Objective Investigate the influence of Qingbi decoction(QB-D)and S1PR5 signal on the biological functions of sphingosine-1-phosphate(S1P)-induced human immortalized keratinocytes(HaCaT)in vitro experiments,and discuss the possible treatment mechanism of QB-D for psoriasis on ke-ratinocytes.Methods Lipopolysaccharides(LPS)(1 μg/mL,24 hours)was used to stimulate HaCaT,S1P content in the supernatant was detected by ELISA,and S1PRs receptor mRNA transcription level was detected by q-PCR to screen the hyper-specific S1P/S1PR5 pathway.CCK-8 was used to detect activity of cell,q-PCR was used to detect mRNA expression of IL-17 and IL-23,in order to select appropriate S1P treatment concentration and time for modeling,the inhibition of QB-D on S1PR5 protein expression was detected by Western blot(WB),S1PR5 protein expression was detected by WB,and efficient siRNA was screened to construct S1PR5 gene defect model.Cells was divided into negative control group(PBS+NC siRNA),S1P inflammation model group(S1P+PBS+NC siRNA),QB-D processing group(S1P+QB-D+ NC siRNA),S1PR5 gene defect group(S1P+PBS+S1PR5 SiRNA)and QB-D processing S1PR5 genetic defect group(S1P+QB-D+S1PR5 siRNA group).The cell mobility was detected by scratch experiments,interleukin(IL)-36γ secretion in the supernatant was detected by EILSA,and the expressions of nuclear factor-kappa B(NF-κB)pathway related proteins,such as IκBα,IKK,p-IKK,p65,p-p65 in the cell were detected by WB.Results Compared with normal cells,the content of supernatant S1P in HaCaT psoriatic inflammatory model cells stimulated by LPS was significantly increased(P＜0.01),and the mRNA expression of S1PR5 was the most significantly increased(P＜0.01).S1P at 0.5 μmol/L for 48 hours was selected as an inflammatory modeling scheme,QB-D lyophilized powder solution could significantly inhibit the high expression of S1PR5 protein caused by S1P(P＜0.01).Compared with the Negative control group,the S1P inflammation model group enhanced the migration ability of HaCaT,up-regulated the concentration of IL-36γ in supernatant,and improved the expression of S1PR5,p-IKK and p-p65 in the cell(P＜0.01),while no significant changes were found in the expressions of IκBα,IKK and p65.Compared with the S1P inflammation model group,the migration ability of HaCaT cells in the QB-D processing group,the S1PR5 gene defect group and the QB-D processing S1PR5 genetic defect group significantly were reduced,IL-36γ secretion and expression of p-IKK,p-p65 in the cell were significantly decreased(P＜0.01),while IκBα,IKK,p65 had no significant changes.However,the changes of IL-36γ,p-ikK and p-p65 in the QB-D processing S1PR5 genetic defect group were more significant than those in the other two groups(P＜0.01).Conclusion Qingbi decoction can inhibit HaCaT cell migration and IL-36γ secretion,and truncate NF-κB pathway signaling by partially blocking the combination of S1P with S1PR5,in order to interfer with inflammatory response.

OBJECTIVE To evaluate the clinical efficacy and safety of external application of Chinese herbal medicine (ex-CHM) for psoriasis vulgaris (PV). METHODS Different search portals, including the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang, SinoMed, clinicaltrials, PubMed, Cochrane Library, and Cochrane Central Register of Controlled Trials, were searched for randomized controlled trials (RCTs) that compared the ex-CHM intervention with other treatment protocols for PV, with available data as of November 25, 2020. The Review Manager 5.3 software was used for analysis. RESULTS Nineteen RCTs involving 1988 participants were included, of which twelve RCTs qualified for the Meta-analysis. The results showed that the addition of CHM bath to narrow-band ultraviolet B (NB-UVB) had a higher response rate [RR = 1.29; 95% CI (1.19, 1.40); P < 0.000 01]; lower psoriasis area severity index (PASI) [MD = -3.15; 95% CI (-4.79, -1.52); P = 0.000 2)], adverse reactions rate [RR = 0.32; 95% CI (0.15, 0.66); P = 0.002], and recurrence rate [RR = 0.48; 95% CI (0.30, 0.79); P=0.004] than NB-UVB alone. The addition of CHM fumigation to NB-UVB also showed a higher response rate [RR = 1.29; 95% CI (1.11, 1.49); P = 0.000 7] and lower adverse reactions rate [RR = 0.44; 95% CI (0.24, 0.79); P=0.006]. In addition, CHM bath could reduce the adverse reactions induced by 308 nm excimer laser and improve patients' quality of life better than phototherapy. CHM fumigation could improve the efficacy of calcipotriol ointment and reduce the adverse reactions. CHM fumigation combined with external washing plus acitretin showed better results than using acitretin alone. No statistical difference was observed between CHM external washing and calcipotriol ointment or CHM ointment and retinoic acids. CONCLUSIONS Current evidence showed that CHM bath and fumigation appeared to be efficient and safe for PV treatment. However, no definite conclusion could be drawn due to the low quality of included studies and thus more well-designed studies are needed for further assessment.

Background Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr) is a rare subtype of DEB, characterized by recurrent pruritus of the extremities, pruritus papules, nodules, and mossy-like plaques. To date, fewer than 100 cases have been reported. We report a misdiagnosed 30-year-old man with sporadic late-onset DEB-Pr who responded well to tacrolimus treatment, thereby serving as a guide to correct diagnosis and treatment. Case summary A 30-year-old man presented with recurrent itching plaques of 1-year duration in the left tibia that aggravated and involved both legs and the back. Examination revealed multiple symmetrical, purple, and hyperpigmented papules and nodules with surface exfoliation involving the tibia and dorsum of the neck with negative Nissl's sign, no abnormalities in the skin, mucosa, hair, or fingernail, and no local lymph node enlargement. Blisters were never reported prior to presentation. Serum immunoglobulin E level was 636 IU/mL. Clinical manifestations suggested DEB-Pr. Histological examination showed subepidermal fissure, scar tissue, and milia. Direct immunofluorescence showed no obvious abnormalities. However, we were unable to perform electron microscopy or genetic research following his choice. We treated him with topical tacrolimus. After 2 wk, the itching alleviated, and the skin lesions began to subside. No adverse reactions were observed during treatment. Conclusion Topical tacrolimus is a safe treatment option for patients with DEB-Pr and can achieve continuous relief of severe itching.

目的 系统评价中药熏蒸治疗寻常型银屑病的临床疗效及安全性.方法 计算机检索CNKI、VIP、WanFang、SinoMed、PubMed、Cochrane Library and CENTRAL、Embase等数据库,从建库至2020年11月5日,获取中药熏蒸对比其他疗法治疗寻常型银屑病的随机对照临床试验.使用Cochrane偏倚风险评估方法评价纳入研究的质量,应用RevMan5.3软件进行统计分析.结果 共纳入11篇RCT,共计1367例患者.Meta分析结果显示:联用中药熏蒸组的有效率高于窄谱中波紫外线(NB-UVB)组(RR=1.31,95％ CI 1.20～1.42,P＜0.00001)、西药外用组(RR =5.00,95％CI 2.13 ～ 11.75,P=0.0002)以及中药口服组(RR=1.37,95％CI 1.20～1.56,P＜0.00001),差异均有统计学意义(P＜0.05).联用中药熏蒸组的PASI评分、不良反应发生率与中药口服组相比,差异无统计学意义,但均低于NB-UVB组及西药外用组(P＜0.05).结论 中药熏蒸治疗寻常型银屑病在提高疗效、改善皮损严重程度方面具有一定的优势,且安全性高.

目的:观察凉血五花汤治疗面部皮炎的临床效果,及其对白介素4、白介素13、CD4、CD8、经皮水分丢失值的影响.方法:中药组采用凉血五花汤加减联合外用氧化锌软膏治疗两周,对照组采用盐酸西替利嗪口服联合外用氧化锌软膏.分别于初诊和第二周进行皮损形态及瘙痒积分标准判定.中药组进一步进行皮肤屏障功能检测、T细胞亚群、IL-4、IL-13血清学检测.结果:48例患者皮损积分明显下降(P＜0.05),对照组总有效率67％,中药组总有效率79％,经皮水分丢失明显下降(P＜0.05),CD3+CD4+、CD3+CD8+治疗后稍升高无统计学意义(P＞0.05),IL-4、IL-13治疗后稍下降无统计学意义(P＞0.05),治疗前CD4与IL-4、IL-13有直线相关性(P＜0.05).结论:凉血五花汤加减联合氧化锌软膏外用治疗面部过敏性皮炎患者,具有显著临床疗效,可以降低经皮水分丢失值,改善皮肤屏障功能,可能使CD4升高或IL-4、IL-13降低,从而破坏CD4与IL-4、IL-13的平衡关系.

Objective:To observe the differences between blood heat syndrome,blood dryness syndrome and blood stasis syndrome of psoriasis in JAK/STAT signaling pathways.Methods:A total of 18 psoriasis cases in our hospital were divided into 3 groups based on TCM syndrome differentiation.The three groups were blood heat syndrome group,blood dryness syndrome group and blood stasis syndrome group.And 6 healthy participants also participated in the trail.Their general information was recorded.RTPCR was employed to test the difference of IL-22R1,JAK1,STAT3 and c-myc in participants' skin tissue samples.Results:The gene transcription correlation test among 24 psoriasis patients show that 1L-22R1,JAK1,STAT3 and c-myc were all positively correlated to each other (P ＜ 0.05 or P ＜ 0.01).The gene transcriptions of IL-22R1,JAK1,STAT3 and c-myc in blood heat group were significantly higher than healthy case group (P ＜ 0.01).In blood dryness group,gene transcription of IL-22R1,JAK1 and STAT3 were higher than healthy group (P ＜ 0.05).Conclusion:The active status of JAK/STAT signaling pathway could be an important factor in the formation of psoriasis blood heat syndrome.While the JAK/STAT signaling pathway may result in blood heat syndrome turning into blood dryness syndrome and blood stasis syndrome.

目的:探索应用聚类分析及主成分分析方法研究糖尿病肾病(DN)中医四诊信息特征.方法:采集120例2014年3月-2015年2月收治的明确诊断DN的120例患者中医证候信息,在线录入,建立数据库,运用聚类分.析、主成分分析探索性研究其四诊信息特征.结果:经聚类分析及主成分分析后,将DN分为4类:气阴两虚证、热盛气滞血瘀兼气虚证、血虚兼阴虚气滞证、湿热兼血虚阳虚证.结论:应用聚类分析及主成分分析研究方法能够在一定程度上反映DN的中医四诊信息特征.

目的:观察复方青黛胶囊联合舒肝颗粒治疗寻常型银屑病(血热证)患者的临床疗效及疾病严重程度、生活质量的变化.方法:以2家三级甲等中医院皮肤科门诊54例银屑病患者为研究对象,治疗组口服复方青黛胶囊、舒肝颗粒,对照组用复方青黛胶囊观察治疗前后疾病信息即皮损面积和严重程度指数及生活质量的变化.结果:临床结果显示治疗组总有效率88.33％,对照组总有效率66.67％,治疗组对寻常型银屑病(血热证)有效率高于对照组,经统计学分析差异有统计学意义.结论:复方青黛胶囊联合舒肝颗粒治疗寻常型银屑病(血热证)疗效优于单独应用复方青黛胶囊.

Chinese medicine is different from Western medicine in terms of understanding human physiology and pathology and diagnosing and treating disease. Different theoretical systems and thinking modes of the two often cause various puzzles among undergraduate beginners. In clinical teaching, teachers should not only solve students ’ puzzles in theory, but also combine with clinical research case to guide them to understand the relationship between Chinese medicine and Western medicine. They both take human body as object of study. There is no“one or the other”relation of them. The teachers should encourage their students to make the best of the two medical systems so as to lay a solid foundation for in-depth study.

Previously there were not enough attention to teaching jobs about experimental diagnosis in TCM colleges, and the teaching effect was not ideal. The article intended to explore the teaching experience of laboratory diagnostics in TCM colleges. From 7 aspects which are the importance of medical ethics education of humanities, differences of Chinese and western thinking mode, logical thinking training method, teaching methods improvement, how to skill training, quality control and scientific research ability training, the author communicates the teaching experiences. The author thinks that we should strengthen the medical ethics education of humanities, the analysis of Chinese and western thinking mode and strengthen the logical thinking training, using a variety of teaching methods, attaches great importance to the skills of operating concept, strengthening the quality control and improving scientific research ability. Attaching importance to the principle and method in the college experimental teaching in traditional Chinese medicine diagnostics, and it is important for students to mastering basic medical skills and promoting modern science literacy.

目的:探讨慢性萎缩性胃炎(CAG)脾虚血瘀证与pEGFR-ACAP4-ARF6的相关性.方法:收集经电子胃镜及病理检测确诊为CAG、并经中医辨证为脾虚血瘀证患者35例和脾胃湿热证患者44例,运用免疫组织化学的方法检测患者胃黏膜pEGFR、ACAP4及ARF6的表达,分析胃黏膜病理及中医证型与pEGFR-ACAP4-ARF6表达的相关性.结果:胃黏膜pEGFR-ACAP4-ARF6在脾虚血瘀证患者的胃黏膜表达高于脾胃湿热证患者(P＜0.05),同时在CAG合并异型增生(DYS)患者胃黏膜的表达水平高于CAG不合并DYS患者(P＜0.05).结论:pEGFR-ACAP4-ARF6可能是CAG脾虚血瘀证的部分内在物质基础,在CAG疾病进展中发挥一定作用.

Objective To explore the correlation of chronic atrophic gastritis( CAG) with Hp infection of spleen and stomach damp heat pattern /syndrome with cytotoxin- associated gene- a( Cag A),cyclooxygenase 2( Cox- 2) and gastric mucosa disorder. Methods Seventy cases of CAG,diagnosed via Hp determination,gastroscope and pathological examination were included. There were 30 cases for each of Hp positive and spleen and stomach damp heat pattern /syndrome and of Hp positive and spleen and stomach deficiency cold pattern /syndrome. Ten cases of Hp negative were included in the negative control group. ELISA was adopted to determine serum Cag A and Cox- 2 expressions. In association with pathological results,Cag A positive rate,Cox- 2 expression level and gastric mucosa disorder were compared and analyzed among groups. Results In CAG plus Hp infection spleen and stomach damp heat group,Cag A positive rate and serum Cox- 2 expression were higher than those in spleen and stomach deficiency cold group,and the results in the two groups were all higher than those in Hp negative group,indicating the significant difference( P 0. 05). The difference in gastric mucosa disorder severity was not significant between spleen and stomach damp heat group and the spleen and stomach deficiency cold group( P 0. 05),but the condition was mild in tendency in the spleen and stomach damp heat group. Conclusion Cag A and Cox- 2 are possibly involved in the formation of spleen and stomach damp heat pattern /syndrome in the patients of CAG and Hp infection.The spleen and stomach damp heat pattern /syndrome plays the important role in the early progression of CAG with Hp infection,which provides a certain evidence on the exploration of the effect mechanism of spleen and stomach damp heat pattern /syndrome in the progression of CAG.

Objective To discuss the relationship between Blood Stagnation in Gastric and cyclooxygenase-2(Cox-2) as well as pathology in chronic atrophic gastritis(CAG).Method 60 CAG patients made definitely diagnosis by electronic gastroscopy and pathological examination were divided into two groups. One group is 30 patients of Blood Stagnation in Gastric, and the other group is 30 patients of deficiency in the spleen and stomach with cold manifestations. The serum Cox-2 of patients was detected by enzyme-linked immunosorbent assay(ELISA). Then analysis the serum Cox-2 as well as pathology differences between the two groups.Results Compared with the spleen and stomach with cold manifestations group, the serum Cox-2 is higher and the gastric pathology grade is more serious in Blood Stagnation in Gastric group(P<0.05).Conclusion There are some relationships between Blood Stagnation in Gastric and Cox-2 as well as pathology in chronic atrophic gastritis,which may provide a certain basis for treatment of CAG by activating blood circulation.

Objective To observe the influences of Jiawei Zhizhu Granules on the levels of orexin and leptin in the patients with cancer-related anorexia. Methods The patients (n=115) were randomly divided into treatment group (n=58) and control group (n=57). The treatment group was orally given Jiawei Zhizhu Granules for 4 weeks and control group, Megestrol Acetate Tablets for 4 weeks. The changes of the levels of orexin and leptin were observed before and after treatment. Results The level of leptin decreased in two groups after treatment (P<0.05). The D-value was not significant in two groups before and after treatment (P>0.05), and the curative effect was similar between two groups. The level of orexin increased in two groups after treatment (P<0.05). The D-value was not statistically significant in two groups before and after treatment (P>0.05), and the curative effect was similar between two groups. Conclusion Jiawei Zhizhu Granules and Megestrol Acetate Tablets all can reduce the level of leptin and raise the level of orexin in the patients with cancer-related anorexia.

小胶质细胞作为中枢神经系统的主要免疫细胞参与多种常见脑病,如缺血性中风、阿尔茨海默病和帕金森病的病理过程,激活的小胶质细胞构成中枢神经系统疾病共同的病理基础.并探讨小胶质细胞在常见脑病中的神经破坏作用机制及中药对其激活的抑制作用.

Objective: To probe into distribution characteristics of TCM syndromes and syndrome essential factors of reflux esophagitis through literature study.Methods: An extensive search including CBM,CNKI,Wanfang and VIP databases was performed up to September 2011 for literatures about reflux esophagitis of TCM,to summarize syndrome types,then to extract syndrome essential factors of it.Results: 37 documents were included in this review,3 078 cases were reported and 26 syndrome types were related to reflux esophagitis,most common syndrome types were stagnated heat of liver and stomach and incoordination between liver and stomach;16 syndrome essential factors were extracted,the main location factors were stomach,liver and spleen;heat,qi stagnation,phlegm and dampness were the main excess factors;the frequency of yang deficiency and yin deficiency was higher in deficiency factors.Conclusions: The main syndrome types of reflux esophagitis are stagnated heat of liver and stomach and incoordination between liver and stomach.Stomach,liver and spleen are the main locations of the disease,and excess syndromes are the most common.

Objective:To investigate the distribution characteristic of common TCM syndrome and syndrome factors of peptic ulcer.Methods: We retrieved literatures about peptic ulcer from CNKI and VIP bibliographic databases,then built a database.Finally,we made use of SPSS17.0 to analyze the frequency of TCM syndrome types and syndrome factors.Results:The common syndrome types were incoordination between the liver and stomach,deficient cold of spleen and stomach、stomach yin deficiency、static blood in stomach collaterals、stagnated heat of liver and stomach etc.The common syndrome elements of disease location were stomach、spleen、liver and stomach collateral,and the common syndrome elements of disease character were qi stagnation、heat、yang deficiency、blood static、qi deficiency、yin deficiency、qi depression、dampness.Conclusions:The distribution of TCM syndrome types of peptic ulcer was scattered,and differentiation of syndrome elements could cover the most of clinical syndromes to standardize clinical identification better.