Objective To determine whether Trichophyton rubrum isolated from different lesions in the same patient is of different strains. Methods DNA was extracted from the isolates, then subjected to a polymerase chain reaction-based typing which analyzed the number of repetitive elements in the non-transcribed spacer region of the ribosomal DNA gene repeats. Results Thirty-six strains of T. rubrum were isolated from 17 patients with fungal infection on multiple sites. All strains could be classified into 10 genotypes. The genotype distribution was unrelated to sites of infection. It happened to 8 of the 17 patients that multiple genotypes were involved in T. rubrum infection on different sites in the same body. Conclusion The study shows that multiple genotypes are involved in T. rubrum infection on different sites in the same patient, suggesting external sources of infection rather than infection from a different site in the same individual.

[Objective]To study the surgical technique for the treatment of acetabular fractures.[Method]Retrospective analysis on consecutive acetabular fractures operatively treated at our hospital from January 1995 to March 2005 was made to find out the correlation factors influenced on the operative approaches.[Result]A total of 107 cases had surgery for an acetabular fracture in the meamtime.Of them,44 were exposed through a Kocher-Langenbeck approach,5 through an extended iliofemoral route,30 through an ilioinguinal or an anterior extensile approach,and 28 through a combined anterior and posterior incisions.After operation,anatomic reduction was obtained in 66 cases,good reduction in 36,incomplete reduction in 5.According to AAOS score,the satisfactory rate was 89.72% after following-up 1 to 11 years.[Conclusion]To determine reasonable surgical exposure of an acetabular fracture,the key factors are fracture type and its displacement direction,and the important reference factors include associated injuries with the fracture,operative time and complications related to different operative routes.

Objective To study method and timing of internal fixation for long bone fractures in polytraumatized patients with fat embolism syndrome (FES). Methods Twenty-eight cases of polytraumatized patients with FES received internal fixation for their long bone fractures in our hospital from January 1990 to August 2004. The method and timing of internal fixation were analyzed retrospectively. The long bone fractures in 27 cases were treated 5 to 7 days after their clinic FES symptoms disappeared, while one fracture was treated five days after the FES symptoms were relieved and the vital signs became stable. Eleven cases of long bone fracture were treated with open fixation by unreamed or slightly reamed intramedullary nailing while 27 cases were fixated with plate internally. Results Of the 27 patients who received open reduction and internal fixation for their fractures 5 to 7 days after disappearance of FES symptoms, 22 cases experienced no postoperative complications but fever and quickened pulse reoccurred in five cases after the first osteosynthesis. However, FES-like symptoms reoccurred in the one case who received the first operation when FES did not disappear. Conclusions Internal fixation by plate and intramedullary nailing without reaming are safe for polytraumatized patients with FES and long bone fractures. Proper timing of the first surgery for this kind of patient should be 5 to 7 days after the disappearance of FES.

Objective To isolate and identify pathogenic f ungus in a patient with intracranial infection.Methods Specimens were taken from the spinal fluid of the patient.Then,microsco py and fungal culture were done to identify the pathogen.The hi stopathologic features were reprod uced through animal pathogenicity s tudy in a mice model.Results According to the colony appearance i n culture medium,the morphological features in microscopy,such as conidia arrangement and size,germ tube forming site,this fungus was identified as Bipolaris spicifera.Hyphae and swollen hyphal cells resembling chlamydospores,septate pi gmented hyphae were observed in brain tissue specimen of mice experimental model,which were consiste nt with phaeohyphomycosis.Conclu-sion This is the first case of phaeohyphom ycosis caused by Bipolaris spicifera reported in China.

ObjectiveComparing gastric perforation repair with traditional contrast,to explore the feasibility and superiority of the laparoscopic gastric perforation repair.Methods68 cases were randomly divided into two groups for laparoscopic gastric perforation repair and traditional repair,then compared two groups of treatment.Results Both operations were successful ( including laparoscopic repair in 34 cases) and surgery time,blood loss,postoperative drainage,length of stay,and cosmetic results of the comparison.ConclusionCompared with the traditional open surgery,the laparoscopic surgery had less trauma,leas pain,faster recovery,shorter hospital stay,high efficacy and good cosmetic results and other advantages.

Objective To characterize the natural history of psoriasis vulgaris.Methods A retrospective study was carried out.Totally,245 patients admitted to hospitals within three months after the first episode of psoriasis vulgaris were selected from 1136 patients with psoriasis vulgaris who had been followed up for more than 20 years.Changes in disease severity during the long-term follow-up were traced,and information on the shape and distribution of skin lesions,family history,use of anticancer drugs,vitamins and traditional Chinese medicines was collected and analyzed.SPSS13.0 software package was utilized to assess factors associated with the evolution of psoriasis vulgaris.Results The natural course of psoriasis vulgaris could be classified into six types:immediate healing,slow healing,intermittent relapse,frequent mild relapse,frequent moderate relapse,and frequent severe relapse.The immediate healing type and slow healing type amounted to 30％ of these patients,and the frequent severe relapse type to less than 10％.Statistical analysis revealed that the clinical severity of psoriasis was associated with the age of onset and family history,and was negatively correlated with the use of anticancer drugs.Conclusions The long-term follow-up study reveals the natural course of psoriasis vulgaris,which may be helpful in guiding the prediction of prognosis,prevention of recurrence and selection of treatment.

Objective To explore the effect of the treating left colon cancer,Compare left colon irrigation at one-stage radical colon resections were performed with the way which is given colon bracket insertion operation then two-stage radical colon resections were performed.Methods 32 cases sigmoid and rectum cancer patients with obstruction were received.And 14 cases were treated by colon irrigation at one-stage radical colon resections; 18 cases were treated by colon bracket insertion operation then two-stage radical colon resections were performed.To analyze the complications of after-operation、the average time in hospital.Results No occurence of anastomotic leakage was found in the two-stage radical colon resections.There was only one case was infected; the operation time(115 ± 26)min.The drainage in 3 days after the operation(127 ± 66)ml,length time(12.5 ± 3.2)d.The group of one-stage radical colon resections:the operation time(210 ± 39)min.The drainage in 3 days after the operation.length time(14.8 ±2.6)d,There was two cases of anastomotic leakage and 12 cases were infected and two dead were found in this group.Conclusion The way which was given colon bracket insertion operation then two-stage radical colon resections were performed,was better than colon irrigation at one-stage radical colon resections were performed,and with the first way patients life quality enhanced.

Objective To develop a murine model for infection by Cladosporium carrioni. Methods A total of 72 ICR mice were equally divided into 4 groups, group A (healthy mice inoculated by C. Carrioni suspension of 1 × 108 cfu conidia mL-1, group B (immune-suppressed mice inoculated by C. Carrioni sus pension of 1 × 108 cfu conidia mL-1), group C (immune-suppressed mice inoculated by C. Carrioni suspen-sion of 1 × 106 cfu conidia mL-1), group D (healthy mice inoculated by sodium chloride solution). C. Car-rioni suspension or sodium chloride solution was subcutaneously inoculated into foot pads of mice. On day 7, 30 and 60 after inoculation, 6 mice were killed in each group followed by the measurement of thickness of foot pads, pathology and mycology of skin samples taken from foot pads. Results In group A, B and C, there were swelling, blackening, ulceration and crusts at the inoculation site of all mice, with a morbidity of 100%. The thickness of foot pads in group A on day 30 was significantly higher than that on day 7 (2.40 ± 0.45 mm vs 2.85 ± 0.47 mm, P < 0.05), but lower than that on day 60 (1.64 ± 0.13 ram, P < 0.05). In group B, increased thickness of foot pads was observed on day 30 compared with that on day 7 and day 60 (2.19 ± 0.27 mm vs 1.80 ± 0.21 mm and 1.86 + 0.22 mm, respectively, both P < 0.05), which was the case with group C (1.98 ± 0.06 nun vs 1.51 ± 0.11 mm and 1.82 ± 0.09 mm, respectively, both P < 0.05). No significant changes occurred to the thickness of foot pads in group D from day 7 to day 60 (P > 0.05). Pathological changes in group A, B and C included necrosis, abscess and chronic granuloma formation; dark brown sclerotic bodies were observed on HE and PAS staining as well as on direct microscopy; cultures of tissue samples grew Cladosporium carrionii. The mice in group D remained uninfected. Conclusion Mouse model for chromoblastomycosis may be established by subcutaneous inoculation of Cladosporium carrionii suspension into foot pads of healthy or immuno-suppressed mice.

Objectives To analyse the antifungal susceptibility of Candida spp. isolated from the patients with recurrent vulvovaginal candidiasis (RVVC), vulvovaginal candidiasis (VVC) and asymptomatic carriers and to study the correlation between different Candida strains and antifungal susceptibility. Method According to the NCCLS-M27-A scheme, the antifungal susceptibility of Candida spp. isolated from the above different groups was measured. Results Almost all the MICs of C. glabrata and C. krusei to 8 antifungal agents were higher than those of C. albicans. The average MIC of C. albicans isolated from RVVC patients was higher than that from asymptomatic carriers. The resistant strains were mainly isolated from the RVVC group. No resistant strains against itraconazole, fluconazole, ketoconazole, econazole and nystatin was found in asymptomatic carriers. Conclusions These results indicate that more attention has to be paid to the low susceptibility of non-Candida albicans in the treatment of vulvovaginal candidiasis, and the resistant strains may result from long-term or irregular antifungal treatment.

0.5).The estimated daily intakes of 10 nutrients were analyzed, and showed that the protein, calcium and saturated fatty acids increase the risk of stomach cancer (P