Clinical application of flexible ureteroscopic sheath with controllable intraluminal pressure in treating ureteral stones

Objective:The purpose of the study was to assess the clinical efficacy and safety of a combined perfusion suction platform with pressure feedback control function and an ureteroscopic suction sheath that can measure the ureteropelvic pressure in implementing lithotripsies.Methods:Fifty-two patients who underwent lithotripsy under intelligent monitoring of ureteral intraluminal pressure from June 2016 to January 2018 were retrospectively recruited.The inclusion standard was stone diameter>1.5 cm but<2.5 cm.After the 12/14 Fr suction sheath was placed,manometer interface and suction interface of the sheath were connected to the platform via the pressure sensor and suction tube,respectively.The ureteroscope was connected to the platform perfusion pump,and the crushed stones were aspirated out under negative pressure.Results:According to the location of the stone,21(40.4%)cases were classified as upper ureteral stones,19(36.5%)were midureteral stones,and 12(23.1%)were lower ureteral stones.Forty-seven patients underwent successful primary sheath placement and lithotripsy with a mean operative time of 34.5(standard deviation 18.3)min.Retrograde stone migration did not occur.There were eight patients with hematuria postoperatively.Serious complication was 1.9% with one case of ureteral perforation.Stone clearance was 95.7% at Day 1e2 postoperatively,and 100% at Day 30 postoperatively.Conclusion:Ureteroscopic lithotripsy with intelligent pressure control using our device improved the efficiency of the lithotripsy and rate of stone clearance.The safety of the operation can be ensured.It is worth popularization and application in clinical practice.

Serine and arginine rich splicing factor 1:a potential target for neuroprotection and other diseases

Alternative splicing is the process of producing variably spliced mRNAs by choosing distinct combinations of splice sites within a messenger RNA precursor.This splicing enables mRNA from a single gene to synthesize different proteins,which have different cellular properties and functions and yet arise from the same single gene.A family of splicing factors,Serine-arginine rich proteins,are needed to initiate the assembly and activation of the spliceosome.Serine and arginine rich splicing factor 1,part of the arginine/serine-rich splicing factor protein family,can either activate or inhibit the splicing of mRNAs,depending on the phosphorylation status of the protein and its interaction partners.Considering that serine and arginine rich splicing factor 1 is either an activator or an inhibitor,this protein has been studied widely to identify its various roles in different diseases.Research has found that serine and arginine rich splicing factor 1 is a key target for neuroprotection,showing its promising potential use in therapeutics for neurodegenerative disorders.Furthermore,serine and arginine rich splicing factor 1 might be used to regulate cancer development and autoimmune diseases.In this review,we highlight how serine and arginine rich splicing factor 1 has been studied concerning neuroprotection.In addition,we draw attention to how serine and arginine rich splicing factor 1 is being studied in cancer and immunological disorders,as well as how serine and arginine rich splicing factor 1 acts outside the central or peripheral nervous system.

Management of psoriasis patients with hepatitis B or hepatitis C virus infection

The systemic therapies available for the management of Psoriasis(PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs(c DMARDs) or biological ones(b DMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus(HBV) and hepatitis C virus(HCV). In particular, the patients eligible to receive an immunosuppressive drug must be screened for the following markers: antibody to hepatitis B core, antibody to hepatitis B surface antigen(anti-HBs Ag), HBs Ag, and antibody to HCV(anti-HCV). In case HBV or HCV infection is diagnosed, a close collaboration with a consultant hepatologist is needed before and during an immunosuppressive therapy. Concerning therapy with immunosuppressive drugs in PsO patients with HBV or HCV infection, data exist mainly for cyclosporine a(Cy A) or b DMARDs(etanercept, adalimumab, infliximab, ustekinumab). The natural history of HBV and HCV infection differs significantly as well as the effect of immunosuppression on the aforementioned infectious diseases. As a rule, in the case of active HBV infection, systemic immunosuppressive antipsoriatic therapies must be deferred until the infection is controlled with an adequate antiviral treatment. Inactive carriers need to receive antiviral prophylaxis 2-4 wk before starting immunosuppressive therapy, to be continued after 6-12 mo from its suspension. Due to the risk of HBV reactivation, these patients should be monitored monthly for the first 3 mo and then every 3 mo for HBV DNA load together with transaminases levels. Concerning the patients who are occult HBV carriers, the risk of HBV reactivation is very low. Therefore, these patients generally do not need antiviral prophylaxis and the sera HBs Ag and transaminases dosing can be monitored every 3 mo. Concerning PsO patients with chronic HCV infection their management with immunosuppressive drugs is less problematic as compared to those infected by HBV.In fact, HCV reactivation is an extremely rare event after administration of drugs such as CyA or tumor necrosis factor-α inhibitors. As a rule, these patients can be monitored measuring HCV RNA load, and ALT, aspartate transaminase, gamma-glutamyl-transferase, bilirubin, alkaline phosphatase, albumin and platelet every 3-6 mo. The present article provides an updated overview based on more recently reported data on monitoring and managing PsO patients who need systemic antipsoriatic treatment and have HBV or HCV infection as comorbidity.

Hepatitis C and double-hit B cell lymphoma successfully treated by antiviral therapy

B cells lymphoma is one of the most challenging extrahepatic manifestations of hepatitis C virus(HCV). Recently, a new kind of B-cell lymphoma, named doublehit B(DHL), was characterized with an aggressive clinical course whereas a potential association with HCV was not investigated. The new antiviral direct agents(DAAs) against HCV are effective and curative in the majority of HCV infections. We report the first case, to our knowledge, of DHL and HCV-infection successfully treated by new DAAs. According to our experience, a DHL must be suspected in case of HCV-related lymphoma, and an early diagnosis could direct towards a different hematological management because a worse prognosis might be expected. A possible effect of DAAs on DHL regression should be investigated, but eradicating HCV would avoid life-threatening reactivation of viral hepatitis during pharmacological immunosuppression in oncohaematological diseases.

Unusual case of B cell lymphoma after immunosuppressive treatment for psoriasis

Lymphomas may be induced by the systemic immunosuppressive therapies used to treat psoriasis,such as ciclosporin,methotrexate and tumour necrosis factor(TNF)-α blockers.The biologic agents currently used in psoriasis include alefacept,efalizumab,and the TNF-α antagonists etanercept,infliximab,and adalimumab.Infections and cancer are the main possible consequences of intended or unexpected immunosuppression.We report a 59-year-old man with a history of severe psoriasis vulgaris treated with traditional immunosuppressant drugs followed by anti-TNF-α therapy;the patient was firstly hospitalized for an acute cholestatic toxic hepatitis,which we supposed to be related to adalimumab.The first liver biopsy showed active disease with severe hepatocellular damage caused by heavy lymphocytes infiltrate in portal tracts at in the interface with a not conclusive diagnosis of lymphoproliferative disease.The correct diagnosis of T cell/histiocyte-rich large B cell lymphoma(T/HRBCL) was only reached through a gastric biopsy and a second liver biopsy.T/HRBCL is an uncommon morphologic variant of diffuse large B-cell lymphoma not described until now in psoriatic patients receiving immunosuppressive biologic agents.In psoriatic patients,treated with biologic immunosuppressive agents,the suspect of abdominal lymphoma should always be included as differential diagnosis.Abdominal ultrasound evaluation need therefore to be included in the pretreatment screening as in the follow-up surveillance.

Synergistic effect of chitin nanofibers and polyacrylamide on electrochemical performance of their ternary composite with polypyrrole

Development of simple methods for preparation of polymeric electrode materials with nanofibrous network structure is a perspective way toward cheap supercapacitors with high specific capacitance and energy density. In this work one-pot synthesis of electroactive ternary composite based on polypyrrole, polyacrylamide and chitin nanofibers with beneficial morphology was elaborated. Ternary system demonstrates better electrochemical performance in comparison with both polypyrrole–polyacrylamide and polypyrrole–chitin binary composites. Possible mechanism of synergistic effect of simultaneous influence of polyacrylamide and chitin nanofibers on the formation of composite＇s structure is discussed.The highest attained specific capacitance of electroactive polypyrrole in ternary composite reached 249 F/g at 0.5 A/g and 150 F/g at 32 A/g. Symmetrical supercapacitor was assembled using the elaborated electrode material. High specific capacitance 89 F/g and good cycling stability with capacitance retention of 90% after 3000 cycles at 2 A/g were measured.

Outcomes assessment of hepatitis C virus-positive psoriatic patients treated using pegylated interferon in combination with ribavirin compared to new Direct-Acting Antiviral agents

AIM To evaluate the outcomes in biological treatment and quality of life of psoriatic patients with chronic hepatitis C(CHC) treated with new Direct-Acting Antiviral agents(DAAs) compared to pegylated interferon-2α plus ribavirin(P/R) therapy.METHODS This is a retrospective study involving psoriatic patients in biological therapy who underwent anti-hepatitis C virus(HCV) treatment at the Department of Dermatology Galeazzi Orthopaedic Institute Milan, Italy from January 2010 to November 2017. The patients were divided into two groups: patients that underwent therapy with DAAs and patients that underwent HCV treatment with P/R. Patients were assessed by a dermatologist for psoriasis symptoms, collecting Psoriasis Area Severity Index(PASI) scores and the Dermatology Quality of Life Index(DLQI). PASI and DLQI scores were evaluated 24 wk after the end of HCV treatment and were assumed as an outcome of the progression of psoriasis. Switching to a different b DMARD was considered as an inadequate response to biological therapy. The dropout of HCV therapy and sustained virological response(SVR) were considered as outcomes of HCV therapy.RESULTS Fifty-nine psoriatic patients in biological therapy underwent antiviral therapy for CHC. Of this, 27 patients were treated with DAAs and 32 with P/R. After 24 wk post treatment, the DLQI and the PASI scores were significantly lower(P < 0.001 and P < 0.005, respectively) in the DAAs group compared with P/R group. None of the patients in the DAAs group(0/27) compared to 8 patients of the P/R group(8/32) needed a shift in biological treatment.CONCLUSION DAAs seem to be more effective and safe than P/R in HCV-positive psoriatic patients on biological treatment. Fewer dermatological adverse events may be due to interferon-free therapy.

Sensitive Skin in China

Background: Many consumers in the USA and Europe define themselves as having sensitive skin, a phenomenon whose etiology appears to include both physiological and psychosocial factors. Objectives: Sensitive skin data from the developing world is sparse. This study evaluates the prevalence and characteristics of sensitive skin in China and compares data collected to existing data from the western world. Patients/Materials/Methods: A total of 408 Chinese women voluntarily completed a survey on sensitive skin. Results: Some degree of skin sensitivity was claimed by 94 (23%) of respondents;most (90.4%) said their skin was only slightly or moderately sensitive. Facial sensitivity was claimed by 21% of Chinese women, sensitivity of the body surface by 9% and genital sensitivity by only 6%. Small numbers of respondents reported a history of skin allergy (3%) or a familial history of sensitive skin (2%). Many reported making buying decisions based on product claims. Conclusions: Only 23% of Chinese women claimed any degree of sensitive skin, a prevalence substantially lower than that observed in most Western countries. Sensitivity of the genital skin, in particular, was dramatically lower, suggesting at least some cultural component to perceptions of sensitive skin.

The Murine (C3H/He) Epidermal la^+ Dendritic Cells (la^+ DECs), Thy-1^+ Dendritic Cells (Thy-1^+DECs) and Aging

Identification and enumeration of both dendritic Ia^+ epi-dermal cells (Ia^+DECs) and dendritic Thy-1^+ epidermalcells (Thy-1^+DECa) from various parts of the body wereexamined by using epidermal sheets of C3H/He inbred miceof different age groups and indirect immunofluorescent tech-nique. A significant decline of both Ia^+DECs and Thy-1^+DECs in the mice of the aged group was demonstrated anddifferent densities and different distribution patterns betweenIa^+DECs and Thy-1^+DECs were obserged. These findingsmay imply that the decline of both Ia^+DECs and Thy-1^+DECs in the aged group may reflect the alterations of im-mune response in aging.

Gut microbiota and nutrient interactions with skin in psoriasis:A comprehensive review of animal and human studies

The intestinal tract(i.e.,the gut),is where the body’s nutrients are absorbed,and is simultaneously inhabited by numerous microbes.An increasing body of literature suggests a crucial role for the gut microbiome in modulating systemic inflammatory disease.Psoriasis is a chronic systemic inflammatory disease and its pathogenesis is related to the interaction between genetic susceptibility,immune response and environmental triggers.The omics era has allowed physicians to assess different aspects of psoriasis pathogenesis such as the microbiome,infectome,and autoinfectome.Furthermore,diet appears to play an important role in modulating disease activity,perhaps by influencing gut microbes.Given these observations,we aimed to summarize the current knowledge regarding skin-microbiome-gut-nutrients and psoriasis.

Cytomegalovirus reactivation after autologous stem cell transplantation in myeloma and lymphoma patients:A single-center study

AIM: To determine the incidence of and the risk factors for cytomegalovirus(CMV) symptomatic infection and end-organ disease after autologous stem cell transplantation(ASCT).METHODS: A total of 327 consecutive non CD34+ selected autografts performed from the Hematology and Stem Cell Transplantation Unit of Regina Elena National Cancer Institute of Rome(Italy) in the period comprised between January 2003 to January 2015, were reviewed. Over the 327 autografts, 201 were performed in patients with multiple myeloma, whereas the remaining 126 in patients affected by non-Hodgkin's lymphoma and Hodgkin's lymphoma. The patients who underwent an ASCT for an acute leukemia(n = 20) in the sameperiod were excluded from this analysis. CMV DNA load in the blood has been determined by polymerasechain reaction in the case of a clinical suspicion of reactivation, therefore, no routine monitoring strategy was adopted. In the presence of signs and symptoms of CMV reactivation an antiviral treatment was performed.RESULTS: Overall, 36 patients(11%) required a specific antiviral treatment for a symptomatic CMV reactivation(n = 32) or an end-organ disease(n = 4). We observed 20 and 16 cases of CMV reactivation among lymphoma(16%) and myeloma patients(8%), respectively. Among cases of end-organ disease, 3 were diagnosed as interstitial pneumonia and one remaining case as hemorrhagic enteritis. All cases of CMV reactivation were observed in Ig G seropositive patients, with no documented cases of primary CMV infection. All patients were treated with a specific antiviral therapy, with a global rate of hospitalization of 55%; four patients received intravenous immunoglobulins. Transplantrelated mortality was significantly higher in patients who experienced a CMV reactivation(8.4% ± 4.7% vs 1.7% ± 0.8%; P = 0.047). In univariate analysis, a pretransplant HBc Ig G seropositivity, a diagnosis of T-cell non-Hodgkin's lymphoma and higher median age at transplant were significantly associated with the risk of developing a clinically relevant CMV infection requiring specific antiviral therapy(P < 0.001, P = 0.042 and P = 0.004, respectively). In multivariate analysis, only a pretransplant HBc Ig G seropositivity(OR = 8.928, 95%CI: 1.991-33.321; P = 0.023) and a diagnosis of T-cell nonHodgkin's lymphoma(OR = 4.739, 95%CI: 1.511-11.112; P = 0.042) proved to be independent predictors of a post-transplant clinically relevant CMV reactivation. CONCLUSION: A symptomatic CMV infection can occur in about 11% of adult patients with lymphoma or myeloma undergoing ASCT. A pre-transplant HBc Ig G seropositivity and a diagnosis of T-cell non-Hodgkin's lymphoma should be considered as independent predictor factors of CMV reactivation.

Inflammatory Tinea Manuum due to <i>Trichophyton erinacei</i>from an African Hedgehog

The zoophylic dermatophytes, as Trichophyton erinacei, frequently cause very inflammatory tineas in the human host. This dermatophyte is carried by some pets, particularly by the terrestrial hedgehog. Herein, we present the case of a 22-year-old male student with an exudative erythematous scaly plaque on his right fifth finger for 1 month. He had a pet African hedgehog (Atelerix albiventris). KOH examination demonstrated hyphae compatible with dermatophytes. The culture revealed a white, radiated dusty colony. PCR sequencing of the region ITS1-5.8S-ITS2 identified T. erinacei. The final diagnosis was inflammatory tinea manuum due to T. erinacei. Clinical and mycological cure was achieved after treatment with oral terbinafine 250 mg/day × 1 month.

Improvement of Scalp Condition and Quality of Life through Proper Skin Care of Dry Scalp

Introduction: Appropriate skin care for dry scalp includes treatment for dandruff and itchiness. However, little is known about the appropriate washing methods for subjects with dry scalp. Me- thods: A scalp moisturizing lotion was used for 8 weeks on 30 outpatients at the Tokushima University Hospital who had dry scalp. All subjects were given the same hair shampoo/conditioner and instructions on how to wash their hair. Scalp symptoms were observed before and after the testing period. Indigenous bacteria were collected from the scalp for quantitative assessment. A survey was conducted to assess the quality of life (QOL). Results: All scalp condition items (dryness, scales and desquamation, itchiness, excoriation, and erythema) improved significantly after the testing period;the levels of Malassezia and bacterial colonization also decreased significantly. The QOL evaluation indicated significant improvements in “symptoms”, “emotions”, and “global” measures. A correlation was found between the extent of dryness at the start of the test and the level of Malassezia colonization, as well as QOL scores. Conclusion: Using a scalp moisturizing lo- tion, washing hair with a shampoo and conditioner that cause low irritation levels, and using a hair washing method that avoids irritation led to improvement in scalp condition, QOL, and pa- tient satisfaction.

皮肤病患者抑郁症筛查:3种问卷的比较

Despite being common, depression often goes undetected in patients with skin diseases. Our aim was to examine and compare the performance of three depression screeners. We studied dermatological inpatients aged 18- 65 years. They completed the questionnaires Primary Care Screener for Affective Disorders (PC- SAD), Patient Health Questionnaire (PHQ) and General Health Questionnaire (GHQ- 12) and were administered a standardized psychiatric interview (SCID- 1) by a mental health professional, who was unaware of the questionnaire answers. The analysis was performed on 141 patients with complete data (79% of all eligible patients, 89% of all patients who agreed to participate). The prevalence of the main forms of depression, major depressive disorder and dysthymic disorder, was 8.4% and 6.3% , respectively. For major depressive disorder, the sensitivity and specificity of the questionnaires were as follows: PC- SAD, 73% and 88% ; PHQ, 55% and 91% ; GHQ- 12, 73% and 78% . For dysthymic disorder, the sensitivity and specificity were as follows: PC- SAD, 56% and 95% ; PHQ, 44% and 90% ; GHQ- 12, 56% and 76% . The small sample size suggests caution in drawing conclusions about the relative merits of these screeners. Although both the GHQ and the PHQ are short and easily hand scored, the first is a generic screener for psychiatric morbidity that is not specific for depression, while the second displayed modest sensitivity. The PC- SAD, with short average administration time, acceptable sensitivity and high specificity, might be particularly useful in settings where the technology for computer automated scoring is available. Although screening programmes might be useful, they should be supplemented by quality improvement programmes and by the development of consultation- liaison services.

英利昔单抗单一疗法治疗银屑病关节炎时的细胞因子情况

Background: Biological therapies are a new breakthrough in the treatment of psoriasis and psoriatic arthritis (PsA). Among these, tumour necrosis factor (TNF)- α antagonists such as infliximab and etanercept are the most promising as TNF is considered to be essential in driving cytokine cascade at sites of cutaneous and synovial inflammation in this disease. Objectives: To evaluate the time- related response of serum cytokine release during infliximab monotherapy and assess serum cytokine levels in order to provide a fast, minimally invasive tool to monitor and/or predict efficacy of anti- TNF- α therapy. Methods: Twenty patients affected by PsA with Psoriasis Area and Severity Index (PASI) score between 0.4 and 42.8 were treated with infliximab for 30- 42 weeks. The assessment of arthritis severity was performed using the American College of Rheumatology (ACR) criteria and ultrasonography evaluation. The treatment schedule consisted of infliximab (5 mg kg- 1 intravenously) at 0, 2 and 6 weeks and every 12 weeks on an individual basis determined by therapeutic results and adverse events reported. At baseline and before every infusion blood samples were taken to assess serum cytokine levels [TNF- α , interleukin (IL- 6), E- selectin, vascular endothelial cell growth factor (VEGF), fibroblast growth factor (FGF), matrix metalloproteinase(MMP- 2)]. Results: Eighteen of 20 psoriatic patients achieved>50% improvement and 14 of 20 patients attained>75% improvement in the PASI score at 10 weeks. All arthritic patients achieved>50% improvement (ACR- 50) and 16 of 20 patients attained>75% improvement (ACR- 75) at 10 weeks. TNF- α did not decrease immediately during the first part of the study. A significant decrease was detected at week 12 (P < 0.01). In contrast, IL- 6, VEGF, FGF and E- selectin showed significant decreases after early infliximab infusions. PASI was not correlated with TNF- α in the serum but was significantly correlated with FGF, VEGF and MMP- 2. Treatment was well tolerated and there were no significant adverse events in most patients, other than an urticarial reaction and an autoimmune hepatitis. Conclusions: Monotherapy with infliximab has to be considered an efficacious and safe treatment for PsA in comparison with traditional disease- modifying antirheumatic drugs. The resolution of cutaneous and synovial symptoms is not related to TNF- α serum levels in the initial phases. Apoptosis may play an important role in the modulation of the inflammatory response.

皮肤淋巴细胞增生性疾病患者发生人疱疹病毒8感染

Objective: To investigate the prevalence of human herpesvirus 8 (HHV-8; Kaposi sarcoma-associated herpes-virus) infection in patients with lymphoproliferative skin diseases such as large plaque parapsoriasis (LPP) and mycosis fungoides compared with inflammatory cutaneous conditions or healthy control subjects. Design: A survey study was undertaken in 123 subjects with various clini cal conditions. Setting: All patients had been seen in the Dermatology Departmen t of the San Gallicano Dermatology Institute, Rome, Italy, in the last 2 years. Patients: Forty-five patientswith inflammatory or autoimmune cutaneous diseases , 50 healthy control subjects, 10 patients with LPP, 12 patients with mycosis fu ngoides, and 6 patients with classic Kaposi sarcoma were included in the study. Main Outcome Measures: The prevalence of HHV-8 infectionwas investigated with s erologic studies using the gold standard assay based on body cavity-based B-cell lymphoma-1 cells latently infected with HHV-8. The presence of HHV-8 conserved sequence, corresponding to open reading frame 26, was also assessed in the peripheral blood and lesion tissue samples from patients with lymphoproliferative cutaneous diseases with nested polymerase chain reaction. The presence and distribution of cell types infected with HHV-8 in the lesion tissues was determined with immunohistochemical staining with the monoclonal antibody directed against the latent nuclear antigen-1 of HHV-8 encoded by open reading frame 73. Results: In healthy control subjects and patients with inflammatory skin diseases, 13.9%were found to have antibody against HHV-8, consistent with the seroprevalence population in Italy. A highly significant association of HHV-8 infection and LPPwas found (100%) compared with mycosis fungoides (25%). The peripheral blood mononuclear cells in 8 of 10 patients with LPP were found to harbor viral sequences at nested polymerase chain reaction, whereas none of them had a detectable serum viral load. All LPP lesion tissue samples were positive for HHV-8-encoded open reading frame 26, and the presence of HHV-8-infected cells was confirmed by immunohistochemistry profiles performed on paraffin-embedded tissues from 4 of 10 patients. The positive cell types included endothelial cells and the infiltrating dermal lymphocytes, characteristic hallmarks of LPP. Analysis of T cell receptor γchain rearrangements in lesion tissue from our patients confirme d the lack of a significant association between T-cell clonality and LPP. Concl usion: These data suggest that HHV-8 may play a role in the onset of LPP, a dis ease whose cause and evolution are still undefined and which has often been cons idered the early stage of mycosis fungoides.

头皮糜烂性脓疱性皮病:1例报道和文献回顾

Erosive pustular dermatosis of the scalp (EPDS) is a rare entity characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The aetiology is unknown, but predisposing factors have been reported such as trauma, skin grafting, prolonged exposure to UV light of a bald scalp a s well as co-existence of auto-immune diseases. Laboratory data, bacteriologic al and mycological investigations and histopathology are generally not diagnosti c. A 45-year-old Caucasian man with 1-year-old pustular, erosive and crusted lesions on his bald scalp was seen. Laboratory data, including auto-immunity, bacteriological and mycological investigations were negative. Histopathology was not diagnostic showing a diffuse polymorphous infiltrate involving the dermis. A diagnosis of EPDS was made. The patient was treated with topical and systemic antibiotics and steroids as well as oral nimesulide with no or partial response. Consequently, isotretinoin (0.75 mg/kg/day) was started obtaining complete reso lution in few months. No relapse after 1 year of follow-up was seen. EPDS repre sents a distinct disease with a history of relapsing and unsatisfactory response to common treatments. Systemic retinoids may be considered as a potentially res olutive choice.

皮肤LEKTI免疫组化检测:一种内瑟顿综合征的潜在诊断方法

Background:Netherton syndrome (NS) is a rare autosomal re-cessive condition characterized by ichthyosi form erythroderma, trichorrhexis invaginata and atopi c manifestations. Confirming the diagnosis may be difficult in the early stages. Mutations in the SPINK5 gene which encodes for the serine protease inhibitor LE KTI are associated with NS. These mutations create premature termination codons which result in absent or abnormal expression of LEKTI in patients with NS. Obje ctives:To investigate the expression of LEKTI in the skin of patients with NS i n comparison with normal controls and patients with other skin conditions, namel y atopic dermatitis, psoriasis and nonbullous ichthyosiform erythroderma. Method s:Immunohistochemistry was performed on skin sections from four patients with N S, four normal controls, four with atopic dermatitis, two with psoriasis and two with nonbullous ichthyosiform erythroderma, using a primary rabbit polyclonal a ntibody against LEKTI. Results:LEKTI was localized to the stratum granulosum in normal skin. All four skin sections from patients with NS showed absent or very reduced staining for LEKTI. Staining in the other disorders showed positive LEK TI expression in varying patterns. Conclusions:NS can be difficult to diagnose especially in the early stage, which can lead to inappropriate treatments partic ularly if it is misdiagnosed as atopic dermatitis. Immunohistochemistry of skin with an antibody against LEKTI is a potentially useful diagnostic test for NS.

Tumor microenvironment and immune surveillance

Tumor microenvironment(TME)comprises of tumor cells in vicinity of many additional cell types.Among many components of TME,immune cells represent a class of distinct cells that normally would be expected to suppress tumor growth and kill tumor cells,but are,instead,modulated by tumor cells to create conditions that support tumor growth,angiogenesis,metastasis and resistance against therapies.These immune cells include lymphocytes,natural killer cells,macrophages,dendritic cells,myeloid-derived suppressor cells and regulatory T-cells.Given the role these immune cells play in immune suppression within TME,it is important to clearly understand the mechanisms thereof so that the future immunotherapies can be tweaked and many of these immune cells could be reprogrammed to perform their normal cytotoxic/phagocytic activity for elimination of tumors.

Perspectives on cancer-microbiome conundrum

Human body is truly an ecosystem in itself harboring numerous microbial species that have profound effect on diseases and health outcomes[1,2].Investigations over past several years have increased our understanding of the effects that microbiome has on several conditions such as obesity,inflammation etc[2,3].Incidentally,these are also risk factors for cancer and moreover evidence is now accumulating for some more direct association of human microbiome with cancer initiation as well as progression.With the documentation of this emerging evidence,it is quite apparent that microbiome is very relevant to carcinogenesis affecting multiple stages of cancer development.