Relationship between rosacea and sleep

Rosacea is a chronic facial skin disease involved in neurovascular dysregulation and neurogenic inflammation. Behavioral factors such as stress, anxiety, depression and sleep were identified to be associated with other inflammatory skin diseases. Few studies have reported sleep status in rosacea. Aiming to investigate the relationship between rosacea and sleep, a case–control survey was conducted, enrolling 608 rosacea patients and 608 sex- and age-matched healthy controls. Sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Diagnosis and severity grading of rosacea were evaluated under the standard guidelines of the National Rosacea Society. More rosacea patients (52.3%, n = 318) suffered poor sleep quality (PSQI, >5) than the healthy controls (24.0%, n = 146), displaying a much higher PSQI score (rosacea vs control, 6.20 vs 3.95). There was a strong association between sleep quality and rosacea (odds ratio [OR], 3.525; 95% confidence interval [CI], 2.759–4.519). Moreover, the severity of rosacea was also associated with sleep quality (OR, 1.847; 95% CI, 1.332–2.570). Single nucleotide polymorphisms in hydroxytryptamine receptor 2A and adrenoceptor-β1 genes, which are associated with sleep behaviour, were detected and revealed to be associated with rosacea. Furthermore, the LL-37-induced rosacea-like phenotype and sleep-deprivation mice models were applied, revealing that sleep deprivation aggravated the rosacea-like phenotype in mice, with higher expression of matrix metallopeptidase 9, Toll-like receptor 2, cathelicidin antimicrobial peptide and vascular endothelial growth factor. In conclusion, rosacea patients presented poorer sleep quality, as well as a higher propability of genetic background with sleep disturbance. In addition, poor sleep might aggravate rosacea through regulating inflammatory factors, contributing to a vicious cycle in the progression of disease.     

基于亚细胞损伤的纳米材料毒性研究进展

纳米材料具有独特的理化、光学、电学及抗菌特性，在生物医药领域具有潜在应用价值。随着纳米材料的广泛应用，其生物安全性引起了研究者们的关注。文章从纳米材料的特性出发，阐述了纳米材料在亚细胞水平上对细胞核、线粒体、内质网和溶酶体等细胞器的毒性作用研究进展，并对可能影响纳米材料亚细胞毒性的主要因素进行了归纳和讨论，对深入认识纳米材料毒效应和进一步开展纳米材料毒性研究提供参考。     

Large cutaneous epithelioid angiomatous nodules in a patient with nephrotic syndrome: A case report

BACKGROUND Cutaneous epithelioid angiomatous nodules(CEAN) are rare, benign, vascular lesions characterized by benign proliferation of endothelial cells with prominent epithelioid features, which can be easily confused with benign and malignant vascular tumors. However, the etiology of CEAN remains unclear, and no association with infection, trauma, or immunosuppression has been described.This case study indicated that CEAN is closely related to the patient’s impaired immune status and may be induced by cyclosporine.CASE SUMMARY A 19-year-old boy with nephrotic syndrome(NS) developed large CEAN on the left foot during treatment for NS. He had repeated relapses of edema in the past 6 years and different types of immunosuppressants were administered including methylprednisolone, mycophenolate mofetil, tacrolimus and cyclosporine;the dosages of these drugs were frequently adjusted. The patient had been receiving cyclosporine and methylprednisolone for 7 mo before he developed CEAN.Cyclosporine was discontinued due to its side effects on skin. After cessation of cyclosporine and 16 mo follow-up, the nodules gradually disappeared without any other treatment for the CEAN.CONCLUSION Impaired immune status is proposed to be a risk factor for CEAN, which may be induced by cyclosporine.     

调强放射治疗在不可切除老年胃癌患者姑息治疗中的临床价值

目的:探讨调强放射治疗（intensity-modulated radiotherapy，IMRT）在老年不可切除胃癌患者中姑息减症治疗的临床价值。方法:回顾性分析23例老年病理确诊胃癌患者，手术无法切除，伴有出血(78.3%)、梗阻(52.2%)及疼痛(69.6%)症状；采用调强放射治疗为主的姑息治疗。观察治疗后症状缓解率、症状缓解时间以及中位生存时间（median overall survival，mOS）。结果: 全组患者男性16例，女性7例，年龄60~89岁(平均74岁)；Ⅲ期9例，Ⅳ期14例。全部采用6MV X线IMRT，常规分割，1.8~2.2 Gy/次，5次/周，总剂量35~50 Gy；同步放化5例，序贯化疗9例。出血、梗阻及疼痛症状缓解率分别为77.8%(14例)、58.3%(7例)和56.2%(9例)；中位症状缓解时间分别为101天、87天和99天。全组中位生存时间114天，症状缓解者中位生存时间较症状未缓解者明显延长(129天 vs 73天，P=0.01)。治疗期间出现Ⅲ级毒副反应者2例。结论:IMRT是一个有效的、可耐受的并能够缓解老年不可切除胃癌患者临床症状的治疗手段，可以改善患者生活质量，延长生存期。     

Progression of anti-mycoplasma drug therapy in children with refractory mycoplasma pneumonia

The incidence of refractory mycoplasma pneumoniae pneumonia (RMPP) in children is increasing year by year, and the disease is progressing rapidly. It is accompanied by serious complications and legacy effects, seriously affecting the quality of life of children. The selection, dosage, and course of anti-MP drugs in children with RMPP have brought a lot of troubles to pediatric hospitals. In the present study, the characteristics, usage and dosage, drug resistance mechanism, and treatment progress of anti-MP drugs for the treatment of RMPP in children were reviewed. Collectively, our findings provided ideas for the treatment of children with RMPP using anti-MP drugs.     

伊贝母异甾体生物碱通过Wnt/β-catenin信号通路调节哮喘大鼠气道炎症和气道重塑机制的研究

目的 探讨伊贝母异甾体生物碱对哮喘大鼠气道炎症、气道重塑及Wnt/β-catenin信号通路的影响。方法 本研究采用吸入卵清蛋白（OVA）致敏和激发的方法建立大鼠哮喘模型，连续给予药物7天；抽取支气管肺泡灌洗液（BALF）进行白细胞分类计数，酶联免疫吸附法（ELISA）检测BALF中白介素4（IL-4）、白介素5（IL-5）和白介素13（IL-13）的水平；取肺组织进行苏木精-伊红（HE）染色，观察药物对哮喘大鼠气道重塑的影响；采用Western blot技术考察异甾体生物碱对Wnt/β-catenin信号通路上Wnt5a、Wnt7b和β-catenin蛋白的调节作用。结果 与模型组比较，异甾体生物碱组大鼠肺泡间质炎性细胞浸润和支气管管腔狭窄均显著改善，支气管壁厚度和平滑肌厚度均明显降低；Western blot结果显示异甾体生物碱对于哮喘大鼠Wnt/β-catenin通路上的Wnt5a、Wnt7b和β-catenin蛋白表达均有显著的调节作用。结论 异甾体生物碱对于哮喘相关的病理变化-炎症和气道重塑均有一定的治疗作用，且该治疗作用与Wnt/β-catenin信号通路有关。     

Eczema and Sensitization to Common Allergens in the United States: A Multiethnic,Population‐Based Study

The relationship between food and environmental allergens in contributing to eczema risk is unclear on a multiethnic population level. Our purpose was to determine whether sensitization to specific dietary and environmental allergens as measured according to higher specific immunoglobulin E (IgE) levels is associated with eczema risk in children. National Health and Nutrition Examination Survey participants ages 1 to 17 years were asked whether they had ever received a diagnosis of eczema from a physician (n = 538). Total and specific serum IgE levels for four dietary allergens (egg, cow's milk, peanut, and shrimp) and five environmental allergens (dust mite, cat, dog, Aspergillus, and Alternaria) were measured. Logistic regression was used to examine the association between eczema and IgE levels. In the United States, 10.4 million children (15.6%) have a history of eczema. Eczema was more common in black children (p < 0.001) and in children from families with higher income and education (p = 0.01). The median total IgE levels were higher in children with a history of eczema than in those without (66.4 vs 50.6 kU/L, p = 0.004). In multivariate analysis adjusted for age, race, sex, family income, household education, and physician‐diagnosed asthma, eczema was significantly associated with sensitization to cat dander (odds ratio [OR] = 1.2, 95% confidence interval [CI] 1.05, 1.4, p = 0.009) and dog dander (OR = 1.5, 95% CI, 1.2, 1.7, p < 0.001). After correction for multiple comparisons, only sensitization to dog dander remained significant. U.S. children with eczema are most likely to be sensitized to dog dander. Future prospective studies should further explore this relationship.     

ZD 7288,an HCN channel blocker,attenuates chronic visceral pain in irritable bowel syndrome-like rats

AIM:To investigate the effects of ZD 7288,a hyperpolarization-activated cyclic nucleotide-gated(HCN)channel blocker,on rats with chronic visceral pain.METHODS:Rats with visceral hypersensitivity were generated using neonatal colon irritation during postnatal days 8-15 as described previously.Visceral hypersensitivity was evaluated using electromyographic(EMG)responses of abdominal external oblique muscles to 20-80 mmHg colorectal distentions(CRD).Abdominal withdrawal reflex(AWR)scores and pain thresholds were also detected in adult rats.Different doses of ZD7288(25,50,and 100 nmol/L)were intrathecally administered in rats to study the role of spinal HCN channel in chronic visceral hypersensitivity.RESULTS:EMG responses to 20-80 mmHg CRD and AWR scores under 20-60 mmHg CRD significantly increased in rats with visceral hypersensitivity compared to control rats(P<0.05).The pain threshold in rats with visceral hypersensitivity significantly decreased compared to control rats(P<0.05).Treatment with50-100 nmol/L ZD 7288 significantly inhibited EMG responses(16%-62%,80-20 mmHg CRD,P<0.05)and AWR scores(24%-37%,40-20 mmHg CRD,P<0.05;12%-61%,80-20 mmHg CRD,P<0.05,respectively),and significantly increased pain thresholds(32%-77%,P<0.05).CONCLUSION:Spinal HCN channels may play an important role in chronic visceral hypersensitivity.     

海博刀与三角刀在经口内镜下肌切开术中疗效的回顾性队列研究

目的 比较海博刀与三角刀在经口内镜下肌切开术(POEM)中的临床疗效。方法 采用回顾性队列研究设计，纳入2012年6月至2014年7月因贲门失弛缓症在南方医科大学南方医院接受POEM治疗的患者，术中使用海博刀者为海博刀组，使用注射针和三角刀者为三角刀组，比较两组手术相关参数、术后症状缓解及并发症发生率。结果 共纳入57例患者，其中海博刀组25例，三角刀组32例。两组患者基线特征比较差异无统计学意义（P>0.05）。海博刀组平均手术时间短于三角刀组[(55.3±17.7)min比(69.5±9.4)min，P=0.038)]；术中平均器械交换次数少于三角刀组[(4.5±1.5)次比(10.7±1.7)次，P=0.000]。所有患者无严重不良事件发生。在1年的随访中，海博刀组治疗成功率92.0%(23/25)，三角刀组96.9%(31/32)，差异无统计学意义（P=0.576)。结论 海博刀能显著缩短POEM手术时间，并且获得与三角刀相似的治疗成功率。