Objective To observe the clinical efficacy of traditional Chinese medicine(TCM)sequential therapy in treating patients with psoriasis vulgaris in Shenzhen,and to explore the syndrome differentiation and treatment for the patients with psoriasis vulgaris in Shenzhen region.Methods From January 2019 to February 2024,70 cases of psoriasis vulgaris admitted to Shenzhen Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Shenzhen Bao'an Traditional Chinese Medicine Hospital Group)were retrospectively analyzed.The patients were divided into the observation group(39 cases)and the control group(31 cases)according to the treatment plans.In the control group,only topical application of Calcipotriol Ointment was given throughout the treatment,while in the observation group the patients were treated with TCM sequential therapy according to the illness stage on the basis of treatment for the control group,i.e.,internal administration of modified Shuiniujiao Huanglian Decoction was given in the acute stage and modified Sijunzi Shuiniujiao Decoction was given in the remission stage.Both groups were treated for 3 months.Before and after the treatment,the changes of Psoriasis Area and Severity Index(PASI)scores,Dermatology Life Quality Index(DLQI)scores and TCM syndrome scores in the two groups were observed.After treatment,the clinical efficacy and drug safety of the two groups were evaluated.Results(1)After 3 months of treatment,the total effective rate of the observation group was 89.74%(35/39),and that of the control group was 74.19%(23/31).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the PASI scores for evaluating the severity of skin lesions in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the DLQI scores for evaluating the quality of life in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the scores of TCM syndromes such as erythema,itching,vexation and dry mouth in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(5)During the treatment period,no obvious adverse reactions occurred in the two groups of patients,with high safety.Conclusion On the basis of conventional western medicine treatment,application of TCM sequential therapy exerts certain clinical efficacy in treating patients with psoriasis vulgaris in Shenzhen region,and the combined therapy is effective on controlling the patients'illness conditions,significantly alleviating the symptoms and improving the quality of life of the patients.

Fresh Chinese herbal medicine,being distinct from the dried herbs,is one of the therapies of traditional Chinese medicine(TCM)widely used in dermatology.It is employed to treat various skin diseases,namely herpes simplex,herpes zoster,common warts,flat warts,boils,carbuncles,erysipelas,acne vulgaris,fungal skin diseases,psoriasis,contact dermatitis,insect bite dermatitis,and eczema.The commonly-used fresh herbs for skin diseases are fresh Portulacae Herba,fresh Houttuyniae Herba,fresh Rubiae Radix,fresh Lygodii Spora,fresh Patriniae Herba,fresh Aloe,fresh Plataginis Herba,fresh Pinelliae Rhizoma,and fresh Taraxaci Herba.These herbs usually have the actions of clearing heat,detoxifying,and cooling blood.For the treatment of skin diseases,fresh herbal medicine can be administered orally or applied topically,with a predominant use of topical application or a combination of oral and topical administration.Due to the rapid development of modern society,the supply and standardization of fresh herbs fail in meeting the demands of a large population of the patients,leading to their gradual decline in use.However,the efficacy of fresh herbs cannot be entirely replaced by that of the dried herbs.This article reviewed the advances in the modern application of fresh Chinese herbal medicine in dermatology,aiming to promote further research and expand its clinical application in treating skin diseases.

Objective:To investigate the molecular mechanism of rabbit ear cartilage remodeling induced by 1064 nm Nd∶YAG laser irradiation.Methods:Thirty-three rabbits were divided into 6 groups according to a random number table, and were used in the following experiments respectively: screening the optimal laser energy (6 rabbits), observing the changes of ear cartilage tissue immediately (6 rabbits), 1 week (6 rabbits), 3 weeks (6 rabbits), and 6 weeks after irridiation (6 rabbits), as well as transcriptome sequencing and verification (3 rabbits). The left ears of rabbits were used as untreated self-controls, while the right ears were irradiated. (1) Laser energy screening: the right ear cartilages of 6 rabbits were irradiated with 1064 nm Nd∶YAG laser at different energy densities (50, 60, 70, 80, 90, 100 J/cm 2). Cartilages without skin and perichondrium were cut into the same thickness and size for HE staining, in order to observe the changes of chondrocytes and to determine the optimal laser energy density for shaping (hereinafter referred to as the optimal energy density). (2) Histological observation of rabbit ear cartilage: the right ears of 24 rabbits were irradiated with laser under the optimal energy density. Bilateral cartilage samples were collected immediately after surgery and at 1, 3 and 6 weeks after surgery for histological observation (HE, Masson and Sirius red staining). (3) Transcriptome sequencing and sample verification: the right ears of 3 rabbits were irradiated with laser under the optimal energy density, and the cartilages were harvested and mixed within 6 hours after irradiation, which was set as the laser irradiation group. Cartilages of the same region and size on the left ears were set as blank control group. Transcriptome RNA sequencing was performed, and the expression levels of related genes and proteins were detected by quantitative polymerase chain reaction (qPCR) and Western blotting. Results:(1) After laser irradiation with different energy density of 50-100 J/cm 2, HE staining showed that the chondrocytes could be changed at the laser energy density of 80 J/cm 2, without causing vacuolar deformation and coagulation necrosis, indicating that the damage degree was suitable.(2) After 80 J/cm 2 laser irradiation, histological observation revealed that there was an irradiated zone immediately after the operation. The overall morphology of chondrocytes in the radiation zone was elongated and exhibited spindle cell-like changes, with deep matrix staining and obvious refraction, as well as a relative increase of type Ⅱ collagen. At 1 week after irradiation, the radiation zone became shallower and the cell size recovered. From 3 weeks to 6 weeks, the matrix staining around the radiation zone gradually deepened and the overall cellular morphology was stretched again. (3) Transcriptome RNA sequencing revealed that there were 198 differentially expressed genes (70 up-regulated and 128 down-regulated) in the laser irradiated group compared with the blank control group. Through further screening and study, CREB3L2 gene expression was up-regulated in the laser irradiation group. qPCR results showed that the relative expression level of CREB3L2 mRNA in laser irradiation group was significantly higher than that in the blank control group, the difference was statistically significant( P<0.01). Western blotting showed that the relative expression level of CREB3L2 protein was higher than that of control group in a time-dependent manner, and the difference was statistically significant( P<0.01). Conclusions:After irradiation with long-pulsed 1064 nm Nd∶YAG laser, the expression level of CREB3L2 gene is up-regulated, which then induced chondrocyte rearrangement and proliferation, resulting in morphological and biomechanical changes of ear cartilage.

Objective:To investigate the molecular mechanism of rabbit ear cartilage remodeling induced by 1064 nm Nd∶YAG laser irradiation.Methods:Thirty-three rabbits were divided into 6 groups according to a random number table, and were used in the following experiments respectively: screening the optimal laser energy (6 rabbits), observing the changes of ear cartilage tissue immediately (6 rabbits), 1 week (6 rabbits), 3 weeks (6 rabbits), and 6 weeks after irridiation (6 rabbits), as well as transcriptome sequencing and verification (3 rabbits). The left ears of rabbits were used as untreated self-controls, while the right ears were irradiated. (1) Laser energy screening: the right ear cartilages of 6 rabbits were irradiated with 1064 nm Nd∶YAG laser at different energy densities (50, 60, 70, 80, 90, 100 J/cm 2). Cartilages without skin and perichondrium were cut into the same thickness and size for HE staining, in order to observe the changes of chondrocytes and to determine the optimal laser energy density for shaping (hereinafter referred to as the optimal energy density). (2) Histological observation of rabbit ear cartilage: the right ears of 24 rabbits were irradiated with laser under the optimal energy density. Bilateral cartilage samples were collected immediately after surgery and at 1, 3 and 6 weeks after surgery for histological observation (HE, Masson and Sirius red staining). (3) Transcriptome sequencing and sample verification: the right ears of 3 rabbits were irradiated with laser under the optimal energy density, and the cartilages were harvested and mixed within 6 hours after irradiation, which was set as the laser irradiation group. Cartilages of the same region and size on the left ears were set as blank control group. Transcriptome RNA sequencing was performed, and the expression levels of related genes and proteins were detected by quantitative polymerase chain reaction (qPCR) and Western blotting. Results:(1) After laser irradiation with different energy density of 50-100 J/cm 2, HE staining showed that the chondrocytes could be changed at the laser energy density of 80 J/cm 2, without causing vacuolar deformation and coagulation necrosis, indicating that the damage degree was suitable.(2) After 80 J/cm 2 laser irradiation, histological observation revealed that there was an irradiated zone immediately after the operation. The overall morphology of chondrocytes in the radiation zone was elongated and exhibited spindle cell-like changes, with deep matrix staining and obvious refraction, as well as a relative increase of type Ⅱ collagen. At 1 week after irradiation, the radiation zone became shallower and the cell size recovered. From 3 weeks to 6 weeks, the matrix staining around the radiation zone gradually deepened and the overall cellular morphology was stretched again. (3) Transcriptome RNA sequencing revealed that there were 198 differentially expressed genes (70 up-regulated and 128 down-regulated) in the laser irradiated group compared with the blank control group. Through further screening and study, CREB3L2 gene expression was up-regulated in the laser irradiation group. qPCR results showed that the relative expression level of CREB3L2 mRNA in laser irradiation group was significantly higher than that in the blank control group, the difference was statistically significant( P<0.01). Western blotting showed that the relative expression level of CREB3L2 protein was higher than that of control group in a time-dependent manner, and the difference was statistically significant( P<0.01). Conclusions:After irradiation with long-pulsed 1064 nm Nd∶YAG laser, the expression level of CREB3L2 gene is up-regulated, which then induced chondrocyte rearrangement and proliferation, resulting in morphological and biomechanical changes of ear cartilage.

Objective To explore the difference of psychological state and the change of psycho logical state between mastectomy group for the purpose of changing gender identity and breast reduction surgery group for the purpose of improving physical beauty.Methods The psychological evaluation scale of three layers and twelve dimensions was used to evaluate the psychological status of 24 patients who underwent clinical breast masculine surgery and aesthetic breast reduction before and after operation.The psychological characteristics between the two groups before and after operation were compared and analyzed.Data analysis was carried out through Stata 13.0 software package.Results There were significant differences in depression factor,anxiety factor and obsessive compulsive symp tom factor in the aesthetic breast reduction group before and after operation (t=2.194,2.183,2.090;P=0.039,0.040,0.048,P＜0.05).There were significant differences in depression factor,anxiety factor,obsessive-compulsive symptom factor,bullying factor,psychological self,physical self and social self before and after mastectomy (t=4.188,3.730,2.484,2.570,5.898,3.531,3.162,P=0.000,0.001,0.021,0.018,0.000,0.002,0.005,P＜0.05).There were significant differ ences in depression,anxiety,psychoticism,obsessive-compulsive symptoms,psychological self,physiological self and social self between mastectomy group and aesthetic mastectomy group before operation.(t=2.629,4.081,2.097,4.246,5.419,2.600,2.545;P=0.015,0.001,0.048,0.000,0.000,0.016,0.018,P＜0.05).There was significant difference in postoperative depression,anxiety and obsessive-compulsive symptoms between the mastectomy group and the aesthetic mastectomygroup (t=2.117,2.170,3.764;P=0.046,0.041,0.001,P＜0.05).Conclusions Plastic surgeons should pay attention to the psychological status and personality characteristics of different beauty seekers and give psychological guidance,which is of great significance to improve the medical experience and surgical effect of the beauty seekers.

Clinical genetic testing results are compiled into a standardized report by genetic specialists and provided to clinicians and patients (Should the patient be intellectually disabled or under 18,the report will be provided to his/her parents or legal guardians).The content of genetic testing report should conform to relevant guidelines,industry standards and consensus.The decisions of clinicians will be made based on the report and clinical indications.Genetic counselors should provide post-test counseling to clinicians and patients or their authorized family members.A mechanism of follow-up visit after the genetic testing should be established with informed consent.Data should be shared by clinical institutions and genome sequencing institutions.As findings upon follow-up visit can help with further evaluation of the results,genome sequencing institutions should regularly re-analyze historical and follow-up data,and the updated results should be shared with clinical institutions.All activities involving reporting,genetic counselling,follow-up visiting,and re-analyzing should follow the relevant guidelines and regulations.

Objective: To investigate the histological and biomechanical changes of rabbit ear cartilage induced by long pulse width 1064 nm Nd: YAGlaser. Methods: Seven New Zealand rabbits weighing 2.0-2.5 kg, male, 4-6 months old were selected. For a self-control, the right ear was irradiated by laser and the left ear was the normal control group. Each rabbit ear was divided into 3 cm × 1 cm, three 2 cm × 1 cm and 1 cm× 1 cm experimental area. After the experimental area of the laser irradiation group was irradiated by long pulse width 1064 nm Nd: YAG laser, Three pieces of 2 cm × 1 cm cartilage in each ear of the experimental rabbits were immediately cut and stained with HE, Sirius red and Masson to observe the histological changes of chondrocytes. The 3 cm × 1 cm and 1 cm× 1 cm cartilage of each rabbit ear was cut for biomechanical examination, and the changes of biomechanical properties such as tension, fracture, elastic modulus and compression of rabbit ear cartilage were observed immediately after the operation. Results: Histological observation showed that the chondrocytes became small, the matrix was stained deeply, the refraction was obvious/evident and the collagen was relatively increased. After being irradiated by long pulse width 1064 nm Nd: YAG laser, the peak tensile stress, tensile elastic modulus, tensile fracture load, compressive stress peak, compressive elastic modulus and compressive failure load of rabbit ear cartilage in laser irradiation group were (5.22 ±0.80) MPa, (42.40 ±9.78) MPa, (22.86 ±4.85) N, (16.04 ±5.57) MPa, (28.71 ±13.97) MPa, (1 211.63 ±427.86) N. All of them were smaller than those of the control group[(6.07±0.64) MPa, (48.44±6.30) MPa, (26.94±4.19) N, (25.12±9.10) MPa, (45.30±19.24) MPa, (1 962.83±896.71) N], and the difference was statistically significant (P<0.05). Conclusions After the operation of long pulse width 1064 nm Nd: YAG laser, the stress of rabbit ear cartilage resisting elastic deformation is reduced, the shape is easier to change, and the remodeling effect is more stable.

Objective To explore the difference of PICC utilization in different time on phlebitis occurrence among patients with tumor by chemotherapy. Methods According to peripheral venous chemotherapy, 325 cases had been divided into chemotherapy group (n = 93) and the first time chemotherapy group (n = 232). We observed the occurrence of patients with phlebitis in two groups after PICC implantation. Results The probability of phlebitis occurrence in patients after PICC placement in chemotherapy group was 26. 9% and that in the first time chemotherapy group was 12. 5% (χ2 = 9. 91,P < 0. 05). ⅠandⅡ grade of phlebitis incidence rates of patients in chemotherapy group were 18. 3% and 8. 6% , but that in the first time chemotherapy group were 9. 5% and 3. 0% (P > 0. 05), there were no Ⅲ grade phlebitis happened in both groups. Conclusions The PICC should be adopted by the patients as early as possible for patient with the first time chemotherapy to reduce the peripheral venous stimulation and reduce the phlebitis occurrence.