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Physical exercise is an effective intervention in controlling gestational plasma glucose (PG) and reducing adverse pregnancy outcomes. However, evidence regarding the appropriate levels of physical exercise for gestational diabetes mellitus (GDM) women is still limited, especially in China. This study aims to explore the association between physical exercise time and the abnormal plasma glucose (APG) during third trimester, and to develop physical exercise instruction for GDM women with different characteristics. In this study, GDM was diagnosed by 75 g oral glucose tolerance test (OGTT). During the routine antenatal checkups subsequent to GDM confirmation, APG was defined as fasting plasma glucose ≥ 5.10 mmol/L, or 2-h plasma glucose ≥ 8.5 mmol/L with breakfast consumption. Information regarding prenatal examination and birth records among GDM women was extracted from the health information system, and physical exercise data was collected through face-to-face interviews. Group-based trajectory modeling (GBTM) was implemented through R software to identify distinct trajectories of APG percentage, and the restricted cubic spline (RCS) curves with four knots were used to model the dose–response relationship between physical exercise time and the APG percentage among GDM women, in the total and different subgroups. In this study, a P -value less than 0.05 (two-tailed) was viewed as statistical significance. The age of 1448 GDM women ranged from 18 to 45 years, with an average age of 31.22 years. GDM women was divided into low APG group (n = 974, 67.27%) and high APG group (n = 474, 32.73%) based on the GBTM. Logistic regression indicated that GDM women with advanced maternal age (odds ratio (OR) = 2.37 and 95% confidence interval [CI] 1.44–3.90 for those aged 36–45 years, and OR = 1.62 (95% CI 1.02–2.56) for those aged 31–35 years), overweight and obese (OR = 1.70, 95%CI 1.34–2.16) had higher APG risk. The RCS curve indicated that physical exercise could lower the APG percentage among GDM women. However, GDM women with advanced maternal age, overweight and obese still had high APG percentage even when physical exercise exceeded 90 min/day. Physical exercise over 60 min/day could effectively lower the APG risk among GDM women, but even over 90 min/day is less efficient for those with advanced maternal age, overweight and obese, so physical exercise incorporated with other intervention measures should be considered.

Background Many effective therapies for psoriasis are being applied in clinical practice in recent years, however, some patients still can’t achieve satisfied effect even with biologics. Therefore, it is crucial to identify factors associated with the treatment efficacy among psoriasis patients. This study aims to explore factors influencing the treatment efficacy of psoriasis patients based on decision tree model and logistic regression. Methods We implemented an observational study and recruited 512 psoriasis patients in Shanghai Skin Diseases Hospital from 2021 to 2022. We used face-to-face questionnaire interview and physical examination to collect data. Influencing factors of treatment efficacy were analyzed by using logistic regression, and decision tree model based on the CART algorithm. The receiver operator curve (ROC) was plotted for model evaluation and the statistical significance was set at P  < 0.05. Results The 512 patients were predominately males (72.1%), with a median age of 47.5 years. In this study, 245 patients achieved ≥ 75% improvement in psoriasis area and severity index (PASI) score in week 8 and was identified as treatment success (47.9%). Logistic regression analysis showed that patients with senior high school and above, without psoriasis family history, without tobacco smoking and alcohol drinking had higher percentage of treatment success in patients with psoriasis. The final decision tree model contained four layers with a total of seventeen nodes. Nine classification rules were extracted and five factors associated with treatment efficacy were screened, which indicated tobacco smoking was the most critical variable for treatment efficacy prediction. Model evaluation by ROC showed that the area under curve (AUC) was 0.79 (95%CI: 0.75 ~ 0.83) both for logistic regression model (0.80 sensitivity and 0.69 specificity) and decision tree model (0.77 sensitivity and 0.73 specificity). Conclusion Psoriasis patients with higher education, without tobacco smoking, alcohol drinking and psoriasis family history had better treatment efficacy. Decision tree model had similar predicting effect with the logistic regression model, but with higher feasibility due to the nature of simple, intuitive, and easy to understand.

Atopic dermatitis (AD) is a chronic inflammatory skin condition that presents a significant disease burden, being the most prevalent non-fatal skin disease globally. While topical treatments play a vital role in managing mild-to-moderate AD, existing therapies often offer limited efficacy or have undesirable side effects. Fuzhiqing ointment, formulated from 15 traditional Chinese herbs, has demonstrated promising effects in anti-inflammatory, antipruritic, and anti-infective properties. Despite its widespread use in clinical practice, particularly for treating itching skin diseases, high-quality clinical evidence supporting its effectiveness in AD remains scarce. This trial seeks to address this gap by evaluating the clinical efficacy of Fuzhiqing ointment in managing mild-to-moderate AD, providing critical evidence for its potential integration into mainstream dermatologic care. This multicenter, randomized, double-blind, placebo-controlled clinical trial aims to assess the efficacy of Fuzhiqing ointment in alleviating the symptoms of mild-to-moderate AD. We hypothesize that the inclusion of Fuzhiqing ointment in the treatment regimen will lead to a significant improvement in clinical outcomes compared to placebo, offering an innovative therapeutic approach in the AD treatment landscape. A total of 210 patients with mild-to-moderate AD will be recruited from 10 hospitals across China between September 2025 and February 2026. Participants will be randomly assigned in a 2:1 ratio to receive either the treatment (urea vitamin E cream combined with Fuzhiqing ointment;  = 140) or the control (urea vitamin E cream combined with placebo Fuzhiqing ointment;  = 70). Both groups will apply the treatments twice daily for 2 weeks, followed by a 4-week observational follow-up period. The primary outcome will be the proportion of patients achieving ≥50% improvement in the Eczema Area and Severity Index (EASI) score at week 2 (EASI ). Secondary outcomes will include changes in the EASI, Numerical Rating Scale (NRS), Investigator's Global Assessment (IGA), Dermatology Life Quality Index (DLQI), and Atopic Dermatitis Control Tool (ADCT) at weeks 1 and 2, as well as the EASI, NRS, and adverse events at week 6. Statistical analyses will be performed using SAS 9.4, with significance defined at a two-tailed level of 0.05. In this study, ethics approval was obtained in December 2024 and registered in Chinese Clinical Trial Registry in January 2025. Participant recruitment was commenced in February 2025 and is expected to be completed by February 2026. Data analysis will be initiated in May 2026, and the preliminary trial results are expected to be submitted for peer-reviewed publication in December 2026. https://www.chictr.org.cn/, Identifier ChiCTR2500095971.

Atopic dermatitis (AD) is a recurrent, inflammatory, and chronic skin disease that influences over 200 million individuals around the world and is viewed as an important health problem due to its elevated prevalence, long course of disease, and heavy disease burden. WuSheZhiYang (WSZY) pills are composed of 11 Chinese herbs and have the effects of nourishing the blood, drying dampness, and relieving itching. In clinical practice, WSZY pills are recommended for itching skin diseases, but high-quality clinical trial evidence is still limited. In this study, we will implement a double-blind, randomized, placebo-controlled trial to evaluate the efficacy of WSZY pills for mild-to-moderate AD. We hypothesized that WSZY pills can effectively alleviate the disease condition of patients with mild-to-moderate AD. In this study, we will recruit 60 patients with mild-to-moderate in Shanghai Skin Diseases Hospital from December 2024 through December 2025. In this study, 60 male and female patients with AD aged 18 years to 65 years will be randomly assigned (2:1) to the treatment group (urea ointment and WSZY pills; n=40) or control group (urea ointment and placebo WSZY pills; n=20), and both groups will receive 4 weeks of treatment and 4 weeks of follow-up. The treatment group will receive 3 sessions of urea ointment and 7.5 g of WSZY pills each day for 4 weeks, and the control group will also receive 3 sessions of urea ointment and 7.5 g of placebo WSZY pills each day for 4 weeks. The primary indicator is the change in the objective Scoring Atopic Dermatitis (SCORAD) score between baseline and week 4. The secondary indicators include SCORAD at week 2 and week 8; Peak Pruritus Numerical Rating Scale (PP-NRS), Investigator's Global Assessment (IGA), Patient-Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI) at week 2, week 4, and week 8; and the proportion of participants receiving remedial treatment, amount of levocetirizine tablets used, and recurrence rate at week 8. In this study, we will analyze the full analysis set and per-protocol set using SAS software version 9.4, and a 2-tailed alpha level of .05 will be viewed as statistically significant. The study received ethics permission in September 2024, and trial registration was completed in October 2024. Recruitment started in December 2024 and is expected to be completed by December 2025. As of June 2025, 30 participants with mild-to-moderate AD were enrolled. Data analysis will begin in January 2026. The main results of the trial are expected to be submitted for publication in peer-reviewed scientific journals in the summer of 2026. This study will evaluate the efficacy of WSZY pills for AD and provide additional evidence, suggest new therapeutic options for patients, and reduce their disease burden. International Traditional Medicine Clinical Trial Registry ITMCTR2024000724; http://itmctr.ccebtcm.org.cn/zh-CN/Home/ProjectView?pid=bda070f8-a733-4f52-87b0-39e4be57ac00. DERR1-10.2196/77927.

Purpose: Tobacco smoking and alcohol drinking are positively associated with psoriasis prevalence and disease severity. Researches focusing on the influence of smoking and drinking on the treatment efficacy of psoriasis are still limited, especially their interaction effect. This study aims to explore the interactive effects of smoking and drinking on the treatment efficacy in psoriasis patients. Patients and Methods: From 2021 to 2022, we recruited 560 patients with psoriasis from Shanghai Skin Diseases Hospital. Demographic and clinical features as well as treatment efficacy were collected through questionnaire interview and physical examination during patient's hospital visit at week 0, week 4 and week 8. Logistic regression model was used to explore the influence of smoking and drinking on the treatment efficacy in psoriasis patients, and multiplicative and additive interaction models were used to verify the interaction effect of smoking and drinking on the treatment efficacy. Results: The prevalence of smoking and drinking among psoriasis patients was respectively 43.8% and 25.4%, and 19.6% of them with both smoking and drinking. Logistic regression analysis showed that patients with smoking (OR=7.78, 95% CI: 5.26~11.49) and drinking (OR=5.21, 95% CI: 3.29~8.27) had higher risk of experiencing the failure to achieve PAS[I.sub.75] at week 8, even with the adjustment of confounders. Moreover, multiplicative as well as additive model showed that tobacco smoking interacted with alcohol drinking which influenced the treatment efficacy more severely (OR=12.74, 95% CI: 7.16~22.67). The proportion of PAS[I.sub.75] achievement in female patients (OR=19.54) and patients with methotrexate (OR=28.31) and biologics (OR=21.61) were more likely being affected by smoking and drinking. Conclusion: Tobacco smoking and alcohol drinking could increase the failure of PAS[I.sub.75] achievement in patients with psoriasis, individually and interactively. We recommend that dermatologists should educate patients to pay attention to the negative effects of smoking and drinking, encourage them to quit, and thus improve the treatment efficacy. Keywords: psoriasis, tobacco smoking, alcohol drinking, interaction, additive model, multiplicative model

Tobacco smoking and alcohol drinking are positively associated with psoriasis prevalence and disease severity. Researches focusing on the influence of smoking and drinking on the treatment efficacy of psoriasis are still limited, especially their interaction effect. This study aims to explore the interactive effects of smoking and drinking on the treatment efficacy in psoriasis patients. From 2021 to 2022, we recruited 560 patients with psoriasis from Shanghai Skin Diseases Hospital. Demographic and clinical features as well as treatment efficacy were collected through questionnaire interview and physical examination during patient's hospital visit at week 0, week 4 and week 8. Logistic regression model was used to explore the influence of smoking and drinking on the treatment efficacy in psoriasis patients, and multiplicative and additive interaction models were used to verify the interaction effect of smoking and drinking on the treatment efficacy. The prevalence of smoking and drinking among psoriasis patients was respectively 43.8% and 25.4%, and 19.6% of them with both smoking and drinking. Logistic regression analysis showed that patients with smoking (OR=7.78, 95% CI: 5.26~11.49) and drinking (OR=5.21, 95% CI: 3.29~8.27) had higher risk of experiencing the failure to achieve PASI at week 8, even with the adjustment of confounders. Moreover, multiplicative as well as additive model showed that tobacco smoking interacted with alcohol drinking which influenced the treatment efficacy more severely (OR=12.74, 95% CI: 7.16~22.67). The proportion of PASI achievement in female patients (OR=19.54) and patients with methotrexate (OR=28.31) and biologics (OR=21.61) were more likely being affected by smoking and drinking. Tobacco smoking and alcohol drinking could increase the failure of PASI achievement in patients with psoriasis, individually and interactively. We recommend that dermatologists should educate patients to pay attention to the negative effects of smoking and drinking, encourage them to quit, and thus improve the treatment efficacy.

Psoriasis is a chronic immune-mediated disease that significantly impacts patients clinically and psychologically. Physician-assessed severity measures, including Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA), often fail to capture patient-reported outcomes, particularly when clinical improvement and perceived quality-of-life gains are misaligned. To clarify the association between clinical improvements and Dermatology Life Quality Index (DLQI) outcomes, identify predictors of substantial DLQI improvement (≥90% reduction), and explore reasons for suboptimal DLQI responses in patients achieving skin clearance. In this 12-week prospective study, 551 psoriasis patients were enrolled at Shanghai Skin Diseases Hospital. Data on demographics, clinical severity (PASI, BSA, and PGA), DLQI scores, and treatment modalities were collected. Logistic regression analyses were employed to assess the dose-response relationships between improvements in clinical parameters and DLQI reduction, and to identify factors of suboptimal DLQI improvement among patients achieving significant skin clearance. Median DLQI improved significantly (8.0 to 3.0) at week 12, with 24.1% of patients achieving ≥90% DLQI reduction. Strong dose-response associations existed between clinical severity improvements (PASI, BSA, PGA) and DLQI gains. PASI responders were significantly more likely to achieve substantial DLQI improvement (OR = 2.48, 95% CI: 1.51-4.07). However, only 33.3% of PASI achievers reached ≥90% DLQI improvement. Early clinical response (as early as week 4) strongly predicted superior DLQI outcomes. Female sex, older age, lower baseline DLQI scores, and shorter disease duration were associated with achieving high skin clearance but suboptimal DLQI improvement. Early clinical response effectively predicts substantial DLQI improvement, whereas demographic and disease-related factors help identify patients at risk for suboptimal quality-of-life gains despite significant skin clearance. These insights support personalized therapeutic strategies aimed at improving patient satisfaction beyond skin clearance alone.

Tobacco smoking is an unhealthy behavior associated with the onset, severity, and treatment response of psoriasis. However, evidence regarding the impact of tobacco smoking on the relapse of psoriasis remains limited. This study aims to examine the relapse condition in psoriasis patients and explore the association between tobacco smoking and psoriasis relapse. We conducted an observational study with 551 psoriasis patients recruited from 2022 to 2024 in Shanghai Skin Disease Hospital. A structured questionnaire and physical examination were used to collect data at baseline, week 12, week 24 and week 48. PASI50 and PASI75 were used to evaluate the improvement of psoriasis patients after treatment at week 12, and disease relapse was defined as the loss of 50% PASI improvement during clinical remission after the achievement of PASI50 or PASI75 at week 12. 75.7% of the 551 psoriasis patients were males, with an average age of 45.8 years, and 282 (51.2%) were tobacco smokers. 41.2% and 61.6% of psoriasis patients with PASI50 achievement at week 12 encounter disease relapsed at week 24 and 48, respectively, while for patients with PASI75 achievement at week 12, the relapse rate was 27.6% and 51.7% at week 24 and 48, respectively. Logistic regression indicated that patients with tobacco smoking had a higher relapse rate, especially among those with PASI75 achievement at week 12. The odds ratio was 2.10 (95% CI: 1.17-3.78) and 1.84 (95% CI: 1.07-3.14) at week 24 and week 48 respectively, even after adjusting for potential confounding factors. Moreover, patients with longer smoking duration and more daily cigarette consumption had higher relapse rate. Tobacco smoking was positively correlated with the relapse, especially among those with longer smoking duration and more daily cigarette consumption. Therefore, patients with psoriasis should quit smoking to reduce the risk of relapse.

Purpose: Tobacco smoking and alcohol drinking are positively associated with psoriasis prevalence and disease severity. Researches focusing on the influence of smoking and drinking on the treatment efficacy of psoriasis are still limited, especially their interaction effect. This study aims to explore the interactive effects of smoking and drinking on the treatment efficacy in psoriasis patients.Patients and Methods: From 2021 to 2022, we recruited 560 patients with psoriasis from Shanghai Skin Diseases Hospital. Demographic and clinical features as well as treatment efficacy were collected through questionnaire interview and physical examination during patient’s hospital visit at week 0, week 4 and week 8. Logistic regression model was used to explore the influence of smoking and drinking on the treatment efficacy in psoriasis patients, and multiplicative and additive interaction models were used to verify the interaction effect of smoking and drinking on the treatment efficacy.Results: The prevalence of smoking and drinking among psoriasis patients was respectively 43.8% and 25.4%, and 19.6% of them with both smoking and drinking. Logistic regression analysis showed that patients with smoking (OR=7.78, 95% CI: 5.26~11.49) and drinking (OR=5.21, 95% CI: 3.29~8.27) had higher risk of experiencing the failure to achieve PASI75 at week 8, even with the adjustment of confounders. Moreover, multiplicative as well as additive model showed that tobacco smoking interacted with alcohol drinking which influenced the treatment efficacy more severely (OR=12.74, 95% CI: 7.16~22.67). The proportion of PASI75 achievement in female patients (OR=19.54) and patients with methotrexate (OR=28.31) and biologics (OR=21.61) were more likely being affected by smoking and drinking.Conclusion: Tobacco smoking and alcohol drinking could increase the failure of PASI75 achievement in patients with psoriasis, individually and interactively. We recommend that dermatologists should educate patients to pay attention to the negative effects of smoking and drinking, encourage them to quit, and thus improve the treatment efficacy.