ObjectiveComparing gastric perforation repair with traditional contrast,to explore the feasibility and superiority of the laparoscopic gastric perforation repair.Methods68 cases were randomly divided into two groups for laparoscopic gastric perforation repair and traditional repair,then compared two groups of treatment.Results Both operations were successful ( including laparoscopic repair in 34 cases) and surgery time,blood loss,postoperative drainage,length of stay,and cosmetic results of the comparison.ConclusionCompared with the traditional open surgery,the laparoscopic surgery had less trauma,leas pain,faster recovery,shorter hospital stay,high efficacy and good cosmetic results and other advantages.

Objective To explore the effect of the treating left colon cancer,Compare left colon irrigation at one-stage radical colon resections were performed with the way which is given colon bracket insertion operation then two-stage radical colon resections were performed.Methods 32 cases sigmoid and rectum cancer patients with obstruction were received.And 14 cases were treated by colon irrigation at one-stage radical colon resections; 18 cases were treated by colon bracket insertion operation then two-stage radical colon resections were performed.To analyze the complications of after-operation、the average time in hospital.Results No occurence of anastomotic leakage was found in the two-stage radical colon resections.There was only one case was infected; the operation time(115 ± 26)min.The drainage in 3 days after the operation(127 ± 66)ml,length time(12.5 ± 3.2)d.The group of one-stage radical colon resections:the operation time(210 ± 39)min.The drainage in 3 days after the operation.length time(14.8 ±2.6)d,There was two cases of anastomotic leakage and 12 cases were infected and two dead were found in this group.Conclusion The way which was given colon bracket insertion operation then two-stage radical colon resections were performed,was better than colon irrigation at one-stage radical colon resections were performed,and with the first way patients life quality enhanced.

Objective To estimate the application value of colony PCR in the detection of pathogenic filamentous fungi. Methods Colony PCR was established and performed to amplify the internal transcribed spacer (ITS) region of 19 species (strains) of filamentous fungus followed by sequencing analysis. At the same time, DNA extracts from 8 of the 19 species of filamentous fungus were subjected to conventional PCR. Hha I and Hinf I endonucleases were used for restriction fragment length polymorphism (RFLP) analysis of the conventional and colony PCR products. Comparison analysis was carried out between the colony and conventional PCR. Results Of the 19 strains, 16(84.2%) yielded positive results by colony PCR; sequence analysis of the PCR products of ITS region revealed a 96% - 100% similarity with the reference sequence (NCBI database)of corresponding fungi. The amplification product length and RFLP profile of these products from the 8 species of filamentous fungus, except for those from Aspergillus nidulans, were consistent between the colony and conventional PCR. Conclusions Compared with conventional PCR, colony PCR-based detection of filamentous fungi is easy to operate, time and labor-saving, with high accuracy and reliability, and can be applied to the rapid identification of filamentous fungi.

A 19-year-old man was admitted to the hospital for erythema and nodules on the face and postauricular region for 6 years. Microscopic examination of lesion scrapings revealed brown septate hyphae. A restricted, velvety and black colony grew on Sabouraud's dextrose agar. Slide culture on potato dextrose agar plate showed flask-shaped phialides at the apex of or around the hyphae with clear collarettes and flaring apex,mucilage-encapsuled, round to oval, semi-endogenous phialosporae accumulating at the apex of the phialides,giving a flower-like appearance. Anti-fungal susceptibility test showed that the fungus was sensitive to itraconazole, terbinafine and amphotericin B, but resistant to fluconazole. Sequence analysis of the ITS1-ITS4 region revealed a 98% consistency with the reference sequence of ITS1-ITS4 of Phialophora verrucosa. On the basis of above findings, the patient was diagnosed with cutaneous phaeohyphomycosis. Clinical improvement was seen after treatment with oral itraconazole (400 mg/d).

Objective To investigate the efficacy and safety of butenafine hydrochloride 1% aerosol in the treatment of tinea pedis,tinea cruris or tinea corporis.Methods A randomized,double-blind,multi-center clinical trial was conducted.Efficacy was assessed in terms of mycological cure,total clinical sign and symptom scores,and clinical response,at baseline,mid-term,end of study,and 2 weeks after treatment.Results One hundred and seventeen patients with tinea cruris or tinea corporis were randomly allocated to individual groups treated with either butenafine 1% aerosol (n = 58,male 53,female 5,age 29.45 ? 11.80,course of disease 3.0 ? 5.0 months) or bifonazole 1% aerosol (n = 59,male 49,female 10,age 34.12 ? 12.98,course of disease 3.0 ? 11.0 months).One hundred and nineteen patients with tinea pedis were also allocated to two groups treated with either butenafine (n = 59,male 59,age 22.97 ? 3.97,course of disease 24.0 ? 36.0 months) or bifonazole (n = 60,male 60,age 23.77 ? 4.12,course of disease 36.0 ? 48.0 months).The cure rates and total response rates were 25.86% vs.40.68%,and 86.21% vs.91.53%,in the study group and the control group,respectively,at the end of study,and 58.62% vs.74.58%,and 96.55% vs.96.61% in 2 weeks following-up,for the patients with tinea cruris or tinea corporis.Also,the cure rates and total response rates were 23.73% vs.25.00%,81.36% vs.78.33%,in the study group and the control group,respectively,at the end of study,and 37.29% vs.41.57% and 81.36% vs.90.00% in 2 weeks following-up,for the patients with tinea pedis.Local adverse reactions were recorded in 13 of butenafine group,and 20 of bifonazole group.The differences of above data between two groups were not statistically significant.Conclusion Butenafine hydrochloride 1% aerosol is effective and well tolerated for the treatment of tinea pedis,tinea cruris or tinea corporis.

Objective To study the difference in pathogenicity and genotype between two isolates of Veronaeae botryosa with different temperature tolerance. Methods Two strains of Veronaeae botryose were isolated from two patients with phaeohyphomycosis in Jiangsu and Henan province respectively. Of them, the Jiangsu strain could grow well at 37 ℃, but Henan strain could not grow at 36 ℃. Eighty mice were equally classified into immunocompetent and immune-suppressed (induced by cyclophosphamide) groups to be inoculated with the two strains of Veronaeae botryosa respectively. Ten mice remained uninoculated and served as the control. The general condition, growth and organic involvement of mice were observed for 4 weeks followed by the killing of surviving mice. Homogenated tissue samples were obtained from liver, spleen, lung, kidney and brain; then, tissue culture, direct microscopy and pathological examination were performed. Genomie DNA was extracted from tissue samples and subjected to random amplified polymor-phic DNA (RAPD) analysis. PCR was performed to amplify the intemal transcribed spacer (ITS) of rDNA followed by sequencing Results Systemic phaeohyphomycosis was induced in both immunocompetent and immune-suppressed mice by the Jiangsu strain of Veronaeae botryose; the mortality was 30% in immune-competent mice and 65% in immune-suppressed mice with statistical significance between the two groups. In immune-suppressed mice inoculated with the Jiangsu strain, the infection rate was 100% in the lung,signifi-cantly higher than in other organs; on direct microscopy the infection rate reached 64.7% in the liver, and 70.5% on tissue culture. There was no significant difference in the infection rate among these organs in immunocompetent mice inoculated with the Jiangsu strain, with the infection rate being 57.8% in the lung and 42.1% in the liver. Increased infection rate was observed in the lung of immune-suppressed mice com-pared with immunocompetent mice (P < 0.05). No definite infection was seen in immunoeompetent or immune-suppressed mice innoculated with the Henan strain. RAPD analysis and sequencing revealed that there was a base variation (A/G) at position 236 of ITS gene between the two strains. Conclusions The two strains of Veronaeae botryosa have different genotypes. Systemic phaeohyphomycosis can be caused in immunocompetent and immuno-suppressed mice by the Veronaeae botryosa isolate from Jiangsu Province; the mortality was higher in immuno-suppressed mice than in immunocompetent mice. The pathogenicity of Veronaeae botryose is associated with the immune status of hosts. In immuno-suppressed mice, lung is the organ most susceptible to infection by Veronaeae botryosa.

Objective To report a case of vaginal colonization due to Trichosporon inkin. Methods A 34-year-old female presented with increased vaginal discharge accompanied by abnormal odor for 2 months. Clinical laboratory examination was carried out. Cultures of vaginal discharge yielded yeast-like colony. Subsequently, the isolate underwent the following mycological examinations: purification, slide micro-culture, temperature test, urea enzyme test, biochemistry identification, antifungal susceptibility test, and gene sequencing. Results Gynecological examination revealed white homogeneous secretions attached to mucous membrane of the vagina. Nugent scores of vaginal discharge amounted to 5-6. Two rounds of culture of vaginal discharge resulted in stramineous, reductus and yeast-like colony. The isolate could grow in 42 ℃. Appressorium on the top of hypha and typical sarcinae formed in slide microculture of corn agar, and yeast malt agar was the optimal growth medium for it. Urea enzyme test was positive. API 20C AUX biochemical test and gene sequencing revealed that the isolate was consistent with Trichosporon inkin. The isolate was sensitive to amphotericin B and azoles such as clotrimazole and fluconazole, but resistant to flucytosine and caspofungin. Conclusions It is the first report of vaginal colonization due to T. Inkin in China. The accu-rate identification of T. Inkin relies on synthetic analysis of phenotype characteristics, biochemistry test and molecular sequencing.

Objective To genotype Trichosporon spp. with rDNA-ITSAGSl-RFLP analysis followed by cluster analysis, and attempt to apply this method to rapid species identification of human pathogenic Trichosporon spp.. Methods Fourteen strains of Trichosporon, which belonged to 8 species, were collected. The rDNA-ITS/IGSl regions were amplified by PCR and sequenced. Simultaneously, the amplicons were digested separately with restriction enzymes, including Hae III, Hha I , Hae IH and Hha I , Hinf I , Msp I and Taq I . Results The 8 species of Trichosporon could be classified into 4 subgroups with rDNA-ITS-RFLP, while inter-species identification of all the 14 strains from 8 species of Trichosporon could be realized with rDNA-IGSl-RFLP. Also, those genotypes of T. asahii which had relative long phylogenic distance could even be discriminated with rDNA-IGSl-RFLP. Conclusion The rDNA-ITS/IGSl-RFLP analysis is expected to be used in rapid interspecific identification of genus Trichosporon.

Objective To develop a PCR-RFLP method to rapidly identify filamentous fungi causing deep infection. Methods Universal fungal primers were used to amplify the internal transcribed spacer (ITS) region of Aspergillus fumigatus, Aspergillus Bavus, Aspergillus terreus, Aspergillus niger, Aspergillus versicolor, Aspergillus nidulans, Scedosporium apiospermum and Fusarium moniliforme followed by restriction fragment length polymorphism (RFLP) analysis with restrictive endonucleases Hha I, Hae III, Hinf I, Taq I and Msp I. Then, 22 clinical and 2 environmental fungal isolates were identified with the developed PCR-RFLP method. Results The RFLP analysis of PCR products with restrictive endonucleases Hha I and Hinf I allowed discrimination of 8 filamentous fungi causing invasive infection, and it took only 1 day to carry out the whole procedure from DNA extraction to PCR and restriction digestion. The identification results of 22 clinical strains and 2 environmental isolates with this PCR-RFLP method were completely consistent with those with conventional morphological method. Conclusion PCR-RFLP analysis is an efficient method for rapid identification of cultured filamentous fungi.

A 76?year?old female patient complained of right chest pain for three months. CT scan showed a clump?like high?density shadow measuring 4.8 cm × 3.0 cm in size in the dorsal portion of the right lower lobe of the lung. Aspiration biopsy was performed, and biopsy samples were subjected to fungal culture and histopathological examination. Histopathological examination showed chronic granulomatous inflammation with hyaline septate hyphae. After 4?day culture, white villous dense colonies were formed on the Sabouraud′s agar medium. The center of the colonies was slightly elevated with wrinkles or radiating striae on the surface, and the bottom of the colonies was faint yellow in color. Microculture yielded abundant septate branched hyphae, and very few colorless hyaline quasi?circular spores. DNA sequencing of rDNA internal transcribed spacer (ITS) regions and β?tubulin genes was performed to identify the isolate, and antifungal susceptibility testing was carried out in vitro. The MEGA7.0 software was used to build phylogenetic trees of Aspergillus fumigatus complex and its closely related species. The isolate was identified as Aspergillus fumigatus by molecular biologic sequencing. The patient was diagnosed with pulmonary aspergilloma. After administration of itraconazole oral solution and vorionazole tablets, the condition got better obviously.