系统性红斑狼疮患者血清及脑脊液中C-反应蛋白的水平及临床意义

目的　探讨系统性红斑狼疮 (SLE)患者血清和脑脊液 (CSF)中C 反应蛋白 (CRP)的水平及临床意义。方法　对 2 5例SLE患者进行血清和CSF中CRP及抗核抗体 (ANA )的检测 ,分析血清CRP与CSFCRP、血清CRP与血清ANA、CSFCRP与CSFANA的相关性。结果　①直线相关分析显示 ,血清CRP与CSFCRP水平呈正相关 (r =0 .4465,P =0 .0 42 5) ;②等级相关分析显示 ,血清CRP与血清ANA、CSFCRP与CSFANA均无明显相关性 (rs′分别为-0 .0 2 2、-0 .0 14 8,P均 >0 .0 5)。结论　①血清CRP水平与SLE活动性无明显关系 ,不能作为SLE活动指标 ;②SLE患者CSF中检出CRP ,其平均水平 2 .0 2± 0 .87mg/L ;③SLE患者CSF出现CRP的基础可能是血脑屏障受损 ,提示临床上无脑损害的SLE患者血脑屏障可能已经发生了不同程度的损伤     

系统性红斑狼疮患者白介素13和神经生长因子的测定及其临床意义

目的 探讨系统性红斑狼疮(SLE)患者血清中白介素13和神经生长因子的水平变化.方法 应用酶联免疫吸附法检测35例SLE患者和15例正常人血清白介素13和神经生长因子水平.结果 SLE活动期患者血清白介素13水平为(92.69±9.87)pg/mL及神经生长因子水平为(339.69±25.60)pg/mL,SLE稳定期患者分别为(54.22±9.31)pg/mL和(300.89±33.51)pg/mL,正常人对照组分别为(35.20±12.70)pg/mL和(111.40±32.54)pg/mL.SLE活动期、稳定期患者血清白介素13和神经生长因子水平均显著高于正常人对照组(P<0.05或<0.01),SLE活动期显著高于稳定期(P值均<0.01).SLE患者血清白介素13水平与SLEDAI积分、血沉、C3均呈显著相关(r值分别为0.813、0.504、-0.605),神经生长因子水平与上述指标也呈显著相关(r值分别为0.442、0.338、-0.463),同时白介素13和神经生长因子水平呈显著正相关(r=0.506,P<0.01).结论 白介素13和神经生长因子在SLE的发病中可能发挥一定的作用.     

系统性红斑狼疮患者血清γ干扰素诱导的T细胞α趋化因子检测

目的探讨血清γ干扰素诱导的T细胞α(I-TAC)趋化因子水平与系统性红斑狼疮(SLE)疾病活动的关系及意义。方法采用双抗体夹心ELISA法检测血清I-TAC水平。结果①SLE患者血清I-TAC水平(20.20±6.62ng/mL)明显高于正常人对照(3.13±0.70ng/mL),活动期患者(43.96±14.08ng/mL)高于非活动期患者(2.03±0.46ng/mL);患者血清I-TAC水平与疾病活动指数(r=0.54,t=4.87,P<0.001)、血沉(r=0.47,t=3.80,P<0.001)及ANA对数值(r=0.37,t=3.05,P=0.003)呈正相关,它与补体C3(r=-0.26,t=2.03,P<0.05)呈负相关。②肾损组患者(50.22±16.86ng/mL)血清I-TAC水平明显高于非肾损组患者(7.33±5.11ng/mL)。结论I-TAC可能参与SLE的发病机制,血清I-TAC水平可作为监测疾病活动程度和肾脏损害的一个指标。     

系统性红斑狼疮患者血清催乳素水平和外周血单一核细胞催乳素受体的表达

目的 探讨系统性红斑狼疮(SLE)患者血清催乳素(PRL)水平和外周血淋巴细胞的催乳素受体(PRLR)的表达与SLE活动性的关系。方法 应用时间分辨免疫发光试验(TrFIA)测定血清PRL,用SLEDAI指数评估了113例SLE患者的病情活动性,并用Logistic多元回归研究临床表现、免疫学指标与高PRL血症的关系;采用放射性受体配基结合试验(RLBA)及RT-PCR研究外周血淋巴细胞PRLR变化。结果 ①63例SLE活动期患者血清PRL水平(14.45±7.25μg/L)显著高于50例静止期患者(11.79±8.08μg/L)和28例正常人对照组(7.08±6.26μg/L);②79.37%的活动期患者血清PRL水平在9~51.2μg/L;③113例SLE患者血清PRL水平与dsDNA抗体、SLEDAI活动指数呈线性正相关;④Logistic多元回归研究发现蛋白尿、低C3和高dsDNA抗体滴度与高PRL血症相关;⑤24例SLE活动期患者外周血单一核细胞(PBMC)的PRLR的特异性结合率(SB,5.03%±2.51%)、总结合率(TB,15.34%±6.98%)和mRNA的表达水平(0.85±0.45)均显著高于22例静止期患者(SB4.18±2.26,TB14.03±6.54%,mRNA0.58±0.43)和15例正常人对照组(SB1.62%±1.05%,TB8.19%±1.47%,mRNA0.20±0.13)。结论 SLE患者血清PRL轻度升高,PBMC的PRLRmRNA高表达以及相应特异性结合率的增加与SLE的病情活动性相关。     

系统性红斑疮患者血清催乳素水平和外周血单一核细胞催乳素受体的表达

目的探讨系统性红斑狼疮(SLE)患者血清催乳素(PRL)水平和外周血淋巴细胞的催乳素受体(PRLR)的表达与SLE活动性的关系.方法应用时间分辨免疫发光试验(TrFIA)测定血清PRL,用SLEDAI指数评估了113例SLE患者的病情活动性,并用Logistic多元回归研究临床表现、免疫学指标与高PRL血症的关系;采用放射性受体配基结合试验(RLBA)及RT-PCR研究外周血淋巴细胞PRLR变化.结果①63例SLE活动期患者血清PRL水平(14.45±7.25 μg/L)显著高于50例静止期患者(11.79±8.08μg/L)和28例正常人对照组(7.08±6.26 μg/L);②79.37%的活动期患者血清PRL水平在9～51.2μg/L;③113例SLE患者血清PRL水平与dsDNA抗体、SLEDAI活动指数呈线性正相关④Logistic多元回归研究发现蛋白尿、低C3和高dsDNA抗体滴度与高PRL血症相关;⑤24例SLE活动期患者外周血单一核细胞(PBMC)的PRLR的特异性结合率(SB,5.03%±2.51%)、总结合率(TB,15.34%±6.98%)和mRNA的表达水平(0.85±0.45)均显著高于22例静止期患者(SB 4.18±2.26,TB14.03±6.54%,mRNA 0.58±0.43)和15例正常人对照组(SB 1.62%±1.05%,TB8.19%±1.47%,mRNA 0.20±0.13).结论SLE患者血清PRL轻度升高,PBMC的PRLR mRNA高表达以及相应特异性结合率的增加与SLE的病情活动性相关.     

系统性红斑狼疮患者血浆血小板活化因子水平及其与血浆脂质过氧化物水平关系的研究

目的探讨系统性红斑狼疮(SLE)患者血浆血小板活化因子(PAF)水平与SLE疾病活动性及血浆脂质过氧化物(LPO)水平的关系。方法采用双抗体夹心ELISA法检测血浆PAF水平,采用硫化巴比妥酸(TBA)比色法检测血浆丙二醛(MDA)含量,并以MDA含量代表血浆LPO水平。结果SLE组血浆PAF水平(270.69±42.68)ngmL明显高于正常对照组(200.85±32.61)ngmL(P<0.05),活动期组(288.90±34.17)ngmL高于非活动期组(225.17±23.73)ngmL(P<0.05);有肾损害组血浆PAF水平(300.13±27.91)ngmL高于无肾损害组(238.30±31.01)ngmL(P<0.05)。血浆PAF水平与血浆LPO水平呈正相关(r=0.700,P<0.01),与疾病活动性指数呈正相关(r=0.730,P<0.01),与血沉(ESR)亦呈正相关(r=0.758,P<0.01)。结论SLE患者血浆PAF水平升高,PAF与血浆LPO水平、SLE活动性相关,也与SLE肾损害有关,PAF可能参与SLE的发病机制。     

系统性红斑狼疮患者转录因子T-bet和GATA3基因的表达

目的 观察转录因子T-bet和GATA3与系统性红斑狼疮(SLE)病情的关系,探讨T细胞在SLE中的发病机制.方法 利用半定量PCR及实时荧光定量PCR技术检测活动期SLE患者、稳定期SLE患者、正常人外周血单一核细胞(PBMC)中T-bet和GATA3mRNA表达状况.结果 GATA3实时荧光定量PCR△Ct值:活动期(8.92±1.29)明显低于稳定期(12.20±1.18)和正常人(11.80±0.80),所以活动期患者GATA3mRNA表达明显高于稳定期患者和正常人,差异具有非常显著性(P<0.01);半定量PCR显示活动期(0.15±0.15)也明显高于稳定期(0.04±0.05)和正常人(0.03±0.03),差异有显著性(P<0.05);两种方法均显示稳定期患者与正常人GATA3表达差异无显著性(P>0.05).T-bet实时荧光定量PCR△Ct值:活动期为10.52±0.82,稳定期为9.93±1.13,正常人为10.23±1.32;半定量PCR:活动期为0.30±0.23,稳定期为0.28±0.14,正常人为0.22±0.11,两种方法均显示活动期患者、稳定期患者、正常人T-bet表达差异无显著性(P>0.05).结论 调控Th2细胞的转录因子GATA3的升高可能与SLE活动有关,而调控Th1细胞的转录因子T-bet可能与SLE活动无关.     

结缔组织疾病

20 0 4 16 19　系统性红斑狼疮患者血清及脑脊液中 C-反应蛋白的水平及临床意义 /冉立伟 (新疆医大一院皮肤科 )… //中国皮肤性病学杂志 .- 2 0 0 3,17(6 ) .- 36 9对 2 5例 SLE患者进行血清和脑脊液 (CSF)中CRP及抗核抗体 (ANA)的检测 ,分析血清 CRP与 CSF中 CRP、血CRP与血清 ANA、CSF中CRP与 ANA的相关性。结果直线相关分析显示 ,血清 CRP与 CSF中 CRP水平呈正相关 ;等级相关分析显示 ,血清 CRP与血清ANA、CSF中 CRP与 ANA均无明显相关性。认为血清CRP水平与 SLE活动性无明显关系 ,不能作为SL E活动指标 ;…     

系统性红斑狼疮患者外周血单一核细胞趋化因子受体2和3 mRNA的表达

目的探讨趋化因子受体(CCR)2及CCR3在系统性红斑狼疮(SLE)患者外周血单一核细胞(PBMC)中的表达及与疾病的相关性.方法对93例SLE患者和30名健康对照者,应用半定量逆转录(RT)-PCR方法检测其CCR2、CCR3 mRNA表达水平,并应用SLE疾病活动性指数评分标准(SLEDAI)对SLE患者进行评分.结果①9例SLE患者活动期、非活动期及对照组PBMC CCR2与CCR3 mRNA表达水平分别为2.989±1.595与2.847±2.400、0.388±0.213与0.585±0.219、0.263±0.157与0.602±0.124,活动期与非活动期、对照组相比差异均有显著性(P值分别为0.013,0.004;0.000,0.007);非活动期与对照组相比差异无显著性(P＞0.01).②SLE患者PBMC中CCR2、CCR3 mRNA表达水平与SLEDAI分别作直线相关性分析,CCR2 mRNA、CCR3mRNA水平与SLEDAI均呈正相关.③具有肌炎临床表现的SLE患者其PBMC CCR2、CCR3表达水平较无肌炎表现时降低.血小板减少的SLE患者比不具有相应症状者CCR2 mRNA表达降低.结论SLE患者PBMC CCR2、CCR3表达均增加,且与疾病活动性呈正相关,而CCR2、CCR3为表达于Th2细胞的趋化因子受体,提示SLE患者Th2细胞占优势.CCR2可能参与SLE患者肌炎及血小板减少的发生,CCR3参与肌炎发生.     

系统性红斑狼疮患者类胰岛素生长因子-1及瘦素检测分析

目的:检测类胰岛素生长因子-1(IGF-1)与瘦素(LEP)在系统性红斑狼疮(SLE)患者中的水平.方法:用放射免疫分析法同时测定42例SLE病人血清IGF-1、LEP水平,与正常人对照.结果:SLE患者血清IGF-1值为(56.2±42.2)ng/mL,显著高于正常人,且与病情活动指标SLEDAI呈正相关(r=0.52,P<0.05).LEP与正常人无显著性差异.与病情活动无相关性.结论:IGF-1在SLE的发病中可能起一定作用.测定血清IGF-1有助于SLE发病机制研究.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.