Objective:To summarize the clinical and related characteristics of hospitalized patients with pemphigus, and to analyze their correlations with systemic inflammatory and serological indicators.Methods:A retrospective analysis was conducted on the clinical data from pemphigus patients hospitalized in the Department of Dermatology, Wuhan No.1 Hospital from January 2021 to December 2023. Spearman correlation analysis was performed to assess the correlations between the Pemphigus Disease Area Index (PDAI) scores and systemic immune-inflammation index (SII) , pan-immune-inflammation value (PIV) , serum albumin levels, anti-desmoglein 1/3 (Dsg-1/3) antibody levels, and C-reactive protein (CRP) levels. Linear regression models were used to evaluate the associations of systemic inflammatory and serological indicators with the length of hospital stay and treatment costs. Logistic regression analysis was conducted to analyze the effect of these indicators on the risk of infection in pemphigus patients.Results:A total of 235 pemphigus patients were included (112 males and 123 females) , with ages of 58.12 ± 16.47 years. Among them, 73 patients (31.06%) had pemphigus alone, while 162 (68.94%) had comorbidities including tumors, infections, or hypoalbuminemia. PDAI scores showed significantly positive correlations with SII, PIV, and CRP levels ( r = 0.62, 0.58, 0.50, respectively, all P<0.001) . According to PDAI scores, 164 cases (69.79%) were classified as mild pemphigus, 57 (24.26%) as moderate pemphigus, and 14 (5.96%) as severe pemphigus; compared with the patients with mild pemphigus, those with moderate-to-severe pemphigus had significantly increased SII, PIV, anti-Dsg-1 antibody and CRP levels, but significantly decreased serum albumin levels (all P < 0.05) . Among the 235 patients, 213 were diagnosed with pemphigus vulgaris, 9 with pemphigus erythematosus, 10 with pemphigus foliaceus, and 3 with paraneoplastic pemphigus; serum albumin levels and anti-Dsg-1/3 antibody levels differed significantly among patients with different subtypes of pemphigus (all P < 0.05) . The serum albumin level was significantly associated with the length of hospital stay and treatment costs ( β [95% CI]: -0.729 [-0.946 - -0.512], -0.266 [-0.362 - -0.171], respectively, both P < 0.001) ; furthermore, the serum albumin level was identified as a relevant factor for infections in pemphigus patients ( OR = 0.938, 95% CI: 0.883 - 0.995, P = 0.036) . Conclusion:SII, PIV, CRP, serum albumin, and anti-Dsg-1 antibody levels could reflect the severity of pemphigus to some extent, and the serum albumin level was significantly associated with comorbid infections, length of hospital stay, and treatment costs in hospitalized patients with pemphigus.

Objective:To summarize the clinical and related characteristics of hospitalized patients with pemphigus, and to analyze their correlations with systemic inflammatory and serological indicators.Methods:A retrospective analysis was conducted on the clinical data from pemphigus patients hospitalized in the Department of Dermatology, Wuhan No.1 Hospital from January 2021 to December 2023. Spearman correlation analysis was performed to assess the correlations between the Pemphigus Disease Area Index (PDAI) scores and systemic immune-inflammation index (SII) , pan-immune-inflammation value (PIV) , serum albumin levels, anti-desmoglein 1/3 (Dsg-1/3) antibody levels, and C-reactive protein (CRP) levels. Linear regression models were used to evaluate the associations of systemic inflammatory and serological indicators with the length of hospital stay and treatment costs. Logistic regression analysis was conducted to analyze the effect of these indicators on the risk of infection in pemphigus patients.Results:A total of 235 pemphigus patients were included (112 males and 123 females) , with ages of 58.12 ± 16.47 years. Among them, 73 patients (31.06%) had pemphigus alone, while 162 (68.94%) had comorbidities including tumors, infections, or hypoalbuminemia. PDAI scores showed significantly positive correlations with SII, PIV, and CRP levels ( r = 0.62, 0.58, 0.50, respectively, all P<0.001) . According to PDAI scores, 164 cases (69.79%) were classified as mild pemphigus, 57 (24.26%) as moderate pemphigus, and 14 (5.96%) as severe pemphigus; compared with the patients with mild pemphigus, those with moderate-to-severe pemphigus had significantly increased SII, PIV, anti-Dsg-1 antibody and CRP levels, but significantly decreased serum albumin levels (all P < 0.05) . Among the 235 patients, 213 were diagnosed with pemphigus vulgaris, 9 with pemphigus erythematosus, 10 with pemphigus foliaceus, and 3 with paraneoplastic pemphigus; serum albumin levels and anti-Dsg-1/3 antibody levels differed significantly among patients with different subtypes of pemphigus (all P < 0.05) . The serum albumin level was significantly associated with the length of hospital stay and treatment costs ( β [95% CI]: -0.729 [-0.946 - -0.512], -0.266 [-0.362 - -0.171], respectively, both P < 0.001) ; furthermore, the serum albumin level was identified as a relevant factor for infections in pemphigus patients ( OR = 0.938, 95% CI: 0.883 - 0.995, P = 0.036) . Conclusion:SII, PIV, CRP, serum albumin, and anti-Dsg-1 antibody levels could reflect the severity of pemphigus to some extent, and the serum albumin level was significantly associated with comorbid infections, length of hospital stay, and treatment costs in hospitalized patients with pemphigus.

Objective To investigate the effect and mechanism of Liuling Jiedu Pills on acute pharyngitis caused by Staphylococcus aureus in rats.Methods The rat model of acute pharyngitis was replicated using the method of injecting 1×109 CFU·mL-1 of Staphylococcus aureus solution into the pharynx of rats.SD rats were randomly divided into a blank group,a model group,a Lanqin Oral Solution group(5 mL·kg-1),and a low-,medium-,and high-dose group of Liuling Jiedu Pills(4.375,8.750,and 17.500 mg·kg-1),with 10 rats in each group.Rats in each group were administered the drug by gavage once a day for 7 days.The general conditions of the rats were observed and recorded every day during the modeling and drug administration periods,and the local inflammation in the pharynx was scored;histopathological changes in the pharynx of the rats were observed by hematoxylin-eosin(HE)staining;serum interleukin 1β(IL-1β),interleukin 6(IL-6),tumor necrosis factor α(TNF-α),and tumor necrosis factor-α(TNF-α)were detected by ELISA.Immunohistochemistry and Western Blot were used to detect the protein expression levels of IL-1β,IL-6 and TNF-α in rat pharyngeal tissue.Results Compared with the blank group,rats in the model group had significantly increased pharyngeal erythema,significantly higher inflammation scores(P＜0.01),significantly lower body mass on days 5-7 after modeling(P＜0.05,P＜0.01),significantly higher pathological scores(P＜0.01),significantly higher levels of the serum inflammatory factors IL-1β,IL-6,and TNF-α(P＜0.01),and significantly higher pharyngeal tissues showed significantly higher levels of IL-1β,IL-6,and TNF-α proteins(P＜0.01).Compared with the model group,the pharyngeal erythema was significantly reduced in the Lanqin Oral Solution group and the low-,medium-and high-dose groups of Liuling Jiedu Pills,and the inflammation scores were significantly reduced(P＜0.01),and the serum levels of IL-1β,IL-6,and TNF-α were significantly reduced(P＜0.01);the body mass of the rats in the Lanqin Oral Solution group,and in the medium-and high-dose groups of Liuling Jiedu Pills,were significantly increased on the seventh day of the modeling(P＜0.01);the histopathological scores and the levels of IL-1β,IL-6 and TNF-α proteins in pharyngeal tissue were significantly decreased(P＜0.05,P＜0.01).Conclusion Liuling Jiedu Pills can significantly improve the symptoms and inflammatory pathological changes of pharyngeal tissues in rats with acute pharyngitis,and its mechanism may be related to the down-regulation of the expression levels of inflammatory factors such as IL-1β,IL-6,and TNF-α.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) or high glucose on the toll-like receptor 4 (TLR4) expression,inflammatory cytokines and fibrotic factors in human tubular epithelial cells (HK-2),revealing the innate immune-related pathogenesis of diabetic nephropathy (DN) which may have clinical implications.Methods Three TLR4 siRNA sequences were designed and synthetized.After transfection,the most effective siRNA was selected to use for further expriments.The experiment consisted of 2 parts.Part 1:Cells were divided into three groups:normal-glucose group (NG,5.5mmol/L glucose),mannose group (M,5.5 mmol/L glucose + 19.5 mmol/L mannose),High-glucose group (HG,25 mmol/L glucose),preliminary validated the effects of high glucose and high osmotic pressure.Part 2:Cells were divided into seven groups:NG group,HG group,Ang Ⅱ group,Ang Ⅱ + negative group,HG+ negative group,Ang Ⅱ + siRNA group and HG+ siRNA group.Real time PCR was used to analyze the mRNA expression of TLR4,myeloid differentiation factor 88 (MyD88),heat shock protein 47 (HSP47).Western blotting was used to observe the protein expression of TLR4,MyD88,HSP47,NF-κB,type Ⅳ collagen (ColⅣ).ELISA was used to detect the expression of monocyte chemotactic protein-1 (MCP-1) and interleukin-6 (IL-6).Results Compared with NG group,TLR4,MyD88,HSP47 mRNA and TLR4,MyD88,NF-κB,ColⅣ,HSP47 protein were highly expressed under high glucose or Ang Ⅱconditions (P ＜ 0.01),and the expression levels of MCP-1 and IL-6 also increased significantly (P ＜ 0.01).Compared with HG or Ang Ⅱ group,the above indicators were obviously inhibited in the TLR4 siRNA groups (P＜0.01).Comparison between blank vector transfected groups and HG group as well as Ang Ⅱ group indicated no statistic significance (P ＞ 0.05).Conclusions Both Ang Ⅱ and high glucose stimulate TLR4 expression,which result in the up-regulation of inflammatory and fibrotic factors in HK-2.Specific target of TLR4 gene silencing can block the TLR4 pathway that is activated by high glucose and Ang Ⅱ,and thus reduce the inflammatory and fibtogenic factors' release.TLR4 signal is the common innate immune response pathway which induces the release of inflammatory and fibrotic factors in HK-2 under high glucose or high angiotension conditions.