Approximately 5% 8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED. METHODS: A 5-y...Approximately 5% 8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED. METHODS: A 5-year retrospective study on patients with dermatological conditions presenting to the Princess Alexandra Hospital ED in Brisbane, Australia was performed. Electronic medical records were used to compare demographics and admission status of the dermatology group and the total ED group presentations. A prospective survey was conducted on low priority triage (triage 4 and 5) patients identifying reasons presenting to the ED. RESULTS: Of a total 281,718 ED presentations, 11,748 dermatology presentations were identified between January 2012 to December 2016. Of the dermatology presentations, 41.5% were female and had an average age of 47. The most common dermatology presentations were cellulitis, abscess, rash unspecified, and ulcer. Of those admitted, 36% were female, average age was 53, mean length of stay of 294 minutes and 83.1% had an infectious aetiology. Of triage 4 and 5 presentations, 66% patients we approached had been seen by a health practitioner prior to coming to the ED. CONCLUSION: Within the population presenting with a skin related condition to the Princess Alexandra Hospital ED, characteristics associated with admission include male sex, older age, and an infectious etiology. This data may help ED clinicians decide on the discharge disposition of these patients. There may be a role for streamlined admissions for skin related infections, or improved hospital in the home services to support this group.展开更多
The aging process is a group of degenerative changes that physiologically occur in most of the people in the elderly. This affects one or more of the human body systems. The treatment of diseases related to the aging ...The aging process is a group of degenerative changes that physiologically occur in most of the people in the elderly. This affects one or more of the human body systems. The treatment of diseases related to the aging process has a huge impact on the economy of all nations. Aging of the skin comes on the top and despite that, the results of the already present lines of treatment are not always satisfactory. This acts as a stimulus for us to dig deeper to discover the root causes of the premature aging of the skin. This was simply caused by the accumulation of repeated minute damage to the internal structure skin. In other words, if the degree of minute damage is more than the capacity of the skin to repair, the repeated micro-damage is presented in the long run as a skin wrinkling. Moreover, the skin acts as a mirror that reflects the internal structures of the human body. Thus, the more degenerative changes in the human body systems, the more the skin could become wrinkled. Our strategy to prevent or at least slow down the aging process of the skin depends on 2 main steps;the 1<sup>st</sup> is to reduce the micro-damage as can as possible, and the 2<sup>nd</sup> is to enhance the capacity of tissue regeneration to be able to reverse the already present damaged skin. As the 2 processes are synchronized with each other, this strategy would be considered the ideal for prevention of skin wrinkling especially premature ones. This not only reverses premature skin wrinkling but also protects it from future wrinklings. This review sharply pointed out the role of the functional collagen of the dermal layer of the skin in the prevention of skin wrinklings. Therefore, it would be the target to study how collagen works in the complex machinery of the dermal layer of the skin. This concept deeply believes that the recovery of dermal collagen has a much better effect than simply ingesting collagen or receiving a topical collagen booster. .展开更多
Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with ...Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with fetid maceration. We report the case of a 35-year-old woman who had a painless, malodorous swelling of the cerebriform scalp measuring 20 × 17 cm in diameter with a wide base of insertion at the occipital level adhering to the deep planes. The excision associated with a skin plasty was carried out. Histology concluded that there was a giant cerebriform naevo-cellular nevus of the scalp.展开更多
Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effecti...Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effective psychological intervention.Methods:Applied questionnaire survey and used the“questionnaire star”platform to investigate the mental health status of medical staff assisting Ili by the General information,the PHQ-9,the GAD-7 and the SCL-90.And the relevant influencing factors were analyzed by univariate analysis and multiple linear regression analysis.Results:Factors such as whether they will support again,whether they need to provide psychological staff,and whether they have a sense of guilt for their families have a significant impact on the PHQ-9 of medical staff(p<0.05);Whether they will support again,whether they need psychological staff,and whether they feel bored and lonely during the closed loop management have a significant impact on the GAD-7 of medical staff(p<0.05);The SCL-90 was compared with the norm,and the scores of somatization,interpersonal sensitivity and terror factors of medical personnel were statistically significant(p<0.05),scores in other aspects(diet sleep)are obvious(1.63±0.72).Conclusion:During the period of COVID-19,the medical staff in Karamay City who assisted Ili had anxiety and depression,and their mental health was not optimistic,more attention and the necessary intervention should be given.展开更多
Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to eval...Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.展开更多
Transient acantholytic dermatosis (TAD, Grover disease) is a benign skin disease with a nonspecific rash that may present as a reddish-brown, dermatomal edematous papule or herpetiform rash with a partially central ho...Transient acantholytic dermatosis (TAD, Grover disease) is a benign skin disease with a nonspecific rash that may present as a reddish-brown, dermatomal edematous papule or herpetiform rash with a partially central horny plug. This disease is usually self-limiting and can subside within weeks or months, but it may also have a chronic progression with a trend towards long-term recurrence. The patient is an 80-year-old male who visited the clinic due to recurring erythema and blisters all over his body that had been present for over 2 years. Based on the patient’s course, laboratory tests and histopathological findings were consistent with the diagnosis. The final diagnosis was transient acantholytic dermatosis. The patient has a long course of the disease, a wide range of skin lesions and he has the different subtypes of pathological manifestations. This case and corresponding literature review help us have a clear understanding of Grover’s disease, which has received reference value for the diagnosis and treatment of this disease in clinical work.展开更多
Aim: The degree of probability to retrieve spermatozoa from testicular tissue for intracytoplasmic sperm injection into oocytes is of interest for counselling of infertility patients. We investigated the relation of s...Aim: The degree of probability to retrieve spermatozoa from testicular tissue for intracytoplasmic sperm injection into oocytes is of interest for counselling of infertility patients. We investigated the relation of sperm retrieval to clinical data and histological pattern in testicular biopsies from azoospermic patients. Methods: In 264 testicular biopsies from 142 azoospermic patients, the testicular tissue was shredded to separate the spermatozoa, histological semi - thin sections of which were then evaluated using Johnsen score. Results: The retrieval of spermatozoa correlated significantly ( P < 0.001 ) with the testicular volume ( r = 0.49), the FSH concentration ( r = - 0.66), the maximum score(r=0.85) and the mean Johnsen score (r= 0.81 ). In the multivariate regression analysis the successful testicular sperm extraction showed the closest relationship to the maximum score. The testicular volume correlated significantly with the mean Johnsen score (r = 0.64, P < 0.00I), and the basal serum FSH concentration mainly with the maximum score ( r = - 0.77; P < 0. 001 ). Patients with a history cryptorchidism showed a significantly lower Johnsen score compared to the patients who did not have any testicular disease in the past (3.7±2.4 vs. 5.9 ±2.5; P <0.01 ). Conclusion: In a limited range, the testicular volume and the FSH concentration in serum were related to the Johnsen score which correlated significantly with the sperm retrieval. The successful sperm retrieval can be expected in all azoospermic patients irrespective of the results of clinical examination. However, the probability of retrieval of spermatozoa decreased significantly in patients with a FSH level > 18 U/L, testicular volume < 5 mL, mean Johnsen score<5, and maximum Johnsen score < 7.展开更多
Objective:To study the therapeutic mechanisms of pseudolaric acid on allergic contact dermatitis in mice.Methods:A total of 50 BALB/C mice were selected and randomly divided into control group,model group,and treatmen...Objective:To study the therapeutic mechanisms of pseudolaric acid on allergic contact dermatitis in mice.Methods:A total of 50 BALB/C mice were selected and randomly divided into control group,model group,and treatment A,B,C groups with 10 rats in each group.ACD model was established in model group,and treatment A,B,C groups but not in control group.Model group received no treatment,but treatment A,B,C groups were treated with external application of the concentration of 0.1%,0.2% and 0.4% of the pseudolaric acid for the lesions of ear skin.And the weight gain and the swelling degree of the mice' ear were recorded,weight of thymus and spleen were measured.Spleen suspension was prepared to test T lymphocyte and B lymphocyte levels of mice in five groups.Changes in serum IFN-ed through the enzyme linked immunosorbent assay(ELISAγ,IL-4 and IL-10 levels were test).Results:The weight gain of mice in model group were significant lower than those of mice in the control group and the treatment A,B,C groups(P<0.05).Weight gain of mice in treatment A,B groups were significant lower than that of control group(P<0.05),but the difference in weight gain between treatment C group and control group showed no significant difference(P>0.05).The swelling degree and the weight of mice ears in model group were significant higher than those of mice in control group and treatment A,B,C groups(P<0.05).Swelling degree and the weight of mice ears of treatment A,B,C groups were obviously higher than that of control group(P<0.05).The swelling degree and weight of mice' ears in treatment A,B,C groups were decreased with the increase of the drug dosage,but comparison between A,B and C group showed statistically differences(P<0.05).The thymus and spleen index of mice in model group were significant higher than those of the other four groups(P<0.05),among the four groups,thymus and spleen index of treatment A and B group were higher than control group and treatment C group(P<0.05).The stimulation index of T and B cells of mice in model group was significantly higher than the rest four groups(P<0.05).The serum IFN-γ level of mice in control group and treatment A,B and C group was obviously lower than that of mice in model group(P<0.05).The serum IFN-γ level of mice in treatment A,B and C group were decreased with the increasing of the drug dosage,and the level of C group was obviously lower than that of A and B group(P<0.05).Conclusion:The pseudolaric acid has anti-inflammation and immune adjustment the effects showing a remarkable therapeutic effects for the ACD mice.展开更多
Objective:To explore the effect of bacilli Galmette-Gurin(BCG)-polysaccharide nuceic acid on atopic dermatitis in mice and its mechanism.Methods:Forty NC/Nga mice were selected and randomly divided into Group A(model ...Objective:To explore the effect of bacilli Galmette-Gurin(BCG)-polysaccharide nuceic acid on atopic dermatitis in mice and its mechanism.Methods:Forty NC/Nga mice were selected and randomly divided into Group A(model group),Group B(dexamethasone treatment group),Group C(BCG polysaccharide nucleic acid treatment group) and Group D(control group) with 10 mice in each group.Atopic dermatitis model were constructed by applying 2,4-dinitrochlorobenzene on the skin of the mice.Mice in Group D were treated with acetone solution(100 μ L) on the foot pad and abdomen after hair removal at the age of 7 weeks.then on ear skin at the age of 8-13 weeks.For mice in A,B and C groups,100 μL of acetone solution containing 2,4-dinitrochlorobenzene was applied to the foot pad and the abdomen at the age of 7 weeks,then on ear skins at the age of8 to 13 weeks.At the age of 7-13 weeks,mice in Group A and Group D were treated with 100 μL saline(i.p.);mice were given dexamethasone(0.1 mL/kg,i.p.) every other day for 7 weeks in Group B;mice were treated with BCG polysaccharide nucleic acid(0.5 mg/kg,i.p.) every other day for7 weeks in Group C.The ear thickness was measured every week and the scratching frequency was recorded 1 times for 10 min a week.The mice were sacrificed after the last administration of drugs,IgE,IL-4,IL-10,IL-I2 and IFN- γ in the plasma were detected using ELISA,and RT-PCR method was employed to detect the concentrations of IL-4,IL-10,IL-12 and IFN- γ proteins.After IIK staining,the lesion degree of inflammation in ear tissue was observed microscopically.Results:The ear thickness and scratching frequency of Group A were significantly higher than those in group B,C and D(P<0.05),and there was no significant difference between Group B and C(P>0.05);the concentrations of IgE,IL-4 and IL-10 in the plasma and the expression of IL-4,IL-10 mRNA in the spleen tissues of Group A,B and C were all significantly higher than those of Group D(P<0.05);the concentrations of plasma IL-12 and IFN- γ,and spleen protein expression of IL-12 and IFN- γ in Group C mice were significantly higher than those of Group A(P<0.05).Histological observation showed obvious ear tissue exudation,erythema,swelling,desquamation of skin,and scabbing in Group A.Histopathology of the skin lesion also showed hyperkeratosis,focal-parakeratosis,stratum spinosum hypertrophy,mild sponge-like edema,a large number of lymphocytes along with plasma cell infiltration in dermis,angiectasis and hyperemia in Group A,while degree of ear skin lesion in Group B and D mice was significandy lighter than that of Group A.Conclusions:BCC polysaccharide nucleic acid can significandy reduce the serum IgE concentrations,increase the expression of IL-12,IFN- γ protein,correct the imbalance of Th1/Th2 in atopic dermatitis mice,and has obvious inhibitory effect on atopic dermatitis in NC/Nga mice.展开更多
Rap1 is expressed in human umbilical vein endothelial cells(HUVECs).Rap1-GTPase ac-tivating protein(Rap1GAP),with its specific target,Rap1,has been shown to be important in the regu-lation of many physiological and ce...Rap1 is expressed in human umbilical vein endothelial cells(HUVECs).Rap1-GTPase ac-tivating protein(Rap1GAP),with its specific target,Rap1,has been shown to be important in the regu-lation of many physiological and certain pathological processes.In this study,we investigated the effect of Rap1GAP expression on endothelial cell function,or,more specifically,proliferation and migration of endothelial cells.HUVECs were transfected with pcDNA3.1(empty vector),pcDNA3.1 containing Flag-tagged-Rap1GAP or Myc-tagged-Rap1N17.The proliferation,migration and tube formation were examined and compared among the 3 groups.Expression of Rap1,Rap1GAP,extracellular sig-nal-regulated kinase(ERK),phospho-ERK,Akt,phosphor-Akt was detected by Western blotting.The results showed that the proliferation,migration and tube formation were significantly reduced in Rap1GAP-and Rap1N17-transfected HUVECs as compared with empty vector-transfected control.These changes were coincident with increased expression of Rap1GAP and decreased expression of ac-tivated Rap1,phospho-ERK and-Akt.After treatment of Rap1GAP-transfected HUVECs with a stimu-lator of Rap1 guanine-nucleotide-exchange factor(Rap1GEF)8CPT-2'OMe-cAMP,it was found that Rap1 activity was decreased as compared with empty vector-transfected control.Pretreatment of HUVECs with an ERK inhibitor PD98059 or a PI3K inhibitor LY294002 prior to stimulation not only blocked 8CPT-2'OMe-cAMP-induced phosphorylation of ERK and Akt,but also significantly reduced cell proliferation and migration.Finally,we examined the effect of vascular endothelial growth factor(VEGF)on HUVECs overexpressing Rap1GAP.VEGF-stimulated Rap1 activity,phosphorylation of ERK and Akt,cyclin D1 expression and cell proliferation were repressed in HUVECs overexpressing Rap1GAP as compared to empty vector-transfected control.Taken together,our findings demonstrate that Rap1GAP/Rap1 and their downstream effectors regulate proliferation and migration of HUVECs via ERK and Akt pathways.展开更多
We reviewed a number of wound repair, keloid and hypertrophic scar research methods that included lasers, microcurrent and ultra-low energy technologies. Laser research reports short-term improvement in wounds, keloid...We reviewed a number of wound repair, keloid and hypertrophic scar research methods that included lasers, microcurrent and ultra-low energy technologies. Laser research reports short-term improvement in wounds, keloid and hypertrophic scars, but without follow up to control for reoccurrence of keloids or diabetic lesions which generally reoccur following laser treatments. The microcurrent and ultra-low energy studies demonstrate significant healing where age is not a factor with no reoccurrence of diabetic wounds and other skin lesions. Our randomized, double-blind longitudinal research on eight wound repair clinical cases with an age range of 28 - 86, followed for one year, evidenced accelerated healing and no reoccurrence. The number of treatments required for substantial healing depended on the chronicity and severity of the lesion, with chronic severe lesions requiring more treatments, rather than age, a conclusion supported by ultra-low microcurrent research. These results on age-independent wound healing directly contradict a large body of literature postulating that healing is much slower with age due to immune insufficiency, age-accumulated oxidative stress, disrupted cell communications and sustained inflammation.展开更多
Objective: To investigate the therapeutic potential of adipose-derived stem cells(ADSCs) for limited cutaneous scleroderma(LS) in mouse models,Methods: ADSCs were isolated from pathogen-free female C57BL/6 mice and LS...Objective: To investigate the therapeutic potential of adipose-derived stem cells(ADSCs) for limited cutaneous scleroderma(LS) in mouse models,Methods: ADSCs were isolated from pathogen-free female C57BL/6 mice and LS was induced in wild type(WT) C57BL/6 mice via daily injection of bleomycin(0.1 m L x 300 μg/m L) for 4 weeks; then the ADSCs were subcutaneously injected into the dorsal area in the model treatment group,and 100 μL of phosphate buffered saline(PBS) solution was injected into the same site in the model control group,Green fluorescent protein(GFP) was used to track the cells using an in vivo imaging system on days 7,14,21 and 28 after transplantation,All mice were sacrificed and histologic analyses were performed after 4 weeks,and the skin thickness,collagen deposition and the total content of hydroxyproline were evaluated,Additionally,immunohistochemistry were performed to compare the tissue expression and distribution of TGF-β1 and VEGF between the ADSCs treatment group and the treatment control group,Results: WT C57BL/6 LS mouse model were successfully established and GFP in vivo fluorescence imaging showed that the translated ADSCs survived at the local for at least 4 weeks,Compared with the control group,the ADSCs treatment group significantly attenuated bleomycin-induced dermal fibrosis,reduced the skin thickness and the total content of hydroxyproline(P<0.05),The ADSCs treatment group displayed significantly lower levels of TGF-β1 and higher levels of VEGF than the control group(P<0.05),Conclusions: ADSCs may provide a feasible and practical treatment for autoimmune diseases such as LS and ameliorate dermal fibrosis.展开更多
Stevens-Johnson syndrome (SJS) is a serious and potentially life-threatening disease. Vanishing bile duct syndrome (VBDS) is a rare cause of progressive cholestasis. Both syndromes are mostly related with drugs. We re...Stevens-Johnson syndrome (SJS) is a serious and potentially life-threatening disease. Vanishing bile duct syndrome (VBDS) is a rare cause of progressive cholestasis. Both syndromes are mostly related with drugs. We report a case of a patient with ciprofloxacin-induced SJS and acute onset of VBDS, and reviewed the related literature. It is the fi rst case of ciprofloxacin-induced VBDS successfully treated with tacrolimus. This case reminds physicians of the importance of drug reactions, their severity, techniques for diagnosis and methods of management.展开更多
Non-alcoholic fatty liver disease(NAFLD)is currently considered the most common cause of liver disease.Its prevalence is increasing in parallel with the obesity and type 2 diabetes mellitus(DM2)epidemics in developed ...Non-alcoholic fatty liver disease(NAFLD)is currently considered the most common cause of liver disease.Its prevalence is increasing in parallel with the obesity and type 2 diabetes mellitus(DM2)epidemics in developed countries.Several recent studies have suggested that NAFLD may be the hepatic manifestation of a systemic inflammatory metabolic disease that also affects other organs,such as intestine,lungs,skin and vascular endothelium.It appears that local and systemic proinflammatory/anti-inflammatory cytokine imbalance,together with insulin resistance and changes in the intestinal microbiota,are pathogenic mechanisms shared by NAFLD and other comorbidities.NAFLD is more common in patients with extrahepatic diseases such as inflammatory bowel disease(IBD),obstructive syndrome apnea(OSA)and psoriasis than in the general population.Furthermore,there is evidence that this association has a negative impact on the severity of liver lesions.Specific risk characteristics for NAFLD have been identified in populations with IBD(i.e.age,obesity,DM2,previous bowel surgery,IBD evolution time,methotrexate treatment),OSA(i.e.obesity,DM2,OSA severity,increased transaminases)and psoriasis(i.e.age,metabolic factors,severe psoriasis,arthropathy,elevated transaminases,methotrexate treatment).These specific phenotypes might be used by gastroenterologists,pneumologists and dermatologists to create screening algorithms for NAFLD.Such algorithms should include non-invasive markers of fibrosis used in NAFLD to select subjects for referral to the hepatologist.Prospective,controlled studies in NAFLD patients with extrahepatic comorbidities are required to demonstrate a causal relationship and also that appropriate multidisciplinary management improves these patients’prognosis and survival.展开更多
Chronic graft-vs-host disease(c GVHD) is the leading cause of long-term morbidity and mortality following allogeneic hematopoietic stem cell transplantation. It presents as a chronic inflammatory and sclerotic autoimm...Chronic graft-vs-host disease(c GVHD) is the leading cause of long-term morbidity and mortality following allogeneic hematopoietic stem cell transplantation. It presents as a chronic inflammatory and sclerotic autoimmune-like condition that most frequently affects the skin, oral mucosa, liver, eyes and gastrointestinal tract. Both clinical and animal studies have shown that multiple T cell subsets including Th1, Th2, Th17, T follicular helper cells and regulatory T-cells play some role in cG VHD development and progression; B cells also play an important role in the disease including the production of antibodies to HY and nuclear antigens that can cause serious tissue damage. An array of cytokines and chemokines produced by different types of immune cells also mediate tissue inflammation and damage of cG VHD target tissues such as the skin and oral cavity. Many of these same immune regulators have been studied as candidate cG VHD biomarkers. Recent studies suggest that some of these biomarkers may be useful for determining disease prognosis and planning long-term clinical followup of cG VHD patients.展开更多
Objective: Patients undergoing total gastrectomy for cancer are at risk of malnourishment. The aim of this selfcontrolled study was to examine the effect of jejunostomy tube feeding(JTF) and other factors on postopera...Objective: Patients undergoing total gastrectomy for cancer are at risk of malnourishment. The aim of this selfcontrolled study was to examine the effect of jejunostomy tube feeding(JTF) and other factors on postoperative weight and the incidence of jejunostomy-related complications in patients undergoing total gastrectomy for cancer.Methods: All consecutive patients who underwent total gastrectomy for gastric cancer with jejunostomy placement were included from a prospective single-center database(2003–2014). Jejunostomy-related complications and postoperative weight changes were evaluated up to 12 months after surgery. Multivariable linear regression analysis was performed to identify factors associated with weight loss 12 months after gastrectomy.Results: Of 113 patients operated in the study period, 65 received JTF after total gastrectomy for a median duration of 18 d [interquartile range(IQR), 10–55 d]. Jejunostomy-related complications occurred in 11(17%)patients, including skin leakage(n=3) and peritoneal leakage(n=2), luxation(n=3), occlusion(n=2), infection(n=1)and torsion(n=1). In 2(3%) patients, a reoperation was needed due to jejunostomy-related complications. The mean preoperative weight of patients was 71.8 kg(100%), and remained stable during JTF(73.9 kg, 103%,P=0.331). After JTF was stopped, the mean weight of patients decreased to 64.9 kg(90%) at 12 months after surgery(P<0.001). A high preoperative body mass index(BMI)(≥25 kg/m^2) was associated with high postoperative weight loss compared to patients with a low BMI(<25 kg/m^2)(16.3% vs. 8.6%, P=0.016).Conclusions: JTF can prevent weight loss in the early postoperative phase. However, this is at the prize of possible complications. As weight loss in the long term is not prevented, routine JTF should be re-evaluated and balanced against the selected use in preoperatively malnourished patients. Special attention should be paid to patients with a high preoperative BMI, who are at risk of more postoperative weight loss.展开更多
Objectives: To evaluate audiological and vestibular functions via basic audiological evaluation. otoacoustic emissions and videonystagmography(VNG) in vitiligo patients.Material and methods: 30 vitiligo patients(8 acr...Objectives: To evaluate audiological and vestibular functions via basic audiological evaluation. otoacoustic emissions and videonystagmography(VNG) in vitiligo patients.Material and methods: 30 vitiligo patients(8 acrofacial and 22 mixed types) as the study group and 30 normal healthy adults as the control group were included in the study. All participants were submitted to basic audiological evaluation. transient and distortion product otoacoustic emmisions(TEOAEs and DPOAEs), vestibular assessment including history taking, office tests and videonystagmography(VNG) and dermatological assessment to determine type, percent of body surface area involvement and duration of vitiligo.Results: This study showed statistically significant difference between control and study groups in pure tone audiometry(PTA) and otoacoustic emissions results. Fitfty percent of vitiligo patients had peripheral vestibular disorders(10 vestibulhar neuritis and 5 posterior canal benign paroxysmal positional vertigo.Conclusion: The results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.展开更多
Dermatological conditions are intimately related to stress. There was a great interest in this field in the last years. Stress could be involved as a trigger factor for a lot of cutaneous diseases: alopecia areata, ps...Dermatological conditions are intimately related to stress. There was a great interest in this field in the last years. Stress could be involved as a trigger factor for a lot of cutaneous diseases: alopecia areata, psoriasis, vitiligo, lichen planus, acne, atopic dermatitis, urticaria. For other conditions: seborrheic dermatitis, hyperhydrosis, herpes, pemphigus, a.s.o, there are anecdotal notices. On the other hand, the skin disease itself could induce a secondary stress for the patient, influencing his quality of life. The stress per se is less important than the "perceived stress", the patient's perception of the stressful situation. This perception could be influenced by the psychological state of the patient. Anxiety, depression could change the perception of the event. It is important to take care of these aspects during the consultation. A good cooperation with psychiatrist or/and psychologist could improve the results, besides the specific therapy.展开更多
文摘Approximately 5% 8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED. METHODS: A 5-year retrospective study on patients with dermatological conditions presenting to the Princess Alexandra Hospital ED in Brisbane, Australia was performed. Electronic medical records were used to compare demographics and admission status of the dermatology group and the total ED group presentations. A prospective survey was conducted on low priority triage (triage 4 and 5) patients identifying reasons presenting to the ED. RESULTS: Of a total 281,718 ED presentations, 11,748 dermatology presentations were identified between January 2012 to December 2016. Of the dermatology presentations, 41.5% were female and had an average age of 47. The most common dermatology presentations were cellulitis, abscess, rash unspecified, and ulcer. Of those admitted, 36% were female, average age was 53, mean length of stay of 294 minutes and 83.1% had an infectious aetiology. Of triage 4 and 5 presentations, 66% patients we approached had been seen by a health practitioner prior to coming to the ED. CONCLUSION: Within the population presenting with a skin related condition to the Princess Alexandra Hospital ED, characteristics associated with admission include male sex, older age, and an infectious etiology. This data may help ED clinicians decide on the discharge disposition of these patients. There may be a role for streamlined admissions for skin related infections, or improved hospital in the home services to support this group.
文摘The aging process is a group of degenerative changes that physiologically occur in most of the people in the elderly. This affects one or more of the human body systems. The treatment of diseases related to the aging process has a huge impact on the economy of all nations. Aging of the skin comes on the top and despite that, the results of the already present lines of treatment are not always satisfactory. This acts as a stimulus for us to dig deeper to discover the root causes of the premature aging of the skin. This was simply caused by the accumulation of repeated minute damage to the internal structure skin. In other words, if the degree of minute damage is more than the capacity of the skin to repair, the repeated micro-damage is presented in the long run as a skin wrinkling. Moreover, the skin acts as a mirror that reflects the internal structures of the human body. Thus, the more degenerative changes in the human body systems, the more the skin could become wrinkled. Our strategy to prevent or at least slow down the aging process of the skin depends on 2 main steps;the 1<sup>st</sup> is to reduce the micro-damage as can as possible, and the 2<sup>nd</sup> is to enhance the capacity of tissue regeneration to be able to reverse the already present damaged skin. As the 2 processes are synchronized with each other, this strategy would be considered the ideal for prevention of skin wrinkling especially premature ones. This not only reverses premature skin wrinkling but also protects it from future wrinklings. This review sharply pointed out the role of the functional collagen of the dermal layer of the skin in the prevention of skin wrinklings. Therefore, it would be the target to study how collagen works in the complex machinery of the dermal layer of the skin. This concept deeply believes that the recovery of dermal collagen has a much better effect than simply ingesting collagen or receiving a topical collagen booster. .
文摘Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with fetid maceration. We report the case of a 35-year-old woman who had a painless, malodorous swelling of the cerebriform scalp measuring 20 × 17 cm in diameter with a wide base of insertion at the occipital level adhering to the deep planes. The excision associated with a skin plasty was carried out. Histology concluded that there was a giant cerebriform naevo-cellular nevus of the scalp.
文摘Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effective psychological intervention.Methods:Applied questionnaire survey and used the“questionnaire star”platform to investigate the mental health status of medical staff assisting Ili by the General information,the PHQ-9,the GAD-7 and the SCL-90.And the relevant influencing factors were analyzed by univariate analysis and multiple linear regression analysis.Results:Factors such as whether they will support again,whether they need to provide psychological staff,and whether they have a sense of guilt for their families have a significant impact on the PHQ-9 of medical staff(p<0.05);Whether they will support again,whether they need psychological staff,and whether they feel bored and lonely during the closed loop management have a significant impact on the GAD-7 of medical staff(p<0.05);The SCL-90 was compared with the norm,and the scores of somatization,interpersonal sensitivity and terror factors of medical personnel were statistically significant(p<0.05),scores in other aspects(diet sleep)are obvious(1.63±0.72).Conclusion:During the period of COVID-19,the medical staff in Karamay City who assisted Ili had anxiety and depression,and their mental health was not optimistic,more attention and the necessary intervention should be given.
文摘Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.
文摘Transient acantholytic dermatosis (TAD, Grover disease) is a benign skin disease with a nonspecific rash that may present as a reddish-brown, dermatomal edematous papule or herpetiform rash with a partially central horny plug. This disease is usually self-limiting and can subside within weeks or months, but it may also have a chronic progression with a trend towards long-term recurrence. The patient is an 80-year-old male who visited the clinic due to recurring erythema and blisters all over his body that had been present for over 2 years. Based on the patient’s course, laboratory tests and histopathological findings were consistent with the diagnosis. The final diagnosis was transient acantholytic dermatosis. The patient has a long course of the disease, a wide range of skin lesions and he has the different subtypes of pathological manifestations. This case and corresponding literature review help us have a clear understanding of Grover’s disease, which has received reference value for the diagnosis and treatment of this disease in clinical work.
文摘Aim: The degree of probability to retrieve spermatozoa from testicular tissue for intracytoplasmic sperm injection into oocytes is of interest for counselling of infertility patients. We investigated the relation of sperm retrieval to clinical data and histological pattern in testicular biopsies from azoospermic patients. Methods: In 264 testicular biopsies from 142 azoospermic patients, the testicular tissue was shredded to separate the spermatozoa, histological semi - thin sections of which were then evaluated using Johnsen score. Results: The retrieval of spermatozoa correlated significantly ( P < 0.001 ) with the testicular volume ( r = 0.49), the FSH concentration ( r = - 0.66), the maximum score(r=0.85) and the mean Johnsen score (r= 0.81 ). In the multivariate regression analysis the successful testicular sperm extraction showed the closest relationship to the maximum score. The testicular volume correlated significantly with the mean Johnsen score (r = 0.64, P < 0.00I), and the basal serum FSH concentration mainly with the maximum score ( r = - 0.77; P < 0. 001 ). Patients with a history cryptorchidism showed a significantly lower Johnsen score compared to the patients who did not have any testicular disease in the past (3.7±2.4 vs. 5.9 ±2.5; P <0.01 ). Conclusion: In a limited range, the testicular volume and the FSH concentration in serum were related to the Johnsen score which correlated significantly with the sperm retrieval. The successful sperm retrieval can be expected in all azoospermic patients irrespective of the results of clinical examination. However, the probability of retrieval of spermatozoa decreased significantly in patients with a FSH level > 18 U/L, testicular volume < 5 mL, mean Johnsen score<5, and maximum Johnsen score < 7.
基金Supported by the Science and Technology Key Project of Education Department of Henan province (grant No.:15A320046)
文摘Objective:To study the therapeutic mechanisms of pseudolaric acid on allergic contact dermatitis in mice.Methods:A total of 50 BALB/C mice were selected and randomly divided into control group,model group,and treatment A,B,C groups with 10 rats in each group.ACD model was established in model group,and treatment A,B,C groups but not in control group.Model group received no treatment,but treatment A,B,C groups were treated with external application of the concentration of 0.1%,0.2% and 0.4% of the pseudolaric acid for the lesions of ear skin.And the weight gain and the swelling degree of the mice' ear were recorded,weight of thymus and spleen were measured.Spleen suspension was prepared to test T lymphocyte and B lymphocyte levels of mice in five groups.Changes in serum IFN-ed through the enzyme linked immunosorbent assay(ELISAγ,IL-4 and IL-10 levels were test).Results:The weight gain of mice in model group were significant lower than those of mice in the control group and the treatment A,B,C groups(P<0.05).Weight gain of mice in treatment A,B groups were significant lower than that of control group(P<0.05),but the difference in weight gain between treatment C group and control group showed no significant difference(P>0.05).The swelling degree and the weight of mice ears in model group were significant higher than those of mice in control group and treatment A,B,C groups(P<0.05).Swelling degree and the weight of mice ears of treatment A,B,C groups were obviously higher than that of control group(P<0.05).The swelling degree and weight of mice' ears in treatment A,B,C groups were decreased with the increase of the drug dosage,but comparison between A,B and C group showed statistically differences(P<0.05).The thymus and spleen index of mice in model group were significant higher than those of the other four groups(P<0.05),among the four groups,thymus and spleen index of treatment A and B group were higher than control group and treatment C group(P<0.05).The stimulation index of T and B cells of mice in model group was significantly higher than the rest four groups(P<0.05).The serum IFN-γ level of mice in control group and treatment A,B and C group was obviously lower than that of mice in model group(P<0.05).The serum IFN-γ level of mice in treatment A,B and C group were decreased with the increasing of the drug dosage,and the level of C group was obviously lower than that of A and B group(P<0.05).Conclusion:The pseudolaric acid has anti-inflammation and immune adjustment the effects showing a remarkable therapeutic effects for the ACD mice.
文摘Objective:To explore the effect of bacilli Galmette-Gurin(BCG)-polysaccharide nuceic acid on atopic dermatitis in mice and its mechanism.Methods:Forty NC/Nga mice were selected and randomly divided into Group A(model group),Group B(dexamethasone treatment group),Group C(BCG polysaccharide nucleic acid treatment group) and Group D(control group) with 10 mice in each group.Atopic dermatitis model were constructed by applying 2,4-dinitrochlorobenzene on the skin of the mice.Mice in Group D were treated with acetone solution(100 μ L) on the foot pad and abdomen after hair removal at the age of 7 weeks.then on ear skin at the age of 8-13 weeks.For mice in A,B and C groups,100 μL of acetone solution containing 2,4-dinitrochlorobenzene was applied to the foot pad and the abdomen at the age of 7 weeks,then on ear skins at the age of8 to 13 weeks.At the age of 7-13 weeks,mice in Group A and Group D were treated with 100 μL saline(i.p.);mice were given dexamethasone(0.1 mL/kg,i.p.) every other day for 7 weeks in Group B;mice were treated with BCG polysaccharide nucleic acid(0.5 mg/kg,i.p.) every other day for7 weeks in Group C.The ear thickness was measured every week and the scratching frequency was recorded 1 times for 10 min a week.The mice were sacrificed after the last administration of drugs,IgE,IL-4,IL-10,IL-I2 and IFN- γ in the plasma were detected using ELISA,and RT-PCR method was employed to detect the concentrations of IL-4,IL-10,IL-12 and IFN- γ proteins.After IIK staining,the lesion degree of inflammation in ear tissue was observed microscopically.Results:The ear thickness and scratching frequency of Group A were significantly higher than those in group B,C and D(P<0.05),and there was no significant difference between Group B and C(P>0.05);the concentrations of IgE,IL-4 and IL-10 in the plasma and the expression of IL-4,IL-10 mRNA in the spleen tissues of Group A,B and C were all significantly higher than those of Group D(P<0.05);the concentrations of plasma IL-12 and IFN- γ,and spleen protein expression of IL-12 and IFN- γ in Group C mice were significantly higher than those of Group A(P<0.05).Histological observation showed obvious ear tissue exudation,erythema,swelling,desquamation of skin,and scabbing in Group A.Histopathology of the skin lesion also showed hyperkeratosis,focal-parakeratosis,stratum spinosum hypertrophy,mild sponge-like edema,a large number of lymphocytes along with plasma cell infiltration in dermis,angiectasis and hyperemia in Group A,while degree of ear skin lesion in Group B and D mice was significandy lighter than that of Group A.Conclusions:BCC polysaccharide nucleic acid can significandy reduce the serum IgE concentrations,increase the expression of IL-12,IFN- γ protein,correct the imbalance of Th1/Th2 in atopic dermatitis mice,and has obvious inhibitory effect on atopic dermatitis in NC/Nga mice.
基金supported by grants from the National Natural Science Foundation of China(No.30971207)Natural Science Foundation of Hubei Province,China(No.2009CBD-386)
文摘Rap1 is expressed in human umbilical vein endothelial cells(HUVECs).Rap1-GTPase ac-tivating protein(Rap1GAP),with its specific target,Rap1,has been shown to be important in the regu-lation of many physiological and certain pathological processes.In this study,we investigated the effect of Rap1GAP expression on endothelial cell function,or,more specifically,proliferation and migration of endothelial cells.HUVECs were transfected with pcDNA3.1(empty vector),pcDNA3.1 containing Flag-tagged-Rap1GAP or Myc-tagged-Rap1N17.The proliferation,migration and tube formation were examined and compared among the 3 groups.Expression of Rap1,Rap1GAP,extracellular sig-nal-regulated kinase(ERK),phospho-ERK,Akt,phosphor-Akt was detected by Western blotting.The results showed that the proliferation,migration and tube formation were significantly reduced in Rap1GAP-and Rap1N17-transfected HUVECs as compared with empty vector-transfected control.These changes were coincident with increased expression of Rap1GAP and decreased expression of ac-tivated Rap1,phospho-ERK and-Akt.After treatment of Rap1GAP-transfected HUVECs with a stimu-lator of Rap1 guanine-nucleotide-exchange factor(Rap1GEF)8CPT-2'OMe-cAMP,it was found that Rap1 activity was decreased as compared with empty vector-transfected control.Pretreatment of HUVECs with an ERK inhibitor PD98059 or a PI3K inhibitor LY294002 prior to stimulation not only blocked 8CPT-2'OMe-cAMP-induced phosphorylation of ERK and Akt,but also significantly reduced cell proliferation and migration.Finally,we examined the effect of vascular endothelial growth factor(VEGF)on HUVECs overexpressing Rap1GAP.VEGF-stimulated Rap1 activity,phosphorylation of ERK and Akt,cyclin D1 expression and cell proliferation were repressed in HUVECs overexpressing Rap1GAP as compared to empty vector-transfected control.Taken together,our findings demonstrate that Rap1GAP/Rap1 and their downstream effectors regulate proliferation and migration of HUVECs via ERK and Akt pathways.
文摘We reviewed a number of wound repair, keloid and hypertrophic scar research methods that included lasers, microcurrent and ultra-low energy technologies. Laser research reports short-term improvement in wounds, keloid and hypertrophic scars, but without follow up to control for reoccurrence of keloids or diabetic lesions which generally reoccur following laser treatments. The microcurrent and ultra-low energy studies demonstrate significant healing where age is not a factor with no reoccurrence of diabetic wounds and other skin lesions. Our randomized, double-blind longitudinal research on eight wound repair clinical cases with an age range of 28 - 86, followed for one year, evidenced accelerated healing and no reoccurrence. The number of treatments required for substantial healing depended on the chronicity and severity of the lesion, with chronic severe lesions requiring more treatments, rather than age, a conclusion supported by ultra-low microcurrent research. These results on age-independent wound healing directly contradict a large body of literature postulating that healing is much slower with age due to immune insufficiency, age-accumulated oxidative stress, disrupted cell communications and sustained inflammation.
文摘Objective: To investigate the therapeutic potential of adipose-derived stem cells(ADSCs) for limited cutaneous scleroderma(LS) in mouse models,Methods: ADSCs were isolated from pathogen-free female C57BL/6 mice and LS was induced in wild type(WT) C57BL/6 mice via daily injection of bleomycin(0.1 m L x 300 μg/m L) for 4 weeks; then the ADSCs were subcutaneously injected into the dorsal area in the model treatment group,and 100 μL of phosphate buffered saline(PBS) solution was injected into the same site in the model control group,Green fluorescent protein(GFP) was used to track the cells using an in vivo imaging system on days 7,14,21 and 28 after transplantation,All mice were sacrificed and histologic analyses were performed after 4 weeks,and the skin thickness,collagen deposition and the total content of hydroxyproline were evaluated,Additionally,immunohistochemistry were performed to compare the tissue expression and distribution of TGF-β1 and VEGF between the ADSCs treatment group and the treatment control group,Results: WT C57BL/6 LS mouse model were successfully established and GFP in vivo fluorescence imaging showed that the translated ADSCs survived at the local for at least 4 weeks,Compared with the control group,the ADSCs treatment group significantly attenuated bleomycin-induced dermal fibrosis,reduced the skin thickness and the total content of hydroxyproline(P<0.05),The ADSCs treatment group displayed significantly lower levels of TGF-β1 and higher levels of VEGF than the control group(P<0.05),Conclusions: ADSCs may provide a feasible and practical treatment for autoimmune diseases such as LS and ameliorate dermal fibrosis.
文摘Stevens-Johnson syndrome (SJS) is a serious and potentially life-threatening disease. Vanishing bile duct syndrome (VBDS) is a rare cause of progressive cholestasis. Both syndromes are mostly related with drugs. We report a case of a patient with ciprofloxacin-induced SJS and acute onset of VBDS, and reviewed the related literature. It is the fi rst case of ciprofloxacin-induced VBDS successfully treated with tacrolimus. This case reminds physicians of the importance of drug reactions, their severity, techniques for diagnosis and methods of management.
文摘Non-alcoholic fatty liver disease(NAFLD)is currently considered the most common cause of liver disease.Its prevalence is increasing in parallel with the obesity and type 2 diabetes mellitus(DM2)epidemics in developed countries.Several recent studies have suggested that NAFLD may be the hepatic manifestation of a systemic inflammatory metabolic disease that also affects other organs,such as intestine,lungs,skin and vascular endothelium.It appears that local and systemic proinflammatory/anti-inflammatory cytokine imbalance,together with insulin resistance and changes in the intestinal microbiota,are pathogenic mechanisms shared by NAFLD and other comorbidities.NAFLD is more common in patients with extrahepatic diseases such as inflammatory bowel disease(IBD),obstructive syndrome apnea(OSA)and psoriasis than in the general population.Furthermore,there is evidence that this association has a negative impact on the severity of liver lesions.Specific risk characteristics for NAFLD have been identified in populations with IBD(i.e.age,obesity,DM2,previous bowel surgery,IBD evolution time,methotrexate treatment),OSA(i.e.obesity,DM2,OSA severity,increased transaminases)and psoriasis(i.e.age,metabolic factors,severe psoriasis,arthropathy,elevated transaminases,methotrexate treatment).These specific phenotypes might be used by gastroenterologists,pneumologists and dermatologists to create screening algorithms for NAFLD.Such algorithms should include non-invasive markers of fibrosis used in NAFLD to select subjects for referral to the hepatologist.Prospective,controlled studies in NAFLD patients with extrahepatic comorbidities are required to demonstrate a causal relationship and also that appropriate multidisciplinary management improves these patients’prognosis and survival.
文摘Chronic graft-vs-host disease(c GVHD) is the leading cause of long-term morbidity and mortality following allogeneic hematopoietic stem cell transplantation. It presents as a chronic inflammatory and sclerotic autoimmune-like condition that most frequently affects the skin, oral mucosa, liver, eyes and gastrointestinal tract. Both clinical and animal studies have shown that multiple T cell subsets including Th1, Th2, Th17, T follicular helper cells and regulatory T-cells play some role in cG VHD development and progression; B cells also play an important role in the disease including the production of antibodies to HY and nuclear antigens that can cause serious tissue damage. An array of cytokines and chemokines produced by different types of immune cells also mediate tissue inflammation and damage of cG VHD target tissues such as the skin and oral cavity. Many of these same immune regulators have been studied as candidate cG VHD biomarkers. Recent studies suggest that some of these biomarkers may be useful for determining disease prognosis and planning long-term clinical followup of cG VHD patients.
文摘Objective: Patients undergoing total gastrectomy for cancer are at risk of malnourishment. The aim of this selfcontrolled study was to examine the effect of jejunostomy tube feeding(JTF) and other factors on postoperative weight and the incidence of jejunostomy-related complications in patients undergoing total gastrectomy for cancer.Methods: All consecutive patients who underwent total gastrectomy for gastric cancer with jejunostomy placement were included from a prospective single-center database(2003–2014). Jejunostomy-related complications and postoperative weight changes were evaluated up to 12 months after surgery. Multivariable linear regression analysis was performed to identify factors associated with weight loss 12 months after gastrectomy.Results: Of 113 patients operated in the study period, 65 received JTF after total gastrectomy for a median duration of 18 d [interquartile range(IQR), 10–55 d]. Jejunostomy-related complications occurred in 11(17%)patients, including skin leakage(n=3) and peritoneal leakage(n=2), luxation(n=3), occlusion(n=2), infection(n=1)and torsion(n=1). In 2(3%) patients, a reoperation was needed due to jejunostomy-related complications. The mean preoperative weight of patients was 71.8 kg(100%), and remained stable during JTF(73.9 kg, 103%,P=0.331). After JTF was stopped, the mean weight of patients decreased to 64.9 kg(90%) at 12 months after surgery(P<0.001). A high preoperative body mass index(BMI)(≥25 kg/m^2) was associated with high postoperative weight loss compared to patients with a low BMI(<25 kg/m^2)(16.3% vs. 8.6%, P=0.016).Conclusions: JTF can prevent weight loss in the early postoperative phase. However, this is at the prize of possible complications. As weight loss in the long term is not prevented, routine JTF should be re-evaluated and balanced against the selected use in preoperatively malnourished patients. Special attention should be paid to patients with a high preoperative BMI, who are at risk of more postoperative weight loss.
文摘Objectives: To evaluate audiological and vestibular functions via basic audiological evaluation. otoacoustic emissions and videonystagmography(VNG) in vitiligo patients.Material and methods: 30 vitiligo patients(8 acrofacial and 22 mixed types) as the study group and 30 normal healthy adults as the control group were included in the study. All participants were submitted to basic audiological evaluation. transient and distortion product otoacoustic emmisions(TEOAEs and DPOAEs), vestibular assessment including history taking, office tests and videonystagmography(VNG) and dermatological assessment to determine type, percent of body surface area involvement and duration of vitiligo.Results: This study showed statistically significant difference between control and study groups in pure tone audiometry(PTA) and otoacoustic emissions results. Fitfty percent of vitiligo patients had peripheral vestibular disorders(10 vestibulhar neuritis and 5 posterior canal benign paroxysmal positional vertigo.Conclusion: The results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.
文摘Dermatological conditions are intimately related to stress. There was a great interest in this field in the last years. Stress could be involved as a trigger factor for a lot of cutaneous diseases: alopecia areata, psoriasis, vitiligo, lichen planus, acne, atopic dermatitis, urticaria. For other conditions: seborrheic dermatitis, hyperhydrosis, herpes, pemphigus, a.s.o, there are anecdotal notices. On the other hand, the skin disease itself could induce a secondary stress for the patient, influencing his quality of life. The stress per se is less important than the "perceived stress", the patient's perception of the stressful situation. This perception could be influenced by the psychological state of the patient. Anxiety, depression could change the perception of the event. It is important to take care of these aspects during the consultation. A good cooperation with psychiatrist or/and psychologist could improve the results, besides the specific therapy.
