Objective To investigate the genotype and antifungal susceptibility of AspergiIlus species isolated from clinical settings and environmental sources. Methods Random amplification of polymorphic DNA (RAPD) analysis was performed to profile the genotypes of 48 Aspergillus fumigatus strains, 59 Aspergillus flavus strains and 30 Aspergillus niger strains isolated from clinical settings and environmental sources. NCCLS M38-A protocol was carried out for antifungal susceptibility testing of these Aspergillus isolates. Results As RAPD analysis showed, the 48 Aspergillus fumigatus strains were classified into 8 genotypes, 59 Aspergillus flavus strains into 12 genotypes, and 30 Aspergillus niger strains into 5 genotypes. A significant difference was observed in the susceptibility to terbinafine among the 8 genotypes of Aspergillus fumigatus (χ2 = 33.092, P ＜0.01 ) as well as in that to amphotericin B among the 5 genotypes of Aspergillus niger (χ2 = 15.185, P＜ 0.05).No statistical difference was found in the susceptibility to amphoteriein B, itraconazole, fluconazole or flucytosine among the 8 genotypes of Aspergillus fumigatus or in that to terbinafine, itraconazole, fluconazole or flucytosine among the 5 genotypes of Aspergillus niger. Conclusion There is some difference in the susceptibility to some antifungal agents between different genotypes of Aspergillus fumigatus and Aspergillus niger.

OBJECTIVETo investigate the clinical efficacy of Panlongqi tablet (Chinese characters) combined with lumbar facet joint release for lumbar spinal stenosis of type Fengshi Bizu (Chinese characters).

METHODSSince February 2012 to February 2013, 120 patients with lumbar spinal stenosis of Fengshi Bizu (Chinese characters) syndrome were retrospectively studied. According to different treatment methods, 120 patients with lumbar spinal stenosis were divided into Panlongqi tablet (Chinese characters)group and control groups, respectively. In Panlongqi tablet (Chinese characters)group, 60 patients were treated by Panlongqi tablet (Chinese characters) combined with lumbar facet joints release solution including 26 males and 34 females with an average age of (60.40±3.36) years old ranging from 46 to 65 ; the course of the disease was 2 to 15 years (averaged 7.6 years). In control group the other 60 patients were treated with lumbar facet joint release including 24 males and 36 females with an average age of (61.20±2.47) years old ranging from 48 to 63; the course was 3 to 14 years (averaged 6.9 years). The clinical effect of patients were evaluated by JOA and ODI score before treatment, at 4 weeks and 3 months after treatment.

RESULTSAll patients were followed up for 4 to 7 months (means 5.6 months). After 3 months,7 cases in control group recurrenced symptoms,only 1 case in Panlongqi tablet (Chinese characters) group recurrenced. At 4 weeks and 3 months of follow-up, ODI score and JOA score of Panlongqi tablet group were much better than those of the control group.

CONCLUSIONFor lumbar spinal stenosis of type Fengshi Bizu (Chinese characters),which were treated with lumbar facet joint release with Panlongqi tablet(Chinese characters), supplemented by back muscle exercise, in relieving waist and low back pain symptoms and improving functional status of lower lumbar spine, can obtain satisfactory clinical outcome, is a good method of conservative treatment for such diseases.

Aged ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Exercise Therapy ; Female ; Humans ; Lumbosacral Region ; physiopathology ; Male ; Middle Aged ; Punctures ; Retrospective Studies ; Spinal Stenosis ; drug therapy ; physiopathology ; therapy

Objective:This study aims to compare the difference in the expression levels of prostaglandin E2 (PGE2), vascular endotheli-al growth factor (VEGF), and the clinicopathological features among gastric carcinoma patients with and without hyperlipidemia and to assess whether hyperlipidemia promotes gastric carcinoma progression. Methods:We analyzed the PGE2 and VEGF serum levels and the VEGF expression in gastric carcinoma tissues in 102 gastric carcinoma patients. The PGE2 and VEGF serum levels were detected by enzyme-linked immunosorbent assay, and the VEGF expression in gastric carcinoma tissues was detected by SABC immunohistochemi-cal staining. Results:Among the 102 gastric carcinoma patients, 49 patients had hyperlipidemia, and 53 did not have the condition. The PGE2 and VEGF expressions in the serum and the VEGF expression in gastric carcinoma tissues were higher in hyperlipidemic pa-tients than in those without hyperlipidemia (P<0.05). The degrees of differentiation, depths of invasion, lymph node metastasis, and TNM staging in the two groups also showed statistical differences (P<0.05). Conclusion:Hyperlipidemia possibly contributes to the pro-gression of gastric carcinoma by upregulating the PGE2 and VEGF expressions.

OBJECTIVE To supervise the environmental fungal load and species distribution in transplantation department and intensive care unit of the Southwest Hospital,and to analyze the relationship with season,temperature,humidity,ventilation and personnel activities.METHODS Data from Dec 2005 to Jan 2006 were collected from liver transplantation department(LTD),cerebral surgery intensive care unit(CSICU) and central intensive care unit(CICU).Air,surfaces and tap water were sampled twice a month at each department.RESULTS The air fungal load was 123.63 CFU/m3,139.90 CFU/m3,7 CFU/m3 and 217.71 CFU/m3 at LTD,CSICU,CICU and outdoor,respectively.The five most prevalent fungi collected from air and surface were Penicillium spp,Cladosporium spp,Alternaria spp,Aspergillus spp and Saccharomyces spp in turn.The five most prevalent fungi collected from water were Saccharomyces spp,Candida spp,Aspergillus spp,Penicillium spp and Rhodotorula spp in turn.The fungal load in LTD was positively correlated with the average temperature and the average humidity;the fungal load in CSICU was correlated with the average temperature and the average humidity,but the correlation between air fungal load and personnel activities wasn′t observed.CONCLUSIONS It demonstrated the fungi are found in the environment of the hospital including air,surface and water.The air fungal load varies throughout the year.The crest-time is May to June and September to October.Air fungal load is lower in winter and higher in summer and autumn.The correlation between air fungal load and temperature and humidity is observed.

Objective To investigate the inhibitory effect of agonistic CD40 monoclonal antibody on the colon cancer cells (HCT116) proliferation in vitro.Methods The DCs (dendritic cells) loaded with tumor cells (HCT116) antigens were activated by different methods.According to the activation method,the cells were divided into three groups:agonistic CD40 monoclonal antibody group,blank control group and TNF-α positive control group.The cells were cultured for 7 days,and the expression rates of CD80,CD83,CD86 and HLA-DR on DC surface in each group were detected by flow cytometry.The concentration of cytokine IL-12(p70) in DCs culture supernatant was determined by ELISA kit.The proliferation activity of the T lymphocytes was evaluated by MTT (methyl thiazolyl tetrazolium).Then the inhibition rate of colon cancer HCT116 cells proliferation,which induced by the tumor-specific effector T lymphocytes,was assayed.Results Compared with the blank control group,the agonistic CD40 monoclonal antibody group had a significantly higher expression rates of CD80,CD83,CD86 and HLA-DR on DC surface (P＜0.05).The concentration of IL-12 in the supernatant of DC was also much higher in the agonistic CD40 monoclonal antibody group (P＜0.05,(716.80±53.43) pg/ml vs.(405.51 ±12.17) pg/ml).The DCs activated by CD40 monoclonal antibody had stronger ability to stimulate proliferation of T lymphocytes (P＜0.05,the stimulation index was (2.006 2±0.438 3) to (1.365 0±0.209 8)).The tumor-specific CTLs induced by DCs in the agonistic CD40 monoclonal antibody group had stronger ability to inhibit colon cancer HCT116 cells (P＜0.05,the inhibition rate was (66.08±0.41)％ vs.(46.60± 1.10)％).However,there was no statistical significance between the agonistic CD40 monoclonal antibody group and the TNF-α positive control group (P＞0.05).Conclusion Agonistic CD40 monoclonal antibody in vitro can promote activation and mature of DCs,then the activated DCs can induce the production of tumor-specific CTL,which can significantly inhibit the proliferation of colon cancer HCT116 cells.

Objective To explore the possible relationship between environmental contamination by Aspergillus and invasive aspergillosis.Methods From November 2005 to October 2006,samples were collected from the environment (air in corridors,air in wards,surfaces and tap water) twice a month,and from patients (nose,pharynx and sputum) at a liver transplantation department (LTD),neurologic surgery intensive care unit (NSICU) and central intensive care unit (CICU) in our hospital,and subjected to fungal culture.The Aspergillus density was determined in these environments.The isolates of Aspergillus flavus were genotyped by random amplification of polymorphic DNA (RAPD) assay to investigate the origin of infection.Results The mean aspergillus density was 12,10.75,0 and 20 cfu/m~3 at LTD,NSICU,CICU and corridors respectively.The five most prevalent species of aspergillus in these environments in decreasing order were Aspergillus flavus,Aspergillus fumigatus,Aspergillus niger,Aspergillus versicolor and Aspergillus clavatus.RAPD demonstrated that the genotypes ofA.flavus isolated from two patients were identical to those of the environmental strains in NSICU.The A.flavus genotypes from 3 patients in CICU were all different from those of the environment strains in CICU,but the genotypes were identical from two of the three patients.Conclusions Aspergillus contamination of different degree does exist at LTD,NSICU and CICU. The genotypes of A.flavus are identical from patients and environment in NSICU,suggesting that the clinical infection may originate from hospital environment.

BACKGROUNDInvasive fungal infections have constituted an increasingly important cause of morbidity and mortality in immunocompromised patients. In this study, a surveillance project was conducted in three different intensive care units of two large tertiary hospitals in China.

METHODSA one-year surveillance project was conducted in two tertiary hospitals which located in northern China and southwest China respectively. Air, surfaces and tap water were sampled twice a month in a central intensive care unit, a bone marrow transplant unit, a neurosurgery intensive care unit and a live transplant department. Environmental conditions such as humidity, temperature and events taking place, for example the present of the visitors, healthcare staff and cleaning crew were also recorded at the time of sampling.

RESULTSThe air fungal load was 91.94 cfu/m(3) and 71.02 cfu/m(3) in the southwest China hospital and the northern China hospital respectively. The five most prevalent fungi collected from air and surfaces were Penicillium spp., Cladospcrium spp., Alternaria spp., Aspergillus spp. and Saccharomyces spp. in the southwest China hospital, meanwhile Penicillium spp., Fusarium spp., Aspergillus spp., Alternaria spp. and Cladospcrium spp. in the northern China hospital. The least contaminated department was intensive care units, and the heaviest contaminated department was neurosurgery intensive care unit. Seventy-three percent of all surfaces examined in the northern China hospital and eighty-six percent in the southwest China hospital yielded fungi. Fifty-four percent of water samples from the northern China hospital and forty-nine percent from the southwest China hospital yielded fungi.

CONCLUSIONSThese findings suggested that the fungus exist in the environment of the hospital including air, surface and water. Air and surface fungal load fluctuated over the year. Air fungal load was lower in winter and higher in summer and autumn, but seldom exceeded acceptable level. The higher values were created during May to August in the northern China hospital and May to June and September to October in the southwest China hospital. A correlation between air fungal load and humidity, as well as personnel was observed.

Air Microbiology ; China ; Environmental Monitoring ; methods ; Fungi ; isolation & purification ; Hospitals ; Intensive Care Units ; Water Microbiology

Objective To evaluate the effectiveness of treatment for osteoarthritis of the first carpometacarpal joint.Methods From June 2019 to June 2022,15 patients with osteoarthritis of the first carpometacarpal joint underwent a combined procedure of trapezium excision,first carpometacarpal joint arthroplasty,ligament reconstruction,and tendon interposition.Surgical efficacy was assessed using X-rays,thumb joint range of motion,grip strength,pinch strength,and pain rating(VAS).Results 9 months postoperative follow-up revealed significant pain reduction,increased thumb range of motion,enhanced grip and pinch strength,with an overall surgical excellence rate of 86.7％.Conclusion Trapeziecotomy arthroplasty with ligament reconstruction and tendon tamponade demonstrates significant efficacy in treating osteoarthritis of the first carpometacarpal joint,effectively alleviating pain,improving thumb mobility,and enhancing hand strength.The method is simple and effective.

Objective To propose a method for classifying small bowel capsule endoscopy images by combining the Swin Transformer network with an improved Adapt-RandAugment data augmentation approach,aiming to enhance the accuracy and efficiency of small bowel lesion classification and recognition.Methods An Adapt-RandAugment data augmentation approach was formulated based on the RandAugment data enhancement sub-strategy and the principles of no feature loss and no distortion when enhancing small bowel capsule endoscopy images.In the publicly available Kvasir-Capsule dataset of small bowel capsule endoscopic images,the Adapt-RandAugment data augmentation approach was trained based on the Swin Transformer network,and the convolutional neural networks ResNet152 and DenseNet161 were used as the benchmarks to validate the combined Swin Transformer network and Adapt-RandAugment data augmentation approach for small bowel capsule endoscopy image classification.Results The proposed algorithm gained advantages over ResNet152 and DenseNet161 networks in the indicators,which had the macro average precision(MAC-PRE),macro average recall(MAC-REC),macro average F1 score(MAC-Fi-S)being 0.383 2,0.314 8 and 0.290 5 respectively,the micro average precision(MIC-PRE),micro average recall(MIC-REC)and micro average F1 score(MIC-Fi-S)all being 0.755 3,and the Matthews correlation coe-fficient(MCC)being 0.452 3.Conclusion The proposed small bowel capsule endoscopy image classification method based on Swin Transformer network and Adapt-RandAugment data augmentation approach behaves well in classified recognition efficiency and accuracy.[Chinese Medical Equipment Journal,2024,45(6):9-16]

BACKGROUND: Posterior pedicle screw fixation of lower cervical spine has many advantages. However, because of the special anatomy of pedicle, the technical requirements of nailing placement are high and it is also a challenge to surgeons. The application of three-dimensional (3D) printing technology can help to complete screw placement, and has certain advantages. OBJECTIVE: To introduce the method of 3D printing personalized navigation template assisted posterior lower cervical pedicle screw fixation and evaluate its clinical application value. METHODS: Totally 20 patients with lower cervical spine pedicle screw internal fixation who were treated from June 2015 to December 2016 in Affiliated Hospital of Yan'an University were retrospectively analyzed. Before the surgery, the patient's lower cervical spine CT data was introduced into the relevant software and the 3D printing personalized navigation template assisted nailing pedicle screw was designed. The number of screws inserted was recorded. After the operation, CT scan was used to calculate the accuracy rate of screw placement. Preoperative and postoperative cervical spine Visual Analogue Scale score and spinal function score of Japanese Orthopedic Association were used to evaluate the clinical effect of cervical nerve. RESULTS AND CONCLUSION: (1) All patients were followed up for 3 months postoperatively. (2) 3D printing personalized navigation template assisted 132 pedicle screws. The precise insertion rate was 94.7%. Among them, 125 screws were at grade 0 (94.7%, 125/132), 3 screws grade 1 (2.3%, 3/132), 4 screws grade 2 (3.0%, 4/132), no screw grade 3. (3) At postoperative 1 and 3 months, the neck shoulder Visual Analogue Scale score and spinal function score of Japanese Orthopedic Association of the patients were significantly improved (P < 0.05), but there was no significant difference (P > 0.05), compared with those at preoperative. (4) In summary, 3D printing personalized navigation template assisted cervical pedicle screw placement had the high insertion rate and satisfactory clinical efficacy.