1.Detection and clinical significance of serum thymic stromal lymphopoietin levels in patients with dermatomyositis
Yongheng CHEN ; Kaile HE ; Shile CHEN ; Xinlin SHAO ; Chenyu WU ; Ling JIN ; Weiru YUAN ; Hua CAO
Chinese Journal of Dermatology 2025;58(8):729-735
Objective:To explore the relationship between serum thymic stromal lymphopoietin (TSLP) levels and the occurrence of pruritus as well as interstitial lung diseases (ILD) in patients with dermatomyositis (DM) or clinically amyopathic dermatomyositis (CADM) .Methods:A retrospective analysis was conducted on the clinical data from 61 diagnosed DM/CADM patients at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between February 2019 and March 2022. Thirty-five age- and sex-matched healthy individuals were included as controls. Serum TSLP and anti-melanoma differentiation-associated gene 5 (MDA5) antibody levels were measured using enzyme-linked immunosorbent assay (ELISA) . A multiplexed flow cytometry assay was performed to detect the serum levels of 12 cytokines, including interferon (IFN) -α2, IFN-γ, interleukin (IL) -4, IL-5, etc. Pruritus severity in DM/CADM patients was assessed using the visual analog scale (VAS) . Relationships of serum TSLP levels with skin lesions, inflammatory markers, and the severity of ILD were analyzed using GraphPad Prism 8.0.1 and R (version 4.3.2) software.Results:Among the 61 patients with DM/CADM, 18 were males (13 with DM and 5 with CADM) and 43 were females (30 with DM and 13 with CADM) , with ages of 53.08 ± 14.97 years and disease duration of 6.27 ± 4.27 months. No significant differences were observed in sex or age between the DM/CADM group and the healthy control group (both P > 0.05) . Of the 61 patients, 15 (24.59%) were positive for anti-MDA5 antibodies, and 31 (51.67%) had ILD, including 11 with acute/subacute interstitial pneumonia (A/SIP) . The pruritus VAS score ( M[ Q1, Q3]) among the 61 patients was 3 (0, 6) points; 20 patients (32.79%) reported no pruritus, while 11 (18.32%) , 17 (27.87%) , and 13 (21.31%) experienced mild, moderate, and severe pruritus, respectively. Serum TSLP levels were significantly higher in the DM/CADM patients than in the healthy controls (91.0 [34.6, 273.0] vs. 25.0 [0.0, 83.5] pg/ml, Z = 1 502.50, P < 0.001]. The TSLP levels were significantly positively correlated with serum levels of alanine aminotransferase (ALT) , lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate and ferritin, and significantly negatively correlated with pruritus VAS scores, eosinophil percentages, and eosinophil counts (all P < 0.05) . Serum TSLP levels were significantly higher in the anti-MDA5 antibody-positive patients than in the anti-MDA5 antibody-negative patients (273.0 [103.8, 2 576.0] pg/ml vs. 67.4 [16.9, 218.7] pg/ml, P = 0.002) , as well as in the patients with A/SIP than in those without A/SIP (390.0 [168.2, 2 869.6] vs. 67.5 [21.8, 235.9] pg/ml, P < 0.001) . ROC analysis showed that the combined detection of serum TSLP levels and anti-MDA5 antibodies had a higher predictive value for A/SIP in DM/CADM patients (AUC = 0.922) than either the detection of anti-MDA5 antibodies (AUC = 0.831) or TSLP (AUC = 0.824) alone did. Conclusions:Serum TSLP levels were significantly higher in patients with DM/CADM than in healthy controls, with particularly higher levels observed in anti-MDA5 antibody-positive patients and patients with coexisting A/SIP, and were correlated with several indicators of disease activity. The combination of serum TSLP levels and anti-MDA5 antibodies provided greater predictive value for A/SIP than either of them alone did.
2.Detection and clinical significance of serum thymic stromal lymphopoietin levels in patients with dermatomyositis
Yongheng CHEN ; Kaile HE ; Shile CHEN ; Xinlin SHAO ; Chenyu WU ; Ling JIN ; Weiru YUAN ; Hua CAO
Chinese Journal of Dermatology 2025;58(8):729-735
Objective:To explore the relationship between serum thymic stromal lymphopoietin (TSLP) levels and the occurrence of pruritus as well as interstitial lung diseases (ILD) in patients with dermatomyositis (DM) or clinically amyopathic dermatomyositis (CADM) .Methods:A retrospective analysis was conducted on the clinical data from 61 diagnosed DM/CADM patients at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between February 2019 and March 2022. Thirty-five age- and sex-matched healthy individuals were included as controls. Serum TSLP and anti-melanoma differentiation-associated gene 5 (MDA5) antibody levels were measured using enzyme-linked immunosorbent assay (ELISA) . A multiplexed flow cytometry assay was performed to detect the serum levels of 12 cytokines, including interferon (IFN) -α2, IFN-γ, interleukin (IL) -4, IL-5, etc. Pruritus severity in DM/CADM patients was assessed using the visual analog scale (VAS) . Relationships of serum TSLP levels with skin lesions, inflammatory markers, and the severity of ILD were analyzed using GraphPad Prism 8.0.1 and R (version 4.3.2) software.Results:Among the 61 patients with DM/CADM, 18 were males (13 with DM and 5 with CADM) and 43 were females (30 with DM and 13 with CADM) , with ages of 53.08 ± 14.97 years and disease duration of 6.27 ± 4.27 months. No significant differences were observed in sex or age between the DM/CADM group and the healthy control group (both P > 0.05) . Of the 61 patients, 15 (24.59%) were positive for anti-MDA5 antibodies, and 31 (51.67%) had ILD, including 11 with acute/subacute interstitial pneumonia (A/SIP) . The pruritus VAS score ( M[ Q1, Q3]) among the 61 patients was 3 (0, 6) points; 20 patients (32.79%) reported no pruritus, while 11 (18.32%) , 17 (27.87%) , and 13 (21.31%) experienced mild, moderate, and severe pruritus, respectively. Serum TSLP levels were significantly higher in the DM/CADM patients than in the healthy controls (91.0 [34.6, 273.0] vs. 25.0 [0.0, 83.5] pg/ml, Z = 1 502.50, P < 0.001]. The TSLP levels were significantly positively correlated with serum levels of alanine aminotransferase (ALT) , lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate and ferritin, and significantly negatively correlated with pruritus VAS scores, eosinophil percentages, and eosinophil counts (all P < 0.05) . Serum TSLP levels were significantly higher in the anti-MDA5 antibody-positive patients than in the anti-MDA5 antibody-negative patients (273.0 [103.8, 2 576.0] pg/ml vs. 67.4 [16.9, 218.7] pg/ml, P = 0.002) , as well as in the patients with A/SIP than in those without A/SIP (390.0 [168.2, 2 869.6] vs. 67.5 [21.8, 235.9] pg/ml, P < 0.001) . ROC analysis showed that the combined detection of serum TSLP levels and anti-MDA5 antibodies had a higher predictive value for A/SIP in DM/CADM patients (AUC = 0.922) than either the detection of anti-MDA5 antibodies (AUC = 0.831) or TSLP (AUC = 0.824) alone did. Conclusions:Serum TSLP levels were significantly higher in patients with DM/CADM than in healthy controls, with particularly higher levels observed in anti-MDA5 antibody-positive patients and patients with coexisting A/SIP, and were correlated with several indicators of disease activity. The combination of serum TSLP levels and anti-MDA5 antibodies provided greater predictive value for A/SIP than either of them alone did.
3.The effect of preoperative anxiety on propofol EC50 for no-movement during painless gastroscopy
Yiwen ZHANG ; Yanjing ZHANG ; Hanwen CHEN ; Jiyuan LI ; Zhiqiang CHEN ; Shile LIU ; Cuiyun ZHOU ; Zumin XING
Journal of Chinese Physician 2018;20(4):493-495
Objective To investigate the effect of preoperative anxiety on propofol EC50 for nomovement during Painless gastroscopy.Methods Thirty-one patients (without anxiety) and twenty-seven patients (with anxiety) undergoing gastroscopy under general anesthesia were enrolled on the study.Anesthesia was conducted with a target-controlled infusion (TCI) of propofol.The initial target effect-site propo fol concentration (Ceprop) was 5.0 μg/ml and was adjusted stepwise by 0.5 μg/ml by an up-down sequential method to reach no-movement.Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety (5.32 μg/ml,95% CI:4.75-5.88 μg/ml vs 4.75 μg/ml,95% CI:4.48-5.01 μg/ml,P < 0.05).Conclusions During painless gastroscopy,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety when intravenous injected of fentanyl 0.1 μg/kg.
4.The influence of preoperative anxiety on popofol EC50 for no-movement during gastroscopy
Hanwen CHEN ; Shijian SHI ; Zumin XING ; Yanjing ZHANG ; Jiyuan LI ; Zhiqiang CHEN ; Shile LIU ; Cuiyun ZHOU ; Yiwen ZHANG
The Journal of Practical Medicine 2017;33(20):3434-3436
Objective To investigate whether the median(50%)effective effect-concentration(EC50)of propofol inducing loss of consciousness (LOC) varies. Methods 56 patients undergoing gastroscopy under general anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion(TCI) of propofol. The initial target effect-site propofol concentration (Ceprop) was 5.00 μg/mL and was adjusted stepwise by 0.50μg/mL by an up-down sequential method to reach no-movement. Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety(6.46μg/mL vs. 5.75μg/mL,P<0.05). Conclusions During general anaesthesia ,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.
5.Distribution and drug resistance of bacterial pathogens isolated from peritonsillar abscess during ;2010-2014 in Wenzhou
Guangzao XIANG ; Weijun CHEN ; Guofeng XIONG ; Shile XU ; Hanshuang ZHANG
Chinese Journal of Clinical Infectious Diseases 2015;(4):311-316
Objective To investigate the distribution and drug resistance of bacterial pathogens isolated from peritonsillar abscess .Methods Data on bacterial pathogens isolated from peritonsillar abscess in Wenzhou Central Hospital from January 2010 to December 2014 were retrospectively analyzed .Strains were identified with Vitek 32 identification system and the drug susceptibility test was performed with K-B method.Chi-square test for linear trend was performed to reveal the changes of distribution and drug resistance of the strains .Results A total of 2 864 bacterial strains were isolated in five years , in which 1 786 strains were Gram-negative bacilli (62.4%), and 1 078 (37.6%) strains were Gram-positive cocci. The positive rate of Gram-negative bacilli was on the rise during year 2010-2014 (χ2 =84.74, P<0.01), and the top three Gram-negative bacilli were Pseudomonas aeruginosa, Acinetobacter baumannii and Haemophilus influenzae, which accounted for 72.5%(1 295/1 786) of the total Gram-negative strains, and the positive rates of first two bacilli were on the rise (χ2 =83.75 and 24.74, P<0.01).Gram-positive cocci were mainly Staphylococcus aureus and Hemolytic streptococcus, which accounted for 83.2% ( 897/1 078) of the total Gram-positive strains.Resistance rates of Pseudomonas aeruginosa to ceftazidime, cefoperazone, piperacillin/tazobactam were on the rise (χ2 =16.17, 13.48 and 11.44, P<0.05), while resistance rates to gentamicin and amikacin were on the decline (χ2 =16.54 and 16.63, P <0.05). Resistance rates of Acinetobacter baumannii to ceftazidime, cefoperazone/sulbactam and piperacillin/tazobactam were on the rise (χ2 =12.52, 10.85 and 14.14, P<0.05).Resistance rates of Haemophilus influenzae to ampicillin were on the rise (χ2 =10.21, P<0.05), and the positive rate of β-lactamase producing strains was also on the rise (χ2 =10.38, P<0.05).Resistance rates of Staphylococcus aureus to cefazolin and methicillin were on the rise (χ2 =15.44 and 12.53, P<0.05), but no vancomycin resistant strain was found .Hemolytic streptococcus were sensitive to all commonly used antibiotics .Conclusions Peritonsillar abscess in Wenzhou Central Hospital is mainly induced by Gram-negative bacilli infection . Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus are the top three bacterial pathogens , and are highly resistant to most antibiotics .

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