Objective To describe the clinical features of invasive fungal disease in Huashan Hospital,Fudan University from January 2004 to December 2006.Methods The medical data were reviewed retrospectively for the patients with fungal infection, which was confirmed by positive fungal culture or microscopic examination with blood,sterile body fluid,deep tissue,sputum specimen or isolation of Aspergillus spp.and Cryptococcus spp.from bronchoalveolar lavage.The proven and probable cases of invasive fungal disease were included in this analysis.Results A total of 111 patients were diagnosed as invasive fungal dis-ease,including 104 proven cases and 7 probable cases.Sixty-one cases were community-acquired and the other 50 were nosoco-mial.The most common site of infection was bloodstream (51,45.9%),followed by central nervous system (44,39.6%)and respiratory system (14,12.6%).The most common pathogens were Candida spp.(50,45%),Cryptococcus (47,42.3%) and Aspergillus spp. (12, 10.8%). The community-acquired fungal infections were mostly found in central nervous system (44,72.1%),and respiratory system (12, 19.7%),mainly caused by Cryptococcus and Aspergillus. The nosocomial fungal infections occurred primarily in blood-stream (96.0%),mainly due to Candida spp.No underlying disease or risk factor was identified in more than half of the pa-tients with community-acquired infection,while almost all the patients with nosocomial fungal infection had underlying disease and predisposing factors.Indwelling venous catheter was closely associated with nosocomial bloodstream infection.Indwelling venous catheter lasted for more than 1 week in 64.7% of the patients with Candida bloodstream infection.The same fungal strain was isolated from both the cather and blood of the same patient in 11 cases.The overall mortality of these invasive fungal diseases was 14.4% (16/111).The mortality rate was 18.0% (9/50)in the patients with nosocomial invasive fungal infection, and 11.5% (7/61)in the patients with community-acquired invasive fungal infection.Conclusions The most common site of in-vasive fungal infection is bloodstream,followed by central nervous system,and respiratory system.Majority of the fungal patho-gens are Candida spp.,Cryptococcus and Aspergillus spp.The community-acquired invasive fungal disease is primarily meningitis caused by Cryptococcus.The nosocomial invasive fungal disease is mainly bloodstream infection caused by Candida spp.

Objective To study the value of spiral CT and ultrasound in the dingnosis of gallbladder cancer.Methods Spiral CT and ultrasonic findings and diagnostic value of gallbladder cancer proved pathologically in 34 cases were comparatively analysed.Results The diagnostic accurate rates of gallbladder cancer by CT and ultrasound were 67.6%(23/34 cases) and 61.8%(21/34 cases),there were no statistically significance.While,spiral CT in combination with ultrasound in diagnosing gallbladder carcinoma,the diagnostic accurate rate was up to 88.2%(30/34 cases),which was of significance statistically .Conclusion Combined utilization of spiral CT and ultrasonography can improve the diagnostic rate of gallbladder cancer.

Objective:To study the effects of soybean phospholipids on learning and memory abilities and contents of fatty acids in hippocampus of mice and its mechanism. Method:Mice were randomly divided into four groups:low dose(2.5g/kg) ,middle dose(5.0g/kg) and high dose(10.0g/kg) groups of soybean phospholipids and control group. The treatment groups were fed with soybean phospholipids every day while the control group with distilled water for 30 d.After learning and memory abilities were measured,the mice were killed and contents of fatty acids in hippocampus of mice were determined by high performance liquid chromatography(HPLC) . Results:(1) The learning and memory abilities of mice in middle and high dose groups were significantly improved,but only memory abilities in low dose groups were stronger than control group.(2) The contents of protein in hippocampus in middle and high dose groups were increased extremely.(3) The contents of oleic acid(C18:1) and docosahexaenoic acid(DHA,C22:6 ) were obviously enhanced in hippocampus of high dose group;but decreased in eicosapentaenoic acid(EPA,C20:5) and linoleic acid(C18:2) . The content of DHA was increased and EPA decreased significantly in middle dose group.The increase of arachidonic acid(C20:4) was not significant.Conclusion:Soybean phospholipids may improve learning and memory abilities,which might contribute to change of fatty acids contents in hippocampus of mice.

Objective To explore the incidence and severity of cancer-related fatigue (CRF),and to analyze the correlation between CRF and quality of life in lung cancer patients receiving chemotherapy.Methods This was a cross-sectional study.72 lung cancer patients receiving chemotherapy were investigated by the Piper Fatigue Scale (PFS) and the 36-item short form of the Medical Outcomes Study questionnaire (SF-36).Results The rate of fatigue for lung cancer patients receiving chemotherapy was 76.4%.The incidence of moderate and severe fatigue in total fatigue,behavior/severity dimension,affective dimension,sensory dimension was 68.1%,63.9%,76.4% and 65.3% respectively.The incidence of mild and moderate fatigue in coguitive/mood dimension was 41.7%.The fatigue dimension scores ranked in a descending order,affective,behavior/severity,sensory and cognitive/mood.There was significant negative correlation between CRF and quality of life for lung cancer patients receiving chemotherapy.Conclusions In lung cancer patients receiving chemotherapy,the incidence and degree of fatigue was high.CRF and QOL affect each other.The health care providers should take measures to alleviate lung cancer patients' fatigue in order to improve the QOL of them.

AIM: To study the possibility that yellow wine improves the pathological changes of atherosclerosis in vivo. METHODS: Six weeks old LDL receptor knockout mice (n=48) on a high-fat and L-methionine diet developed plasma hyperhomocysteinemia and atherosclerosis. The animals were randomly divided into yellow wine group, red wine group, ethanol group and control group (n=12 in each group) and were sacrificed after 14 weeks. The levels of plasma lipids and homocysteine in serum were examined. The morphological changes of aorta artery and the atherosclerosis of aorta sinus were observed under microscope. The expression and activation of matrix metalloproteinase-2 (MMP-2) were determined by the method of immunohistochemistry. RESULTS: No significant difference of plasma total cholesterol, triglyceride or high density lipoprotein cholesterol among groups was observed. Plasma homocysteine was significantly decreased in yellow wine group as compared to other three groups (P<0.01). Compared to ethanol and control groups, use of yellow wine and red wine significantly reduced the atherosclerosis lesion area (P<0.01). However, no significant discrepancy between the yellow wine group and red wine group was found. Compared to control group, the expression of MMP-2 in yellow wine group, red wine group and ethanol group decreased by 26.3%, 27.6% (P<0.01) and 5.7% (P>0.05), respectively. The activity of MMP-2 in yellow wine group, red wine group and ethanol group decreased by 31.7%, 32.5% (P<0.01) and 6.7% (P>0.05), respectively. CONCLUSION: Yellow wine and red wine inhibit the expression of MMP-2 and improve the pathologic changes of atherosclerosis, indicating that they have benefic effects on cardiovascular system.

Objective To explore the effect of the midwife-leading labor pain management model on the pregnancy outcomes and pain control satisfaction.Methods The randomized grouping and single blind trial design were performed.One hundred and ten pregnant women were recruited and randomized into the control group (n=55) and intervention group (n=55).The control group received the routine prenatal examination by the outpatientdepartment obstetric doctors and intrapartum nursing care during labor.On this basis the intervention group participated in the labor pain educational course in the midwife clinic,and received the repeated pain assessment and pain management intervention during labor.Results There was no statistical difference in the delivery mode between the two groups(P＞0.05).The cesarean section rate without indication in the intervention group was significantly lower than that in the control group,the difference was statistically significant(x2 =6.798,P＜0.05).The average each item score of the labor pain education and pain control satisfaction in the intervention group was significantly higher than that in the control group,the difference was statistically significant(P＜0.01).Conclusion The midwife-leading labor pain management model can reduce the cesarean section rate without indication,and improves the satisfaction of labor pain education and pain control in pregnant women and parturients.

Searching for new antidiabetic lead compound, 4-(1-aryl-3-oxo-5-phenylpentylamino) benzenesulfonamides were designed and synthesized directly by three component one-pot condensation of 4-phenyl-2-butanone and sulfanilamide with some aromatic aldehydes at an yield of 23%-97%. The chemical structures of the twelve new Mannich bases were confirmed by 1H NMR, 13C NMR, FTIR, ESI-MS and HR-MS. The screening results of antidiabetic activity indicated that most of these title compounds possess alpha-glucosidase inhibitory activity, among which compound le is the strongest one. And compound 11 possesses good peroxisome proliferator-activated receptor response element (PPRE) agonist activity. The structure-activity relationship of these new beta-amino ketones containing benzenesulfonamide unit was also discussed preliminarily.

10.3969/j.issn.1000-3606.2013.06.010

Objective To identify the significance of serum phospholipase A2 receptor antibody (PLA2R-Ab) in idiopathic membranous nephropathy (IMN) patients.Methods A total of 108 patients diagnosed as IMN by medical history,physical examination,laboratory examination and renal biopsy in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology between Dec 1,2014 and Aug 31,2017 were enrolled,and all related data were recorded.According to the results of serum PLA2R-Ab test,patients were divided to positive group and negative group,and the data were compared with the independent sample t test and the chi-square test.Kaplan-Meier survival analysis was performed to compare remission rates between groups,and the Logrank method was used to evaluate the significance of differences.Univariate and multivariate Cox regression analysis were used to verify predicting factors for achieving remission.Results Overall,67.6％(73/108) patients had detectable serum PLA2R-Ab.Compared with patients in negative group,patients in positive group exhibited higher proportion of male patients (P=0.002),lower level of serum albumin (P ＜ 0.001),higher level of cholesterol (P ＜ 0.001),lower level of immunoglobulin G (P ＜0.001),higher level of proteinuria (P=0.003),a lower of chance of remission (P=0.049),longer time needed to achieve partial remission (P=0.001) and complete remission (P=0.002).The 1-and 2-year cumulative renal partial remission rates were 72.4％,86.1％,and the cumulative renal complete remission rates were 43.8％,54.0％,respectively.Patients in negative group had higher partial remission (x2=9.84,P=0.002) and complete remission (x2=15.50,P＜0.001) than those in positive group.Multivariate Cox regression model indicated that serum positive PLA2R-Ab was a significant independent risk factor.Conclusions IMN patients with serum PLA2R-Ab show more severe condition and lower remission rates than those without serum PLA2R-Ab.Serum positive PLA2R-Ab is an independent remission-related predictor for IMN patients.