Sodium lauiyl sulphate damaged skin in vivo in man: a water barrier repair model

Background/aims: Few studies describe enhancing the repair of surfactant-induced damaged skin. In vivo human studies were conducted to evaluate the efficacy of a topical agent after sodium lauryl sulphate (SLS) induced water barrier disruption. Methods: Occlusive chambers with 1 % SLS were applied to the upper-backs of volunteers for 24 h, removed and topical agents applied on the SLS-treated skin sites daily for 5 days. Water barrier restoration was monitored by measuring transepidermal water loss (TEWL). Results: The data were expressed as the percentage of recovery representing normalization of water barrier function. Results showed that a topical agent produced more rapid improvement in barrier function than its placebo vehicle, markedly accelerating repair at 48 h (P<0.01), and persisting throughout the experiment (P<0.05), in comparison with SLS-control sites. Conclusions: This study suggests that topical agents may accelerate the repair rates of water barrier function in SLS-treated human skin. This model appears facile and robust for evaluating such repair.     

胸腔内血容量指数和血管外肺水在创伤性ARDS患者液体管理中的应用

目的 探讨胸腔内血容量指数(ITBVI)及血管外肺水(EVLW)在指导创伤性ARDS患者液体管理中的应用价值,从而探寻ARDS患者的最佳液体管理策略.方法 选取2011年5月～2012年5月符合纳入标准的创伤性ARDS患者57例为研究对象,随机分为限制性液体管理组和开放性液体管理组.记录SOFA评分、氧合指数以及7d和28 d生存率为主要终点,以机械通气时间、ICU住院时间为次要终点进行评价.结果 限制性液体管理组患者在治疗后36 h较开放性液体管理组SOFA评分明显降低,P=0.037,ICU住院时间及机械通气时间明显缩短,P＜0.05,两组患者病死率差异无统计学意义,P＞0.05;治疗前后不同时间氧合指数之间差异有统计学意义,F =60.232,P=0.000;两组患者氧合指数组内、组间比较差异有统计学意义,P ＜0.05.结论 对于创伤性ARDS患者,联合应用ITBVI和EVLW为液体管理目标,精准地进行限制性液体管理能明显改善氧合指数,缩短机械通气时间、ICU住院时间,具有积极的临床意义.     

经皮水分丢失与健康人性别、年龄、解剖部位的关系

通过经皮水分丢失（TEWL）来评价皮肤的屏障功能，并研究经皮水分丢失与性别，年龄，解剖部位的关系，参加本次实验的为健康志愿者共104名，其中女性53名，男性51名，分为5个不同年龄组，用与计算机相连的蒸发测定仪Darmalab TEWL探头测量。结果发现不同年龄组男女性别之间TEWL值均无显著性差异（P＞0．05），新生儿组TEWL值明显高于其他各年龄组（P＜0．05），老年组TEWL值低于其他年龄组。在8个不同部位测量中，经统计得到TEWL值顺序为：手掌＞额部＞颊部＝手背＞小腿＝背部＞前臂＝胸部。说明TEWL与性别无明显相关性，而与年龄相关，以新生儿最高，老年人最低，在身体各部位的测量中，四肢末端和暴露部位经皮水分丢失较高。     

Free residual chlorine in bathing water reduces the water-holding capacity of the stratum corneum in atopic skin

Some patients with atopic dermatitis (AD) develop dry skin or exacerbated cutaneous inflammations with frequent swimming in public pools or after bathing. We examined the effects of residual chlorine in bathing water on the function of the stratum corneum (SC) in patients with AD and determined the lowest chlorine concentration showing an effect. In addition, we investigated the relationship between the free residual chlorine concentration in bathing water and the water-holding capacity of the SC in patients with AD. Twenty patients with AD and 10 normal control (NC) subjects were included in this study. The hydration status of the SC on the flexor surface of the forearm was measured with a corneometer before and after the subject's arms were immersed in tubs filled with comfortably hot water (40 degrees C) containing residual chlorine at concentrations of 0, 0.5, 1.0 and 2.0 mg/L for 10 minutes in a room maintained at normal temperature (24 degrees C) and relative humidity (55%). The water-holding capacity of the SC after immersion was calculated by integration of the hydration status determined every 30 seconds over a period of 10 minutes. In the patients with AD, the average SC hydration status after immersion in comfortably hot water containing residual chlorine at 1.0 and 2.0 mg/L was significantly lower than that following immersion in water containing a negligible concentration of residual chlorine (i.e., less than 0.03 mg/L) (p<0.05). In the NC subjects, significant differences were observed only between the 2.0 mg/L and the negligible residual chlorine groups (p<0.05). The water-holding capacity of the SC was significantly decreased with a residual chlorine concentration of 0.5 mg/L or higher in the patients with AD (p<0.01). However, in the NC subjects, a significant decrease in water-holding capacity was observed only at a residual chlorine concentration of 2 mg/L (p<0.01). These results indicate, first, that the water-holding capacity of the SC in patients with AD is more sensitive to free residual chlorine exposure than that in NC subjects without AD. Second, these results suggest that free residual chlorine exposure in patients with AD may play a role in the development or exacerbation of AD.     

Biophysical changes after mechanical injury of the stratum corneum in normal skin

Scrubbing off the stratum corneum with a rough towel after soaking in warm water is a bathing custom unique to Korea. However, Korean dermatologists have advised against this practice due to the potential harm that it may cause, though there is little data to support this advice. This study aimed to evaluate the changes in biophysical characteristics after such mechanical injury of stratum corneum, as reflected by water-holding capacity, stratum corneum barrier function, and stratum corneum turnover time (SCTT). 10 Korean female volunteers (aged 19-34 years) were enrolled in this study to investigate the acute effects and 32 volunteers (aged 19-49 years) the chronic effects. After soaking in warm water (36 degrees C) for 5 min, the flexor surfaces of the forearms were scrubbed with a rough towel. The volunteers' forearms were divided into 4 compartments, and each compartment was scrubbed 0, 5, 10, and 15x, respectively. After a single injury of the stratum corneum, there was an initial decrease in water-holding capacity until 6 h. Thereafter, it increased until day (D) 3, when it began to descend to the normal range. The transepidermal water loss (TEWL) values also peaked at D2 and declined thereafter. However, there were no changes in either water-holding capacity or skin barrier function, and only the SCTT was significantly shortened, after chronic injury of the stratum corneum.     

Comparative study of five instruments measuring stratum corneum hydration (Corneometer CM 820 and CM 825, Skicon 200, Nova DPM 9003, DermaLab). Part II. In vivo

Background/aims: The hydration state of stratum corneum can be measured with different instruments. In the present study, five instruments were compared under different experimental in vivo conditions: Corneometer CM 820 and CM 825 (both capacitance based), Skicon 200 (conductance), Nova DPM (impedance based capacitance) and DermaLab (capacitance).
Methods: Seven anatomical sites were tested, a sorption-de-sorption test (SDT) and a moisture accumulation test (MAT) were performed. Different hydration states were created on the volar forearms by occluded application of an oil-in-water (o/w) emulsion, glycerol and urea containing oil-in-water (o/w) emulsion, an untreated control site and a site after lipid extraction with acetone. Measurements were performed 15 min after removal of occlusion.
Results: The coefficient of variation for CM 820 ranged between 9.3% and 23.7%; for CM 825 between 14.9% and 36.8%; for Skicon 200 between 53.0% and 167.3%; for Nova DPM between 36.4% and 95.8%; for DermaLab between 23.6% and 45.6%. All devices showed a highly significant correlation (P<0.0001) with a high Spearman coefficient r ranging between 0.7928 and 0.9358.
Conclusions: CM 820 and CM 825 seem to differentiate more precisely than Nova DPM, Skicon 200 and DermaLab in dry conditions according to previous findings, i.e., that conductance measurements might be more sensitive for hydrated skin and capacitance measurements might be more sensitive for dry skin conditions. The CM 825, the Skicon 200 and the Nova DPM are suitable for dynamic measurements of hydration parameters of the stratum corneum.     

Low‐dose methotrexate treatment for moderate‐to‐severe atopic dermatitis in adults

Background Atopic dermatitis (AD) is a common inflammatory skin disease. Methotrexate (MTX) was suggested as an effective treatment option in cases of moderate‐to‐severe atopic dermatitis. This study assessed the efficacy and safety of treatment with low weekly doses of methotrexate for moderate‐to‐severe AD in adults. Methods Twenty adult patients with moderate‐to‐severe AD were included in this retrospective study. Those patients were unresponsive to topical treatments, antihistamines and at least one of the second‐line treatments. MTX in low weekly doses of 10–25 mg was administered orally or intramuscularly with folic acid supplementation 5 mg per week for at least 8–12 weeks. The response to treatment was evaluated by change in SCORAD (SCORing Atopic Dermatitis), DLQI (Dermatology Quality of Life Index) and the global assessment of the clinical response score. Results After 8–12 weeks of treatment, we observed an objective response in most patients. There were 16 responders and 4 non‐responders. The mean SCORAD and DLQI decreased by 28.65 units (44.3%) and 10.15 units (43.5%), respectively. The first improvement was observed after a period ranging from 2 weeks to 3 months (mean 9.95 w ± 3.17). Treatment was more effective in adult onset AD than in childhood onset. Tolerance of treatment was good. However, nausea and an increase of liver enzymes were observed in 5 patients and 3 of them required a transient discontinuation of MTX. One patient developed peripheral neuropathy, which was resolved several weeks after the discontinuation of MTX. Conclusion MTX seems to be an effective and safe second‐line treatment for patients with moderate‐to‐severe atopic dermatitis. A randomized, controlled study is warranted.     

血清ES、VEGF水平和多囊卵巢综合征患者血清胰岛素及卵巢间质血流的相关性分析

目的探讨分析血清内皮抑素(endostatin,ES)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平和多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者血清胰岛素及卵巢间质血流的相关性。方法选取2016年8月至2018年3月滕州市妇幼保健院诊治的85例PCOS患者作为研究对象。将这85例患者设为PCOS组,选择同期在滕州市妇幼保健院健康体检的60例健康女性作为对照组,检测两组受试者血清胰岛素水平、性激素水平、ES以及VEGF水平,并采用经阴道多普勒超声监测受试者卵巢间质血流,记录受试者搏动指数(pulse index,PI)以及阻力指数(resistance index,RI),分析ES以及VEGF水平与各指标相关性。结果 PCOS组患者黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)水平显著高于对照组,差异具有统计学意义(P<0.05),两组雌二醇(estradiol,E2)、促卵泡刺激素(follicle stimulating hormone,FSH)以及泌乳素(prolactin,PRL)水平比较差异无统计学意义(P>0.05)。PCOS组患者PI、RI显著低于对照组,差异具有统计学意义(P<0.05),而PCOS组患者胰岛素(insulin,Ins)、VEGF以及ES水平显著高于对照组,差异具有统计学意义(P<0.05)。PCOS患者血清VEGF水平与PI、RI呈显著负相关关系,差异具有统计学意义(P<0.05),与Ins呈显著正相关关系,差异具有统计学意义(P<0.05);患者ES水平与PI、RI呈显著负相关关系,差异具有统计学意义(P<0.05),与Ins呈显著正相关关系,差异具有统计学意义(P<0.05)。结论 PCOS患者血清VEGF以及ES水平显著升高,二者表达与卵巢间质血流增加以及胰岛素水平增加密切相关,可能影响PCOS疾病发展过程。     

Protective effects of topically applied CO2-impregnated water

Background/aims: The‘positive effect’of CO₂-impregnated water (mechanical process of producing carbonated therapeutic waters for medical use) on the skin of the hands was reported by 76% of 107 users questioned. The present study intends to evaluate this effect by using bioengeneering methods. Methods: In 20 healthy volunteers, mild to moderate irritation was induced on both hands using a standardised washing procedure. One hand was rinsed with CO₂-impregnated water (carbonic acid) once daily for 1 min, the other with tap water as the control. Baseline values and values 30 min after application were recorded by measuring transepidermal water loss (TEWL), skin humidity (SH), microcirculation of the blood (BF) and skin surface pH. Wilcoxon's signed rank test was used for statistical analysis; P-values of less than 0.05 were considered to be significant. Results: Baseline TEWL, BF and pH tended to be lower (in some cases significantly lower) in the test regions treated with carbonic acid, whereas baseline SH tended to be higher (in some cases significantly higher). TEWL and pH were significantly lower for the side treated with CO₂ 30 min after application, whereas in some cases SH was significantly higher compared with the control side. Visual comparison revealed a lesser degree of irritation for the region treated with CO₂ in comparison with the control side. Conclusions: The results show that the skin physiology parameters of irritated skin are favourably influenced by the topical application of CO₂-impregnated water. Although those test regions treated with carbonic acid did not remain uninfluenced by repeated irritation in clinical comparisons, the irritation was more intensive in the test regions treated with fresh water.     

良性前列腺增生患者经尿道前列腺电切术水中毒预防与治疗的方法探讨

目的:探讨良性前列腺增生(BPH)患者经尿道前列腺电切术水中毒预防与治疗的有效方法。方法:选取我院2014年5月至2016年5月收治的良性前列腺增生(BPH)患者100例,其中3例患者术中发生水中毒,水中毒发生率为3%,给予患者脱水利尿治疗,途径为对患者应用20%甘露醇,对高渗钠进行补充,将酸中毒及低血压纠正过来,膀胱前或腹腔间隙穿刺对积液进行引流,以将手术尽可能快地中止或结束,然后分析其治疗效果。结果:3例水中毒患者中,具有正常电解质、以较快的速度纠正生命体征、排除膀胱周围及腹腔间隙积液、没有对手术进程造成影响2例,具有正常的生命体征的时间为治疗1h左右后而将手术中止1例。回病房后均具有较为稳定的生命体征,术中输血400mL 1例,术后输血400mL 1例。术后1~3d、5d分别停止冲洗膀胱并将膀胱造瘘管拔除、将导尿管拔除出院。3例患者术后1个月均具有令人满意的排尿且没有显著并发症发生。结论:早期发现和治疗是BPH患者经尿道前列腺电切术水中毒预防与治疗的有效方法,值得临床充分重视。     

重型颅脑损伤后早期血清IL-17、IL-23、乳酸水平变化及对继发性大面积脑梗死的预测价值

目的 探讨重型颅脑损伤后早期血清白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、乳酸(Lac)水平变化及对继发性大面积脑梗死的预测价值.方法 选取2017年9月—2020年9月新华医院崇明分院收治的158例重型颅脑损伤患者为研究组,另选同期来院体检的146例健康体检者,为对照组.比较两组血清IL-17、...     

非淋菌性尿道炎的病原检查研究

目的：探讨有性乱史女性沙眼衣原体、解脲支原体和人型支原体感染的检查方法。方法：沙眼衣原体抗原检查采用C-C快速法解脲支原体和人型支原体的检查采用培养法。结果：406例被检者，沙眼衣原体抗原阳性者106例（26.10%)解脲支原体和人型支原体培养阳性者266例（65.52%)。结论：有性乱史的女性支原体感染率较高；对非淋菌性尿道炎的病原检查，沙眼衣原体抗原采用C-C快速法检查，解脲支原体和人型支原体采用培养法检查均较简便、快速、实用。     

香菊流浸膏对水痘─带状疱疹病毒抑制作用的实验研究

采用细胞培养技术，通过五种不同的给药途径，观察香菊流浸膏对分离的水痘－带状疱疹病毒的实验室抑制作用。结果证实香菊流浸膏对水痘－带状疱疹病毒复制的每一环节均有不同程度的抑制作用。     

5-氨基酮戊酸光动力疗法治疗痤疮

目的 探索5-氨基酮戊酸光动力疗法（ALA-PDT）治疗中、重度痤疮的安全性及有效性。方法 将70例中、重度痤疮患者随机分为两组。治疗组35例,给予ALA-PDT治疗,每2周治疗1次,共治疗1 ~ 3次;对照组35例,口服异维A酸胶囊治疗,共服用6周。在治疗第2、4、6周对两组患者进行疗效判断和比较。结果 35例接受ALA-PDT治疗的患者经过1 ~ 3次治疗后（第2、4、6周）,总有效率达97.1%;对照组于6周时总有效率为80.0%,治疗组疗效明显优于对照组（P < 0.05）。另外,ALA-PDT组复发程度明显轻于对照组,且病情控制时间明显延长。ALA-PDT组有个别患者局部出现暂时性色素沉着,但无瘢痕发生。结论 ALA-PDT是一种简单、高效、不良反应轻微的治疗中、重度痤疮的新疗法。     

子宫内膜异位症患者血清MMIF、Ang-2的水平及临床意义

目的探讨子宫内膜异位症(EMs)患者血清巨噬细胞移动抑制因子(MMIF)、血管生成素-2(Ang-2)的水平及临床意义。方法选取2017年4月至2018年12月在广州市番禺区何贤纪念医院妇科治疗的EMs患者103例(EMs组),卵巢良性肿瘤患者90例(卵巢良性肿瘤组)和健康志愿体检者100例(健康组),检测各组血清MMIF、Ang-2水平。结果 EMs组血清MMIF和Ang-2分别为(1.92±0.31)ng/mL和(73.39±11.40)ng/mL,明显高于卵巢良性肿瘤组和健康组(P<0.05);R-AFS分期Ⅳ期患者血清MMIF和Ang-2分别为(2.54±0.25)ng/mL和(88.29±9.40)ng/mL,明显高于Ⅰ期、Ⅱ期和Ⅲ期患者(P<0.05);MMIF、Ang-2与R-AFS分期呈正相关(rs=0.343和0.350,P<0.05);MMIF与Ang-2呈正相关(r=0.866,P<0.05)。结论子宫内膜异位症患者血清MMIF、Ang-2水平明显升高,两者间可能存在一定的相关性,两者水平与EMs的病情程度具有显著相关性,值得进一步研究。     

香菊流浸膏对水痘─带状疱疹病毒抑制作用的实验研究

采用细胞培养技术，通过五种不同的给药途径，观察香菊流浸膏对分离的水痘－带状疱疹病毒的实验室抑制作用。结果证实香菊流浸膏对水痘－带状疱疹病毒复制的每一环节均有不同程度的抑制作用。     

Hydrating effect of potassium lactate is caused by increasing the interaction between water molecules and the serine residue of the stratum corneum protein

Natural moisturizing factors (NMFs) play an important role in maintaining the physical properties of the stratum corneum (SC). The relationship between SC water content and NMFs has long been investigated. Recently, we demonstrated that potassium lactate as an NMF increased SC water content more than sodium lactate did. The details of the moisturizing mechanism of NMFs, however, were not revealed. We, therefore, investigated the cause of the SC moisturizing effect of potassium lactate in comparison with sodium lactate. Using differential scanning calorimetry, we found that potassium lactate increased the bound water content of plantar SC more than what sodium lactate did. We also found, however, that the bound water content of the potassium lactate solution was less than that of the sodium lactate solution, suggesting that potassium lactate increased the water molecules interacting with SC components. Moreover, potassium lactate increased the ratio of hydrogen/deuterium exchange at 1340/cm, which represents the OH bending mode, of plantar SC spectra obtained by the attenuated total reflectance infrared spectroscopy. We assign this band to the OH group of the serine residue. These results suggest that potassium lactate increases the water-holding capacity of the SC by increasing interaction between water molecules and the OH group of serine in SC keratin.     

北京地区患者沙眼衣原体、淋球菌及解脲脲原体感染分析

目的分析门急诊患者泌尿生殖道沙眼衣原体(CT)、淋病奈瑟菌(NG)及解脲脲原体(UU)感染情况。方法选取2014年1月至2019年6月北京大学第三医院诊治的23 847例门急诊就诊患者的CT、NG和UU荧光核酸恒温扩增检测结果及相应临床诊断信息进行回顾性分析。结果 23 847例患者中,22 953例男性患者CT、NG、UU的检出率分别为5.0%、2.0%与22.6%;894例女性患者CT、NG、UU的检出率分别为7.9%、1.9%与48.9%。女性患者CT、UU检出率均高于男性,差异具有统计学意义(P=0.000),而NG检出率差异无统计学意义(P=0.858)。按年龄段分层,各性别中CT、NG最高检出年龄段均为≤20岁年龄段。临床诊断明确的男性患者中,CT检出最高为附睾炎(27.4%)人群,NG检出率则以尿道炎患者(16.7%)最高,UU检出率最高为不育症患者(32.6%)。结论女性患者CT检出率高于男性,男性附睾炎患者应注意筛查CT、NG。