[Summary] This article reviewed the clinical features in two diabetes cases complicated with nasal‐brain mucormycosis by pathology and pulmonary mucormycosis. In one patient with diabetes combined with pulmonary mucormycosis ,manifestations of chest pain and hemoptysis ,the right upper lung biopsy tip morphology was consistent with Mucor ,successfully cured with amphotericin and operation treatment. The other patient with diabetes‐complicated nasal mucormycosis with headache and nasal cavity clump , showed black caseous matter ,finally hemiplegia. A nasal cavity tumor was proved by pathological examination. After treatment with fluconazole and operation ,the patientdied. Mucormycosisis rare and may be secondary to diabetes and hypoimmunity disease. It needs rapid diagnosis and treatment.

BACKGROUND: Hibiscus Mutabilis L. Is a very effective Chinese traditional herb for non-specific inflammation in the clinic adopted by Professor Wei Zhixin, the eminent expert in Traumatology Department in China, lasting for near 60 years. In order to explain its pharmaceutical mechanism, the research of Hibiscus Mutabilis L. Was carried on in the model of ischemic reperfusion injury to explain its mechanism on anti-inflammation.OBJECTIVE: To observe the protection of the effective fraction of Hibiscus Mutabilis L. (MFR) on renal ischemic reperfusion injury in rats to probe into the mechanism of MFR on anti-inflammation.DESIGN: Randomized and controlled study on experimental animal.SETTING: A Municipal Institute of Traumatology and Orthopedic Department.MATERIALS: The experiment was performed in the Key Experiment Room (Institute of Traumatology and Orthopedic Department, Shanghai) of State Administration of Traditional Chinese Medicine, in which, 55 male Wistar rats were employed.METHODS: The rat model of renal ischemic reperfusion was adopted and MFR was applied for gastric perfusion to determine serum blood urea nitrogen(BUN) and serum creatinine(Scr) and the level of interleukin-1 (IL-1).MAIN OUTCOME MEASURES: ① Changes in serum BUN and Scr; ②Effect of MFR on level of serum IL-1.RESULTS: After MFR treatment, the renal function was improved remarkably after ischemic reperfusion in rats. In sham-operation group, serun BUN was (6.72 ± 1.30) mmol/L and serum Scr was (38.40 ± 6.23) μmol/L. In 24hours of reperfusion after one-hour ischemia, BUN was(60. 72±4.64)mmol/L in the control and(47.34 ± 8.32) mmol/L in the MFR treatment group, and the significant difference presented between two groups(t=2.562, P ＜ 0.05) .Serum Scr was(347.95±95) μmol/L and(518.20 ± 41.15) μmol/L in the treatment group and the control respectively, indicating significant difference ( t = 3.69, P ＜ 0.01 ) . Concerning to the effect on IL-1, in 1 hour of reperfusion after 1 hour renal ischemia,IL-1 was( 122.79 ±27.56) ng/L in the MER treatment group,(180. 28 ±33. 15) ng/L in the control group, indicating that IL-1 level in the treatment group was remarkably superior to that in the control group(t = 2.98, P ＜ 0.05). In 3 hours of reperfusion after 1 hour ischemia, level of IL-1 in the treatment group and control group was(15.58±8.59) ng/L and (34. 13±± 10. 02) ng/L respectively, indicating significant difference( t = 3.14, P＜ 0.05).CONCLUSION: MFR provides protection on renal ischemic reperfusion injury, which probably is related to its inhibition on IL-1 formation.

ObjectiveTo investigate the role of active protein C (APC) in lipopolysaccharide (LPS) induced microglia activation.MethodsMicroglia from one day old Sprague-Dawley newborn rat was collected, purified and identified by primary culture and immunofluorescence staining, and then was randomly divided into four groups including LPS group (1.0μg/ml LPS plus 10μl phosphate buffered saline 12 h later), LPS+ APC group (1.0μg/ml LPS plus 0.1μg/ml APC 12 h later), APC group (10μl phosphate buffered saline plus 0.1μg/ml APC 12 h later) and control group (10μl phosphate buffered saline at each time point). The morphology of micaroglia in all groups was observed under microscope, and the expression of tumor necrosis factor-α (TNF-α) and protease-activated receptor-1 (PAR-1) were determined by immunofluorescence staining. One-way analysis of variance and LSD test were applied for statistical analysis.ResultsPrimary culture microglia was successful and the purity was no less than 99%. In LPS group, the microglia morphology was activated, and the expression of TNF-α was increased significantly than the control group (2.11±0.35 vs 1.38±0.28, LSD test,P=0.002). In LPS+APC group, the microglia morphological change was reversed, and the expression of TNF-α had no significant difference with the control group (1.35±0.36 vs 1.38±0.28, LSD test,P>0.05). The expression of PAR-1 in LPS+APC group was higher comparing with that in the control group (4.60±0.84 vs 2.64±0.41, LSD test,P=0.008) and the LPS group (2.44±0.86, LSD test,P=0.002). The expression of PAR-1 in APC group and LPS group had no obvious difference with control group (2.62±0.69, 2.44±0.86 vs 2.64±0.41, LSD test, bothP>0.05).ConclusionsBy increasing the level of PAR-1 in microglia, active protein C could inhibit the activation of miciroglia and the expression of TNF-α induced by lipopolysaccharide, therefore, protecting the brain tissues from inflammation-induced damage.

Objective To investigate the prevalence of BRAF T1799A mutation and RET/PTC rearrangement in Qingdao and detect the expression of platelet-derived growth factor B (PDGF-B) in order to investigate the correlation between gene mutation and PDGF-B.Methods Fresh tissue from 48 papillary thyroid carcinomas (PTC) patients was examined for BRAF mutation RET rearrangements (RET/PTC1 and RET/PTC3) by PCR,followed by direct-sequence analysis.The expression of PDGF was analyzed by immunohistochemistry.Results Among the 48 patients,14 (29.2％) were micro PTC; 18 (37.5％) had BRAF T1799A mutations and 23(47.9％) had RET/PTC rearrangement.There were 17 (35.4％) cases of RET/PTC1 and 6 (12.5％) of RET/PTC3,with no multiple rearrangements.Both BRAF T1799A mutation and RET/PTC rearrangement were present in 6 (12.5％) cases of non-micro PTC.The level of PDGF-B expression in BRAF T1799A positive was higher than that in the negative,and the level of PDGF-B expression in RET/PTC3 was higher than that in RET/PTC1 (P ＜ 0.05).The more advanced neoplasm stage was,the stranger PDGF-B expression was.Conclusions The incidence of BRAF T1799A mutation and RET/PTC rearrangement is higher in Qingdao.BRAF T1799A mutation and RET/PTC3 rearrangement in patients suggests a poorer prognosis than the negative one.The BRAF T1799A mutation and RET/PTC3 rearrangement may strengthen the expression of PDGF-B.Both variations suggest a poor prognosis.

Objective To analyze the genotype of Japaneso encephalitis virus (JEV) strains isola-ted in 2004 from mosquitoes collected in Bazhong city, Sichuan province of China, and the characters of amino acid in the PrM and E gene. Methods The isolated virus strains from mosquitoes were identified by biological, serological and molecular biology. PrM and E segments of the isolated JEV were amplified by RT-PCR, the PCR products were purified and sequenced. Multiple alignment, phylogenetic and amino acid (AA) analysis were carried out by Clustal X (1.8) , MEGA4 and GENEDOC (3.2) . Results The total of 4688 mosquitoes were collected including Armigeres and Culex. Six isolates were identified be-longing to genotype 1 JEV. The comparison between new genotype 1 JEV strains and live attenuated vaccine strain SA14-14-2 in PrM and E gene showed that total 3 sites amino acid differences in PrM gene and 14 sites in E gene, respectively. Three sites (PrM2, 64 and 65 ) in PrM protein and four sites (E129, 222,327 and 366) in E protein were only belonging to genotype 1 JEV. Conclusion The new isolated JEV strains in Sichuan province belong to genotype 1. It suggests that the vaccine strain SA14-14-2 currently used for preventing Japanese encephalitis is able to protect people against JEV, although in the segments of it had some amino acid differences between vaccine strain and the epidemic genotype 1 JEV strains in PrM and E gene.

Objective To investigate a new clinical classification of hepatolithiasis based on biliary anatomy and pathology in order to guide clinical decision-making.Methods The cases of hepatolithiasis admitted to our hospital from Mar 2015 to Aug 2018 were classified into six types and an additional type according to biliary anatomy,stone site and extent,liver pathological changes,and Oddi sphincter function.Results Of the214 cases of hepatolithiasis,5 cases (2.3％) were type Ⅰ;41 cases (19.2％) were type Ⅱ;76 cases (35.5％) were type Ⅲ;17 cases (7.9％) were type Ⅳ;29 cases (13.5％) were type Ⅴ;46 cases (21.5％) of type Ⅵ.The most common complication was incision infection (28 cases,13.1％),liver failure 0,and perioperative death 0.During the follow-up from 3 months to 3 years,there were 14cases of stone recurrence,the recurrence rate was 7.6％.Conclusion This classification scheme and the "individualized precise anatomical combined hepatectomy or segmental hepatectomy" based on this classification is safe and effective while enhancing the cure rate.

Objective: To study the genome molecular characteristics of Getah virus (SC1210) which isolated in Sichuan province in 2012. Methods: Reverse transcriptase polymerase chain reaction (RT-PCR) was used to identify the isolate and the genome was sequenced by the second Ion Torrent PGM. Computer softwares, including Mega Align and Mega 6, were used to analyze the nucleotide and deduced amino acid sequence, and draw phylogenetic trees. Results: SC1210 was identified as Getah virus. The full genome sequence was 11 690nt, the nucleotide and amino acid homology of the full sequence with other strains were 99.2%-99.7% and 96.5%-99.4%.The capsid protein of SC1210 consisting of 804 nucleotides, encoding 268 amino acids and the full-length of E2 protein, had 1 266 nucleotides, encoding 422 amino acids. The nucleotide homology of the capsid protein and the E2 protein with other strains were 94.9%-99.2% and 94.6%-99.6%, and the amino acid were 97%-99.6% and 97.1%-99.5%. The 3′ UTR of the virus included 402 nucleotides and there were three repeat sequence elements and 19 nucleotides conservation sequence. Conclusions The first GETV isolate SC1210 in Sichuan province has a closer relationship with Yunnan strain YN040 and a far genetic relationship with MM2021.

OBJECTIVE To explore the effect of volatile oil of Ligusticum chuanxiong on the transdermal properties and cytotoxicity of triptolide in vitro. METHODS The chemical constituents of the volatile oil of L. chuanxiong were analyzed by gas chromatography-mass spectrometry. The lower abdominal skin of KM mice was separated and divided into triptolide group， triptolide in compatibility with volatile oil of L. chuanxiong groups at 1∶10， 1∶50， 1∶100 （hereinafter referred to as “compatibility 1∶10”“compatibility 1∶50”“compatibility 1∶100” groups）. After the skin of mice in each group was fully exposed to 0.2 g of the corresponding cream for 24 h， the cumulative transdermal dose （Qn） of triptolide in the receiving solution of each group was determined by high-performance liquid chromatography， and the transdermal absorption rate （Jss） was calculated. Human immortalized keratinocytes （HaCat） were used as a model， the CCK-8 method was used to detect the cell survival rate of different concentrations of the volatile oil of L. chuanxiong and triptolide before and after compatibility. RESULTS A total of 62 chemical constituents of the volatile oil of L. chuanxiong were identified， including Z-ligustilide， senkyunolide， and β-selinene. The Qn （P＜ 0.01） and Jss of triptolide increased within 24 h in the compatibility 1∶10 and 1∶50 groups， while the Qn （P＜0.05） and Jss decreased in the compatibility 1∶100 group as compared with the triptolide group. Compared with the triptolide group， the cell survival rate of HaCat was significantly increased in the compatibility 1∶10 and 1∶50 groups when the triptolide concentrations were 36， 72 and 144 ng/mL （P＜0.05 or P＜0.01）； while the cell survival rate of HaCat was decreased in the compatibility 1∶100 group， but the difference was not statistically significant （P＞0.05）. CONCLUSIONS When the compatibility ratio of triptolide and volatile oil of L. chuanxiong was 1∶10 or 1∶50， it can promote the transdermal absorption of triptolide and reduce the cytotoxicity of triptolide to HaCat.