This paper summarizes clinical experience in treating acne based on the staged therapeutic principles of "eruption in warm diseases". It is considered that acne results from wind-heat retained in the lungs， invading the ying level and obstructing the blood collaterals， and is primarily a disorder involving both the wei and ying systems. In clinical practice， the treatment emphasizes the use of acrid-cool and sweet-cold methods. The core prescription is namely Yinqiaosan Qu Douchi Jia Xishengdi Danpi Daqingye Bei Xuanshen Fang （from Epidemic Warm Diseases ［《温病条辨》］）， and is adjusted according to the stage of disease. In the non-inflammatory stage， when the pathogen initially attacks the wei level， treatment focuses on acrid-cool herbs to release the exterior， with supplementary bitter-sweet ingredients such as Yejuhua （Chrysanthemum Indicum）. In the inflammatory stage， with pronounced heat toxin in the qi level affecting the ying and blood， and local stagnation of qi and blood， the approach is to clear heat and resolve toxin， using blood-cooling and stasis-resolving herbs early to prevent progression. Herbs such as Pugongying （Taraxacum Mongolicum）， Zihuadiding （Viola Yedoensis）， Tiankuizi （Semiaquilegia Adoxoides）， Chonglou （Paris Polyphylla）， Machixian （Portulaca Oleracea）， Zaojiaoci （Gleditsia Sinensis）， Chuanshanjia （Manis Pentadactyla） may be added. In the post-inflammatory erythema stage， when yin of the ying level is depleted and internal deficiency-heat arises， sweet-cold herbs are recommended to nourish the stomach and generate fluids， with the possible addition of Yiwei Decoction （益胃汤）.

Objective:To investigate the diagnostic value of plasma cytokines such as interleukin (IL)-2, IL-6 and interferon (IFN)-γ in non-Hodgkin lymphoma (NHL).Methods:A retrospective case-control study was conducted. A total of 48 NHL patients admitted to the Second Affiliated Hospital of Xuzhou Medical University between January 2020 and December 2022 were selected as NHL group, and another 34 healthy people who underwent physical examimation during the same period were selected as the healthy control group. The levels of IL-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor (TNF) - α and IFN-γ in the plasma of patients at first admission and healthy subjects during physical examination were detected by using flow cytometry. The differences in general data and all cytokines levels of both groups were compared. The collinearity stepwise screening was made in 7 cytokines levels, and the screened variables were included in multivariate binary logistic regression model. Plasma cytokines with independent effects on the pathogenesis of NHL were screened. Taking local biopsy, histopathological examination or immunohistochemical examination as the gold standard, the receiver operating characteristic (ROC) curves of individual and combined diagnosis of NHL based on the selected cytokines were drawn to judge the diagnostic effect of all indicators on NHL.Results:There were 32 males (66.7%) and 16 females (33.3%) in NHL group, with the median age [ M ( Q1, Q3)] of 56.50 (45.75, 67.50) years; there were 28 males (82.4%) and 6 females (17.6%) in the healthy control group, with the median age of 52.00 (47.50, 55.50) years. There were no statistically significant differences in age and gender composition between the 2 groups (all P > 0.05). The levels of IL-2 [1.44 (1.36, 1.85) pg/ml vs. 1.19 (0.86, 1.68) pg/ml] and TNF-α [3.46 (2.68, 4.06) pg/ml vs. 2.23 (1.52, 3.46) pg/ml] in NHL group were higher than those in the healthy control group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in IL-4, IL-6, IL-10, IL-17, IFN-γ levels (all P > 0.05). According to collinear stepwise screening of independent variables, IL-4 and TNF-α were excluded from 7 cytokines, and the other 5 cytokines were included in multivariate logistic regression model, and the result showed that the decreased level of IL-2 ( OR = 0.20, 95% CI: 0.08-0.53, P = 0.001) and the increased levels of IL-6 ( OR = 1.18, 95% CI: 1.04-1.33, P = 0.009) and IFN-γ ( OR = 1.26, 95% CI: 1.08-1.46, P = 0.003) were independent risk factors for the onset of NHL. The results showed that the area under the curve of IL-2, IL-6, IFN-γ and the combination of 3 indexes for the diagnosis of NHL was 0.760 (95% CI: 0.651-0.870), 0.595 (95% CI: 0.468-0.722), 0.508 (95% CI: 0.373-0.642), 0.847 (95% CI: 0.763-0.930), and the optimal cut-off value of the combination of 3 indexes was 0.730 which was calculated by logistic regression model formula; the corresponding sensitivity and specificity were 70.2% and 94.1%, respectively. Conclusions:The decreased level of IL-2 and increased levels of IL-6 and IFN-γ at initial diagnosis are risk factors for the onset of NHL. The combined detection of the 3 indexes shows a good value in the diagnosis of NHL.

Objective To evaluate the effect of Weisu granule combined with conventional therapy in treatment of chronic atrophic gastritis (CAG). Methods A total of 99 CAG patients who met the inclusion criteria were randomly divided into control group (49 cases) and observation group (50 cases) according to random number table method. The control group was treated with quadruple therapy, while the observation group was treated with Weisu granule on the basis of the control group. Both groups were treated for 90 days. Interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) were detected by ELISA. The scores of TCM symptoms between the two groups before and after treatment were compared. Adverse reactions during treatment were observed and recorded. The eradication rate of H.pylori was measured by 14C urea breath test, and the clinical efficacy was evaluated. Results The total effective rate was 92.0% (46/50) in the observation group and 73.5% (36/49) in the control group. There were significant differences between the two groups (χ2=5.975, P=0.015). After treatment, the level of serum IL-6, hs-CRP and TNF-α in the observation group was significantly lower than those in the control group (t=7.112, 7.753, 9.310, respectively, all P<0.01). After treatment, the scores of symptoms such as abdominal distension and pain, emotional disturbance, hypochondrium pain and belching in both groups decreased (P<0.01), and those in the observation group was significantly lower than those in the control group (t=12.892, 12.451, 10.596, respectively, P<0.01). The eradication rate of H.pylori was 90.0% (45/50) in the observation group and 24.5% (12/49) in the control group. There was a significant difference between the two groups (χ2=43.381, P<0.01). Conclusions The Weisu granule combined with quadruple therapy has a definite theraputic effect. It can improve the clinical symptoms of patients, improve the clearance rate of H.pylori, and alleviate inflammation.

Objective To explore the therapeutic effect and nursing revelation of ERCP interventional therapy in biliary lithotripsy, biliary stone extraction, and stent placement. Methods We reviewed nursing cooperation of 18 elderly patients with ERCP surgery, and summarized the matters needing attention and nursing revelation of ERCP treatment in elderly patients. Results 13 cases were successfully in 18 elderly patients treated with ERCP, 4 cases of stents placement were successful, and 1 case of failure.Conclusions With the improvement of scientific and technological level and nursing cooperation, strengthening safety measures is the key to the success of ERCP intervention in the treatment of elderly urgent patients.

Objective To assess the clinicopathological and confocal microscopic features of porokeratosis.Methods This study included 186 patients with porokeratosis.The clinical and pathological findings from the patients were retrospectively analyzed.Confocal laser scanning microscopy(CLSM)was used to observe the lesions of disseminated superficial porokeratosis in 16 patients.Results Most of the patients had characteristic lesions of porokeratosis,i.e.,papules or plaques with a thread-like elevated border.Comoid lamella was observed in all of the cases,which was unassociated with sweat glands or hair follicles in most cases(171/186),and located in sweat pore or hair follicles in a few cases(15/186).There were dyskeratocytes as well as vacuolized and degenerated basal cells beneath the cornoid lamella.Varying amounts of lymphocytes and melanophages were observed in the superficial dermis.Amyloid was deposited in the papilla dermis in 2 cases.CLSM showed dyskeratocytes in a characteristic arcuate arrangement in spinous cell layer.Conclusions The CLSM images of porokeratosis are consistent with its histopathological manifestations,and CLSM may serve as a sensitive and specific noninvasive method for the diagnosis of porokeratosis.

A 2-month-old baby girl developed universal keratotic plaques soon after birth. Physical examination revealed well-defined, dark erythematous, keratotic plaques with thick scales and mild infiltration at the periorbital, perioral, perianal and vulvar regions, as well as deep fissures of both hands and feet covered with thick yellowish crusts. Another case was a 24-year-old female, the mother of the baby, who presented with hyperkeratotic plaques at perioral and perianal regions, congenital alopecia universalis, mutilation of fingers and toes with massive thick keratotic yellow crusts and scales. Histopathology of skin lesions from the gluteal region of the baby showed psoriasiform hyperplasia of the epidermis, slight inflammatory infiltration of dermal papillae and superficial dermal perivascular regions. Immunohistochemistry demonstrated the positive staining for acidic keratin (AE1) in the prickle cell layer and granular layer and for CK10 in the upper prickle cell layer and granular layer. Electron microscopy showed increased cell space and decreased tonofilament. Both the baby girl and her mother were diagnosed with Olmsted syndrome.

Objective To investigate the effects of blockade on non-peptide specific SDF-1/CXCR4 receptor ligand system with AMD3100 on the proliferation and angiogenesis of human pancreatic cancer cells AsPC-1. Methods AsPC-1 was divided into control group, SDF-1α group, group, SDF-1α + AMD3100 group. MTT test was performed to determine the proliferative level of AsPC-1 cells. Vascular endothelial growth factor (VEGF) was detected with Western blotting assay. Immunohistochemistry was used to detect the microvessel density (MVD) in subcutaneous xenografts of AsPC 1 of nude mice model, which was intratumorally and peritumorally injected with AMD3100. Results SDF-1α could induce the proliferation of AsPC-1(1.430 ±0. 122 vs 1. 002 ± 0. 001, P <0. 05). While the proliferative effect induced by SDF-1α could be inhibited by AMD3100 (0.983 ±0. 068vs 1.430 ± 0. 122, P <0.05). SDF-1α could induce the expression of VEGF (0. 565 ± 0. 047 vs 0. 439 ± 0.034, P < 0.05). While the protein expression of VEGF induced by SDF-1α on AsPC-1 cells was inhibited by AMD3100 (0. 450 ± 0. 071 vs 0. 565 ± 0. 04, P <0. 05). The growth and angiogenesis of subcutaneous xenografts of nude mice model were inhibited by AMD3100; the tumor inhibitory rate was 59. 5% at 24th day. The MVD of xenografts was significantly decreased (28.56 ± 6.94 vs 98.75 ± 20. 60, P < 0. 01 ). Conclusions AMD3100 could inhibit the proliferation and angiogenesis of AsPC-1 cells both in vitro and in vivo.

Objective To explore the effects of ursodeoxycholic acid (UDCA) on the fluidity of rat visceral sac and placental glutathione (GSH) concentration in rats with intrahepatic cholestasis. Methods Sixty rats were randomly divided into 3 groups (20 in each). Refined vegetable oil 2.5 ml/(kg?d) was given to the control group since the 13 days of pregnancy. The ICP treatment and non treatment group received either progesterone 75 mg/(kg?d) or 17? ethynylestradiol 1.25 mg/ (kg?d) from the 13th to 17th day, respectively. From the 17th day, the control and non treatment group were fed with 0.9% nitrachloride solution 5 mg/(kg?d) and the treatment group with UDCA 50 mg/(kg?d). All rats were sacrificed on the 21st day. The visceral yolk sac cell membrane and GSH concentration were measured Results The concentration of GSH in the ICP non treatment group (1.12?0.02 mmol/g protein) was significantly lower than that of the treatmentgroup (1.38?0.03 mmol/g protein) and the control group (1.56?0.07 mmol/g protein) ( P 0.05). The fetal death rate in treatment group (9.55%) and control group (1.97%) was significantly lower than that of the non treatment group (20.47%) ( P