Objective To improve the diagnosis and surgical management of pulmonary aspergilloma.Methods Twenty-four patients underwent surgical treatment for pulmonary aspergilloma were enrolled in our study from April 2005 to May 2012 at the second hospital of Xiamen.The information of all cases was recorded.Results There were 18 males and 6 females in all subjects,and their age ranged from 22 to 67 year.The surgical outcome were 15 lobectomies,3 segmentectomies or wedge resections,1 right upper and middle lobectomy,1 radical debridement,4 pneumonectomy.Results There was no preoperative mortality.Seven cases (29.2％) developed complications in this series including 1 postoperative bleeding,1 bleeding during operation,2 pulmonary infection,1 bronchial fistula,1 pulmonary reexpansion insufficiency,1 wound infection.Conclusion Surgical resection of pulmonary lesion is the most effective method for pulmonary aspergilloma.Moreover strengthening the perioperative management could decrease the morbidity and mortality.

Objective To investigate the protective effect of ischemic postconditioning on lung injury in situ during lung ischemic reperfusion.Methods 24 SD rats were randomly divided into 3 groups,sham-operated group(S),ischemic-reperfusion group(I/R) and ischemic postconditioning group (IpostC).IpostC was established by several brief reperfusion-ischemia (30 s,5 cycles) before continuous reperfusion.AKT,p-AKT,p70S6K,p-p70S6K protein expression,apoptotic cells were tested by Western blotting and TUNEL,wet to dry weight ratio(W/D) in lung tissue were determined respectively.The lung pathological changes were also observed.Results Compared with S group,expression of Akt、p-Akt、p70S6K、p-p70S6K and the ratio of W/D,apoptotic index in lung tissue all markedly increased in I/R and IpostC group (P ＜ 0.05).Compared with I/R group,expression of Akt、p-Akt、p70S6K、p-p70S6K markedly increased in IpostC group(P ＜0.05),while the ratio of W/D and apoptotic index significantly reduced (P ＜ 0.05),the pathological injury in IpostC group also reduced significantly.Conclusion IpostC has a protective effect on lung ischemic reperfusion injury via PI3K/Akt pathway.

Objective To investigate the prevalence and characteristics of non-nucleoside reverse transcriptase inhibitors (NNRTIs)resistance-related gene mutations among the AIDS patients with virological suppression failure in Guangdong Province 2015.Methods Plasma samples from AIDS patients receiving highly active antiretroviral therapy for more than one year with viral loads > 1000 copies/mL from Guangdong province (except Shenzhen)were collected from January to December 2015.Total 612 HIV-1 gene fragments were amplified from plasma samples using self-developed lab method.Sub-genotypes were determined by phylogenetic tree according to the sequences,NNRTIs resistance-related mutations were determined in Stanford University HIV-1 Drug Resistance Database. The NNRTIs-resistance, the relationships of NNRTIs resistance-related mutations with baseline CD4 +T lymphocyte counts,transmission routes,antiviral regimens and HIV-1 genotypes were analyzed.SPSS 17.0 software was used to analyze the data.Results In 612 patients with virological suppression failure,the main NNRTIs resistance-related mutations were K103 (26.80%),Y181 (14.71 %),V179 (13.73%),G190 (11 .44%) and V106 (10.62%).The susceptibility rate of 310 patients (50.65%)to NNRTIs had changed,the highly resistant rate to nevirapine was 49.51 %,which was higher than that of efavirenz (43.14%),etravirine (5.56%) and rilpivirine (12.25%),respectively,and the differences were statistically significant (χ2 =5.00,296.3 and 198.0,all P <0.05).The incidence rate of drug resistance in patients with baseline CD4 +T lymphocyte counts >200 cells/μL was lower than that in those with baseline CD4 +T lymphocyte counts <200 cells/μL (χ2 =17.93,P <0.01 );the incidence rate of drug resistance was lower in intravenous drug abusers than that of sexually transmitted patients (χ2 =44.21 ,P <0.01 );while the incidence of drug resistance in patients receiving NVP-containing regimens was higher than that in those receiving EFV-containing regimens (χ2 =8.93,P <0.01 ),and the incidence rate was higher in patients with CRF01 _AE than that in those with CRF07_BC and CRF08 _BC (χ2 =8.46 and 8.47,P <0.01 ).Conclusions The results suggest that compliance education and follow-up should be strengthened in patients with high baseline CD4 +T lymphocyte counts and intravenous drug users,and patients with liver diseases should avoid using drugs containing NVP regimens.

Objective To investigate the genetic variations of gag-pol gene in human immunodeficiency virus-1(HIV-1) CRF07_BC strain in Guangdong Province.Methods From February to September in 2015,plasma samples of 78 cases with HIV 1 CRF07_BC infection in Guangdong were collected before antiretroviral treatment.Viral RNA was extracted from plasma.Gene (gag and pol) sequences were amplified by reverse transcriptase and nested-PCR using specific primers.Phylogenetic tree,genic dispersion rate,nucleotide polymorphism,selection pressure and variation characteristics were analyzed.Results The main transmission route of the enrolled patients was homosexual transmission (80.77％,63/78).The gag pol gene phylogenetic tree was divided into two sub-clusters.The strains from different transmission routes were not in cluster.The average genetic dispersion rate and average entropy of gag gene were both higher than those of pol gene.The average genetic dispersion and average entropy of p17 and p6 regions of gag gene were both higher than those of p24.The average genetic dispersion and average entropy of pol gene were higher than those of rt region.The average ds/dn values of gag and pol genes were greater than one.Compared with the common HIV-related antigenic epitopes (A2,A11,B39,B60,Cw1,Cw3,Cw8),the cytotoxic lymphocyte (CTL) epitope mutations in the P17 region were more in the consensus of GAG region than those in the P24 region.The epitope conserved rates were 26.92％,0,1.28％,0,96.15％,82.05％,84.62％ and 98.72％,respectively.The drug resistance rate of pol gene was 2.56％ (2/78).Conclusions The gag and pol genes of CRF07_BC strain in Guangdong are all mutated.Diversity of gag gene is greater than that of pol gene,and gag gene variation is mainly in p17 and p6 regions.gag and pol genes are both affected by negative selection pressure.P17 protein CTL epitope variability is greater than P24 protein epitope.The prevalence of drug resistance mutation is lower than the threshold.It's important to monitor the spread of drug-resistant strains.