类脂质渐进性坏死1例

报告类脂质渐进性坏死1例。患者女,68岁,因右下肢胫前斑块2年就诊。皮肤专科检查:右下肢胫前可见一大小约10 cm×3 cm黄棕色斑块,边界清楚,表面光滑有光泽,可见毛细血管扩张和褐色斑,上覆鳞屑,上下端皮损中央萎缩凹陷,上见痂,质硬,无压痛。皮损组织病理检查:表皮轻度萎缩,真皮见胶原变性灶,周围组织细胞呈栅栏状排列,真皮浅深层毛细血管增生,管壁增厚,血管周围淋巴细胞、浆细胞、组织细胞及多核巨细胞浸润。实验室检查:血、尿、大便常规、肝肾功能正常,口服葡萄糖耐量试验提示糖耐量异常,糖化血红蛋白正常。诊断:类脂质渐进性坏死。予铒点阵激光(2 940 nm)联合卤米松/三氯生乳膏外用,皮损较前消退,目前仍在随访中。     

健脾利湿法中药复方联合抗组胺药治疗亚急性湿疹的临床疗效观察

目的观察健脾利湿法中药复方联合抗组胺药治疗亚急性湿疹的临床疗效。方法根据标准招募亚急性湿疹患者90例,随机分为两组,分别给予抗组胺药或者抗组胺药联合健脾利湿法中药复方治疗,3周后评价药物治疗临床疗效。结果治疗组患者痊愈17例,显效21例,总显效率84.4%,高于临床对照组的总显效率73.3%(P<0.05)。结论健脾利湿法中药复方联合西药治疗亚急性湿疹有较好的临床疗效。     

斑秃患者中医体质特点研究

目的:探讨斑秃患者中医体质类型特点;方法:对103例斑秃患者采用中医体质问卷进行中医体质调查,采用聚类分析对其进行体质分型;结果:103例患者中,单一体质32例,占总病例数的31.07%,兼杂体质71例,占总病例数的68.93%;平和质(正常体质)16例,占总病例数的6.22%;病理体质者87例,占总病例数的93.78%,气郁质出现频率最高(31.91%)。结论:兼杂体质是斑秃患者的主要病理体质,气郁质在本病发生发展中占重要地位。     

复方二藤洗剂治疗掌跖脓疱病疗效观察

目的:观察清热解毒类中药治疗掌跖脓疱病的临床疗效。方法:采用复方二藤洗剂(南蛇藤、忍冬藤、三桠苦、大飞杨、黑面神、虎杖等)外洗治疗本病38例,并设对照组,观察两组临床症状改善情况。结果:治疗组总有效率为86.84%,对照组总有效45.16%,差异有统计学意义(P<0.01)。结论:本方法对本病有清热解毒,祛班消疱的功效。     

皮肤支气管源性囊肿1例

 报告成人皮肤支气管源性囊肿1例。患者男，22岁，左颈部皮疹3年。皮肤科检查：左颈部皮肤见一约0.2 cm×0.2 cm大小的淡红色丘疹，边界清楚，中间可见破口，未见明显液体流出。皮肤镜检查：非偏振光下淡红色背景，可见湿润性破损口；偏振光下淡红色背景，镜下见中央破损口，外周红白色无结构区，绕以扩张的分支状血管。皮损组织病理学检查：真皮层见一角囊肿及一腺腔，腺腔内衬假复层纤毛柱状上皮，可见个别粘液细胞。腺腔周围见淋巴细胞浸润。真皮上方表皮呈息肉样突起，表皮鳞状上皮组织局部与复层柱状上皮组织相移行。诊断：皮肤支气管源性囊肿。外科手术切除后随访3个月，未见复发。     

小鼠真皮间充质干细胞与成纤维细胞共培养对胶原分泌和TGF-β1表达的影响

Objective To explore the role of mouse dermis-derived mesenchymal stem cells (mdMSC) on skin repair. Methods mdMSC and human dermal fibroblasts were isolated and identified. Human dermal fibroblasts were cultured alone or eoeultured with mdMSC in Transwell chambers with the density ratio of human dermal fibroblasts to mdMSC being 2/5, 1/1, and 2/1. On day 4 and 8 of culture, the expression levels of hydroxyproline and transforming growth factor-beta (TGF-beta) 1 were measured in the supematant of monoculture and coculture by alkaline hydrolysis and ELISA respectively. Results The level of hydro-xyproline was significantly higher in the supematants of coculture system with a density ratio of 2/5 and 1/1 than that in monoculture supematants of human dermal fibroblasts on day 8 (both P < 0.05). Elevated level of TGF-betal was observed in all coculture supematants on day 8 (all P < 0.01) and in the supernatants of coculture system with a density ratio of 1/1 on day 4 (P < 0.05). There was no significant correlation between the expression level of TGF-betal and hydroxyproline in the coculture supernatants (r = 0.108, P ＞ 0.05). Conclusion In vitro coculture with mdMSC can increase the production of hydroxyproline and TGF-betal by fibroblasts, which may be a mechanism underlying the facilitation of skin repair by mdMSC.     

小鼠真皮间充质干细胞与成纤维细胞共培养对胶原分泌和TGF-β1表达的影响

Objective To explore the role of mouse dermis-derived mesenchymal stem cells (mdMSC) on skin repair. Methods mdMSC and human dermal fibroblasts were isolated and identified. Human dermal fibroblasts were cultured alone or eoeultured with mdMSC in Transwell chambers with the density ratio of human dermal fibroblasts to mdMSC being 2/5, 1/1, and 2/1. On day 4 and 8 of culture, the expression levels of hydroxyproline and transforming growth factor-beta (TGF-beta) 1 were measured in the supematant of monoculture and coculture by alkaline hydrolysis and ELISA respectively. Results The level of hydro-xyproline was significantly higher in the supematants of coculture system with a density ratio of 2/5 and 1/1 than that in monoculture supematants of human dermal fibroblasts on day 8 (both P < 0.05). Elevated level of TGF-betal was observed in all coculture supematants on day 8 (all P < 0.01) and in the supernatants of coculture system with a density ratio of 1/1 on day 4 (P < 0.05). There was no significant correlation between the expression level of TGF-betal and hydroxyproline in the coculture supernatants (r = 0.108, P ＞ 0.05). Conclusion In vitro coculture with mdMSC can increase the production of hydroxyproline and TGF-betal by fibroblasts, which may be a mechanism underlying the facilitation of skin repair by mdMSC.     

浅谈邓铁涛教授软皮汤

硬皮病是慢性自身免疫性疾病,现代医学尚无确切疗法。邓铁涛教授针对其肺脾肾亏损的病机,根据“损者益之”,“虚者补之”的原则,并结合历代医家治疗的经验,自拟软皮汤作为治疗硬皮病的基础方。全方配伍严谨,具有补肾益精之效,临床取得满意疗效。本文就该方的方药配伍及单味药的药理研究作一综述,以利于复方药效物质基础筛选,为下一步复方化学成分及功效研究奠定基础。     

基于网络药理学-分子对接探讨益气养阴通络方抗类风湿关节炎的作用机制

[目的] 采用网络药理学与分子对接探究益气养阴通络方干预类风湿关节炎（RA）的作用机制。[方法] 通过中药系统药理学数据库及分析平台（TCMSP）、本草组鉴（HERB）和文献查阅获得复方活性成分与靶点,采用Genecards、在线人类孟德尔遗传数据库（OMIM）等数据库获得疾病靶点,然后采用数据库计算出益气养阴通络复方成分与疾病的交集靶点。对交集靶点施行功能和通路富集分析,选取益气养阴通络方核心药物靶点与关键化合物施行分子对接。[结果] 网络药理学共筛选出益气养阴通络方的 83种活性成分和779个潜在靶点,RA相关靶点5 393个,交集靶点465个,其中交集核心靶点9个（分别为SRC、STAT3、MAPK3、MAPK1、HSP90AA1、PIK3R1、GRB2、AKT1、PIK3CA）。富集得出PI3K-AKT、癌症相关及神经活性配体-受体相互作用等通路,其中PI3K-AKT信号通路可能是复方干预RA的关键通路之一。对接计算表明,益气养阴通络方的11种主要活性成分与关键靶点SRC、STAT3、PIK3R1、AKT1均有较稳定的结合,其中与AKT的结合可能最大。[结论] 益气养阴通络方通过多成分-靶点-通路的方式干预RA,PI3K-AKT、癌症相关及神经活性配体-受体相互作用通路均为可能的作用通路。     

补肾益精中药复方对内皮间质转化的影响

目的:探讨补肾益精中药复方对转化生长因子-β1(transforming growth factor-β1,TGF-β1)诱导的内皮间质转化的作用及机制。方法:TGF-β1诱导人脐静脉细胞(human umbilical vein endothelial cell,HUVEC)构建内皮间质转化模型,分别用对照血清、补肾益精复方含药血清、黄芪甲苷、Fli1 siRNA+含药血清干预模型,显微镜检测HUVEC细胞内皮间质转化过程,实时荧光定量聚合酶链式反应(quantitative polymerase chain reaction,QPCR)法检测各组VE-cadherin、FSP1、Fli1的表达。结果:①经TGF-β1诱导后,细胞形态呈现纤维化改变,VE-cadherin表达降低,FSP1表达升高,提示内皮间质转化模型诱导成功;同时Fli1在内皮间质转化模型中为低表达。②采用Fli1 siRNA干扰设计Fli1 siRNA序列,显示Fli1 siRNA-1明显抑制Fli1 mRNA表达,同时VE-cadherin表达明显下降,FSP1表达明显上升。③黄芪甲苷组、补肾益精复方含药血清组中Fli1、VE-cadherin的表达较内皮间质转化模型组升高,FSP1表达降低,提示血管内皮间质得到改善;Fli1siRNA+含药血清组较含药血清组Fli1下降、VE-cadherin下降、FSP1上升,其改善不如单独含药血清组明显。结论:补肾益精法中药复方可改善硬皮病血管内皮间质转化,其机制可能与上调Fli1有关。