BACKGROUND:Lung invasive fungal infection is the main reason for the failure in renal transplant recipients. Caspofungin has specific anti-fungi mechanism, and can effectively prevent the candida fungus that is resistant to Fluconazol and Itraconazole. Caspofungin exerts good tolerance, without dose-or time-dependent toxicity.
OBJECTIVE:To evaluate the efficacy and safety of Caspofungin in treatment of pulmonary invasive fungal infection fol owing kidney transplantation.
METHODS:A retrospective analysis was performed in renal transplant patients who were diagnosed pulmonary invasive fungal infection in Department of Respiratory Medicine, Sanmenxia Central Hospital between January 2013 and December 2013. The patients were then treated with Caspofungin as antifungal therapy. The initial dose was 70 mg per day and then changed to 50 mg per day, via intravenous drip. After drug intervention, liver function was evaluated twice per week. The severity of liver functional impairment or emergency of new impairment indicated the adjustment of Caspofungin dose or withdrawal. The treatment was given for 10-14 days. The curative effect and adverse reaction of patients were observed.
RESULTS AND CONCLUSION:Total 12 patients were treated, and the percentage of fungi microbiology evidence was 66.7%. Among these evidenced patients, candida fungus was the dominant, accounting for 75.0%, accompanying bacterial infection was found in 58.3%, accompanying cytomegalovirus infection was found in 25.0%. The effective treatment rate was up to 91.67%(11/12), the mortality was 8.33%(1/12), and the incidence of adverse reactions was 25%. Caspofungin effectively prevented pulmonary invasive fungal infection fol owing kidney transplantation, as empirical antifungal therapy, with low incidence of adverse reactions. Therefore Caspofungin is the preferred drug against pulmonary invasive fungal infection in renal transplant recipients.

BACKGROUND:The hedgehog pathway has paid an important role in the progress of chondrogenesis from bone marrow mesenchymal stem cells. However, the definite signal transduction pathway and cross-talking relationship with other common signal pathways are stil poorly understood and the researches related to this field is to continue as a hotspot in the future study. OBJECTIVE:To investigate the research progress of hedgehog signal pathway on the regulation of the chondrogenesis from bone marrow mesenchymal stem cells and the relationship between hedgehog and other signal pathways in the process. METHODS:A computer-based online search in CNKI, PubMed and Google Scholar databases was performed using key words of“Hedgehog, IHH, SHH, bone marrow mesenchymal stem cells, cartilage, chondrogenesis”in English and Chinese, respectively. Literatures related to the process of chondrogenesis from bone marrow mesenchymal stem cells were included and 36 articles were extensively summarized for review. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells are currently accepted optimal cellseeds for the cartilage tissue engineering, and hedgehog is a critical signal molecule in the development of skeletal system. The IHH and SHH in hedgehog signal closely participate in control ing the processes of bone marrow mesenchymal stem cellproliferation and chondrogenesis, chondrocyte phenotype maintenance and cooperation with other common single pathways. However, the specific signal transduction mechanism and cross-talking contact with other signal pathways stil need to be further studied, and it stands for the future research directions.

Hearing Loss ; epidemiology ; Humans

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Scalp ; Sleep Initiation and Maintenance Disorders ; therapy ; Young Adult

We report a case of symptomatic bradycardia caused by consumption of a Chinese herbal medicine which was initially undisclosed to the attending emergency physician. The scientific name of the herb is Panax japonicus. Electrocardiogram revealed sinus bradycardia. Laboratory tests were normal except for the detection of a high serum digoxin level. Further interrogation of the patient eventually disclosed ingestion of the herb which, however, did not contain any digoxin. Other active ingredients in the herb include various types of ginsenoside. These are digoxin-like substances that had caused the observed false-positive detection of digoxin by fluorescence polarization immunoassay due to cross-reactivity. Our case-report provides an important insight about a blind-spot in the field of laboratory medicine (clinical pathology), namely, the false positive detection of digoxin due to crossreactivity in the immunoassay when we come across digoxin-like substances in clinical scenarios, which has barely received attention in the medical literature. It also conveys a clear educational message that with full understanding of the laboratory methodology and its mechanistic rationale there are actually some tricks-of-the-trade that allow us to optimize the specificity of the biochemical tests and the treatment of digoxin-like substances overdose.

Objective To evaluate the diagnosis and treatment for the patients infected with Candida species.Methods A total of 47 patients with persistent fever,pathology of pulmonary infection,no response to the antibiotic therapy,Candida species found in sputum after long time hospitalization were retrospectively analyzed.Results The 47 patients were 24 males and 23 females.The mean age was 57.0?16.1.The mean temperature was(38.4?0.6)℃ and all lasted for over 6 days.Pulmonary infections with Candida species was diagnosed at the(17.7?5.2)th day after admission.The species isolated were 38 strains Candida albicans,5 strains Candida glabrata,2 strains Candida kruseic,1 strain Candida tropicalis,and 1 strain Candida lusitaniae.Fluconazole was given to 28 patients(2 with voriconazole as sequential therapy),itraconazole to 9(2 with voriconazole too),voriconazole in 7(including the 4 patients mentioned above),Casfungin aceate to 7,Amphotericin B to 1(Casfungin aceate was given alone later for serious adverse reactions).Results two patients infected with C.albicans and Candida glabrata separately had no improvement in the 28 patients treated with fluconazole,but voriconazole showed good effect on the 2 patients.Two patients infected with C.albicans and Candida glabrata separately had no improvement to itraconazole in the 9 patients treated with Itraconazole,but voriconazole showed good effect on them too.The 7 patients treated with voriconazole all had good effect,including 3 infected with Candida glabrata,1 with Candida lusitaniae,3 with C.albicans.Conclusion Candida albicans is the main pathogen in this group of invasive pulmonary infections with Candida species.All the patients have fever and long-time hospitalization.The currently used antifungal drugs,such as voriconazole,Casfungin aceate,are reliable.Caspofungin is generally better tolerated than other antifungal drugs.

Objective:To investigate the clinical value of total parenteral nutrition for patients with tetanus. Methods:TPN was used in 13 tetanus patients. The nutrition parameters were recorded in these patients and compared with those in 25 tetanus patients without TPN. Results:Compared with the control, body weight, albumin, Hb, peripheral lymphocyte count in TPN group were higher and the complication and mortality were less. Conclusions:Total parenteral nutrition can improve nutrition parameters and prognosis of tetanus patients.

BACKGROUND:Gait deviations are the important diagnosis criteria and surgical indications of cervical myelopathy. Conventional three-dimensional gait laboratory failed to apply in clinics due to complex operations and time consuming. In recent years, a portable gait analyzer based on the micro-sensors is emerging and developing, it has been verified by clinical practice, al owing gait analysis in the ward.
OBJECTIVE:To quantitatively analyze gait characteristics of patients with cervical spondylotic myelopathy (CSM) by a portable gait analyzer.
METHODS:From March 2013 to November 2013, 15 CSM patients and 30 healthy subjects were enrol ed in the study. The involved patients were accompanied by gait abnormalities. A portable gait analyzer was used for gait analysis. Subjects walked on a 30-meter corridor back and forth for 120 meters. Total y 12 gait parameters were involved in this study, including seven common parameters (single limb support, double limb support, gait cycle, speed, cadence, step length and stride length) and five new parameters (pul ing acceleration, swing power, ground impact, foot fal , and pre-swing angle). Three patients underwent cervical decompression surgery. The gait characteristics were re-evaluated one week later, carrying neck support.
RESULTS AND CONCLUSION:The double limb support and gait cycle duration of CSM group were significantly longer than control group (P<0.05). Speed, cadence, step length, stride length, swing power, ground impact, foot fal , and pre-swing angle of CSM patients were significantly smal er than healthy subjects (P<0.05). No differences were found in single limb support and pul ing acceleration (P>0.05). after cervical decompression surgery, the mean remission rate of Japanese Orthopedics Association scores was 32.5%and lower limb acceleration was improved obviously in the graph one week after surgery. Varying degree of correlation was seen between Japanese Orthopedics Association scores and the detected 12 gait parameters in CSM patients. The portable gait analyzer can effective measure the pathological gait deviation in CSM patients with abnormal gaits, and assists to evaluate the lower limb functions.

Objective: To summarize the methods of preventing and managing the complications in thoracoscopic lobectomy. Methods:The participants of this study included 317 patients undergoing lobectomy with video-assisted thoracoscopic surgery in the Department of Thoracic Surgery between January 2007 and December 2012. Intra-operative complications were observed, and countermeasures were summarized. Results: Complications occurred 28 times (8.8%), including bleeding in 16 cases because of accidental vascular injury (5.0%), accidental injury/break of bronchus in two cases (0.6%), vascular stump errhysis from cutting stapler in four cases (1.3%), lung stump air leakage in three cases (0.9%), lung injury in two cases (0.6%), and diaphragmatic injury in one case (0.3%). Conversion to thoracotomy was conducted in 17 cases, with a conversion rate of 5.4%. Thoracoscopic repair operation was performed in 14 cases that exhibited bleeding, with a success rate of 70% (14/20). No mortality was reported during the operation. Conclusion:Thoracoscopic lobectomy is a highly difficult method in thoracic surgeries. The procedure requires substantial attention on the timely prevention and correct management of intra-operative complications, particularly the injury and bleeding of major vessels, to reduce the rate of conversion to thoracotomy and the incidence of post-operative complications, as well as to promote the surgery in clinics.

In this paper, optimization of the conditions of microwave technique in extraction process of Guizhi Fuling capsule in the condition of a pilot scale was carried out. First of all, through the single factor experiment investigation of various factors, the overall impact tendency and range of each factor were determined. Secondly, L9 (3(4)) orthogonal test optimization was used, and the contents of gallic acid in liquid, paeoniflorin, benzoic acid, cinnamic acid, benzoyl paeoniflorin, amygdalin of the liquid medicine were detected. The extraction rate and comprehensive evaluation were calculated with the extraction effect, as the judgment basis. Theoptimum extraction process of Guizhi Fuling capsule by microwave technology was as follows: the ratio of liquid to solid was 6: 1 added to drinking water, the microwave power was 6 kW, extraction time was 20 min for 3 times. The process of the three batch of amplification through verification, the results are stable, and compared with conventional water extraction has the advantages of energy saving, time saving, high efficiency advantages. The above results show the optimum extracting technology of high efficiency, stable and feasible.
Capsules ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; isolation & purification ; Microwaves ; Technology, Pharmaceutical ; methods