Progress of blood-letting puncture on the treatment of psoriasis

Psoriasis is a chronic skin disease characterized by localized or wide spread squamous erythema or plaque. The pathogenesis is complicated. According to the TCM theory, psoriasis results from internal heat toxin and the deficiency of blood. And blood stasis exists throughout the disease, the treatment should focus on promoting blood circulation and removing blood stasis. Blood-letting puncture can balance Qi and blood through stimulating the meridians, forcing evil Qi to go out, so as to dispel pathogenic factors and dredge the meridians. This article briefly discusses the basic mechanisms and clinical researches of psoriasis with blood-letting puncture, in order to provide new ideas for the clinical treatment of psoriasis.

Clinical effects of antidiabetic drugs on psoriasis:The perspective of evidence-based medicine

Psoriasis and diabetes shared common underlying pathophysiological mechanisms.Emerging data suggested that antidiabetic medications may improve the psoriasis severity in patients with diabetes mellitus.Several hypoglycemic agents including thiazolidinediones,glucagon-like peptide-1 receptor agonists,dipeptidyl peptidase-4 inhibitors,and biguanides have been reported to make a remarkable reduction in the Psoriasis Area and Severity Index score from baseline.This antipsoriatic effect could be mediated not only by the glucoselowering action of these agents but also via inhibition of keratinocyte over proliferation,increase expression of differentiation markers,suppression the immune inflammatory pathway,and blocking the calcium channels and mitogen-activated protein kinase signaling pathways.On the other hand,there was no significant increase in adverse reactions associated with the treatment of pioglitazone or metformin.However,previous studies often had the relatively short duration of the trials,and did not have enough power to assess recurrence of psoriasis.Potential bias in the study and missing data could undermine the reliability of the results.Therefore,the appropriately randomized controlled studies with large sample sizes and long-term durations in various psoriasis patients are warranted for further support.

Observation on the effect of licorice flavonoid Chinese herbal medicine spotting cream combined with Awei A capsule in the treatment of psoriasis

Objective: To study the curative effect of licorice flavonoid Chinese herbal frond cream combined with Awei A capsule in the treatment of psoriasis. Methods: During the period from April 2016 to March 2018, a total of 116 patients with psoriasis in our hospital were randomly divided into the experimental group (the treatment of licorice flavonoids and Chinese acupoint cream combined with Awei A capsule) and the control group (single use) Avi A capsule treatment). Comparison of blood lipid metabolism indexes (high-density lipoprotein, apolipoprotein, low-density lipoprotein) and serum biochemical indicators (neutrophil elastase, endogenous inhibitor of NE, placental cadherin) statistical difference in content. The statistical differences between PASI score and DLQI score before and after treatment were compared between the two groups. At the end of treatment, the statistical difference between the clinical efficacy and the incidence of adverse reactions was compared between the two groups. Results:The levels of serum NE, Trappin-2 and P-cad in patients before and after treatment showed a significant downward trend. The content of NE, Trappin-2 and P-cad in the experimental group was significantly lower than that in the control group. The content of HDL-C in lipid metabolism index increased significantly before and after treatment, and the content of APOA and LDL-C decreased significantly. The content of HDL-C in the experimental group was significantly higher than that in the control group. The content of APOA and LDL-C was significantly lower than that of the control group. The PASI score and DLQI score of patients before and after treatment decreased significantly. After treatment, the PASI score and DLQI score of the experimental group were significantly lower than those of the control group. The clinical efficacy of the two groups was significantly different. The efficacy of the experimental group was significantly better than that of the control group. The skin of the experimental group was dry, itchy, and the skin desquamation was significantly less than that of the control group. Conclusion: Licorice Flavonoids and Avi A capsules have the advantages of improving blood lipid metabolism in the treatment of psoriasis, while reducing the recurrence rate and reducing the occurrence of common adverse reactions such as skin itching, dryness and abnormal liver function. It has a good clinical application significance.

Meta-analysis of clinical effect of clearing heat and cooling blood on psoriasis and its effect on inflammatory cytokines

Objective:To evaluate the effect of Qingreliangxue method compared with Acitretin Capsules on clinical efficacy of psoriasis and serum inflammatory cytokines.Methods:The computer searches databases such as CNKI,Wanfang,VIP,PubMed,Embase and Cochrane Library.The search time is from the time the library is built until December 2019.According to the criteria for screening and selection of studies,extract data,use risk assessment tools for quality evaluation,and use Revman 5.3 software to perform meta-analysis on the outcome indicators of the included studis.Results:Finally,20 studies were included,with a total of 1592 patients.The analysis results showed that the total effective rate(OR=3.70,95%CI[2.58,5.30],P<0.00001)and cure rate(OR=2.40,95%CI[1.86,3.10],P<0.00001),PASI score(OR=-2.65,95%CI[-3.60,-1.70],P<0.00001),serum inflammatory cytokines(OR=-8.84,95%CI[-10.52,-7.16],P<0.00001),adverse reactions(OR=0.25,95%CI[0.11,0.57],P=0.001)are superior to Acitretin Capsules.Statistics of the top 10 Chinese medicines in clinical used frequency are,in order,habitat,red peony root,paeonol,honeysuckle,comfrey,soil tuckahoe,salvia miltiorrhiza,buffalo horn,heliotrope,angelica.Conclusion:Based on the current evidence,the treatment of psoriasis with clearing heat and cooling blood as the mainstay of Chinese medicine alone or in combination with Acitretin Capsules can better improve the efficacy,and its mechanism may be related to reducing inflammation.Due to the limitation of the included literature,this conclusion needs to be further verified.

Childhood pustular psoriasis--A case of a patient treated with traditional Chinese medicine

Generalized pustulous psoriasis is characterized by the sudden onset of diffuse erythema, with a scattering of pustules, sometimes with fever and others symptoms. It is a relatively rare disease^1. The treatment of traditional western medicine have various adverse drug reactions and easy to recur. Meanwhile, this report describes a 12-year-old female patient of generalized pustulous psoriasis with a satisfactory effect of traditional Chinese medicine.

Investigating the gut microbiota's influence on psoriasis and psoriatic arthritis risk: a Mendelian randomization analysis

Background:Numerous investigations have revealed the interplay between gut microbiota(GM)and psoriasis(Ps)and psoriatic arthri-tis(PsA).However,the causal relationship between them remains unknown.Methods:We curated a collection of genetic variants(P<1×10^(-5))associated with GM(n=18340)derived from the MiBioGen study.To explore the intricate relationship between GM and Ps as well as PsA,we harnessed the comprehensive resources of the FinnGen database,encompassing a vast cohort of individuals,including 4510 Ps cases and 212242 controls and 1637 PsA cases and 212242 controls.Mendelian randomization(MR)was used,including an inverse variance weighting method,followed by a sensitivity analysis to verify the robustness of the results.Results:For Ps,some bacterial taxa,including Lactococcus,Ruminiclostridium 5,and Eubacterium fissicatena,were identified as risk factors;but Odoribacter demonstrated a protective effect against Ps.In the case of PsA,Lactococcus,Verrucomicrobiales,Akkermansia,Coprococ-cus 1,and Verrucomicrobiaceae were identified as risk factors;Odoribacter and Rikenellaceae exhibited a protective effect against the developmentof PsA.Conclusion:Our study establishes a causal link between the GM and Ps and PsA.These findings provide insights into the underlying mechanisms and suggest potential therapeutic targets.

Effects of effective stress and temperature on permeability of sandstone from CO2-plume geothermal reservoir

Rock is generally complex and heterogeneous,therefore the heterogeneity effects of effective stress and temperature on permeability should be taken into account.In this study,two-part Hooke’s model（TPHM） is introduced to understand the influences of effective stress and temperature on permeability of soft and hard parts（two parts） of rock based on coupling thermo-hydro-mechanical tests.Under a fixed temperature level（25 ℃.35 ℃.50 ℃.65 ℃.80 ℃.90 ℃ and 95 ℃）.the tests were carried out in a conventional triaxial system whereas the confining pressure was remained at 50 MPa.and the pore pressure was increased to the specified levels step by step.i.e.8 MPa,18 MPa.28 MPa.38 MPa.41 MPa,44 MPa.46 MPa and 48 MPa.The temperature-dependent relationships for two parts permeabilities are proposed on the basis of the initial test results.We point out that temperature of 65 ℃-90 ℃ is the threshold for the development of CO2-plume geothermal（CPC） reservoir sandstone cracking under low effective stress（2-9 MPa） based on the relationship between temperature and soft part permeability.Furthermore,we discuss the effect of temperature on the two parts in the rock.The results indicate that as the temperature increases from 25 ℃ to 65 ℃.the flow channel in the hard part has a stronger response to temperature than that in the soft part at a fixed effective stress level,which is opposite to the situation of effective stress.Considering that natural rock is generally heterogeneous with non-uniform pore structure,we suggest a physical interpretation of the phenomenon that before the thermal cracking threshold the two parts have different responses to temperature.

复杂微型构件特种能场辅助微成形研究进展

随着复杂微型构件特征尺寸的不断减小,尺度范围不断扩大,材料种类日益增多,单纯依靠模具施加载荷的塑性微成形技术受到越来越多的挑战,成为制约微型构件实际应用的关键技术瓶颈。特种能场微成形技术利用超声场、电场和电磁场等能场与材料相互作用产生的特殊物理效应进行微加工,可以明显改善材料的塑性流动,降低微成形载荷,从而显著提高微型构件成形质量。本文综述了超声场、电场和电磁场等特种能场作用下塑性微成形的研究进展。首先探讨了特种能场作用下材料力学性能响应机制及微成形尺度极限,其次介绍了特种能场作用下微成形过程中材料微观组织结构演化与缺陷形成机理,最后总结了特种能场辅助微成形的关键工艺参数及其对成形质量的影响规律,强调了通过优化工艺参数实现高精度成形的重要性,为复杂微型构件的低成本、高效制造提供了新的技术路径。

本维莫德治疗掌跖脓疱病:一项天津地区多中心临床研究

目的:评价本维莫德在临床研究中治疗掌跖脓疱病的安全性和有效性。方法:选择2021年3月一10月于天津地区多中心应用本维莫德治疗的掌跖脓疱病患者,进行为期8周的治疗及停药后4周的随访,评价患者用药前、后掌跖脓疱病面积和严重程度指数(PPPASI)评分和皮肤病生活质量指数(DLQI)评分,并观察不良反应。结果:治疗8周后,所有患者PPPASI评分与DLQI评分较基线均显著降低,差异均有统计学意义(P<0.05)。治疗8周后,所有患者中痊愈4例、显效4例、有效8例、无效5例,有效率为38.1%。疗程中患者不良反应少且轻微,1例患者出现皮肤肥厚、干燥、脱屑。随访4周,痊愈、显效及有效患者皮损均未复发。结论:本维莫德有望成为治疗掌跖脓疱病的一种有效选择,且不良反应轻微,值得临床进一步研究及应用。

毛头牛蒡子总木脂素有效部位的化学成分研究

研究毛头牛蒡子总木脂素有效部位中的化学成分,采用紫外分光光度法测定其中总木脂素含量,采用高效液相色谱法测定其中牛蒡苷和牛蒡苷元的含量,结果表明,毛头牛蒡子总木脂素有效部位中总木脂素含量为95.68%,牛蒡苷含量为55.71%,牛蒡苷元含量为2.99%。通过对毛头牛蒡子总木脂素有效部位中化学成分进行分析,为进一步研究其活性打下相关基础。

卡泊三醇软膏联合司库奇尤单抗在中重度银屑病患者中的应用效果研究

目的分析卡泊三醇软膏与司库奇尤单抗联合用于中重度银屑病患者的治疗效果。方法选取2021年3月—2023年7月聊城市人民医院收治的82例中重度银屑病患者为研究对象,按随机数字表法将其分为对照组和研究组,各41例。对照组采用卡泊三醇软膏治疗,研究组采用卡泊三醇软膏联合司库奇尤单抗治疗。观察两组患者的治疗效果和不良反应发生情况,比较两组患者的银屑病病情程度、生活质量、免疫功能指标水平、炎症因子水平。结果研究组治疗总有效率为87.80%,高于对照组的73.17%,差异有统计学意义(P<0.05)。治疗12周后,研究组银屑病的皮损面积及严重程度指数评分、皮肤病生活质量指数评分均低于对照组,组间差异有统计学意义(P<0.05);研究组白细胞分化抗原4+、白细胞分化抗原8+水平均高于对照组,辅助性T细胞17水平低于对照组,组间差异有统计学意义(P<0.05);研究组肿瘤坏死因子-α、血清白细胞介素-17、γ干扰素水平均低于对照组,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论卡泊三醇软膏与司库奇尤单抗联合应用能够提升中重度银屑病患者的治疗效果。

基于Weibull分布的缺口件多轴疲劳寿命建模

针对多轴缺口件,引入Weibull分布建立考虑应力梯度效应的疲劳寿命预测方法.首先,将最大应变能密度定义为损伤参量,并结合坐标变换确定能反映裂纹萌生和扩展的临界面位置;其次,利用有限元方法提取临界面特定路径的应力分布,并对其进行归一化处理得到多轴等效应力梯度因子,进而基于GSP应变能密度模型得出应变能密度与实验寿命的线性关系;最后,结合等效应力梯度因子、应变能密度模型和Weibull分布,基于Von-Mises准则提出了新的疲劳寿命预测方法,并利用该方法分别求出失效概率10%、50%和90%对应的疲劳寿命.为验证该方法,将计算结果与SWT模型、FS模型和Manson-Coffin方程的计算结果进行对比,结果表明该方法的预测精度较高.

可善挺治疗中重度斑块型银屑病的疗效分析

目的探究对中重度斑块型银屑病患者使用可善挺的治疗效果。方法便利选取2020年1月—2023年1月南平市疾病预防控制中心收治的64例中重度斑块型银屑病患者为研究对象,按随机数表法分为两组。对照组32例患者口服阿维A,外用卡泊三醇治疗,研究组32例患者使用可善挺治疗。比较两组用药后第2周、第6周以及第12周的严重度指数(Psoriasis Area and Severity Index,PASI)应答率、特殊部位受累应答率,停药后复发时间。结果研究组第2周PASI应答率(21.88%)、第6周PASI应答率(68.75%)、第12周PASI应答率(96.88%)高于对照组,差异有统计学意义(χ^(2)=5.143、18.515、13.166,P均<0.05)。研究组第6、12周特殊部位受累应答率高于对照组,差异有统计学意义(P均<0.05)。研究组停药后复发时间长于对照组,差异有统计学意义(P<0.05)。结论中重度斑块型银屑病患者使用可善挺治疗效果显著,在相同的治疗周期内,可善挺可明显减轻皮损面积与严重程度,停药后复发的时间较传统治疗明显延后。

应用200μm钬激光光纤治疗球、膜部尿道狭窄临床分析及新思考

目的:分析和思考内镜下应用(200μm)钬激光光纤治疗球、膜部尿道狭窄的疗效及治疗经验。方法:选取2018年1月—2020年6月样本医院收治的86例内镜下应用冷刀及200μm钬激光光纤治疗男性球、膜部尿道狭窄患者的临床资料进行分析。所有患者尿道造影均提示狭窄段<1 cm,彩超检查提示瘢痕厚度<0.5 cm和(或)合并部分假道。按手术方式分为两组,对照组(冷刀组,41例):应用冷刀纵形辐射状切开狭窄段至正常海绵体深度;观察组(激光组,45例):采用200μm钬激光光纤,“同轴法”纵向切开狭窄段并切除尿道瘢痕,深度同对照组。术后均留置16 F硅胶尿管,2周后拔除,观察其自行排尿情况。结果:观察组患者手术时间长于对照组,术中、术后出血量少于对照组,差异有统计学意义(t=8.494、15.112、14.351、13.300,P<0.05);两组患者术后即刻、术后3个月、术后12个月其自行排尿情况同时复查最大尿流率比较,差异无统计学意义(t=0.130、0.528、0.298、0.312,P>0.05);术后2周,两组患者生理、心理、社会、环境、独立评分均较治疗前明显升高,且观察组高于对照组,差异有统计学意义(t=13.416、5.429、14.367、9.426、5.529,P<0.05)。结论:直视下尿道内切开术(DVIU)应用200μm钬激光光纤较冷刀不增加并发症,术后患者生活质量更高,评估手术疗效则需要狭窄长度和瘢痕厚度综合考虑。

情志护理干预对改善寻常型银屑病患者不良心理的效果

寻常型银屑病是一种常见的皮肤疾病,患者常常伴随着不良心理状态,如焦虑、抑郁和自卑等,因此在对寻常型银屑病患者进行护理时,需要重视情志护理干预对患者所产生的作用,通过情志护理干预,降低寻常型银屑病患者的焦虑和抑郁水平,并逐渐建立患者的自尊心,提升患者的生活质量。文章就情志护理干预对改善寻常型银屑病患者不良心理的效果进行分析与探讨,以供相关人员参考。

通痹祛湿活血汤对血虚风燥型银屑病患者症状积分及血清因子的影响

目的探讨通痹祛湿活血汤对血虚风燥型银屑病患者的症状积分及血清因子的影响。方法选取2021年1月—2023年6月同济大学附属东方医院胶州医院收治的94例血虚风燥型银屑病患者,随机数表法分为两组,每组47例。对照组采取常规西药治疗,观察组在对照组基础上加上通痹祛湿活血汤治疗,两组均治疗12周。比较两组症状积分、病症改善情况、血清因子、临床疗效。结果治疗12周后,观察组主症、次症总积分低于对照组(P<0.05)。治疗12周后,观察组的皮损角质层含水量高于对照组,PASI评分低于对照组,关节疼痛/肿胀个数少于对照组(P<0.05)。治疗12周后,观察组白细胞介素-6(IL-6)、C反应蛋白(CRP)、骨桥蛋白(OPN)水平低于对照组(P<0.05)。治疗12周后,观察组总有效率高于对照组(P<0.05)。结论在常规西药基础上采用通痹祛湿活血汤治疗血虚风燥型银屑病,可以促进皮损、关节疼痛等症状的恢复,减少炎性物质,提升临床效果。

桑树不同药用部位本草考证及现代研究进展

桑树是一种重要的药用植物,其不同药用部位药理活性多样,极具药用价值。桑源药材桑叶、桑枝、桑白皮及桑椹中富含黄酮类、生物碱类、多糖类、酚酸类、香豆素类、萜类、芪类、氨基酸等诸多化学成分;且桑类中药具有降血糖、降血脂、抗炎、抗氧化、保护肝脏、抗肿瘤、抗微生物、免疫调节、抗肥胖、保护心脏、保护神经等多种药理活性。本文通过查阅历代本草及现代文献,对桑树不同药用部位的本草考证、化学成分和药理作用的研究进行梳理概述,以期为桑源药材的功效特点、物质基础和作用机制的深入探究,及桑树资源综合开发利用提供参考。

当归化学成分及药理作用研究进展

当归在补血药中因“补而不滞”的特点,被广泛用于临床。其化学成分主要包括挥发油类、多糖类、有机酸类、氨基酸类、黄酮类等,常用水蒸气蒸馏法、超临界CO_(2)萃取法、有机溶剂萃取法、煎煮法、渗漉法、超声提取等方法进行提取,而炮制方式、地域、物候期、药用部位的不同皆可影响其化学成分。关于当归药理作用的研究亦愈发深入,当前已证实的包括调节血液循环、缺血后损伤保护、抗组织纤维化、镇痛、保护脑和神经、改善机体骨损伤状态、提高机体免疫力等。参考文献76篇。

瓦楞子的本草考证

瓦楞子为常用的多基原海洋中药,药用历史悠久。《中华人民共和国药典》记载其基原动物为蚶科动物毛蚶Arca subcrenata Lischke、泥蚶Arca granosa Linnaeus或魁蚶Arca inflata Reeve。在查阅历代本草书籍、文献的基础上,对瓦楞子的名称、基原、入药部位、产地分布、药性功效等方面进行系统的本草考证,以正本清源,为其深入研究提供思路。经考证,瓦楞子以“魁蛤”之名首载于《名医别录》,瓦楞子一名首见于《本草备要》。在古代蚶科多种属动物均可入药,最早以肉入药,南北朝至唐代起壳与肉均可入药,其肉名“蚶”,甘、平,为药食两用之品,清代至今所用瓦楞子多为其壳。其壳由单一药味“咸”发展为复合药味“甘、咸”,《本草求真》首次记载其“专入肝”,今认为其主入肝经,兼入肺胃二经。沿海广分布。目前《中华人民共和国药典》只收载其壳为瓦楞子。

夏枯草不同部位化学成分、药理作用研究进展及质量标志物的预测分析

夏枯草Prunella valgaris.是传统的清热泻火类中药,具有清肝泻火、明目、散结消肿的功效。夏枯草中含有多种化学成分,主要为萜类、酚酸、黄酮、有机酸类、挥发油类等。夏枯草药用部位古今存在差异,传统多以茎叶入药,2020版《中华人民共和国药典》规定夏枯草果穗为药用部位。研究表明,夏枯草茎叶和果穗在化学组分上无差异,仅含量上有差异,黄酮和多糖类成分在叶中含量最高,异迷迭香酸苷是果穗的特征性成分,夏枯草种子含有较多的挥发油,β-香树酯醇是其特有成分。现代药理学研究表明,夏枯草在临床上常用于治疗甲状腺癌、乳腺癌、肝癌、肺癌、子宫癌等癌症。除此之外,夏枯草还具有抗炎、降血压、降血脂、降血糖、抗菌、抗病毒、抗氧化、镇静催眠的作用。通过对夏枯草本草考证、不同部位化学成分的差异、药理作用的总结,根据质量标志物的定义,从植物亲缘学及化学成分特有性证据、传统功效、传统药效、化学成分可测性、复方配伍环境等几个方面对夏枯草的质量标志物进行分析,可推断芦丁、槲皮素、迷迭香酸、异迷迭香酸苷、亚油酸、角鲨烯、β-香树醇、木犀草素、山柰酚、谷甾醇、咖啡酸等为夏枯草中的质量标志物。