Objective To investigate the effects of kidney transplantation in sensitized recipients receiving conventional human leukocyte antigen(HLA) and cross-reactive groups(CREG) matching.Methods The HLA and CREG matching were used to select the best donors for 82 recipients with high titer of panel reactive antibody(PRA),and adjunctive application of plasma exchange and intravenous immunoglublin were conducted.Results The successful rate was 90%(74/82) and mortality rate was 1%(1/82).The incidence of hyperacute rejection,accelerated acute rejection,acute rejection and delayed graft function was 4%(3/82),6%(5/82),28%(23/82) and 21%(17/82),respectively.The incidences of acute rejection in groups of broad sensitized,HLA class Ⅰantibody positive recipients,HLA antibody positive recipients of post-transplantation and donor specific antibody were higher than those in groups of mild sensitized,HLA classⅡantibody positive recipients,HLA antibody positive recipients of pre-transplantation non-donor and specific antibody respectively(all P

Objective To report a case of black-dot ringworm caused by Trichophyton tonsurans in a 3-year-old girl. Methods Lesional hair was obtained from the patient and subjected to direct microscopic examination as well as culture. Subsequently, the isolate underwent morphological, biochemical and molecular biology identification. The extracellular enzymatic activity of the isolate was analyzed. Results Microscopy revealed that the hair shaft was filled with fungal spores. Typical colony of the isolate was grayish-white with downy appearance. Slide culture showed centipede-like, lateral, rod-shaped microconidia. Urease test was positive. The amplification of ribosomal DNA (rDNA) ITS domains by PCR produced a 687 bp-sized fragment which had a 100% homology with the sequences of several Trichophyton tonsurans strains in the GenBank database. The extracellular enzymatic activity analysis showed an increase in the activity of alkaline phos-phatase, acid phosphatase, esterase (C4), β-glucosidase, leucine arylamidase, N-acetyl-β-glucosaminidase and a-mannosidase. Conclusions The pathogenic fungus is identified as Trichophyton tonsurans based on morphological and biochemical features as well as sequence of the ITS region of rDNA, and the child was diagnosed with black-dot ringworm.

Objective To evaluate the late complications of continent ileocolic reservoir with an unaltered in situ appendix conduit and the management. Methods Thirty patients with bladder cancer who had undergone the surgery of continent ileocolic diversion with an unaltered in situ appendix conduit were followed up for 108 to 126 months (mean 118 months).The long-term post-operative complications were documented. Results The complications occurred as follows:urinary pouch superdistention in 5 cases,calculus formation in the urinary pouch in 6,difficulty with catheterization in 4,uerteral obstruction in 3,hemorrhage of the pouch in 1 and mild hyperchloremic acidosis in 1.These complications were managed accordingly and good results achieved. Conclusions Although continent ileocolic diversion with an unaltered in situ appendix conduit has a long-term efficacy,the complications occur frequently.The procedure needs further improvement.

Objective To study the cellular apoptosis and telomerase activity in bladder cancer before and after treatment with cell wall skeleton of bacillus Calmett Guerin(BCG CWS) and interleukin 2(IL 2). Methods The cellular apoptosis and telomerase activity of 33 cases of bladder cancer tissues were detected by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL) and telomeric repeat amplification protocol(TRAP) assay both before and after treated with BCG CWS and IL 2. Results The apoptosis index for bladder cancers before and after treatment with BCG CWS and IL 2 was (35.6?12.7)% and (79.1?11.3)% respectively, the apoptosis index being obviously increased after the treatments, P

A strain of Prototheca species isolated from a case of meningitis was identified by routine morphologic and biochemical methods as well as amplification of the related genes, in which the 28S large-subunit (LSU) region of ribosomal RNA (rRNA) gene and intergenic space (ITS) were amplified with universal fungal primers. The small-subunit (SSU) rRNA gene was amplified with eukaryote-specific primers and Prototheca genus-specific primers. Then, compared the sequences with the ones posted on BLAST (www. ncbi. nlm. nih. gov/BLAST). The organism choice giving the closest match, up to 99%, was considered the most likely correct identification. It was found that this strain of fungus grew well at 25 ℃ or 37 ℃. Smooth,moist colonies with white color were observed on Sabouraud Dextrose Agar (SDA) and Potato Dextrose Agar (PDA). Microscopically, globular or ovoid cells, a number of round, ovoid shaped endospores could be observed. No hypha, ascus or blastic conidia was found upon cultivation on SDA. Based on the morphological characteristics, this isolate could be identified as Prototheca species. The identity with Prototheca wickerhamii was 2.9 % as demonstrated by the API 20C AUX system. Sequence analysis showed that the ITS gene was proved to be a complex structural region which was not suitable for the identification of Prototheca species, but the LSU and SSU rDNA regions showed 94% and 99.9% sequence identities with Prototheca zopfii var. hydrocarbonea (P. zopfii var. hydrocarbonea) respectively, indicating that the SSU rRNA gene sequence might be more reliable on than the LSU rRNA gene sequence for identification of Prototheca species.

Objective To investigate the diagnosis and treatment outcomes of testieulax endodermal sinus tumor. Methods Twenty-four cases diagnosed with testieular endodermal sinus tumors from November 1996 to April 2007 were retruspeetively reviewed. Eighteen patients presented with stage Ⅰ disease, 4 presented with stage Ⅰ , and 2 presented with stage Ⅲ. Inguinal radical or-chieetomy were performed in all patients. Retroperitoneal lymph node dissection was performed in 8 ea-ses. Results The histological structures were rather complicated in 24 tumors. Twenty-three eases (96%) were found with reticular pattern, 22(92%) with hyaline body, 20(83%) with glandlike structure, 16(67%) with Shiller-Dural body, and 13(54%) with solid formation. The former 3 kinds were regarded as the main diagnostic criteria. Twenty-one eases were followed up for 20 months to 12 years. During the follow-up, 2 patients died of the disease. Condesions Early diagnosis and combi-nation therapy, including radical orehieetomy and chemotherapy, are the keys to improve the curative effect of testieular endodermal sinus tumors. Active surveillance of AFP is critical for monitoring the recurrence and metastasis of this tumor.

Objective To investigate the distribution of Malassezia species in lesional and non-lesion-al sites of patients with pityriasis versicolor(PV),species-variation in different anatomic sites and in lesions with different pigmentation,and the relationship between various Malassezia species and severity and age of PV patients.Methods A total of629skin specimens taken by sterile adhesive tape from the lesions and non-lesional skin were inoculated on media containing rapeseed oil in113patients with PV.Isolated colonies were identified to species based on physiological and morphological characteristics.Results The isolation rates of Malassezia spp.were not significantly different from both lesions and corresponding non-lesional skin.Among non-lesional sites,the isolation rate was significantly higher in forehead and trunk than that in upper and lower extremities.Five species were identified out of565strains obtained from the patients,including M.sympodialis(44.78%),M.furfur(32.94%),M.globosa(11.68%),M.obtusa(5.84%)and M.restricta(4.76%).Two dif-ferent species were isolated simultaneously from27sites.There was no obvious difference in species distribu-tion patterns between lesions and non-lesional sites.M.restricta was isolated from forehead exclusively.Species-variation was closely linked to lesions with different pigmentation and the age of patients,not to the severity of disease.Conclusion There is neither statistical difference of Malassezia isolation rate and species distribution between lesions and non-lesional skin,nor correlation between disease severity and species-varia-tion.The anatomic sites,the diversity of pigmentation pattern and the age of patients seem to be associated with different Malassezia species.

Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula.Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic fracture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively.The mean diameter of maximum urethrovaginal fistula was approximately 2.3 cm.The paries anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas,and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again.Results Fifteen patients were followed up for 6 to 80 months,and they gained normal voiding,with no urine leakage,urinary incontinence and urethral stricture occurring.Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.

Objective To examine the distribution of Malassezia species in follicular contents and perifollicular superficial skin in patients with Malassezia folliculitis and search for its causative agent. Methods A total of 120 patients with Malassezia folliculitis were investigated. Follicular lesions at three different anatomic sites were selected in each patient. Perifolliclar superficial skin specimens were taken by sterile adhesive tape, and the follicular contents of the same follicle were taken by sterile haemostatic forceps. The above specimens were cultured respectively on media containing rapeseed oil. The isolated colonies were identified by their physiological and morphological characteristics. Results Out of 319 isolates obtained from the perifollicular superficial skin, 247 isolates (77.43%) were identified as M. sympodialis, 40 isolates (12.54%) as M. furfur, 27 isolates(8.46%) as M. globosa and 5 isolates(1.57%) as M. obtusa. Out of 314 isolates obtained from follicular contents, 252 isdates(80.25%) were identified as M. globosa, 57 isolates(18.15%) as M. sympodialis, 4 isolates(1.27%) as M. furfur, and 1 isolate(0.32%) as M. obtusa. There was statistical difference in species distribution between the follicular contents and the perifolliclar superficial skin (P

Objectives To compare the difference between multipoint inoculation and routine method for isolation of pathogenic fungi from nail samples of onychomycosis,and to analyze the epidemiology of pathogenic fungi in those patients.Methods The nail clipping samples from each patient were inoculated onto the plates with Sabouraud's agar,Sabouraud's agar without cycloheximide and medium containing rapeseed oil,respectively,by an approach of at least seven inoculating points in each plate (multipoint inoculation),and onto medium slope in tubes with the same media as above mentioned (routine method).In the multipoint inoculation method,plates with more than 3 colonies were taken for further identification of pathogenic fungi based on morphological and biochemical properties.Results Based on the data from 150 samples of onychomycosis,significant differences were found between multipoint inoculation method and routine method (P