Background Fungal keratitis has a high incidence in China and its clinical treatment is very difficult,and its etiology diagnosis and appraisal is the premise to improve the prognosis of disease.With the changes of regional environment and climate in recent years,whether the spectrum of fungal keratitis change in South China is remarkable.Objective The purpose of this study was to investigate recent pathogenic distribution of fungal keratitis in South China area.Methods The consecutive fungal culture resuhs of 3 350 purulent keratitis at Zhongshan Ophthalmic Center from January 2009 to December 2014 were retrospectively reviewed.The positive rate of fungal culture,genus or species distribution,seasonal distribution and different term distribution were analyzed.Results The culture-positive rate was 31.34％ in this study (1 050/3 350),and the average culture-positive number was 175 strains per year.In the positive fungus,the highest positive rate was Fusarium SP (32.10％,337/1 050),and followed by Aspergillus SP (25.71％,270/1 050),Heminthosporium SP (14.29 ％,150/1 050) and Mucor SP (9.14％,96/1 050).The fungal culture-positive rate was 36.05％ (367/1 018) in 2009 to 2010,32.45％ (324/1 014) in 2011 to 2012,and 26.86％ (354/1 318) in 2013 to 2014,respectively,with a significant difference among the three periods (x2 =22.37,P＜0.01),showing a decreasing tendency of incidence.Two hundreds and sixtyone strains were isolated from January to March (31.15 ％,261/838),182 strains from April to June (25.53 ％,182/713),237 strains from July to September (30.00％,237/790),370 strains from October to December (36.67％,370/1 009),showing a statistically significant difference among them (x2 =25.19,P ＜ 0.01).The number of infectious strains was most during October to December and fewest during April to June.Conclusions The leading pathogenic fungi of fungal keratitis is Fusarium SP and followed by Aspergillus SP,Helminthosporium SP,Mucor SP in turn.Fungal keratitis is usually prevalent from October to December,and its incidence is still rising in Chinese mainland recently.However,the increasing tendency in South China has been prevented in recent six years.

Objective To explore the genuineness of Exocarpium Citri Grandis(ECG) from Huazhou city of Guangdong province.Methods We used the method of high performance liquid chromatography to detect the naringin content in ECG from different producing areas of Huazhou city.Random amplified polymorphic DNA analysis was used for the examination of genetic distance,and plasma-atomic emission spectrometry for the detection of soil elemental abundance of 8 elements such as aluminium(Al),kalium(K),calcium(Ca),ferrum(Fe),titanium(Ti),boron(B),magnesium(Mg),and manganese(Ma).The correlation of the above three parameters was analyzed by statistical software SPSS 11.5.Results Ca abundance in the surface soil layer had an obvious effect on the content of naringin,and the difference of Al and K abundance in subsoil layer was correlated with the genetic distance of ECG.Conclusion The genuineness of ECG is probably related with the abundance of phlopopitum in the soil of producing areas of Huazhou city.

Objective To compare the efficacy between bronchial artery infusion (BAI) chemotherapy plus radiation therapy and systemic chemotherapy plus radiation for locally advanced non-small cell lung cancer (NSCLC). Methods One hundred and twenty-one patients with stage III NSCLC were randomized into treatment group(58 cases) and control group (63 cases). In the treatment group, all patients were administered with BAI for 2-3 sessions, followed by irradiation 4-7 days after BAI. In the control group, altogether 4-6 cycles of standard systemic chemotherapy were given. Radiation was delivered alternately between the cycles of chemotherapy. Results The short-term, long-term survival, median response duration and median survival time were similar between the two groups, except patients with stage Ⅲb who had a higher distant metastasis rate in the treatment group. The major side effects of chemotherapy and radiotherapy were hematological, gastrointestinal toxicities, pneumonitis, mediastinitis, and esophagitis, respectively. The side effects were milder, better tolerated and did not influence the regimen schedule in the treatment group, as compared with the control group. Seven patients withdrew from the control group, and in 28 patients, the scheduled chemotherapy and radiation was delayed or canceled. Conclusions Bronchial artery infusion plus radiation is more advantageous over systemic chemotherapy plus radiation in less toxicities, better compliance, shorter treatment courses and more cost-effectiveness.

OBJECTIVETo study the role of the synthesis and degradation of collagen at the transcription level during liver fibrogenesis due to schistosomiasis japonica in rabbits.

METHODSNew Zealand rabbits challenged by cercariae of Schistosoma japonicum (S. japonicum) were served as animal models for liver fibrosis. Liver specimens were collected through operations at 4, 6, 8, 10, 12, 16, 20, 24 and 28 wks after challenge. Type I collagen, type III collagen, type IV collagen, MMP-1 and MMP-9 mRNA levels of liver tissue were detected by RT-PCR + Dot blot. The size of egg granulomas and the degree of liver fibrosis were measured by histopathological examinations.

RESULTSType I collagen, type III collagen, type IV collagen, MMP-1 and MMP-9 mRNA levels increased simultaneously in the early stage after challenge. Most of them reached their peak at 10 weeks, and compared with normal controls, type I collagen, type III collagen, type IV collagen, MMP-1 and MMP-9 mRNA levels increased by 12.0-, 11.0-, 6.6-, 10.0- and 11.0-fold, respectively, coinciding with the change of egg granulomas, i.e., the change in the inflammatory process. Then both collagen and collagenase mRNA levels decreased. Type I, III and IV collagen mRNA levels declined to 2-fold to 3-fold as compared with normal controls (P < 0.05), while MMP-1 and MMP-9 mRNA levels declined close to normal levels (P > 0.05) at 28 wks. This study shows that the synthesis and degradation of collagen keep a dynamic balance at the early stage of schistosomiasis japonica challenge, while at the later stages the quantity of collagen synthesis was higher than that of collagen degradation.

CONCLUSIONSIt was confirmed at transcription level that when the quantity of collagen synthesis was higher than that of collagen degradation liver fibrogenesis may be resulted in.

Animals ; Collagen ; metabolism ; Liver Cirrhosis, Experimental ; metabolism ; Matrix Metalloproteinase 1 ; genetics ; Matrix Metalloproteinase 9 ; genetics ; RNA, Messenger ; analysis ; Rabbits ; Schistosomiasis japonica ; metabolism ; Transcription, Genetic

Objective To observe the influence of the trinity pharmaceutical care intervention on medicine compliance,quality of life,the recurrence rate and re-hospitalization rate of first-episode schizophrenic patients.Methods A total of 60 first-episode schizophrenics in our hospital were randomly divided into control group and intervention group,with 30 patients in each group,all of these patients received routine antipsychotic treatment,and the intervention group was additionally given antipsychotic medication.The treatment compliance,the World Health Organization quality of life-BREF (WHOQOL-BREF) scores,the recurrence rate and re-hospitalization rate were assessed on admission,at discharge and at 3 months and 6 months after discharge.Results There were no significant differences in drug compliance and scores of WHOQOL between the two groups on admission (P ＞ 0.05).The medication compliance of intervention group was remarkably higher than that in the control group (P ＜ 0.05),the recurrence rate and re-hospitalization rate had no significant differences (P ＞ 0.05),the scores of physiology,psychology,social relations and environment of WHOQOL in the intervention group were obviously higher than that in the control group after 3 months of discharge (P ＜ 0.05).At 6 months after discharge,the medication compliance of intervention group was evidently higher than that in the control group (P ＜ 0.01),the recurrence rate was lower than the control group (P ＜ 0.05),and there was no significant difference in re-hospitalization rate between two groups (P ＞ 0.05),while the scores of physiology,psychology,social relations and environment of WHOQOL in intervention group weresignificantly higher than that in the control group (P ＜ 0.01).Conclusion Trinity pharmaceutical care can improve the medication compliance and reduce the recurrence rate of patients with first-episode schizophrenia,and improve patients' quality of life,so it can be used as an effective method for rehabilitation of schizophrenia patients.

Objective To observe the influence of the trinity pharmaceutical care intervention on medicine compliance,quality of life,the recurrence rate and re-hospitalization rate of first-episode schizophrenic patients.Methods A total of 60 first-episode schizophrenics in our hospital were randomly divided into control group and intervention group,with 30 patients in each group,all of these patients received routine antipsychotic treatment,and the intervention group was additionally given antipsychotic medication.The treatment compliance,the World Health Organization quality of life-BREF (WHOQOL-BREF) scores,the recurrence rate and re-hospitalization rate were assessed on admission,at discharge and at 3 months and 6 months after discharge.Results There were no significant differences in drug compliance and scores of WHOQOL between the two groups on admission (P ＞ 0.05).The medication compliance of intervention group was remarkably higher than that in the control group (P ＜ 0.05),the recurrence rate and re-hospitalization rate had no significant differences (P ＞ 0.05),the scores of physiology,psychology,social relations and environment of WHOQOL in the intervention group were obviously higher than that in the control group after 3 months of discharge (P ＜ 0.05).At 6 months after discharge,the medication compliance of intervention group was evidently higher than that in the control group (P ＜ 0.01),the recurrence rate was lower than the control group (P ＜ 0.05),and there was no significant difference in re-hospitalization rate between two groups (P ＞ 0.05),while the scores of physiology,psychology,social relations and environment of WHOQOL in intervention group weresignificantly higher than that in the control group (P ＜ 0.01).Conclusion Trinity pharmaceutical care can improve the medication compliance and reduce the recurrence rate of patients with first-episode schizophrenia,and improve patients' quality of life,so it can be used as an effective method for rehabilitation of schizophrenia patients.

Objective:To investigate the application value of biological muscle flap in laparo-scopic radical proximal gastrectomy with esophagogastric anastomosis.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 10 patients with adeno-carcinoma of esophagogastric junction who were admitted to The First Affiliated Hospital of Xi′an Jiaotong University from May 2023 to August 2023 were collected. All patients were males, aged (65±5)years. All patients underwent laparoscopic radical proximal gastrectomy and esophagogastric anastomosis with digestive tract reconstruction using the esophagogastric biological muscle flap. Observation indicators: (1) surgical situations and early complications; (2) follow-up and late com-plications. Measurement data with normal distribution were represented as Mean± SD, and measure-ment data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations and early complications. All 10 patients success-fully completed the surgery without conversion to open surgery, and the operation time was (166±18)minutes. Cases with digestive tract reconstruction as end-to-side anastomosis and Overlap anas-tomosis were 1 and 9, respectively. The time of digestive tract reconstruction, the number of lymph node dissected, volume of intraoperative blood loss, time to postoperative first anal exhaust, time to postoperative first intake of liquid food, duration of postoperative hospital stay were (40±12)minutes, 24±6, (41±9)mL, (3.4±0.5)days, (4.1±1.0)days, (8.3±0.7)days in the 10 patients. Of 4 cases with postoperative early complications, 1 case developed pulmonary infection (Clavien-Dindo grade Ⅱ) on the second day after surgery, with pulmonary infection absorbed after 5 days of antibiotic treat-ment. Two cases experienced chest distress and shortness of breath on the third day after surgery, with the diagnosis of a small to moderate amount of pleural effusion after chest B-ultrasound examination. After pleural puncture and active treatment, the symptoms of them were improved and the pleural effusion disappeared. There was 1 case with choking sensation when eating solid food, which was started from the third week after surgery. Upper gastrointestinal imaging revealed mild anastomotic stenosis of Clavien-Dindo grade Ⅰ in the patient, who was improved after conservative treatment. On the 7th day after surgery, all 10 patients underwent upper gastrointestinal angiography, and no anastomotic leakage or stenosis occurred. There was no sign of contrast agent reflux in the supine position and 30° head down position. (2) Follow-up and late complications. All 10 patients were followed up for 59.5(range, 31.0-127.0)days. The esophageal reflux scale score of 10 patients was 1.4±0.3. During the follow-up, 1 case underwent gastroscopy on 40 days after surgery, which showed reflux esophagitis with Los Angeles grade as B and the Clavien-Dindo grade as Ⅰ. There was no clinical symptom such as heartburn or acid reflux. Results of 24-hour pH monitoring showed that the patient experienced 24 instances of reflux in an upright position and 15 instances of reflux in a supine position, with no prolonged reflux. The total reflux time within 24 hours was 75 minutes. The DeMeester score was 38.3. Results of esophageal pressure measurement showed that the esophageal contraction morphology was normal, but the anastomotic opening was not well relaxed. The rest of 9 cases had no complication such as reflux esophagitis.Conclusion:Biological muscle flap applied in the laparoscopic radical proximal gastrectomy with esophagogastric anastomosis is safe and feasible, with satisfied short-term efficacy.