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This systematic review evaluated the Chinese herbal medicine (CHM) for treating atopic dermatitis (AD). PubMed, EMBASE, the Cochrane library, the Wanfang database, and China National Knowledge Infrastructure (CNKI) were searched for relevant randomized controlled trials (RCTs) from inception to December 2021. Overall recovery rate, disease/symptom severity scoring, quality of life (QoL), recurrence rate, and incidence of adverse events (AEs) were evaluated. STATA SE 14.0 software was used for statistical analysis. 17 RCTs involving 1624 patients were eligible. CHM was associated with a higher overall recovery rate (risk ratio [RR] = 1.15, 95% confidence interval [CI]: 1.05, 1.26, p =.003) and decreased recurrence rate (odds ratio [OR] = 0.19, 95% CI: 0.07, 0.55, p =.002), both confirmed by sensitivity analyses. CHM could decrease scoring atopic dermatitis index (MD = −0.61, 95% CI: −1.12, −0.11, p =.017), however, sensitivity analysis revealed non-robustness. No significant differences were found between the CHM and the control group in Eczema Area and Severity Index, QoL, and the incidence of AEs. CHM was effective for treating AD as it could improve the overall recovery rate and decrease the recurrence rate. More studies are required to validate the potential of CHM on disease/symptoms severity and QoL. [ABSTRACT FROM AUTHOR]

Psoriasis and skin tumors (such as basal cell carcinoma, squamous cell carcinoma, and melanoma) are chronic diseases that endanger physical and mental health, and yet the causes are largely unknown and treatment options limited. The development of targeted drugs requires a better understanding of the exact pathogenesis of these diseases, and Yes-associated protein (YAP), a member of the Hippo signaling pathway, is believed to play an important role. Psoriasis and skin tumors are characterized by excessive cell proliferation, abnormal differentiation, vasodilation, and proliferation. Here, we review the literature related to YAP-associated disease mechanisms and discuss the latest research. YAP regulates cell apoptosis, proliferation, and differentiation; inhibits cell density and intercellular contacts and angiogenesis; and maintains the three-dimensional structure of the skin. These mechanisms may be associated with the occurrence and development of psoriasis and skin tumors. The results of recent studies have shown that YAP expression is increased in psoriasis and skin tumors. High expression of YAP in psoriasis and skin tumors may indicate its positive functions in skin inflammation and malignancies and may play an important role in disease pathogenesis. The study of new drugs targeting YAP can provide novel approaches for the treatment of skin diseases. [ABSTRACT FROM AUTHOR]

• Th2, Th17 cell numbers increased, and Treg cell numbers decreased in acute AD. • Treg cell number increased in chronic AD. • YAP was downregulated in Treg and upregulated in Th17 cells. • YAP downregulation in AD epidermis inhibited proliferation and migration. • YAP downregulation induced apoptosis of keratinocytes. Atopic dermatitis (AD) is characterized by impaired skin barrier function and immune system dysfunction. The expression and role of Yes-associated protein (YAP) in AD are unclear. To characterize the role of the YAP in T cell imbalance and epidermal keratinocyte dysfunction in the pathogenesis of AD. We included 35 patients with AD (21 acute and 14 chronic). An AD mouse model was constructed using 2,4-dinitrofluorobenzene, and AD-like inflammatory cell model was constructed using TNF-α/IFN-γ-activated HaCaT cells. The proportion of Th1/Th2/Th17/Treg cells was detected using flow cytometry. After mononuclear cells were obtained from human peripheral blood or mouse spleen and induced to differentiate into different T cell subsets, YAP mRNA and protein expression were analyzed. Up-regulation of YAP was induced by lentivirus and down-regulation of YAP was induced by its specific inhibitor verteporfin (VP). The expression of YAP in skin lesions and infiltrating T cell subsets was detected using immunohistochemistry and double immunofluorescence staining, respectively. We found differing degrees of Th1/Th2/Th17/Treg imbalance in acute and chronic AD. YAP expression was downregulated in Treg cells and upregulated in Th17 cells; YAP expression was downregulated in the AD epidermis. After YAP overexpression, the proportion of both Th17 and the Treg cells differentiated from mouse spleen mononuclear cells increased. There was an opposite trend after YAP inhibition. The proliferation and migration decreased and apoptosis increased after YAP inhibition in HaCaT cells. Change of YAP expression may cause T cell imbalance and hamper the healing of the epidermis in AD. [ABSTRACT FROM AUTHOR]

Objective. To assess the efficacy of bloodletting therapy (acupoint pricking and cupping) in patients with chronic idiopathic urticaria (CIU) in a randomized, control, parallel-group trial. Methods. A total of 174 patients with CIU enrolled from March 2018 to October 2019 were randomized into three groups: group A treated with bloodletting therapy and ebastine, group B treated with placebo treatment (acupoint pseudopricking and cupping) and ebastine, and group C treated with ebastine only. The intention-to-treat analysis was conducted, and the primary outcome was the effective rate of UAS7 score being reduced to 7 or below after treatment phase. Results. The effective rates at the end of treatment phase were different among the three groups (P < 0.05), which were 73.7% in group A, 45.6% in group B, and 42.9% in group C. Multiple analysis indicated differences between groups A and B (P < 0.0125) and groups A and C (P < 0.0125) and no difference between groups B and C (P > 0.0125). No severe bloodletting therapy-related adverse events were observed. Conclusions. In this study on patients with CIU, one month of bloodletting therapy combined with ebastine is clinically beneficial compared with placebo treatment combined with ebastine and treatment with ebastine only. Thus, bloodletting therapy can be an effective complementary treatment in CIU. This trial is registered with ChiCTR1800015294. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that microRNA (miR)-146a is involved in the inflammatory response of atopic dermatitis (AD). The aim of the present study was to investigate the expression of miR-146a in the serum of patients with AD and in skin lesions of AD animal models. In addition, we aimed to predict and verify the target genes of miR-146a. miR-146a expression was measured in AD patient serum via reverse transcription-quantitative PCR. T-helper (Th)1 [CD4+; interferon (IFN)-γ+] and Th2 [CD4+; interleukin (IL)-4+] expression in peripheral blood mononuclear cells was evaluated using flow cytometry. Following the establishment of a 2,4-dinitrofluorobenzene-induced C57BL/6 mouse AD model, Th1 (CD4+IFN-γ+) and Th2 (CD4+IL-4+) expression was analyzed in murine spleen cells via flow cytometry. Plasmids were transfected into 293T cells and at 48 h post-transfection, cells were analyzed using a luciferase assay system. The results revealed that the AD group had a significantly lower Th1/Th2 ratio and a significantly higher miR-146a expression compared with the control group (P<0.05). Furthermore, a decreased Th1/Th2 ratio and a significantly increased miR-146a expression were observed in the model group compared with the control group (P<0.01). We also conducted a dual-luciferase assay to determine whether small ubiquitin-related modifier 1 (SUMO1) if the target gene of miR-146a. We observed a ~30% decrease in the relative luciferase activity in cells containing the 3′-untranslated region of SUMO1 + miR-146a). The results of the luciferase assay indicated that may be a direct mRNA target of miR-146a; however, the quantification of band density of SUMO1 expression following western blotting did not significantly differ. The development of animal models in AD research is of vital importance. The results revealed that miR-146a may be a potential regulator involved in the pathogenesis of AD. Furthermore, the current study determined that miR-146a could be a valuable marker of AD and thus, may be applied in the development of therapeutic strategies for treating AD. [ABSTRACT FROM AUTHOR]

In parallel with the prevalence metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in most countries. It features a constellation of simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and even hepatocellular carcinoma. There are no approved drugs for effective management of NAFLD and NASH. Jianpi Huoxue formula (JPHX) mainly consists of Atractylodes macrocephal (Baizhu), Salvia miltiorrhiza (Danshen), Rasux Paeonia Alba (Baishao), Rhizoma Alismatis (Zexie), and Fructus Schisandrae Chinensis (Wuweizi), which may have beneficial effects on NAFLD. The aim of the study was to identify the effect of JPHX on NAFLD. A NAFLD model was induced by methionine-choline-deficient food (MCD) in Wistar rats and orally administered with simultaneous JPHX, once a day for 8 weeks. Hepatocellular injury, lipid profile, inflammation, fibrosis, and apoptosis were evaluated. The results showed that JPHX significantly decreased the abnormal serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels compared with the MCD model (P<0.05). Furthermore, JPHX protected MCD diet-fed rats from accumulation of hepatic triglycerides (TG) and total cholesterol (TC). Histological examination demonstrated that JPHX noticeably normalized the NAFLD activity score (NAS). Moreover, JPHX ameliorated liver inflammation by decreasing TNF-α levels and reduced collagen and matrix metalloproteinases in MCD diet-fed rats. In addition, JPHX prevented rats from MCD-induced cellular apoptosis, as suggested by TUNEL staining, and suppressed the activation of caspase 3 and 7 proteins. JPHX also inhibited the phosphorylation of JNK. In conclusion, JPHX exhibited a hepatoprotective effect against NAFLD in an MCD experimental model. [ABSTRACT FROM AUTHOR]

Atopic eczema (AE), or atopic dermatitis, is a common inflammatory skin disease. As conventional medicines for moderate and severe AE patients have been reported to be associated with unwanted side effects, many patients with AE have sought other therapies. Chinese herbal medicine (CHM) is one of the most commonly used complementary therapies with a long history of being applied for the treatment of AE. Clinical evidence for CHM for AE in systematic reviews and randomised controlled trials (RCTs) published from 2013 to 2016 was reviewed. Findings from the Cochrane systematic review suggested that oral use of a CHM formulation may improve health-related quality of life (HRQoL) of children with moderate or severe AE. The benefit on improvement of AE requires further high-quality clinical studies. [ABSTRACT FROM AUTHOR]

Background: Atopic eczema or atopic dermatitis is a chronic inflammatory skin disease. Current conventional medical treatment for moderate and severe atopic eczema is not satisfactory. There is promising evidence derived from randomised clinical trials to support the clinical use of Chinese herbal medicine in the management of atopic eczema. However, the available evidence is compromised by the high risk of bias associated with most of the included trials. Therefore, well-designed and adequately powered randomised clinical trials are needed. The primary aim of this trial is to evaluate the efficacy and safety of oral ingestion of an oral Chinese herbal formula (Pei Tu Qing Xin granules; PTQX) in children aged between 6 and 16 years with moderate to severe atopic eczema. Methods/Design: We have designed a randomised, double-blind, placebo-controlled, two-arm, parallel clinical trial with 12 weeks of treatment and a 4-week follow-up period. A pilot study with 30 participants will be conducted at the RMIT University in Australia to determine the feasibility of the full-scale randomised clinical trial (N = 124). Eczema Area and Severity Index score will be the primary outcome. Secondary outcome measures include change in symptoms using the Patient-Oriented Eczema Measure, the Children's Dermatology Life Quality Index and the use of concomitant medicines. Safety parameters include report of adverse events and pathology tests during the trial period. Discussion: Key elements for conducting a high-quality randomised clinical trial have been addressed in this protocol. Findings from the proposed trial will provide critical evidence regarding Chinese herbal medicine treatment for atopic eczema. [ABSTRACT FROM AUTHOR]

Background: Atopic eczema or atopic dermatitis is a chronic inflammatory skin disease. Current conventional medical treatment for moderate and severe atopic eczema is not satisfactory. There is promising evidence derived from randomised clinical trials to support the clinical use of Chinese herbal medicine in the management of atopic eczema. However, the available evidence is compromised by the high risk of bias associated with most of the included trials. Therefore, well-designed and adequately powered randomised clinical trials are needed. The primary aim of this trial is to evaluate the efficacy and safety of oral ingestion of an oral Chinese herbal formula (Pei Tu Qing Xin granules; PTQX) in children aged between 6 and 16 years with moderate to severe atopic eczema.Methods/design: We have designed a randomised, double-blind, placebo-controlled, two-arm, parallel clinical trial with 12 weeks of treatment and a 4-week follow-up period. A pilot study with 30 participants will be conducted at the RMIT University in Australia to determine the feasibility of the full-scale randomised clinical trial (N = 124). Eczema Area and Severity Index score will be the primary outcome. Secondary outcome measures include change in symptoms using the Patient-Oriented Eczema Measure, the Children's Dermatology Life Quality Index and the use of concomitant medicines. Safety parameters include report of adverse events and pathology tests during the trial period.Discussion: Key elements for conducting a high-quality randomised clinical trial have been addressed in this protocol. Findings from the proposed trial will provide critical evidence regarding Chinese herbal medicine treatment for atopic eczema.Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12614001172695. Date of Registration: 7 November 2014. [ABSTRACT FROM AUTHOR]

Cardiomegaly is the main imaging finding for canine heart diseases. There are many advances in the field of medical diagnosing based on imaging with deep learning for human being. However there are also increasing realization of the potential of using deep learning in veterinary medicine. We reported a clinically applicable assisted platform for diagnosing the canine cardiomegaly with deep learning. VHS (vertebral heart score) is a measuring method used for the heart size of a dog. The concrete value of VHS is calculated with the relative position of 16 key points detected by the system, and this result is then combined with VHS reference range of all dog breeds to assist in the evaluation of the canine cardiomegaly. We adopted HRNet (high resolution network) to detect 16 key points (12 and four key points located on vertebra and heart respectively) in 2274 lateral X-ray images (training and validation datasets) of dogs, the model was then used to detect the key points in external testing dataset (396 images), the AP (average performance) for key point detection reach 86.4 %. Then we applied an additional post processing procedure to correct the output of HRNets so that the AP reaches 90.9 %. This result signifies that this system can effectively assist the evaluation of canine cardiomegaly in a real clinical scenario. [ABSTRACT FROM AUTHOR]

• The current review summarizes TCMs exerts pharmacological effects on atopic dermatitis. • TCMs mainly exhibit the anti-inflammatory and immunomodulatory effects on atopic dermatitis. • This review covers animal model construction, pharmacodynamic mechanisms regulated by TCMs for atopic dermatitis. Atopic dermatitis (AD) is a common relapsing inflammatory skin disease characterized by severe pruritus that seriously affects the quality of patients' life. There is an increasingly large amount of research demonstrating that traditional Chinese medicine (TCM) including herbal formulae and bioactive ingredients exerts pharmacological effects on atopic dermatitis. It has been a long history of TCM being used to treat atopic dermatitis, especially in preventing disease recurrence, maintaining long-term remission, and reducing disease burden. Nowadays, both of TCM monomer preparations and traditional formulae are still widely used. This review focuses on TCM as well as its bioactive ingredients for the treatment of AD, from the perspectives of animal model construction, pharmacodynamic mechanisms and clinical studies of formulae. To be more specific, the regulation and molecular mechanisms of the herbal formulae and bioactive ingredients of TCM are investigated, and the latest clinical research on TCM formulae is discussed. Furthermore, it provides a summary of the strengths and utilities of TCM, and will be useful for doctors who use Chinese medicine for treatment or researchers who select candidates for clinical treatments or further high-quality clinical studies. [ABSTRACT FROM AUTHOR]

Background: Scalp mycosis is often caused by dermatophytes and was so called tinea capitis. There is no published report caused by Aspergillus protuberus. We report a rare case of kerion-type scalp mycosis caused by A. protuberus.Case Presentation: A 5-year-old girl developed pyogenic mass with pain for 8 days and got a fever for 2 days prior to admission. Surgical incision and drainage of the mass, intravenous cefuroxime and metronidazole in the local hospital aggravated the skin lesions. Species identification was performed by observation of morphologic and biochemical characteristicsand sequencing of the internal transcribed spacer (ITS) and β-tubulin (BT2). Treatment with oral and topical antifungal agents was effective with no relapse during the six months of clinical follow-up.Conclusions: Aspergillusis a opportunistic pathogenic fungus and its infection occurs mostly in patients with underlying conditions and immunocompromised statuses. So far no report of kerion-type scalp infection has been reported. The first case of kerion-type scalp mycosis caused by A. protuberus was described to highlight the importance of mycological examination that helps to recognize rare pathogenic fungi. Any boggy lesion with hair loss over the scalp and non-responsive to antibiotics should be suspected as resulting from fungal infection, and mycological examination should be performed, especially in children. [ABSTRACT FROM AUTHOR]

Background: Zheng represents pattern differentiation in Traditional Chinese Medicine (TCM), as the basic unit and a key concept in TCM therapeutic theory, is based on the physiology and pathology of TCM. None of the outcome measurements of atopic dermatitis (AD) are Zheng-specific. The effectiveness of TCM is likely to be underestimated without a Zheng-related symptom-specific instrument. The aim of this study was to develop an instrument for measuring the Zheng-related symptom-specific status of patients with AD.Methods: We followed standard methodology to develop the instrument, including item generation and selection, item reduction and presentation, and pretesting, and recruited 188 patients with AD involved in a six-center randomized-controlled trial (ChiCTR-TRC-08000156) to validate the questionnaire. We conducted construct validity, reliability, and responsiveness analysis. The standardized effect size (SES) and standardized response mean (SRM) were used to calculate the responsiveness of additional items and the total score for the rating items.Results: ZRADSQ has 15 items, with 12 rating items and 3 additional items. The 12 rating items fall within three domains: AD symptoms (n = 6 items); Heat (n = 4 items) and Mood (n = 2 items). Confirmatory factor analysis provided good support for a three-factor model (d.f. = 51, x2=97.11, RMSEA = 0.07, CFI = 0.96), and the Pearson's correlation coefficient between ZRADSQ and Severity Scoring of Atopic Dermatitis (SCORAD) was 0.40 (P < 0.001). The reliability was also good, with a Cronbach's alpha value for ZRADSQ of 0.84, a split-half coefficient of 0.75, and a test-retest reliability coefficient of 0.98. The standardized effect size and standardized response mean were close to or larger than 1, which indicated moderate to good responsiveness.Conclusions: The ZRADSQ demonstrates promising reliability, validity, and responsiveness. It can be used to determine whether Zheng-specific or symptom-specific treatments relieve the symptom that is most bothersome the patient. [ABSTRACT FROM AUTHOR]