盐酸氨酮戊酸光动力治疗外阴硬化性苔藓的疗效观察

目的探讨盐酸氨酮戊酸光动力(ALA-PDT)治疗外阴硬化性苔藓(LS)的疗效及安全性。方法选取40例经病理检查确诊为外阴硬化性苔藓的患者,随机分为实验组和对照组,每组各20例,实验组采用20%ALA-PDT,每2周治疗1次,治疗6次。对照组局部外用0.1%他克莫司软膏,2次/d,治疗3个月,观察两组治疗效果和不良反应。结果两组均完成19例,治疗后,实验组总有效率为89.47%(17/19),对照组总有效率为78.95%(15/19),两组疗效比较差异有统计学意义(P<0.05)。实验组的皮损面积(2.89±3.25)cm^2、白斑(1.67±1.21)、瘙痒(0.87±1.32)、症状/体征总分(7.64±5.63)分与对照组皮损面积(4.15±3.04)cm^2、白斑(2.98±1.05)、瘙痒(1.45±1.24)、症状/体征总分(9.72±6.47)分,组间比较差异有统计学意义(P<0.05)。两组均未见明显的不良反应发生。结论ALA-PDL治疗LS疗效高且安全性好。

Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing: A prospective serial study

AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.

Detection of Genetically Modified Crops by Combination of Multiplex PCR and Low-density DNA Microarray

Objective To develop a technique for simultaneous detection of various target genes in Roundup Ready soybean by combining multiplex PCR and low-density DNA microarray. Methods Two sets of the multiplex PCR system were used to amplify the target genes in genetically modified （GM） soybean. Seventeen capture probes （PCR products） and 17 pairs of corresponding primers were designed according to the genetic characteristics of Rroundup Ready soybean （GTS40-3-2）, maize （MonS10, Nk603, GA21）, canola （T45, MS1/RF1）, and rice （SCK） in many identified GM crops. All of the probes were categorized and identified as species-specific probes. One negative probe and one positive control probe were used to assess the efficiency of all reactions, and therefore eliminate any false positive and negative results. After multiplex PCR reaction, amplicons were adulterated with Cy5-dUTP and hybridized with DNA microarray. The array was then scanned to display the specific hybridization signals of target genes. The assay was applied to the analysis of sample of certified transgenic soybean （Roundup Ready GTS40-3-2） and canola （MS1/RF1）. Results A combination technique of multiplex PCR and DNA microarray was successfully developed to identify multi-target genes in Roundup Ready soybean and MS 1/RF1 canola with a great specificity and reliability. Reliable identification of genetic characteristics of Roundup Ready of GM soybean from genetically modified crops was achieved at 0.5% transgenic events, indicating a high sensitivity. Conclusion A combination technique of multiplex PCR and low-density DNA microarray can reliably detect and identify the genetically modified crops.

Seven-day triple therapy is a better choice for Helicobacter pylori eradication in regions with low antibiotic resistance

AIM: To investigate whether 7-d triple therapies are still valid in populations with low levels of resistance.METHODS: A total of 1106 Helicobacter pylori(H. pylori)-positive patients were divided into three groups,each of which received one type of 7-d triple therapy. Therapeutic outcomes of the patients were assessed by the 13C-urea breath test at 8 wk after treatment. The susceptibility of H. pylori to antibiotics was determined by an agar-dilution method. Data analysis was performed by χ2 tests.RESULTS: The eradication rates in groups A,B and C were 90.71%(332/366),90.46%(313/346) and 90.87%(189/208),respectively(P = 0.986). The resistance rates were 8.91% for clarithromycin,14.78% for levofloxacin and 0% for amoxicillin. The eradication rate was significantly different between clarithromycin-and levofloxacin-resistant patients(P < 0.05) in group A. Patients whose treatment failed in group A also had a higher clarithromycin resistance rate than did successive patients(P = 0.034). However,levofloxacin resistance had no obvious influence on the eradication rate. Furthermore,three main antibiotics(clarithromycin,levofloxacin and amoxicillin) had lower DID(defined daily dose per 1000 inhabitants per day) in this city.CONCLUSION: Clarithromycin resistance is the main reason for the failure of 7-d triple therapy. In populations with low levels of resistance,a 7-d triple therapy is a viable choice. The choice of therapy should not be influenced by conditions in high antibiotic resistance regions.

Centralized isolation of Helicobacter pylori from multiple centers and transport condition influences

AIM:To evaluate the efficacy of centralized culture and possible influencing factors.METHODS:From January 2010 to July 2012,66452 patients with suspected Helicobacter pylori(H.pylori) infection from 26 hospitals in Zhejiang and Jiangsu Provinces in China underwent gastrointestinal endoscopy.Gastric mucosal biopsies were taken from the antrum for culture.These biopsies were transported under natural environmental temperature to the central laboratory in Hangzhou city and divided into three groups based on their transport time:5,24 and 48 h.The culture results were reported after 72 h and the positive culture rates were analyzed by a χ2 test.An additional 5736 biopsies from H.pylori-positive patients(5646 rapid urease test-positive and 90 14C-urease breath test-positive) were also cultured for quality control in the central laboratory setting.RESULTS:The positive culture rate was 31.66%(21036/66452) for the patient samples and 71.72%(4114/5736) for the H.pylori-positive quality control specimens.In the 5 h transport group,the positiveculture rate was 30.99%(3865/12471),and 32.84%(14960/45553) in the 24 h transport group.In contrast,the positive culture rate declined significantly in the 48 h transport group(26.25%; P < 0.001).During transportation,the average natural temperature increased from 4.67 to 29.14℃,while the positive culture rate declined from 36.67%(1462/3987) to 24.12%(1799/7459).When the temperature exceeded 24℃,the positive culture rate decreased significantly,especially in the 48 h transport group(23.17%).CONCLUSION:Transportation of specimens within 24 h and below 24℃ is reasonable and acceptable for centralized culture of multicenter H.pylori samples.

Development and application of a real-time polymerase chain reaction method for Campylobacter jejuni detection

AIM:To develop a real-time polymerase chain reaction(PCR) method to detect and quantify Campylobacter jejuni(C.jejuni) from stool specimens.METHODS:Primers and a probe for real-time PCR were designed based on the specific DNA sequence of the hipO gene in C.jejuni.The specificity of the primers and probe were tested against a set of Campylobacter spp.and other enteric pathogens.The optimal PCR conditions were determined by testing a series of conditions with standard a C.jejuni template.The detection limits were obtained using purified DNA from bacterial culture and extracted DNA from the stool specimen.Two hundred and forty-two specimens were analyzed for the presence of C.jejuni by direct bacterial culture and real-time PCR.RESULTS:The optimal PCR system was determined using reference DNA templates,1 × uracil-DNA glycosylase,3.5 mmol/L MgCl 2,1.25 U platinum Taq polymerase,0.4 mmol/L PCR nucleotide mix,0.48 μmol/L of each primer,0.2 μmol/L of probe and 2 μL of DNA template in a final volume of 25 μL.The PCR reaction was carried as follows:95 ℃ for 4 min,followed by 45 cycles of 10 s at 95 ℃ and 30 s at 59 ℃.The detection limit was 4.3 CFU/mL using purified DNA from bacterial culture and 10 3 CFU/g using DNA from stool specimens.Twenty(8.3%,20/242) C.jejuni strains were isolated from bacterial culture,while 41(16.9%,41/242) samples were found to be positive by realtime PCR.DNA sequencing of the PCR product indicated the presence of C.jejuni in the specimen.One mixed infection of C.jejuni and Salmonella was detected in one specimen and the PCR test for this specimen was positive.CONCLUSION:The sensitivity of detection of C.jejuni from stool specimens was much higher using this PCR assay than using the direct culture method.

Establishing a model to measure and predict the quality of gastrointestinal endoscopy

BACKGROUND Tens of millions of gastrointestinal endoscopic procedures are performed every year in China,but the quality varies significantly and related factors are complex.Individual endoscopist-and endoscopy division-related factors may be useful to establish a model to measure and predict the quality of endoscopy.AIM To establish a model to measure and predict the quality of gastrointestinal endoscopic procedures in China's Mainland.METHODS Selected data on endoscopy experience,equipment,facility,qualification of endoscopists,and other relevant variables were collected from the National Database of Digestive Endoscopy of China.The multivariable logistic regression analysis was used to identify the potential predictive variables for occurrence of medical malpractice and patient disturbance.Linear and nonlinear regressions were used to establish models to predict incidence of endoscopic complications.RESULTS In 2012,gastroscopy/colonoscopy-related complications in China's Mainland included bleeding in 4,359 cases(0.02%)and perforation in 914(0.003%).Endoscopic-retrograde-cholangiopancreatography-related complications included severe acute pancreatitis in 593 cases(0.3%),bleeding in 2,151(1.10%),perforation in 257(0.13%)and biliary infection in 4,125(2.11%).Moreover,1,313(5.0%)endoscopists encountered with medical malpractice,and 5,243(20.0%)encountered with the disturbance from patients.The length of endoscopy experience,weekly working hours,weekly night shifts,annual vacation days and job satisfaction were predictors for the occurrence of medical malpractice and patient disturbance.However,the length of endoscopy experience and the ratio of endoscopists to nurses were not adequate to establish an effective predictive model for endoscopy complications.CONCLUSION The workload and job satisfaction of endoscopists are valuable predictors for medical malpractice or patient disturbance.More comprehensive data are needed to establish quality-predictive models for endoscopic complications.

Proteome Analysis of Neisseria meningitidis Serogroup Strains C Associated with Outbreaks in China

Objective During 2003-2005, an outbreak of meningitis due to Neisseria meningitidis serogroup C occurred in China. With the aim to find strain clues result in the final epidemics, the ancestral strain 053442, a clinical isolate, and a carrier strain 053426 with different gene type were analyzed. Methods Clinical strain 053442 and carrier strain 053426 were cultured on GC agar plates under the same condition. Two-dimensional electrophoresis was performed using the pH 3–10 nonlinear IPG strips of 24 cm length, and all the protein spots were identified by matrix-assisted laser desorption/ionization time of flight spectrometry. Results 502 and 380 protein spots were identified in 053426 and 053442 respectively, relating to 266 and 202 different genes covering a wide range of cellular functions. The express volume and number of proteins involved in energy metabolism, protein synthesis and amino acid biosynthesis in 053426 were higher than in 053442. Virulence factor Opa, Opc and a series of proteins involved in pilus assembly and retraction were identified in 053442, which appear to be of primary importance in colonization and invasion of human cells. Compared to 053442, virulence protein species were less in 053426, with lower express volumes too. No Opa and Opc were detected in 053426. Conclusion The different protein expression profiles of the clinical strain 053442 and carrier strain 053426 in the present study provide some clues of the different pathogenicity of the two strains, which may account for result in the final epidemics.

Photonic lantern with multimode fibers embedded

A photonic lantem is studied which is formed by seven multimode fibers inserted into a pure silica capillary tube. The core of the tapered end has a uniform refractive index because the polymer claddings are removed before the fibers are inserted. Consequently, the light distribution is also uniform.Two theories describing a slowly varying waveguide and multimode coupling are used to analyze the photonic lantern. The transmission loss decreases as the length of the tapered part increases. For a device with a taper length of 3.4 cm, the loss is about 1.06 dB on average for light propagating through the taper from an inserted fiber to the tapered end and 0.99 dB in the reverse direction. For a device with a taper length of 0.7 cm, the two loss values are 2.63 dB and 2.53 dB, respectively. The results show that it is possible to achieve a uniform light distribution with the tapered end and a low-loss transmission in the device if parameters related to the lantern are reasonably defined.

Assessment of Comparative Genomic Hybridization Experiment by an in situ Synthesized CombiMatrix Microarray with Yersinia pestis Vaccine Strain EV76 DNA

Objective The quality of microarray data influences the accuracy of comparative genomic analyses to a large extent.To ensure that the results obtained by using an in situ synthesized microarray are accurate,data quality is to be assessed by evaluating the melting temperature (Tm) of probes,probability of false synthesis rates,and fragmentation of labeled targets.Methods DNA from the Yersinia pestis vaccine strain EV76 was used for microarray analyses.Microarray results were confirmed by PCR.Statistical and bioinformatics methods were employed to perform microarray data analyses and evaluation.Results Correlation coefficients of the three datasets were above 0.95 after two-time stripping and hybridization with a labeled DNA with the size of fragmentation being 200 bp-2 kb,which showed that the hybridization results were highly reproducible.Correlation coefficients were lower with the values ranging from 0.87 to 0.92 between the datasets generated from hybridization with different sizes of the labeled DNA fragment.For the relationship between Tm and signal intensity,there was a different distribution of Tm in the lowest 300 or 3 000 probes with a range of 70 ℃-72 ℃ and the highest 300 or 3 000 probes with a range of 72 ℃-74 ℃.Conclusion The results of this study suggest that the initial microarray design may affect the accuracy of final analyses and that the probe Tm and the size of the labeled fragment may be the two factors of the greatest importance.

Intra-Cavity Absorption Gas Sensors Using Wavelength Modulation and Wavelength Sweep

Wavelength modulation technique （WMT） and wavelength sweep technique （WST） are introduced into intra-cavity absorption gas sensors （ICAGS） for low concentration gas detection. The optimized parameters of the system maximizing the signal-to-noise ratio （SNR） are found. Calibration of acetylene concentration and gas recognition are both realized.

CH4 Gas Extraction by CO2: Substitution in Clathrate Hydrate through Bimolecular Iteration

Methane clathrate hydrate(MCH)is a promising energy resource,but controllable extraction of CH4 from MCH remains a challenge.Gradually replacing CH4 in MCH with CO2 is an attractive scheme,as it is cost efficient and mitigates the environmentally harmful effects of CO2 by sequestration.However,the practicable implementation of this method has not yet been achieved.In this study,using in situ neutron diffraction,we confirm that CH4 in the 51262 cages of bulk structure-I(si)MCH can be substituted by gaseous CO2 under high pressure and low temperature with a high substitution ratio(~44%)while conserving the structure of the hydrate framework.First-principles calculations indicate that CO2 binds more strongly to the 51262 cages than methane does,and that the diffusion barrier for CH4 is significantly lowered by an intermediate state in which one hydrate cage is doubly occupied by CH4 and CO2.Therefore,exchange of CO2 for CH4 in MCH is not only energetically favorable but also kinetically feasible.Experimental and theoretical studies of CH4/CO2 substitution elucidate a method to harness energy from these combustible ice resources.

OVER-EXPRESSION OF EXTRACELLULAR SIGNAL-REGULATED KINASE IN VASCULAR SMOOTH MUSCLE CELL OF HYPERTENSIVE RATS

Objective To investigate whether extracellular signal-regulated kinase (ERK1/2) was involved in changes of vascular smooth muscle cell (VSMC) under hypertension.Methods Two-kidney one clip Wistar hypertensive rats (WHR) were sacrificed and their right kidneys were harvested 4 weeks after surgery.The spontaneously hypertensive rats (SHR) were divided into 4, 8, and 16 weeks old groups (SHR4w, SHR8w, and SHR16w), respectively.The control group were sham operated age-matched Wistar rats.Immunohistochemical technique and Western blotting were applied to study ERK1/2 protein expression in VSMC of the renal vascular trees in WHR, SHR, and control rats.Results Blood pressure in two-kidney one clip WHR obviously increased at one week after surgery, and reached to 198.00±33.00 mm Hg at the end of experiment, significantly higher than that in the control rats (P<0.01).Blood pressure in SHR4w (108.00±11.25 mm Hg) was similar to that in the controls.However, it rose to 122.25±21.75 mm Hg in SHR8w, and even up to 201.75±18.00 mm Hg in SHR16w, which were significantly higher than that of both the SHR4w and the controls (P<0.01).The rate and degree of glomerular fibrosis in WHR were significantly higher than controls (P<0.05).Hyaline degeneration of the afferent arterioles was found in WHR.In contrast, either fibrosis of glomerulus or hyaline degeneration of the arterioles or protein casts was not observed in SHR4w, SHR8w, and SHR16w.Immunohistochemical staining results showed expression of ERK1 was similar to that of ERK2.The positive rates of ERK2 staining in VSMC of afferent arterioles, interlobular, interlobar, and arcuate arteries in two-kidney one clip WHR were significantly higher (7.09%±1.75%, 14.57%±4.58%, 29.44%±7.35%, and 13.63%±3.85%, respectively) than that of the controls(P<0.01).The positive rates of ERK2 staining in VSMC at afferent arterioles, interlobular, interlobar, and arcuate arteries in SHR16w were significantly higher (12.09%±1.40%, 24.17%±6.92%, 32.44%±4.05%, and 18.61%±3.35%, respectively) than that of the controls (P<0.01), too.The expression of ERK1/2 protein of kidney in WHR and SHR16w was significantly higher than that in the controls by Western blotting assay (P<0.01).Conclusion Extracellular signal transduction system are highly expressed in kidney VSMC of two-kidney one clip WHR and SHR.Phospho-ERK1/2 may play an important role in VSMC hypertrophy and hyperplasia under hypertension.

Intra-Cavity Absorption Sensors for Gas Detection Using Wavelength Sweep Technique

Wavelength sweep technique （WST） is introduced into intra-cavity fiber laser （ICFL） for low concentration gas detection. The limitation induced by noise can be eliminated using this method, and the performance of the system is improved. The sensitivity of the system is reduced to less than 300 ppm. With WST, sweeping characteristic of the ICFL can be described according to known gas absorption spectra.

日本血吸虫虫卵排泄分泌物中具有诊断价值的抗原分子的初步鉴定

目的鉴定日本血吸虫虫卵分泌排泄物(ESA)中有血吸虫病诊断价值蛋白分子,为建立新的高敏感性和特异性的日本血吸虫病诊断方法奠定基础。方法日本血吸虫尾蚴感染家兔后42d,解剖家兔,取肝脏,匀浆后收集虫卵,置于PBS中,4℃过夜,收集上清,制备虫卵排泄分泌物。以虫卵排泄分泌物包被酶标板,采用ELISA检测不同感染度、不同感染时间小鼠血清抗体滴度。同时以虫卵ESAELISA分别检测血吸虫病患者血清、健康人血清和弓形虫病患者血清,观察虫卵ESA用于血吸虫病诊断的敏感性和特异性及交叉反应性。通过一维电泳免疫印迹、二维电泳免疫印迹和飞行质谱分析,鉴定虫卵ESA中具有诊断潜能的蛋白分子。结果ELISA检测结果显示血吸虫感染小鼠血清中抗虫卵ESA抗体IgG水平随着感染时间的延长而升高,且与血吸虫感染度呈正相关,在感染早期即检出相应抗体。虫卵ESA检测血吸虫病患者血清的敏感性为97.2%,检测健康人血清的特异性为95.2%,与弓形虫病患者血清的交叉反应性为25.0%。一维电泳免疫印迹试验显示血吸虫感染兔血清可识别170×103、150×103、130×103、100×103、72×103、70×103、30×103ku左右的ESA蛋白;二维电泳免疫印迹试验显示血吸虫感染兔血清可识别8个蛋白斑点,质谱分析其中1个蛋白斑点为日本血吸虫主要的虫卵蛋白P40。结论日本血吸虫虫卵排泄分泌抗原具有一定的血吸虫病诊断与早期诊断价值,虫卵的主要蛋白P40可能是一个具有诊断潜能的抗原分子。

Clinical Features of Adult/Adolescent Atopic Dermatitis and Chinese Criteria for Atopic Dermatitis

Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. The clinical manifestations of AD are heterogeneous. We have proposed Chinese diagnostic criteria for adolescent and adult AD, which are simple and sensitive for diagnosis of adult/adolescent AD.

Secukinumab demonstrates high efficacy and a favorable safety profile over 52 weeks in Chinese patients with moderate to severe plaque psoriasis

Background:Psoriasis is a chronic inflammatory skin disease,affecting about 0.6%of the Chinese population.Many patients are not well controlled by conventional treatments,thus there is need for new treatment regimens.In this study,we assessed the efficacy and safety of secukinumab in Chinese patients with moderate to severe plaque psoriasis.Methods:This study was a 52-week,multicentre,randomized,double-blind,placebo-controlled,parallel-group,Phase 3 trial.A sub-population of study participants(≥18 years)of Chinese ethnicity were randomized to receive subcutaneous injections of 300 or 150 mg secukinumab,or placebo.The co-primary endpoints were psoriasis area severity index(PASI)75 and Investigator’s Global Assessment(IGA)0/1 at Week 12.Results:A total of 441 Chinese patients were enrolled in this study.Co-primary outcomes were achieved;300 and 150 mg secukinumab were superior to placebo as shown in the proportion of patients that achieved PASI 75(97.7%and 87.2%vs.3.7%,respectively;P<0.001),and IGA 0/1(82.3%and 69.7%vs.2.7%;P<0.001)at Week 12.Treatment efficacy was maintained until Week 52.There was no increase in overall adverse events with secukinumab relative to placebo throughout the 52-week period.Conclusion:Secukinumab is highly effective and well tolerated in Chinese patients with moderate to severe plaque psoriasis.

A double-blind,randomized,placebo-and positive-controlled phase III trial of 1% benvitimod cream in mild-to-moderate plaque psoriasis

Background:Benvitimod cream,a novel synthetic small molecule,was effective in treating mild-to-moderate plaque psoriasis.We conducted a phase III clinical trial to assess the efficacy and safety of benvitimod cream in patients with mild-to-moderate plaque psoriasis.Methods:We randomly assigned 686 patients(2:1:1)to receive 1%benvitimod cream,0.005%calcipotriol ointment or placebo twice a day for 12 weeks.The primary efficacy end points were the percentage of patients with a 75%or greater reduction from baseline in the psoriasis area and severity index(PASI 75)score and with a score of 0 or 1 in static physician’s global assessment(sPGA)at week 12.Results:The results showed that 50.4%of patients in the benvitimod group achieved PASI 75,which was significantly higher than that in the calcipotriol(38.5%,P<0.05)and placebo(13.9%,P<0.05)groups.The proportion of patients achieving an sPGA score 0 or 1 was 66.3%in the benvitimod group and 63.9%in the calcipotriol group,which were both significantly higher than that in the placebo group(34%,P<0.05).In the long-term follow-up study,50.8%of patients experienced recurrence.After retreatment with 1%benvitimod,73.3%of patients achieved an sPGA score of 0 or 1 again at week 52.Adverse events included application site irritation,follicular papules,and contact dermatitis.No systemic adverse reactions were reported.Conclusion:During this 12-week study,benvitimod cream was demonstrated with high effectiveness and safety in patients with mild-to-moderate plaque psoriasis.

Efficacy and safety of secukinumab in Chinese patients with moderate-to-severe plaque psoriasis: a real-life cohort study

Background:There have been few real-life dose-comparing studies on the efficacy and safety of secukinumab in Chinese patients with plaque psoriasis.We conducted a real-life cohort study to investigate the efficacy and safety of secukinumab 150 and 300 mg in Chinese patients with moderate-to-severe plaque psoriasis.Methods:A total of 106 patients with moderate-to-severe plaque psoriasis were included in this study.Patients received either secukinumab 150 mg or secukinumab 300 mg according to patients’weights and severity of psoriasis.The treatment continued for at least 24 weeks.The efficacy was evaluated by improvement in the psoriasis area and severity index(PASI)scores.The safety was also analyzed.Results:Fifty-nine patients(55.7%)were treated with secukinumab 300 mg and 47 patients(44.3%)were treated with secukinumab 150 mg.After 12-week treatment,PASI75/90/100 responses were achieved in 100%,97.8%,and 95.7%of patients,respectively,in secukinumab 150 mg group,and the efficacy was maintained to week 24.In secukinumab 300 mg group,PASI75/90/100 responses were achieved in 93.2%,81.4%,and 76.3%of patients,respectively,at week 12.In this group,PASI75/90/100 responses reached 91.5%,86.4%,and 79.9%,respectively,at week 24.Biologic-experienced patients had lower responses than biologic-naïve patients.Secukinumab 150 and 300 mg were well tolerated.Five patients discontinued treatment due to poor response,adverse event,or economic reasons.Conclusions:This real-life study demonstrated that high PASI 90 and PASI 100 responses were achieved in Chinese psoriasis patients receiving secukinumab 150 or 300 mg.Biologic-naïve was associated with better clinical efficacy.

Aryl hydrocarbon receptor expression in serum,peripheral blood mononuclear cells,and skin lesions of patients with atopic dermatitis and its correlation with disease severity

Background:The aryl hydrocarbon receptor(AhR)is a ligand-activated transcription factor,which is critically involved in the pathogenesis of a variety of skin diseases.The aim of this study was to detect AhR and its downstream regulators including cytochrome P450(CYP1A1),AhR nuclear translocation(ARNT),and aryl hydrocarbon receptor repressor(AhRR)in serum,peripheral blood mononuclear cells(PBMCs),and skin lesions in patients with atopic dermatitis(AD).Methods:Twenty-nine AD patients defined according to the criteria of Hanifin and Rajka and Chinese criteria of AD were included.Subjects without allergic and chronic diseases were recruited as controls.Patients and controls were selected from the dermatology outpatient clinic of Peking University People’s Hospital from August 1 to December 31 in 2018.Enzyme-linked immunosorbent assay was performed to detect serum AhR level.ThemRNA of AhR,AhRR,ARNT,and CYP1A1 in PBMCs were measured by realtime quantitative polymerase chain reaction.AhR expression in skin lesions was measured by immunohistochemistry.Results:AhR was significantly higher expressed in serum(41.26±4.52 vs.33.73±2.49 pmol/L,t=6.507,P<0.001)and skin lesions(0.191±0.041 vs.0.087±0.017,t=10.036,P<0.001)of AD patients compared with those of controls.The mRNA levels of AhR(1.572±0.392 vs.1.000±0.173,t=6.819,P<0.001),AhRR(2.402±1.716 vs.1.000±0.788,t=3.722,P<0.001),CYP1A1(2.258±1.598 vs.1.000±0.796,t=3.400,P=0.002)in PBMCs of AD patients were higher compared with those of controls.The difference in mRNA levels of ARNT was not statistically significant between the patients and controls(1.383±0.842 vs.1.000±0.586,t=1.653,P=0.105).AhR mRNA levels in PBMCs positively correlated with eczema area and severity index score and serum interleukin-6 levels.Conclusion:AhR and its downstream regulators were highly expressed in serum,PBMCs,and skin of AD patients,which might contribute to the pathogenesis of AD.