Objective To explore the clinical characteristics ,diagnosis, treatment and prognosis of phaeohyphomycosis. Methods Clinical data were collected, including history, physical examination, cranial and spinal imaging. Brain biopsy was performed. Data of the pathology and incubation of brain tissue were analyzed. Responsiveness to treatment was followed up. Results A previously healthy three and half years old boy was presented to our unit, with a three- month history of recurrent headache, vomiting, progressive paraplegia accompanied by urinary continence and constipation. A computed tomogram scan and magnetic resonance imaging of the brain revealed multiple lesions located in the region of the parietal - occipital lobes, periventricular area and frontal lobe, with prominent surrounding edema and irregular peripheral enhancement of the mass after the administration of contrast materials. A cerebral biopsy was performed and the pathological report was cerebral phaeohyphomycosis. The culture of the tissue and cerebrospinal fluid grew a same fungus identified as exo-phiala dermatitidis. The patient's response to therapy was poor, the parents of the boy gave up therapy, and the boy died 1 month later. Conclusions Cerebral Phaeohyphomycosis caused by Exophiala dermatitidis is rare, but the most serious form of fungus infection. Pathology and incubation of the tissue are essential for diagnosis. There is no curative therapy and the prognosis is poor.

Brain Edema ; etiology ; Brain Stem ; pathology ; Encephalitis ; etiology ; Female ; Hand, Foot and Mouth Disease ; complications ; therapy ; Humans ; Infant, Newborn

Bacterial Infections ; diagnosis ; urine ; Colorimetry ; Female ; Humans ; Male ; Middle Aged ; Peritonitis ; diagnosis ; urine ; Urinalysis ; methods

OBJECTIVETo observe the clinical efficacy of Xiaoshui Decoction (XSD) in treating ascites in patients suffered from primary liver cancer of Pi-deficiency with damp harassment syndrome (PDDHS) as well as to study the effect through the experiment in mice.

METHODSSixty-one patients confirmed to be primary liver cancer of PDDHS and accompanied with ascites were randomly divided into the treated group (n=33) and the control group (n=28). The treated group was treated by XSD combined with chemotherapy by locally applying of DDP via abdominal infusion, while the control group treated by DDP infusion alone. The treatment lasted for two months. The conditions of ascites, quality of life (QOL), survival period, and TCM syndrome after treatment were observed. In the experimental study, the mice models of ascites were grouped and treated to observe the conditions of ascites and their survival period.

RESULTSThe short-term total effective rate of the treated group and the control group was 42.4% and 21.4%, the interval of aspirating ascites after treatment was 17.95 +/- 9.63 days and 10.87 +/- 7.76 days, and the 1-year survival rate 33.3% and 14.3%, respectively, significant difference was shown between the two groups in the three parameters (all P < 0.05 ). QOL was improved in both groups with insignificant difference (P > 0.05). Besides, the main symptoms were improved in patients of both groups, especially in the ameliorating of fatigue, abdominal distension, nausea and vomiting. Evaluation on safety of treatment showed that XSD had no obvious toxic and adverse reaction, and so it was safe in use. Experimental study showed that on the two mice models of ascites induced by inoculating two kinds of tumor cell, the effect of XSD was superior to that of the control group in aspects of reducing ascites and prolonging survival period, showing significant difference (P < 0.05).

CONCLUSIONSatisfactory short-term efficacy in treating primary liver cancer with ascites of the Pi-deficiency with damp harassment syndrome could be obtained by XSD. Its effect in prolonging survival period was confirmed by experimental study. XSD can also improve the symptoms and QOL of patients, therefore, it is an effective and reliable remedy for treatment of primary liver cancer with ascites.

Adult ; Aged ; Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Ascites ; drug therapy ; etiology ; Carcinoma, Hepatocellular ; complications ; drug therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Liver Neoplasms ; complications ; drug therapy ; Male ; Medicine, Chinese Traditional ; Mice ; Middle Aged ; Phytotherapy ; Single-Blind Method ; Tumor Cells, Cultured

OBJECTIVETo compare clinical outcomes between two suturing methods using non absorbable materials through drilling the bone and suturing anchors for the treatment of complete rupture of the deltoid ligament.

METHODSFrom January 2009 to January 2013, 58 hospitalized patients with ankle fracture combined with complete rupture of the deltoid ligament were treated with suturing using non absorbable materials through drilling the bone or suturing anchors. There were 29 patients who received suturing treatments using non absorbable materials through drilling the bone (Group A), including 18 males and 11 females, with an average age of (39.76 +/- 11.81) years old. According to the Lauge-Hansen classification, 12 patients had supination external rotation (SER) injuries with IV degree, 5 patients had pronation external rotation (PER) injuries with III degree, 10 patients had PER injuries with IV degrss, and 2 patients had pronation abduction injuries with III degree. There were 29 patients who received treatments with suturing using anchors (Group B), including 14 males and 15 females, with an average age of (41.79 +/- 13.28) years old. According to the Lauge-Hansen classification,9 patients had SER injuries with IV degree, 6 patients had PER injuries with III degree,13 patients had PER injuries with IV degree, and 1 patient had pronation abduction injuries with III degree. All the patients were treated with open reduction and internal fixation, as well as reconstruction of deltoid ligaments to restore the stability of the medial ankle structures. The clinical examination, imaging evaluation, American society for ankle surgery (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) were used to evaluate the clinical results after operation, and the results of the two groups were compared and analyzed statistically.

RESULTSThe follow-up duration of the 58 patients ranged from 23 to 40 months,with an average of 27.3 months. All the patients had fracture union, and the mean healing time was 12.3 weeks (ranged, 10 to 17 weeks). There were no incision complications and ankle instability. There were no significant differences between two groups in AOFAS (P=0.666) and the VAS (P=0.905).

CONCLUSIONTreatments of complete rupture of the deltiod ligaments with the two suturing methods get similar good clinical effects, but the suturing using non absorbable materials through drilling the bone has several advantages such as reducing the financial burden of patients, saving social medical resources and avoiding the shortcoming in difficult removal of anchor suture.

Adolescent ; Adult ; Ankle Fractures ; surgery ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Lateral Ligament, Ankle ; injuries ; surgery ; Male ; Middle Aged ; Young Adult

OBJECTIVETo study the cleavage activity of specific deoxyribozyme to hepatitis C virus in vitro.

METHODSThree deoxyribozymes were designed to cleave at sites 157, 168, 173 in HCV 5'-noncoding region with the active region of 5'-GGCTAGCTACAACGA-3' respectively. Plasmid pCMV/T7-NCRC -Delta Luc was completely linearized with restriction endonuclease Xba I. HCV RNA5'-NCRC was transcribed in vitro from the linearized products and radiolabelled with [alpha-32P] UTP. Under the conditions of 37 degrees C, pH7.5, Mg2+ 10 mmol/L, the three deoxyribozymes were mixed with substrate RNA individually for 120 minutes and then the reactions were terminated. The cleavaged products were separated with 8% denaturated polyacrylamide gel electrophoresis and displayed by autoradiography. DRz3 was mixed with the substrate RNA at different Mg2+ concentrations. The cleavage efficiency was analyzed with a gel document action analyzing systems.

RESULTSUnder the adopted conditions the three deoxyribozymes efficiently cleaved to the target RNA in vitro and the cleavage activity of DRz3 was increased with the increase of Mg2+ concentration.

CONCLUSIONThe designed deoxyribozymes can cleave 5'-NCR mRNA of HCV efficiently in vitro and it is dose-respondent to Mg2+ concentration.

DNA, Catalytic ; genetics ; DNA, Single-Stranded ; genetics ; Genetic Therapy ; Hepacivirus ; genetics ; Hepatitis C ; therapy ; Humans ; RNA, Messenger ; genetics

OBJECTIVETo study the genetic relationship and diversity of 3 species which belong to Tripterygium.

METHODSamples were collected and divided into 4 types: typical T. wilfordii, typical T. hypoglaucum and their middle type according to morphological characters, and T. regelii. RAPD markers were used to measure the genetic relationship and diversity of 110 individuals from 22 natural populations in China.

RESULT AND CONCLUSION10 primers were selected from 100 ones screened. A total of 128 bands were scored and 123 of them were polymorphic. Cluster analysis indicated that all the samples could be divided into 3 parts: 5 individuals from T. regelii gathered closely and were separated from other population and formed single branch. All 4 populations from T. hypoglaucum gathered directly. The middle type showed a nearer relationship with T. wilfordii than with T. hypoglaucum, although there was genetic differentiation between populations from middle type and those from T. wilfordii. The middle type has more diversity than T. wilfordii. The distance between different middle type populations and T. wilfordii was different. The existence of middle type populations between T. wilfordii and T. hypoglaucum suggested that the 2 species should be combined into one species. Considering all populations except T. regeli, the generic differentiation among populations was significant and the genetic diversity existed mainly among different populations. So samples of Tripterygii should be collected from different ppopulations for the reservation of the genetic diversity.

Biodiversity ; China ; Cluster Analysis ; DNA, Plant ; analysis ; genetics ; Genetic Variation ; Genetics, Population ; Phylogeny ; Plants, Medicinal ; classification ; genetics ; growth & development ; Random Amplified Polymorphic DNA Technique ; Tripterygium ; classification ; genetics ; growth & development

Adult ; Antibodies ; blood ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Interferons ; immunology ; therapeutic use ; Liver Function Tests ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the origin and the recombinant model of H7N9 virus prevailing in China by sequence analysis.

METHODSThe sequences of H7N9 virus were collected and analyzed with the software BLAST and MEGA 5.0. The phylogenetic trees were constructed after multiple sequences alignment. The homologous sequences of H7N9 segments were determined and the model was inferred according to the origin of H7N9 segments.

RESULTSThe most relevant sequences of HA, NA, NS and PB2 segments were located at one branch of the phylogenetic tree, while the closest relevant sequences of PB1, PA, NP and MP contained two H9N2 virus origins. According to the analysis of sequence origin, H7N9 viruses might be divided into 5 genotypes: namely A, B, A/Shanghai/1/2013-H7N9, A/Pigeon/Shanghai/S1069-H7N9 and A/Zhejiang/HZ1/2013-H7N9, and the genotype A consisted of A1 and A2 subtypes.

CONCLUSIONThe prevailing H7N9 virus might be derived from 5 different viruses after 4 times of recombination, which resulted in the two major types of A and B. The subtypes of A1 and A2 were two different derivatives from one reassortant. The A/Pigeon/Shanghai/S1069-H7N9 strain might be the recombinant of type A H7N9 virus with a local H9N2 virus during the H7N9 epidemics. The A/Zhejiang/HZ1/2013-H7N9 strain could be the re-arrangement of subtype A2 with type B H7N9 virus.

China ; Genome, Viral ; Genotype ; Humans ; Influenza A Virus, H7N9 Subtype ; classification ; genetics ; isolation & purification ; Influenza, Human ; virology ; Phylogeny ; Reassortant Viruses ; classification ; genetics ; isolation & purification ; Sequence Analysis, RNA ; Viral Proteins ; genetics

Adolescent ; Adult ; Aged ; Child ; Female ; Hemorrhagic Fever with Renal Syndrome ; physiopathology ; Humans ; Liver ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Prognosis