Objective:To compare the clinical data and peripheral blood levels of CXC chemokine ligand (CXCL) 9 and CXCL10 between patients with progressive non-segmental vitiligo who were sensitive to systemic glucocorticoid treatment and those who were resistant, and to clarify key clinical factors influencing the sensitivity to systemic glucocorticoid treatment.Methods:From May 2021 to May 2023, a cohort of patients with progressive non-segmental vitiligo receiving systemic glucocorticoid treatment was established in Huashan Hospital, Fudan University. Clinical data and peripheral blood samples were prospectively collected from all enrolled patients. Standard treatment, i.e., intramuscular injections of 1 ml of compound betamethasone once a month, was administered. After 3-month treatment, the improvement of patients′ skin lesions was estimated, and the vitiligo area and severity index (VASI) score and the Vitiligo European Task Force assessment tool (VETFa) were used to evaluate the efficacy. Patients with VASI changes ≥ 0 and VETFa progression scores ≤ 0 point were included in the glucocorticoid-sensitive group (i.e., the patients′ condition was stable or improved), otherwise those with VASI changes < 0 and VETFa progression scores of 1 point were included in the glucocorticoid-resistant group. Associations of lesion locations, specific clinical markers (trichrome lesions, confetti-like depigmentation, and Koebner phenomenon), previous medication history, family history of vitiligo, etc. with the response to systemic glucocorticoid treatment were analyzed. At baseline and after 3-month treatment, peripheral blood samples were collected from the patients, and enzyme-linked immunosorbent assay was performed to detect the plasma levels of CXCL9 and CXCL10. Statistical analysis was carried out by using the chi-square test, Fisher′s exact test, binary logistic regression analysis, Mann-Whitney U test, and Wilcoxon signed-rank test. Results:A total of 142 patients with vitiligo were enrolled, and 127 completed 3-month treatment, including 77 males and 50 females. Their age at diagnosis was 18 to 65 (36.6 ± 11.4) years, and the disease duration ranged from 2 months to 58 (13.5 ± 10.7) years; 25 (19.7%) had a family history of vitiligo; the percentage of lesion area to total body surface area before treatment ranged from 1% to 70% (11.5% ± 12.7%), and the VASI score was 1% to 70% (10.8% ± 11.6%). Multivariate logistic regression analysis showed that the absence of specific clinical markers (odds ratio [ OR] = 6.900, 95% confidence interval [ CI]: 1.228, 38.757, P = 0.028), carrying a single specific clinical marker ( OR = 2.579, 95% CI: 1.012, 6.574, P = 0.047), having a history of topical glucocorticoid treatment ( OR = 2.643, 95% CI: 1.019, 6.850, P = 0.041), the absence of family history of vitiligo ( OR = 5.090, 95% CI: 1.070, 24.215, P = 0.030), and lesions on the proximal extremities ( OR = 3.767, 95% CI: 1.315, 10.793, P = 0.037) were risk factors for the resistance to systemic glucocorticoid treatment in the patients with vitiligo. After 3-month treatment, the glucocorticoid-sensitive group showed a significant decrease in plasma CXCL10 levels compared with those before treatment ( W = 571.00, P < 0.001), while there was no significant difference between the pre- and post-treatment CXCL10 levels in the glucocorticoid-resistant group ( W = 48.00, P = 0.524). Additionally, no significant difference was observed in changes of the plasma CXCL9 level before and after treatment between the glucocorticoid-sensitive and glucocorticoid-resistant groups ( P > 0.05) . Conclusions:Carrying no or a single specific clinical marker, having a history of topical glucocorticoid treatment, the absence of family history of vitiligo, and lesions on the proximal extremities appeared to be risk factors for the resistance to systemic glucocorticoid treatment in patients with progressive non-segmental vitiligo. Changes in CXCL10 levels after treatment may be used as an important evaluation indicator for determining whether patients with progressive vitiligo were resistant to systemic glucocorticoid treatment.

Objective:To disclose the genome characteristics and mutations of 2019 novel coronavirus (2019-nCoV) strains from the imported cases of Coronavirus Disease 2019 (COVID-19) in Gansu province, thereby to provide scientific reference for the prevention and control of COVID-19 in Gansu province. Methods:The respiratory tract specimens of imported COVID-19 cases from seven countries in Gansu province in 2020 were collected. The virus genome was sequenced by the second-generation sequencing technology, the whole genome sequences were compared and analyzed, and the MEGA software was used to construct a phylogenetic tree based on the neighbor-joining method.Results:A total of 46 2019-nCoV genome sequences with a length of 29 605~29 903 bp were obtained. Compared with the Wuhan reference strain (GenBank ID: NC_045512.2), it was found that the median (minimum to maximum) number of the nucleotide mutations of the 2019-nCoV genome sequence of the imported cases was 10 (7-24). A total of 134 nucleotide mutation sites were found in all 2019-nCoV genome sequences from 7 entry countries in Gansu province, distributed in 11 open reading frames (ORFs). The top three nucleotide mutations in different proteins: ORF1ab (78), S(20), N(12). Among the 134 nucleotide mutations, 82 caused amino acid mutations, and all of them were missense mutations. No insertions or deletions were seen. Types of deletion mutations, the top three amino acid mutations in different proteins: ORF1ab (46), S(11), N(10); the key sites of the receptor binding domain (RBD) of the S protein have not been mutated.Conclusions:No imported cases in Gansu province have been found to carry the reported mutations that can clearly lead to changes in the spread and pathogenicity of 2019-nCoV.

Objective:To analyze the influenza surveillance results and epidemiological characteristics of the disease in Gansu province in 2010-2018, and provide scientific basis for the formulation and adjustment of influenza prevention and control strategies.Methods:Real-time PCR was used to detect the specimens of ILI illness (ILI) cases reported by 19 national influenza surveillance sentinel hospitals in Gansu province. Influenza virus isolation and culture were carried out using canine kidney cells (MDCK).Results:Total of 93 334 specimens from ILI cases were collected from Jan. 2010 to Dec. 2018, and 13 439 samples were positive for influenza virus nucleic acid. The positive rate of viral nucleic acid detection was 14.40%, and the proportion of influenza B virus in positive samples was the highest (37.02%), and seasonal H3N2 influenza virus (35.25%), H1N1 influenza virus (26.78%). The advantages are different in various periods. The peak period of influenza is from Dec. to Mar., and the highest incidence rate is in the age group of 5-15 years (20.34%). The incidence rates of the other age groups are similar. The difference of influenza positive rate in different age groups is statistically significant ( χ2=775.153, P<0.001), but in male and female was not significant. Total of 16 101 ILI specimens positive for influenza virus nucleic acid were subjected to virus isolation and cultured, and 3 892 strains of influenza virus were isolated, of which influenza B virus accounted for the highest proportion (37.82%), followed by seasonal H3N2 influenza virus (33.04%), H1N1 influenza virus (28.96%). Conclusions:The epidemic of influenza in Gansu province had an obvious regularity, and it was undulating and prevalent. It is necessary to strengthen prevention and control measures among school-age children and adolescents.

Objective To assess the quality of donor liver allografts by employing laser scanning confocal microscope (LSCM ) and clinical liver function tests .Methods Sprague-Dawley rats were used for establishing cold ischemia models of liver allografts .According to different timepoints of cold ischemia ,four groups of CIT1h ,CIT6h ,CIT12h and CIT24h were designated .At the end of cold ischemia time (CIT) of each group , perfusion and preservation fluids were collected and fluoresceins perfused . After LSCM examinations ,tissue samples were harvested for HE examination .Finally a comparison was made between LSCM results and hematoxylin & eosin (HE) examinations .Also some relevant clinical parameters were detected in preserving and flushing fluids .Results Both LSCM examination and pathological examination indicated that the quality of liver allografts decreased significantly with the elapsing of time . Only the difference of LDH was statistically significant (P<0 .001) .Conclusions LSCM may be used for evaluating the ex vivo qualities of liver allografts .Simple handling and time efficiency re great advantages of LSCM .As compared with alanine transaminase (ALT ) and aspartate transaminase (AST ) ,LDH is a better indicator reflecting the quality of liver allografts .

Accelerated forgetting has been identified as a feature of Alzheimer's disease (AD), but the therapeutic efficacy of the manipulation of biological mechanisms of forgetting has not been assessed in AD animal models. Ras-related C3 botulinum toxin substrate 1 (Rac1), a small GTPase, has been shown to regulate active forgetting in Drosophila and mice. Here, we showed that Rac1 activity is aberrantly elevated in the hippocampal tissues of AD patients and AD animal models. Moreover, amyloid-beta 42 could induce Rac1 activation in cultured cells. The elevation of Rac1 activity not only accelerated 6-hour spatial memory decay in 3-month-old APP/PS1 mice, but also significantly contributed to severe memory loss in aged APP/PS1 mice. A similar age-dependent Rac1 activity-based memory loss was also observed in an AD fly model. Moreover, inhibition of Rac1 activity could ameliorate cognitive defects and synaptic plasticity in AD animal models. Finally, two novel compounds, identified through behavioral screening of a randomly selected pool of brain permeable small molecules for their positive effect in rescuing memory loss in both fly and mouse models, were found to be capable of inhibiting Rac1 activity. Thus, multiple lines of evidence corroborate in supporting the idea that inhibition of Rac1 activity is effective for treating AD-related memory loss.

BACKGROUND: Severe cutaneous adverse reactions (SCAR) to drugs are a crucial public health issue and the use of systemic corticosteroids in SCAR has been controversial. OBJECTIVE: To analyze clinical features, causative drugs, treatment, outcomes, and prognostic factors of SCAR in the case-series of 173 patients, and add more information to the debate of using systemic corticosteroids in SCAR management. METHODS: A retrospective study of 173 SCAR patients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) or acute generalized exanthematous pustulosis (AGEP) at a tertiary care institution in China between January 2014 and December 2017 was conducted. RESULTS: Of 173 patients, allopurinol, carbamazepine, and antibiotics are the most frequently implicated drugs for DRESS (40.4%), SJS/TEN (26.0%), and AGEP (40.0%) respectively. Moreover, there is a strongly negative correlation between early corticosteroids use and the progression (p=0.000) and severity (p=0.01) of skin lesions. However, there is no association between early corticosteroids use and the mortality of SCAR (odds ratio: 1.01, 95% confidence interval: 0.95~1.08). In addition, lymphadenopathy, eosinophilia, and interval from onset to corticosteroids treatment were correlated with SCAR prognosis. CONCLUSION: Prompt short-course systemic corticosteroids use is associated with early-stage skin lesions remission without influencing the disease mortality. Lymphadenopathy and eosinophilia were the independent poor prognostic factors of SCAR.
Acute Generalized Exanthematous Pustulosis ; Adrenal Cortex Hormones ; Allopurinol ; Anti-Bacterial Agents ; Carbamazepine ; China ; Cicatrix ; Drug Hypersensitivity Syndrome ; Eosinophilia ; Humans ; Lymphatic Diseases ; Mortality ; Prognosis ; Public Health ; Retrospective Studies ; Skin ; Stevens-Johnson Syndrome ; Tertiary Healthcare

Objective To understand the situations of departments of intensive care units (ICUs) of different level hospitals in Guizhou Province, and to provide directions and evidences for improving quality control in critical care medicine.Methods A county-level hospital and a provincial-level hospital's comprehensive ICU in Guizhou Province were selected to record and analyze and compare the structural indicators, patient admission and transfer, disease distribution, ventilator associated pneumonia (VAP), intravascular catheter related blood stream infection (CRBSI) and catheter-associated urinary tract infection (CAUTI) of the two hospitals' comprehensive ICU in 2017.Results The ICU of the People's Hospital of Suiyang County (county hospital) was found in 2012, and the ICU of the Affiliated Hospital of Guizhou Medical University (provincial hospital) was found in 1994. Until 2017, there were 10 and 46 beds, 6 (all of them hold bachelor's degree) and 18 physicians (6 of them hold PhD, 5 of them hold master's degree, 7 of them hold bachelor's degree), 17 (4 of them hold bachelor's degree, 13 of them hold college degree or graduated from secondary school) and 69 nurses (2 of them hold master's degree, 53 of them hold bachelor's degree, 14 of them hold college degree or graduated from secondary school) in the two ICUs respectively, there were significant differences in the education background of the physicians and nurses between the two ICUs (bothP < 0.01). During 2017, 471 cases were admitted to the ICU of the county hospital while 1633 cases were admitted to the ICU of the provincial hospital. Compared with the ICU of the provincial hospital, the ratio of the patients with acute physiology and chronic health evaluationⅡ(APACHE Ⅱ) ≥ 15 at admission was lower (74.8％ vs. 85.1％,P < 0.01), the ratio of direct admission was higher (30.8％ vs. 17.4％,P < 0.01), the ratio of the patients admitted to the ICU more than once was lower (0.8％ vs. 5.0％,P < 0.01), the ratio of the patients whose the length of ICU stay less than 24 hours was higher (51.6％ vs. 13.7％,P < 0.01), the ratio of the patients whose the length of ICU stay more than 28 days was lower (1.1％ vs. 2.9％, P < 0.05), the ratio of the patients discharged against-advice (25.5％ vs. 20.5％,P < 0.05) was higher, the ratio of the patients transferred to other hospitals was higher (5.1％ vs. 0.3％,P < 0.05), and the ICU mortality was lower (4.0％ vs. 13.9％,P < 0.01) in the ICU of the county hospital. The top three kinds of diseases treated in the ICU of the county hospital were brain injury (27.4％), trauma (19.1％) and toxication (6.8％); while in the ICU of the provincial hospital were brain injury (18.6％), sepsis (16.2％) and severe acute pancreatitis (4.8％). In addition, the incidences of VAP, CRBSI and CAUTI in the ICU of the county hospital were 10.0/1000 ventilator days, 1.4/1000 catheter days, 0.5/1000 catheter days; while in the ICU of the provincial hospital were 5.8/1000 ventilator days, 2.0/1000 catheter days, 3.7/1000 catheter days, respectively.Conclusions There are short of physicians and nurses in the ICU of the provincial and county hospitals in Guizhou Province, and the educational level of the medical staff in the ICU of the county hospital is relatively low. Moreover, there were significant differences in the admissions and treatments and the outcomes of the critically ill patients between the two ICUs. The characteristics of the ICUs of county hospitals should be fully considered when the quality control of critical care medicine and continuing medical education are done.

Objective To explore the diagnosis and treatment of bronchogenic cyst in the abdomen.Methods Clinical data of 7 cases with abdominal bronchogenic cyst in the First Affiliated Hospital of China Medical University from October 2001 to February 2016 were retrospectively analyzed.Results Of the 7 patients,5 were male and 2 were female aging from 36 to 50 years with a median age of 37 years.Two cases were complaining for upper abdominal pain,5 cases were asymptomatic.Ultrasonography revealed hypoechoic or anechoic mass.Color doppler flow imaging showed no blood flow.Contrast-enhanced CT scans showed no obvious enhancement in 6 out of 7 cases,all patients underwent cystectomy successfully.Cysts were of unilocular in 6 cases and multilocular in one.Bronchogenic cysts were diagnosed by pathology in all 7 cases.Six patients were followed up from 1 month to 6 years with no recurrence.Conclusions Abdominal bronchogenic cyst is benign and postoperative prognosis is very good.

BACKGROUND:Hepatic fibrosis in chronic liver disease can be reversed. Studies have shown that Periplaneta americana extract has anti-fibrosis effect, and has protective effect on the experimental hepatic fibrosis rats.
OBJECTIVE:To observe the effect of Periplaneta americana extract sticky sugar amino acid on hepatic fibrosis, and to primarily explore the mechanism of sticky sugar amino acid against hepatic fibrosis.
METHODS:Rat models of immune hepatic fibrosis were induced by pig serum and intragastricaly administered 0.5, 0.25, 0.10 g/kg sticky sugar amino acid. Four indexes of hepatic fibrosis were detected by radioimmunoassay. Immunohistochemical staining wasused to measure transforming growth factor beta 1, tissue inhibitor of metaloproteinase protein expression intensity and positive cel rate, to determine the correlation of different concentrations of sticky sugar amino acid, transformation growth factorbeta 1 and tissue inhibitor of metaloproteinase.
RESULTS AND CONCLUSION:(1) The Periplaneta americana extract sticky sugar amino acid reduced the levels of laminin, type III procolagen, type IV colagen and hyaluronidase (P< 0.01) and reduced the expression of transformation growth factor beta 1 and tissue inhibitor of metaloproteinase 1 in liver tissue (P< 0.01). (2) Sticky sugar amino acid concentration and transformation growth factor beta 1 and tissue inhibitor of metaloproteinase 1 protein expression showed a significant negative correlation (|r| > 0.9). (3) Results confirmed that the Periplaneta americana extract sticky sugar amino acid can change the reversal of hepatic fibrosis. Its mechanism of action is associated with expression of transforming growth factor beta 1 and tissue inhibitor of metaloproteinase 1 inhibited by sticky sugar amino acids.

BACKGROUND: Kidney ischemia-reperfusion injury often combines with acute kidney and lung injury. The expression of cutin cel growth factor receptor (KGFR) and alpha sodiumchannel protein (α-ENaC) in kidney and lung after ischemia-reperfusion injury and the protective effect of α-melanocyte require further observation and research. OBJECTIVE:To explore the therapeutic effect of α-melanocyte on the expressions of KGFR and α-ENaC in rat models of ischemia-reperfusion injury. METHODS:A total of 30 healthy male Sprague-Dawley rats were randomly divided into control group, ischemia-reperfusion group and α-MSH group. Models of renal ischemia-reperfusion injury were established by 30-minute ligation of renal artery in the ischemia-reperfusion and α-melanocyte groups. Rats in the control group were only used to expose the renal artery, no ligation. Rats in the α-melanocyte group were intraperitonealy injected with α-melanocyte (0.25 mg/kg) at 30 minutes before model establishment. Rats in the ischemia-reperfusion group were injected with 4 mL of physiological saline. RESULTS AND CONCLUSION: Compared with control group, water content of kidney and lung increased significantly in rats of ischemia-reperfusion group and a-MSH group, while the levels of KGFR and α-ENaC of kidney and lung in rats were lower (P < 0.05). Compared with the ischemia-reperfusion group, water content of kidney and lung in rats of a-MSH group decreased significantly, while the levels of KGFR and α-ENaC of kidney and lung increased gradualy (P < 0.05). Moreover, edema was significantly lessened in the rat kidney and lung. Results confirmed that after renal ischemia-reperfusion injury, KGFR and α-ENaC expression was consistent to the kidney and lung injury. α-MSH could increase the protein and mRNA expression of KGFR and α-ENaC in kidney and lung of rats, reduce the kidney and lung injury, and exert a certain protective effect.