This article discusses the ethical problems about Senile patients of dermatosis and venereal disease in the diagnosis and treatment.The problems mainly include:(1)moral responsibility is not strong and skills are not taken into account when inquiring history;(2)it is not careful enough and personality of patients may be hurt when making medical examination;(3)attitude is not solemn and operation not normative;(4)treatment is not normative and charcteristics of senile patients are not considered.We bring forward some suggestions including of:(1)moral responsibility must be strong enough and skills should be taken into account when inquiring history;(2)it must be careful engough and personality of patients may be respected when making medical examination;(3)attitude must be solemn and operation must be normative;(4)characteristics of senile patients must be considered and treatment should be reasonable;(5)life of senile patients should be respected and cherished,the quality of life should be attached importance to:

This article discusses the ethical problems about Senile patients of dermatosis and venereal disease in the diagnosis and treatment.The problems mainly include:(1)moral responsibility is not strong and skills are not taken into account when inquiring history;(2)it is not careful enough and personality of patients may be hurt when making medical examination;(3)attitude is not solemn and operation not normative;(4)treatment is not normative and charcteristics of senile patients are not considered.We bring forward some suggestions including of:(1)moral responsibility must be strong enough and skills should be taken into account when inquiring history;(2)it must be careful engough and personality of patients may be respected when making medical examination;(3)attitude must be solemn and operation must be normative;(4)characteristics of senile patients must be considered and treatment should be reasonable;(5)life of senile patients should be respected and cherished,the quality of life should be attached importance to:

This article discusses the influential considerations between doctors and patients relationship in the sexually transmitted diseases(STDs)diagnosis and treatment.The mainly include:(1)the medical attitude of doctors and patients;(2)the moral culture of doctors and patients;(3)the commercial consciousness in medical business;(4)the management of hospital.We bring forward some measures including of:(1)the medical attitude of doctors should be changed,the personality of patients shoud be respected;(2)the education of medical moral should be tstrengthened,the moral culture and skills should be improved during doctors and nurses;(3)the medical reforming should be deepened further.

To discuss the ethical factors influencing the standard diagnosis and treatment of sexual transmitted diseases(STDs) on special population including senile patients,pregnant and lying-in women and children.The senile patients with STDs had a decline of physiological function and might have foundational diseases,some of these patients had the psychological characteristics such as unclear talk,uncertain memory,stronger self-esteem,and had a decline of life quality.Therefore hte main ethical measures during the senile patients with STDs should include considering the pathophysiological and psychological characteristics,adopting individual diagnosis and treatment,making the skill of inquiring and physical examination,and attaching importance to the improvement of life quality.The main ethical measures during the pregnant and lying-in women with STDs should include attaching importance to the marriage examination and pregnant examination,finding potential STDs as soon as possible,and weighing potential medical risk.The main ethical measures during the children with STDs should include paying attention to the infection of family members or sex-aggression,making the protective medicine,doing well the propaganda and education,and making the children away from STDs.

We evaluated the differential expression and function of chitinase 3‐like‐1 in macrophage stimulated by Sporothrix schenckii and Candida albicans fungicidal ability of macrophage after stimulation with Sporothrix schenckii and Candida albi‐cans separately was detected .The expression of CHI3L1 gene in macrophage stimulated by Sporothrix Schenckii and Candida albicans was evaluated with real‐time PCR .The function of CHI3L1 protein in macrophages against the reproduction of Sporo‐thrix schenckii and Candida albicans was detected in vitro .Results showed that macrophages could engulf and kill Sporothrix Schenckii and Candida albicans in vitro .The expression of CHI3L1 gene in macrophage stimulated by Candida albicans was increased obviously .At the same time ,CHI3L1 protein can damper the reproduction of Candida albicans .However ,the ex‐pression of CHI3L1 gene was not elevated when macrophage was stimulated by Sporothrix schenckii and CHI3L1 protein played little role in reproduction of Sporothrix schenckii .The expression of CHI3L1 gene in macrophage was elevated after stimulation with Candida albicans ,but was not elevated with Sporothrix Schenckii .In correspondence with differential ex‐pression ,CHI3L1 in macrophages could impair the reproduction of Candida albicans but had a weak function on Sporothrix schenckii which might contribute to the pathogenesis of spo‐rotricosis .

Objective To explore the expressions of Toll-like receptors (TLRs) 2 and 4 in mouse skin during early immune responses against Sporothrix.Methods A total of 60 BALB/c mice were randomly and equally divided into an experimental group and a control group to be intracutaneously injected with Sporothrix conidium suspensions at a concentration of 1 × 106 cfu/ml and sodium chloride physiological solution respectively.Five mice were sacrificed before the injection,and at 6,12,24,48,and 96 hours after the injection in each group,blood samples were obtained from the mice before sacrifice,and skin tissue specimens were resected from the area around the injection sites after sacrifice.Realtime fluorescence-based quantitative PCR was performed to quantify the mRNA expressions of TLR2 and TLR4,and immunohistochemical staining to observe the protein expressions of TLR2 and TLR4 in mouse skin specimens.Enzymelinked immunosorbent assay (ELISA) was conducted to determine the levels of interleukin 12 (IL-12) and tumor necrosis factor α (TNFα) in serum samples from the mice.Results After injection of Sporothrix conidium suspensions,the mRNA expression level of TLR2 gradually increased and peaked at 24 hours,which was 18.8 times that in the control group at 6 hours and 34 times at 24 hours.In addition,the mRNA expression level of TLR4 in the experiment group reached a peak,and was 56.7 times that in the control group at 6 hours after injection,then gradually decreased and reached the nadir at 96 hours.As immunohistochemical staining revealed,TLR2 and TLR4 were apparently expressed in both keratinocytes and macrophages in skin specimens from the experimental group,but not obviously in those from the control group.No significant differences were observed between the experimental group and control group in serum levels of IL-12 or TNF-α at any of the sampling time points.Conclusion TLR2 and TLR4 may play a favoring role in immunological defense by participating in the recognition of Sporothrix by keratinocytes and macrophages in mouse skin.

Objective To investigate the incidence, clinical patterns, and species distribution of pathogenic fungi of onychomyeosis in patients with chronic viral hepatitis (CVH), and to analyze the relationship between onychomycosis and CVH. Methods From November 2005 to October 2006, direct microscopy and fungal culture were performed on nail samples from CVH patients with clinically suspected onychomycosis in the two largest institutions for communicable disease control in Guangzhou city. The incidence, clinical patterns, and species distribution of pathogenic fungi of onychomycosis were assessed based on the findings in mycologic examinations. Results The study randomly recruited 995 patients with CVH, and onychomycosis was diagnosed in 116 patients. The incidence of onychomycosis was 11.66% in total, 6.20%, 8.59%, 14.09%, 19.67% in patients with mild, moderate, severe and extremely severe CVH respectively, 7.09%, 17.29%, 19.13% and 27.27% in patients with a clinical course of CVH of 0.5-9 years, 10-19 years, 20-29 years, ≥30 years respectively. The most common clinical pattern was distal and lateral subungual onychomycosis (DLSO, 69.83%), followed by total dystrophic onychomycosis (TDO, 14.66%). Among the pathogenic fungi, dermatophytes amounted to 71.43%, yeasts 21.43%, moulds 7.14%, and Trichophyton rubrum was the most frequently isolated fungus (42.86%). Conclusions The incidence of onychomycosis in patients with CVH is correlated with the severity and course of CVH. Among these patients, the most common clinical pattern is DLSO with the most frequent fungal species being dermatophytes and predominant fungal isolate being Trichophyton rubrum.

Candida albicans （CA） is the predominant cause of vulvovaginal Candidiasis （VVC）. Increasing circulatory estrogen levels such as pregnancy， the use of oral contraceptives， and hormone replacement therapy predispose women to VVC. Estrogen affects the progression of VVC by regulating the growth of CA hyphae， the immune response of the innate immune cells and epithelial cells of host vaginal， but the mechanism is unclear till now. Candidalysin （CL） is a fungal peptide toxin critical for mucosal infection and plays an important role in the CA infection. CL was encoded by ECE1， which was regulated by estrogen. This article reviews the correlation between estrogen， CL， and VVC for further clarifying the role of estrogen and CL in the pathogenesis of VVC.

ObjectiveTo compare the efficacy and tolerability of 1-week 1％ terbinafine hydrochloride cream, 1- and 4-week 2％ miconazole nitrate cream in the treatment of interdigital tinea pedis, and to observe the relapse in patients treated with these regimens. MethodsA multi-center, randomized, double-blind and parallel group study was conducted. By using a stratified randomization protocol, patients were divided into 3 groups to apply terbinafine cream twice daily for 1 week and inert cream(placebo) for the next 3 weeks (1week terbinafine group), miconazole cream twice daily for 1 week and inert cream(placebo) for the next 3 weeks (1-week miconazole group), and miconazole cream twice daily for 4 weeks (4-week miconazole group),respectively. Clinical and mycological assessment was made on week 1, 3, 4, 6, 9 and 12 after the initiation of treatment. ResultsA total of 152 patients with positive baseline mycological culture were eligible for the efficacy analysis. After 4-week treatment, the mycological cure rates were 94.7％, 87.8％ and 82.6％, global effective rates 89.5％, 81.6％ and 63.0％, respectively for the 1-week terbinafine group, 4-week miconazole group and 1-week miconazole group. On week 12, the mycological relapse rates in 1-week terbinafine, 4-week miconazole and 1-week miconazole group were 13％, 14％ and 21％ respectively, and the incidence of adverse reaction was 2.38％, 2.38％ and 3.57％, respectively. ConclusionsAs far as the efficacy and recurrence in patients are concerned, the 1-week terbinafine cream regimen is similar to the 4-week miconazole cream regimen for the treatment of interdigital tinea pedis.