Abstract: AIDS combined with Pneumocystis jirovecii pneumonia (PJP) and disseminated infections of Talaromyces marneffei and Cryptococcus neoformans are rare. This paper summarizes and analyzes the diagnosis and treatment of an AIDS patient with multiple fungal infections for reference. A 79-year-old male patient was admitted to the hospital with "stool habit change for more than 20 days". The white blood cell count was 4.57×109/L, the percentage of neutrophils was 81.8%, the absolute count of CD4+ lymphocytes was 6/μL, and the CD4/CD8 ratio was 0.17. HIV antibody positive was confirmed by CDC. The cerebrospinal fluid and alveolar lavage fluid were positive for Cryptococcus neoformans capsular antigen, and Pneumocystis jirovecii was found by the bronchoalveolar lavage fluid stained with hexamine silver. The cerebrospinal fluid culture was positive for Cryptococcus neoformans, and the blood culture was positive for Cryptococcus neoformans and Talaromyces marneffei. CT showed that bronchovascular bundles in both lungs were more thick, patchy and cable-like high-density shadows were seen in both lungs, and the edges were blurred. Nodular and cable-like high-density shadows were seen in the posterior apical segment of the left upper lobe, with clear margins. Infection of both lungs was considered, and secondary pulmonary tuberculosis occurred in the left upper lobe. After admission, the patient was treated with various anti-bacterial and fungal drugs due to recurrent fever, but the effect was not effective. The fever symptoms of the patient could not be significantly improved, and his condition continued to worsen, and he eventually died. The patient with AIDS complicated with bacterial and fungal infection, especially PJP infection in serious condifiton and has a poor prognosis for rapid development, so clinical attention should be paid to. 

OBJECTIVETo investigate the clinical effect and safety of anti-D immunoglobulin (anti-D) in the treatment of children with newly diagnosed acute immune thrombocytopenia (ITP) through a Meta analysis.

METHODSPubMed, EMBASE, Cohrane Library, Ovid, CNKI, and Wanfang Data were searched for randomized controlled trials (RCTs) published up to April 2017. Review Manager 5.3 was used for the Meta analysis.

RESULTSSeven RCTs were included. The Meta analysis showed that after 72 hours and 7 days of treatment, the intravenous immunoglobulin (IVIG) group had a significantly higher percentage of children who achieved platelet count >20×10/L than the anti-D group (P<0.05). There were no significant differences in platelet count after 24 hours, 72 hours, and 7 days of treatment between the anti-D (50 μg/kg) group and the IVIG group (P>0.05), and there were also no significant differences in platelet count after 24 hours and 7 days of treatment between the 50 μg/kg and 75 μg/kg anti-D groups (P>0.05). The anti-D group had a significantly greater reduction in the hemoglobin level than the IVIG group after treatment, but did not need transfusion. No children in the anti-D group or the IVIG group experienced serious adverse reactions.

CONCLUSIONSIntravenous injection of anti-D may have a similar effect as IVIG in improving platelet count in children with acute ITP, but it may be slightly inferior to IVIG in the rate of platelet increase after treatment. The anti-D dose of 50 μg/kg may have a similar effect as 75 μg/kg. The recommended dose of anti-D for treatment of ITP is safe.

Humans ; Immunoglobulins, Intravenous ; adverse effects ; therapeutic use ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; blood ; drug therapy ; Rho(D) Immune Globulin ; adverse effects ; therapeutic use

Objective To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) during aortic arch surgery in the adult patients,to offer the evidence for the detection of which temperature provides best brain protection in the subjects who accept the great aortic surgery.Methods A total of 109 patients undergoing the surgery of aortic arch were divided into the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.We recorded the characters of the patients and their cardiopulmonary bypass time,aortic clamping time,cerebral perfusion time and postoperative recovery time,tracheal intubation time,time of intensive care unit (ICU) and postoperative cognitive dysfunction.Results Patients' characteristics were similar in two groups.All the patients were cured.There were no significant differences in aortic clamping time of each group [(111.4 ± 58.4) min vs.(115.9 ± 16.2) min];selective cerebral perfusion time [(27.4 ± 5.9) min vs.(23.5 ±6.1) min] of the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.There were significant differences in the cardiopulmonary bypass time[(207.4 ± 20.9) min vs.(263.8 ± 22.6) min],the postoperative recovery time [(19.0 ± 11.1) h vs.(36.8 ± 25.3) h],intubation time [(46.4 ± 15.1) h vs.(64.4 ± 6.0)h];length of ICU [(4.7 ± 1.7) d vs.(8.± 2.3) d],and postoperative cognitive dysfunction of the two groups.Conclusion Compared to the deep hypothermic circulatory arrest,the moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.

Objective To explore the microsurgical technique and clinical value of endoscope-assisted microsurgery via the transsphe-noidal approach to the clivus. Methods According to the results of microanatomy of endoscope-assisted via the transsphenoidal approach to sellar and clival area, the clinical data of 12 cases (8 with invasive pituitary adenoma, 3 with chordoma, 1 with chondroma) treated by transsphenoidal approach were studied retrospectively. All cases were followed-up 3 months to 6 years after operation. Results The tumor was totally removed in 8 patients, removed subtotally in 3 patients, and removed partially in 1 patient. 6 patients occurred transient diabetes insipidus, 2 patients with transient cerebrospinal rhinorrhoea. There were no death or intracranial infection. Postoperative follow-up was performed for 3 months to 6 years, No recurrence occurred except for enlargement of 1 chordoma. Conclusion Transsphenoidal approach satisfactorily and quickly reaches and helps remove the larger tumors in sellar and clival area without severe complication. It has the advantages of low incidence of surgical complication and high total removal rate. Endoscope-assisted may be helpful for this approach.

AIM:To investigate the gene expression profile of human lung squamous cell carcinoma in early stage.METHODS:The mRNA was extracted from cancer tissue and normal lung tissue.The mixed probes were labeled and hybridized with chip containing 480 carcinoma related genes,then analyzed by SuperArray Image software to study the gene expression patterns in lung squamous cell carcinoma.RESULTS:192 genes associated with lung squamous cell carcinogenesis were found,which were grouped into transporter,adhesion molecules,cytoskeleton proteins,transcription regulator,genes associated with metabolism and immune response according to functions.127 gens were positive to lung squamous cell carcinogenesis and 65 genes were negative to lung squamous cell carcinogenesis.CONCLUSION:The screen of gene expression profile of human lung squamous cell carcinoma provides valuable information for the research of molecular mechanism of the lung squamous cell carcinogenesis.

To study the chemical constituents of Fructus Xanthii and to determine the contents of total phenolic acids (TPA) in fruits of Xanthium from different populations for evaluating the quality of them.

OBJECTIVE: To investigate the effects of Liriope platyphylla total saponin (LPTS) on learning, memory, neuromediators and metabolites in aging mice induced by D-galactose. METHODS: Ninety Kunming mice were randomly divided into nine groups: normal saline (NS)-treated group, untreated group, high- (100 mg/kg), medium- (50 mg/kg) and low-dose (10 mg/kg) LPTS-treated groups, Shuxuening-treated group, jiaogulanosidi-treated group, flunarizine-treated group and vitamin E-treated group. The Kunming mice in the NS-treated group were administered with NS by intraperitoneal injection, while the aging mice in the other eight groups were administered with D-galactose by intraperitoneal injection. At the same time, the aging mice in different groups were fed with corresponding drugs for 42 days, and the aging items of the mice in different groups were measured, respectively. RESULTS: LPTS could improve the memory of aging mice induced by D-galactose, promote its body weight, and increase the thymus and spleen indexes of the aging mice. LPTS could decrease the levels of MDA and lipofuscin, inhibit MAO activity and increase SOD activity and GSH-Px level. CONCLUSION: LPTS may improve the ability of learning and memory and delay aging.

OBJECTIVEThe research aimed to investigate the entophytic fungal community of Vitex negundo var. cannabifolia, including the biodiversity from different organs and the correlations with habitations.

METHODPDA medium was used to isolate and purify the endophytic fungi in V. negundo var. cannabifolia. The purified strains were identified by morphology together with similarity of 5.8S gene and internal transcribed spacer (ITS) sequence.

RESULTNinety-seven strains of endophytic fungi were isolated from V. negundo var. cannabifolia. They were identified belonging to 12 species, 10 genera, 8 families and 6 orders, while 60 isolations identified into 9 species, 9 genus ,7 families and 6 orders were obtained from the wild plants and 37 belonging to 7 species, 5 genus, 3 families and 3 orders were from the cultivated ones.

CONCLUSIONIt indicated that the entophytic fungi in V. negundo var. cannabifolia were diverse, and there were some differences at quantity and species in different sites and organs of V. negundo var. cannabifolia.

Biodiversity ; Fungi ; classification ; growth & development ; isolation & purification ; Phylogeny ; Symbiosis ; Vitex ; microbiology

Objective:This study aimed to present the time trend of suicide rate in people aged 5 years and over in China from 2002 to 2015,and to describe the rural and urban distribution,and population characteristics of suicide rate in recent 13 years.Methods:The data of suicide rate were based on the China Health Statistics Yearbook published by the National Health and Family Planning Commission (formerly as the Ministry of Health) of the Peoples Republic of China.Poisson regression models were used to test the time trend of the general suicide rate,and region-,gender-and age-specific suicide rates.Results:Since 2002,the suicide rates in urban population,rural population,male and female have decreased significantly.Urban population had higher decreasing trend than rural population,and female had higher decreasing trend than male.Suicide rates in women of reproductive age (15 -49 years) both in rural and urban areas had significantly decreasing trends,and were lower than male with same ages in recent years.There was no statistical difference of the decreasing trend in rural population aged 85 years and over,or young male population in rural area.The annual average suicide rate from 2012 to 2015 was 6.75/100 000.Rural population,male and the older persons had higher suicide rate.Conclusion:The overall suicide rate decreased over the period of 2001-2015.However,it is still important to carry out suicide prevention program,especially in rural area,and in older persons and young male.

Objective To compare the differences,correlation,and consistency among central corneal thickness (CCT) measurements by anterior segment optical coherence tomography (AS-OCT),Lenstar,and ultrasound biomicroscopy (UBM). Methods In this cross-sectional study,AS-OCT,Lenstar,and UBM were used to measure the CCT in 54 patients (83 eyes) between October 2015 and August 2016 in the Fourth Affiliated Hospital of China Medical University. Data were statistically analyzed by random analysis of variance, Pearson correlative analysis,and Bland-Altman analysis to compare the difference,correlation,and consistency among the three instruments. Results The differences in the mean CCT measured by the three instruments were statistically significant (P < 0. 05 for all comparisons). There was also a high correlation (all P < 0. 001) and consistency among the three instruments. Conclusion There is a high level of correlation and consistency in the CCT measurements by the three instruments. Therefore,these could be interchangeable under some circumstances. AS-OCT could be the first choice as an early screening tool for glaucoma.