Modulation of epidermal terminal differentiation in patients after long-term topical corticosteroids.

The expression of the various markers for terminal epidermal differentiation in atrophic skin of patients after long-term topical corticosteroids (TCS) was studied by electron microscopy, immunofluorescence using antibody to profilaggrin/filaggrin (PF/FG), immunoperoxidase staining using antibody to involucrin, and oil red O stain for neural lipids of the stratum corneum. Thirty-nine patients were subdivided into two groups: (A) 19 patients suffering from rebound phenomenon after stopping TCS and (B) 20 patients without rebound phenomenon. Biopsy specimens were taken before ending the use of TCS in both groups. In group A, both the morphological markers (including the different epidermal strata, keratohyalin granules, lamellar granules, and cornified cell envelopes) and the molecular markers (including involucrin, PF/FG, and neutral lipids) of terminal epidermal differentiation were significantly suppressed. On the other hand, the differentiational markers in the atrophic skin of patients without rebound phenomena were only slightly altered. These results suggest that potent TCS not only has antiproliferative actions but also inhibits the differentiation of epidermis, resulting in structural defects in the epidermis, especially the stratum corneum.     

基于辅助化疗前血清白蛋白水平的列线图预测胃癌患者术后复发及远期生存

[目的]对于胃癌根治术后接受辅助化疗的患者,构建基于化疗开始前血清白蛋白水平的预后预测模型。[方法]回顾性分析根治术后接受辅助化疗的胃癌患者的临床、病理资料以及生存数据;依据时间依赖性受试者工作特征曲线(ROC曲线)确定白蛋白水平的最佳截断值;采用多因素Cox回归分析校正混杂因素,探讨白蛋白水平对无病生存期(disease-free survival,DFS)和总生存期(overall survival,OS)的影响;绘制预测列线图并进行验证。[结果]共纳入121例患者,白蛋白对12个月OS影响的曲线下面积(area under curve, AUC)为0.69(95%CI:0.55~0.83),白蛋白最佳截断值为37.0 g/L。Cox回归分析结果提示化疗前血清白蛋白<37.0 g/L、低/差分化肿瘤和存在癌结节是增加患者复发及死亡风险的独立因素。基于3个参数构建的列线图预测DFS和OS的c-指数分别为0.671(95%CI:0.526~0.816)和0.649(95%CI:0.553~0.745),校准曲线基本沿45°线分布。[结论]对于接受辅助化疗的胃癌根治术后患者,基于化疗开始前血清白蛋白水平的列线图可用于预测复发、转移和生存结局。     

Current topical and systemic approaches to treatment of rosacea

Rosacea is a common, often overlooked, chronic facial dermatosis characterized by intermittent periods of exacerbation and remission. Clinical subtypes and grading of the disease have been defined in the literature. On the basis of a genetic predisposition, there are several intrinsic and extrinsic factors possibly correlating with the phenotypic expression of the disease. Although rosacea cannot be cured, there are several recommended treatment strategies appropriate to control the corresponding symptoms/signs. In addition to adequate skin care, these include topical and systemic medications particularly suitable for the papulopustular subtype of rosacea with moderate to severe intensity. The most commonly used and most established therapeutic regimens are topical metronidazole and topical azelaic acid as well as oral doxycycline. Conventionally, 100–200 mg per day have been used. Today also a controlled release formulation is available, delivering 40 mg per day using non-antibiotic, anti-inflammatory activities of the drug. Anti-inflammatory dose doxycycline in particular allows for a safe and effective short- and long-term therapy of rosacea. Topical metronidazole and topical azelaic acid also appear to be safe and effective for short-term use. There are indications that a combined therapy of anti-inflammatory dose doxycycline and topical metronidazole could possibly have synergy effects. Further interesting therapy options for the short- and long-term therapy of rosacea could be low-dose minocycline and isotretinoin; however, too little data are available with regard to the effectiveness, safety, optimal dosage and appropriate length of treatment for these medications to draw final conclusions.

Conflicts of interest

None declared.     

Risk appraisal and endoscopic screening for esophageal squamous cell carcinoma in Japanese populations

Epidemiological studies have shown several strong predictors for selecting Japanese persons at high risk for esophageal squamous cell carcinoma (ESCC). (1) Alcohol consumption and tobacco smoking synergistically increase the risk, and a low intake of green and yellow vegetables or fruit and a low body mass index also increase the risk of ESCC. (2) The presence of esophageal distinct iodine-unstained lesions and melanosis are associated with an increased risk of ESCC. (3) The combination of alcohol consumption and inactive heterozygous aldehyde dehydrogenase-2 (ALDH2) and less-active homozygous alcohol dehydrogenase-1B (ADH1B) increases the risk of ESCC in a multiplicative fashion. (4) The results of a simple flushing questionnaire predict the ALDH2 phenotype with a high accuracy. (5) High mean corpuscular volume (MCV), which is induced by heavy drinking, high acetaldehyde exposure, heavy smoking, and poor nutrition, may be useful in identifying high-risk persons. Endoscopic screening with esophageal iodine staining in Japanese high-risk populations yields very high rates of early ESCC. Treatment of early ESCC by endoscopic mucosectomy has become a widespread practice in Japan and has succeeded in improving the outcome of this high-mortality cancer. New evidence concerning ALDH2/ADH1B/alcohol flushing/MCV-related cancer susceptibility has renewed interest in alcohol and acetaldehyde as important subjects for cancer research and has served as a powerful tool for cancer prevention and cancer screening of Japanese subjects. Review articles on this topic also appeared in the previous issue (Volume 4 Number 3). An editorial related to this article is available at .     

Preparation of PSF/FEP mixed matrix membrane with super hydrophobic surface for efficient water-in-oil emulsion separation

Polysulfone (PSF)/fluorinated ethylene propylene (FEP) mixed matrix membranes (MMMs) with super hydrophobic surface were successfully fabricated via non-solvent induced phase separation (NIPS) method. The effects of FEP content on the morphology, roughness, wettability, pore size, and mechanical property of PSF/FEP MMMs were characterized by scanning electron microscope, confocal microscopy, contact angle goniometer, mercury porosimetry, and tensile testing instrument, respectively. When the FEP content was 9 wt%, the average roughness of M-4 reached 0.712 μm. Meanwhile, the water contact angle (CA) and the water sliding angle (SA) was 153.3° and 6.1°, respectively. M-4 showed super hydrophobicity with a micro- and nanoscale structure surface. Then, M-4 was used for separating of water-in-oil emulsion, showing high separation efficiency for water-in-kerosene and water-in-diesel emulsions of 99.79% and 99.47%, respectively. The flux and separation efficiency changed slightly after 10 cycles. Therefore, this study indicated that the obtained PSF/FEP MMM with super hydrophobic surface could be used for efficient water-in-oil emulsion separation.

The PSF/FEP membrane with super hydrophobic and super oleophilic surface had an outstanding separation performance for water-in-oil emulsion.     

Complete Resolution of a Case of TAFRO Syndrome Accompanied by Mediastinal Panniculitis,Adrenal Lesion,and Liver Damage with Hyperbilirubinemia

TAFRO syndrome is a systemic inflammatory, lymphoproliferative disorder, but the pathophysiology of the disease is unknown. It is typically characterized by thrombocytopenia, anasarca, a fever, reticulin fibrosis, renal dysfunction, and organomegaly. However, other manifestations have been also reported. We encountered a 43-year-old man with TAFRO syndrome who showed mediastinal panniculitis, liver damage, and adrenal lesions in addition to the core signs. He achieved complete remission with combination therapy of corticosteroids, tocilizumab, and cyclosporin, and remission was maintained even after drug discontinuation at 15 months. Atypical manifestations and complete remission of TAFRO syndrome were remarkable features of our case.     

Copper stress impairs angiogenesis and lymphangiogenesis during zebrafish embryogenesis by down-regulating pERK1/2-foxm1-MMP2/9 axis and epigenetically regulating ccbe1 expression

Angiogenesis - Molecular transport and cell circulation between tissues and organs through blood and lymphatic vessels are essential for physiological homeostasis in vertebrates. Despite the report...