Secondary infections are the leading cause of death in patients with bullous pemphigoid. Early identification of risk factors for secondary infections in patients with bullous pemphigoid can improve their prognosis. This review summarizes the relationships of secondary infections in bullous pemphigoid with clinical characteristics, laboratory indicators, drug treatment, and duration of hospitalization, providing a reference for clinical evaluation and treatment.

Objective:To explore the pathogenesis of flunarizine-induced parkinsonism from gut-brain axis perspective.Methods:Thirty male C57BL/6 mice were randomly divided into control group and flunarizine group ( n=15). Mice in the control group were given 0.1 mL 50% polyethylene glycol 400+50% saline by gavage once/d for 2 weeks, while mice in the flunarizine group were given 6 mg/mL flunarizine+50% polyethylene glycol 400+50% saline by gavage at a daily dose of 30 mg/kg for 2 weeks. Body mass was recorded 1, 3, 5, 7, 10 and 14 d after drug administration, and motor function was assessed by rotarod test 14 d after drug administration; 16s RNA sequencing was performed in the feces to observe the intestinal flora; intestinal transit function was detected by Evans blue by gavage; and then, the mice were sacrificed and homogenate or frozen sections (brain and intestinal tissues) were prepared; dopamine-ergic neuron expression was detected by Western blotting; RT-qPCR was applied to detect the expressions of inflammatory factors in the substantia nigra, and immunofluorescent staining was used to detect the expressions of ZO-1 and Claudin-5 in the intestinal epithelial tissues. Results:Compared with the control group, the flunarizine group had lower body mass ratio 1, 3, 5, 7, 10 and 14 d after drug administration (ratio to body mass before drug administration). Compared with the control group, the flunarizine group had significantly shortened residence time in rod rotating and lower rotational speed when falling ( P<0.05). Compared with the control group, the flunarizine group had decreased tyrosine hydroxylase protein in the substantia nigra without significant difference ( P>0.05). Compared with the control group, the flunarizine group had significantly increased interleukin-6 and tumor necrosis factor-α in the substantia nigra (1.00±0.00 vs. 2.79±0.83; 1.00±0.00 vs. 3.39±1.37), significantly lower intestinal Evans blue propulsion rate (80.67%±4.51% vs. 50.67%±6.03%), and statistically decreased ZO-1 and Claudin-5 expressions in the colonic epithelial tissues (27.01±1.41 vs. 16.32±2.83; 37.00±2.80 vs. 24.52±2.12, P<0.05). Totally, 576 microorganisms were noted in both control group and flunarizine group, 744 in the control group alone, and 634 in the flunarizine group alone. The intestinal flora β diversity indices in the 2 groups were significantly different based on weighted Unifrac-principle coordinates analysis (PCoA, PCoA1: 39.88%; PCoA2: 30.69%). Compared with the control group, the microbial colony structure of mice in flunarizine group was dominated by phylum thick-walled bacteria and phylum warty microbacteria, and by families Muribaculaceae, Lachnospiraceae and Akkermansiaceae. Compared with the control group, the flunarizine group had significantly decreased relative abundance of Ackermannia spp. and Lactobacillus spp. in the intestinal flora ( P<0.05). Conclusion:Flunarizine may contribute to the pathogenesis of DIP by causing structural disturbances in the intestinal flora and inducing neuroinflammation based on the gut-brain axis.

Mendelian Randomization Analysis ; Bone Density ; Genome-Wide Association Study ; Minerals ; Life Expectancy ; Polymorphism, Single Nucleotide

Objective This study aims to determine the effects of a health management program based on WeChat platform on a hypertensive population aged under 45. Methods 1 128 hypertensive patients aged between 18 and 44 received a health examination from January 2016 to December 2016 and they were divided into intervention (n=561) and control (n=567)groups. The two groups were followed up after 1 year, and initially both the intervention group (n=521) and the control group (n=510) completed a lifestyle questionnaire, and their systolic blood pressure, diastolic blood pressure, triglyceride (TG), total cholesterol (TC), high density lipoprotein‐cholesterol (HDL‐C), low density lipoprotein‐cholesterol (LDL‐C), body mass index (BMI), and pulse wave velocity (PWV) were recorded. For the control group, lifestyle health management programs were conducted. For the intervention group, a learning platform was arranged on WeChat, which uploaded questionnaires, and provided medical information to create electronic health records. The group gained hypertension‐related knowledge, dynamically monitored blood pressure and lifestyle, and participated in interactive question‐and‐answer sessions. Both groups were followed up after a year, and their systolic pressure, diastolic blood pressure, TG, TC, HDL‐C, LDL‐C, BMI, and PWV levels were measured. The changes in their daily exercise time, vegetable intake, sleep time, weekly blood pressure reading, smoking, and salt intake were recorded. Results The mean age of the WeChat intervention group was 33.1 (+10.6) years, which had 319 males (61.2%), and the mean age of the control group was 32.8 (+10.2) years, with 307 males (60.1%). No difference of clinical data was found between the two groups at baseline. The systolic and diastolic blood pressure of the intervention group, (142.4±10.4) mmHg (1 mmHg=0.133 kPa) (85.1±8.2) mmHg was significantly lower than that of the control group (149.6±10.1) mmHg, (92.3±9.1) mmHg (t=3.67, 2.33, P<0.05) at the end of the first year of follow‐up. The TG, TC, LDL‐C, BMI, and PWV levels of the intervention group [(1.6±0.6) mmol/L, (4.4±0.7) mmol/L, (2.8± 0.4 ) mmol/L, (23.9±4.2) kg/m2, (11.3±3.7) m/s respectively] were significantly lower than those of the control group [(1.8±0.7) mmol/L, (5.0±0.8) mmol/L, (3.3±0.5) mmol/L, (25.9±4.5) kg/m2, (15.8± 4.8) m/s, respectively] (t=6.63, 7.24, 4.96, 5.68, 9.25, all P<0.05). The HDL‐C level of the intervention group (1.8±0.7) mmol/L was significantly higher than that of the control group (1.4±0.4) mmol/L(t=8.14, P<0.05). After 1 year of intervention, daily exercise time [(40.5±12.2)min/d, (20.8±9.2) min/d)], vegetable intake [(423.6±145.8) g/d, (204.8±79.3) g/d)], sleeping time [(6.3±2.2) h/d, (5.9±1.7) h/d)], and weekly monitoring of blood pressure (23.4%, 8.1%) showed an increase with statistical significance (t =2.36, 1.95, 9.07, χ2=46.31, P<0.05), while smoking (14.4%, 21.9%) and high‐salt diet (20.2%, 30.5%) decreased showing statistical significance ( χ 2=‐9.83, -14.27, P<0.05). The daily exercise time [(22.9±11.3)min/d, (21.7±9.5)min/d], vegetable intake [(211.8±85.4) g/d, (198.5±81.4) g/d], sleeping time [(5.9±1.8) h/d,(5.8±1.9) h/d], weekly monitoring of blood pressure (9.2%, 8.6%), smoking(18.9%, 19.8%), and high‐salt diet (28.8%, 30.2%) were not significantly different in the control group at the one‐year follow‐up (t=0.14, 0.26, 0.31, χ2=0.11, 0.16, 0.23, all P>0.05). Conclusions The health management program based on WeChat platform can improve diet, exercise compliance, and lifestyle, and effectively reduce blood pressure and blood lipid levels for a hypertensive population under the age of 45.

Objective: To investigate the genetic characteristics of VP1 genes carried by coxsackievirus A16 strains isolated from cases of hand foot and mouth disease (HFMD) in Shenzhen during 2016 to 2017. Methods: Fecal and anal swab specimens were collected from patients with mild HFMD in four sentinel hospitals and the Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, China during 2016 to 2017. All specimens were tested for CVA16 viral RNA using real-time RT-PCR. The VP1 genes of 51 randomly selected CVA16 strains were amplified by RT-PCR and then sequenced using TaKaRa Biomedical Technology (Dalian). Bioinformatics software, including Mega6.02, BioEdit and DNAStar, was used for comparison and analysis of the VP1 genes. Results: CVA16 strains in Shenzhen during 2016 to 2017 mainly belonged to B1a and B1b subtypes as well as an emerging subtype B3. The epidemic of B1b subtype was found in both 2016 (28 strains) and 2017 (19 strains), while the B1a subtype (two strains) was only detected in 2017. Two B3 subtype strains were detected in 2017. The strains of B1b subtype were closely related to the strains isolated in Shanghai (JQ314149), Wenzhou (KP289416) and Beijing (KU254598), while the B1a subtype strains were closely related to the strains isolated in Kunming (JQ316639) and Tailand (GQ184139). The B3 subtype strain was an emerging CVA16 epidemic strain in mainland China. Further comparison of the CVA16 epidemic strains in Shenzhen area during 2016 to 2017 with the CVA16 strains causing severe neurological symptoms showed that two amino acid mutations (S14N and M23L) were found in VP1 protein. Conclusions The epidemic strains of CVA16 were B1b subtype in Shenzhen area in 2016. However, B1a, B1b and the emerging B3 subtype strains were prevalent in 2017. Compared with the CVA16 strains causing severe neurological symptoms, the CVA16 strains circulating in Shenzhen during 2016 to 2017 carried two amino acid mutations inVP1 protein.

The latest American hypertension guideline in 2017 proposed new diagnostic criteria for hypertension,control target values,and threshold for starting a drug treatment.This article reviews the related contents of hypertension guidelines in Europe,America and China in recent years,hoping to help clinicians and health managers better understand the new progress of hypertension,and manage patients with hypertension more scientifically and more regularly.

Objective To study the relationship between serum homocysteine (Hey) level and firstever cardiocerebral vascular events in elderly hypertension-free population.Methods A total of 6124 hypertension-free patients aged 60-80 years admitted to our hospital for physical examination were randomly divided into control group (n=4122) with their Hcy≤13 μmol/L and experimental group (n=2002) with their Hcy＞13 μmol/L.Their serum Hcy levels were measured.The patients were followed up for 3 years,during which the incidence of first-ever cardiocerebral vascular events was recorded every 6 months and compared.Results No significant difference was found in sex,age,smoking,BMI,SBP,DBP,FBG and LDL-C between the two groups (P＞0.05).The serum Hcy level was significantly higher in experimental group than in control group (29.68±12.87 μmol/L vs 8.12 ± 4.36 μmol/L,P =0.001).The incidence of cardiocerebral vascular events,cerebral infarction and non-lethal myocardial infarction was significantly higher in experimental group than in control group at the end of 3-year follow-up period (18.8％ vs 10.2％,P=0.001;9.0％ vs 4.6％,P=0.025;5.8％ vs 3.0％,P=0.034).Multivariate Cox harzards regression analysis showed that serum Hcy level was an independent risk factor for first-ever cardiocerebral vascular events in elderly hypertension-free population (β=0.78,95 ％ CI:1.76-4.12,P =0.003).Conclusion Elevated serum Hcy level is a risk factor for first-ever cardiocerebral vascular events,especially for cerebral and myocardial infarction in elderly hypertension-free population.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Culture Techniques ; methods ; Child ; Female ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Male ; Middle Aged

Objective To investigate the effects of health management on risk factors of cardiovascular diseases in community residents.Methods A total of 208 adults from one single community who visited our health check-up center were randomly assigned to the control group(receiving routine consultation,n =104)and health management group(receiving health management intervention,n =104).At 1-year follow-up,fasting blood glucose(FBG),lipid profiles,and blood pressure(BP)were measured and risk factors of cardiovascular were surveyed.t or x2 test was used for data analysis.Results No difference of clinical data was found between the two groups at baseline.Follow-up results indicated that absolute risk of cardiovascular diseases,number of risk factors,health satisfaction,sick leave,daily vegetables intake and physical exercise,and BP were significantly improved in the health management group.Ten-year absolute risk of cardiovascular diseases(0.8 ± 0.4 vs 1.3 ± 0.5),number of risk factors(172 vs 283),and sick leave per year(118 d vs 264 d)were significantly decreased in the health management group when compared to the control group(all P ＜ 0.05).Furthermore,health satisfaction(83.7％(87/104)vs 52.9％(55/104)),and daily vegetables intake(520.5 g vs 348.3 g)and physical exercise(1.2 h vs 0.3h)were significantly improved in the health management group(all P ＜ 0.05).Conclusion Health management may be effective in decreasing risk factors of cardiovascular diseases in community residents.

Genetic manipulation of human pluripotent stem cells (hPSCs) provides a powerful tool for modeling diseases and developing future medicine. Recently a number of independent genome-editing techniques were developed, including plasmid, bacterial artificial chromosome, adeno-associated virus vector, zinc finger nuclease, transcription activator-like effecter nuclease, and helper-dependent adenoviral vector. Gene editing has been successfully employed in different aspects of stem cell research such as gene correction, mutation knock-in, and establishment of reporter cell lines (Raya et al., 2009; Howden et al., 2011; Li et al., 2011; Liu et al., 2011b; Papapetrou et al., 2011; Sebastiano et al., 2011; Soldner et al., 2011; Zou et al., 2011a). These techniques combined with the utility of hPSCs will significantly influence the area of regenerative medicine.
Cell Line ; Chromosomes, Artificial, Bacterial ; genetics ; Deoxyribonucleases ; genetics ; Dependovirus ; genetics ; Gene Targeting ; methods ; Genetic Engineering ; methods ; Genetic Vectors ; Genome, Human ; Humans ; Mutagenesis, Insertional ; Mutation ; Plasmids ; Pluripotent Stem Cells ; cytology ; metabolism ; Zinc Fingers ; genetics