OBJECTIVE To analyze the susceptible factors to offer prevention and treatment of nosocomial pulmonary fungal infection in comprehensive ICU. METHODS The clinical materials of 82 patients with pulmonary fungal nosocomial infection in our department from May 2003 to May 2008 were reviewed. RESULTS The infection rate of total 836 patients was 9.81%.Candidiasis was the most frequent type in fungal infection,59.7% of which were due to Candida.The most clinical features were a large amount of light yellow sputum after tracheotomy and intratracheal indwelling cannula.The factors related to pulmonary fungal nosocomial infection were the severity of the underlying disease,tracheal intubations,broadspectrum antibiotics abuse,long-term use of glucocorticoid,interventional treatment,etc.Fluconazole,amphotericin B and voriconazole had better clinical effects on treatment of fungal infection than other antifungal drugs. CONCLUSIONS It′s important to eliminate the susceptible factors and to provide the early diagnosis and experimental treatment.

Adenocarcinoma ; pathology ; Carcinoma in Situ ; pathology ; Digestive System Neoplasms ; classification ; pathology ; Esophagogastric Junction ; pathology ; Humans ; Liver Neoplasms ; pathology ; Neoplasm Staging ; Neuroendocrine Tumors ; classification ; pathology ; Pancreatic Neoplasms ; pathology ; Precancerous Conditions ; pathology ; World Health Organization

Terpenoids constitute a chemically diverse family of naturally occuring compounds with pharmaceutical significance, such as artemisinin and taxin. They are synthesized in many kinds of microorganisms and plants with very low yield. Metabolic engineering, modifying metabolic pathways of terpenoids-synthesized cells by recombinant DNA techniques, has been developed and applied to improve the production of terpenoids, as well as create a novel biosynthesis pathway of terpenoids in terpenoid-free organisms. The biosynthetic pathway of terpenoids was sumed up, and recent progress of metabolic engineering aiming at raising content of terpenoids in microorganisms and plants was described.

Egr-1 is an important transcription factor, which regulates at least 30 kinds of gene expression. Egr-1 couples extracellular signals to long-term responses by altering expression of Egr-1 target genes. So egr-1 can directly or indirectly affect cell differentiation,apoptosis,immune response,injury and repair. This article reviewed the progress in Egr-1 and the lung disease.

AIM: To determine the effect of phacoemulsification and intraocular lens (IOL) implantation for angle closure glaucoma previously treated by laser iridotomy.METHODS: Thirty-nine patients(39 eyes )with angle closure glaucoma previously treated by laser iridotomy and cataract were divided into two groups according need for anti-glaucoma medications for controlling intraocular pressure (IOP) or not. All the patients underwent phacoemulsification and foldable IOL implantation and were followed up 3 months postoperatively.RESULTS: The best-corrected visual acuity(BCVA) of both groups improved significantly (P<0.05). The post-operative IOP of group I at 3 months was 15.72±3.02mmHg,and that of group Ⅱwas 16.30±3.81mmHg. The IOP of both group decreased significantly(P<0.05). The central anterior chamber depth of group I was deepened from 1.64±0.45mm preoperatively to 3.21±0.41mm at 3 months postoperatively,group Ⅱ was deepened from 1.92±0.52mm preoperatively to 3.18±0.39mm at 3 months postoperatively. The postoperative central anterior chamber depth of both groups increased significantly(P<0.05).Anterior chamber angle was much wider postoperatively.CONCLUSION: Phacoemulsification and IOL implantation was effective for angle closure glaucoma previously treated by laser iridotomy,and can improve visual acuity and completely relieve the pupillary block of angle closure glaucoma.

In order to investigate the effects of TGF-beta1 on the expression of MMP-2, -9 and TIMP-1 in human retinal pigment epithelial (RPE) cells, the third-sixth passage cultured RPE cells were treated with TGF-beta1 at different concentrations (0.01, 0.1, 1.0, 10 ng/mL), the expression of MMP-2, -9 and TIMP-1 mRNA was detected by semi-quantitative RT-PCR assays. MMP-2, -9 and TIMP-1 mRNA were expressed in the cultured RPE cells. The values of MMP-2/beta-actin in the cells treated with 0.1, 1.0, 10 ng/mL TGF-beta1 were 1.04 +/- 0.04, 1.07 +/- 0.02 and 1.11 +/- 0.03, respectively, significantly higher than in the control group (0.96 +/- 0.03, P < 0.05-0.01). The expression of MMP-2 mRNA could be up-regulated by TGF-beta1, in a dose-dependent manner. The expression of MMP-9 mRNA in the cultured RPE cells was slightly up-regulated by various TGF-beta1 concentrations treatment. The values of TIMP-1/beta-actin in the cells treated with 0.01 and 0.1 ng/ mL TGF-beta1 were 0.85 +/- 0.01 and 0.97 +/- 0.02 respectively, significantly lower than in the control group (1.07 +/- 0.04, P < 0.01), indicating that the expression of TIMP-1 mRNA was down-regulated by TGF-beta1 at low concentrations. But along with the increase of TGF-beta1 concentrations (1.0 and 10 ng/mL), the expression of TIMP-1 mRNA was slightly up-regulated, not significantly different from that in the control group (P > 0.05). It was concluded that TGF-beta1 might play an important role in the up-regulation of the expression of MMP-2 in RPE cells and result in a directional shift in the balance between MMP and TIMP. This may be facilitated for RPE cells to migrate in the pathogenesis of vitreoretinopathy.

Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.

Objective:To investigate the expressions of Th 1-Th2-Th17 cytokines in the coxsackievirus B 3-induced mice chronic viral myocarditis(VMC).Methods:BALB/c mice were intraperitoneally(i.p) infected with increased CVB3 for establishing chronic VMC models.Control mice were treated with phosphate-buffered saline(PBS)i.p.Cardiac tissues were obtained 8 weeks after CVB3 in-jection,myocardial histopathologic changes were observed by HE and Masson staining .Th1-Th2-Th17 cytokines in plasma were detected by protein array technology , and their cardiac mRNA expressions were measured by RT-PCR.Results: Compared with the control group,levels of IL-2,IL-5,IL-10,IL-13,IL-17,IL-6,IL-22,IL-21 and TGF-βobviously increased in chronic VMC group (P all<0.05). Conclusion:The imbalance of Th1-Th2-Th17 cytokines may play an important roles in the pathogenesis of chronic VMC .

Objective To evaluate the application of duct endoscopy in the diagnosis of breast diseases characterized by nipple discharge.Methods One hundred and sixty-nine consecutive cases from October 2003 to September 2004 who had duct endoscopy for nipple discharge were reviewed and followed up.Results Of 169 cases,79 ductitis,62 intraductal papilloma,9 intraductal carcinoma in situ,19 without breast diseases were diagnosed under duct endoscopy.During following up,the diagnostic accuracy of intraductal papilloma and intraductal carcinoma in situ with duct endoscopy was 89.8%(44/49) and 55.6%(5/9),respectively.There was only one patient who had breast pain and mild skin redness which was cured with oral antibiotics for 3 days.Conclusion Duct endoscopy is an only technique to explore the etiology for duct discharge under vision.It is direct,safe and effective,with a high accuracy.

Objective To study the effect of purified water on the neurobehavioral development of the offspring and the synergistic effect of the magnesium deficiency in food. Methods SD rats were divided into four groups,control food plus control water (control group),control food plus purified water,magnesium deficiency food plus control water,magnesium deficiency plus purified water,from five weeks of age of the F0 generation to five weeks of the F1 generation respectively. Morris water maze (MWM) was used to test the spatial learning and memory ability of offspring of rats. Results In the early training days of the place navigation,control group offspring of rats showed a shorter swimming time than the other groups. There were no significant differences among all experimental groups in the later training days of the place navigation,spatial probe test and visible platform trial,however the tendency was still to remain. Conclusion Purified water can damage the learning ability of offspring of rats and the learning ability delay will be more obviously when magnesium is deficient in food.