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The burden of hepatitis B virus (HBV) infection in China is high. The safety and efficacy of secukinumab in psoriasis patients with HBV infection have not been fully elucidated.To investigate the safety and efficacy of secukinumab in psoriasis patients with HBV infection in China.In this retrospective study, 20 psoriasis patients with HBV infection were identified, all of whom had been treated with secukinumab for ≥24 weeksFour patients had chronic inactive HBV infection, two patients had occult HBV infection, and the other 14 patients had resolved HBV infection. The HBV-DNA load and HBV markers measured at baseline and Week 24 showed no viral reactivation. Nineteen patients showed normal levels of liver enzymes after 24 weeks of therapy. However, one patient with resolved HBV infection and fatty liver with elevated baseline liver enzymes experienced hepatitis, with negative HBV load at baseline and Week 24. All patients showed a significant improvement in the Psoriasis Area and Severity Index (−13.35 ± 7.41: p0.0001), per cent of body surface area (−17.11 ± 17: p = 0.0002), Investigator Global Assessment (−2.55 ± 0.94: p0.0001), and Dermatology Life Quality Index (−12.3 ± 7.39; p0.0001)Secukinumab showed good efficacy in psoriasis patients with HBV infection. Chronic, inactive, occult and resolved HBV infection may not increase the risk of hepatitis during secukinumab treatment. Patients with poor baseline liver function, without any intervention during secukinumab treatment, may experience hepatitis. Periodic monitoring with HBV markers, HBV-DNA load, and serological liver function tests is necessary during secukinumab treatment.

Generalized pustular psoriasis is an immune‐mediated dermatologic condition characterized by widespread, sterile, subcorneal pustules. However, limited information exists regarding the clinical course of generalized pustular psoriasis. This study aimed to examine the precipitating factors, clinical manifestations, laboratory data, relapse patterns, and prognosis of generalized pustular psoriasis at our hospital and to improve the diagnosis and treatment. A retrospective analysis was conducted for generalized pustular psoriasis in our department from 2014 to 2019. In total, 110 patients were included in our study (mean age 46.5 years). The female:male ratio was 1:2.7. Ninety‐four (85.5%) had a psoriasis vulgaris history, 12 (10.9%) had a psoriatic arthritis history, five (4.5%) had an erythrodermic psoriasis history, and 16 (14.5%) had a family history of psoriasis. Eleven (10.0%) cases were triggered by infections and 17 (15.5%) were caused by the sudden discontinuation of systemic drugs. During hospitalization, the proportion of patients with hyperlipidemia was higher after acitretin treatment than before acitretin treatment (P 0.05). The onset age of generalized pustular psoriasis was younger in patients without prior psoriasis (P 0.05). Moreover, among patients with fever, skin lesion clearance rates were highest in the biological agent group (81.8%). However, among patients without fever, skin lesion clearance rates were highest in the acitretin group (86.7%). No patients presented serious complications or died. Our study presents the detailed clinical course of generalized pustular psoriasis in Chinese patients. These results will help to better understand and treat generalized pustular psoriasis.

In order to improve the comprehensive nursing effect of the hospital emergency treatment, this paper analyzes the process of the hospital emergency treatment. In addition, this paper combines the possible risks to analyze the risk factors of the comprehensive nursing in the hospital emergency treatment and builds an intelligent analysis model based on the actual situation of the hospital emergency treatment. At the same time, this paper conducts a systematic survey of emergency services and gives the composition and structure of the system. In addition, this paper divides the business required by the system into modules, including registration module, doctor workstation, nurse workstation, query statistics module, decision-making module, and maintenance module. Finally, this paper suggests that in the process of the clinical triage, more ideas for improving the existing evaluation model should be proposed, and experience should be transformed into advantages, so as to improve emergency triage skills; establish an objective, quantitative, and scientific concept of emergency classification and triage; and fully realize scientific triage and precise triage.

It is well known that the Unet has been widely used in the area of medical image segmentation because of the cascade connection in the up-sampling process. However, it does not perform well in dealing with complex medical images, such as brain MRI. In order to achieve better segmentation performance by adopting the Unet, many researchers have paid more attention to stacking the Unet. However, the stacking process leads to a large increase in the number of parameters. This is not a good choice when considering the tradeoff between precision and efficiency. Another problem is that as the depth of the network increases, the excessive loss of information is also a tricky problem. To address those problems, in this paper, we are trying to improve the network structure of Unet to make it more suitable for brain tumor segmentation. We propose a novel framework called Stack Multi-Connection Simple Reducing_Net(SMCSRNet) that are stacked by our basic blocks called Simple Reducing_Net(SRNet). The basic block SRNet is improved from the original Unet, which consists of four downsampling and upsampling operations during the encoding and decoding. Only one convolution operation is performed before each downsampling process. The operation of copy and crop is preserved between encoding and decoding. The main advantage of the SRNet is that the amount of parameters is reduced by 4/5 by comparing with the original Unet. Except for the problem of parameters number, we also proposed a series of bridge connections among the stacked cascade network to improve the loss of information. More specifically, some bridge connections will be adopted before the pooling operation in each layer during the downsampling process. It means that each layer in one basic block has a bridge connection with the same feature size from the previous basic block before pooling, and it is worth noting that the training time of the proposed framework is much less than the original stacked Unet. Moreover, the performance of the proposed method is also improved compared to the stacked Unet. When further comparing with other state-of-the-art segmentation networks, it can be found that the performance is as good as the most popular DenseNet or ResNet. Overall, by evaluating the proposed framework on the BRAT2015, it can be proven that the proposed segmentation network has the ability to accurately extract the brain tumor boundary so as to obtain higher recognition quality with high efficiency.

The association of psoriasis with thyroid dysfunction has been investigated. However, it remains unclear; some papers indicate it, and others do not. In this study, we evaluate the prevalence of thyroid dysfunction in patients with psoriasis vulgaris (PsV), psoriatic arthritis (PsA), generalized pustular psoriasis (GPP) and erythrodermic psoriasis (EP), and the association of thyroid dysfunction with inflammation. Data on 201 psoriatic patients visiting our hospital from January 2014 to November 2017 (159 men and 42 women; 74 PsV, 42 PsA, 38 GPP and 47 EP) were retrospectively analyzed. Thirty-three percent of psoriatic patients had thyroid dysfunction. The percentage of patients with thyroid dysfunction was the highest in those with EP (60% EP, 42% GPP, 19% PsA, 19% PsV). The prevalence of thyroid dysfunction decreased significantly when patients switched from EP to PsV or PsA (58% vs 17%; median, 20.5; range, 4-65 months). Most of the patients with thyroid dysfunction had low thyroxine syndrome (serum levels of free thyroxine are low, but serum thyroid-stimulating hormone level is normal). Patients with thyroid dysfunction demonstrated significantly higher CD3+ and CD4+ T-cell absolute count levels than those without thyroid dysfunction. Meanwhile, patients with thyroid dysfunction demonstrated lower immunoglobulin (Ig)A and IgM levels than those without thyroid dysfunction. Finally, patients with thyroid dysfunction demonstrated higher elevated serum C-reactive protein levels than those without dysfunction in total, although there were no statistical differences. Our data indicate that thyroid dysfunction in patients with psoriasis may be associated with inflammation caused by psoriasis.

Psoriasis and pemphigus are clinically well-characterized chronic, inflammatory skin diseases. Many case reports have described the coexistence of psoriasis and bullous pemphigoid. However, the present report is about a rare case of pemphigus vulgaris in a patient with psoriasis vulgaris. We had a 68-year-old male psoriatic patient who developed blisters lesions and erosions on the trunk and extremities. The histopathology of a blister lesion showed the intraepidermal blisters that contained serous fluid and inflammatory cells. Both of desmoglein core protein 1 antibody and desmoglein core protein 3 antibody were detected. Diagnoses of pemphigus vulgaris and psoriasis vulgaris were made. The patient was treated with methotrexate (12.5 mg/week) and methylprednisone (16 mg/day) after his admission. Two weeks after admission, the patient's lesions gradually subsided. This case reminds us that the therapeutic effect of pemphigus vulgaris may be related to the incidence of psoriasis.

It is well known that U-net is the most advanced medical image processing framework, but it performs poorly in processing complex images. DenseNet is a framework for improvement based on U-net, which has been proposed in recent years, with well performance but large parameters compared with U-net. This paper proposes a Half Dense U-net network, which combines the advantages of DenseNet and U-Net, reduces the number of DenseNet parameters and improves the segmentation accuracy. Compared with U-Net, DenseNet and ResNet proposed in recent years, our proposed model can precisely locate the tumor boundary of brain tumors, thus obtaining higher recognition quality.

We all know the advanced framework which is used to medical image processing is Unet, but it is struggling when it processes complex images. DenseNet is the state-of-the-art network, which has large parameters compared with Unet. Unet++ performs better on complex images than Unet. In this work, we proposes an novel network structure called Dense_Unet++(DU++), that can take advantage of feature fusion of the Unet++, reduces the DenseNet's parameters and further improves the segmentation accuracy. Our model is mainly implemented by combine Half Dense Unet(HDU)and Unet++. The long connections with different semantic levels do not achieve the effect of feature fusion, so our paper propose that built a series of bridges for different semantic levels within the DU++ and abandoned the original long connections. We apply this framework to brain tumor segmentation. In the end, our experiment achieved a promising result.

Melanoma is the most aggressive type of skin cancer, exhibiting extensive local invasion and early distant metastasis. Aberrant expression of ubiquitin-protein ligase E3C (UBE3C) plays a key role in tumor development and progression. In the present study, we analyzed UBE3C expression in samples of cancerous and normal skin tissue. Levels of UBE3C expression were much higher in primary and metastatic melanoma tissues than in normal skin, cutaneous squamous cell carcinoma or basal cell carcinoma. Melanoma cells overexpressing UBE3C frequently exhibited a mesenchymal phenotype, including reduced expression of the epithelial marker E-cadherin and expression of the mesenchymal marker vimentin. Knockdown of UBE3C expression in melanoma cells significantly suppressed melanoma growth and progression. Furthermore, silencing UBE3C led to increased E-cadherin expression and decreased vimentin and Snail1 expression. Thus UBE3C promotes melanoma progression, possibly by inducing epithelial-mesenchymal transition in melanoma cells. Inhibiting UBE3C activity may suppress melanoma invasion and metastasis and may represent a targeted therapeutic approach.