Objective To observe the ultrastructure of dimorphic Penicillium marneffeiisolates from wild bamboo rats (Rhizomys pruinosus) in Guangxi region as well as from a patient with penieilliosis marneffei,and to compare their biological characteristics and anti-oxidative mechanisms.Methods Two Penicillium marneffei strains,including one isolated from wild bamboo rats (Rhizomys pruinosus) in Guangxi region and one from a patient with penicilliosis marneffei,were cultured with or without the presence of 2.0 mmol/L hydrogen peroxide in potato dextrose agar (PDA) at 25 ℃ and in brain-heart infusion (BHI) broth at 37℃ for seven days.The shape of colony and growth of both strains were observed.Light microscopy was carried out to study the morphology,and transmission electron microscopy to observe the ultrastructure,of both isolates.Results Ater incubation with hydrogen peroxide,there was a slowdown in the growth of both Penicillium marneffei isolates at both mycelial phase and yeast phase,with an increase in the production of pigment at mycelial phase at 25℃.No obvious changes were observed at 37 ℃ in the morphology of either the clinical isolate or the bamboo rat isolate when cultured with hydrogen peroxide compared with those cultured without hydrogen peroxide.Light microscopy showed attenuated spore formation by the clinical isolate when cultured at 25 ℃ with hydrogen peroxide,crenation of both isolates when cultured at 37 ℃ with hydrogen peroxide.Under a transmission electron microscope,the mycelial cells of both isolates exhibited smooth cell walls,intact cell membranes,with nuclei,mitochondria,endoplasmic reticulum,lipid body,vacuoles of various sizes in the cytoplasm at 25 ℃,and even microbodies at 37 ℃,when cultured without the presence of hydrogen peroxide.After incubation with hydrogen peroxide,the cell wall of both isolates became incomplete with defects in some areas and uneven thickness,the cell membrane discontinuous with shrinkages and projections,and the cytoplasm was inhomogeneous with obvious phagocytosis and numerous phagocytic vacuoles.Conclusions The clinical and bamboo rat isolates of Penicillium marneffei experience different biological and morphological changes under oxidative stress,hinting differences in antioxidative mechanism between them.

Objective To explore the expression and significance of hsa-miR-181a (miR-181a) in can-ceration progression of endometrial carcinoma. Methods A total of 75 formalin-fixed paraffin-embedded tissue specimens were studied in this study , of which , 13 were normal endometrium , 18 were endometrial hyperplasia , 44 were endometrial carcinoma. After total RNA had been extracted , real-time PCR was applied to detect the ex-pression level of miR-181a in endometrial tissue in each group. Results miR-181a expression in formalin-fixed paraffin-embedded tissue specimens can be detected. Expression of miR-181a in endometrial carcinoma was high-er than that in endometrial hyperplasia , its expression in endometrial hyperplasia was also higher than that in normal endometrium, and the difference was statistically significant (P < 0.05). The expression of miR-181a in endometrial carcinoma was associated with FIGO stages (P < 0.05). Conclusion The up-regulation of miR-181a expression in women with endometrial carcinoma may play the role of oncogenes. Abnormal expression of miR-181a is probably associated with the occurrence and development of endometrial carcinoma.

Objective To study the clinical features and possible pathogenesis of acute ischemic stroke in renal cell cancer patients. Methods The clinical data from in-hospital patients with renal cell cancer who developed acute ischemic stroke were collected, including the patients with renal cell cancer who developed acute ischemic stroke during anti-cancer therapies and those patients with acute ischemic stroke who were firstly diagnosed to have renal cell cancer during anti-stroke therapies between January 2003 and December 2015. Results A total of 2516 patients with renal cell cancer were screened, and there were 36 patients (1.43%) with acute ischemic stroke. Out of the 36 patients, there were 29 men (80.56%) and 7 women (19.44%). Their age ranged from 45 to 68 years, with a average age of (65.11 ± 14.77) years. Eight patients (22.22%) had some conventional cardiovascular risk factors, while the other 28 patients (77.78%) had no such risk factors. Magnetic resonance imaging (MRI) scans at the acute stage of ischemic stroke were carried out for all these patients. Based on the diffusion weighted imaging (DWI) of MRI, 8 patients (22.22%) had single lesion and 28 patients (77.78%) had multiple lesions in different arterial territories in their brains. The pathological types of renal cell cancer were:suprarenal epithelioma (18 patients, 50.00%), papillary cell carcinoma (12 patients, 33.33%) and chromophobe renal cell carcinoma (6 patients, 16.67%). Metastases were found 10 patients (27.78%) out of the 36 patients. Blood biochemical examination showed that 28 patients had elevated plasma D-dimer level, 22 patients had elevated plasma cancer antigen (CA)125 level, and 17 patients had elevated plasma carcinoembryonic antigen (CEA) levels. Conclusions It is suggested that the renal cell cancer associated stroke is characterized by lacking of traditional risk factors and having multiple lesions in brain;and that the elevated plasma D-dimer, CA125 and CEA levels may lead to hypercoagulable state and lead to ischemic stroke eventually .

Objective To investigate the difference of apparent diffusion coefficients (ADCs) changes in three major salivary glands after gustatory stimulation using two different stimuli. Methods Thirty healthy volunteers were examined with a 1.5 T MR unit. A diffusion-weighted MR imaging (MR DWI) sequence was performed once at rest and continuously repeated 13 times after gustatory stimulation using a commercially available lemon juice and vitamin C tablets in the same volunteer by using self-controlled method. The subsequence of two stimuli was random. In addition, the salivary flow rates at rest and after stimulation were measured. Characteristics and differences in ADCs curves of three salivary glands before and after stimulation between two stimuli were analyzed. Comparison of maximum ADCs, maximum ADCs increase rates (IRs) and times to maximum ADCs(Tmax) between two stimuli was performed by using independent-samples t test. Correlation analysis between rest salivary flow rates and rest ADCs, the maximum salivary flow rates and ADCs after stimulation, the maximum salivary flow IRs and ADC IRs after stimulation were performed by using Pearson correlation test. Results In lemon juice stimulation group, the mean ADCs mostly showed a steady increase to peak values during the first DW MRI scan after stimulation in all glands, followed by a gradually decrease fluctuating slightly around the baseline values. In vitamin C stimulation group, the mean ADCs were significantly increased in all glands during the first DW MRI scan after stimulation, followed by a gradual upward trend till peak values. In lemon juice stimulation group, the mean Tmax of submandibular and sublingual glands[(184±122)s, (345±232)s, respectively] were significantly earlier than those[(454 ± 301)s, (528 ± 297)s, respectively] in vitamin C stimulation group (t=-3.517 and-2.548 respectively, P<0.01 for all). The mean maximum ADCs of three glands in lemon juice stimulation group[(1.05 ± 0.12) × 10-3 mm2/s, (1.22 ± 0.10) × 10-3 mm2/s and (1.26 ± 0.21) × 10-3 mm2/s, respectively] were all lower than those in vitamin C stimulation group[(1.13±0.13) ×10-3 mm2/s, (1.32±0.25) × 10-3 mm2/s and (1.57 ± 0.36) × 10-3 mm2/s, respectively], and the differences in parotid and sublingual glands between two groups were significant(t=-2.894 and-3.681 respectively, P<0.01 for all). The mean maximum ADC IRs of three glands in lemon juice stimulation group[(11.35±4.07)%, (8.81±5.40)%, (34.08±21.66)%, respectively] were significantly lower than those[(17.80 ± 12.72)%, (18.16 ± 18.93)%, (67.49 ± 46.04)% , respectively] in vitamin C stimulation group (t=-2.252,-2.330 and-3.432 respectively, P<0.05 for all) . In two groups, the mean maximum ADC IRs of parotid and submandibular gland were all significantly lower than sublingual gland (t=-5.994 and-6.443 respectively, P<0.01 for all). No correlation was observed between ADCs and salivary flow rates, ADC IRs and salivary flow rate IRs in two groups (P>0.05). Conclusion MR DWI with transient stimulation using lemon juice is more stable for evaluating the physiologic changes of salivary glands in vivo.

OBJECTIVE: To investigate the effect of Eustachian tube balloon dilation (ETBD) in treatment of eustachian tube related diseases. METHOD: Fifteen cases (20 ears) of otitis media with effusion and 22 cases (30 ears) of symptomatic Eustachian tube dysfunction were recruited. Technique of tubomanometry (TMM) showed obstructive Eustachian tube dysfunction in all patients. All the patients were received ETBD and followed up with VAS evaluation of ear fullness, muffled hearing, poping sound in the ear and tinnitus. And also the TMM change and middle ear effusion. RESULT: Ear fullness, muffled hearing released with 1 week (ear fullness: 8.2 ± 1.4 vs. 2.0 ± 1.2, P < 0.05, muffled hearing: 6.2 ± 1.2 vs. 3.1 ± 0.8, P < 0.05). No recurrence was seemed within 6 months. The eustachian function test turned better. Symptomatic Eustachian tube dysfunction had an effective rate of 96.6% while otitis media with effusion was 95.0%. CONCLUSION ETBD have good short-term effect in obstructive eustachian tube dysfunction related middle ear dysfunction, which might provide a good way to solve the eustachian tube related diseases.
Catheterization ; Ear Diseases ; Ear, Middle ; Eustachian Tube ; physiopathology ; Humans ; Otitis Media ; Otitis Media with Effusion ; Recurrence

Objective To verify the validity of standard air cushion inflation method, and to explore the relationship between patients' body mass index (BMI) and the optimal air cushion inflation pressure. Methods A total of 90 orthopedic patients who were treated in Liangxiang Hospital of Fangshan District in Beijing from June 2017 to March 2018 were randomly divided into experimental group and control group, with 45 cases in each group. The control group used air cushion bed routinely according to the experience of nurses, while the observation group used standard air cushion bed inflation method according to previous research. Comparing the skin pressure and the feeling of using the mattress softness and hardness between the two groups, and analyzing the relationship between the pressure value of the mattress and the BMI of the patients in the observation group, the regression equation was obtained.Results The local skin redness rate of the observation group was 4.4％, 2.2％ and 4.4％ after 2, 48 and 72 hours of using air cushion mattress, which was lower than that of the control group 22.2％, 31.1％ and 33.3％. The result was statistically significant (P<0.01). Within 72 hours, the satisfaction degree of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). The BMI of the patients in the observation group was linearly correlated with the optimal air cushion pressure (R2=0.962). The air cushion pressure (kpa)=3.835+BMI×0.379. Conclusions Reasonable adjustment of the pressure of the air cushion bed can improve the effect of using air cushion bed. The method of adjusting the pressure of the air cushion bed based on patient BMI is convenient for nurses to master and operate.

OBJECTIVE:To study the protective effect of fingolimod on renal ischemia reperfusion injury (RIRI) model mice and its mechanism.METHODS:A total of 60 mice were randomly divided into sham operation group,model group,fingolimod group (1 mg/kg) and fingolimod+wortmannin group [fingolimod 1 mg/kg+phosphatidylinositol 3-kinase (PI3K) specific blocker wortmarmin 1.4 mg/kg],with 15 mice in each group.Except for sham operation group,RIRI model was induced in other 3 groups,and those model mice were given relevant medicine via caudal vein at once 24 h before surgery.Serum of mice were collected in each group after 24 h perfusion.Serum levels of Scr and BUN were measured by automatic biochemical analyzer.The pathological changes of renal tissue were observed under light microscope.The protein expression of intercellular cell adhesion molecule-1 (ICAM-1),monocyte chemoattractant protein-1 (MCP-1) and phosphorylated protein kinase B (p-Akt) in renal tissue were measured by Western blot assay.RESULTS:Compared with sham operation group,the serum levels of Scr and BUN in model group were increased significantly (P＜0.01).Pathological changes were found in the kidney,and RIRI led to widespread renal tubular epithelial cell injury,apoptosis and inflammatory cells infiltration.The protein expression of ICAM-1 and MCP-1 in renal tissue were increased significantly (P＜0.01),the protein expression of p-Akt was increased slightly (P＞0.05).Compared with model group,other indexes of fingolimod group were improved significantly (P＜0.01) except that the protein expression of p-Akt in renal tissue was increased significantly (P＜0.01).Compared with fingolimod group,above indexes of fingolimod+wortmannin group were reversed (P＜0.05 or P＜0.01).CONCLUSIONS:Fingolimod can obviously ameliorate renal injury induced by RIRI in mice,the mechanism of which may be associated with the activation of PI3K/Akt signaling pathway.

Objective? To explore the effects of family participation in the respiratory rehabilitation of the patients with chronic obstructive pulmonary disease (COPD) in terms of their treatment compliance and outcomes. Methods? Totally 80 COPD patients admitted in The First Affiliated Hospital of Guangzhou Medical University from March 2016 to August 2017 were selected and divided into the control group (n=40) and the observation group (n=40) according to the random number table. Patients in the control group received conventional respiratory rehabilitation intervention, while the patients had their family members participated in the rehabilitation process in the observation group. Treatment compliance and effects were compared between the two groups. Results? The compliance of the observation group totaled 97.50%, while that of the control group totaled 87.50% (χ2=7.207, P＜ 0.05). After 3 months' intervention, the walking distance within 6 min of the observation group was (278.72±45.89) m; the PEF pred% was (93.46±13.47)%; and FEV1% was (87.42±14.71)%, better than those of the control group (t=4.127,7.156,3.859;P＜ 0.05). Conclusions? Family participation in respiratory rehabilitation process can improve the compliance of COPD patients significantly, thus improve the treatment effects, which is worth promoting in clinical practice.

Objective To study the relationship between tubomanometry(TMM) and tympanograms before and after the treatment of otitis media with effusion(OME) in children,and to evaluate the function of tubomanometry in forecasting the prognosis of OME.Methods Data from 66 patients(98 ears) were collected before and after one to four weeks treatment,all the patients received tympanometry and tubomanometry ETS,recorded eustachian tube scores(ETS) and tympanogram types.Results Before treatment,there were significant differences between the ETS of normal ears and sick ears,also between ETS of type B tympanograms and type C.There was significant difference between ETS before and after treatment,but not between the ETS of type B tympanograms and type C after treatment.The increased ETS value of type B tympanograms was higher than type C with a significant difference.There was a significant difference between the ETS of the effective group and the invalid group before and after treatment,whether type B tympanograms or type C.Conclusion Eustachian tube scores increased after treatment,and the functions of eustachian tube were improved in children of otitis media with effusion.Before treatment,the ETS of type B tympanograrns was lower than type C,indicating a poorer function of eustachian tube.After treatment,the increased ETS value of type B tympanograms was more than type C.Tubomanometry could forecast the prognosis of otitis media with effusion in children.