Objective:To explore the therapeutic effect of low-dose interleukin-2 (LdIL-2) on psoriasis and the regulatory role of peripheral blood Th17/Treg imbalance and cytokine disorder.Methods:45 psoriasis patients and 40 healthy individuals were collected from January 2021 to December 2022 in the Second Hospital of Shanxi Medical University. All patients were given with MTX (7.5 mg/week) for 12 weeks, followed by LdIL-2 (50×10 5 U/d×2 weeks×3 courses) until the 24 th week. PASI and ACR20 were collected at the 0, 12th and 24th weeks. Th17, Treg cell, IL-17 and IL-10 were detected. Statistical analysis included t-test, generalized estimating equations, Wilcoxon analysis, Chi-Square Test, Pearson linear correlation analysis, Spearman rank correlation analysis, etc. Results:①The number of patients who reached PASI50/75 in the 24 th week(31,10) was significantly higher than in the 12th week (14, 1), and the differences were statistically significant ( χ2=15.059, P<0.001; χ2=7.111, P=0.004). ②Compared the 0 week with the 24th week, Th17 cell was decreased [1.520%(0.985%, 2.005%) vs. 0.830%(0.675%, 1.125%), H=25.493, P<0.001], Treg cell was increased [3.010%(2.255%, 3.615%) vs.5.190%(4.605%, 6.030%), H=152.106, P<0.001], Th17/Treg ratio also was decreased [0.547(0.348, 0.712) vs. 0.170(0.105, 0.225), H=47.025, P<0.001], and the differences were statistically significant. ③Compared the 0 week with the 24th week, IL-17 was decreased [(19.7±8.7)pg/ml vs. (14.20±6.0)pg/ml, F=21.814, P<0.001], IL-10 was increased [(2.01±0.97)pg/ml vs. (2.62±0.92)pg/ml, F=11.230, P=0.004], IL-17/IL-10 ratio also was decreased [10.644(5.925, 14.705) vs. 5.410(3.455, 7.180), H=16.647, P<0.001], and the differences were statistically significant. ④The correlation analysis showed that PASI were significantly positively correlated with Th17 cells( r=0.598, P<0.001), Th17/Treg( r=0.772, P<0.001), IL-17( r=0.500, P<0.001) and IL-17/IL-10( r=0.776, P<0.001), and significantly negatively correlated with Treg cells( r=-0.822, P<0.001) and IL-10( r=-0.715, P<0.001). Conclusion:LdIL-2 can effectively reverse Th17/Treg imbalance and cytokine disorder in psoriasis patients, significantly alleviate the condition, and has good safety.

A 43-year-old male patient presented with recurrent edema in different anatomical sites for over 10 years, with facial edema worsening 1 day prior to admission. He had been repeatedly admitted to dermatology, general surgery, and emergency departments of external hospitals due to " acute abdomen" and " laryngeal edema, " resistant to antihistamines and glucocorticoid therapy. Physical examination revealed non-pitting swelling of the right upper eyelid, bilateral cheeks, and lips asymmetrically. On the night of admission, he developed acute laryngeal edema with dyspnea, which was promptly treated, leading to clinical stabilization. Laboratory screening during the attack revealed decreased serum complement C4 levels, along with reduced functional activity and concentration of C1 esterase inhibitor, confirming a diagnosis of type 1 hereditary angioedema. The patient received lanadelumab for prophylaxis and achieved satisfactory clinical outcomes. He remains under long-term follow-up.

Objective:To explore the therapeutic effect of low-dose interleukin-2 (LdIL-2) on psoriasis and the regulatory role of peripheral blood Th17/Treg imbalance and cytokine disorder.Methods:45 psoriasis patients and 40 healthy individuals were collected from January 2021 to December 2022 in the Second Hospital of Shanxi Medical University. All patients were given with MTX (7.5 mg/week) for 12 weeks, followed by LdIL-2 (50×10 5 U/d×2 weeks×3 courses) until the 24 th week. PASI and ACR20 were collected at the 0, 12th and 24th weeks. Th17, Treg cell, IL-17 and IL-10 were detected. Statistical analysis included t-test, generalized estimating equations, Wilcoxon analysis, Chi-Square Test, Pearson linear correlation analysis, Spearman rank correlation analysis, etc. Results:①The number of patients who reached PASI50/75 in the 24 th week(31,10) was significantly higher than in the 12th week (14, 1), and the differences were statistically significant ( χ2=15.059, P<0.001; χ2=7.111, P=0.004). ②Compared the 0 week with the 24th week, Th17 cell was decreased [1.520%(0.985%, 2.005%) vs. 0.830%(0.675%, 1.125%), H=25.493, P<0.001], Treg cell was increased [3.010%(2.255%, 3.615%) vs.5.190%(4.605%, 6.030%), H=152.106, P<0.001], Th17/Treg ratio also was decreased [0.547(0.348, 0.712) vs. 0.170(0.105, 0.225), H=47.025, P<0.001], and the differences were statistically significant. ③Compared the 0 week with the 24th week, IL-17 was decreased [(19.7±8.7)pg/ml vs. (14.20±6.0)pg/ml, F=21.814, P<0.001], IL-10 was increased [(2.01±0.97)pg/ml vs. (2.62±0.92)pg/ml, F=11.230, P=0.004], IL-17/IL-10 ratio also was decreased [10.644(5.925, 14.705) vs. 5.410(3.455, 7.180), H=16.647, P<0.001], and the differences were statistically significant. ④The correlation analysis showed that PASI were significantly positively correlated with Th17 cells( r=0.598, P<0.001), Th17/Treg( r=0.772, P<0.001), IL-17( r=0.500, P<0.001) and IL-17/IL-10( r=0.776, P<0.001), and significantly negatively correlated with Treg cells( r=-0.822, P<0.001) and IL-10( r=-0.715, P<0.001). Conclusion:LdIL-2 can effectively reverse Th17/Treg imbalance and cytokine disorder in psoriasis patients, significantly alleviate the condition, and has good safety.

Kaposi varicelliform eruption(KVE)refers to an infectious skin disease that occurs after in-fection with herpes simplex virus,Coxsackie virus,or other viruses on the basis of preexisting skin diseases,commonly observed in the patients with eczema.It is rare for the patients with erythroderma to be complicated with KVE,and symptoms are often atypical,which pose a challenge to the diagnosis and treatment.This article reports a case of erythroderma complicated with KVE,aiming to raise awareness of clinicians in treating this disease.

Annular elastolytic giant cell granuloma(AEGCG) is a rare granulomatous skin condition. We present a case of a 67-year-old man with annular plaques on the face, neck, shoulder, back and upper limbs, and mildly pruritis exceeding one year. Histopathological examination demonstrated granulomatous inflammatory infiltration of lymphocytes, histiocytes and multinuclear giant cells in the middle and the upper dermis, with more local eosinophils. Elastic fiber staining showed that elastic fibers were absent in granuloma area and were engulfed by multinucleated giant cells. Based on the clinical and histopathological findings, a diagnosis of AEGCG was made. The etiology and pathogenesis of this condition are unclear, and atypical manifestations of non-exposed areas can also occur.It is usually related to systemic diseases lacks specific treatment at present.

Objective To explore the relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains. Methods The National Committee for Clinical Laboratory Standards (NCCLS)M27-A2 broth microdilution method was conducted to evaluate antifungal susceptibility of 34 clinical Candida albicans isolates in vitro. Total RNA was extracted from these Candida albicans strains and transcribed into cDNA. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of ERG4 gene. Statistical analysis was carried out by a two-sample t-test. Results The expression level of ERG4 mRNA was significantly higher in fluconazole-resistant than in -sensitive Candida albicans strains (4.20 ± 2.56 vs. 1.72 ± 1.33, t = 3.99, P < 0.05), higher in itraconazole-resistant than in -sensitive Candida albicans strains (3.60 ± 2.47 vs. 1.66 ± 1.61, t = 3.71, P < 0.05), and higher in voriconazole-resistant than in -sensitive Candida albicans strains (3.99 ± 2.72 vs. 2.07 ± 1.58, t = 2.91, P <0.05). Further more, increased ERG4 mRNA expression was also observed in isolates cross-resistant to all the three azole antifungal agents compared with those susceptible to all of them (4.49 ± 2.73 vs. 1.69 ± 1.82, t = 3.81, P < 0.05). Conclusions The overexpression of ERG4 gene may be associated with cross resistance to fluconazole, itraconazole and voriconazole in clinical Candida albicans strains, but its exact role is expected to be investigated through downregulation of the ERG4 gene.

Objective The aim of this study was to investigate the diagnostic impact of polymerase chain reaction (PCR) assays for fungal pathogens in fluid samples,and to evaluate the feasibility of fast PCR diagnostic method for the invasive fungal infection.Methods The sterility body fluid samples from 60 cases hospitalized immunocompromised patients with clinical underlying diseases and suspect of invasive infections with fungi between January 2008 and December 2011 were processed for microscopy and cultures.Applying fungal ITS4 and ITS86 universal primers to amplify pathogenic fungi genes from the sterility body fluid with method of rapid PCR.The results were compared between the standard and PCR methods.Results Humoral direct clinical specimens by PCR amplification of DNA fragments with the scan results were similar.Positive rate of PCR test with clinical body fluid samples and the traditional fungal cultivation was similar.There was no significant statistical difference [38.3％ (23/60) vs 33.3％ (20/60),P ＞ 0.05].Conclusions PCR test is feasibility with clinical fungal diagnosis from directly humoral specimens.To amplify the clinical sterility body fluid samples with ITS fungal universal primers and PCR method might provide an accurate and rapid approach to detect the pathogenic fungi.Its methods on early diagnosis and prognosis of invasive fungal infections are of guiding significance.