Objective To analyze the clinical characteristics of Candida parapsilosis septicemia of prematurity and provide a reference for both diagnosis and treatment.Methods The clinical data of 9 premature suffering with candida parapsilosis septicemia were retrospectively analyzed.Results All 9 cases (0.73 percent in the corresponding period) were premature infants with gestational age less than 37 weeks.The average weight of the patients was (1 621.00 ±372.22) g,among which 5 cases were of very low birth weight and 4 cases were of low birth weight.The average time of the fungi infection was (22.00 ± 7.58) d.Of the 9 cases,7 cases had been treated with broad spectrum antibiotics previously,9 cases were given nutrition intravenously,7 cases were treated with mechanical ventilation,7 cases adopted peripherally inserted central catheter(PICC) and 1 case received surgery.The symptoms included poor response,unstable serum oxygen saturation,jaundice,poor perfusion,abdominal distention,fever and no bodyweight increase.Laboratory tests results presented platelet decrease(6 cases),C-reaction protein increase (6 cases),high plasma (1-3)-β-D glucan level(9 cases) and white blood cells in the normal range(6 cases).All 9 infants recovered after receiving fluconazole and supporting treatment.Two cases failed to complete the hospital treatment but after discharge from hospital continued treatment by administering prescribed medicine,and through regular follow-up was done,the prognosis of all cases turned out to be good,and no case died.Conclusions Gestational age,birth weight,application of broad spectrum antibiotics,mechanical ventilation and peripherally inserted central catheter are common high risk factors of Candida parapsilosis septicemia in premature infants.The disease was featured with normal white blood cell,low platelet,high serum levels of C-reaction protein and (1-3)-β-D glucan.Anti-fungi therapy with fluconazole may be a good choice for it.

In the previous study, a high-throughput screening method was established to find the antagonists of CD36. In the present study, a new compound named IMB-1680 was found using this method. The anti-atherosclerotic activities of IMB-1680 were then evaluated. Dose-dependent activities of IMB-1680 were detected by using Sf9 [hCD36] and CHO [hCD36] models. Fluorescence microscopic photography and flow cytometry were used to analyze uptake of mLDL. Foam cell test with RAW264.7 macrophages was used to examine lipid accumulation. The results showed that IMB-1680 inhibited CD36 activity with IC50 of 2.80 and 8.79 micromol x L(-1) in Sf9[hCD36] and CHO [hCD36] cells, respectively. Fluorescence microscopic photography and flow cytometry revealed that IMB-1680 could significantly reduce DiI-AcLDL uptake. Meanwhile, IMB-1680 also could reduce lipids accumulation in RAW264.7 macrophages. In all, the data indicated that IMB-1680 might be a potent effective anti-atherosclerotic leading compound.

Objective To evaluate the mechanism,prevention and prognosis of complications after stent angioplasty in the treatment of carotic artery stenosis. Methods[WT5”BZ] From 1997 to 2003,312 cases of carotid artery stenosis were treated by transluminal stent-assistant angioplasty. Results Procedure-related complication developed in 23 cases including 19 cases of transient mild complications such as transient arrhythmia and hypotension in 10 cases (3.2%) during deploying stent or balloon dilation,transient cerebral ischemia symptoms in 6 cases after balloon dilation,hypotension in 3 cases after the procedure. Severe complications occurred in 4 cases after the procedure,including embolus detachment,stent migration,carotic artery occlusion and fatal cerebral hemorrhage. Conclusion Although stent-assistant angioplasty are effective for treatment of carotid artery stenosis,severe complications could develop.

Objective To explore the possible effects of methyl methanesulfonate sensitive 2(MMS2)in the process of angiotensin Ⅱ inducing differentiation of neural stem cells (NSCs) into dopaminegic phenotype neurons. Methods NSCs were isolated from the brain of newborn rats and were cultured in the serum-free medium.Identification of neural precursor cells was done by Nestin immunocyt ochemical staining. Then the second generation of NSCs was divided into the following six groups: A, control; B, AⅡ; C, AT1 antagonist ZD7155; D, ZD7155+AⅡ; E, AT2 antagonist PD123319; F, PD123319+AⅡ. The detection of expression of MMS2 and TH mRNA level was done by real-time PCR. The silence of the expression of MMS2 in NSCs was brought about via the transfection of MMS2-siRNA, and then the NSCs were induced to differentiate into dopaminegic neurons. The expression of TH mRNA level in the cells of the groups after transfection was detected by real-time PCR. Results Nestin-positive cells were observed in suspended growth in the medium.Real-Time PCR revealed that the MMS2 and TH mRNA expression of group B and D were significantly higher than that of the control group(P<0.05), There was no significant difference in MMS2 and TH mRNA expression between group C, E, F and the control, respectively. Conclusion AⅡ increased the expression of MMS2 mRNA in NSCs and induced the differentiation of NSCs into DA neurons via AT2 recepter. MMS2 may play important roles in the process of angiotensin Ⅱ inducing NSCs to differentiate into dopaminergic neurons.

Objective To evaluate the clinical therapeutic efficacy and adverse reactions of Coix Seed Extract combined with transcatheter arterial chemoembolization(TACE) in the treatment for hepatic metastases and to compare the levels of serum VEGF of the patients before and after the treatment.Methods FromJuly 2009 to July 2011, 62 patients with hepatomatic metastases were enrolled in this study and were randomized into combining group and control group.The combining group were treated by TACE combined with Coix Seed Extract, and the control group were treated with TACE only. Both groups underwent TACE at least twice.Before and after the treatment,the enzyme linked immunosorbentassay(ELISA)was used to examine the change of VEGF. Results Among 62 assessable patients, overall response rate was 61.3 ％(19/31) in combining group and 45.2 ％ (14/31)in control group respectively (P＞ 0.05).The disease control rate was 80.6 ％(25/31) in combining group and 54.8 ％ (17/31) in control group(P＜0.05).The 1-year survival rates were 67.7 ％(21/31) in combining group and 38.7 ％(12/31) in control group(P ＜ 0.05).The median PFS(progression free survival time) was 7.0 months in combining group and 5.1 months in control group (P＜ 0.05).The levels of serum VEGF in combining group were significantly decreased after treatment (P ＜ 0.05). There was no significant difference between the levels of serum VEGF before and after treatment in control group(P＞ 0.05).The levels of serum VEGF in combining group after treatment were lower than that in control group after treatment (P ＜ 0.05). Adverse reactions in both groups were grade Ⅰ to Ⅲ.The fatigue,anorexia and the right upper quadrant pain was significantly superior in combining group. Conclusion Coix Seed Extract combined with transcatheter arterial chemoembolization in the treatment of hepatomatic metastases can improve disease control rate,decrease the levels of serum VEGF,improve clinical symptoms,prolong the PFS and 1-year survival rate.

Objective To study the findings of 256‐slice CT angiography in atherosclerosis of the intracranial carotid arteary . Methods 402 cases of atherosclerotic lesions in the neck and brain were collected from 2013 to 2014 in our hospital ,in which there were 274 cases of male and 128 cases female .All patients underwent 256‐slice CT angiography of the head and neck .The incidence of atherosclerosis involvement in the intracranial carotid artery was analysed .The characteristics of carotid plaque on different sexes , age(≤60 years and >60 years) and location (right and left ) were observed .The length and property of plaque ,and stenostic rate of the artery were measured respectively .Results There were 164 cases (40 .80% ) of intracranial carotid artery athrosclerosis in 402 cases of atherosclerotic lesions of the neck and brain ,in which the incident rate of male was 38 .32% and female 46 .09% (χ2 =2 .182 ,P=0 .140) .The incident rate of >60 years group was more than that of ≤60 years group (χ2 <31 .105 ,P<0 .001)for both sexes . There were no differences on lesion location (right or left)for different sexes or age groups (χ2 <0 .035 ,P>0 .088) .And there were also no differences on lesion length (≤10 mm ,11-20 mm ,>20 mm) for different sexes or age groups (χ2 <0 .027 ,P>0 .091) . Calcified plaques were seen the most (79 .81% ) ,mixed plaques were seen more (15 .46% ) ,and lipid plaques (1 .58% ) and fibrous plaques (3 .15% ) were seen less .The mixed plaques were more seen on >60 years group than that on ≤60 years group for male pa‐tients (χ2 =12 .204 ,P=0 .001) ,but no other difference was found for plaque property in other different sexes or age groups .Mild stenosis of the corated artery was found in 54 .57% lesions ,moderate stenosis in 39 .75% and severe stenosis in 5 .68% ,and there were no any difference in different sexes or age groups (χ2 <2 .062 ,P>0 .151) .Conclusion CT angiography of the head and neck is of important significance for diagnosis of atherosclerosis in the intracranial carotid artery .

Objective:To investigate the risk factors and treatment outcome of recurrent Acanthamoeba keratitis (AK) after corneal transplantation. Methods:A serial case-observational study was carried out.Twenty-eight eyes of 28 patients with AK who underwent corneal transplantation in Shandong Eye Hospital from January 2012 to January 2019 were enrolled.All the eyes received corneal transplantation from failing to respond to topical and systemic anti- Acanthamoeba medical therapy, including 13 eyes that received penetrating keratoplasty (PKP) and 15 eyes that received lamellar keratoplasty (LKP). The corneal lesion was removed by a trephine with a diameter of 0.5 mm over infiltration area during PKP or LKP.The clinical features of recurrent AK were summarized, including recurrence time, site and signs, and the risk factors of AK recurrence were analyzed.Local and systemic anti- Acanthamoeba medical therapy was performed in all relapsed eyes, and secondary surgery was performed for the eyes with poor response to medication.The therapeutic outcome of recurrent AK was evaluated.The study adhered to the Declaration of Helsinki.This study protocol was approved by an Ethics Committee of Shandong Eye Hospital (No.201112). Results:In the 28 eyes, 7 eyes (25%) appeared recurrent AK after keratoplasty, including 2 eyes after PKP and 5 eyes after LKP.There was no significant difference in the recurrence rate between the two methods ( P=0.396). The recurrence rate of eyes that had used glucocorticoids drugs before operation was 57.14% (4/7), which was significantly higher in comparison with 14.29% (3/21) of eyes without glucocorticoids before surgery ( P=0.043). The recurrence rate of eyes with ulcer diameter ≥8.2 mm was 50.00% (5/10), which was significantly higher than 11.11% (2/18) of eyes with ulcer <8.2 mm ( P=0.036). The recurrent lesions began at the edge of implant bed accounted for 85.71% (6/7), and the recurrent lesions located below graft accounted for 14.29% (1/7). In 7 eyes with recurrent AK, 6 eyes were completely cured.Among recurrent AK eyes after LKP, 2 eyes were cured by long-term medical therapy, and 2 eyes were cured by extended-diameter LKP, and another 1 eye was cured by conjunctival flap covering surgery.One eye with recurrent AK after PKP was cured by extended-diameter PKP. Conclusions:The risk factors of recurrent AK after surgery are application of glucocorticoids before surgery and big lesions.Recurrent AK after surgery is curable by individualized therapy targeting to different clinical characteristics.

Objective To evaluate the effect of desflurane-remifentanil anesthesia on balance between cerebral oxygen supply and demand during cerebral revascularization in the patients with moyamoya disease.Methods Forty patients of both sexes with moyamoya disease,aged 18-64 yr,with body mass index of 18-25 kg/m2,undergoing superficial temporal artery-middle cerebral artery anastomosis,were allocated into 2 groups using a random number table method:desflurane-remifentanil group (D group) and propofol-remifentanil group (P group),with 20 cases in each group.Anesthesia was induced by intravenously injecting etomidate 0.3 mg/kg,sufentanil 0.4-0.5 μg/kg,and cis-atracurium 0.15-0.2 mg/kg.The patients were mechanically ventilated after tracheal intubation,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia was maintained with propofol 4-6 mg · kg-1 · h-1 (group P),4％-6％ desflurane (group D),remifentanil 0.1-0.3 μg· kg-1 · min-1,remifentanil 0.1-0.3 μg · kg-1 · min-1 and intermittent intravenous boluses of cis-atracurium,and BIS value was maintained at 40-60.At 15 min after intubation (T1),30 min after skin incision (T2),immediately after opening the dura mater (T3),immediately after vascular bypass and patency (T4),and at the end of surgery (T5),blood samples were obtained from the radial artery and internal jugular bulb for blood gas analysis,jugular venous oxygen saturation (SjvO2) was recorded,and arteriovenous blood O2 content difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.Results Compared with group P,Da-jvO2 at T3-6 and CERO2 at T4-6 were significantly decreased,and SjvO2 was increased at T4-6 in group D (P＜0.05).Compared with the value at T1,Da-jvO2 was significantly decreased,and SjvO2 was increased at T5 in group D (P＜0.05).CERO2 was significantly lower,and SjvO2 was higher at T5 than at T3 in group P (P＜0.05).Compared with the values at T4,CERO2 was significantly decreased,and SjvO2 was increased at T5 in P and D groups (P＜ 0.05).Conclusion Compared with propofol-remifentanil anesthesia,desflurane-remifentanil anesthesia can maintain the balance between cerebral oxygen supply and demand better during cerebral revascularization in the patients with moyamoya disease.

OBJECTIVETo analyze the audiologic results of cochlear implantation in bilateral severe to profound sensorineural hearing loss following head trauma.

METHODSA retrospective study of our cochlear implantation cases in bilateral severe to profound sensorineural hearing loss following head trauma (with or without temporal bone fractures). Four patients in second hospital of Shandong university were analyzed in this study.

RESULTSAll the patients received unilateral cochlear implantation and gained open-set speech perception ranging from 92% to 100%. The aided hearing threshold ranged from 30 dBHL to 35 dBHL. None of them experienced a decrease in the hearing performance in the follow-up (1-2 years).

CONCLUSIONWith sufficient preoperative assessment, cochlear implantation is an effective management for hearing rehabilitation in bilateral severe to profound sensorineural hearing loss following head trauma.

China ; Cochlear Implantation ; Craniocerebral Trauma ; Hearing ; Hearing Loss, Bilateral ; Hearing Loss, Sensorineural ; surgery ; Hearing Tests ; Humans ; Retrospective Studies ; Speech Perception

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.