A 13 year old male farmer suffered from cutaneous and nail phaeohyphomycosis for five years is reported in this paper. The lesions were dull red, nodules and well defined plaques with ulcerations, mainly on the face, extremities, palmar and plantar surfaces and buttocks. Some of them were covered with thick greyish black crusts. General examination did not reveal abnormal findings except the skin lesions. Histopathology showed granulomatous response with numerous light brown septate branching hyphae. The colonies were greyish brown on SDA and PDA at 25℃ and 37℃ with brownish black ascomata. The ioslated strain was identified as Chaetomium globosum based on the morphological features of ascomata, ascomal hairs and ascospores.

Objective To investigate the mycologic features and variation in gene sequence of a hot-resistant Trichophyton rubrum which caused granulomatous skin lesion.Methods The isolate was identified by routine and polymerase chain reaction(PCR)technique.Ribosomal conserved sequence and trs-1(tandem repetitive subelement)sequence in the ribosomal non-transcribed spacer(NTS)were determined.Results The hot-resistant isolate was identified as T.rubrum by routine and PCR technique.The trs-1sequence variation in rDNA NTS was found in the strain.Conclusion The trs-1sequence variation suggests that this strain be one of isotypic variants of T.rubrum,which has much higher pathogenicity to cause granulomatous skin lesion,or sequence variation of the strain may be the result of adapting itself to environmental change(37℃),which needs further studies.

Objective To report a case of subcutaneous phaeohyphomycosis caused by Curvularia clavata in China. Methods The skin specimen was collected, and examined by KOH preparation, fungus culture and histopathology. Results A 17-year-old male farmer had dull red, warty and well-defined plaques with some ulceration on his face and his left upper arm for nine years and a history of trauma of his face before the appearance of the lesions. General examination did not reveal abnormal findings except the skin lesions. KOH direct examination showed septate hyphae with irregular branches. On the culture medium the colonies were black in color. Under microscope the conidia were borne singly or in groups at the tip or at the sides of the conidiophores, they were light brown to brown, smooth, straight or slightly curved and clavate, measuring 15 ~ 30 ?m long and 6 ~ 12 ?m thick, with 3 ~ 4 septates. Histopathology showed a granulomatous response. PAS staining showed irregularly swollen or toruloid conidia with branched hyphae. The isolated strain was identified as Curvularia clavata Jain. Conclusion It is the first case report of subcutaneous phaeohyphomycosis caused by Curvularia clavata in China.

Objective To develop a microtitration plate en zyme immunoassay to differentiate Candida albicans from Candida dubliniensis isolates using two specific probes s imultaneously.Methods The fun-gus-specific universal primers derived from the internal transcribed s pacer region of fungal rDNA were labeled with biotin,while the C.albicans or C.dubliniensis specific capture probes were coated on the microplates.Genomic DNA purified from the two species was amplified by PCR.The biotinylated p roducts were captured by the probes coated on the microplates.The A 405 value was finally determined by the c olorimetric assay.Results The two species of Candida could be detected specifically.Out of 108clinical isolates originally identified as C.albicans on the basis of germtube formation,two isolates were positive for C.dubliniensis and negative for C.albicans.The other106isolates were positive for C.albicans and negative for C.dubliniensis.Conclusions Two-specific-probe hybridization method is rapid and re liable for differentiating C.albicans from C.dubliniensis.

0.05). Conclusion It is encouraging that ravuconazole is effective against clinical and environmental isolates of C. neoformans, whether the isolates were sensitive to fluconazole or not.

This study was aimed to optimize the extraction process of ginseng in Shen-Qi Bu-Qi (SQBQ) granules. The orthogonal experiment method was used to optimize the extraction process of ginseng adopting ethanol concentration, ethanol volume, extraction time and extraction times as factors. The content of ginsenoside Rg1, Re, Rb1 content in the extract was determined by HPLC. And the optimum extraction conditions were determined with indexes of three kinds of saponin yield. The results showed that the optimum extraction process of ginseng for SQBZ granules was that adding 6 times amount of 60% ethanol technology for medicinal materials, extract for 2 times, and 3 h for each time. It was concluded that the optimization of ginseng extraction process was stable, reasonable and feasible with high extraction rate.

Objective To explore the long-term prognosis of the patientswithpulmonary arterial hypertension ( PAH) after cardiac repair operations through follow up .Methods We filtered the CHD patients with PAH after cardiac repair operation , admitted to the department of pediatric cardiology in Beijing Anzhen Hospital from June 2004 to December 2014, and collected their preoperative and postoperative data to analysis the long-term prognosis.Results 92 patients were included, median age was 20.78 years(2.44-60.26 years),median operation age was 13.54 years(1.33-53.99 years), World Health Organiza-tion functional classⅠ-Ⅱ was 80(86.96%), Ⅲ -Ⅳ was 12(13.04%), mean 6 min walk test distance was(481.74 ± 80.74) meters, mean Borg score was 1.53 ±1.14, and mean percutaneous oxygen saturation was 0.95 ±0.05.Among them, 64 patients completed preoperative right heart catheterization.Their average pulmonary artery pressure was(72.23 ±12.83) mmHg, aortic pressure on average was(85.57 ±11.91) mmHg, and average pulmonary vascular resistancewas(10.79 ±5. 04) Wood· U.The range of follow-up was between 6 months and 28.32 years(median 13.67years).During the follow-up, there were arrhythmia in 2 cases(2.17%), syncope in 7 cases(7.61%), hemoptysis in 4 cases(4.35%),heart failure in 8 cases(8.70%) and death in 1 case(1.09%).Compared with preoperative data, WHO cardiac function was found decreased in 22 patients(23.91%), stabled in 61 patients(66.30%) and significantly improved in 9 patients (9.78%).63 patients (68.48%) received targeted drug therapy, only 5 patients were treated with combined therapy,29 cases were not.Conclusion Compared with idiopathic pulmonary hypertension , PAH after defect correction has a lower incidence of arrhythmia , hemop-tysis and heart failure, and a higher long-term survival rate, and heart function is stable.To patients with PAH after defect cor-rection, targeted therapy is not only in perioperative period, but also more important in the long-term after surgery.In the targe-ted drug therapy, the combination treatment rate is low.

Background Epidemiologieal survey suggests that visual impairment in teenagers is a worldwide public health problem,and its leading cause is uncorrected refractive error.To conduct an extensive screening of visual impairment in teenagers and analyze the relevant affecting factors are significant works for the prevention and management of refractive errors.But high-quality epidemiological data on visual impairment and refractive error from large groups of children are lacking in Shanghai.Objective This study was to investigate the prevalence of ametropia and visual impairment in schoolchildren aged 6 to 12 years old.Methods In this cross-sectional study,4 686 students from 6 elementary schools in Baoshan District of Shanghai,a rural-urban fringe zone,China were selected by clustering sampling from May 2010 to April 2011.The eye examinations included visual acuity,ocular surface,ocular anterior segment,ocular media,fundus and intraocular pressure measurement,and the data autorefraction under cycloplegia and eye position were recorded.The cause of visual impairment was evaluated.Results A total of 4 594 students received examination with the response rate 98.0％,and autorefraction under cycloplegia was completed in 84.8％ schoolchildren (3 975/4 594).The prevalence rate of uncorrected visual acuity 0.5 or worse in both eyes was 14.4％ (662/4 594),with the wearing glasses rate 51.8％ (343/662).The percentage of students with the uncorrected visual acuity 0.5 or worse in at least one eye was 22.4％ (1 031/4 594).The prevalence rate of refractive error in the visual impaired students was 96.9％ (999/1 031),followed by amblyopia (37/1 031,3.6％).The prevalence rate of myopia,hyperopia,and astigmatic in the pupils after cycloplegia was 31.1％,4.3 ％ and 33.0％,respectively.In addition,the prevalence rate of myopia in public elementary schools was higher than that in migrant elementary schools (33.9％ versus 30.3％) (x2 =5.46,P =0.02).Logistic regression analysis showed that myopia was associated with age (OR =1.60,95 ％ CI:1.53-1.68,P ＜ 0.01) and female (OR =1.33,95％ CI:1.16-1.54,P＜0.01).Conclusions The leading cause of vision impairment is myopia in the elementary school students in Shanghai,China.The screening-ratio of refractive error and the coverage of refractive correction in the elementary school students in Shanghai are matters of urgent concern.

Objective: To investigate the risk factors, clinical features, treatments, and prevention of pulmonary hypertensive crisis (PHC) in children with idiopathic pulmonary arterial hypertension (IPAH) undergoing cardiac catheterization. Methods: This retrospective study included 67 children who were diagnosed with IPAH and underwent cardiac catheterization between April 2009 and June 2017 in Beijing Anzhen Hospital. The medical histories, clinical manifestations, treatments, and outcomes were characterized. Statistical analyses were performed using t test, χ² test and a multiple Logistic regression analysis. Results: During cardiac catheterization, five children developed PHC who presented with markedly elevated pulmonary artery pressure and central venous pressure, decline in systemic arterial pressure and oxygen saturation. Heart rate decreased in 4 cases and increased in the remaining one. After the treatments including cardiopulmonary resuscitation, pulmonary vasodilator therapy, improving cardiac output and blood pressure, and correction of acidosis, 4 of the 5 cases recovered, while 1 died of severe right heart failure with irreversible PHC 3 days after operation. Potential PHC was considered in 7 other patients, whose pulmonary artery pressure increased and exceeded systemic arterial pressure, oxygen saturation decreased, and central venous pressure and vital signs were relatively stable. Univariate analysis showed that the risk factors of PHC in children with IPAH undergoing cardiac catheterization were younger age (t=3.160, P=0.004), low weight (t=4.004, P<0.001), general anesthesia (χ²=4.970, P=0.026), history of syncope (χ²=4.948, P=0.026), and WHO cardiac functional class Ⅲ or Ⅳ (χ²=19.013, P<0.001). Multivariate Logistic regression analysis revealed that worse WHO cardiac functional class (Wald=13.128, P<0.001, OR=15.076, 95% CI: 3.475-65.418) was the independent risk factor of PHC. Conclusions PHC is a severe and extremely dangerous complication in children with IPAH during cardiac catheterization. WHO cardiac functional class may be associated with PHC. Integrated treatment is required for these patients. Reducing risk factors, early identification, and active treatment may help to prevent the occurrence and progression of PHC.

OBJECTIVETo investigate the correlation of G487A polymorphism of aldehyde dehydrogenase-2 (ALDH2) gene with hypertension in patients with coronary heart disease complicated by type 2 diabetes.

METHODSThis study was conducted among 167 patients with coronary heart disease complicated by diabetes mellitus. The polymorphisms of gene G487A ALDH2 were determined using polymerase chain reaction-restricted fragments length polymorphism technique (PCR-RFLP). According to the genotypes, the patients were divided into GG group (n=105) and GA/AA group (n=62), and the incidence of hypertension, risk factors of hypertension, systolic and diastolic pressures, and pulse pressure indexes were compared between the two groups. Multivariate logistic regression analysis was performed to adjust the effects of the confounding factors.

RESULTSThe incidence of hypertension in GA/AA group was significantly higher than that in GG group (P<0.05), and the former group showed a significantly greater differences between systolic and pulse pressure; the diastolic pressure was comparable between the two groups. Multivariate logistic regression analysis showed that GA/AA was associated with an increased risk of hypertension in synergy with high insulin level and insulin resistance.

CONCLUSIONALDH2 gene G487A polymorphism may be associated with hypertension in patients with coronary heart disease complicated by type 2 diabetes, and the patients with an A allele have a greater risk of developing hypertension.

Aged ; Alcohol Dehydrogenase ; genetics ; Coronary Disease ; complications ; genetics ; Diabetes Mellitus, Type 2 ; complications ; genetics ; Female ; Humans ; Hypertension ; etiology ; Male ; Middle Aged ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Risk Factors