Improvement of early and specific diagnosis of fungal infection is the key point remains to be resolved in the clinical mycology field.Besides the basic mycological methods,there is an urgent needs to develop the new diagnosis assays such as the non-culture methods for detection of the fungal antigen and nuclear acid.The prospective study performed by multiple-center is quite necessary to better standardize these methods.The role of clinical mycology laboratory should be fully emphasized.Through the setting up of standardized mycological diagnosis system and the application of modernized methods,and the diagnosis of funsal infection could be improved.

Objective To develop a new specie-specific nest PCR to diagnose the invasive aspergillosis and to estimate the detection of circulating galactomannan by sandwich ELISA in immunocompromised patients. Methods (1) To develop an animal model of IA and collect the whole blood and tissues from the animal model. To extract the DNA from the whole blood and perform nest PCR of the DNA ;To perform the nest PCR of the clinical blood samples from immunocompromised patients (2)To detect the circulating galactomannan from the immunocompromised patients samples by use of sandwich ELISA. Results (1) In animal model, the positive rate of nest PCR and blood culture were 77.8% and 16.7%;The sensitivity and specificity of nest PCR in animal model with invasive aspergillosis are 77.8% and 100%;(2) The sensitivity and specificity of nest PCR in immunocompromised patient were 100% and 83.3%;The sensitivity and specificity of sandwich ELISA in immunocompromised patient were 55.6% and 88.2%. Conclusions The positive rate of the nest PCR was higher than that of the blood culture in animal model. The nest PCR method has good sensitivity and specificity in both animal model and patients. It will be a promising method in diagnosis of invasive aspergillosis. The ELISA method will be helpful in diagnosis of invasive aspergillosis.

Interleukin (IL) -17A plays a key role in the occurrence and development of psoriasis. To date, several marketed IL-17A and its receptor antagonists have been applied to the treatment of psoriasis, and definite therapeutic effects have been achieved. However, several adverse reactions, including upper respiratory tract infection, Candida infections, neutropenia, inflammatory bowel disease, which can be life-threatening, have been reported in clinical trials and after marketing of these biologics. This review summarizes clinical safety profiles of 3 types of interleukin-17A and its receptor antagonists, i.e., secukinumab, ixekizumab and brodalumab.

ObjectiveTo prevent late cerebral ischemic stroke by carotid endarterectomy (CEA). Methods From Dec. 1995 to Dec. 2000, CEA was performed under local anaesthesia for 30 patients with more than 50% of carotid stenosis detected by MRA. Stemp index (SI) was measured before carotid was clamped. Temporary intraluminal shunts were used in cases with demonstrated contralateral carotid occlusion, prior cerebrovascular accident (CVA), or SI less than 40. Results At follow-up of 3～36 months, 97%(29/30) patients were at satisfactory condition, and one died perioperatively from cardiac insufficiency, and severe respiratory infection.Conclusion CEA effects a definite prevention for cerebral stroke in patients with severe carotid stenosis.

To investigate the DNA typing of Trichophyton mentagrophytes,and to find the relation- ship of DNA type with morphology,teleomorph type,the geographic origin and the sites of infection. DNA extraction was carried out by using benzyl chloride and random amplification of polymorphic DNA (RAPD)assay was employed for DNA typing of 42 strains of T.mentagrophytes isolated from clinical specimens and some other dermatophytes,also 8 preserved strains of Arthroderma.Results:(1)Forty two isolates of T.mentagrophytes can be classified into 3 main types,and the intratype polymorphism has been revealed with some primers.(2)There is no simple relationship between DNA type and mor- phology,but the DNA types are closely related to the geographic origin,and the isolates from different sites of infection have their own genotype characteristics.(3)DNA patterns of Arthroderma benhamiae and A.vanbreuseghemii are distinctly different,while 42 clinical isolates of T.rnentagrophytes share sim- ilar pattern with A.vanbreuseghemii.The clinical isolates of T.mentagrophytes can be divided into 3 types by RAPD,and its DNA type has certain relationship with morphology,teleomorph type,the geo- graphic origin and ttie sites of infection.RAPD provides an useful tool for the pathogenic diagnosis and epidemiology study to investigate the source of infection,and geographic distribution of strains.

Objective To study the curative effect of transurethral incision for male urethral stricture or atresia. Methods A retrospective) review was made on 55 male patients with urethral stricture or atresia treated by transurethral incision. Results The success rate of the operation on one session was 90.9% (50/55), while the remaining 5 patients were cured by two times of operations.Forty-seven patients were followed for 6~12 months (mean,10 months).Urethral dilatation was performed for once within 1 week after the remorval of catheter in 10 patients,for 3~5 times within 3 months after operation in 21 patients,and after the third postoperative month in 16 patients. Conclusions Transurethral incision for male urethral stricture or atresia is effective.

Objective: To compare the biotype and genetic similarity between groups of commensal and pathogenic strains of candida species. Methods:Random amplified polymorphic DNA (RAPD) was used to analyse the type of Candida albicans. Results: 12 pathogenic isolates of Candida albicans, 3 commensal isolates of Candida abicans and 3 isolates of pathogenic non-albicans were obtained. The similarity coefficient of albicans with non-albicans was 51.7% by RAPD. Intra-candida similarity coefficient was more than 70%. Both the commensal and pathogenic isolates showed the genetically similar to C. albicans. Intro-isolate DNA polymorphism was observed by RAPD. Conclusion: Both the commensal and pathogenic groups contain a major cluster of genetically similar C. albicans isolates.

Objective Through isolating the histidine kin ase gene of Aspergillus fumigatus,to detect its role in the invasive aspergillosis.Methods Using degenerate primers for highly conserved regions of his-tidine kinase,RT -PCR was performed with cDNA of Aspergillus fumigatus as a template.The gene expression of it in vitro and in vivo was investig ated by Northern blot.Results A fragment of this gene was cloned fro m Aspergillus fumigatus that is highly homologous to tesA gene of Aspergillus nidulans,which was expressed at high level during invasive infection.Conclusion The results indicate that this gene may attribute to the invasive aspergillosis.

Objective To study the molecular identification method of Candida species and lay the foundation of molecular diagnosis for deep candidiasis. Methods PCR was used to amplify the internal transcribed spacer region of ribosomal DNA from 11 type strains of 9 pathogenic Candida spp. and 39 clinical Candida isolates, and the products were digested with three types of restriction endonucleases (MspⅠ,DdeⅠand HaeⅢ). Results Five patterns of products with different molecular weights were obtained after amplification from 9 Candida spp., and the products were digested with MspⅠ, DdeⅠand HaeⅢ, producing 8, 5 and 4 unique band patterns, respectively. Conclusion PCR-RFLP is reliable, specific and useful for the identification of common pathogenic Candida species.

Objective To study the molecular identification method of Sporothrix schenckii based on the nucleotide sequences in internal transcribed spacer region 2 of ribosomal DNA (rDNA) genes. Methods Species-specific primers were used to amplify the internal transcribed spacer region 2 of rDNA of 22 clinical isolates of Sporothrix schenckii and 12 strains of dematiaceous fungi. Totally 11 strains of Sporothrix schenckii were sequenced and analyzed, in which 1 strain came from the US and the others were isolated from different areas in China. A pair of species-specific oligonucleotide primers (SSP) were designed based on the ITS2 sequence. With the species-specific primers, rDNA of Sporothrix schenckii and dematiaceous fungi were amplified by PCR. Results Sequencing and analysis showed that internal transcribed spacer region 2 of rDNA gene was conservative in Sporothrix schenckii. A 300 bp fragment was obtained from 22 strains of Sporothrix schenckii, but not from the other species. Conclusions This method is specific, sensitive and reliable for the identification of Sporothrix schenckii and could be used for clinical molecular diagnosis.