Objective To report two cases of Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and to assess their clinical features,diagnosis and treatment.Methods A medical history including medication history and therapeutic response was carefully collected from two male patients.Physical examination was carried out with a focus on skin lesions.Diagnosis was made according to medical history as well as physical,mycological and histopathological examination findings.Antifungal agents were given at a high enough dose in time.After lesions improved,the doses of antifungal agents were tapered gradually,and drugs were withdrawn until patients completely healed.Compound preparations containing both antifungal agents and glucocorticoids were also topically applied in the early period of treatment.Results Both patients were diagnosed as Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and cured after 100-day supporting treatment and antifungal treatment with oral itraconazole,etc.Conclusions Candida parapsilosis-caused candidiasis should be managed with combination therapy mainly including antifungal agents.To achieve a satisfying efficacy,antifungal agents should be given early at a high enough dose for a long enough period.

Objective To find out the present situation and influence factor in core capabilities of nurses that with blood purification skills in 18 hospitals, and offer reference frame for training. Methods The questionnaires were used to investigate, theresults underwent analysis. Results Among three parts of core capabilities, total score of N1-2 made the highest,the mean score was 236.75,N3 score made the lowest,the mean score was 168.00. The percent of pass in every hierarchy didn't passed 50%. Using the multiple regression to analyze the factor,N1-1 was the work experience in department of nephrology;N3 was the training time of blood purification. Conclusions Percent of pass in core capabilities of nurses of blood purification is in a low level,every hospital should follow the principle of recruitment,and regulate the training of nurses in blood purification.

Objective To find out the present situation and influence factor in core capabilities of nurses of blood purification, and offer reference frame for evaluation, selection, authentication and engagement of nursing post. Methods Core capability training module for nurses of blood purification was selected as theoretical basis for rough draft of evaluation index system establishment. The selected index underwent expert consultation with Delphi method. Results Four hierarchy were confirmed after 3 rounds of consultation (N1-1,N 1-2, N2, N3). Each hierarchy had three evaluation indexes, knowledge, technology and clinical practice. Number of grade one evaluation indexes of each hierarchy was 5,5,4; 5,5, 4;5,5,5; 5,5,1. Number of grade two evaluation indexes was 20,20,24;20,20,20;25,25,48;23,24,14.Only N1- 1,N1-2 and N2 had grade three evaluation indexes, 16, 5, 13 respectively. Conclusions Preliminary establishment of core capability evaluation index system can basically evaluate capability of nurses of blood purification.

Objective To analyze the status quo of the diagnosis and treatments of primary gastro-intestinal lymphoma (PGIL) in order to improve it. Methods Eighty-one patients with PGIL were ana-lyzed retrospectively including clinical manifestations, endoscopic features, pathological features, HP in-fection, treatment, and prognosis. Results The age of patients with gastric lymphoma was (52.84±15.33) years. The age of patients with intestinal lymphoma was (42.09±15.28) years. Common symp-toms included abdominal pain (76.5%), gastrointestinal bleeding (55.6%), anemia (54.3%), abdominal mass (25.9%), hypoproteinemia (40.7%), bowel obstruction (11.1%), abdominal dis-tension, vomiting, and other non-specific gastrointestinal symptoms (32.1%), weight loss (33.3%); fever (8.6%), diarrhea (7.4%), digestive tract perforation (1.2%), constipation (1.2%), and dysphagia (1.2%). Endoscopic appearances were as follows: tumor type (67.7%), ulcer type (27.7%), and diffuse type (4.6%). Clinical diagnosis rate and endoscopic biopsy confirmation rate were 30.9% and 73.8%. MALT lymphoma accounted for 61.7% of the patients. HP detection rate was 39.5 % and positive rate was 37.5 %. A total of 69 patients received surgeries: 3 had preoperative chem-otherapy, and 34 had postoperative chemotherapy. Twelve patients had non-surgical treatment, 6 patients of whom had simple chemotherapy and HP eradication therapy, and the other 6 gave up during the treat-ment. There was no significant difference in the survival rate of Stage Ⅰ～Ⅱ patients in the surgery alone group, surgery plus chemotherapy group, and chemotherapy and HP eradication therapy group (P>0.05). The survival rate of Stage IIIⅢ～Ⅳ patients in the surgery alone group was lower than that in the other 2 groups (P<0.05). The 5-year, 3-year, and 1-year survival rate was 55.87%, 70.96%, and 96.39%, respectively. Conclusion There are no specific clinical and endoscopic features in PGIL, so the misdiagnosis rate is high. Multi-site biopsy or repeated biopsies and immunohistochemical methods can be used to raise the pathological diagnosis rate. Chemotherapy and HP eradication are recommended.

OBJECTIVE: To investigate the effect of Losartan and Amlodipine on serum and urine transforming growth factor -β_1 in patients undergoing kidney transplantation. METHODS: A total of 40 patients with mild or moderate hypertension (systolic pressure 140-170 mm Hg, and diastolic pressure 85-100 mm Hg, 1 mm Hg=0.133 kPa) following primary kidney transplantation were selected from First People's Hospital of Foshan, including 23 males and 17 females aged (38.6±19.2) years. They were randomly divided into two groups (n=20): Losartan group (oral administration 50 mg per day) and Amlodipine group (oral administration 5 mg per day). The blood pressure of patients should be controlled below 130/80 mm Hg. The blood pressure, renal function, 24 h-proteinuria, serum and urine transforming growth factor-β_1 6 months after medication were observed. RESULTS: A total of 40 patients were included in the final analysis. The systolic pressure and diastolic pressure of patients were decreased after administration (P < 0.05) and decreased to normal levels 6 months after administration (P < 0.01). During treatment, there were significant differences in blood pressure decrease and mean arterial pressure between two groups (P > 0.05). No difference was found in total efficacy between two groups (P > 0.05). In addition, blood urea nitrogen, creatinine, and blood uric acid did not significantly alter after treatment in two groups (P > 0.05). After 6 months of treatment, 24 h-proteinuria, serum and urine transforming growth factor -β_1 in Losartan group were significantly decreased compared with before treatment (P < 0.05), while no obvious changes were found in Amlodipine group (P > 0.05). The 24 h-proteinuria, serum and urine transforming growth factor-β_1 in Iosartan group were significantly less than Amlodipine group (P < 0.05).CONCLUSION: Both Losartan and Amlodipine effectively controlled hypertension of patients following kidney transplantation, but Losartan significantly decreased 24 h-proteinuria, serum and urine transforming growth factor-β_1 compared with Amlodipine.

Objective To investigate the expression levels of CD40L in CD4 + T cells from systemic sclerosis (SSc) patients.Methods PBMC ( peripheral blood mononuclear cells) cells were isolated from the peripheral venous blood of SSc patients (16females,10males) and healthy donors (15females,10males) by density gradient centrifugation.CD4 + T cells were isolated using magnetic beads.mRNA levels of CD40L in CD4 + T cells were measured by real-time quantitative polymerase chain reaction (RTPCR).Flow cytometric analysis was used to detect the CD40L protein on the surface of CD4 + T cells.Results Both CD40L mRNA and protein expression in CD4 +T cells was significantly elevated in female SSc patients compared with female healthy controls [5.61 ± 1.86 vs 2.80 ±0.94,P ＜0.01 ; (6.70 ±3.55)％vs (2.37 ± 1.39)％,P ＜ 0.05,respectively].No significant increase in CD40L mRNA and protein expression was observed in male SSc patients compared with male controls [2.59 ± 0.89 vs 1.92 ± 0.56,P ＞0.05; (2.06±1.09)％ vs (2.13±0.87)％,P ＞0.05,respectively].Conclusions CD40L was overexpressed in CD4 + T cell of female patients but not males,which maybe one of the important reasons for female susceptibility to SSc.

[Objective] To study the methylation status of CD40L gene regulatory regions in peripheral blood CD4+ T cells from patients with systemic sclerosis (SSc).[Methods] Peripheral blood mononuclear cells were isolated from the venous blood of 21 SSc patients and 20 healthy controls by density gradient centrifugation.CD4+ T cells were separated by using magnetic beads.Genomic DNA was isolated from the CD4+ T cells and treated with sodium bisulfite.Nested PCR was perfonned to amplify the desired regulatory sequences (including the promotor and enhancer) of CD40L,and the amplicons were transformed into the Escberichia coli DH5α.Subsequently,8 independent clones were selected and sequenced for each of the amplified fragments.[Results] In healthy female controls,half of the cloned fragments of CD40L regulatory sequences were unmethylated,and the other half were methylated.The mean methylation levels of CD40L promoter and enhancer from female SSc patients were significantly lower than those from healthy female controls (both P ＜ 0.01 ).Almost all of the cloned fragments of CD40L promoter and enhancer were unmethylated in healthy male controls and male SSc patients,with no significant difference in the methylation level between male SSc patients and healthy controls (both P ＞ 0.05,respectively).[Conclusion]s There is a low methylation level of CD40L regulatory elements on the inactive X chromosome in female SSc patients,which may contribute to the CD40L overexpression in CD4+ T cells.