Immunologic skin diseases encompass a spectrum of immune system-mediated autoimmune or inflammatory skin conditions,such as lupus erythematosus,psoriasis,atopic dermatitis,and vitiligo.Immunologic skin diseases are characterized by an unclear pathogenesis,complex disease processes,diverse clinical manifestations,and treatment difficulties,thereby presenting sig-nificant diagnostic and therapeutic challenges.Notably,Chinese researchers have achieved numerous innovative research findings on immunologic skin diseases in recent years.Over the past decade,Chinese scholars have contributed 11 919 SCI papers to the field of immune dermatosis,with more than 10 being published in the world's leading medical journals.These publications include one in Sci-ence,one in Nature,two in Cell,three in The New England Journal of Medicine,two in The Lancet,and one in Nature Medicine,as well as four in Immunity.Here,we aim to present a comprehensive summary of Chinese research progress pertaining to the pathogene-sis,diagnosis and treatment of immunologic skin diseases.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.

Objective To investigate the risk factors for cognitive impairment and their correlation with collateral circulation in patients with acute ischemic stroke.Methods From January 2016 to December 2017,patients with acute ischemic stroke admitted to the Department of Neurology,Jiangmen People's Hospital were enrolled.According to their status of collateral circulation,they were divided into either good collateral circulation group or poor collateral circulation group.According to the Montreal cognitive score,they were divided into cognitive impairment group and non-cognitive impairment group.Multivariate logistic regression analysis identified the independent risk factors for cognitive impairment in patients with acute ischemic stroke.Results A total of 225 patients were enrolled,including 106 females (47.1％) and 119 males (52.9％),aged 47-87 years,average 66.96 ± 9.65 years.The average baseline score of the National Institutes of Health Stroke Scale was 4.5 ± 2.1.Ninety-seven patients (43.1％) had cognitive impairment;79 had obvious stenosis or occlusion at the intracranial and extracranial segments of cerebral arteries;148 (65.8％) had good collateral circulation,and 77 (34.2％) had poor collateral circulation.The proportions of patients with atherosclerotic stroke (P =0.033) and cognitive impairment (P =0.041) in the good collateral circulation group were significantly higher than those in the poor collateral circulation group.There were significant differences in the proportions of patients with large-artery atherosclerotic stroke (P =0.007),anterior circulation stroke (P=0.018),collateral dysfunction (P=0.041),as well as baseline systolic blood pressure (P =0.006),baseline diastolic blood pressure (P =0.013),low-density lipoprotein cholesterol (P=0.021),and homocysteine (P=0.024) between the cognitive impairment group and the non-cognitive impairment group.Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio[OR] 1.007,95％ confidence interval[CI] 1.001-1.012;P =0.036),and large-artery atherosclerotic stroke (OR 2.650,95％ CI 1.490-4.714;P =0.001) were independently positively correlated with cognitive impairment,while the status of collateral circulation was not an independent risk factor for cognitive impairment (P =0.073).Conclusions The status of collateral circulation was associated with cognitive impairment in patients with acute ischemic stroke,but it was not an independent risk factor.

Objective To explore the effects of strength training on aging muscular atrophy and inflammatory factors levels in old men.Methods 11 old men participated in 12 weeks of strength training. Muscle strength/muscle thickness and serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, high sensitivity C-reactive protein (hsCRP) and adiponectin were measured before and after training. Results After training, the muscle thickness increased, but there was no significantly difference (P>0.05); the levels of hsCRP decreased (P<0.001) and adiponectin increased (P<0.05). Conclusion Strength training may assist in maintaining or improving muscle strength/muscle mass and reducing inflammatory factors levels.

[Objective] To study the methylation status of CD40L gene regulatory regions in peripheral blood CD4+ T cells from patients with systemic sclerosis (SSc).[Methods] Peripheral blood mononuclear cells were isolated from the venous blood of 21 SSc patients and 20 healthy controls by density gradient centrifugation.CD4+ T cells were separated by using magnetic beads.Genomic DNA was isolated from the CD4+ T cells and treated with sodium bisulfite.Nested PCR was perfonned to amplify the desired regulatory sequences (including the promotor and enhancer) of CD40L,and the amplicons were transformed into the Escberichia coli DH5α.Subsequently,8 independent clones were selected and sequenced for each of the amplified fragments.[Results] In healthy female controls,half of the cloned fragments of CD40L regulatory sequences were unmethylated,and the other half were methylated.The mean methylation levels of CD40L promoter and enhancer from female SSc patients were significantly lower than those from healthy female controls (both P ＜ 0.01 ).Almost all of the cloned fragments of CD40L promoter and enhancer were unmethylated in healthy male controls and male SSc patients,with no significant difference in the methylation level between male SSc patients and healthy controls (both P ＞ 0.05,respectively).[Conclusion]s There is a low methylation level of CD40L regulatory elements on the inactive X chromosome in female SSc patients,which may contribute to the CD40L overexpression in CD4+ T cells.

Objective To investigate the expression levels of CD40L in CD4 + T cells from systemic sclerosis (SSc) patients.Methods PBMC ( peripheral blood mononuclear cells) cells were isolated from the peripheral venous blood of SSc patients (16females,10males) and healthy donors (15females,10males) by density gradient centrifugation.CD4 + T cells were isolated using magnetic beads.mRNA levels of CD40L in CD4 + T cells were measured by real-time quantitative polymerase chain reaction (RTPCR).Flow cytometric analysis was used to detect the CD40L protein on the surface of CD4 + T cells.Results Both CD40L mRNA and protein expression in CD4 +T cells was significantly elevated in female SSc patients compared with female healthy controls [5.61 ± 1.86 vs 2.80 ±0.94,P ＜0.01 ; (6.70 ±3.55)％vs (2.37 ± 1.39)％,P ＜ 0.05,respectively].No significant increase in CD40L mRNA and protein expression was observed in male SSc patients compared with male controls [2.59 ± 0.89 vs 1.92 ± 0.56,P ＞0.05; (2.06±1.09)％ vs (2.13±0.87)％,P ＞0.05,respectively].Conclusions CD40L was overexpressed in CD4 + T cell of female patients but not males,which maybe one of the important reasons for female susceptibility to SSc.

To construct the recombinant vector Pact-EGFP, the Act-1 core promoter region was amplified from the pUCm-T/Act-1 and subcloned into pEGFP-4.1 vector (derived from pEGFP-N1 with the removal of human cytomegalovirus immediate early promoter), by restriction enzymes Bgl II and Hind III. Transfection of Pact-EGFP vector into Vero cell by liposome indicated that Act-1 core promoter regulated the expression of EGFP gene in lower level in Vero cells. After Pact-EGFP microinjection into the gonad of Caenorhabditis elegans with pRF4 as a gene marker, green fluorescence was detected in the cortex, vice cortex and the pharyngeal of C. elegans. According to the locations, two different transgene lines were separated. The expression level of EGFP expressed in C. elegans was more than that in Vero cell. Some unique motifs might exist in Act-1 core promoter region of C. elegans, which was closely related to the expression level of EGFP. These results lay the foundation for the further research on gene function of parasitic nematodes using C. elegans.
Animals ; Caenorhabditis elegans ; genetics ; metabolism ; Cercopithecus aethiops ; Connexin 43 ; genetics ; Green Fluorescent Proteins ; genetics ; metabolism ; Organisms, Genetically Modified ; Peptide Fragments ; genetics ; Promoter Regions, Genetic ; genetics ; Transcription, Genetic ; Vero Cells

Objective To investigate the ability of different standards on the evaluation of vascular invasion of pancreatic carcinoma. Methods The MSCT imagings of 56 cases of pancreatic carcinoma confirmed by surgery were analyzed retrospectively. The vascular invasion degrees of 5 large vessels around the pancreas were evaluated according to Loyer classification standard, Lu classification standard and the Changhai standard, the surgical result was used as the gold standard. The accuracy of different standards was evaluated, and the Kappa coefficient were calculated. Results The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Loyer classification standard were 86.79%, 86.27%, 86.90%, 59.46% and 96.60%, respectively, and the Kappa coefficient was 0.623. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Lu classification standard were 93.21%, 84.31%, 95.20%, 79.63% and 96.46%, respectively, and the Kappa coefficient was 0.777. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Changhai standard were 95.36%, 84.31%, 97.82%, 89.58% and 96.55%, respectively. The Kappa coefficient was 0.841. Conclusions The Changhai standard was feasible to evaluate the vascular invasion of pancreatic carcinoma.

AIM: To observe anti inflammatory, anti bacterial and immune regulation effects of shuyanling soft capsule. METHODS: The dimethylbenzene induced the degree of ear swelling in mice and turpentine induced proliferation in rats were used to observe the anti inflammation effects of shuyanling soft capsule. The anti bacterial effects were observed both in vitro and in vivo. The immune regulation effects were studied by the splenocyte proliferation response, the activity of antibody producing cells and the phagocytosis of leukocyte in mice. RESULTS: Shuyanling soft capsule inhibited dimethylbenzene induced the degree of ear swelling in mice and turpentine induced proliferation in rats, protected the mice from the infections of staphylcoccus aureus and salmonella typhi, and repressed sixteen kinds of bacterium in vitro. Furthermore, the capsule remarkably enhanced the phagocytosis of neutropil and increased the activity of spleen antibody producing cells and the transformation of the T and B cell in spleen in mice. CONCLUSION: Shuyanling soft capsule has anti inflammatory, anti bacterial and immune regulation effects.