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Toxic epidermal necrolysis (TEN) is a rare severe cutaneous adverse reaction that involves more than 30% of the body surface area. TEN can be accompanied by a series of systemic symptoms and has a high risk of death. Tumor necrosis factor (TNF)-α inhibitors such as adalimumab and etanercept have been shown to be safe and effective for the treatment of TEN in some cases. However, clinical data on the use of TNF-α inhibitors to treat TEN with severe systemic infection are scarce. In the present study, three adult patients who developed TEN with serious active infection were successfully treated with etanercept. One of the three patients had active open pulmonary tuberculosis, and the other two had septicemia and/or fungal sepsis. All patients’ skin lesions significantly improved after several days, and none of the patients developed emerging or re-emerging infectious diseases, adverse reactions, or a similar rash during follow-up. TNF-α inhibitors may be an effective treatment choice for TEN with severe systemic infection. However, further studies with large samples are still required for validation because clinical experience is limited.

In this work, an ultrafine-grained high-Nb–TiAl alloy with a nominal composition of Ti–45Al–8Nb–0.2W–0.2B (at%) was prepared by cryomilling and subsequent spark plasma sintering (SPS) technique. The chemical composition, particle size, morphology and crystallite size of cryomilled powder were studied. It is found that cryomilling can effectively reduce the particle size and enhance grain refinement. The ingots sintered at 900 and 1000 °C show an equiaxed near-γ microstructure with grain sizes < 700 nm, while the sample sintered at 1100 °C exhibits duplex microstructure. Especially, the one sintered at 1000 °C has excellent mechanical properties, whose compression yield strength, fracture strength, bending strength and plastic strain achieve 1310, 2174, 578 MPa and 16.8%, respectively. The reasons for the effect of cryomilling and the mechanical behavior of sintered ingots were discussed. It is suggested that cryomilling in combination with SPS is an effective way to synthesize high-Nb–TiAl alloy with ultrafine-grained structure.

Primary cutaneous amyloidosis (PCA) is a relatively rare and itchy skin disorder characterized by amyloid deposits in the superficial dermis. The cosmetic disfigurement and severe pruritus dramatically affects the patient's quality of life. In spite of the prevalence of the disease in China, the quality of life (QoL) impact of the PCA has not been well defined and is the focus of this study. To examine the HRQoL of patients with PCA and to evaluate the association between HRQoL scores, disease, and socio-demographic determinants. A total of 104 PCA patients and 101 healthy participants completed the questionnaires. HRQoL was measured using dermatology life quality index (DLQI) and SF-36. The socio demographic and clinical data such as age, sex, duration of disease and distribution of lesion pattern were analyzed mainly by hierarchical multiple regression analyses. Patients with PCA experienced significantly impaired health-related quality of life. The mean DLQI score was 9.05. Younger age, female gender, more pruritus and distribution pattern were independent predictor correlates of the high DLQI scores. The PCA group showed significantly decreasing average scores in several aspects of psychological symptoms, including SF, RE and MH. PCA disease has a negative impact on the HRQoL of patients, and the HRQoL is associated with various disease characteristics. In conjunction with medical interventions, psychological and sociocultural assessment and intervention should be an essential part of the management of these cases.

In this study we aimed to investigate the prevalence of SARS-CoV-2 infection in psoriasis patients, and outcomes of SARS-CoV-2 infection and associated risk factors. A cross-sectional survey was conducted from February 2023 to March 2023. Information was obtained with online questionnaire about psoriasis patients on demographic characteristics, clinical characteristics, SARS-CoV-2 infection and outcomes, vaccination, and routine protection against COVID-19. Logistic regression analysis was used to explore risk factors with SARS-CoV-2 infection and exacerbation of psoriasis. A total of 613 participants were recruited. 516 (84.2%) were infected, and associated factors were sex, working status, routine protection against COVID-19, COVID-19 vaccination, impaired nail, infection exacerbate psoriasis, and severity of psoriasis. Among the patients infected with SARS-CoV-2, 30 (5.8%) required hospitalization, 122 (23.6%) had psoriasis exacerbation due to SARS-CoV-2 infection, and associated factors were subtype of psoriasis, discontinuation of psoriasis treatment during SARS-CoV-2 infection, response following COVID-19 vaccination, and severity of psoriasis. Booster dose vaccination contributed a low probability of COVID-19 sequelae. COVID-19 vaccine’s effectiveness was unsatisfactory, while booster dose vaccination reduced the occurrence of COVID-19 sequelae in psoriasis patients of Southwest China. Patients treated with psoriasis shown to be safe, without a higher incidence of SARS-CoV-2 infection or COVID-19hospitalization compared to untreated patients. Stopping treatment during SARS-CoV-2 infection led to psoriasis exacerbation, so psoriasis treatment could be continued except severe adverse reaction.

Silty sand is a poor filler of highway and railway subgrade, and various physical and chemical improving methods have been applied to increase the strength and stability of silty sand. Adding gravel to silty sand is a routine physical improving method. In this paper, large-scale triaxial tests were carried out on silty sand and improved soil which is obtained by adding 4 different proportions of gravel into the silty sand in order to analyze the strength and deformation characteristics of the improved soil. The stress-strain relations obtained from tiaxial tests were analyzed and the effect of coarse particles and fine particles on the strength and deformation of the specimen were also analyzed. The test results show that with more coarse particles and under a higher confining pressure, a greater deviator stress is required to produce the same axial strain. The increase of coarse particles helps to enlarge the angle of internal friction and cohesion, while the increase of fine particles decreases the angle of internal friction and cohesion. Under low confining pressure, the soil specimens with more coarse particles exhibit evident shear dilation. Under high confining pressure, the soil specimens produce a greater volume strain. Adding appropriate amount of gravel into the silt soil can increase its strength and restrain its deformation, but excessive amount of gravel may produce too much volume deformation.

In deep roadway mining, high water pressure causes rock mass cracking and weakens the overall strength, affecting the stability of underground metal mine mining roadways. Therefore, using a numerical simulation method, we analyzed the strain softening characteristics of rocks after the inflexion point of elasticity and studied the strain distribution and the minimum support resistance under high-pressure groundwater conditions. Considering the groundwater pressure and effective porosity on the strain softening characteristics of the surrounding rocks, we investigated the critical groundwater pressure under which the surrounding rocks would remain stable. Actual engineering verification helps to obtain the supporting characteristic curves under different influencing factors. We found that water pressure and effective porosity are the significant factors that decide the development scope of the plastic zone. The more significant the increase of the plastic zone, the more notable the changes in the support curve. Moreover, the plastic zone is likely to occur when the hydraulic head is between 30 and 50 m; when the hydraulic head exceeds 50 m, it is likely to produce a relaxation zone.

Background Since H7N9 influenza A virus (H7N9) was first reported in 2013, five waves of outbreaks have occurred, posing a huge threat to human health. In preparation for a potential H7N9 epidemic, it is essential to evaluate the efficacy of anti-H7N9 drugs with an appropriate model. Methods Well-differentiated pseudostratified human airway epithelium (HAE) cells were grown at the air–liquid interface, and the H7N9 cell tropism and cytopathic effect were detected by immunostaining and hematoxylin-eosin (HE) staining. The H7N9 replication kinetics and anti-H7N9 effect of recombinant human α2b (rhIFN-α2b) and rhIFN-λ1 were compared with different cell lines. The H7N9 viral load and interferon-stimulated gene (ISG) expression were quantified by real-time PCR assays. Results H7N9 could infect both ciliated and non-ciliated cells within the three-dimensional (3D) HAE cell culture, which reduced the number of cilia and damaged the airways. The H7N9 replication kinetics differed between traditional cells and 3D HAE cells. Interferon had antiviral activity against H7N9 and alleviated epithelial cell lesions; the antiviral activity of rhIFN-α2b was slightly better than that of rhIFN-λ1. In normal cells, rhIFN-α2b induced a greater amount of ISG expression (MX1, OAS1, IFITM3, and ISG15) compared with rhIFN-λ1, but in 3D HAE cells, this trend was reversed. Conclusions Both rhIFN-α2b and rhIFN-λ1 had antiviral activity against H7N9, and this protection was related to the induction of ISGs. The 3D cell culture model is suitable for evaluating interferon antiviral activity because it can demonstrate realistic in vivo-like effects.

Skin aging caused by UV radiation is called photoaging is characterized by skin roughness and dryness accompanied by a significant reduction of dermal collagen. Rapamycin is a macrolide immunosuppressant which has been shown to exhibit “anti-aging” effects in cells and organisms, however, its roles in the skin photoaging remains unclear. Here, we investigate the role of rapamycin and HSP27, which we have previously identified as an inhibitor of UV-induced apoptosis and senescence in HaCat cells, in a UVA-induced photoaging model of primary human dermal fibroblasts (HDFs). Results from senescence-associated beta-galactosidase (SA-β-gal) staining revealed that rapamycin significantly reduced senescence in UVA-treated HDFs. In addition, treatment with rapamycin significantly increased cell autophagy levels, decreased the expression of p53 and phosphorylated HSP27, and reduced genotoxic and oxidative cellular stress levels in UVA-induced HDFs. Knockdown of HSP27 resulted in a significant increase of MMP-1 and MMP-3 as well as a decrease in type I collagen expression. Rapamycin mitigated these effects by activation of the classical TGF-β/Smad signaling pathway and increasing the transcriptional activity of MAPK/AP-1. Taken together, these results suggest that rapamycin may potentially serve as a preventive and therapeutic agent for UVA-induced photoaging of the skin.

Background: Nail involvement has a tremendous impact on psoriasis patients. Early detection and prompt intervention of psoriatic nail damage are necessary. Methods: A total of 4290 patients confirmed to have psoriasis between June 2020 and September 2021 were recruited from the Follow-up Study of Psoriasis database. Among them, 3920 patients were selected and divided into the nail involvement group (n = 929) and the non-nail involvement group (n = 2991) by inclusion and exclusion criteria. Univariate and multivariable logistic regression analyses were performed to identify the predictors of nail involvement for the nomogram. Calibration plots, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the discriminative and calibrating ability and clinical utility of the nomogram. Results: Sex, age at onset, duration, smoking, drug allergy history, comorbidity, sub-type of psoriasis, scalp involvement, palmoplantar involvement, genital involvement, and PASI score were selected to establish the nomogram for nail involvement. AUROC (0.745; 95% CI: 0.725–0.765) indicated the satisfactory discriminative ability of the nomogram. The calibration curve showed favorable consistency, and the DCA showed the good clinical utility of the nomogram. Conclusion: A predictive nomogram with good clinical utility was developed to assist clinicians in evaluating the risk of nail involvement in psoriasis patients.

The mechanism of hydrolysis and extension diffusion of heavy metal pollution elements infiltrated into rock is analyzed by the theory of ion hydrolysis displacement. The hydrolysis properties of typical elements such as cadmium, zinc, lead, and copper are verified by convective dispersion model, and the diffusion law and fission characteristics of heavy metal with different hydrolysis constant are discussed. A three-dimensional constitutive relation model of rock extension diffusion surface is established by combining viscoelastic monomer model with a damage monomer model. Considering the influence of diffusion coefficient, hydrolysis constant, deformation factor, and other parameters, the rationality of the test results and model fitting results of heavy metal invading rock are verified. The results show that the replacement rate of colloidal mineral elements in rock varies with different hydrolysis constant, when the hydrolysis constant is large, the extension diffusion rate in rock is large; otherwise, the extension diffusion rate is small. Constitutive relation curves of polluted rock with different lithologies are in good agreement with the fitting results of the combination model under the influence of the same test conditions and the same parameters.