Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was conducted with 42 cases of fungemia in our hospital from Jan 2002 to Jan 2011.Results Forty cases candida fungemia accounted for 95.2％ in 42 fugemia.The main pathogen agent was non-Candida albicans in candida fungemia,which were candida albicans(14.3％),candida parapsilosis (38.1％),candida glabrata (35.7 ％),candida tropicalis (2.4％).Eleven uneffecfive cases accounted for 26.2％.Multiple-factor analysis showed that neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlated with bad prognosis.Our study also showed that chemotherapy regiments including hormone、combining with other organs fungal infection and non-Candida albicans were risk factors of bad prognosis.Conclusion The main pathogen agent of fungimia is candida,especially non-Candida albicans.Neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlate with poor prognosis.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was done with the 42 cases of fungemia in our hospital.Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia.95.2％ of the fungemia pathogen agent was monilia.8 cases combined with bacterial septicemia,accounting for 19.0％.Drug sensitivity test showed that 2 cases were intermediary to Fluconazole,1 patient was resisdence to Amphotericin B but sensitive to Voriconazole,Itraconazole and fluorocytosine.The main risk factors of fungimia included using wide-spectrum antibiotic,neutophil less than 0.5 × 109/L,central venous indwelling catheter,age and the time of in hospital more than 15 days.Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors.Timely and effectively antifungal therapy is also needed.

Objective To observe the effects of mesenchymal stem cells (MSCS) transplantation on the brain-derived neurotrophic factors (BDNF) after the spinal cord injury (SCI) of rats, and investigate the mechanism of repairing the SCI by MSCS transplantation.Methods Mesenchymal stem cells were cultured from the thighbone of adult SD rats and identified by immunoctochemistry.Seven days after the operation of spinal cord injury, the mesenchymal stem cells were transplanted into the injured spinal cord site.Sixty adult SD rats were random divided into three groups: Spinal cord injury cured with transplants of mesenchymal stem cells to the injured spinal cord site ( group A), spinal cord injury received PBS solution( group B) and control group ( group C).The expression of brain - derived neurotrophic factors of the lesion and neighbor areas were examined by immunohistochemistry, The mechanism of repairing the lesion and neighbor areas were examined by immunohistochemistry, and the mechanisms of repairing the spinal cord injury after mesenchymal stem cells transplantation were investigated.Results Mesenchymal stem cells began to grow after 24 hours of inoculation and proliferate 72 hours later.The proliferate the proliferous cyclewas 4 ～6 days, it declined on the 10th era.Mesenchymal stem cells turned to flat, and the mesenchymal stem cells could maintain the ability of proliferation if bFGF was added.Compared with group B, transplantation of mesenchymal stem cells enhanced more expression of brain-derived neurotrophic factors in group A ( 14 d :0.31 ± 0.03 vs 0.25 ± 0.04, P ＜ 0.01 ).Conclusion Mesenchymal stem cells in transplantation group showed a continued high level of brain-derived neurotrophic factors, which may be one of the mechanisms of repairing the spinal cord injury by mesenchymal stem cells transplantation.

Objective To explore the clinical presentation,etiology of sepsis,common positions of in-fection and anti-infectious treatment of pediatric acute leukemia with septicemia resistance to carbapenem. Meth-ods A retrospective chart review of all pediatric acute leukemia with septicemia cases of Beijing Children 's Hospital from December 2011 to September 2015 were analyzed. All cases were selected based on the clinical presentation,at least one Gram-negative bacteria positive result of blood culture and were resistant to carbapen-em. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were ana-lyzed. Results All 45 cases with fever,among them 8 cases under went continued fever,The other 37 cases fe-ver days were ( 6. 1 ± 5. 2 ) d. Twenty-six cases had agranulocytosis. Agranulocytosis time from 2 to 79 days, mean days(15. 2 ± 16. 2)d. Significant difference of fever time between agranulocytosis team and non-agranulo-cytosis team was significant(P=0. 011). Twenty-three cases had infection positions among 45 cases. Lung,di-gestive tract,mouth and crissum were the common positions of infection. The quantum of blood culture samples were 711 parts. There were 162 parts resistant to carbapenems. The primary pathogens were pseudomonas aerugi-nosa,klebsiella pneumoniae, enterobacter cloacae and Escherichia coli. Among those 45 cases, 36 cases were cured,9 cases were ineffective treatment. Conclusion Pseudomonas aeruginosa, klebsiella pneumoniae, enter-robacter cloacae and Escherichia coli accounted for the most of G-bacteria infections resistant to carbapenem in our center. The incidence of septicemia was related to the level of granulocyte and duration of agranulocytosis.

OBJECTIVETo examine the change of puerarin on the expression of apelin and its receptor of the two-kidney, one-clip (2K1C) rats.

METHODTirty male Sprague-Dawley rats were randomly divided into normal control group (C), model group (M) and puerarin group (P). The mean of carotid arterial pressure (mCAP), mean of left ventricular end diastolic pressure (LVEDP), and the weight ratio of left ventricular mass (left ventricle plus septum) to bodyweight (LVM/BW) were measured to evaluate the model of 2K1C renal hypertension. The concentrations of apelin in the plasma and left ventricle (LV) were measured with radioimmunoassay. Apelin mRNA and APJ mRNA expressed in the LV were examined by reverse transcription-polymerase chain reaction (RT-PCR). The peptides of apelin and APJ expressed in the LV were detected with immunohistochemistry (IHC).

RESULTCompared with C group, the mCAP, LVEDP and LVM/BW of M group were higher 36.58%, 333.8% and 20.24%, respectively (P<0.05, P<0.01, P<0.01). Compared with M group, LVEDP and LVM/BW of P group were lower 65.24% and 13.12%, respectively (both P<0.05). However mCAP was of no significant difference between these two groups. The levels of apelin-36 in the plasma and LV of M group were respectively higher 18.56% and 207.38% than those of C group (both P<0.05), while ones of P group were lower 24.21% and 49.40% than those of M group (both P<0.05). The expressions of apelin mRNA and APJ mRNA at left ventricle tissues of 2K1C rats were higher 77.66% and 119.00% (both P<0.05) than those of C group. The ones of P group were lower 27.40% and 45.66% than those of M group (both P<0.01). The IHC results indicate that the expressions of apelin and APJ peptides at left ventricle tissues of 2K1C rats were higher 129.51% and 154.1% (both P<0.01) than those of C group, respectively. Whereas the ones of P group were lower 65.36% and 62.87% than those of M group (both P<0.01).

CONCLUSIONThrough regulating apelin/APJ system puerarin has protective effect on the development of left ventricular hypertrophy by renal hypertension.

Animals ; Apelin ; Apelin Receptors ; Carrier Proteins ; genetics ; metabolism ; Gene Expression ; drug effects ; Hypertension, Renal ; drug therapy ; metabolism ; physiopathology ; Hypertrophy, Left Ventricular ; prevention & control ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Isoflavones ; therapeutic use ; Male ; Radioimmunoassay ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

Objective: To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV). Methods: The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed. Patients were divided into four groups according to the mapping and ablation results: DGCV1(10 patients), DGCV2 (13 patients), proximalanterior interventricular vein (PAIV, 17 patients)and extend distal great cardiac vein (EDGCV, 9 patients). We analyzed the similarities and differences between surface 12-lead ECG of patients with PVCs/VT from different portions of DGCV, and compared with random chosen 290 patients with PVCs/VT from ventricular outflow tract and adjacent structure. Results: A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR were found among all groups. The different characteristics of surface 12-lead ECG of VAs originating from DGCV were as follows: (1)EDGCV patients demonstrated a positive R or r wave on lead Ⅰ(6/9) while a negative rS or qr wave was evidenced in other three groups (39/40). (2)A positive R pattern on lead V₁, V₅-V₆ (11/13) was presented in patients of DGCV2 group; R (without S or s) wave on V₁ (9/10), RS or Rs wave on V₅-V₆ were found in DGCV1 group; RS or rS wave was seen on lead V₁, R(without S)wave in lead V₅-V₆ (25/26) were found in EDGCV and PAIV group and the amplification of R wave in EDGCV was higher than V₁ of PAIV group.(3)Precordial lead transition zone was in front of V₁ for DGCV1 and DGCV2 groups (23/23), within V₁-V₃ for EDGCV group, but on V₂ or within V₂-V₃ for PAIV group.(4)Patients of DGCV1 and DGCV2 demonstrated a longer Pseudo delta wave time(PdW), intrinsicoid deflection time (IDT), significantly larger maximum deflection index (MDI) than those in PAIV and EDGCV groups (P<0.001). (5)The different characteristics of surface 12-lead ECG between VAs originating from DGCV and those from ventricular outflow tract and adjacent structure were as follows: ① The ECG features were similar between PVIA and LCC group, both demonstrated a rs wave on the lead Ⅰ, rS wave on V₁-V₂ and R wave on V₅-V₆; ②The ECG features were similar betweenEDGCV and RCC group, both presented with R or r wave on the lead Ⅰ, the QRS wave of precordial leads was similar as PAIV and LCC groups; ③A R wave on the lead V₁, V₅-V₆ was found in group DGCV2, and ILCC; ④Similar to the group Endo-MAA, patients in DGCV1 group also demonstrated a R wave on the lead V₁ and a Rs wave on V₅-V₆. Conclusion A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR are seen in all patients, but different electrocardiographic characteristics of PVC/VT originating from the different portions of the DGCV are presented on lead Ⅰ and V₁-V₆.

ObjectiveTo analyze the characteristics of HIV-1 molecular network and pretreatment drug resistance genes in the middle-aged and elderly people aged ≥50 years in Huzhou City, Zhejiang Province, and to provide an evidence for the prevention and control of AIDS epidemic. MethodsA total of 332 samples from the newly reported and untreated AIDS patients aged ≥50 years in Huzhou City from January 2020 to December 2023 were collected, pol genes were amplified by reverse transcription polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (nest⁃PCR). Phylogenetic trees analyzing the subtypes were constructed, and a molecular network with a gene distance threshold of 1.0% were constructed at the same time. Mutation sites of drug resistance-related genes were identified through the Data Analysis and Detection System of HIV-1 Resistance Gene Detection of Stanford University, USA. ResultsSequence samples of 308 patients were obtained, and9 genotypes were identified, including CRF07_BC in 172 cases (55.8%), CRF01_AE in 61 cases (19.8%), CRF08_BC in 43 cases (14.0%), CRF85_BC in 9 cases (2.9%), and CRF55_01B in 8 cases (2.6%), subtype B in 5 cases (1.6%), subtype C in 4 cases (1.3%), CRF67_01B in3 cases (1.0%), and unique recombination URF01_AE/07_BC in 3 cases (1.0%). When the gene distance threshold was 1.0%, 28 molecular clusters were formed, and 139 cases were connected to the network, with an access rate of 45.0%. The largest transmission cluster C1 contained 44 cases infected with CRF07_BC subtype, all of whom were heterosexually transmitted, and predominantly by males. A total of 30 patients were found to have low-grade or higher drug resistance mutations, and the pretreatment drug resistance rate was 9.7% (30/308). Among them, there were 5 cases (16.7%) of protease inhibitor (PI) related drug resistance mutations, and 26 cases (86.7%) of non-nucleoside reverse transcriptase inhibitors (NNRTI) related drug resistance mutations. ConclusionCRF07_BC is the subtype with the most clusters among the middle-aged and elderly infected patients aged ≥50 years in Huzhou City. Middle-aged and elderly transmission clusters are formed within the three counties of WX, NX and CX through related activities. Molecular network monitoring on newly reported cases aged ≥50 years in Huzhou City should be strengthened so that the new characteristics of epidemic changes can be detected in time, providing a scientific basis for adjusting AIDS prevention and control measures for the elderly.