| Lichen planus(LP)is a common and chronic inflammatory disease which causes common etiologies occuring in the skin,hair follicles,mucous membranes,and finger-s.Its equivalent to the zidianfeng in traditional Chinese medicine.Clinically,it can be seen typical purple red flat papules and pink,purple blue,dark red or reddish brown and other color lesions.Its histopathology has a certain specificity.The pathogenesis o-f li-chen planus is not yet fully understood,as a variety of factors are involved.As a tra-ditional and highly conserved signaling pathway,MAPK signaling pathways are invol-ved in their pathologic processes,which are required for further study.ObjectTo explore the pathology in the wind-dampness-heatness syndrome and blood stasis wi-th qi stagnation of the Lichen planus;To further study the expression of COX-2,JNK and P3 8 in wind-dampness-heatness s-yndrome and blood stasis with qi stagnation of the Lichen planus to help to make out the pathogenesis of lichen planus.Methods1.Screening the paraffin blocks which are diagnosis of lichen planus in clinical and histopathological from June 2012 to December 2016 in Dermatology department of Ai-r force General Hospital,with the integrity of clinical general,historical data and pat-hological data of its skin lesions and clinical symptoms and signs.The syndrome of i-t is determinded by 2 veteran dermatologists,which are divided into wind-dampne-ss-heatness syndrome and blood stasis with qi stagnation with a total of 93 patients.Th-e two types were 42 cases and 51 cases respectively were treated by HE staining.The differences of histopathology between epidermal edema,basal cell liquefaction a nd degeneration,lymphocyte infiltration,spine,vasodilator,erythrocyte spill,fissure fo-rmation and granule layer are observed.All data are analyzed by SPSS20.0.The data with non-grade is analyzed by the chisquare test,the ranked datas of counting data i-s by rank sum test,metering data in line with the normal distribution of the use of t test,if not by the rank and test;all tests are used bilateral test,and test level a =0.05.2.Selecting the paraffin blocks randomly from the above groups during June 2014-2016 in the hospital with a total number of 30 cases,including wind-dampness-heatn-ess syndrome and blood stasis with qi stagnation.The expression of COX-2,JNK an d P38 in the two groups are observed by immunohistochemistry(SP method)in 10 c-ases,20 cases,the same to the normal skin.Using SPSS20.0 for the statistical analys-is.If all the measurement data in line is the normal distribution,using the variance a-nalysis with the three groups,if not by using the rank sum test,;then compared bet-ween the groups;The correlation analysis of the three factors,in line with the nor mal distribution using the Pearman test,if not by using the Spearman test;all tests w-ere used for bilateral tests,the test level a = 0.05;When the two pairs between the gro-ups were compared,the test level was a = 0.05/group number,in this test a ?0.0167.ResultsTest I1.Epidermis edema:Part of the skin lesions can be seen epidermal sponge edema,th-e number in the wind-dampness-heatness syndrome is higher than that in the blood s-tasis with qi stagnation,which accounted for their respective total of 47.6%,49.0%,b-ut there was no significant difference between the two groups,P>0.05;2.Basal cell liquefaction:there is a full layer of band liquefaction,while others are partially,including the foci and flake;the former is accounted for 59.5%,while the 1-atter is 40.5%,the rates of them are 49.1%?52.9%respectively in the stagnation of blood stasis type,which is lower than the wind-dampness-heatness syndrome in the f-ull layer of band liquefaction,but there is no significant statistical differences,P>0.05;3.Lymphocyte infiltration:there are different forms of the lymphocytes,varying from banded,focal to flaky in the dermis shallow,the syndrome of the wind-dampness-h-eat and the blood stasis with qi stagnation are infiltrated with the respective accounte-d for 73.8%and 56.1%of the total,while the non-band is 26.2%and 43.9%respect-ively.There was no significant difference in the two groups(P>0.05).The amount of lymphocytes in different forms was different,And the percentage of the bands was 32.3%,38.7%and 29.0%respectively in the case of "large,medium and less,when t-he band was infiltrated.The group of the blood stasis with qi stagnation is 58.1%,25.6%,16.3%,the latter is larger than the former banded infiltration obviously,but no significant difference,P>0.05;The proportion of non-banding is 36.4%,9.1%and 54.5%in wind-dampness-heat syndrome and 16.7%,27.8%,55.6%respectively in the h-e blood stasis with qi stagnation,but no significant statistical difference between the?m,P>0.05;4.Spike layer:there are different changes in the spike layer,including the existence of thinning and thickening,in the rheumatic fever type,qi stagnation and blood stasis in the percentage of it are 76.2%,62.7%respectively in the group of wind-dampness-he at syndrome and qi stagnation and blood stasis,the former has a much more radio in spike layer than the latter,but There is no significant difference between the two g-roups;21.9%,56.3%,21.9%respectively in the wind-dampness-heat syndrome,while 18.8%,78.1%?3.1%respectively in the qi stagnation and blood stasis,the former is s-ignificantly thicker than the latter,while the latter moderate thicker than the former,But there is no significant difference between the two,p>0.05;5.Red blood cells;some red blood cells spill,the spill-over and non-spill are the tot-al number of 53.8%,46.2%;the rates of them is 59.5%and 40.0%in the wind-damp ness-heatness syndrome and blood stasis with qi stagnation type.The former has more erythrocyte spillover than the latter,but no significant difference,P>0.05;6.Chromatin cells:Most of the dermis showed visible cytochrome cells with the total number of 74.2%;the rates in the WInd-dampness-heatness syndrome and blood stasis with qi stagnation is accounted for their respective total 66.7%,80.4%,the latter tha-n the former increased the number of tigels,but with no significant difference,P>0.05;7.Fracture:part of the tissues can see the fracture between the basal layer and the d-ermis,the fracture and the not are with the total number of 33.3%,66.7%respective-ly;the two groups of cracks are with the its own number of cracks are38.1%29.4%,but there is no significant difference between the two groups(P>0.05).8.Granule layer:There is a thickening in different extent in granule layer,which is th-icker in the wind-dampness-heatness syndrome when compared with the blood stasis-with qi stagnation,between the two types is a significant statistical differences,P<0.05.Test ?1.The rates of positive expression in COX-2,JNK and P38 in wind-dampness-heatness syndrome were 50%,20%and 100%respectively(Table 2).COX-2,JNK,P38 positi-ve expression rates were 70%,20%,100%in syndrome of blood stasis with qi stagn-ation(see Table 3),while 0,0,40%respectively in the normal tissue(see Table 4);Com-pared with the normal group,COX-2,JNK and P38 are significantly higher than tho-se in the normal group(P<0.05),and there is no significant difference between the t-wo groups(P>0.05).The positive rate of P38 was higher than that of normal group(P<0.05).2.The expression of COX-2 in the wind-dampness-heatness syndrome and qi stagnatio-n and blood stasis type is little,but much more than that in the normal tissues,but th-ere is no significant difference between the two groups in lichen planus(P>0.05);3.JNK is rarely expressed in lichen planus,but no expression in the normal tissues,There is no significant difference between the two groups,but the two types compa-ring with the normal group have a statistical differences;4.P3 8 in the wind-dampness-heatness syndrome and qi stagnation is expressed in a lar-ge number comparing with the normal expression,but there is no significant differen-ce between the two groups in lichen planus(P>0.05);5.The expression of COX-2,JNK and P38 in in lichen planus are positively correlate-d.Conclusion1.When compared with the wind-dampness-heatness syndrome and blood stasis with qi stagnation,the former have much more numbers than the latter in epidermal edem-a,basal layer of liquefaction degeneration,lymphocyte band infiltration,red blood cel-Is,spine thickening,thickening of particles,cracks,etc.while there is no significant st-atistical difference in histopathology between the two types,probably because the change of histopathology is likely to the parabolic in the whole development process,which is covered by the two types generally;2.P38 was expressed in the wind-dampness-heatness syndrome and blood stasis with q-i stagnation obviously,and there was no significant difference between the two group s,but they are much more than the normal one,which makes a great important imp-a-ct on the occurrence and development of lichen planus.;3.There is little occurrence of JNK in the lichen planus,and the expression of JNK i-n wind-dampness-heatness syndrome and blood stasis with qi stagnation is not obviou-s,but they are more than the normal,which suggests that JNK may be involved in t-he development of lichen planus;4.There is a little occurrence of COX-2 in the lichen planus.And there was no signif-icant difference of COX-2 between the two groups,while they are more than the n-ormal one;However,COX-2 was involved in the development of lichen planus.5.There was a positive correlation between COX-2,P38 and JNK,and there may be a direct or indirect relationship of the three factors in the occurrence of lichen planu-s. |
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