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.

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

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 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

OBJECTIVETo explore the possibility of repairing periodontal defects with carbonated calcium phosphate bone cement (CCPBC) modified with synthesized peptides.

METHODSPeriodontal bone defects in 4 dogs were surgically created and then restored directly with hydroxyapatite (HA), Perioglass, CCPBC and CCPBC modified with peptides. The results were compared at different levels.

RESULTSBone replacement materials were lost in HA and Perioglass groups. In the HA group defects were restored with connective tissue. Perioglass group had only a little new bone around materials by alveolar bone. CCPBC could firmly stay in bone defects to maintain the space of bone defects even without membrane use. CCPBC modified with peptides was superior to HA, Perioglass, and CCPBC, surrounded by a great deal of new bone.

CONCLUSIONUnder limitation of this study, CCPBC modified with peptides has some osteoinuctive activity and may have good prospect for the clinical application in periodontal defect repair.

Alveolar Bone Loss ; therapy ; Animals ; Bone Cements ; Bone Regeneration ; Bone Substitutes ; Calcium Phosphates ; Dogs ; Durapatite ; Male

Cerebral Cortex ; physiology ; Electric Stimulation Therapy ; Electroencephalography ; Epilepsy ; pathology ; physiopathology ; surgery ; Female ; Glioma ; pathology ; physiopathology ; surgery ; Humans ; Middle Aged

OBJECTIVETo observe the effects of forearms devascularization on the volt-ampere (V-A) characteristics of Neiguan (PC 6) and Taiyuan (LU 9) so as to investigate the relationship among functions of acupoints, qi and blood in human body and V-A characteristics of acupoints.

METHODSEither forearms of 23 healthy volunteers were devascularized and the changes of V-A characteristics in ipsilateral Neiguan (PC 6) and Taiyuan (LU 9) in normal and devascularization statuses were detected by home-made intelligent V-A detecting system.

RESULTSCompared with the normal status, both range-increasing and range-decreasing V-A areas of Neiguan (PC 6) and Taiyuan (LU 9) were significantly increased in devascularization status (P < 0.05, P < 0.01), and the change rates of these two V-A areas of Neiguan (PC 6) were larger than those of Taiyuan (LU 9) (both P < 0.05). The inertia areas of Neiguan (PC 6) but not Taiyuan (LU 9) became significantly larger after devascularization (P < 0.01).

CONCLUSIONThe changes in V-A characteristics of Neiguan (PC 6) and Taiyuan (LU 9) can reflect the alteration of local blood supply, and Neiguan (PC 6) is more sensitive to changes of blood flow than Taiyuan (LU 9).

Acupuncture Points ; Adult ; Blood Circulation ; Electrophysiology ; Female ; Forearm ; blood supply ; physiology ; Humans ; Male ; Young Adult

BACKGROUNDThe maximal use of the limited resource to improve peritoneal dialysis (PD) penetration and clinical outcomes is a challenge for all PD centers. In this study, we reported the experience and outcomes in successfully managing a rapidly growing PD center in Southern China.

METHODSA standard PD program with a team consisted of 6 nephrologists (3 doctors were in charge of catheter insertion and in-patients care, the other 3 doctors focused on PD patients' follow-up and education) and 11 nurses in a PD center at Sun Yat-sen University was established for PD patients follow-up in 2005. A prospective and observational study was conducted in all patients undergoing continuous ambulatory PD (CAPD) at our center from January 1, 2006 to December 31, 2009.

RESULTSThe yearly number of prevalent CAPD patients was 297, 409, 547 and 695 in 2006, 2007, 2008 and 2009, respectively. The PD catheter insertion was performed by the nephrologists with open surgical procedure and 94% of catheters were patent at one year. In 841 incident CAPD patients, the survival rates at the end of 1, 2, 3 and 4 years were 94%, 87%, 83% and 76%, respectively, while cumulative technique survival rates (death-censored) were 98%, 95%, 91% and 90%, respectively. Peritonitis rate was 1/68.5 patient months.

CONCLUSIONSBetter patient and technical survival rates as well as lower peritonitis episode have been achieved in our rapidly growing PD center. A standardized PD program, well-trained team members of PD doctors and nurses, and continuous quality improvement of PD are important elements in managing a successful PD program.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory ; statistics & numerical data ; Survival Rate ; Young Adult

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

OBJECTIVETo investigate the distribution of babA2 cagA and vacA genotypes of Helicobacter pylori (Hp) in chronic gastritis and peptic ulcer and to discuss the relationship between babA2, cagA and vacA genotypes of Hp and chronic gastritis and peptic ulcer.

METHODSbabA2, cagA genotypes and vacA subtype of 58 Hp strains isolated from patients of Zhejiang province with chronic gastritis or peptic ulcer were tested by polymerase chain reaction.

RESULTSThe positive rates of babA2, cagA, vacAs1a, vacA m1 and vacA m2 of 58 Hp strains were 87.9%, 100%, 93.1%, 1.7% and 65.5%, respectively. There were no significant differences between the positive rates of babA2, vacA s1a and vacA m2 genes of Hp strains isolated from patients with chronic gastritis and peptic ulcer.

CONCLUSIONThe genotypes of Hp isolated from patients of Zhejiang province were predominatly babA2 positive, cagA positive and vacA s1a/m2. The relationships between babA2, cagA and vacA genotypes of Hp and chronic gastritis and peptic ulcer can not be identified.

Adhesins, Bacterial ; Antigens, Bacterial ; Bacterial Proteins ; genetics ; Carrier Proteins ; genetics ; Chronic Disease ; Gastritis ; microbiology ; Genotype ; Helicobacter pylori ; genetics ; Humans ; Peptic Ulcer ; microbiology