Glucagonoma is a rare neuroendocrine tumor of α cells of the pancreas. The tumor excessively secretes glucagon and causes glucagonoma syndrome.70%-90% of patients with glucagonoma will develop necrolytic migratory erythema (NME). We reported a patient of glucagonoma syndrome who was presented to the dermatology outpatient clinic with a 2-year-history of recurrent erythema and scaling on the skin migrating throughout the body. A skin biopsy was performed and resulting features matched with NME, whilst imaging examinations suggested a soft tissue density tumor present in the tail of the pancreas with somatostatin receptor expression and laboratory tests found an elevated levels of serum glucagon. After the diagnosis was confirmed, the patient was treated with surgical resection of the glucagonoma and the skin eruptions resolved rapidly in 4 days. Meanwhile, we reviewed relevant literature published in recent years and summarized its clinical characteristics in order to improve its understanding by clinicians, including clinical manifestations, laboratory and imaging examinations, diagnosis and treatments.

Despite growing prevalence and incidence, the management of gout remains suboptimal. The intermittent nature of the gout makes the long-term urate-lowering therapy (ULT) particularly important for gout management. However, patients are reluctant to take medication day after day to manage incurable occasional gout flares, and suffer from possible long-term toxicity. Therefore, a safe and easy-to-operate drug delivery system with simple preparation for the long-term management of gout is very necessary. Here, a chitosan-containing sustained-release microneedle system co-loaded with colchicine and uricase liposomes were fabricated to achieve this goal. This microneedle system was confirmed to successfully deliver the drug to the skin and maintain a one-week drug retention. Furthermore, its powerful therapeutic potency to manage gout was investigated in both acute gouty and chronic gouty models. Besides, the drug co-delivery system could help avoid long-term daily oral colchicine, a drug with a narrow therapeutic index. This system also avoids mass injection of uricase by improving its stability, enhancing the clinical application value of uricase. In general, this two-drug system reduces the dosage of uricase and colchicine and improves the patient's compliance, which has a strong clinical translation.

Growth hormone deficiency (GHD) has become a serious healthcare burden, and presents a huge impact on the physical and mental health of patients. Here, we developed an actively separated microneedle patch (PAA/NaHCO₃-Silk MN) based on silk protein for sustained release of recombinant human growth hormone (rhGH). Silk protein, as a friendly carrier material for proteins, could be constructed in mild full-water conditions and ensure the activity of rhGH. After manually pressing PAA/NaHCO₃-Silk MN patch to skin for 1 min, active separation is achieved by absorbing the interstitial fluid (ISF) to trigger HCO₃ ^‒ in the active backing layer to produce carbon dioxide gas (CO₂). In rats, the MN patch could maintain the sustained release of rhGH for more than 7 days, and produce similar effects as daily subcutaneous (S.C.) injections of rhGH in promoting height and weight with well tolerated. Moreover, the PAA/NaHCO₃-Silk MN patch with the potential of painless self-administration, does not require cold chain transportation and storage possess great economic benefits. Overall, the PAA/NaHCO₃-Silk MN patch can significantly improve patient compliance and increase the availability of drugs, meet current unmet clinical needs, improve clinical treatment effects of GHD patients.

Authenticity verification is a very important aspect of medical device registration quality management system verification of medical device. How to verify the authenticity of samples is a problem worth discussing. This study analyzes the methods of authenticity verification from the aspects of product retention sample, registration inspection report, traceability of records, hardware facilities and equipment. In order to provide reference for relevant supervisors and inspectors in the verification of registration quality management system.

Bullous pemphigoid (BP) can be comorbid with a variety of immune diseases, such as immune skin diseases (psoriasis, vitiligo, alopecia areata and various other immune bullous diseases) , immune digestive diseases (inflammatory bowel disease, primary biliary cirrhosis) , autoimmune thyroid diseases, autoimmune rheumatic diseases (rheumatoid arthritis, dermatomyositis, scleroderma and systemic lupus erythematosus) , immune renal diseases (immune nephropathy, renal allograft rejection) and acquired hemophilia A. The above comorbidities markedly affect the quality of life of and treatment options for patients. This review elaborates on currently reported immune diseases associated with BP and their concomitant mechanisms.

To analyze the clinical characteristics and drug resistance in patients with non-tuberculous mycobacteria (NTM) pulmonary disease in Changsha Central Hospital of Hunan Province in recent three years.
 Methods: The clinical data of 153 patients with NTM pulmonary disease, who were diagnosed in Changsha Central Hospital of Hunan Province from February 2014 to May 2017, were retrospectively analyzed. According to the concentration of drug sensitivity test, the patients were divided into a low concentration group and a high concentration group. The status of drug sensitivity and drug resistance were examined.
 Results: Among 153 patients, 79 patients (51.63%) were male, 74 patients (48.37%) were female. The mean ages were (60.27±19.46) years. The NTM pulmonary disease mainly occurred in the individuals with bronchiectasis, and the course of disease was long (mean 7.8 years). The clinical symptoms were not specific and mostly misdiagnosed as pulmonary tuberculosis (92.81%). Mycobacterium avium-intracellulare (56.21%) and mycobacterium chelonae-abscess (20.92%) were the majority. The drug-resistance rate of the first-line and second-line anti-tuberculosis drugs was high. The majority was resistant to more than eight drugs, 38.56% patients in the low concentration group were resistant to total drugs, and 25.49% patients in the high concentration group were resistant to total drugs.
 Conclusion: The NTM pulmonary disease is easily misdiagnosed, and the drug resistance rate is high. Identification of mycobacterium species and detection of drug sensitivity play an important role in clinical diagnosis and treatment.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous ; Nontuberculous Mycobacteria ; Retrospective Studies

BACKGROUND: Embryonic stem cells and mesenchymal stem cells are two main cell sources for stem cell transplantation in the treatment of acute lung injury. There are few reports on the study of autologous induced pluripotent stem cells in the treatment of acute lung injury. OBJECTIVE: To investigate the possibility of induced pluripotent stem cells derived from autologous dermal fibroblasts injected through the caudal vein in the treatment of acute lung injury in rats. METHODS: Twenty-four Sprague-Dawley rats (provided by Beijing Vital River Laboratory Animal Technology Co., Ltd.) were randomly divided into three groups. The control group was intraperitoneally injected with normal saline, and the model group and the experimental group were intraperitoneally injected with lipopolysaccharide to make acute lung injury models in rats. At 24 hours after modeling, phosphate buffer solution was injected into the tail vein of the rats in the control and model groups, while the rats in the experimental group were given induced pluripotent stem cell suspension by the tail vein. The changes of lung tissue morphology, lung wet/dry weight ratio, pathological injury score, serum interleukin 1beta, interleukin 6 and tumor necrosis factor alpha levels were observed at 7 days after treatment. RESULTS AND CONCLUSION: (1) At 7 days after treatment, pulmonary interstitial edema, alveolar septum thickening, inflammatory cell infiltration, capillary congestion, irregular alveolar morphology, and exudate in the alveolar cavity were significantly improved in the experimental group. (2) At 7 days after treatment, the wet/dry weight ratio of lung tissue in the model and experimental groups was significantly higher than that in the control group, but the wet/dry weight ratio of lung tissue and pathological injury score in the experimental group were significantly lower than those in the model group (P < 0.01). (3) At 7 days after treatment, the levels of serum interleukin 1beta, interleukin 6 and tumor necrosis factor alpha were ranked as follows: model group> experimental group> control group, and there were significant differences between groups (P < 0.01). To conclude, the transplantation of induced pluripotent stem cells derived from autologous dermal fibroblasts can effectively alleviate acute lung injury and reduce serum inflammatory factor levels in rats.

Objective To study the expression and targeted relationship of miR-103/KLF4 (Krüppel like factor) in A549 and resistant cell lines of lung cancer.Methods To culture the A549 cell lines and A549/DDP (cisplatin) resistant cell lines in vitro and detect survival rates by methyl thiazolyl tetrazolium (MTT) method.Real-time polymerase chain reaction (RT-PCR) and Western blotting were used to test the expression of miR-103/KLF4 of these cell lines.Dual-luciferase reporter gene experiment to detect the targeted relationship.Results A higher expression of miR-103 and a obvious lower expression of KLF4 were observed in A549/DDP resistant cell lines.MiR-103 target KLF4-3'UTR (3'untranslated regions) directly in lung cancer cells.Conclusions In A549/DDP resistant cells,miR-103 can regulate KLF4 at target.

Objective To investigate the important role of angiogenin-like protein 4 (Angptl4) in pulmonary fibrosis and to provide a new therapeutic targets for pulmonary fibrosis.Methods We established the pulmonary fibrosis animal models in rat by tracheal instillation of bleomycin.Then,we detected the expression of Angptl4 through real-time polymerase chain reaction (RT-PCR) and Western Blot.Rat lung fibroblast (RLF) was transfected into Angptl4-shRNA plasmid.Then we detected the changed collagen expression in RLF cells after transfection through RT-PCR and Western blot.Results The expression of Angptl4 was up-regulated in the bleomycin-induced rat pulmonary fibrosis model.The expression of both collagen Ⅰ and collagen Ⅳ in RLF cells transfected with Angptl4-shRNA plasmids were down-regulated compared with control after TGF-β treatment.Conclusions Inhibiting the expression of Angptl4 can reduce the expression of collagen fibers in lung tissue,then delaying the progression of pulmonary fibrosis.

Objective To investigate the antitumor activity of the procaspase-3 activator SM-1 in BGC-823 cells in vivo and in vitro and the mechanisms.Methods The inhibitory effects of SM-1 on proliferation of BGC-823 cells were evaluated using MTT method, the cell apoptosis rate was detected by flow cytometry, and the expression of caspase-3 protein and procaspase-3 mRNA was detected by Western blotting and RT-PCR, respectively.SM-1 Antitumor activity was evaluated using the xenograft of BGC-823 cells in nude mice.Results SM-1 effectively inhibited the proliferation in vitro and in-duced apoptosis of BGC-823 cells in a dose-dependent manner.After treatment with SM-1 for 48 h, the protein expression levels of caspase-3 and mRNA expression levels of procaspase-3 were increased.SM-1 significantly inhibited growth of BGC-823 xenograft tumor at the 300 mg/kg dose and the inhibition rate was 56.3%(P<0.05).Conclusion SM-1 can significantly inhibit the tumor growth of BGC-823 cells in vivo and in vitro.The mechanism is possibly related to the activation of procaspase-3 and induced apoptosis of tumor cells.