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.

This paper reports reaction of Bacillus lichendermis on the inhibitor vacations. The result Shows that, inhibition of the 500?g/mL of cephalosporin 1000?g/mL of penicillin, 500?g/mL of streptimycin, on the Bacillus Licheniformis,Whe the Phis 7.0. This provides a sicentific basis for using the preparation of Bacillus licheniformis.

ObjectiveTo compare the differences in stroke subtype classification between ASCO and modified TOAST.MethodsAll 425 first-ever ischemic stroke patients were recruited and classified into different stroke subtypes according to the ASCO and modified TOAST criteria.Results Comparing ASCO grade 1 with modified TOAST,more patients were classified as atherosclerosis (60.2％ vs 57.9％ ; x2 =2.68,P=0.132) and fewer as small artery disease and cardiac disease subtype (13.4％ vs 14.8％ and 8.5％ vs 8.7％ ; x2 =1.30 and 0.00,P =0.238 and 1.000,respectively).ASCO grade 1 did not reduce the proportion of cause undetermined patients compared with modified TOAST ( 15.5％ vs 16.2％ ; x2 =0.09,P =0.795 ). Agreement was showed in every subtype categories between the two approaches.Agreement for atherosclerotic cause and small artery disease was very good ( all κ over 0.81 ),and for the cardiac disease subtype was good (κ: 0.61-0.80). Conclusion Agreement can be found in every subtype categories between ASCO and modified TOAST classification.ASCO grade 1 does not reduce the proportion of cause undetermined cases compared with modified TOAST,but the subtype categories characteristics of the two approaches should be considered in practice.

Objectives To explore the correlation between lipoprotein (a) and left main coronary artery ( LMCA) disease in patients with acute coronary syndrome (ACS). Methods A total of 264 ACS patients managed with coronary angiography (CAG) from June 2012 to December 2013 were included in the study and then they were divided into 2 groups (high-Lp(a) (> or = 300 mg/L) group (n = 93) and low-Lp(a) (< 300 mg/L)group(n = 171). The clinical data were studied and compared between the two groups. Binary unconditional logistic regression analysis was used to select the risk factors of LMCA disease. Results The percentages of multiple branch lesion (43.0% vs. 25.1%) and LMCA disease (17.2% vs. 8.2%)were higher in the high-Lp(a) group as compared with the low-Lp(a) group (P<0.05). Logistic regression analysis showed Lp(a) was independent factor of LMCA disease. Conclusions In ACS patients the elevated Lp(a) levels are associated with the severity of coronary disease and Lp(a) is an independent factor of LMCA disease.

Objective To observe the effects of exogenous basic fibroblast growth factor (bFGF) on radiation-induced apoptosis of C17.2 neural stem cells (NSCs) with γ-secretase inhibitor (DAPT) condition and explore the relationship between bFGF and Notch signal pathway.Methods The cell viability was detected by using the MTF method.After the cells attached to the flasks,different concentrations of DAPT was added in accordance with the experimental design and cultured cells for 24 h.C17.2 NSCs were subjected to irradiation exposure by linear accelerator and treated with bFGF (40 ng/ml) 5 min after the exposure.After 48 hours,the apoptosis of cells was detected by using Flow Cytometry.Results After adding in DAPT,the cells growth was inhibited and depended on the concentrations of DAPT.Compared with the control group,all groups had statistically significant differences(P＜0.05).Flow cytometry showed compared with the control group all groups had significant differences (P＜0.05).The apoptosis rate was (11.53±0.81)％ in radiation group,(7.18±0.0.94)％ in radiation+bFGF group,(9.82±0.77) ％ in DAPT group,(21.45±0.98) ％ in Radiation+DAPT group and (10.26+ 1.03) ％ in Radiation+ DAPT +bFGF group.Between Radiation + bFGF group and Radiation group,it had statistically significant difference(P＜0.05).The pairwise comparisons of DAPT group and Radiation + DAPT group which had the same DAPT concentration had statistically significant differences (P＜0.05).The pairwise comparisons of Radiation + DAPT+bFGF group and Radiation + DAPT group which had the same DAPT concentration had statistically significant difference(P＜0.05).Conclusion Fx ogenous bFGF can inhibit apoptosis of C17.2 NSCs.Notch signaling patbway inhibitor DAPT can promote apoptosis of C17.2 NSCs which are subjected to irradiation exposure by linear accelerator and bFGF can weak apoptosis.bFGF protective effect on radiation-induced neural stem cells may be related to the Notch signaling pathway.

Objective To observe the effects of Zhuyunjiaonang on morphological change of the ovary, serous hormone and the expression of P450arom in PCO model rats. To explore its target and mechanism in treating PCO model rats. Methods Using INS and HCG to establish PCO model. The PCO rat models were devided into 4 groups randomly, which included control group, model group, Zhuyunjiaonang group and mefformin group. Zhuyunjiaonang group was given 3.0 g/(kg ? d) Zhuyunjiaonang, mefformin group was given 0.75 g/(kg ? d) metformin, control group and model group were given same volume distilled water 1 mL/100 g. The effects of Zhuyunjiaonang on ovaries and ovarial follicular development were observed by light microscope. The levels of serum gonadal hormone were detected by radioimmunoassay. The expression level of P450arom was detected with immtmohistochemical staining technique. Results Zhuyunjiaonang could increase the thickness of granular cell layer and decrease the thickness of theca cell layer, decrease the level of T and LH, and increase the level of FSH and E_2 in serum. Meanwhile the expression of P450arom in ovary were increased. Conclusion Zhuyunjiaonang could indirectly or directly affect the expression of the P450arom in ovary, it could regulate the endocrine function of PCO rat and promote the mature and ovulation of follicular.

To evaluate initial experience with shape memory alloy stent as an alterative to colostomy in patients with intestinal obstruction by colorectal cancer, forty four patients diagnosed with acute and chronic colorectal obstructions from malignant causes were subjected to stent placement. Among them 41 patients achieved clinical decompression. Thirty three cases died within 51～720 days and the other 5 cases were still alive without intestinal obstruction for 1～8 months. Our conclusions are shape memory alloy stent may be useful in the management of terminal or high risk surgical patients for palliative purposes instead of colostomy. Palliative management by stent placement combined with chemotherapy and immunotherapy might prolong the survival time of these patients. Placement of stent for acute colorectal bowel obstructions facilitates preoperative bowel preparation for surgical resection and obviates the need for fecal diversion or on table lavage.

Objective To investigate the relationship between the leptin level and neonatal weight and the expression of leptin in placenta. Methods The concentrations of leptin in 100 maternal blood and umbilical blood of the term pregnant women were examined by radioimmunoassay (RIA). According to the neonatal weight to divide into the large for gestational age (LGA) group 19 cases, the appropriate for gestational age (AGA) group 65 cases, the small for gestational age (SGA) 16 cases. The level of leptin mRNA in 41 placental tissue was examined by Reverse transcription polymerase chain reaction (RT PCR). Results (1) The expression level of leptin mRNA in placenta was 0 97?0 04, which was positively related to the neonatal weight significantly ( r =0 43, P 0 05).(3)The concentration of leptin in umbilical blood was (7 58? 5 15) ?g/L, which was positively related to the neonatal weight ( r =0 57, P

Objective To investigate the effect of delayed PTCA and stenting for infarct related artery on the chronic phase of left ventricular remodelling and cardiac events in patients with acute myocardial infarction. Methods Fifty two patients with primary acute myocardial infarction were divided into PTCA group ( n =27) and non PTCA group ( n =25). Twenty seven patients underwent PTCA and coronary stenting with an average of 12 days after the acute onset. Left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) and cardiac events in each group were followed up. Results There were no significant differences in preoperation and postoperation for LVEDV and LVESV in the PTCA group, on the contrary a significant increase for before and after follow up for LVEDV and LVESV in the non PTCA group( P 0.05). Conclusions Delayed PTCA and stenting for infarct related artery would inhibit ventricular enlargement and delay chronic phase of left ventricular remolding. Moreover, cardiac events were significantly reduced in patients with acute myocardial infarction after delayed PTCA and stenting.

Objective To investigate the relationship among 18 F-fluorodexyglucose (FDG) PET, pattern of lipiodol retention CT and serum ?-fetoprotein(AFP) in evaluating the effect of transcatheter arterial chemoembolization(TACE) for hepatocellular carcinoma (HCC). Methods TACE was performed in thirty-five patients with HCC. 18 F-FDG PET and lipiodol-CT examination were performed after TACE, and thus the patterns of lipiodol retention, and the tumor necrosis rates semi-quantitatively by 18 F-FDG PET were obtained with simultaneous calculation of the decrease percentage of serum AFP before and after TACE. Results The patterns of lipiodol retention were divided into four types; A. dense type (n=12), B. rarity type (n=13), C. scattering type (n=7) and D. empty type (n=3). The positive correlation between the tumor necrosis rate (7%～95%) and the decrease percentage of AFP(0～100%) were found (r=0.761 P