Apigenin ameliorates imiquimod-induced psoriasis in C57BL/6J mice by inactivating STAT3 and NF-κB

Psoriasis is a chronic autoimmune disease featured by patches on the skin.It is caused by malfunction of immune cells and keratinocytes with inflammation as one of its key features.Apigenin(API)is a natural flavonoid with anti-inflammatory and immunoregulatory properties.Therefore,we speculated that API can ameliorate psoriasis,and determined its effect on the development of psoriasis by using imiquimod(IMQ)-induced psoriasis mouse model.Our results showed that API attenuated IMQ-induced phenotypic changes,such as erythema,scaling and epidermal thickening,and improved splenic hyperplasia.Abnormal differentiation of immune cells was restored in API-treated mice.Mechanistically,we revealed that API is a key regulator of signal transducer activator of transcription 3(STAT3).API regulated immune responses by reducing interleukin-23(IL-23)/STAT3/IL-17A axis.Moreover,it suppressed IMQ-caused cell hyperproliferation by inactivating STAT3 through regulation of extracellular signal-regulated kinase 1/2 and nuclear factor-κB(NF-κB)pathway.Furthermore,API reduced expression of inflammatory cytokines through inactivation of NF-κB.Taken together,our study demonstrates that API can ameliorate psoriasis and may be considered as a strategy for psoriasis treatment.

Spontaneous uterine perforation of pyometra leads to acute abdominal pain and septic shock:a case report

Dear editor,Uterine pyometra is a rare disease that mostly affects elderly women and is usually asymptomatic.Pyometra is defined as an accumulation of pus in the uterine cavity caused by genital tract malignancy or benign cervical diseases such as senile cervicitis,cervical polyps,or remaining intrauterine devices after menopause.[1]The incidence of spontaneous uterine perforation due to pyometra is extremely low,ranging from 0.01%to 0.05%.[2]Although it has low morbidity,it can progress to diffuse peritonitis,and the mortality rate associated with septic shock is as high as 25%-40%.[3]It is still difficult for emergency doctors to provide an accurate diagnosis and perform surgery on time.Here,we present a rare case of a 72-year-old woman who was diagnosed with spontaneous uterine perforation of pyometra and successfully treated with an emergency laparotomy.

Changes in surgical gynecology-Sense and nonsense

The changes in operative gynecology in the past decades have been dramatic in terms of shifting strategies.For example there has been a shift not only from ultraradical techniques such as exenterations,which were first proposed by Brunschwig in 19481 and used in gynecologic oncology by Felix Rutledge in 1974,2 to minimally invasive techniques such as endoscopic or robotic surgery,but also the level of training in terms of anatomical and surgical skills,which are significantly influenced by medico-legal aspects(i.e.,legal regulations).Thus there has been a significant reduction of personal expertise and a changing attitude towards life goals.Moreover,with the European Working Time Directive leading to a reduction in working hours and expansion of the number of trainees,surgical training in areas such as operative experience,patient management,communication,and teaching skills has been getting worse.