Ferroptosis plays a critical role in different types of cancers, but the prognostic impact of ferroptosis in cutaneous melanoma remains lacking. Therefore, ferroptosis-related genes (FRGs) were firstly obtained from the FerrDb database and the differentially expressed FRGs were identified by the “limma” algorithm. Next, the prognostic differentially expressed FRGs were screened out by univariate Cox regression, which were subsequently used to cluster melanomas into two subtypes (clusters A and B). Besides, the Boruta algorithm and principal component analysis (PCA) were performed to build a 15-FRGs indicator, which can robustly predict patients’ overall survival (OS) and be considered as an independent prognostic factor in melanoma. The melanoma patients were further divided into high- and low-FRGs score groups. The high score group have a good prognosis, with higher T cell immune infiltrating and lower mutation frequencies in NRAS, KRAS, and NF1. Finally, we discovered that many immune processes and several chemotherapy drugs were closely associated with FRGs score. Thus, our study provides a novel ferroptosis-associated classifier and indicator to predict the prognosis of melanoma. Besides, we identified several potential chemotherapy drugs to induce ferroptosis and could supply additional effective treatments.

Purpose We investigated the influence of amoxicillin pre-exposure on treatment outcomes, Chlamydia trachomatis (CT) culture, the presence of drug-resistant genes, minimum inhibitory concentrations (MICs), and fractional inhibitory concentrations (FICs) in CT clinical strains. Additionally, we explored the effect of different antimicrobial combinations on CT. Patients and Methods Clinical data of 62 patients with CT infection were recorded. Of these, 33 had pre-exposure to amoxicillin and 29 did not. Among patients with pre-exposure, 17 received azithromycin and 16 received minocycline. Among the patients without pre-exposure, 15 received azithromycin and 14 received minocycline. All patients underwent microbiological cure follow-ups one month after completing the treatment. 23S rRNA gene mutations, acquisition of tet (M) and tet (C) were detected using reverse transcription PCR (RT-PCR) and PCR, respectively. The MICs and FICs of azithromycin, minocycline, and moxifloxacin, alone or in combination, were determined using the microdilution and checkerboard methods, respectively. Results More cases of treatment failure occurred in pre-exposed patients, in both treatment groups ( P <0.05). No 23S rRNA gene mutations or tet (M) and tet (C) acquisitions were found. More inclusion bodies were cultured from patients without amoxicillin pre-exposure than from those with pre-exposure ( P <0.0001). The MICs of all antibiotics were higher in pre-exposed patients than in those without pre-exposure ( P <0.01). The FICs of azithromycin plus moxifloxacin were lower than those of the other antibiotic combinations ( P <0.0001). The synergy rate of azithromycin plus moxifloxacin was significantly higher than those of azithromycin plus minocycline and minocycline plus moxifloxacin ( P <0.001). The FICs of all antibiotic combinations were comparable between isolates from the two patient groups (all P >0.05). Conclusion Pre-exposure to amoxicillin in CT patients may inhibit CT growth and decrease sensitivity of CT strains to antibiotics. Azithromycin plus moxifloxacin may be a promising treatment regimen for genital CT infections with treatment failure.

Condylomata lata are flat-topped, moist papules or plaques usually found in the anogenital area as cutaneous manifestations of secondary syphilis. Here, we present a unique case of a solitary interdigital condyloma latum of secondary syphilis in a 16-year-old female sex worker without other cutaneous findings. Sexual contact history, histopathology, including direct detection of Treponema pallidum , and serological tests were essential for the diagnosis of this case. The patient reached serological cure with two doses of intramuscularly delivered penicillin G benzathine. Owing to the dramatic rise in the incidence of primary and secondary syphilis, medical workers should be aware of the atypical skin manifestations of secondary syphilis in adolescents who are at risk of acquiring sexually transmitted diseases to avoid the progression to late syphilis and further transmission to sexual partners.

Background: Omalizumab is a humanized anti-immunoglobulin (Ig)E monoclonal antibody that is effective for some patients with chronic spontaneous urticaria (CSU) who do not respond to antihistamines. However, the mechanism by which omalizumab improves urticaria remains obscure. Gut microbiome plays a role in the pathogenesis of allergies. Here, we aimed to investigate differences in gut microbiome of adolescent CSU patients before and after omalizumab treatment, which has not been reported until date. Methods: Ten adolescent patients with CSU were given 300 mg omalizumab subcutaneously in three treatment sessions at 4-week intervals. The personal and clinical factors of patients before and after treatment were collected. Urticaria Activity Score (UAS7) was applied to evaluate the efficacy of omalizumab treatment every 4 weeks during the follow-up period. Fecal samples were collected before treatment and at 12 weeks after the first treatment. Total DNA of the gut microbiota in all fecal samples were extracted. The 16S rRNA gene-targeted sequencing technology was used for the analysis of the diversity and distribution of gut microbiome, followed by bioinformatics analysis. Results: UAS7 scores decreased significantly after each omalizumab treatment sessions compared with the baseline (all P < 0.0001). The dominant bacteria in fecal samples before and after treatment were Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria at the phylum level. Alpha diversity analysis showed no significant difference before and after omalizumab treatment (P > 0.05) whereas beta diversity analysis revealed significant difference in the bacterial abundance before and after omalizumab treatment (P < 0.01) in adolescent patients with CSU. The relative abundance of Alphaproteobacteria and Betaproteobacteria at the class level and Burkholderia, Rhodococcus, and Sphingomonas at the genus level decreased significantly after omalizumab treatment (linear discriminant analysis > 4, P < 0.05). The functional prediction results showed that the differences noted before and after treatment were mainly in the dioxin and xylene degradation pathways, which were more abundant in adolescent patients with CSU before omalizumab treatment.Conclusions: Omalizumab is effective in treating CSU and can reduce the abundance of Alphaproteobacteria and Betaproteobacteria, which may help improve the treatment outcomes of CSU in adolescent patients.

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