Candida esophagitis is mainly caused by candida albicans. Risk factors include using antibiotics and glucocorticosteroid, chemotherapy and/or radiation therapy, malignancies and immunodeficiency syndromes. Acute onset of symptoms such as dysphagia and odynophagia is typical. It can coexist with heartburn, retrosternal discomfort, nausea and vomiting. Abdominal pain, anorexia, weight loss and even cough are present sometimes. Severe candida esophagitis may lead to development of strictures, hemorrhage, esophagotracheal fistula, and a consequent decrease in quality of life. The purpose of article is to review the epidemiology, pathogeny, risk factors, diagnosis and treatment of candida esophagitis.

Background:Gastric xanthelasma is a benign and uncommon lesion with unknown etiology. It has been noted thatatrophic gastritis is frequently seen in patients with gastric xanthelasma. Aims:To investigate the relationship betweengastric xanthelasma and atrophic gastritis and its clinical significance. Methods:A total of 10645 consecutive patients whohad undergone gastroscopy from Apr. 2015 to Mar. 2016 at the Shanxi Provincial People's Hospital were enrolled andanalyzed retrospectively with respect to their demographic,clinical,endoscopic and histological features. Results:Theprevalence of gastric xanthelasma in patients recruited in this study was 2. 9％ . The mean age and prevalence of atrophicgastritis (47. 9％ vs. 16. 6％ )were significantly higher and the gastric atrophy was more severe in patients with gastricxanthelasma than those without (P all < 0. 001). Multivariate Logistic regression analysis revealed that age ≥50 years(adjusted OR =1. 349,95％ CI:1. 042 ～ 1. 747,P = 0. 023)and atrophic gastritis (adjusted OR = 3. 892,95％ CI:3. 076 ～4. 924,P <0. 001)were independently related to the presence of gastric xanthelasma. Likewise,the prevalence ofgastric xanthelasma in patients with atrophic gastritis was significantly higher than those without (7. 9％ vs. 1. 8％ ,P <0. 001). Age- and sex-matched control analysis proved the correlation between gastric xanthelasma and atrophic gastritis(P <0. 001). In addition,multiple xanthelasma was more prevalent in gastric xanthelasma patients with atrophic gastritisthan those without (32. 0％ vs. 13. 8％ ,P <0. 001). Conclusions:Gastric xanthelasma is correlated with age and presenceand severity of atrophic gastritis. Atrophic gastritis might be one of the etiological factors of gastric xanthelasma,and gastricxanthelasma might be an atypical mucosal lesion caused by gastric atrophy.

The efficacy and safety of Saccharomyces boulardii in treatment of candida esophagitis was investigated by a single center, prospective, open label and non-inferiority trial.Eighty nine patients with candida esophagitis attending in Shanxi Provincial People′s Hospital during April 2015 to March 2016 were randomly divided into Saccharomyces boulardii group (45 cases) and nystatin group (44 cases), and oral Saccharomyces boulardii powder and Nystatin tablets were given to two groups respectively.The curative effect was evaluated by gastroscopy after the treatment.The results showed that the cure rate of Saccharomyces boulardii group and nystatin group was 68.9%(31/45)and 63.6%(28/44), and the Saccharomyces boulardii was noi inferior to nystatin (x2=3.027, P<0.05).Chi-square test showed that there was no significant difference in effective rate between two groups [91.1%(41/45)vs.93.2%(41/44), x2<0.001, P>0.05].The incidence of adverse reactions in boulardii group was significantly lower than that in nystatin group [2.2%(1/45) vs.22.7%(10/44), x2=8.636, P<0.05].The study suggests that the cure rate of Saccharomyces boulardii is not inferior to nystatin in treatment of candida esophagitis, while the incidence of adverse reactions of Saccharomyces boulardii is lower.

The clinical data and imaging findings of 10 patients with reversible splenial lesion syndrome ( RESLES ) admitted in Shanxi people′s Hospital from August 2014 to August 2016 were retrospectively analyzed .All 10 patients were acute or subacute onset , the etiology included viral meningitis ( n =5 ) , purulent meningitis ( n =2 ) , tuberculous meningitis ( n =1 ); and one schizophrenic patient receiving antipsychotic drug and one epileptic patient treated with phenytoin .There were 8 patients under 30 years.The clinical manifestations included headache , fever, disorder of consciousness and mental symptoms.Seven patients had prodromic infections before the onset of the disease and focal neurological defects were present in the early stage .The initial MRI showed isolated splenium of corpus callosum (SCC) lesions with homogeneous hyperintense on T 2WI, hypointense on T1WI, and patchy, round, ovoid, schistose diffusion with hyperintense on DWI in all 10 cases;and there was no significant strengthening on enhanced MRI in 4 cases.The follow-up MRI showed that SCC abnormalities disappeared after treatment in 9 cases and the neurological symptoms disappeared after one-month follow up in 6 cases.The results indicate that RESLES is frequently secondary to infections , and presents the symptoms of mild encephalitis or encephalopathy .

This study examined the protective effect of ischemic postconditioning (IPoC) and minocycline postconditioning (MT) on myocardial ischemia-reperfusion (I/R) injury in atherosclerosis (AS) animals and the possible mechanism. Forty male healthy rabbits were injected with bovine serum albumin following feeding on a high fat diet for 6 weeks to establish AS model. AS rabbits were randomly divided into 3 groups: (1) I/R group, the rabbits were subjected to myocardial ischemia for 35 min and then reperfusion for 12 h; (2) IPoC group, the myocardial ischemia lasted for 35 min, and then reperfusion for 20 s and ischemia for 20 s [a total of 3 cycles (R20s/I20s×3)], and then reperfusion was sustained for 12 h; (3) MT group, minocycline was intravenously injected 10 min before reperfusion. The blood lipids, malondialdehyde (MDA), superoxide dismutase (SOD), soluble cell adhesion molecule (sICAM), myeloperoxidase (MPO), and cardiac troponin T (cTnT) were biochemically determined. The myocardial infarction size (IS) and apoptosis index (AI) were measured by pathological examination. The expression of bcl-2 and caspase-3 was detected in the myocardial tissue by using reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the AS models were successfully established. The myocardial IS, the plasma levels of MDA, sICAM, MPO and cTnT, and the enzymatic activity of MPO were significantly decreased, and the plasma SOD activity was significantly increased in IPoC group and MT group as compared with I/R group (P<0.05 for all). The myocardial AI and the caspase-3 mRNA expression were lower and the bcl-2 mRNA expression was higher in IPoC and MT groups than those in I/R group (all P<0.05). It is concluded that the IPoC and MT can effectively reduce the I/R injury in the AS rabbits, and the mechanisms involved anti-oxidation, anti-inflammation, up-regulation of bcl-2 expression and down-regulation of caspase-3 expression. Minocycline can be used as an effective pharmacologic postconditioning drug to protect myocardia from I/R injury.

This study examined the protective effect of ischemic postconditioning (IPoC) and minocycline postconditioning (MT) on myocardial ischemia-reperfusion (I/R) injury in atherosclerosis (AS) animals and the possible mechanism. Forty male healthy rabbits were injected with bovine serum albumin following feeding on a high fat diet for 6 weeks to establish AS model. AS rabbits were randomly divided into 3 groups: (1) I/R group, the rabbits were subjected to myocardial ischemia for 35 min and then reperfusion for 12 h; (2) IPoC group, the myocardial ischemia lasted for 35 min, and then reperfusion for 20 s and ischemia for 20 s [a total of 3 cycles (R20s/I20s×3)], and then reperfusion was sustained for 12 h; (3) MT group, minocycline was intravenously injected 10 min before reperfusion. The blood lipids, malondialdehyde (MDA), superoxide dismutase (SOD), soluble cell adhesion molecule (sICAM), myeloperoxidase (MPO), and cardiac troponin T (cTnT) were biochemically determined. The myocardial infarction size (IS) and apoptosis index (AI) were measured by pathological examination. The expression of bcl-2 and caspase-3 was detected in the myocardial tissue by using reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the AS models were successfully established. The myocardial IS, the plasma levels of MDA, sICAM, MPO and cTnT, and the enzymatic activity of MPO were significantly decreased, and the plasma SOD activity was significantly increased in IPoC group and MT group as compared with I/R group (P<0.05 for all). The myocardial AI and the caspase-3 mRNA expression were lower and the bcl-2 mRNA expression was higher in IPoC and MT groups than those in I/R group (all P<0.05). It is concluded that the IPoC and MT can effectively reduce the I/R injury in the AS rabbits, and the mechanisms involved anti-oxidation, anti-inflammation, up-regulation of bcl-2 expression and down-regulation of caspase-3 expression. Minocycline can be used as an effective pharmacologic postconditioning drug to protect myocardia from I/R injury.
Animals ; Atherosclerosis ; physiopathology ; Ischemic Preconditioning, Myocardial ; methods ; Male ; Minocycline ; pharmacology ; Myocardial Reperfusion Injury ; physiopathology ; Rabbits ; Reperfusion Injury ; physiopathology

Objective:To investigate the clinical characteristics of asymptomatic carriers with 2019 novel coronavirus (2019-nCoV), and to provide clinical guidance for the management of asymptomatic infection with 2019-nCoV.Methods:The clinical data of 663 patients with confirmed coronavirus disease 2019 (COVID-19) admitted to Renmin Hospital of Wuhan University from January 11 to February 6, 2020 were collected. Patients were divided into asymptomatic group (21 cases) and symptomatic group (642 cases) according to the diagnostic criteria. General conditions, clinical classification, death, chest computed tomograph (CT) and laboratory results of patients were retrospectively collected. Mann-Whitney U test, chi-square test and Fisher exact test were used for statistical analysis. Results:All 663 patients were positive for 2019-nCoV nucleic acid tests. The age of patients in the asymptomatic group were significantly younger than those in symptomatic group (35.0 (31.5, 58.0) years old vs 58.5 (45.0, 69.0) years old, U=4 234.500, P=0.002). The proportion of patients <30 years old in the two groups was significantly different (19.0%(4/21) vs 6.1%(39/642), Fisher exact test, P=0.047). There were 15 women (71.4%) in the asymptomatic group and 327 women (50.9%) in the symptomatic group, while the difference of gender distributions was not statistically significant ( χ2=3.420, P=0.064). In addition, among patients with asymptomatic infection, the proportions of mild/ordinary, severe and critical patients were 10 cases (47.6%), 10 cases (47.6%), and one case (4.8%), respectively, which were not significantly different from those in symptomatic group (244 cases (38.0%), 305 cases (47.5%) and 93 cases (14.5%), respectively, χ2=1.847, P=0.397). As of February 9, one(4.8%) mild/ordinary patient in the asymptomatic group died who had malignant tumor. Twenty-four (3.7%) patients in the symptomatic group died including two mild/ordinary and 22 critical patients. There was no significant difference in mortality between the two groups(Fisher exact test, P=0.560). CT examination was performed on 594 patients, and 591 cases (99.5%) showed unilateral or bilateral pneumonia, and three cases (0.5%) showed normal. Conclusions:Patients with asymptomatic infection with 2019-nCoV are younger than symptomatic patients, and there are more patients under 30 years old in the asymptomatic group. The absence of clinical symptoms is not significantly associated with clinical classifications and mortality in COVID-19 patients.

Objective:To retrospectively analyze the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) accompanied with diarrhea.Methods:From January 11 to February 6 in 2020, the clinical data of 663 patients diagnosed with COVID-19 admitted to Renmin Hospital of Wuhan University were collected and divided into diarrhea group and non-diarrhea group according to whether they had diarrhea or not. The differences in baseline characteristics, basic disease history, clinical manifestations, chest computed tomography (CT), laboratory findings, disease severity and mortality between the two groups were compared. Chi-square test and Fisher exact test were used for statistical analysis.Results:Among 663 COVID-19 patients, 70 (10.6%) patients accompanied with diarrhea. The proportion of fatigue and increased lactate dehydrogenase (LDH) levels of diarrhea group were higher than those of non-diarrhea group (58.6%, 41/70 vs. 28.2%, 167/593; and 64.2%, 43/67 vs. 50.4%, 277/550), and the differences were statistically significant ( χ2=26.891 and 4.566, both P<0.05). There was no statistically significant difference in the proportion of pneumonia in chest CT between diarrhea group and non-diarrhea group (100.0%, 62/62 vs. 99.4%, 529/532) ( P>0.05). There were no statistically significant differences in the proportions of mild and normal type, severe type and critical type between diarrhea group and non-diarrhea group (35.7%, 25/70 vs. 38.6%, 229/593; 50.0%, 35/70 vs. 47.2%, 280/593; and 14.3%, 10/70 vs. 14.2%, 84/593, respectively) (all P>0.05). There were no statistically significant differences in the mortality of mild and normal type, severe type and critical type between diarrhea group and non-diarrhea group (0 vs. 0.5%, 3/593; 0 vs. 0 and 1.4%, 1/70 vs. 3.5%, 21/593) (all P>0.05). Conclusions:Patients with COVID-19 accompanied with diarrhea are more likely to have fatigue and increased LDH level. Diarrhea is not significantly correlated with the disease severity of patients with COVID-19.