In this paper, the advances of the treatment for the most common pulmonary mycosis is introduced, and the recommended medications described. It is indicated that amphotericin B is still the first choice for the treatment of severe and rapidly progressive pulmonary mycosis. Lipid formulations of AmB can be used for those refractory or intolerant to the conventional amphotericin B. Fluconazole has proved effective in treating pulmonary candidosis, cryptococosis and coccidioidomysis. Itraconazole has been widely used in the treatment of pulmonary aspergillosis, histoplasmosis ans coccidioidomycosis.

Objective To study the effects and the therapeutic mechanism of Humulus scandens particles ( HSP ) on the mice with chronic bronchitis ( CB ) . Methods Mice were divided into normal control group, dextromethorphan group or ammonium chloride group, the high-, middle-and low-dose of HSP groups ( These three groups received gavage administration of HSP at 3.00 g??kg-1, 1.50 g??kg-1 and 0.75 g??kg-1,respectively) randomly.The effects of HSP on ammonia-induced cough and trachea phenol red excretion in mice were observed.CB mouse model was established by inhaling smoke and formaldehyde.In total, 60 mice were divided into 6 groups by the method of random digits table: normal control group, model control group, Guilong kechuanning capsule group, the high-, middle-and low-dose HSP groups (n=10 each group).After modeling for 18 days, mice in normal control group and model control group were administered intragastrically with 0. 9% sodium chloride solution. Mice in the high-, middle-and low-dose HSP groups were daily treated with HSP at 3.00, 1.50 and 0.75 g??kg-1 ,respectively, by intragastric administration.Mice in Guilong kechuanning Capsule group were administered with Guilong kechuanning Capsule (600 mg??kg-1), once a day, for 15 days.The tumor necrosis factor alpha ( TNF-α) & interleukin-8 ( IL-8) contents in lung tissues of each group were determined. Results By hematoxylin-eosin (HE) staining, it was found that HSP alleviated the damage of CB in mice.The frequency of cough in 2 min in the normal control group, the high-, middle- and low-dose HSP groups were (17.50±5.38), (11.90±4.46), (12.60±3.47), (9.50±3.24), respectively, and the ecretion of phenol red were (0.52±0.11), (0.65±0.15), (0.64±0.14), (0.67±0.19) μg??mL-1, respectively.The content of TNF-α in lung tissues of the normal control group, model control group,the high dose HSP group was (25.8±6.9), (66.3±11.7), (43.5±7.7) ng??mg-1, respectively.The content of IL-8 in lung tissues of the normal control group, model control group, the high-dose HSP group were (27.1±9.1), (48.2±11.4) and (36.5±8.2) ng??mg-1, respectively.The contents of TNF-α and IL-8 in lung tissues of the model control group were significantly higher than those in normal control group (both P<0.01).Compared with the model control group, high-dose HSP could obviously decrease the contents of TNF-α and IL-8 in lung tissues (P<0.01 or P<0.05). Conclusion HSP can obviously alleviate the pathomorphological changes in mice with CB and has antitussive and expectorant effecs.The therapeutic mechanism of HSP for CB may be related to decreasing the contents of TNF-αand IL-8 in lung tissue.

Elderly individuals make up a considerable large part of the breast cancer population.There are many different biological and pathological characteristics for this population as compared with the younger ones.Evidences on the treatment of elder patients with breast cancer are scarce.This article reviews the studies in the treatment and provides suggestions for the care of elder women with breast cancer.

Objective To observe the effect of the reinforcing kidney,nourishing and activating blood on promoting ovulation and improving the endometrium thickness and pregnancy rate in the process of in vitro fertilization-embryo transplantation(IVF-ET).Methods The 63 cases receiving IVF-ET were randomly divided into two groups: the treatment group(n=31) treated with GnRHa/r-FSH/HMG/HCG combined with the herbs of kidney-reinforcing,blood-nourishing and blood-activating in different periods of IVF-ET,and the control group(n=32) with GnRHa/ r-FSH/HMG/HCG alone.The dose of gonadotropin(Gn),endometrium thickness,follicular oocyte number,high-quality oocyte rate,fertilization rate,high-quality embryo rate and pregnancy rate of both groups were observed.Results In the treatment group,Gn dose was significantly lower(P

Objective To develop and verify a multiplex fluorescence quantitative PCR(Taqman probe) method for the detection of telomerase activity.Methods Specific reverse transcription primers,two pairs of quantitative primers and probes were designed for the CDS sequence of telomerase catalytic subunit telomerase reverse transcriptase(TERT).After optimization of the reverse transcription primers(specific reverse transcription primers and random primers) and quantitative primers(two pairs of quantitative primer probes used alone or in combination) in the reaction system,with the primer probe of internal reference gene GAPDH,multiplex fluorescence quantitative PCR was performed in a single tube.In addition,telomerase positive standard and negative standard were prepared with 293T and MRC-5 cells respectively,and the stability and precision of the method were verified.The telomerase activity in 19 normal mesenchymal cell samples and 32 breast cancer cell samples were detected by the developed method.Results The optimum reaction system was as follows:using cDNA synthesized with specific reverse transcription primers as the template,2 pairs of quantitative primer probes of TERT gene were mixed with internal reference gene GAPDH primer probes for multiplex fluorescence quantitative PCR reaction in a single tube.After optimization,the sensitivity and TERT fluorescence signal quantity of the system were greatly improved,and the ΔRn was enhanced by 3 times.The amplification curve of positive standard TERT gene was normal,and the ΔCt between TERT gene and GAPDH gene remained stable.The amplification curve of GAPDH gene in negative standard was normal,while there was no amplification curve of TERT gene.There was a little difference in ΔCt between TERT and GAPDH genes in the positive standard frozen and thawed for 3 and 5 times repeatedly and the positive standard without freezing and thawing,and the CVs of precision in intra-and inter-groups were all less than 1%.Telomerase activity was negative in 19 normal mesenchymal cell samples and positive in 32 breast cancer cell samples,and significant difference in Ct value of TERT gene between them was observed(t=4.236,P <0.001).Conclusion The developed multiplex fluorescence quantitative PCR(Taqman probe) method for the detection of telomerase activity has good stability and precision,which is expected to be used in early diagnosis and gene therapy of tumors.

OBJECTIVETo explore the molecular biological mechanism of ZHU's Tiaojing Cuyun Recipe (TCR) for treating anovulatory infertility patients with Shen deficiency syndrome (SDS) by observing its clinical efficacy.

METHODSUsing randomized blocking methods, 80 patients were assigned to the treatment group (40 cases) and the control group (40 cases). Patients with regular menstrual cycle started medication from the 5th day of menstruation. Those with irregular menstrual cycle first took progesterone till withdrawal bleeding ,and then started medication from the 5th day of vaginal bleeding. Patients in the treatment group took ZHU's TCR, one dose per day, while those in the control group took Clomifene Citrate (CC), 50 mg per day. Three menstrual cycles consisted of one therapeutic course, a total of 2 courses. Clinical efficacy such as pregnancy rates and abortion rates were observed. Ovulation indices (the maximal diameter of mature follicles, luteinized follicles, ovulational follicles, and the endometrial thickness on the ovulation day), SDS, and integrals of menstrual symptoms were monitored before and after treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) , and estradiol (E2) were determined using chemiluminescent immunoassay before treatment and after on therapeutic course. Serum levels of activin A (ACTA), inhibin B (INHB), and follistatin (FS) were detected using double antibody sandwich ELISA.

RESULTSCompared with the control group, the pregnancy rate was obviously elevated and the abortion rate was obviously lowered in the treatment group (P <0. 05). Ovulation rates of mature follicles and luteinizing follicles decreased more in the treatment group (P < 0.05). Compared with before treatment, integrals for SDS were lower, the maximal diameter of pre-ovulational follicles was increased, and integrals for menstrual symptoms in non-pregnant patients of the two groups were obviously lowered. Meanwhile, the endometrial thickness on the ovulation day was increased in the treatment group after treatment, but reduced in the control group (P < 0.05, P < 0.01). Compared with the control group, integrals for SDS were decreased, and the maximal diameter of pre-ovulational follicles was lowered in the treatment group after treatment (P < 0.05, P < 0.01). Integrals for SDS and the difference in the endometrial thickness on the ovulation day were increased, but the difference in the maximal diameter of pre-ovulational follicles were reduced (P < 0.05, P < 0.01). In the treatment group serum levels of E2 and ACTA increased more after one therapeutic course than before treatment (P < 0.01), but serum levels of INHB and FS decreased more after one therapeutic course than before treatment (P < 0.05). In the control group serum levels of FSH and ACTA increased more, and the serum level of FS decreased more after one therapeutic course than before treatment (P < 0.05, P < 0.01). Compared with the control group, serum levels of FSH and ACTA increased more, and serum levels of INHB decreased more in the treatment group after one therapeutic course than before treatment (P < 0.05, P < 0.01).

CONCLUSIONSZHU'sTCR could improve SDS of anovulatory infertility patients, regulate the follicular development, and elevate the pregnancy rate. Its actions might be associated with regulating their sex hormones, expressions of ovary local factors such as INHB, ACTA, and FS.

Activins ; Clomiphene ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; Female ; Follicle Stimulating Hormone ; Follistatin ; Humans ; Infertility, Female ; complications ; therapy ; Inhibins ; Luteinizing Hormone ; Medicine, Chinese Traditional ; Ovarian Diseases ; Ovarian Follicle ; Ovulation ; Progesterone

Objective To study the clinical factors affecting the prognosis of adrenocortical car-cinoma (ACC) in order to guide the diagnosis and treatment of ACC. Methods The clinical data of 40 cases of ACC were retrospectively analyzed. The patients were diagnosed as ACC by histopatholo-gical examination after operation or biopsy, including 19 cases of nonfunctional ACC and 21 cases of functional ACC. The functional ACC included 14 cases of Cushing's syndrome, 4 cases of sexual ab-normality (3 cases of androphany and one case of male sexual precosity) and 3 cases of primary aldo-steronism. The clinical stage included 3 cases in stage Ⅰ , 10 cases in stage Ⅱ , 7 cases in stage Ⅲ, and 21 cases in stage Ⅳ. Eighteen cases underwent complete excision, 10 cases underwent palliative excision, 12 cases underwent expectant treatment (2 cases underwent arterial embolism). All patients were followed up for 2 to 121 months. The total life span and survival rate were calculated, and the dependability between life span and certain indices (tumor size, function, clinical stage and surgical treatment, etc) was compared. The results were statistically analyzed by utilizing the SPSS 11.5 soft-ware. Rank-sum test was used for the two independent samples, one-factor analysis of variance was used for multiple samples and Pearson correlation analysis was used for the correlation of two vari-ances. Results There were no statistical correlations between gender, age, sides and survival time (P>0.05). The survival time of nonfunctional ACC patients was 37.0 months, of which 11 dead ca-ses survived 11.0 months and 8 survival cases survived 73.5 months. The survival time of functional ACC patients was 11.5 months, of which 19 dead cases survived 12.2 months and 2 survival cases survived 4.8 months. The survival time of nonfunctional ACC was significantly longer than that of functional ACC (P<0. 05). The actual survival time was 66 months and 120 months in stage Ⅰ , of which both survived. The actual survival time was (44.9±40. 2) months in stage Ⅱ, of which 4 sur-vival cases survived 59.0 months. The actual survival time was(34. 5±29.8) months in stage Ⅲ, ofwhich 2 survival cases survived 42.0 months. The actual survival time was (7.1±6.7) months instage Ⅳ, of which 2 survival cases survived 8. 0 months. There was significant difference of the sur-vival time among different clinical stages(F=11. 078, P<0. 05). There was no significant difference of survival time between treatment methods[(10.04±0.0) vs (4.5±1.5) months, P>0. 05]. Con-clusions The most important influencing prognostic factors of ACC are function and clinical stage. For ACC in stage Ⅰ and Ⅱ , tumor resection is the most effective treatment, and second surgical oper-ation is recommended for local recurrence. For ACC in stage Ⅲ, radical or extensive surgical operation is recommended, and for ACC in stage Ⅳ, surgical operation has no effect on the prognosis.

Objective To report a case of multiple endocrine neoplasia type 2B (MEN 2B) combined with analogous Marfan's syndrome with the related literature review,in order to improve the knowledge of this disease.Methods A case of MEN 2B combined with analogous Marfan's syndrome was admitted in Peking Union Medical College Hospital in Nov 2011.The patient was a 21-year-old male with the chief complaint of tongue thick for 13 years,found a tumor in right adrenal gland for 3 months.The patient underwent radical thyroidectomy and lymph node dissection in April 2011 because of thyroid tumor,and postoperative pathology confirmed the diagnosis of medullary thyroid carcinoma(T2N1bM0).The patient had normal blood pressure without fluctuation.Physical examination indicated that the patient had thin limbs,long fingers and long toes.Carpal syndrome and finger syndrome were positive.There were multiple tumor like nodules in the tip of the tongue,lips,inner canthus of eyelids,and laryngoscopy showed multiple nodulars in bilateral vocal cord and bilateral tip splitting.Enhanced CT showed a tumor of 2.9 cm×3.4 cm×3.8 cm in the right adrenal gland.Endocrine examination revealed high catecholamines:norepinephrine 159.3 nmol,epinephrine 13.3 nmol,and DA 918.2 nmol.131I-MIBG was positive for pheochromocytoma.The clinical manifestation was in stationary state.Preoperative diagnosis was MEN 2B,right adrenal pheochromocytoma,medullary thyroid carcinoma (T2N1bM0)after operation,multilple mucosa neurofibroma and analogous Marfan's syndrome.Results The pheochromocytoma in right adrenal gland was removed by laparoscopy under general anesthesia successfully on Dec 12,2011.The postoperative pathology confirmed the diagnosis of pheochromocytoma.And gene mutation was found in exon 16 of RET gene.MEN 2B with analogous Marfan's syndrome was diagnosed.During the follow-up period for 28 months,the patient had normal blood pressure and heart rate without tumor recurrence or metastasis.Conclusions MEN 2B combined with analogous Marfan's syndrome is extremely rare.For patients with medullary thyroid carcinoma,pheochromocytoma should be considered before operation.For patients with analogous Marfan's appearance,Marfan's syndrome should be differentially diagnosed.

BACKGROUND:Currently, buccal tubes are mostly preferred rather than molar bands to control posterior tooth movement. However, the buccal tube is difficult to bind the molar because of its position. Meanwhile, due to the relatively large masticatory forces on the posterior tooth, the buccal tube is easier to drop off. OBJECTIVE: To investigate the clinical effects of two kinds of adhesives bonding the buccal tube. METHODS:Sixty orthodontic patients were selected randomly. The right side of the upper and lower first molars of each patient was bonded by 3M TransbondTM light-cured resin binder, and the left side of the upper and lower first molar of each patient was bonded by 3M chemical curing adhesive. Cases of buccal tube shedding were recorded within 4 months. Meanwhile, 3M TransbondTM RESULTS AND CONCLUSION: The dropout rate of 3M Transbond light-cured resin binder and 3M chemical curing adhesive were used to bond the isolated human first molar, respectively. The normal oral environment and temperature were stimulated, and the shear bonding strength was measured after measured after 10 000 thermal cycles. TM light-cured resin binder and 3M chemical curing adhesive groups was 10.80% and 24.10% respectively, and there was a significant difference (P < 0.05). In vitro experiments confirmed that two kinds of adhesives could meet the clinical requirements, but 3M TransbondTM light-cured resin binder was better than 3M chemical curing adhesive. These findings indicate that compared with 3M chemical curing adhesive, 3M TransbondTM light-cured resin binder is more suitable for the binding between the molar and buccal tubes.

Objective To identify candidate regions of sporadic pheochromacytoma (PCC).Methods Totally 42 patients who were clinically diagnosed as sporadic PCC from 2011-9 to 2013-5 in PUMCH were enrolled .To extract whole genome DNA from their tumors as well as peripheral blood leukocytes and to exclude inherited cases by San-ger sequence mutation .Within 14 verified cases of sporadic PCC , we applyed single nucleotide polymorphism ( SNP) chip to detect whole genome DNA copy number variations ( CNV) and loss of heterozygosity ( LOH) to ini-tiallylocatethehotregions.FinallyapplyQ-PCRtoconfirmthehotregionsinleftcases.Results 38caseswere identified as sporadic PCC , and 4 as inherited cases .CNV were found in 14/14 tumors, of which deletions were more common.Missing regions occurred in 1p,3q,17p,22q,11p.On the other hand, of the 3 inherited cases, de-letion was also detected.The loss of parts of arm 1p is the most common, including chr1:74 957 006 ~86 132 879 , chr1:58 096 424~67 700 471 , and chr1:98 902 091~107 622 430 .The result of Q-PCR confirmed the above-mentioned three regions , and the three segments are final candidate regions .Conclusions Partially de-letion of 1p in most cases is the most striking phenomenon , we believe that the deletion of 1p may occur with PCC development , and there may be some tumor suppressor gene ( s) within these areas .