1.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
2.Knowledge,attitude and practice of transitional care in nurses of 41 hospitals in Shaanxi province:a cluster analysis of current status
Gaiping CHENG ; Zhihua YANG ; Jiang ZHAO ; Qin YUE ; Honghong SHEN ; Chunxiu FAN ; Juan XIE
Modern Clinical Nursing 2024;23(4):15-23
Objective To investigate current status in knowledge,attitude and practice(KAP)of transitional care among the nurses in Shaanxi province,identify the influencing factors that hinder the transitional care and carry out training of transitional care for the nurses in different specialties in order to provide a theoretical basis for establishing a transitional care model for discharged patients.Methods A total of 2 288 nurses were selected to participate the survey from 41 hospitals in Shaanxi province by the stratified two-stage random sampling method.A self-designed questionnaire for general information,an obstacle factor scale,and a KAP of transitional care questionnaire were used as the survey instruments.The data acquired from the survey were processed by Cluster analysis to identify potential categories and the influencing factors.Results Totally 2085 nurses finished the study.Total score of KAP of transitional care among the nurses in Shaanxi province was found at(134.96±23.75),which was at a medium level.The scores of knowledge,attitude and practice were 77.24%,80.64%and 76.98%respectively.Cluster analysis showed that all the nurses could be categorised into either a lower scored group(n=1 596,76.5%)or a higher scored group(489,23.5%),with a best potential category number of 2 for the 2 085 nurses who participated the survey.There were statistically significant differences between the groups in terms of care training,telephone follow-up,network platform,outpatient service of nursing experts,family visits,patient club and hospital categories(all P<0.05).Logistic regression analysis on even factors above showed that care training,telephone follow-up,network platform and patient club could significantly affect the potential categorisation of KAP of the nurses in transitional care(all P<0.05).The main factors that hindered the transitional care included insufficient human resources(93.81%),insufficient supply of community services(93.57%)and lack of a standardised flowchart for transitional care(93.09%).Conclusions Levels of KAP about the transitional care are at a medium level among the nurses of 41 hospitals in Shaanxi province,which indicates that the nurses are active in attitude,but the knowledge and practice are required to be further improved and standardised.The results of cluster analysis indicate that it is necessary for nursing managers to carry out targeted trainings in transitional care for the nurses in different categories.This study provides a theoretical basis to establish a diversified transitional care mode for discharged patients in Shaanxi province.
3.Construction and verification of prognostic classification model for elderly cancer patients in rural areas based on machine learning algorithm
Li CHANG ; Zhihua YANG ; Jiang ZHAO ; Qin YUE ; Honghong SHEN ; Chunxiu FAN ; Juan XIE
Chinese Journal of Practical Nursing 2024;40(21):1661-1670
Objective:The classification model of prognosis of elderly cancer patients in rural areas of Shaanxi province was constructed based on machine learning algorithm, and its effectiveness was verified, providing reference for early prognosis recognition and intervention treatment.Methods:Using a multicenter, cross-sectional survey method and convenience sampling method, 597 elderly cancer patients in rural areas hospitalized in 9 different medical institutions (Shaanxi Cancer Hospital and its member units of specialty alliance) in Shaanxi Province from July to August 2022 were selected as the research objects, and a variable database of "basic information", "self-care ability", "symptoms", "comprehensive needs" and "quality of life" of elderly cancer patients in rural areas was established. Machine learning and statistical analysis were carried out to explore the important prognostic characteristics of elderly cancer patients in rural areas, and a prognostic classification model for elderly cancer patients in rural areas was constructed and verified.Results:The 597 valid questionnaires were ultimately collected.Among the 597 elderly cancer patients in rural areas, 207 were males and 390 were females, aged (69.56 ± 8.84) years. The results of cluster exploration showed that the prognosis of elderly cancer patients in rural areas was divided into three categories: good, medium and poor. The areas under the working characteristic curves of the subjects in good, medium and poor were 0.84, 0.79 and 0.69, respectively. The results of characteristic exploration showed that 10 indicators of "whether accompanied by metastasis", "distress", "sadness", "numbness", "eating", "walking", "fatigue", "forgetfulness", "fun of life" and "relationship with others" were important characteristic indicators of prognosis evaluation of elderly cancer patients in rural areas. There were statistically significant differences among the 10 important characteristic indicators in the three categories of prognosis of rural elderly cancer patients ( χ2=21.07, H values were 18.51-144.38, all P<0.01). There were statistically significant differences in the three categories of "comprehensive needs", "quality of life", "self-care ability" and "symptoms" ( H values were 519.40, 40.80, 103.69, all P<0.01). Conclusions:The construction and verification of a prognostic classification model for elderly cancer patients in rural areas based on machine learning algorithm can effectively explore the important characteristic indicators and prognostic classification of elderly cancer patients in rural areas, and provide basis and guidance for clinical medical staff to make individualized plans.
4. Effect of radix scutellariae microemulsion gel on chronic eczema in mice model
Ke WANG ; Chenbing NIU ; Yinxia CHANG ; Zhihua LUAN ; Xuemei QIN ; Yue ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):447-454
AIM: To prepare radix scutellariae microemulsion gel and investigate its therapeutic effect on chronic eczema based on the previous research of radix scutellariae self microemulsion. METHODS: The gel matrix and humectant were optimized by single factor method and response surface method to obtain the formula and preparation technique of the gel. The Franz diffusion cell method was used to evaluate the transdermal properties of microemulsion and microemulsion gel in vitro. By establishing a chronic eczema model in the mouse ear, the swelling degree, swelling inhibition rate, pathological changes and tumor necrosis factor α (TNF-α), Interleukin-1β (IL-1β) and interleukin - 6 (IL-6) of radix scutellariae microemulsion gel were measured, to investigate the therapeutic effect on chronic eczema in mice. RESULTS: The physical and chemical properties of radix scutellariae microemulsion gel were stable. Compared with microemulsion, the microemulsion gel had better transdermal performance. The cumulative transdermal amount of baicalein and wogonin, the main components of microemulsion gel, was 1.85 times and 2.77 times of that of microemulsion respectively. Moreover, the steady flow rate and permeability coefficient of microemulsion gel significantly increased, and the lag time significantly shortened. Pharmacodynamic study showed that compared with the model group, the radix scutellariae microemulsion gel could significantly reduce the ear swelling of mice (P<0.05), and the serum inflammatory factor TNF - α, IL-1β and IL-6 reduced content by over 37%. Compared with the radix scutellaria aqueous extract and aqueous extract gel, the treatment of chronic eczema was better. CONCLUSION: The preparation process of radix scutellaria microemulsion gel is feasible, with strong transdermal property, and a significant therapeutic effect on chronic eczema.
5.Effect of radix scutellariae microemulsion gel on chronic eczema in mice model
Ke WANG ; Chenbing NIU ; Yinxia CHANG ; Xuemei QIN ; Zhihua LUAN ; Yue ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):447-454
AIM:To prepare radix scutellariae mi-croemulsion gel and investigate its therapeutic ef-fect on chronic eczema based on the previous re-search of radix scutellariae self microemulsion.METHODS:The gel matrix and humectant were op-timized by single factor method and response sur-face method to obtain the formula and preparation technique of the gel.The Franz diffusion cell meth-od was used to evaluate the transdermal proper-ties of microemulsion and microemulsion gel in vi-tro.By establishing a chronic eczema model in the mouse ear,the swelling degree,swelling inhibition rate,pathological changes and tumor necrosis fac-tor a(TNF-a),Interleukin-1β(IL-1β)and interleukin-6(IL-6)of radix scutellariae microemulsion gel were measured,to investigate the therapeutic ef-fect on chronic eczema in mice.RESULTS:The physi-cal and chemical properties of radix scutellariae mi-croemulsion gel were stable.Compared with micro-emulsion,the microemulsion gel had better trans-dermal performance.The cumulative transdermal amount of baicalein and wogonin,the main compo-nents of microemulsion gel,was 1.85 times and 2.77 times of that of microemulsion respectively.Moreover,the steady flow rate and permeability co-efficient of microemulsion gel significantly in-creased,and the lag time significantly shortened.Pharmacodynamic study showed that compared with the model group,the radix scutellariae micro-emulsion gel could significantly reduce the ear swelling of mice(P<0.05),and the serum inflamma-tory factor TNF-a,IL-1β and IL-6 reduced content by over 37%.Compared with the radix scutellaria aqueous extract and aqueous extract gel,the treat-ment of chronic eczema was better.CONCLUSION:The preparation process of radix scutellaria micro-emulsion gel is feasible,with strong transdermal property,and a significant therapeutic effect on chronic eczema.
6.Effect of radix scutellariae microemulsion gel on chronic eczema in mice model
Ke WANG ; Chenbing NIU ; Yinxia CHANG ; Xuemei QIN ; Zhihua LUAN ; Yue ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):447-454
AIM:To prepare radix scutellariae mi-croemulsion gel and investigate its therapeutic ef-fect on chronic eczema based on the previous re-search of radix scutellariae self microemulsion.METHODS:The gel matrix and humectant were op-timized by single factor method and response sur-face method to obtain the formula and preparation technique of the gel.The Franz diffusion cell meth-od was used to evaluate the transdermal proper-ties of microemulsion and microemulsion gel in vi-tro.By establishing a chronic eczema model in the mouse ear,the swelling degree,swelling inhibition rate,pathological changes and tumor necrosis fac-tor a(TNF-a),Interleukin-1β(IL-1β)and interleukin-6(IL-6)of radix scutellariae microemulsion gel were measured,to investigate the therapeutic ef-fect on chronic eczema in mice.RESULTS:The physi-cal and chemical properties of radix scutellariae mi-croemulsion gel were stable.Compared with micro-emulsion,the microemulsion gel had better trans-dermal performance.The cumulative transdermal amount of baicalein and wogonin,the main compo-nents of microemulsion gel,was 1.85 times and 2.77 times of that of microemulsion respectively.Moreover,the steady flow rate and permeability co-efficient of microemulsion gel significantly in-creased,and the lag time significantly shortened.Pharmacodynamic study showed that compared with the model group,the radix scutellariae micro-emulsion gel could significantly reduce the ear swelling of mice(P<0.05),and the serum inflamma-tory factor TNF-a,IL-1β and IL-6 reduced content by over 37%.Compared with the radix scutellaria aqueous extract and aqueous extract gel,the treat-ment of chronic eczema was better.CONCLUSION:The preparation process of radix scutellaria micro-emulsion gel is feasible,with strong transdermal property,and a significant therapeutic effect on chronic eczema.
7.Effect of radix scutellariae microemulsion gel on chronic eczema in mice model
Ke WANG ; Chenbing NIU ; Yinxia CHANG ; Xuemei QIN ; Zhihua LUAN ; Yue ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):447-454
AIM:To prepare radix scutellariae mi-croemulsion gel and investigate its therapeutic ef-fect on chronic eczema based on the previous re-search of radix scutellariae self microemulsion.METHODS:The gel matrix and humectant were op-timized by single factor method and response sur-face method to obtain the formula and preparation technique of the gel.The Franz diffusion cell meth-od was used to evaluate the transdermal proper-ties of microemulsion and microemulsion gel in vi-tro.By establishing a chronic eczema model in the mouse ear,the swelling degree,swelling inhibition rate,pathological changes and tumor necrosis fac-tor a(TNF-a),Interleukin-1β(IL-1β)and interleukin-6(IL-6)of radix scutellariae microemulsion gel were measured,to investigate the therapeutic ef-fect on chronic eczema in mice.RESULTS:The physi-cal and chemical properties of radix scutellariae mi-croemulsion gel were stable.Compared with micro-emulsion,the microemulsion gel had better trans-dermal performance.The cumulative transdermal amount of baicalein and wogonin,the main compo-nents of microemulsion gel,was 1.85 times and 2.77 times of that of microemulsion respectively.Moreover,the steady flow rate and permeability co-efficient of microemulsion gel significantly in-creased,and the lag time significantly shortened.Pharmacodynamic study showed that compared with the model group,the radix scutellariae micro-emulsion gel could significantly reduce the ear swelling of mice(P<0.05),and the serum inflamma-tory factor TNF-a,IL-1β and IL-6 reduced content by over 37%.Compared with the radix scutellaria aqueous extract and aqueous extract gel,the treat-ment of chronic eczema was better.CONCLUSION:The preparation process of radix scutellaria micro-emulsion gel is feasible,with strong transdermal property,and a significant therapeutic effect on chronic eczema.
8.SiO2 Induces Iron Overload and Ferroptosis in Cardiomyocytes in a Silicosis Mouse Model
Wang YONGHENG ; Li NING ; Guan YI ; LI TONG ; Zhang YUXIU ; Cao HONG ; Yu ZHIHUA ; Li ZHIHENG ; Li SHUOYAN ; Hu JIAHAO ; Zhou WENXIN ; Qin SISI ; Li SHUANG ; Yao SANQIAO
Biomedical and Environmental Sciences 2024;37(6):617-627
Objective The aim of this study was to explore the role and mechanism of ferroptosis in SiO2-induced cardiac injury using a mouse model. Methods Male C57BL/6 mice were intratracheally instilled with SiO2 to create a silicosis model.Ferrostatin-1(Fer-1)and deferoxamine(DFO)were used to suppress ferroptosis.Serum biomarkers,oxidative stress markers,histopathology,iron content,and the expression of ferroptosis-related proteins were assessed. Results SiO2 altered serum cardiac injury biomarkers,oxidative stress,iron accumulation,and ferroptosis markers in myocardial tissue.Fer-1 and DFO reduced lipid peroxidation and iron overload,and alleviated SiO2-induced mitochondrial damage and myocardial injury.SiO2 inhibited Nuclear factor erythroid 2-related factor 2(Nrf2)and its downstream antioxidant genes,while Fer-1 more potently reactivated Nrf2 compared to DFO. Conclusion Iron overload-induced ferroptosis contributes to SiO2-induced cardiac injury.Targeting ferroptosis by reducing iron accumulation or inhibiting lipid peroxidation protects against SiO2 cardiotoxicity,potentially via modulation of the Nrf2 pathway.
9.Effect of radix scutellariae microemulsion gel on chronic eczema in mice model
Ke WANG ; Chenbing NIU ; Yinxia CHANG ; Xuemei QIN ; Zhihua LUAN ; Yue ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):447-454
AIM:To prepare radix scutellariae mi-croemulsion gel and investigate its therapeutic ef-fect on chronic eczema based on the previous re-search of radix scutellariae self microemulsion.METHODS:The gel matrix and humectant were op-timized by single factor method and response sur-face method to obtain the formula and preparation technique of the gel.The Franz diffusion cell meth-od was used to evaluate the transdermal proper-ties of microemulsion and microemulsion gel in vi-tro.By establishing a chronic eczema model in the mouse ear,the swelling degree,swelling inhibition rate,pathological changes and tumor necrosis fac-tor a(TNF-a),Interleukin-1β(IL-1β)and interleukin-6(IL-6)of radix scutellariae microemulsion gel were measured,to investigate the therapeutic ef-fect on chronic eczema in mice.RESULTS:The physi-cal and chemical properties of radix scutellariae mi-croemulsion gel were stable.Compared with micro-emulsion,the microemulsion gel had better trans-dermal performance.The cumulative transdermal amount of baicalein and wogonin,the main compo-nents of microemulsion gel,was 1.85 times and 2.77 times of that of microemulsion respectively.Moreover,the steady flow rate and permeability co-efficient of microemulsion gel significantly in-creased,and the lag time significantly shortened.Pharmacodynamic study showed that compared with the model group,the radix scutellariae micro-emulsion gel could significantly reduce the ear swelling of mice(P<0.05),and the serum inflamma-tory factor TNF-a,IL-1β and IL-6 reduced content by over 37%.Compared with the radix scutellaria aqueous extract and aqueous extract gel,the treat-ment of chronic eczema was better.CONCLUSION:The preparation process of radix scutellaria micro-emulsion gel is feasible,with strong transdermal property,and a significant therapeutic effect on chronic eczema.
10.Effect of radix scutellariae microemulsion gel on chronic eczema in mice model
Ke WANG ; Chenbing NIU ; Yinxia CHANG ; Xuemei QIN ; Zhihua LUAN ; Yue ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):447-454
AIM:To prepare radix scutellariae mi-croemulsion gel and investigate its therapeutic ef-fect on chronic eczema based on the previous re-search of radix scutellariae self microemulsion.METHODS:The gel matrix and humectant were op-timized by single factor method and response sur-face method to obtain the formula and preparation technique of the gel.The Franz diffusion cell meth-od was used to evaluate the transdermal proper-ties of microemulsion and microemulsion gel in vi-tro.By establishing a chronic eczema model in the mouse ear,the swelling degree,swelling inhibition rate,pathological changes and tumor necrosis fac-tor a(TNF-a),Interleukin-1β(IL-1β)and interleukin-6(IL-6)of radix scutellariae microemulsion gel were measured,to investigate the therapeutic ef-fect on chronic eczema in mice.RESULTS:The physi-cal and chemical properties of radix scutellariae mi-croemulsion gel were stable.Compared with micro-emulsion,the microemulsion gel had better trans-dermal performance.The cumulative transdermal amount of baicalein and wogonin,the main compo-nents of microemulsion gel,was 1.85 times and 2.77 times of that of microemulsion respectively.Moreover,the steady flow rate and permeability co-efficient of microemulsion gel significantly in-creased,and the lag time significantly shortened.Pharmacodynamic study showed that compared with the model group,the radix scutellariae micro-emulsion gel could significantly reduce the ear swelling of mice(P<0.05),and the serum inflamma-tory factor TNF-a,IL-1β and IL-6 reduced content by over 37%.Compared with the radix scutellaria aqueous extract and aqueous extract gel,the treat-ment of chronic eczema was better.CONCLUSION:The preparation process of radix scutellaria micro-emulsion gel is feasible,with strong transdermal property,and a significant therapeutic effect on chronic eczema.

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