甲氨蝶呤联合小剂量叶酸治疗中重度银屑病疗效观察

目的观察小剂量叶酸配合甲氨蝶呤(methotrexate,MTX)治疗中重度银屑病临床疗效及安全性。方法124例银屑病患者随机分为治疗组与对照组。治疗组62例每周口服MTX7.5～15mg,每日口服叶酸5mg,共8周。对照组62例采用维生素A、维生素E、氨肽素及抗组胺药常规治疗。结果治疗12周和24周后,治疗组与对照组治疗后显效率经卡方检验,P<0.05,差异有显著性。两组均无严重不良反应。结论MTX每周口服7.5～15mg,同时补充小剂量叶酸治疗中重度银屑病有效。     

阿维A联合窄谱中波紫外线照射治疗寻常型银屑病临床疗效分析

目的观察阿维A联合窄谱中波紫外线照射治疗寻常型银屑病临床疗效。方法治疗组口服阿维A胶囊10mg,3次/d同时窄谱中波紫外线全身照射,3次/周;对照组口服阿维A胶囊,疗程均为8周。结果治疗组有效率90.00%,对照组有效率64.28%,两组有效率差异有显著性(P<0.05)。结论阿维A联合窄谱中波紫外线照射治疗寻常型银屑病疗效好,不良反应少。     

白芍总苷联合阿维A和窄谱中波紫外线治疗寻常性银屑病临床观察

目的观察白芍总苷联合阿维A、窄谱中波紫外线(NB-UVB)照射治疗中、重度寻常性银屑病临床疗效和安全性。方法 60例中、重度寻常性银屑病患者随机分为两组,试验组和对照组各30例。试验组予口服白芍总苷600 mg每日3次、阿维A 0.5 mg/(kg?d)、NBUVB照射(隔日1次)治疗,对照组给予口服阿维A 0.5 mg/(kg?d)、NB-UVB照射(隔日1次)治疗,疗程均为8周。以银屑病皮损面积严重度指数(PASI)评分评价疗效,并记录不良反应。结果试验组完成观察28例,对照组完成27例。治疗8周后,治疗组PASI评分为(4.23±2.96)分,低于对照组(7.45±3.05)分,差异有统计学意义(P0.05);试验组有效25例,有效率为89.28%,高于对照组(66.67%),差异有统计学意义(P0.05)。两组未见明显不良反应。结论白芍总苷联合阿维A、NB-UVB治疗中、重度寻常性银屑病患者疗效好、安全性高,是一种治疗寻常性银屑病较好的方法。     

中西医结合治疗红皮病型银屑病的疗效观察

目的观察中药与小剂量阿维A治疗红皮病型银屑病的临床疗效。方法33例红皮病型银屑病患者随机分为两组,治疗组采用本院中药清热活血方(150mL,2次/d,早晚饭后半小时口服)配合小剂量阿维A(20mg,1次/d)治疗,对照组采用口服阿维A胶囊治疗(20mg,1次/d),4周为1个疗程,治疗1个疗程后进行疗效判定,观察有效率、PASI积分及不良反应情况。结果治疗组有效率为94.12%,对照组为81.25%,两组有效率差异有显著性(P<0.01),治疗组有效率明显高于对照组,其不良反应也低于对照组。结论中药与小剂量阿维A治疗红皮病型银屑病疗效较好,不良反应少。     

阿维A联合润燥止痒胶囊治疗寻常性银屑病临床观察

目的观察阿维A联合润燥止痒胶囊治疗寻常性银屑病的疗效。方法80例患者随机分为两组,各40例,治疗组予阿维A30mg/次,1次/d,联合润燥止痒胶囊2.0g/次,3次/d口服;对照组予阿维A30mg/次,1次/d口服治疗。均治疗4周。结果治疗组SPASI评分下降明显优于对照组;治疗组、对照组有效率分别为97.5%和55.0%,差异有统计学意义（P〈0.005）。结论阿维A联合润燥止痒胶囊治疗寻常性银屑病疗效确切,能明显减轻阿维A所致的皮肤口唇干燥及瘙痒等不良反应。     

白芍总苷联合阿维A治疗中、重度银屑病32例临床观察

目的观察白芍总苷联合阿维A治疗中、重度银屑病的临床疗效和安全性。方法 62例中、重度银屑病患者随机分为2组,治疗组32例,予口服白芍总苷600mg3次/d,阿维A0.5mg/(kg.d)治疗,对照组30例仅予口服阿维A0.5mg/(kg.d)治疗,疗程8周。以银屑病皮损面积和严重程度(PASI)评分评价疗效并记录不良反应。结果治疗8周后,治疗组PASI评分(4.36±3.12)低于对照组(6.38±2.81),差异有统计学意义(P<0.05);治疗组有效率(90.62%)高于对照组(76.67%)。差异有统计学意义(P<0.05)。两组未见明显不良反应。结论白芍总苷联合阿维A治疗中、重度银屑病的患者疗效好,安全性高。     

银屑胶囊联合阿维A胶囊治疗寻常性银屑病的临床观察

目的观察银屑胶囊联合阿维A胶囊治疗寻常性银屑病的疗效和安全性。方法将患者随机分为试验组和对照组,各40例。两组均口服阿维A胶囊20mg,1次/d,试验组加用银屑胶囊3粒,3次/d。两组均治疗8周判效。结果试验组、对照组的有效率分别为87.18%和63.16%,二者差异有统计学意义(P<0.05);试验组、对照组的不良反应发生率分别为47.50%和50.00%,二者差异无统计学意义(P>0.05),两组的不良反应均轻微,可耐受。结论银屑胶囊联合阿维A胶囊治疗寻常性银屑病安全、有效。     

香丹、复方甘草酸苷注射液辅助治疗寻常性银屑病疗效观察

目的 探讨寻常性银屑病有效的治疗手段.方法 观察组复方甘草酸苷注射液40～60mL加入5%葡萄糖溶液250mL中,静脉滴注,1次/d;香丹注射液30mL加入5%葡萄糖250mL中,静脉滴注,1次/d;同时予阿维A胶囊10 mg/次,3次/d口服;窄谱中波紫外线(NB-UVB)照射,每周3次.对照组仅予阿维A胶囊10 mg/次,3次/d口服;NB-UVB照射,每周3次.两组患者疗程均为4周.结果 观察组和对照组有效率分别为94.34%、84%,两组比较差异有统计学意义(P<0.05).结论 香丹、复方甘草酸苷注射液联合阿维A胶囊、NB-UVB照射治疗寻常性银屑病疗效较好,无明显不良反应.     

阿维A联合PUVA治疗寻常性银屑病疗效观察

目的探讨阿维A联合PUVA治疗寻常性银屑病的临床疗效。方法将90例患者随机分为两组,治疗组45例口服阿维A 0.5 mg/(kg.d)并加用光化学疗法(PUVA),对照组45例仅口服阿维A 0.5-0.8 mg/(kg.d),两组均外用本院自制冰霜。结果治疗组有效率为88.89%,对照组为73.33%,两组比较差异有显著性(P<0.05)。结论阿维A联合PUVA治疗寻常性银屑病安全有效,值得临床应用。     

复方青黛丸联合阿维A及卡泊三醇治疗中、重度寻常性银屑病34例临床观察

目的评价复方青黛丸联合阿维A及卡泊三醇治疗中、重度寻常性银屑病的临床疗效和安全性。方法将入选的67例中、重度寻常性银屑病患者随机分为2组,全部患者予口服阿维A胶囊0.4mg/(kg·d),卡泊三醇乳膏外搽(2次/d)。治疗组(34例)同时还予口服复方青黛丸6g(3次/d),两组患者疗程均8周。结果治疗8周后,治疗组PASI评分(4.11±3.11)低于对照组PASI评分(5.94±2.97),治疗组有效率(93.93%)高于对照组有效率(75.75%),差异均有统计学意义(P均O.05)。另外,两组患者治疗过程中未见发生明显不良反应。结论复方青黛丸联合阿维A及卡泊三醇治疗中、重度寻常性银屑病的疗效好,安全性可靠。     

中外白癜风诊疗指南及共识比较

本文从白癜风分型、分期、病情评估、药物治疗及非药物治疗等方面比较了欧洲、美国、日本、韩国、中国等地区和国家的白癜风诊疗指南或共识, 概要分析各指南及共识中推荐的白癜风疗法和强调理念的异同, 以帮助临床医生为白癜风患者提供合适的个体化治疗方案。     

两种氯雷他定药物治疗湿疹、皮炎的成本效果分析

目的：对两种氯雷他定(百为坦和开瑞坦)治疗湿疹、皮炎的成本效果进行分析．方法：将患者分为两组，每组30例，分别服用百为坦和开瑞坦，除观察疗效外还进行成本效果分析。结果：两组疗效相当，均无明显的不良反应。但百为坦的治疗成本明显低于开瑞坦．结论：氯雷他定治疗湿疹、皮炎疗效高，安全性好。百为坦比开瑞坦治疗成本低。     

Visual attention to and perception of undamaged and damaged versions of natural and colored female hair

Female hair color is thought to influence physical attractiveness, and although there is some evidence for this assertion, research has yet not addressed the question if and how physical damaging affects the perception of female hair color. Here we investigate whether people are sensitive (in terms of visual attention and age, health and attractiveness perception) to subtle differences in hair images of natural and colored hair before and after physical damaging. We tracked the eye‐gaze of 50 men and 50 women aged 31–50 years whilst they viewed randomized pairs of images of 20 natural and 20 colored hair tresses, each pair displaying the same tress before and after controlled cuticle damage. The hair images were then rated for perceived health, attractiveness, and age. Undamaged versions of natural and colored hair were perceived as significantly younger, healthier, and more attractive than corresponding damaged versions. Visual attention to images of undamaged colored hair was significantly higher compared with their damaged counterparts, while in natural hair, the opposite pattern was found. We argue that the divergence in visual attention to undamaged colored female hair and damaged natural female hair and associated ratings is due to differences in social perception and discuss the source of apparent visual difference between undamaged and damaged hair.     

Sterilization and care of surgical instruments and supplies

Adequate instrument handling and sterilization are important aspects of office surgery. Heat sterilization is the most reliable choice. The steam autoclave is highly recommended. Dry heat is effective but can pose some storage problems. Gas sterilization is useful for heat-sensitive materials but not practical for the private office. Cold "sterilization" is not reliable for incisional surgery. In addition to proper sterilization modality selection, the surgeon must observe important standards of instrument care, packing, and storage.     

Treatment and prevention of rickettsial and ehrlichial infections

Rickettsial and ehrlichial infections are both carried by arthropod vectors. Both Rickettsia and Ehrlichia are small intracellular gram-negative coccobacilli. Clinical manifestations of Rickettsia range from spotted fevers to various forms of typhus. Human ehrlichiosis can present as monocytic ehrlichiosis or granulocytic anaplasmosis. Prevention is by avoidance of the responsible vectors. Therapy is usually with doxycycline, but chloramphenicol can also be used.     

角质形成细胞和成纤维细胞对白癜风发病和治疗的影响

黑素细胞在白癜风发病及治疗中是最关键的一环，但表皮、真皮间的沟通联系对皮损及非皮损皮肤的功能均具有重要影响，其中角质形成细胞、成纤维细胞及细胞外基质等非黑素细胞起了重要作用，并影响白癜风的发病。本文从细胞因子、氧化应激等角度总结了角质形成细胞、成纤维细胞对白癜风发病的影响及在临床治疗中的作用机制。     

Effects and interactions of increased environmental temperature and UV radiation on photoageing and photocarcinogenesis of the skin

Solar radiation is one of fundamental elements sustaining and maintaining life on earth. Previous studies on health effects from the sun exposure mostly focused on ultraviolet (UV) radiation. Although exposure to the solar radiation likely occurs in an environment with elevated temperature, the effects and interactions of elevated environmental temperature with UV radiation on the skin, especially in the context of ageing and carcinogenesis, have not been carefully examined. It is known that UVA radiation results in reduced production and increased degradation of dermal collagen, contributing to photoageing of the skin. Previous studies showed conflicting results regarding the effects of increased environmental temperature on dermal collagen. Additionally, we demonstrated that solar‐simulated radiation and increased environmental temperature have similar impacts on dermal fibroblasts through activation of distinct pathways. UVB radiation is well known for its carcinogenic capacity. Previously, it was reported that exposure to heat treatment before UVB radiation reduces epidermal keratinocyte cell death. We demonstrated that exposure to elevated environmental temperature prior to UVB radiation reduces UVB‐induced skin tumor formation. We proposed that alterations in molecular dynamics and quantum mechanics were involved for the observed increased environmental temperature‐induced protective effect against UVB damage. This review emphasizes that both environmental temperature and solar radiation are important elements in nature that have significant impacts on the human health, and future studies should focus on the biological effects and interactions of environmental temperature and solar radiation since this scenario is most relevant to the real‐world setting.