Objective To report the clinical features and treatment outcomes of 27 patients with fungal endophthalmitis (27 eyes)over a five year period.Methods The authors retrospectively reviewed the etiology,direct smear examination,fungal cul-ture and treatments of 27 patients with culture-proven fungal endophthalmitis at the affiliated Hospital of Medical College Qing-dao University from 2007 to 2012.Results Exogenous infection was defined in 21 patients (77.8%),including 20 associated with penetrating wound,and 1 following cataract surgery.Endogenous infection was found in 6 patients (22.2%),including 3 associated with recent use of high-dose steroids,1 after abortion,1 following pelvic fracture,and 1 with long-term use of im-munosuppressive agents.Fungal hyphae were found in 17 smears of 27 samples (63.0%)by direct microscopic examination. The fungal strains cultured from 27 samples belonged to 8 genus and 12 species.The most common isolates were Aspergillus , Fusarium and Candida species.A.flavus (22.2%)and A.fumigatus (18.5%)were the predominant Aspergillus species. F .moniliforme (14.8%)and F .oxysporum (11 .1 %)were the most predominant Fusarium species.Two eyes were eviscer-ated immediately due to the serious condition.Among the other 25 eyes,22 (88.0%)got improvement after at least one of such treatments as intravitreal injection of antifungal agent,vitrectomy or penetrating keratoplasty (PK).Conclusions Exoge-nous fungal endophthalmitis is the most common type of fungal endophthalmitis in this hospital.Penetrating wound is the main cause of such infections.Microscopic examination of hyphae and fungal culture were effective for the diagnosis of fungal endophthalmitis.Aspergillus is the predominant pathogens, followed by Fusarium.Intravitreal injection of antifungal a-gent combined with vitrectomy is an effective treatment of fungal endophthalmitis.

Aim To investigate the effect of p38 MAPK AS-ODNs on the expression of GLT-1 during the induction of brain ischemic tolerance induced by cerebral ischemic preconditioning (CIP).Methods Eighty healthy male Wistar rats with permanent occlusion of the bilateral vertebral arteries were randomly divided into 6 groups: ①Sham group (n=10);②CIP group (n=10);③ischemic insult (Ⅱ) group (n=10);④CIP+Ⅱ group (n=10);⑤p38 MAPK AS-ODNs+CIP+Ⅱ group (n=30);⑥p38 MAPK S-ODNs+CIP+Ⅱ group (n=10).Group ⑤ was divided into 5 nmol, 10 nmol and 15 nmol subgroups according to the dose of p38 MAPK AS-ODNs (n=10).The dose of p38 MAPK S-ODNs was 15 nmol.All the rats were sacrificed 6 h and 2 d after the sham operation or the last time of global brain ischemia reperfusion.Western blot and immunohistochemistry analysis were used for detecting the expression of p-p38 MAPK and GLT-1 protein.Results CIP moderately up-regulated the expression of p-p38 MAPK and significantly up-regulated the expression of GLT-1 protein, inhibited the excessively up-regulation of p-p38 MAPK and the down-regulation of GLT-1 induced by ischemic insult.p38 MAPK AS-ODNs significantly inhibited the up-regulation of p-p38 MAPK and GLT-1 protein in a dose-dependent manner during the induction of brain ischemic tolerance by CIP.Conclusion p38 MAPK AS-ODNs inhibit the up-regulation of GLT-1 during the induction of brain ischemic tolerance induced by CIP.

Objective:To observe the effect of icariin on the osteoporosis of the ovariectomized rats,and to explore the mechanism.Methods:Fifty female rats aged 6 months were randomly divided into sham operation group, model group,positive drug group,low dose of icariin group and high dose of icariin group (n= 10).The rats in positive drug group were given with 1 mg· kg-1 nilestriol every week;the rats in low and high doses of icariin groups were given with 50 and 100 mg · kg-1 icariin every day.The bilateral ovaries of rats were excised by operation to establish the osteoporosis models.2 weeks after operation,the rats were treated with icariin for 12 weeks,and then they were sacrificed by drawing blood from abdominal aorta under anesthesia condion.The bone mineral density (BMD),serum biochemical indicators,bone histomorphology and the expressions of apoptosis-related proteins were detected.Results:Compared with sham operation group,the BMD of the rats in model group was decreased (P <0.01),the serum calcium level was decreased (P <0.05),and the serum phosphorus level was increased (P <0.05),and the serum BGP,ALP,NO and NOS levels were significantly decreased (P <0.05 or P <0.01).Compared with model group,the BMD of the rats in positive drug group and high dose of icariin group were obviously increased (P < 0.01 ), the serum calcium levels were increased, the phosphorus levels were decreased (P <0.05),and the BGP and ALP levels were increased significantly (P < 0.05 ). Compared with control group,the cortical in model group was thinned,the width of bone trabecula was reduced,the Bax and Caspase-3 expression levels in bone tissue were increased,and the Bcl-2 expression level was decreased.Compared with model group,the cortical in icariin group was thicked,the width of bone trabecula was increased,the Bax and Caspase-3 expression levels were decreased,and the Bcl-2 expression level was increased (P <0.05 or P <0.01). Conclusion:Icariin can protect the osteoporosis of ovariectomized rats,the function may be related to the inhibition of apoptosis.

Background and Objectives: This study investigated the relative incidence of contrast induced nephropathy (CIN) and long-term outcomes between iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) undergoing elective percutaneous coronary intervention (PCI). Methods: A total of 9,431 patients receiving elective PCI were enrolled in the cohort. The patients were divided into IOCM group and LOCM group. Propensity score matching (PSM) was applied to minimize the selection bias between groups. Results: The multivariate analysis showed that the use of IOCM compared with LOCM did not affect the CIN incidence (odds ratio [OR], 0.912; 95% confidence interval [CI], 0.576–1.446; p=0.696). After PSM, the incidence of CIN was 1.5% and 4.0% in IOCM group (n=979) and LOCM group (n=979), respectively, p=0.001. IOCM significantly reduced the incidence of CIN compared with LOCM (OR, 0.393; 95% CI, 0.214–0.722; p=0.003). After 2 years of follow-up, the all-cause mortality was higher in IOCM group than LOCM group (2.1% vs. 0.9%, p<0.001). Cox regression analysis showed IOCM was not independent risk factor of 2-years all-cause mortality (OR, 0.849; 95% CI, 0.510–1.412; p=0.528). After PSM, the difference of all-cause death between groups disappeared (1.7% vs. 1.9%, p=0.739). Cox regression analysis showed that the use of IOCM compared with LOCM did not affect the incidence of 2-year all-cause mortality (OR, 1.037; 95% CI, 0.534–2.014; p=0.915). Conclusions Compared with LOCM, IOCM significantly reduced the incidence of CIN after elective PCI, but had no significant effect on 2-year all-cause mortality.

Background and Objectives: This study investigated the relative incidence of contrast induced nephropathy (CIN) and long-term outcomes between iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) undergoing elective percutaneous coronary intervention (PCI). Methods: A total of 9,431 patients receiving elective PCI were enrolled in the cohort. The patients were divided into IOCM group and LOCM group. Propensity score matching (PSM) was applied to minimize the selection bias between groups. Results: The multivariate analysis showed that the use of IOCM compared with LOCM did not affect the CIN incidence (odds ratio [OR], 0.912; 95% confidence interval [CI], 0.576–1.446; p=0.696). After PSM, the incidence of CIN was 1.5% and 4.0% in IOCM group (n=979) and LOCM group (n=979), respectively, p=0.001. IOCM significantly reduced the incidence of CIN compared with LOCM (OR, 0.393; 95% CI, 0.214–0.722; p=0.003). After 2 years of follow-up, the all-cause mortality was higher in IOCM group than LOCM group (2.1% vs. 0.9%, p<0.001). Cox regression analysis showed IOCM was not independent risk factor of 2-years all-cause mortality (OR, 0.849; 95% CI, 0.510–1.412; p=0.528). After PSM, the difference of all-cause death between groups disappeared (1.7% vs. 1.9%, p=0.739). Cox regression analysis showed that the use of IOCM compared with LOCM did not affect the incidence of 2-year all-cause mortality (OR, 1.037; 95% CI, 0.534–2.014; p=0.915). Conclusions Compared with LOCM, IOCM significantly reduced the incidence of CIN after elective PCI, but had no significant effect on 2-year all-cause mortality.

Objective: To compare the biomechanical characteristics of four-implants mandibular overdentures supported by Locator attachment or bar-clip attachment under different mechanical loads using three-dimensional finite element analysis method. Methods: Two different models of four-implants supported mandibular overdentures using Locator attachment and bar-clip attachment (hereinafter called Locator model and bar-clip model) were established. Each model was subjected to five different mechanical loading conditions: 100 N vertical loading in central incisor (vertical load of incisor), 100 N vertical loading or oblique loading in canine (vertical or oblique loads of canines), 100 N vertical or oblique loading in mandibular first molar (vertical or oblique loads of mandibular first molar). The stress distributions in implants, peri-implant bone and mucosa were recorded under the above five conditions to evaluate the effects of different attachments on the biomechanical properties of implant-supported mandibular overdentures. Results: Regardless of loading conditions and types of attachments, the stress concentration in implants were located at the neck of implants, and the stress concentration in peri-implant bone was located in the cortical bone. The stress values in mucosa were always much smaller than those in implants and cortical bone. Regardless of loading positions (on canine or on mandibular first molar), the maximum stress at the bone interface around the implant under lateral loading was much higher than that under vertical loading. Under various loading conditions, the stress in implants and cortical bone of the Locator model (the highest von Mise stress value was respectively 79.5 and 22.3 MPa) were lower than that of bar-clip model (the highest von Mise stress value was 110.3 and 28.7 MPa respectively) while the maximum compressive stress in mucosa (0.198 MPa) in Locator model was slightly higher than that in the bar-clip model (0.137 MPa). Conclusions In clinical practice, the lateral force applied to the implant-retained overdenture should be minimized to avoid complications caused by pathological loads. Under the same loading condition, the stress distributions in overdenture using Locator attachment are more dispersed, which is more conducive to long-term stability of implants.

Medicinal Polyporus umbellatus is the dry sclerotia of P. umbellatus, with the effect of diuresis; Armillaria mellea is a parasitic fungus which can infect plants up to 300 genera, with sedative, anticonvulsant and some other biological activities. As the medicinal value of P. umbellatus and A. mellea is increasingly wide concerned, the market quantity demanded of them is gradually increased and the demand outstrips the supply. The symbiotic A. mellea and P. umbellatus are both the medicinal and edible fungi with diverse activities, including hypoglycemic action, improve immunity and antitumor and so on. The growth of the sclerotia forming from the mycelium of P. umbellatus is related to the infection of the symbiotic A. mellea and their secondary products. In this study, by comparing the chemical constituents of the mycelium and sclerotia of P. umbellatus and A. mellea, we found that they all produced steroids and nitrogen-containing heterocycles. The sclerotia of P. umbellatus and A. mellea also produced triterpenes secondary metabolites. In addition, the mycelium and infected sclerotia of P. umbellatus mainly produced different steroids, and the sclerotia produced some other special secondary metabolites, such as long-chain fatty acids, ceramides, phenol and so on. By analyzing above all kinds of differences, speculated that these may be caused by the infection of the symbiotic A. mellea which mainly produced sesquiterpenes, diterpenes and other secondary metabolites. The contents and types of compounds of P. umbellatus and A. mellea are closely related to their symbiosis and reproduction, therefore, many symbiosis mechanisms should be found by utilizing more molecular biology technology to elucidate this complex symbiotic infection and provide scientific basis for improving the yield and quality of P. umbellatus and A. mellea.