The incidence of invasive fungal infections has increased dramatically in recent years.However,the traditional methods used in routine practice for the diagnosis of invasive fungal infections could not meet the requirements.The detection of specific fungal antigens by serological methods will have a widely applications in near future.Fungal DNA detecting by molecular biological technique is the most promising technique and it will make high speed selecting to clinic specimens possible.

Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.

Objective To make a clinical and mycological analysis of tinea capitis in Guangzhou region. Methods A retrospective analysis was performed on 241 cases of tinea capitis collected from Feb, 1997 to Aug, 2010 in the Department of Dermatology, Sun Yet-sen Memorial Hospital. Results Among the 241 cases, 179 (74.27%) were tinea alba, 34 (14.11%) tinea kerion, 28 (11.62%) black dot ringworm, and no favus was observed. The dominant pathogenic fungi in decreasing order were Microsporum canis (182,80.89%), Trichophyton violaceum (25, 11.11%), Trichophyton mentagrophytes (10, 4.44%), Trichophyton tonsurans (3, 1.33%), Trichophyton rubrum (2, 0.89%), Microsporum gypseum (2, 0.89%) and Trichophyton verrucosum (1, 0.44%). Children were the main population (39.00%) suffering from tinea capitis. Conclusions In Guangzhou region, tinea alba is the most common type of tinea capitis, Microsporum canis is the main causative pathogen, and children are the predominate population affected by tinea capitis.

Objective To detect the mutations in connexin genes in a family with hidrotic ectodermal dysplasia(HED)complicated by pseudo-ainhum.Methods Peripheral blood samples were collected from a 20-year-old patient with HED complicated by pseudo-ainhum,and from his unaffected sister.Total DNA was extracted from these samples,and PCR was performed to amplify the partial coding region of GJB2,GJB5 and GJB6 genes.Subsequently.PCR products were bidirectionally sequenced in both subjects.Results No mutation was detected in GJB5 or GJB6 gene in either subjects.Two mutations (V27I and V37I)were detected in the GJB2 gene in the patient but not in his sister.Conclusion The mutation in the GJB6 gene may be absent in patients with HED;there might be other genes involved in the pathogenesis.

Objective To report a case of chromomycosis caused by Phialophora verrucosa and explore the laboratory features of the pathogen. Methods Skin lesion was examined by histopathology and fungus culture. The morphology of the isolate was observed by microscopy and scanning electron microscopy. The coenzyme Q system of this isolate was analyzed by HPLC assay. The DNA sequences of LSU rDNA D1/D2 region of this isolate and a standard fungus strain were compared. Results The initial lesion was an erythematous papule that subsequently developed into one or multiple coalescing warty papules or plaques slowly. The bronze-colored spores could were observed in the dermis or macrophages. The isolate grew very slowly, requiring 4 weeks of incubation. Microscopically, no characteristic structures were found on Sabourand′s dextrose agar, while there were vase-like structures, which were referred to as phialides on potato dextrose agar (PDA) and corn meal agar I (CMA-I). The phialides on PDA mostly grew at the top of hypha, but on CMA-I they mostly grew on the side of hypha. The isolate contained coenzyme Q-10, and its DNA sequence of LSU rDNA D1/D2 region completely consistent with those of the standard strain. Conclusion Chromomycosis caused by Phialophora verrucosa is rare in China. It can be diagnosed by fungus culture and histopathological examination. Coenzyme Q system analysis and DNA sequencing can exclude the interference from different phenotypes.

Objective To investigate the relationship between the concentration of plasma (1→3)-?-D-glucan (?-D-glucan) and deep fungal infection. Methods Thirteen patients were recruited in this study, who were suspected with deep fungal infection. G-test TE reagent for ?-D-glucan measurement was used to detect the plasma (1→3) ?-D-glucan in the patients by using UV-2450 spectrophotometer at 545 nm wavelength. The final concentrations were calculated according to concentration conversion formula. Results Nine of thirteen patients were confirmed as deep fungal infection by positive tissue culture, in whom high concentrations of ?-D-glucan were detected, the highest concentration was 352.94 pg/mL (mixed infection), with a mean value of 203.47 pg/mL. In the other four patients with negative culture, the ?-D-glucan concentration was over 54.40 pg/mL in three patients and 16.16 pg/mL in the another. Our results showed that the sensiti-vity, specificity, positive predictive value and negative predictive value of this test were 92.31%, 100%, 100% and 98.36%, respectively. Conclusion G-test TE method is a simple and rapid test and may be used for the diagnosis of patients with deep fungal infection.

Objective To analyze the incidence of the disease, clinical features, diagnostic criteria, therapy and prognosis of Penicilliosis marneffei found in Guangdong province. Methods To analyze patients data, clinical features, laboratory findings, response to therapy, and prognosis of 15 cases Penicilliosis marneffei found in Guangdong province of China. Results The male was predominant compared with the female (ratio 2 to 1) and without occupational preference, but the patients with AIDS as underlying disease were mostly drivers and the unemployed. Thirteen patients were immunocompromised such as AIDS, connective tissue disease, and kidney transplant. Clinical features showed different manifestations, such as high fever, loss of weight, skin lesion, and respiratory system symptoms. Biopsy of the skin lesion showed PAS stain positive yeast-like, or sausage-form spores. Four patients were localized infection of the skin, eleven patients were systemic infection. Nine patients died, five recovered, 1 patient refused to be treated. Fifteen isolates from different anatomic sites of the patients were identified to be Penicillium marneffei by morphology and dimorphism in the culture, and eleven isolates among these 15 isolates were also confirmed by DNA sequence analysis. Conclusion The incidence rate of Penicilliosis marneffei become higher in the recent years and many patients were accompanied with AIDS in Guangdong province. Attention should be paid to the disease.

Abstract: Objective - - （ ） To investigate the influencing factors of high frequency noise induced hearing loss NIHL in young ， Methods maleworkersexposedtonoise andtoestablishariskpredictionmodelforNIHL. Theyoungmaleswhowerenewly recruitedandwithnormalhearinginnoiseoperationsinanautomobilemanufacturingenterprisefrom 2016to2018wasselected - asresearchsubjectusingaretrospectivecohortstudy.Afollow upsurveywasconducted.MultivariateCoxproportionalhazards， regressionmodelwasusedtoanalyzetheinfluencingfactorsofNIHL andthepartialregressioncoefficientwasusedtoconstruct （PI） PI ， - （PI< ） - theprognosticindex model.Accordingtothe value thesubjectsweredividedintolow riskgroup 0.00 andhigh （PI ） - Results ， risk group ≥0.00 .Kaplan Meiermethod wasused toanalyzetherisk ofNIHL. By 2020 theincidenceofNIHL （ ）， - ， was 33.4% 167/500 which was pure high frequency NIHL and no speech frequency NIHL was detected. Cox proportional - hazard regression model analysis showed that the risk of high frequency NIHL was 2.03 times higher than those with （P< ）， occupational noise exposure level exceeding the standard 0.01 1.62 times higher in those with drinking than in those （P< ）， （P< without drinking 0.05 and 1.69 times higher in those with noisy living environment than in those without drinking ） PI 0.05 . The model constructed according to the partial regression coefficients of the above three influencing factors is PI x x x - （ ， =−0.44+0.71 occupational intensity + 0.49 drinking + 0.52 The probability of high frequency NIHL 3.9% ， ， ， ） - ， ， ， ， 12.3% 19.4% 30.4% 51.1% in the high risk group at 12 24 36 48 and 52 months after taking office was higher than - （ ， ， ， ， ）， that in the low risk group 2.3% 8.3% 10.7% 15.3% and 27.5% especially in the third year after taking office.

Objective To evaluate the performance of nested PCR in the detection of different fungi in paraffin wax embedded tissues. Methods Forty-four tissue samples were resected from rats infected with Fonsecaea monophora, patients with chromoblastomycosis, sporotrichosis or penicilliposis marneffei followed by preparation of paraffin wax embedded tissue sections for pathological examination and DNA extraction. Nested PCR was performed by using specific primers targeting the ribosomal DNA of Fonsecaea, Sporothrix and Penicillium marneffei, respectively. The sensitivity and specificity of nested PCR were analyzed and compared with those of pathological examination. Results The nested PCR showed positive results in 8 of 20 samples from rats with chromoblastomycosis, 7 of 10 samples from patients with sporotrichosis and all of the 10 samples from patients with penicilliposis marneffei, but not in the control samples. In the detection of Fonsecaea,Sporothrix schenki and Penicillium marneffei, the sensitivity was 40% ,70% and 100%, respectively, and the specificity was consistently 100%, for the nested PCR. Pathological examination revealed fungal elements in 95%, 70% and 80% of the corresponding samples, respectively. Conclusion Detection of fungal DNA in paraffin wax embedded tissue by nested PCR can be applied to the diagnosis of deep mycosis, especially to the diagnosis of penicilliposis marneffei.

Cochlear Implantation ; Cochlear Implants ; Guidelines as Topic