AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been tr...AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.展开更多
目的:探讨窄谱中波紫外线(narrow-band ultraviolet B,NB-UVB)通过促进维生素D(vitamin D,VD)代谢缓解咪喹莫特(imiquimod,IMQ)诱导银屑病样小鼠皮炎的效应机制。方法:C57BL/6小鼠背部去毛外涂IMQ乳膏进行银屑病样皮炎的造模,检测小鼠...目的:探讨窄谱中波紫外线(narrow-band ultraviolet B,NB-UVB)通过促进维生素D(vitamin D,VD)代谢缓解咪喹莫特(imiquimod,IMQ)诱导银屑病样小鼠皮炎的效应机制。方法:C57BL/6小鼠背部去毛外涂IMQ乳膏进行银屑病样皮炎的造模,检测小鼠血清中VD代谢产物25(OH)D_(3)和1,25(OH)_(2)D_(3)的含量,以及皮损中VD受体(vitamin D receptor,VDR)mRNA表达;确定NB-UVB照射小鼠的辐照能量后,进行造模联合NB-UVB照射,观察小鼠皮损,检测血清中25(OH)D_(3)和1,25(OH)_(2)D_(3)的含量、皮损中VDR和炎症因子[白细胞介素(interleukin,IL)-17A、IL-23、肿瘤坏死因子(tumor necrosis factor,TNF)-α、IL-1β]的mRNA表达及蛋白含量及CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例。使用特异性抑制剂Dafadine-A阻断小鼠VD代谢关键酶细胞色素P450家族27亚家族A成员1(cytochrome P450 family 27 subfamily A member 1,CYP27A1)活性后,再进行造模和NB-UVB照射,观察皮损,检测皮损中CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例、炎症因子表达情况、VDR mRNA表达情况和血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)的含量。结果:银屑病样小鼠模型血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)含量和皮损中VDR的mRNA表达均显著降低。NB-UVB照射银屑病样小鼠模型后,相比模型组,小鼠血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)含量和皮损中VDR的mRNA表达上调,皮损中炎症因子IL-17A、IL-23、TNF-α、IL-1β的表达及含量均下调、CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例也显著下降。使用Dafadine-A预处理小鼠后进行造模联合NB-UVB照射,相比IMQ联合NB-UVB照射组,血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)含量和皮损中VDR的mRNA表达均显著降低,皮损中CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例和炎症因子IL-17A、IL-23、TNF-α、IL-1β的含量均显著升高。结论:NB-UVB照射通过促进VD代谢缓解银屑病样小鼠皮肤炎症。特异性阻断VD代谢关键酶CYP27A1活性后,NB-UVB照射缓解银屑病样小鼠皮损及炎症反应的效应显著减弱。展开更多
目的观察凉血解毒加味方联合窄谱中波紫外线(Narrow-band ultraviolet B,NB-UVB)照射治疗血热证寻常型银屑病患者的临床疗效。方法选取2024年1月—2024年7月中国中医科学院广安门医院保定医院收治的96例寻常型银屑病患者,按随机数字表...目的观察凉血解毒加味方联合窄谱中波紫外线(Narrow-band ultraviolet B,NB-UVB)照射治疗血热证寻常型银屑病患者的临床疗效。方法选取2024年1月—2024年7月中国中医科学院广安门医院保定医院收治的96例寻常型银屑病患者,按随机数字表法分为对照组和观察组,每组各48例。对照组采用NB-UVB照射治疗,观察组在对照组治疗基础上联合凉血解毒加味方治疗,均连续治疗8周。观察比较两组患者的临床疗效、不良反应情况,治疗前后中医证候积分、银屑病皮损面积与严重程度指数(Psoriasis area and severity index,PASI)、皮肤病生活质量指标调查表(Dermatology life quality index,DLQI)评分、外周血T淋巴细胞亚群指标、炎性因子指标[白细胞介素-2(Interleukin-2,IL-2)、白细胞介素-17(Interleukin-17,IL-17)、干扰素-γ(Interferon-γ,IFN-γ)]水平。结果治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者PASI、DLQI评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组PASI、DLQI评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)均较治疗前降低,差异有统计学意义(P<0.05);且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-2、IL-17、IFN-γ指标均较治疗前降低,差异有统计学意义(P<0.05);且观察组IL-2、IL-17、IFN-γ指标均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率91.67%(44/48)明显高于对照组75.00%(36/48),差异有统计学意义(P<0.05)。治疗期间,两组患者尿常规、大便常规、肝肾功能、心电图等均无异常。结论凉血解毒加味方联合NB-UVB照射治疗寻常型银屑病(血热证)疗效确切,能够抑制炎症因子表达,调节机体免疫力,降低皮损严重程度,缓解临床症状,提高患者生活质量。展开更多
文摘AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.
文摘目的:探讨窄谱中波紫外线(narrow-band ultraviolet B,NB-UVB)通过促进维生素D(vitamin D,VD)代谢缓解咪喹莫特(imiquimod,IMQ)诱导银屑病样小鼠皮炎的效应机制。方法:C57BL/6小鼠背部去毛外涂IMQ乳膏进行银屑病样皮炎的造模,检测小鼠血清中VD代谢产物25(OH)D_(3)和1,25(OH)_(2)D_(3)的含量,以及皮损中VD受体(vitamin D receptor,VDR)mRNA表达;确定NB-UVB照射小鼠的辐照能量后,进行造模联合NB-UVB照射,观察小鼠皮损,检测血清中25(OH)D_(3)和1,25(OH)_(2)D_(3)的含量、皮损中VDR和炎症因子[白细胞介素(interleukin,IL)-17A、IL-23、肿瘤坏死因子(tumor necrosis factor,TNF)-α、IL-1β]的mRNA表达及蛋白含量及CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例。使用特异性抑制剂Dafadine-A阻断小鼠VD代谢关键酶细胞色素P450家族27亚家族A成员1(cytochrome P450 family 27 subfamily A member 1,CYP27A1)活性后,再进行造模和NB-UVB照射,观察皮损,检测皮损中CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例、炎症因子表达情况、VDR mRNA表达情况和血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)的含量。结果:银屑病样小鼠模型血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)含量和皮损中VDR的mRNA表达均显著降低。NB-UVB照射银屑病样小鼠模型后,相比模型组,小鼠血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)含量和皮损中VDR的mRNA表达上调,皮损中炎症因子IL-17A、IL-23、TNF-α、IL-1β的表达及含量均下调、CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例也显著下降。使用Dafadine-A预处理小鼠后进行造模联合NB-UVB照射,相比IMQ联合NB-UVB照射组,血清中25(OH)D_(3)、1,25(OH)_(2)D_(3)含量和皮损中VDR的mRNA表达均显著降低,皮损中CD_(3)^(+)CD4^(+)IL-17A^(+)T细胞比例和炎症因子IL-17A、IL-23、TNF-α、IL-1β的含量均显著升高。结论:NB-UVB照射通过促进VD代谢缓解银屑病样小鼠皮肤炎症。特异性阻断VD代谢关键酶CYP27A1活性后,NB-UVB照射缓解银屑病样小鼠皮损及炎症反应的效应显著减弱。
文摘目的观察凉血解毒加味方联合窄谱中波紫外线(Narrow-band ultraviolet B,NB-UVB)照射治疗血热证寻常型银屑病患者的临床疗效。方法选取2024年1月—2024年7月中国中医科学院广安门医院保定医院收治的96例寻常型银屑病患者,按随机数字表法分为对照组和观察组,每组各48例。对照组采用NB-UVB照射治疗,观察组在对照组治疗基础上联合凉血解毒加味方治疗,均连续治疗8周。观察比较两组患者的临床疗效、不良反应情况,治疗前后中医证候积分、银屑病皮损面积与严重程度指数(Psoriasis area and severity index,PASI)、皮肤病生活质量指标调查表(Dermatology life quality index,DLQI)评分、外周血T淋巴细胞亚群指标、炎性因子指标[白细胞介素-2(Interleukin-2,IL-2)、白细胞介素-17(Interleukin-17,IL-17)、干扰素-γ(Interferon-γ,IFN-γ)]水平。结果治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者PASI、DLQI评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组PASI、DLQI评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)均较治疗前降低,差异有统计学意义(P<0.05);且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-2、IL-17、IFN-γ指标均较治疗前降低,差异有统计学意义(P<0.05);且观察组IL-2、IL-17、IFN-γ指标均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率91.67%(44/48)明显高于对照组75.00%(36/48),差异有统计学意义(P<0.05)。治疗期间,两组患者尿常规、大便常规、肝肾功能、心电图等均无异常。结论凉血解毒加味方联合NB-UVB照射治疗寻常型银屑病(血热证)疗效确切,能够抑制炎症因子表达,调节机体免疫力,降低皮损严重程度,缓解临床症状,提高患者生活质量。
