Abstract: Objective　To investigate the clinical characteristics and diagnosis key points of brain abscess caused by Nocardia asiatica, and provide a clinical basis for diagnosing and treating intracranial infection caused by Nocardia. Methods　A case of pulmonary Nocardia asiatica complicated with brain abscess diagnosed at the Second Affiliated Hospital of Hainan Medical University was selected to analyze the clinical manifestations, cerebrospinal fluid characteristics, pulmonary and cranial imaging features, and treatment plan, and to summarize the diagnosis and treatment experience. Results　The patient was an elderly woman with a history of diabetes, dry cough was the first symptom without fever or headache. At the beginning of the course, it was diagnosed as pulmonary infection and tuberculosis in the local hospital, and received conventional antimicrobial and anti-tuberculosis therapies, but showed no improvement. The patient developed progressive limb weakness, followed by consciousness disorders, and coma. Cerebrospinal fluid (CSF) adenosine deaminase and lactate dehydrogenase were not abnormal, CSF pressure, protein and white blood cells were high, mainly with multiple nuclear cells. CSF glucose and chloride were normal in the early stage of the disease, but decreased significantly in the later stage. Metagenomic analysis of cerebrospinal fluid indicated Nocardia asiatica with a specific sequence number of 537. Lung CT showed exudation, abscess, and cavity in the right lung. Skull MRI scan + enhancement suggested multiple scattered abscesses in both cerebral hemispheres. The abscesses were of different sizes and showed ring enhancement, with extensive surrounding edema, and ventricular compression. After treatment with meropenem, linezolid, and compound sulfamethoxazole tablets, the cerebrospinal fluid recovered, and the lesions in the lungs and intracranial structures improved. Conclusions　Brain abscess caused by Nocardia asiatica is similar to the tuberculous brain in clinical symptoms, cerebrospinal fluid examination, craniocerebral imaging, so we should be alert to the possibility of Nocardia infection in patients with diabetes. At the same time, metagenomic testing of the cerebrospinal fluid can help confirm the diagnosis. The mortality and disability rates of brain abscess caused by Nocardia are high. Early diagnosis and treatment can improve the prognosis.

Objective To explore the changes of plasma angiotensinⅡ (AngⅡ) and cardiac function,and the curative effect of children with acute viral myocarditis (VMC) treated with captopril(CAP).Methods Concentrations of plasma AngⅡ were measured with radio-immunity and cardiac function was detected by Doppler echocardiography for the VMC group (n=60) before and after treatment [the CAP group (n=30), the routine group (n=30) and the control group (n=30)].Results 1. The level of plasma AngⅡ significantly increased and the contractive and diastolic function obviously declined in children with acute VMC. There was a significant difference between VMC group and control group, with a significant correlation between the level of AngⅡand the contractive diastolic function.2. Compared with the level before treatment, the level of AngⅡ decreased and the contractive function obviously ameliorated in two groups; the diastolic function obviously ameliorated in the CAP group and did not ameliorate in the routine group after treatment. In CAP group the level of AngⅡ and the cardiac function significantly improved; there were statistical differences between the two groups after treatment.Conclusions 1.The increase of the plasma AngⅡ was an important factor for decrements of the contractive and diastolic function in acute viral myocarditis.2.It could decrease the concentration of plasma AngⅡ and ameliorate cardiac function in children with acute VMC treated with captopril,which was an effective therapy for acute VMC.

OBJECTIVETo explore the influence of blood pressure lowering treatment on the International Prostate Syndrome Score (IPSS) and maximum flow rate (Qmax) in old and middle-aged male patients with essential hypertension.

METHODSWe enrolled 193 hypertensive male patients aged 50-75 years from the rural area of Anqing, Anhui, treated them with Amlodipine for 4 weeks, and then analyzed the correlation of their baseline blood pressure and reduced blood pressure with the changes of IPSS and Qmax.

RESULTSAfter 4 weeks of medication, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the subjects dropped by 16.8 +/- 16.7 and 8.1 +/- 7.7 mmHg respectively (P < 0.01), IPSS decreased by 2.5 +/- 5.5 points (P < 0.01) and Qmax increased by 0.2 +/- 4.7 ml/s (P = 0.46). Changes of Qmax were not significantly correlated with either the baseline or decreased blood pressure, while changes of IPSS had a significant linear correlation with the former but not with the latter.

CONCLUSIONLowering blood pressure in old and middle-aged male patients with essential hypertension can prevent or alleviate the subjective symptoms of benign prostatic hyperplasia, and it reduces IPSS more significantly in those with higher baseline blood pressure.

Aged ; Blood Pressure ; Humans ; Hypertension ; complications ; physiopathology ; Male ; Middle Aged ; Prostatic Hyperplasia ; etiology ; physiopathology ; Treatment Outcome ; Urodynamics

OBJECTIVETo analyze the epidemiological and etiologic characteristics of ocular fungal infection in Haikou.

METHODSThe samples of corneal, conjunctivae, anterior chambers, lacrimal sacs were taken from the outpatients and inpatients in the Department of Ophthalmology for fungal culture. The positivity rates of fungal culture were statistically analyzed to describe the seasonal and genus distribution of the fungal infections.

RESULTSA total of 683 patients were involved in this study, and the total positivity rate of fungal culture was 27.96%. The positivity rate was 33.42% in male patients and 21.52% in female patients (P<0.01). The positivity rates were 31.42%, 11.32%, 10.81%, 21.28% and 29.17% in the cornea, conjunctivae, anterior chambers, lacrimal sacs and other locations (P<0.01), and were 34.88%, 22.58%, 11.76%, 4.11%, 21.43% and 13.33% in farmers, workers, teachers, government officers, students and personnel of other occupations (Chi2=39.550, P=0.001), respectively. In terms of age, the rate was 32.30% in 21-40 years group, 31.72% in 41-60 years group, 17.12% in over 60 years group and 26.61% in below 20 years group, showing significant differences (P<0.01). The rates were higher in August, September, October, December, November, all above 30%, but lower in March. Nine genera were identified, including Candida (49.21%), Aspergillus (19.37%), Fusarium (9.42%), mucor (5.76%), Actinomyces (5.24%), Penicillium (3.66%), Saccharomyces (2.62%), non-spore group (1.57%), Alternaria (1.57%), and other genera (1.57%). Among the 94 strains of Candida, 63 (67.02%) belonged to Candida albicans and 14 to Candida tropicalis (14.89%).

CONCLUSIONOcular fungal infection occurs more often in male patients and in the cornea. The common pathogen of ocular fungal infection is Candida, which is different from the etiological characteristics in other areas possibly in association with the tropical climate.

Adult ; Candida albicans ; isolation & purification ; China ; epidemiology ; Eye Infections, Fungal ; epidemiology ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To study the evolutionary characteristics and rules of two lineages on influenza B virus.Methods A total of 126 HA1 sequences of strains isolated during 1940 to 2012were downloaded from the GenBank.Time of the most recent common ancestor (TMRCA) and divergence of the two lineages were calculated based on the data from phylogenetic analysis of HA1gene,using Bayesian Markov Chain Monte Carlo (Bayesian-MCMC) and molecular clock method.Results The average amino acid variant ratios were ranged from 5.4％ to 10.2％ within the strains of influenza B virus isolated during 1978 to 2010.Compared with the Victoria-like strains,all Yamagatalike strains showed an amino acid deletion at 163th site,while some of them showing a deletion at position 166.HA1 gene of influenza B virus seemed not have been affected by positive selection except a few sites.The evolutionary average rate on HA1 gene was 2.138 × 10-3 substitutions/site/year (95％HPD:1.833 × 10-3-2.437 × 10-3 substitutions/site/year).The estimated dates for TMRCA of the two lineages of influenza B virus could be dated back to 1971 (95％ HPD:1969-1972),while the divergence times of the two lineages were 1973 (95％ HPD:1971-1974) and 1977 (95％ HPD:1975-1978) respectively.Conclusion Significant differences were found on HA1 gene between earlier and recent identified strains of Victoria and Yamagata lineage.Differences between the two lineages increased and showing the potential of dividing themselves into different subtypes in the future.More attention should be paid to these trends and the related epidemiological significance.

Objective: To study the influence of electret on surface charge of fibroblast cells (3T3 cells) and to probe the relationship between cell growth, apoptosis and cell surface charge. Methods: Electrets Teflon PTFE, ±300 V,±1 000 V were used to treat 3T3 cells for 24, 48 and 72 h. Then the influences of electrets on cell cycle and surface charge of 3T3 cells were studied by flow cytometry and electrophoresis, respectively. Results: (1) After 24 h action of negative electrets, electrophoretic mobility (or surface charge) and cell number in S phase of 3T3 cells were significantly increased compared with those in control group. (2) Effect of negative electrets enhancing cell growth and increasing cell surface charge was in proportional to the surface potential of electret. (3) Surface charge density of apoptotic cell was reduced by electret. (4) After 24 h action of positive electret, the cell number in S and G2 phase were decreased and cell surface charge was also reduced. Conclusion: Negative electret can improve cell growth and increase cell surface charge density. Positive electret can restrain cell growth and reduce cell surface charge density. Surface charge of apoptotic cell is less than that of normal cell.

Objective To assess the efficacy of two antibiotic prophylactic regimens in a prospective randomized trial in 1 year for patients undergoing insertion of catheters,and to provide the evidence for uniform consensus existing on the timing,route,and choice of antibiotic.Methods During a period of 12 months,78 patients,who consecutively entered the peritoneal dialysis programme,[45 women and 33 men,mean age (48.2?15.7)years] were included.The prophylactic regimens were a single dose of ceftriaxone (1.0 g) given intravenously 30 minutes before surgery (Group A) and given cefazolin (0.25 g/L) i.p.in the each dialysis bag for 3 days postoperatively (Group B).All operations were performed in one room.The wound was observed every day,and body temperature,Count of white blood corpuscle and type,dialysate were examined every day. Results In Group A and B,none of the patients showed peritonitis or wound infection during the post-operative period (within 10 days).One of 39 patients(2.5%) in the group A,and 2 of 39 patients (5.1%) in the group B had exit site infection (P＞0.05).Conclusions There is no significant difference in the incidence of peritonitis and wound infection between two groups. Prophylactic preoperative single-dose antibiotics intravenously do as well as antibiotics given intraperitoneally for peritoneal dialysis catheter insertion,but is much more convenient.

Objective To investigate the characteristics of infecting pathogens,their changes and antimicrobial susceptibilities on CAPD related peritonitis in our peritoneal dialysis(PD) center in the past 15 years.Methods Two hundred and six CAPD related peritonitis episodes in 145 patients from 2000 to 2005 were analyzed and compared with 109 episodes from 1991 to 2000.The causative pathogens,their antimicrobial susceptibilities and outcomes on CAPD related peritonitis from the two periods were retrospectively reviewed and compared.Results Culture negative rate decreased from 60.6% in 1990 s to 47.6% in the last five years (P=0.031 ).Among culture positive peritonitis episodes,the incidence of gram positive bacteria (GPB) peritonitis increased from 25.6% to 39.8% (P=0.059).This was mainly due to a significant increase in coagulase-neagative staphylococcus peritonitis,which significantly increased from 4.7% to 26.9% (P=0.01).Gram negative bacteria (GNB) peritonitis decreased slightly (44.2% vs 34.3%,P=0.322).The incidence of Klebsiella pneumoniae peritonitis significantly decreased (14.0% vs 3.7%,P=0.023),while Pseudomonas aeruginosa and Escherichis coli peritonitis rates slightly increased (4.7% vs 9.3%,P = 0.338;7% vs 18.7%,P=0.072).The decrease of fungal peritonitis rate was not significant (30.2% vs 17.6%,P= 0.123).The comparison of clinical outcomes showed an improvement of total recovery rate from 68.8% in 1990 s to 73.9% for 2000-2005 (P=0.09).The catheter removal rate decreased from 19.2% to 14.3% (P=0.238),and the mortality from 10.1% to 5.4% (P=0.118).In both periods,fungal peritonitis had the poorest results,which all the patients either withdrew from PD or died.Conclusions Compared with that in 1990 s,the culture positive rate for CAPD related peritonitis in 2000-2005 has been greatly improved.Coagulase-negative staphylococcus is the most common causative pathogen.The mortality and catheter removal rate have been markedly reduced in the last five years.Fungal peritonitis is the most important reason for patients' dropout.

This essay is to present an improvement on the concentration assay for hemihydrate gypsum in plaster of Paris bandage-Viscose form.
Calcium Sulfate ; analysis ; Casts, Surgical ; Titrimetry ; methods

OBJECTIVETo study the relationship between influenza epidemic and genetic characteristic on HA and NA regions of influenza virus subtype A3 isolates of Zhejiang province in the recent years.

METHODSRNA of 25 influenza virus subtype A3 isolates, circulated in Zhejiang province during 1998 to 2005, was extracted. HA1 and NA regions were amplified and sequenced. All the sequence data were analyzed using BioEdit.

RESULTSHA1 and NA regions of all the isolates belonged to 987nt and 1362nt, encoding protein of 329 and 454 amino acids respectively. Isolates shared amino acid homology of 90.9%-99.3% and 95.2%-99.5% on HA1 and NA regions, while divergence on HA1 was greater than that on NA region. During a period of 8 years, 30 amino acids on HA1 region were substituted and 14 of which refer to 4 antigenic determinant sites. Meanwhile,21 amino acids on NA region were substituted and 5 of which referred to 3 antigenic determinant sites. Significant divergences, both in HA1 and NA, were observed among isolates in 1998 and 2002, showing that they belonged to absolutely different branches. Additionally, influenza virus subtype A3 isolates identified in recent years, with 11 N-linked glyeosylation sites in HA1 region, had 5 sites more than early A/Aichi/2/68 strain. Since 1998,3 sites had been inserted in epidemic strains, indicating the accelerated trend of glyeosylation sites were increasing.

CONCLUSIONThere is a correlation between antigenic drift of influenza virus subtype A3 and the two epidemics in Zhejiang province in 1998 and 2002.

Amino Acid Sequence ; Antigens, Viral ; genetics ; China ; Epitopes ; genetics ; Evolution, Molecular ; Genetic Drift ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; Humans ; Influenza A virus ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; Molecular Sequence Data ; Neuraminidase ; genetics ; RNA, Viral ; genetics ; Sequence Analysis, RNA ; Sequence Homology, Amino Acid