Objective To investigate the clinical effect of voriconazole in the treatment of invasive fungal infections in lung cancer patients with radiotherapy and chemotherapy,to provide a reference for clinical treatment. Methods The clinical data of 64 lung cancer patients with radiotherapy and chemotherapy with invasive fungal infec-tions were retrospectively analyzed.According to the treatment methods,they were divided into control group and observation group,32 cases in each group.Fluconazole treatment was used in the control group,and the observation group used voriconazole therapy.The overall response rate,time to return to normal white blood cells and other indica-tors of liver and kidney function were compared between the two groups.Results The effective rate of the observation group was 81.25%,which was significantly higher than 68.75% of the control group,the difference was statistically significant(χ2 =5.876,P=0.008).The temperature recovery,cough disappeared,leukocyte recovery time of the observation group were (3.61 ±0.61)d,(6.11 ±0.81)d,(7.85 ±0.92)d,which were significantly shorter than those of the control group,the differences were statistically significant(t=4.145,P=0.025;t=4.045,P=0.027;t=4.385,P=0.021).The treatment of the two groups had mild liver and kidney damage,and there was no signifi-cant difference between the two groups(all P>0.05 ).Conclusion Voriconazole treatment has good clinical effect for lung cancer patients after radiotherapy and chemotherapy with invasive fungal infections,the treatment period is short,but with mild liver and kidney function impairment,the treatment should strengthen the monitoring.

Objective To explore the hospitalization costs of patients with diabetic foot ulcer and analyze key influencing factors.Methods A total of 570 diabetic foot inpatients were recruited from January 2008 to March 2012 for analysis of the relationship between their hospitalization costs and clinical symptoms.The multifactor regression analysis model was used to identify main influencing factors for their hospitalization costs.Results The medical costs of such inpatients amounted to 1 9 825.6 yuan (12 476.6~32 745.9)yuan,while average hospitalization costs of the 3 401 diabetic patients admitted over the same period were but 9 757.1 yuan (6 282.1 ~ 1 5 723.7 )yuan,a difference of statistic significance.The single-factor analysis found statistical differences from the differences of hospitalization among various age,occupation,dorsal artery of foot,B ultrasound of lower extremity arteries,wagner classification,amputation,transfer,leucocyte,hemoglobin,serum albumin,serum creatinine and high density lipoprotein.Multifactor analysis found that the significant factors influencing the medical costs of inpatients were days of stay,albumin,wagner classification,dorsal artery of foot,leucocyte and age. Conclusion Hypoalbuminemia,high stage of wagner classification,weak or absent pulsation of foot dorsal artery,severe infection and aging were significant factors contributing to higher medical costs of hospitalization for patients with diabetic foot ulcer.

Urinary excretions of transforming grow th factor-? 1 (TGF-? 1), laminin (LN) and type Ⅳ collagen were determined i n 182 type 2 diabetic patients. Urinary excretions of TGF-? 1, LN and type Ⅳ collagen were increased in type 2 diabetic patients, and these findings were fa irly well correlated with severity of diabetic nephropathy (DN). Urinary TGF-? 1 seems to be the early index of DN, urinary LN and type Ⅳ collagen appear to be the indices of DN severity.

AIM: To investigate the molecular mechanism of amylin in inducing apoptosis of human pancreatic islet ?-cells. METHODS: Human pancreatic islet cells were isolated and cultured. The cells were treated with amylin or amylin and aminoguanidine (AG group) for 24 h, respectively. Apoptosis of pancreatic islet ?-cells was studied by in situ TUNEL method combined with double staining for insulin and ELISA. The levels of insulin, NO 2 -/NO 3 - and glutathione (GSH), p53 mRNA and bcl-2 mRNA were also detected. RESULTS: (1) The enrichment factor and the apoptosis rate of pancreatic islet ?-cells in amylin group were markedly higher than that in control group and AG group ( P

AIM: To investigate the effect of losartan on the mRNA expression of type 2 angiotensin II receptor and cytokines in diabetic rat kidney.METHODS: SD rats were randomly divided by following groups: control rats(group C),diabetic rats(group D) and diabetic rats treated with losartan (30(mg?kg~(-1)?d~(-1)),by gavage,group DT).At the end of 8-weeks study,mRNA expressions of the type 2 angiotensin II receptor(AT_2),transforming growth factor-?_1(TGF-?_1),platelet-derived growth factor-B(PDGF-B),tumor necrosis factor-?(TNF-?) and collagen Ⅳ in rats renal cortex were measured by RT-PCR,respectively.In addition,angiotensin Ⅱ level in renal cortex was determined by the radioimmunoassay.RESULTS: In group D,urine protein excretion(P

Regular assessment is a key to early detect and treat delirium. However, studies showed poor compliance and accuracy of delirium assessment by nurses. Moreover, delirium was characterized by acute onset and fluctuation of cognition. Therefore, delirium was frequently unrecognized. Postoperative delirium incidence in the intensive care unit was high and associated with poor outcome. Studies demonstrate delirium was preventable. Delirium prediction models were warranted to identify high-risk critically ill patients in order to apply preventive strategies. This article was to provide an overview of postoperative delirium and review postoperative delirium prediction models for surgical patients in the intensive care unit, thereby providing reference for development, validation as well as application of models in China.

AIM:To investigate the antagonism mechanism of benazepril on renal fibrosis of unilateral uretreal obstructire (UUO).METHODS:Fiftyfour Sprague-Dawley (SD) rats were randomly divided into three groups:sham operation group,model group,benazepril group.All the other groups were treated with surgery method of unilateral ureteral ligation to establish a rat model of renal fibrosis except the sham operation group.The pathological changes were observed by Masson staining;the positive staining expression of TGF-β1,Col-Ⅳ,Wnt1,Wnt4 in frozen sections were observed by immunofluorescence staining;the expressions TGF-β1,Col-Ⅳ,Wnt1 and Wnt4 mRNA in renal tissues were detected by real time fluorescence quantitative PCR.RESULTS:Masson staining results:compared with the sham group,the parts of blue dye collagen fiber and the degree of renal fibrosis increased significantly in all modeled groups;compared with the model group,the parts of blue dye collagen fiber and the degree of renal fibrosis decreased significantly in benazepril group.Immunofluorescence and PCR results:compared with the model group,the positive expression of Wnt1,Wnt4,TGF-β1,Col-Ⅳ and mRNA in the benazepril group decreased significantly.CONCLUSION:Benazepril can improve renal fibrosis by inhibiting the expression of TGF-β1,Col-Ⅴ,Wnt1,Wnt4 and ameliorating the level of renal fibrosis.

Background: and Purpose X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is characterized by peripheral neuropathy with or without episodic neurological dysfunction. We performed clinical, neuropathological, and genetic investigations of a series of patients with mutations of the gap-junction beta-1 gene (GJB1) to extend the phenotypic and genetic description of CMTX1. Methods: Detailed clinical evaluations, sural nerve biopsy, and genetic analysis were applied to patients with CMTX1. Results: We collected 27 patients with CMTX1 with GJB1 mutations from 14 unrelated families. The age at onset (AAO) was 20.9±12.2 years (mean±standard deviation; range, 2–45 years). Walking difficulties, weakness in the legs, and pes cavus were common initial symptoms. Compared with female patients, males tended to have a younger AAO (males vs. females=15.4±9.6 vs. 32.0±8.8 years, p=0.002), a longer disease course (16.8±16.1 vs. 5.5±3.8 years, p=0.034), and more-severe electrophysiological results. Besides peripheral neuropathy, six of the patients had special episodic central nervous system (CNS) evidence from symptoms, signs, and/or reversible white-matter lesions. Neuropathology revealed the loss of large myelinated fibers, increased number of regenerated axon clusters with abnormally thin myelin sheaths, and excessively folded myelin. Genetic analysis identified 14 GJB1 variants, 6 of which were novel. Conclusions These findings expand the phenotypic and genetic spectrum of CMTX1. Although CMTX1 was found to have high phenotypic and CNS involvement variabilities, detailed neurological examinations and nerve conduction studies will provide critical clues for accurate diagnoses. Further exploration of the underlying mechanisms of connexin 32 involvement in neuropathy or CNS dysfunction is warranted to develop promising therapies.

Objective: To investigate the efficacy and safety of percutaneous lauromacrogol injection (PLI) in treatment of cystic or predominantly cystic thyroid nodules. Methods: A total of 114 cystic thyroid nodules and 61 predominantly cystic thyroid nodules with pain or uncomfort or aesthetic complaints were offered PLI. Therapeutic success rates and side effects were evaluated. From October 2012 to December 2015,114 patients with cystic thyroid nodules and 61 with predominantly cystic thyroid nodules with pain or uncomfortable or aesthetic complaints at the outpatient clinic of the First Affiliated Hospital of Wenzhou Medical University were offered percutaneous lauromacrogol sclerotherapy. Cytological results were benign. This study was a prospective trial. Ultrasonography sound examination was performed in all patients before treatment. The baseline data of all the patients and the data of the patients examined at the follow-up of 1, 3, 6 and 12 months were analyzed. Therapeutic success rate (nodule volume reduction >50%) and safety were observed. The data of nodule volume reduction ratio and the function of thyroid were normal distribution and analyzed by Mann-Whitney test and t test. The data of nodule volume, symptoms score and cosmetic score were skewed distribution, which were indicated with median and analyzed by nonparamentic test. Results: The mean volume of the cystic thyroid nodules was reduced from 12.5 cm³ before PLI to 0.2 cm³ at 12 months after PLI (χ²=266.175, P<0.001), with a therapeutic success rate of 100%, and the mean volume of the predominantly cystic thyroid nodules was reduced from 10.5 cm³ before PLI to 2.0 cm³ at 12 months after PLI (χ²=203.122, P<0.001) with a therapeutic success rate of 93.4%(57/61). Pressure symptom score and cosmetic grade were significantly improved at 12 months after PLI in patients with cystic or predominantly cystic thyroid nodules. Pressure symptom score and cosmetic grade in patients with cystic thyroid nodules were Z=-6.126 and Z=-13.735, respectively; pressure symptom score and cosmetic grade in patients with predominantly cystic thyroid nodules were Z=-3.126 and Z=-7.212, respectively (all P<0.001) . There no significant difference in the thyroid functions before and after PLI in two groups of patients (all P>0.05) . The side effects of PLI were mild. Conclusion PLI is a safe and effective alternative to treat benign cystic or predominantly cystic thyroid nodules.

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.