Objective To investigate the clinical and laboratory profiles of a case of infantile chronic mucocutaneous candidiasis due to malnutrition.Methods Skin specimens were collected and examined by KOH preparation,fungus culture,biochemical tests and molecular biological study.The pathogenic strain and antimicrobial susceptibility were defined.Results A 5 month-old-girl was presented with big head,and erythema,erosion and crust on her head,auricles,nostrils,oral cavity,neck and buttocks,and itching,for 1 month.Dystrophic hair and nails were observed.Candida albicans was isolated from specimens of the buttocks and Candida glabrata from the scalp.The abnormalities,CD16+ (56 6.5%),serum IgG (6.74 g/L),IgA (0.321 g/L),and albumin (18 g/L) were found with flow cytometry and immunoassays.Conclusion The patient is diagnosed as infantile chronic mucocutaneous candidiasis,who is immunocompromised due to protein malnutrition.

Objective To study the value of two-dimensional Echocardiography(2DE)and doppler tissue synchronization imaging (TSI) during early diagnosis of close myocardial contusion.Methods 9 small Guizhou-Panama pigs were used.The close myocardial contusion animal model was successfully established by using the serf made small impactor.Echocardiography wag applied before and after injury for 0.5,2,4,8 and 12h respectively,these data were analyzed together with the TYC pathological results.Results After the strike for 0.5h,the location and area of the damage call be directly and rapidly shown by 2DE and TSI,which showed that after myocardial contusion (MC),main damaged areas are anterior and lateral myocardial walls.After myocardial contusion MC,three echocardiography techniques were used to observe the scale of the abnormal segment,the movement of the myocardial wall,Time tO Peak of Systolic Velocity and wall motion segmental inter(WMSI),Time to Peak of Systolic Velocity index(TPI),which all were increased than that pre-injury.Conclusion 2DE and TSI can be used for accurately early diagnosis of the location of myocardial contusion.TSI is more specific for the diagnosis of myocardial contusion.

Objective To establish a diagnosis method for fungal infection using two-round PCR,and to evaluate its sensitivity in the detection of clinical specimens suspected to be infected with fungi.Methods A total of 29 specimens of clinical sputum and alveolar wash solution were collected from patients with suspicious fungal infection.All specimens uaderwent direct microscopy with 10%KOH,fungal culture,one-round PCR and two-round PCR.The fungal universal primer targeting ITS regions of rDNA was used in PCR.The detection rate for fungi was compared between these methods.Results The detection rate for fungi was 20.69%by direct microscopy,37.9%by fungal culture,17.2%by one-round PCR,and 48.3%by two-round PCR.More than one species of fungus were detected in 6.9%(2/29),3.4%(1/29)and 24.1%(7/29)of these specimens by fungal culture.one-round PCR and two-round PCR, respectively.There was a significant difference in the detection rate between two-and one-round PCR(x2=6.34,P＜0.05).With regard to the detection rate for more than one species of fungus,two-round PCR was significantly higher than one-round PCR and fungal culture(x2=4.09,6.30.bom P＜0.05).Conclusion Two-round PCR may help to improve the sensitivity of molecular diagnosis of fungus-infected specimens.

Objective To evaluate the two-dimensional strain by speckle tracking echocardiography in healthy piglets.Methods 9 small Guizhou-Panama pigs were used.High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex.Radial strain,circumferential strain and rotation were measured in the left ventricular short-axis views using two-dimensional strain software.Results Left ventricular two-dimensional radial strain gradually increased from the base to apex.As seenfromthe apex.LV performs a wringing motion with a clockwise rotation at the base and counterclockwise rotation at the apex.Conclusion 2DS technique is a rapid,accurate,easy,repeatable and no angle reliant method to quantitatively estimate the left ventrlcle function.

Objective To investigate the species and DNA polymorphism of Candida strains from different individuals and to find the relationship between the species or DNA patterns of strains and different patient groups. Methods The present study chose the isolates from 3 different sources groups(from the patients with vulvovaginal candidiasis, recurrent vulvovaginal candidiasis or asymptomatic carriers respectively). Germ tube test, chlamydospore test, CHROMagar Candida and API20 kit system were applied to separate non-Candida albicans strains from Candida albicans. Random amplification of polymorphic DNA (RAPD) analysis was used to study DNA typing of 97 strains of Candida collected from different patients and to determine whether isolates from different patients were genetically similar or dissimilar. The data were analyzed by SPSS10.0. Results The ninety-seven isolates consisted of 83 strains of Candida albicans and 14 of non-Candida albicans. Of 9 random primers used, two primers (primer 4 and primer 7) gave good reactions, the sequences of which were 5′-ACCCGACCTG-3′, 5′-GGTGACGCAG-3′ respectively. The 99 isolates could be classified into 19 and 21 genotypes by the two primers respectively. Different genotype was not shown in most isolates from different groups. A particular genotype associated with different conditions was seen in only a few isolates. Conclusion Candida albicans is the main pathogenic yeasts and most strains of non-Candida albicans are C.glabrata in the vulvovaginal candidiasis. Genotyping of most isolates didn′t show obvious correlation with different patient groups.

Objective: To observe the effect of edaravone combining ulinastatin on brain protection in patients of type A aortic dissection (AAD) after total arch replacement. Methods: A total of 60 AAD patients with total arch replacement in our hospital from 2014-09 to 2016-01 were prospectively studied. Based on peri-operative application of edaravone and ulinastatin, the patients were divided into 2 groups: EU group: 1) the patients received ulinastatin 300000 U/8h and edaravone 0.5mg/Kg/12h from administration to 3 days post-operation, 2) during cardiopulmonary bypass, the patients received ulinastatin 300000 U/2h and edaravone 0.5mg/Kg; Control group, the patients had no such treatment.n=30 in each group. The following items were observed:①operative condition;②blood levels of speciifc brain injury markers as S-100 and neuron speciifc enolase (NSE) at different time points: beginning of surgery (T0), opening aorta clamp (T1), right after cardiopulmonary bypass (T2), entering ICU (T3), 24h post-operation (T4) and 3 days post-operation (T5); ③post-operative condition. Results:①Durations of operation, cardiopulmonary bypass, cardiac arrest and bilateral antegrade selective cerebral perfusion (BACP), the frequency of BACP and UACP (unilateral antegrade selective cerebral perfusion), the lowest rectal temperature and blood levels of S-100, NSE at T0 were similar between 2 groups.②Compared with Control group, EU group had decreased S-100 and NSE from T1 to T5,P<0.05.③The in-hospital and ventilation time, frequency of PND and TND, the patients with CSS score≥16 before discharge and the in-hospital death rate were similar between 2 groups,P>0.05. Conclusion: Edaravone combining ulinastatin had brain protective effect in AAD patients after total arch replacement;it may reduce blood speciifc brain injury markers while the clinical signiifcance should be further investigated.

Objective To study the clinical diagnosis and treatment of malignant gastrointestinal stromal tumor. Methods To retrospectively analyze the clinical data of 28 cases with malignant gastrointestinal stromal tumors underweat surgical treatment . Results The malignant gastrointestinal stromal tumor in adults were more than 50 years old,71.4%(20/28) ,and common clinical symptoms were gastrointestinal bleeding,anemia,and pain. The lesion site: 19 cases of gastric bowel, 8 cases of small intestine, 1 case of colon, radical excision in 22 cases, local excision palliative resection in 5 cases, three cases were multi-visceral resection. Conclusion Malignant gastrointestinal stromal tumor could be diagnosed by the means of endoscopic imaging and clear,and preoperative diagnosis was difficult. Surgical resection was the pathology diagnosis and treatment of primary method,if necessary,to ensure multi-visceral resection of the tumor to prevent recurrence of thoroughness, had important significance.

Objective To estimate the application value of colony PCR in the detection of pathogenic filamentous fungi. Methods Colony PCR was established and performed to amplify the internal transcribed spacer (ITS) region of 19 species (strains) of filamentous fungus followed by sequencing analysis. At the same time, DNA extracts from 8 of the 19 species of filamentous fungus were subjected to conventional PCR. Hha I and Hinf I endonucleases were used for restriction fragment length polymorphism (RFLP) analysis of the conventional and colony PCR products. Comparison analysis was carried out between the colony and conventional PCR. Results Of the 19 strains, 16(84.2%) yielded positive results by colony PCR; sequence analysis of the PCR products of ITS region revealed a 96% - 100% similarity with the reference sequence (NCBI database)of corresponding fungi. The amplification product length and RFLP profile of these products from the 8 species of filamentous fungus, except for those from Aspergillus nidulans, were consistent between the colony and conventional PCR. Conclusions Compared with conventional PCR, colony PCR-based detection of filamentous fungi is easy to operate, time and labor-saving, with high accuracy and reliability, and can be applied to the rapid identification of filamentous fungi.

A 19-year-old man was admitted to the hospital for erythema and nodules on the face and postauricular region for 6 years. Microscopic examination of lesion scrapings revealed brown septate hyphae. A restricted, velvety and black colony grew on Sabouraud's dextrose agar. Slide culture on potato dextrose agar plate showed flask-shaped phialides at the apex of or around the hyphae with clear collarettes and flaring apex,mucilage-encapsuled, round to oval, semi-endogenous phialosporae accumulating at the apex of the phialides,giving a flower-like appearance. Anti-fungal susceptibility test showed that the fungus was sensitive to itraconazole, terbinafine and amphotericin B, but resistant to fluconazole. Sequence analysis of the ITS1-ITS4 region revealed a 98% consistency with the reference sequence of ITS1-ITS4 of Phialophora verrucosa. On the basis of above findings, the patient was diagnosed with cutaneous phaeohyphomycosis. Clinical improvement was seen after treatment with oral itraconazole (400 mg/d).

Objective To study the difference in pathogenicity and genotype between two isolates of Veronaeae botryosa with different temperature tolerance. Methods Two strains of Veronaeae botryose were isolated from two patients with phaeohyphomycosis in Jiangsu and Henan province respectively. Of them, the Jiangsu strain could grow well at 37 ℃, but Henan strain could not grow at 36 ℃. Eighty mice were equally classified into immunocompetent and immune-suppressed (induced by cyclophosphamide) groups to be inoculated with the two strains of Veronaeae botryosa respectively. Ten mice remained uninoculated and served as the control. The general condition, growth and organic involvement of mice were observed for 4 weeks followed by the killing of surviving mice. Homogenated tissue samples were obtained from liver, spleen, lung, kidney and brain; then, tissue culture, direct microscopy and pathological examination were performed. Genomie DNA was extracted from tissue samples and subjected to random amplified polymor-phic DNA (RAPD) analysis. PCR was performed to amplify the intemal transcribed spacer (ITS) of rDNA followed by sequencing Results Systemic phaeohyphomycosis was induced in both immunocompetent and immune-suppressed mice by the Jiangsu strain of Veronaeae botryose; the mortality was 30% in immune-competent mice and 65% in immune-suppressed mice with statistical significance between the two groups. In immune-suppressed mice inoculated with the Jiangsu strain, the infection rate was 100% in the lung,signifi-cantly higher than in other organs; on direct microscopy the infection rate reached 64.7% in the liver, and 70.5% on tissue culture. There was no significant difference in the infection rate among these organs in immunocompetent mice inoculated with the Jiangsu strain, with the infection rate being 57.8% in the lung and 42.1% in the liver. Increased infection rate was observed in the lung of immune-suppressed mice com-pared with immunocompetent mice (P < 0.05). No definite infection was seen in immunoeompetent or immune-suppressed mice innoculated with the Henan strain. RAPD analysis and sequencing revealed that there was a base variation (A/G) at position 236 of ITS gene between the two strains. Conclusions The two strains of Veronaeae botryosa have different genotypes. Systemic phaeohyphomycosis can be caused in immunocompetent and immuno-suppressed mice by the Veronaeae botryosa isolate from Jiangsu Province; the mortality was higher in immuno-suppressed mice than in immunocompetent mice. The pathogenicity of Veronaeae botryose is associated with the immune status of hosts. In immuno-suppressed mice, lung is the organ most susceptible to infection by Veronaeae botryosa.