Objective To study the effect of paeoniflorin on inflammatory chemokines and their receptor in a rat model of ovalbumin-induced asthma.Methods Sixty 6-week old SPF female BALB/c mice were used in this study.To es-tablish a mouse model of asthma by sensitizing and challenging with ovalbumin.ELISA was used to analyze the serum IL-6 and TNF-α, and the specific IgE against ovalbumin ( OVA-IgE ) , CCL19 and CCL21 in bronchoalveolar lavage fluid (BALF).RT-PCR was performed to determine CCR7mRNA and protein expression of chemokine receptor CCR7, and the level of NF-κB was tested by Western blot.ResultsIn In the paeoniflorin groups, the serum IL-6 and TNF-αlevels were significantly lower, and the OVA-IgE, CCL19 and CCL21 levels in BALF were significantly reduced, compared with that in the control group.CCR7mRNA and protein expression of chemokine receptor CCR7 and NF-κB in the lung were significant-ly reduced by paeoniflorin.Conclusions Paeoniflorin has a remarkably inhibitory effect on the airway inflammatory chemo-kines CCL19/CCL21 and the receptor CCR7 in the mouse model of asthma.

Psoriasis is an immune-mediated chronic recurrent inflammatory disease, and biological agents targeting cytokines and their receptors involved in its pathogenesis have become an increasingly important option for its treatment in recent years. With the successive appearance of biological agents such as secukinumab and ustekinumab on the market in China, the use of biologics will become increasingly common in the treatment of psoriasis. This review summarizes the efficacy of different biological agents and individualized drug selection in the treatment of moderate to severe plaque psoriasis and psoriatic arthritis, with a view to providing a reference for physicians in clinical practice.

Objective:To investigate the clinical efficacy of subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture in surgical treatment of benign pigmented facial lesions in infants and preschoolers.Methods:Totally, 100 infants and preschoolers with pigmented facial lesions were enrolled from the Department of Dermatology, Hanzhong Central Hospital and the Second Affiliated Hospital of Xi′an Jiaotong University from January 2018 to January 2019, and their clinical data were analyzed retrospectively. Among these patients, there were 59 males and 41 females, and their age ranged from 3 months to 5 years, with an average age of 15 months. All patients underwent outpatient surgery under local anesthesia, and sedative drugs were used before operation. The skin lesions were excised once or in stages according to their areas, and incisions were closed by using a subcutaneous asymmetric suture-based tension reduction technique, followed by dermal buried angular mattress sutures. After surgery, medical silicone gels and tension reduction devices were used for 6 months to 1 year, and postoperative follow-up was performed.Results:All patients were followed up for more than 1 year after surgery. Four patients showed suture rejection reaction within two months after surgery, and the incisions completely healed after the suture knots were discharged; cat′s ear-shaped scars were formed at the upper and lower ends of the incisions in 3 cases when the sutures were removed 1 week after surgery, no treatment was given, and the cat′s ear-shaped scars gradually became flat after 1 year of follow-up; fat liquefaction occurred in 1 case 4 days after surgery, re-suturing of the incision was done 1 week after the removal of internal sutures and drainage, and the incision healed well; 1 case developed infection 3 days after surgery, and then received the removal of internal sutures, drainage, and anti-infection treatment, re-suturing was performed after complete regression of the incision swelling, and the incisions healed well; scar hyperplasia occurred in 4 cases 3 to 6 months after surgery, and the scars became flat after the local injection of triamcinolone acetonide. In the remaining children, fine white linear scars were formed after the healing of incisions, the depressions and ridges at both ends of the incisions became flat, and there was no obvious pulling sensation in facial organs or formation of cat′s ear-shaped scars.Conclusions:Subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture can effectively reduce tension twice during delicate facial surgery in infants and preschoolers, and help to avoid incision widening and scar hyperplasia. The follow-up showed favorable long-term efficacy and aesthetic effect.

To explore the effect of application of soft tissue loosening and acetabular reconstruction in hip replacement for patients with severe femoral head necrosis on joint function.
 Methods: From June 2012 to August 2016, 68 patients with severe femoral head necrosis (Ficat III, IV) underwent total hip replacement with soft tissue release and acetabular reconstruction at the Second Xiangya Hospital of Central South University. Total hip replacement is performed by the posterolateral approach. The acetabulum was rebuilt and the length of the affected limb was prolonged after clearing the scar tissue, proliferating the epiphysis, releasing the abductor muscle group and the adductor muscle group, dissecting the soft tissue around the acetabulum. One year after surgery, Harris score, X-ray positive lateral radiograph for the affected side and full-length X-ray examination for both lower extremities were performed to evaluate the curative effect.
 Results: The postoperative follow-up time ranged from 1.0 to 5.5 years. All patients' femoral heads returned to normal anatomical position and the affected limb length was restored to 1.5-3.5 cm; all patients did not damage the sciatic nerve. The Harris scores for 68 patients increased from 38.6±7.5 to 78.2±5.7 (P=0.029) in the first year after surgery.
 Conclusion: During hip replacement surgery for severe femoral head necrosis, soft tissue dissection and acetabular reconstruction can be used to ensure anatomical reconstruction for the acetabular fossa and to improve abductor function.
Acetabulum ; Arthroplasty, Replacement, Hip ; Femur Head ; Femur Head Necrosis ; surgery ; Follow-Up Studies ; Humans ; Radiography ; Treatment Outcome

Atherosclerosis （AS） is a chronic multifactorial vascular disease and a major pathological basis of cardiovascular diseases. It mainly occurs in the middle-aged and elderly and causes high mortality. Apoptosis is a form of spontaneous programmed death. Under pathological conditions， the apoptosis of vascular endothelial cells （VECs）， vascular smooth muscle cells （VSMCs）， and macrophages is the key factor of the occurrence and development of AS. The apoptosis of VECs may be an early event that promotes the formation and progression of AS lesions， while the subsequent apoptosis of VSMCs and macrophages accelerates the formation of AS unstable plaques and plays a key role in the late stage of AS. Therefore， apoptosis may provide a new target for the treatment of AS. Increasing evidence has demonstrated that Chinese medicine plays a positive role in the treatment of AS by regulating apoptosis factors and apoptosis-associated signaling pathways. However， the studies about the treatment of AS with Chinese medicine from apoptosis have not been systematically reviewed. Therefore， we reviewed the relevant literature and systematically summarized the molecular mechanisms of apoptosis. Specifically， we focused on mitochondrial apoptosis pathway， death receptor apoptosis pathway， endoplasmic reticulum stress apoptosis pathway and explored the role of apoptosis in AS. Further， we reviewed the progress in the role and mechanism of Chinese medicine in regulating apoptosis against AS， aiming to provide a theoretical basis for the treatment of AS and the development of drugs.

Objective: To establish a mouse model of psoriasis complicated by bone loss by long-term topical application of imiquimod. Methods: Twelve 10-week-old Kunming mice were randomly and equally divided into 2 groups: experimental group topically treated with 50 mg/d imiquimod cream every day on the shaved back, and control group topically treated with equivalent vaseline ointment every day on the shaved back. Skin manifestations were observed on the mouse back every day. The mice were sacrificed 10 weeks later. Before the sacrifice, the degree of erythema, scaling and skin thickening was evaluated, psoriasis area severity index (PASI) was calculated, mouse weight was measured, and eyeball blood was obtained. After the sacrifice, skin lesions on the back were resected and subjected to hematoxylin-eosin staining, so as to evaluate histological changes. Then, the left tibia was obtained from the mice, immunohistochemical staining was performed to observe the expression and distribution of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-β ligand (RANKL) in bone tissues, and micro-computerized tomography was conducted to determine the bone mass of spongy bone, and the bone volume-to-total volume ratio, number, thickness, spacing and connectivity density of the trabecular bone in the proximal tibia. The left femur was also obtained from the mice, and subjected to three-point bending test for evaluating its biomechanical properties. Enzyme-linked immunosorbent assay (ELISA) was performed to detect serum levels of tumor necrosis factor (TNF) -α and interleukin (IL) -17. RNA was extracted from the right tibia, and real-time PCR was conducted to determine the mRNA expression of OPG and RANKL. Two-independent-sample t test was used to compare the above indices between two groups. Results: Ten-week topical stimulation with imiquimod could lead to psoriasiform dermatitis on the mouse back, presenting as erythema, scales and skin thickening. The PASI score was significantly higher in the experimental group (9.167 ± 1.722) than in the control group (0, t = 13.31, P < 0.001) . Hematoxylin-eosin staining showed thickened spinous layer, extended rete ridges, infiltration of inflammatory cells in the superficial dermis, spongiosis, vasodilatation and increased hair follicles in the experimental group. Immunohistochemical staining revealed that the expression of OPG and RANKL was significantly higher in the experimental group (16 021.33 ± 1 954.61, 35 433.33 ± 1 197.95 respectively) than in the control group (3 307.00 ± 1 158.72, 13 644.67 ± 4 764.61, respectively; t = 9.692, 7.682 respectively, both P < 0.01) . Micro-computerized tomography showed that the bone volume-to-total volume ratio and thickness of trabecular bone in the proximal tibia were significantly lower in the experimental group than in the control group, but the spacing of trabecular bone was significantly higher in the experimental group than in the control group (P < 0.01 or < 0.05) . There were no significant differences in the elastic modulus and fracture energy of the femur between the experimental group and control group (both P > 0.05) . Moreover, no significant differences in the serum levels of TNF-α and IL-17 were observed between the two groups (both P > 0.05) . Real-time PCR revealed that the mRNA expression of OPG and RNAKL was significantly higher in the experimental group than in the control group (P < 0.05, < 0.01 respectively) . Conclusions Long-term topical application of imiquimod can not only induce psoriasiform dermatitis in mice, but also lead to bone loss of spongy bone and micro-architectural deterioration in the proximal tibia. Thus, mouse models of psoriasis complicated by bone loss can be established by long-term imiquimod stimulation.