Objective Metagenomic high-throughput sequencing (mNGS) was applied to analyze the differences in the diversity, structure, and abundance of the urethral microbiota between male gonorrhea patients and healthy individuals and to explore the relationship between Neisseria gonorrhoeae (NG) infection and urethral microbiota in the urethra of male gonorrhea patients. Methods Fourteen male gonorrhea patients (NG group) treated at the dermatological clinic of the Sixth People's Hospital of Panyu District from March 2023 to December 2024 were selected. Seventeen healthy individuals served as the control group (HC group). DNA was extracted from urethral swab samples. After removal of host sequences, the resulting data were subjected to high-throughput sequencing. The differences in urethral microbial communities were compared between the two groups. Results The abundance and diversity of the microbiota in male gonorrhea patients was significantly lower than those in the HC group. Abundance of Neisseria was observed at the Order, Family, Genus, and Species levels. The classification model established using the read count of Neisseria accurately distinguished male gonorrhea patients. NG infection was accompanied by an increased abundance of Bacillus spp. compared with other species. Conclusions The urethral microbiota of male gonorrhea patients is strikingly distinct from that of healthy individuals in terms of species composition, structure, and diversity. NG infection potentially induces Bacillus spp. to transform into pathogenic microorganisms involved in the onset and progression of urinary tract infections, suggesting that urethral microbiota dysbiosis is a hallmark of gonococcal infection.

Objective To observe the clinical efficacy of 308 nm excimer laser combined with fire needle therapy in the treatment of vitiligo patients.Methods A total of 69 vitiligo patients were enrolled from the 903 Hospital and randomly divided into a control group (34 cases) and an experimental group (35 cases), using a random number table. The control group received 308 nm excimer laser therapy alone, while the experimental group received a combined treatment with 308 nm excimer laser and fire needle therapy. The vitiligo lesion area, clinical efficacy, and incidence of adverse reactions were compared between the two groups. Furthermore, the relationship between the lesion recovery area and patient age was analyzed in both groups.Results Before the treatments at the 8th and 12th weeks, as well as at the end of the treatment, the vitiligo lesion area in the experimental group (13.77±2.86, 12.24±1.86, and 11.33±1.98, respectively) was significantly smaller than that in the control group (15.83±3.17, 13.95±2.23, and 13.25±2.05, respectively) (all P<0.01).The overall effective rate was significantly higher in the experimental group than in the control group (94.29% vs. 73.53%; $\chi $²=5.55, P=0.019). However, the total incidence of adverse reactions did not differ significantly between the two groups (P>0.05). The recovery area of skin lesions in both groups correlated negatively with age (control group: r=-0.32, P=0.043; experimental group: r=-0.21, P=0.023), with the experimental group showing a smaller slope. Conclusions The clinical effectiveness of 308 nm excimer laser combined with fire needle treatment is remarkable, with a reduction in lesion area, faster repigmentation, suitability for a broad age range, safety and reliability.

Objective To investigate the analgesic effect and underlying mechanisms of pulsed radiofrequency (PRF) on the thoracic dorsal root ganglia combined with medication in the treatment of elderly patients with severe postherpetic neuralgia (PHN).Methods A total of 121 elderly patients with PHN in our hospital from October 2022 to October 2024 were enrolled. They were divided into an observation group and a control group according to different treatment methods. The control group (61 cases) was treated with oral pregabalin and conventional medications, while the observation group (60 cases) received additional PRF on the thoracic dorsal root ganglia on the basis of the treatment given to the control group. Both groups were treated for 12 weeks. The visual analogue scale (VAS) scores and 36-item short form health survey (SF-36) scores were compared between the two groups after 1, 4, 8, and 12 weeks of treatment. The serum levels of interferon-gamma (IFN-γ), interleukin-4 (IL-4), interleukin-10 (IL-10), substance P (SP), and neurokinin-1 (NK-1) before and after the treatment were compared between the two groups.Results After 1, 4, 8, and 12 weeks of treatment, both the VAS scores and SF-36 scores in the two groups significantly improved from baseline (P<0.05). The VAS scores of the observation group were lower than those of the control group (P<0.05), while the SF-36 scores were higher than those of the control group (P<0.05). After the treatment, the serum levels of IL-10, SP, and NK-1 in both groups were significantly lower than their baseline levels (P<0.05), and the levels of IL-10, SP, and NK-1 in the observation group were lower than those in the control group (P<0.05). However, serum levels of IFN-γ and IL-4 did not differed significantly between the two groups.Conclusions For elderly patients with severe PHN, pulsed radiofrequency on the thoracic dorsal root ganglia, combined with medication, has a significant analgesic effect and greatly improves the quality of life. Its mechanisms may be related to inhibiting the inflammatory response, regulating neurotransmitters, and blocking the transmission of pain signals.

Objective To evaluate the clinical efficacy and safety of Liangxue Xiaoban Granules combined with conventional western medicine in treating psoriasis of blood-heat and wind-dryness type, and to explore its effects on inflammatory cytokines. Methods Ninety psoriatic patients were randomly assigned to a control group (n=45) and an observation group (n=45). The control group received the standardized conventional western medicine, while the observation group was given Liangxue Xiaoban Granules in addition to the conventional treatment. After 12 weeks of treatment, outcomes were compared between the two groups, including the overall response rate, psoriasis area and severity index (PASI) score, traditional Chinese medicine (TCM) syndrome score, and the adverse reaction rates. Additionally, serum levels of interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), and interferon-gamma (IFN-γ) were compared. Results After 12 weeks of treatment, the total effective rate was significantly higher in the observation group than in the control group (97.62% vs. 83.72%, P<0.05). Compared to the control group,the observation group demonstrated greater reductions in PASI score, TCM syndrome scores (generalized erythema, pruritus, dryness and scaling), and serum levels of IL-2, IL-6, IL-8, and IFN-γ (all P<0.05 vs. the controls). No severe adverse reactions were observed in any patients during the treatment period. Conclusions The combination therapy of Liangxue Xiaoban Granules and conventional Western medicine is safe and effective. It can significantly alleviate skin lesions, reduce inflammatory irritation, and improve TCM syndrome in psoriatic patients of blood-heat and wind-dryness type.

Objective To explore the spatial impact characteristics of the major pollutant emissions in the atmosphere on the number of outpatient and emergency visits to dermatology departments in hospitals across the country, providing a reference for monitoring skin health risks and developing intervention strategies.Methods Data on dermatology outpatient and emergency visits and emissions of major air pollutants (sulfur dioxide, nitrogen oxides, and particulate matter) were collected from 31 provinces (including autonomous regions and municipalities) in China in 2022. A Geographically Weighted Regression (GWR) model was employed to analyze the spatial impact differences in pollutant emissions on the number of outpatient and emergency visits to dermatology, as well as spatial autocorrelation. Results In 2022, the total number of dermatology outpatient and emergency visits in China reached 106 million, accounting for 2.84% of the total outpatient and emergency visits in the country. The global Moran's I index analysis indicated a positive spatial correlation between dermatology outpatient and emergency visits (Moran's I=0.17, P=0.043). The GWR model revealed that sulfur dioxide emission generally had a negative effect on dermatology visits, with the strongest impact observed in the northeastern region. Nitrogen oxide emission had a generally positive impact, with the effects being most significant in the northeastern and central regions, whereas particulate matter emission had a positive impact in the eastern region but a negative impact in the western region.Conclusions There is evident spatial heterogeneity in the distribution of dermatology outpatient and emergency visits across China, and the impact of various pollutant emissions on the number of visits varies by region. Tailored intervention strategies and optimized resource allocation should be implemented based on regional pollution characteristics and healthcare infrastructure to promote the coordinated development of pollution control and skin health management.

Objective To understand the epidemiological characteristics and trends of syphilis in Macau and to provide feasible recommendations for developing syphilis prevention and control measures. Methods Syphilis case data from the Macau Health Bureau from 2016 to 2023 were collected and epidemiologically analyzed in terms of temporal distribution, population characteristics, clinical stages, and titer levels. Results From 2016 to 2023, the Macau Health Bureau reported 392 cases of syphilis, with an average of 49 cases per year and an annual incidence of approximately 7.2/100 000. The number of cases increased from 2016 to 2019 and decreased from 2020 to 2023. The male-to-female ratio was 2.56 ∶1, with an average annual incidence rate of 11.5/100 000 for males and 3.76/100 000 for females. The number of syphilis cases increased with age, with the peak incidence occurring in the 30~39 age group. Among the 197 cases from Kiang Wu Hospital,latent syphilis predominated, accounting for 48% of cases. Among cases of symptomatic syphilis, primary syphilis accounted for 9%, secondary syphilis for 23%, and tertiary syphilis for 3%. The top three titer distributions were 1 ∶2(16.7%), 1 ∶32(13.2%), and 1 ∶1(12.2%), respectively. Conclusions Over the past eight years, the incidence of syphilis in Macau has shown an upward and then downward trend, with a higher incidence among males, a predominance of young and middle-aged people, a high proportion of latent syphilis, and fluctuating temporal trends. Syphilis screening and health education should be strengthened for young and middle-aged men to improve early diagnosis ability of latent syphilis. At the same time, prevention and control strategies should be adjusted according to the temporal trends of the epidemic to control the spread of syphilis and reduce its harm to the public.

The capability for scientific innovation is an important manifestation of the comprehensive abilities of college students in the new era. Cultivating the capability for scientific innovation is a crucial goal of undergraduate education and is of great significance for the construction of "A Country Strong in Education". It has become an urgent issue to improve the capability for scientific innovation among undergraduates. Current cultivation models, such as the undergraduate tutorial system, face challenges, including insufficient time and energy from tutors and low enthusiasm among undergraduates, which hinder the achievement of expected outcomes. Based on our teaching reflections and practical experiences, we introduce the concept and development of the "tutor-graduate student-undergraduate student" hierarchical joint cultivation model. It elaborates on how this model enhances undergraduates' capability for scientific innovation through measures such as establishing academic connections, leading scientific research projects, and writing papers. Furthermore, we illustrate the roles of tutors and graduate students in this process, respectively. The aim is to provide novel approaches for cultivating the scientific innovation capabilities of undergraduates in China.

We report a case of acquired reactive perforating collagen disease with typical dermoscopic features. A 66-year-old woman presented with a 2-year history of generalized erythemas, papules, and itching, which had been aggravated for more than 2 months. Physical examination revealed a large erythema on the back, multiple keratinizing papules with central umbilical fovea in tan color. Erythemas, papules, scratches, and erosions were present on both lower extremities. A surgical scar about 10 cm long was visible on the right abdomen. (Back)Histopathology showed acanthosis, cup-like depression of the epidermis filled with parakeratotic debris, and necrotic collagen fibers penetrating the epidermis. Dermatoscopic examination revealed a central yellowish-brown amorphous area with a peripheral white halo, surrounded by pink amorphous area, along with reticular and linear blood vessels. Acquired reactive perforating collagenosis was diagnosed. After one-week treatments with oral Tripterygium wilfordii tablets, Olopatadine tablets, Levocetirizine tablets, and Pregabalin capsules, along with topical compounded Miconazole ointment and Polymyxin ointment, and phototherapy, rashes and erosions had basically healed and scabbed over, with significant improvement in itching. After three weeks, a phone follow-up indicated partial resolution of the rashes, with itching mostly under control.

We report a case of pemphigus vulgaris induced by secukinumab treatment for plaque psoriasis. A 48-year-old man visited our department due to blisters on his lower extremities for over 2 months, and on the trunk and upper extremities for 7 days. He had a 6-year history of psoriasis. After 5 weeks of treatment with secukinumab, blisters appeared on the lower limbs, and after more than 3 months, blisters appeared on the trunk and upper limbs. Dermatological examination revealed well-demarcated erythematous plaques with silvery scales on the scalp. The trunk and limbs exhibited multiple well-defined dark red patches with some silvery scales on the surface, scattered red papules, vesicles, and a positive Nikolsky's sign. The pathological examination of the scalp skin lesions showed epidermal hyperkeratosis and parakeratosis with irregular acanthosis, significant perivascular infiltration of lymphocytes and plasma cells in the dermis. The biopsy of the blister on the right forearm revealed hyperkeratosis, focal incomplete acantholysis of the epidermis, and perivascular inflammatory cell infiltration in the dermis. Direct immunofluorescence showed IgG and C3 deposition in a reticular pattern in the epidermis, while both IgA and IgM were negative. Diagnosis: psoriasis (scalp rash) and pemphigus vulgaris (rash of upper limbs). Secukinumab was discontinued, and 10 mg of methotrexate was given orally once weekly. After 6 months of treatments, the effect was inadequate, with new blisters still appearing. Therefore, it was switched to taking oral Cyclosporine soft capsules, 50 mg, twice daily. After 1 month of treatment, the patient reported no new blisters and noted improvement in the existing psoriasis lesions on the scalp, trunk, and limbs. The patient is currently still under treatment and follow-up.

Erythrodermic psoriasis is a rare and unique type of psoriasis that often occurs in individuals with a history of psoriasis. It can affect people of any age but is more common among middle-aged and elderly individuals. The incidence of erythrodermic psoriasis is relatively low worldwide. However, the specific incidence rate varies due to factors such as region and race. This review summarizes its epidemiology, pathogenesis(such as the activation of the Th17/IL-23 axis, and HLA-C*01:02 gene polymorphism), clinical diagnosis (such as biomarkers, IL-17A and CCL20), and treatment advancements (traditional drugs like methotrexate and new biological agents such as IL-17 inhibitors) related to EP. It also explores objective assessment methods for the severity of EP (such as PASI and DLQI scores) and future research directions (such as gene therapy).

Tissue-resident memory T cells (TRM) play a pivotal role in skin immunity, serving not only as key mediators of local immune defense but also as contributors to the onset, persistence, and recurrence of chronic inflammatory skin diseases. Recent studies have identified TRM as major drivers of disease relapse and chronic maintenance. This review summarizes the mechanisms underlying differentiation, residency, and survival of TRM in the skin, with an emphasis on their subset heterogeneity and tissue-specific regulation. We further highlight recent evidence of TRM pathogenicity in representative diseases such as psoriasis, vitiligo, and atopic dermatitis, paying particular attention to their unique role in disease recurrence. In addition, we discuss how current therapeutic interventions may influence TRM development and survival. A deeper understanding of the dual roles of TRM will provide new insights and potential breakthroughs for the precise management of chronic inflammatory skin diseases.

Psoriasis is a chronic, recurrent inflammatory skin disease that significantly impacts patients' quality of life. With the advancement of patient-centered care, shared decision-making (SDM) has gradually been introduced into psoriasis management. SDM enables healthcare professionals and patients to collaboratively formulate individualized treatment plans through mutual communication and respect. It has been widely applied in chronic dermatological conditions abroad and has been shown to improve patient satisfaction, adherence, and quality of life. Patient decision aids (PDAs), a core component of SDM, have been proven to enhance patient understanding, reduce decisional conflict, and promote active involvement in treatment decisions. This article reviews the theoretical foundation, practical application, and effectiveness of SDM and PDAs in the management of psoriasis, drawing on international experiences. It also discusses key challenges and strategies for localization in China, including clinician training, PDA development, digital integration, and policy support. Establishing standardized SDM procedures and localized PDA systems may foster a more efficient, precise, and patient-centered chronic disease management model for psoriasis.