Atopic dermatitis is a common chronic recurrent atopic constitution-associated inflammatory skin disease mainly characterized by eczematous lesions and itching. Its etiology and pathogenesis are still not very clear, and there are many controversies about its origin, definition, clinical phenotypes and diagnostic criteria. This review analyzes and discusses these controversies in order to provide a meaningful reference for the diagnosis and treatment of atopic dermatitis.

XIAP(X-linked inhibitor of apoptosis protein)is one of the most important members of IAPs family.It inhibits cell apoptosis mainly by inhibiting the caspases activation and interfering with other apoptotic pathway,which plays a critical role in tumor development.Recently,genetic therapy targeting on XIAP for malignant tumors has deeply developed.Research on XIAP as a malignant and prognositic indicator is ongoing.

Objective To improve the ingestion protocol of esophageal capsule endoscopy in right lateral supine (RLS) position. Methods A total of 53 patients were randomized into RLS group and improvement group. The time of passing the esophagus, visual range and clarity of esophagus and z-line, and comfort of the procedure were compared between the two groups. Results The time of capsule passing the esophagus in improvement group was significantly longer than that in RLS group [ 202 (20-480) s vs.63 (8-210) s, P ＜ 0. 001 ) ]. The range of visualization in esophagus (2. 69 ± 0. 21 ) and Z-line (2. 54 ±0. 22) in improvement group was significantly larger than that in RLS group (2. 55 ± 0. 23 and 2. 40 ± 0. 24,respectively, P =0. 019 and P =0. 037, respectively). No significant difference was detected in clarity of esophagus or Z-line between 2 groups (P ＞0. 05). Two patients (7.7%) in RLS group had transient cough due to frequent water drinking, while no cough was observed in improvement group. Conclusion Compared with the ingestion protocol of esophageal capsule endoscopy in right lateral supine position, the improved ingestion protocol shows larger range of visualization, better safety and the same definition.

Objective To investigate the clinical characteristics of the patients with portal hypertension secondary to primary myelofibrosis (PH-PMF). Methods The clinical data of patients with PH-PMF retrieved from Peking University Third Hospital were collected and analyzed. Results A total of 6 from illness onset to definite diagnosis was 24 months. The symptoms related to portal hypertension included bloating, abdominal mass, hematemesis and melena. The signs related to portal hypertension included splenomegaly ( moderate or severe in all patients), hepatomegaly ( mild or moderate in most of patients),shifting dullness positive and varices in abdominal wall. Only a small portion of patients had jaundice, liver palms and spider angioma. The indexes related to liver functions were normal or only mild abnormal in most cases. The average diameters of portal vein and splenic vein were ( 16. 0 ±3.2) mm and ( 11.0 ±3.4) mm,respectively. Thrombosis of portal vein or splenic vein was found in 2 cases. Liver biopsy revealed extramedullary hemopoiesis in one patient. In addition to medicine therapy related to portal hypertension in 5 patients with PH-PMF, 1 patient received splenectomy and another received endoscopic variceal ligation.Conclusions The patients with PH-PMF were clinically rare and easy to be misdiagnosed. The main keys to differentiate PH-PMF from cirrhosis included marked splenomegaly, mild or moderate hepatomegaly, good liver functions, lack of liver palms or spider angioma and extramedullary hemopoiesis showed in liver biopsy samples.

Objective To establish a cell model that is close to the HCV replication in vivo and can support long-term HCV replication in vitro.Methods A human liver cell line 7721 was inoculated with serum from a chronic hepatitis C patient for 8 hours.After incubation,the presence of HCV RNA,the expression of HCV antigen and the location of HCV RNA in cells and/or supernatant were detected by RTPCR,immunohistochemistry and in situ hybridization respectively.Results It was found that plus-and minus-strand of HCV RNA could be discontinuously detected in both cells and supernatant as late as 66 days after inoculation even if cells had been subcultured for 6 times.HCV NS3、NS5 antigens could be expressed in cells and HCV RNA was mainly located within cytoplasm.Conclusion The above results suggested that 7721 cell line was not only susceptible to HCV but also could support its long-term replication in vitro.This HCV infection model in vitro was proved to be a useful tool for studying the mechanism of HCV infection and replication,as well as evaluating the antiviral compounds and screening the protective antibodies/vaccines.

Objective To evaluate the efficacy and safety of common therapy and individualized treatment in newly diagnosed patients with Helicobacter pylori (H.pylori) infection.Methods From March 2008 to February 2010,September 2013 to April 2014,January to October 2015,a total of 1 440 patients with H.pylori infection who received eradication therapy and with complete clinical data were retrospectively enrolled.Each was 350 cases in individualized treatment group,clarithromycin and bismuth containing quadruple therapy group and concomitant therapy group.A total of 100 cases were in standard triple therapy group,90 cases in sequential therapy group,and 200 cases in levofloxacin and bismuth-containing quadruple therapy group.The eradication rate of H.pylori,incidence of adverse events and compliance rate were compared in the six groups.Chi square test was performed for statistical analysis.Results The results of intention-to-treat analysis indicated that there was no statistically significant difference in H.pylori eradication rates among six groups (x2 =0.985,P=0.323).However,the results of modified intention-to-treat analysis showed that H.pylori eradication rate of individualized treatment group was the highest (92.5％ (282/305) and 93.3％ (278/298)),second was levofloxacin and bismuth-containing quadruple therapy group (90.3％ (167/185) and 91.6％ (164/179)),and the differences were statistically significant (x2 =11.285 and 13.981,both P＜0.01).There was statistically significant difference in indcidence of adverse events among the six groups (x2 =5.692,P=0.018),the incidence of adverse events in levofloxacin and bimuth-containing quadruple therapy group was lowest (16.2 ％ (30/185)),and second was individualized treatment group (21.0％ (64/305)).There was statistically significant difference in compliance rates among the six groups (x2 =4.712,P=0.023),the compliance rates of standard triple therapy group and sequential therapy group were highest (100％ (100/100) and 100％ (90/90)),and second was individualized treatment group (97.7％ (298/305)).Conclusions Both the levofloxacin and bimuth-containing quadruple therapy group and individualized treatment group can effectively eradicate H.pylori infection.The former may be safe and effective to patients unable to receive individualized therapy.

Atopic dermatitis is a recurrent inflammatory skin disease. Although the existing systemic and topical treatment can relieve symptoms, there are still some limitations and adverse effects. In recent years, with the in-depth study on the pathogenesis of atopic dermatitis, especially the discovery of key inflammatory molecules and development of targeted therapeutic drugs, some new therapeutic methods and concepts have been brought to clinical practice. Awareness of new progress in atopic dermatitis-related biologics, small-molecule drugs, adjuvant treatment, monitoring methods and models for managing disease, will help clinicians better treat and manage atopic dermatitis.

Clinical phenotypes and endophenotypes of atopic dermatitis are diverse, and it is of great significance to identify characteristics of different clinical phenotypes and endophenotypes for auxiliary diagnosis and targeted treatments. This review elaborates clinical phenotypic differences of atopic dermatitis in terms of age of onset, ethnic background, disease severity, etc., and summarizes clinical significance of endophenotypes and related biomarkers.

Systemic contact dermatitis (SCD) is a kind of allergic inflammatory skin disease caused by contact with the same or cross-reactive allergens via systemic absorption in individuals who have been exposed to allergens. SCD lesions are diverse and easily overlooked in clinical practice. This review summarizes progress in clinical manifestations, pathogenesis, diagnosis, treatment of and sensitizers in SCD, aiming to improve its clinical diagnosis and treatment.

Persistent centrofacial erythema with transient flushing is the most common clinical manifestation of rosacea. However, its pathological mechanisms are poorly understood, and there is a lack of high-level evidence from clinical studies. Based on research progress and clinical experience in China and other countries, the authors emphasize the necessity that facial flushing with erythema should be investigated as an independent clinical phenotype during the study. It is believed that mental stress, anxiety and/or depression may be driving factors in the pathogenesis of facial flushing with erythema. Based on mental factors, it is of potential clinical significance to investigate the relationship of neuroinflammation involved in facial flushing and erythema with skin immunity and blood vessels in rosacea.