physical examination showed more than 20 scattered,irregularly shaped,well-demarcated,yellowish red nodules and plaques measuring 0.5-15 cm in diameter on the trunk.The plaques on the right lower abdomen showed central ulceration and atrophy with scar formation.Plasma protein electrophoresis revealed that the levels of immunoglobulin G (IgG) and kappa light chain were 18.3 g/L and 20.70 g/L respectively.Histopathologically,large necrobiotic areas and granuloma were observed alternately in the dermis and subcutis.There were numerous Touton giant cells,foreign body giant cells and foamy histiocytes in the granuloma,and many cholesterol clefts were found in the center of necrobiotic areas with the formation of lymphoid follicles in some regions.Both eyes of the patient were involved to different degrees.He was diagnosed as necrobiotic xanthogranuloma with IgG kappa paraproteinemia and eve involvement.

Objective To detect mycoplasma pneumoniae antibody in children having the upper respiratory tract infection.And then investigate mycoplasma pneumoniae infection status of different season different age children.Methods In 5 403 cases of suspected pneumonia mycoplasma infection of 0 to 14 years old children using the method of passive particle agglutination determination of mycoplasma pneumoniae antibody,and analysis of the statistical results.Results The positive rate was 67.8％ in the groups of children.The rates of infection was biggest during 2 to 3 years old children and 3-4 years old children,14.9％ and 18.4％,respectively.In addition,we found that the highest rate of mycoplasma pneumoniae infection arised from October to January every year of the following year.Conclusion The infection of mycoplasma pneumoniae is on the rise,and children aged 0 to 6 years old are the main population.

Objective To investigate the correlation between interleukin 10(IL‐10) ,tumor necrosis factor (TNF‐α) and serum CD4+ T‐lymphocytes cell in people who infected HIV .Methods The HIV antibody screening test ,IL‐10 and TNF‐αmeasurement adopted enzyme‐linked immune‐sorbent assay(ELISA) .The HIV antibody confirm test adopted western blot(WB) and CD4+ cell count determination used flow cytometry .Results Compared with the normal control group(NC group) ,the concentration of TNF‐αand IL‐10 in patients group have statistically significant difference(P<0 .05) .Moreover ,the extent of the increase in group A(pa‐tients with the CD4+ T cell count less than 3 .5 × 105 cells/mL) was higher than that in group B(patients with the CD4+ T cell count no less than 3 .5 × 105 cells/mL) .Conclusion Due to the defect of the immune system ,the serum concentration of TNF‐αand IL‐10 in people infected with HIV would increased ,and the increase of the concentration could be more significant in patients whose CD4+cell count obviously decrease .This study have shown that dynamic measurement of TNF‐α and IL‐10 concentration would provide data to konw the patients′immune status and illness development .

Objective: To investigate the risk factors of ventricular arrhythmias in patients with Brugada syndrome. Methods: Clinical data of 60 Brugada syndrome patients admitted in the department of cardiology of the First Affiliated Hospital of Nanjing Medical University from March 2003 to December 2016 were collected and retrospectively analyzed. The age at diagnosis was (43.2±13.1) years (0.6-83.0 years), 98.3% were males (n=59), and the patients were followed up to (92±41) months (12-169 months). The 12-lead surface electrocardiogram (ECG) recorded at the time of diagnosis and showing the highest type 1 ST elevation, either spontaneously or after provocative drug test, was used for the analysis. Patients were divided into ventricular arrhythmia (VA, n=12) group and non-ventricular arrhythmia (non-VA, n=48) group depending on the presence or absence of clinical VA event. The demographic data and ECG data of the 2 groups were compared, and the independent risk factors of VA events were analyzed by stepwise logistic regression. Results: Incidence of family history of sudden death (7/12 vs. 22.9% (11/48)) and percentage of type 1 ST elevation in the peripheral ECG leads (6/12 vs. 16.67% (8/48)) were significantly higher in VA group than in non-VA group (both P<0.05). Max Tpeak-Tend (Max-Tpe) interval ((144±53)ms vs. (110±16)ms) and dispersion of Tpe ((74±50)ms vs. (43±17)ms) were significantly higher in VA group than in non-VA group (both P<0.05). The area under receiver operating characteristic (ROC) curves for the Max-Tpe interval was 0.693 and Max-Tpe interval ≥140 ms was determined as an optimized cutoff point with increased risk of VA event, which had a sensitivity of 50.0%, a specificity of 98.0%, a positive predictive value of 85.7%, and a negative predictive value of 88.7% for predicting VA event. The ROC curves for the dispersion of Tpe was 0.775 and dispersion of Tpe ≥45 ms was determined as an optimized cutoff point for predicting VA event, which had a sensitivity of 91.7%, a specificity of 64.6%, a positive predictive value of 39.3%, and a negative predictive value of 96.9% for predicting VA event. In multivariate analysis, Max-Tpe interval ≥140 ms (OR=27.53, 95%CI 1.07-706.77, P=0.045) and family history of sudden death (OR=24.63, 95%CI 2.05-295.38, P=0.011) were found to be the independent risk factors of arrhythmic events. Conclusions Max-Tpe interval ≥140 ms and family history of sudden death are risk factors of VA event in included patients with Brugada syndrome.

Objective To study the relationship between gestational glucose,lipid metabolism parameters and fetal distress.Methods Retrospectively,82 cases of primipara with fetal distress and 246 cases of primipara without any obstetric complications were analyzed.The latter were treated as control group.All the patients were from the same hospital between January,2014 and January,2016.Factors as fasting plasma-glucose (FPG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein (HDL-C),low-density lipoprotein (LDL-C) parameters during early pregnancy,blood glucose of fasting,1 hour and 2 hours in 75 g oral glucose tolerance test (OGTT),at 24 to 28 weeks of gestation,hemoglobin and blood pressure parameters during ante partum were recorded for all the cases while parameters as glucose and lipid,hemoglobin,blood pressure and cesarean section rate were compared between the 2 groups.Results FPG during early gestation,blood glucose of fasting,1 hour and 2 hours 75 g OGTT during mid gestation,systolic blood pressure and diastolic blood pressure during late gestation in the 'fetal distress' group were significantly higher than that of the control group.Hemoglobin during late gestation in the fetal distress group was lower than that of the control group,with statistically significant difference (P＜0.05).The rate of cesarean section in the fetal distress group was higher than that in the control group (x2=4.489,P=0.034).Conclusions High BMI at pre-pregnancy,high blood glucose during early and mid-gestation,high blood pressure and anemia during late gestation were related to the fetal distress group.Cesarean section rate was high for pregnancy women with fetal distress.