Objective To report a case of toxic epidermal necrolysis associated with geotrichosis due to Geotrichum silvicola. Methods The exudates from the body surface, blood and urine of the patient were examined by microscopy and simultaneously inoculated onto the Sabouraud dextrose agar (SDA) medium. The isolate was examined by microscopy, PCR which amplified the D1/D2 domain of 26S rDNA, and gene sequencing. Homologous sequences were searched in the GenBank/EMBL/DDBJ/PD nucleotide sequence library, and the genetic relationship was analyzed with the genealogical tree. Results Microscopy of pus from the abscess on the dorsa of left hand revealed a lot of spores and a few hyphae, which were not observed in the blood or urine specimens. Meanwhile, whitish colonies were grown in all the three successive cultures of blood and urine specimens, rather than the exudates on the body surface. After itraconazole and garlicin were administered for one week, both microscopic exam and fungus culture were negative. Microscopic exam of the isolate showed arthrospores arranged in chains, budding spores and a few of hyphae. It was found that there was a one-base difference between our isolate (Hebei-1) and the isolate from kerion -like eruptions (Changzheng-1), and a four-base difference between our isolate and the reference Geotrichum silvicola strain as well, in the D1/D2 domain of 26S rDNA. This isolate was identified to be most close to Changzheng-1 in the phylogenetic tree. Conclusion The patient with toxic epidermal necrolysis is associated with geotrichosis due to Geotrichum silvicola.

Objective To report a case of kerion caused by Geotrichum in China. Methods A 9 year-old-boy had kerion-form lesion on his scalp with swollen posterior auricular lymph nodes, and did not show other definite underlying disease. The pathogenic fungus was identified according to culture, scanning electron microscopy, biochemical tests and DNA sequencing. The hair infection test was performed and the infected hairs were examined by scanning electron microscope. Animal test confirmed the pathogenicity of the fungus. Results The fungal colonies were the same when the tissue cultures were repeated. The colonies showed milky white to yellowish in color. The hyphae could be identified at the periphery on Sabouraud′s agar culture at 27 ℃, which were moist and smooth on the surface at 37 ℃. Under microscope, there were many rectangular arthrospores, round or oval spores with or without buddings, as well as branched hyphae. The isolated fungus was identified as a Geotrichum silvicola by culture, scanning electron microscope, biochemical test and DNA sequencing. The patient′s condition was improved markedly after treatment of terbinafine for 4 weeks. Conclusions This is the first case report of kerion caused by Geotrichum in China, and terbinafine is effective.

Objective To study the role of calcitonin gene-related peptide(CGRP)and vasoactive intestinal peptide(VIP)in the pathogenesis of alopecia areata(AA).Methods Radioimmunoassay(RIA)was used to measure the levels of CGRP and VIP in plasma from30patients with AA and20normal controls.Immunohistochemistry was employed to detect the expression of CGRP and VIP in lesions of21patients with AA and16normal scalps.Results①The plasma levels of CGRP in progressing stage of AA(142.63?67.95pg/mL)were significantly lower than those in stable stage of AA(197.33?67.15pg/mL)and in normal controls(188.40?72.95pg/mL).②The plasma levels of VIP in progressing stage of AA(105.94?55.42pg/mL)were significantly lower than those in stable stage of AA(156.86?47.37pg/mL)and in normal controls(176.44?84.70pg/mL).③The expression of CGRP and VIP was significanly decreased in lesions of AA than that in normal scalps.Conclusion These findings indicate that CGRP and VIP may play a role in the pathogenesis of alopecia areata.

Objective To determine the degree of damage to hairs by Geotrichum, and to compare the difference in infection duration and intensity by Geotrichum silvicola isolates from skin lesions and blood and Geotrichum candidumn isolates between hairs from different age groups. Methods In vitro hair perforation test was carried out on the hairs from healthy individuals of different age groups. Scanning electron microscopy was performed to observe hairs perforated by Geotrichum silvicola isolates from skin lesions and blood as well as Geotrichum candidumn isolates. Results Both Geotrichum silvicola and Geotrichum candidumn isolates could perforate hairs. The time taken to perorate hairs was significantly different between isolates of Geotrichum silvicola from skin lesions, blood and Geotrichum candidumn in every age groups (all P ＜ 0.05).The Geotrichum silvicola isolates from blood perforated hairs in the shortest time (range: 53 - 64 days, mean:58.07 ± 3.15 days), followed by those from skin lesions (range: 57 - 66 days, mean: 61.05 ± 2.55 days), and Geotrichum candidumn (range: 61 - 74 days, mean: 67.11 ± 3.78 days). The time taken to perforate hairs by Geotrichum significantly increased with age, and significant difference was observed between hairs from the four age groups, i.e., ＜ 2 years, 2 - 13 years, 14 - 19 yeas, ＞ 19 years, but not between the age group of ＜ 2 years and that of 2 - 13 years (P ＞ 0.05 ). As scanning electron microscopy showed, both Geotrichum silvicola and Geotrichum candidumn could damage hairs, and the degree of damage by Geotrichum silvicola was more severe than that by Geotrichum candidumn. Conclusions The damage to hairs by Geotrichum silvicola is earlier and more severe than that by Geotrichum candidumn. The younger the age, the more liable the hairs to be damaged by Geotrichum.

Objective There is a high occurrence rate of thalassaemia in Guangdong Province .Major and intermedia thalas-saemia bring severe burden for patients , families, and societies.This study aimed to reveal the economic burden of thalassaemia major and intermedia thalassaemia in Guangdong Province . Methods Eight areas of Guangdong Province were selected as the sampling ar-eas.Patients with major or intermedia thalassaemia were enrolled in the study .The patients′economic burden of this disease , inclu-ding direct economic burden , indirect economic burden and intangible economic burden was calcultated .The direct economic burden was estimated by outpatient fee , hospitalization expense , nutrition and transportation fees , indirect economic burden was evaluated u-sing disability adjusted life years ( DALY) combined with human capital , and intangible economic burden was calculated using method of willingness. Results Per average annual direct economic burden of 45 patients with major or intermedia thalassaemia was 43 058.66 yuan, per average annual indirect economic burden was 20 474.51 yuan, and per person intangible economic burden was 302 466.67 yuan. Conclusion Economic burden of major and intermedia thalassaemia is huge and most patients do not receive standardized treatment .More effective way should be taken to reduce the economic burden of thalassaemia and help the patients to re -ceive standardized treatment .

BACKGROUNDDeep fungal infection is one of the important complications and causes of death in late stage patients with lung cancer, to explore and analyze the pathogen of deep fungal infection is helpful to early diagnose and treat deep fungal infection in patients with lung cancer. The aim of this study is to investigate the changes and pathogenicity of the main pathogen of deep fungal infection in patients with lung cancer.

METHODSTotal DNA per cell, proliferation index (PI) and cell cycle of the main pathogen of deep fungal infection were analyzed in patients with lung cancer by FCM.

RESULTSHistograms of stationary-growth-phase Candida albicans isolates demonstrated that the majority of population of the fungus were at the G0/G1 phase of cell cycle. There was no significant difference in cell proportion of G0/G1, G2/M phases and the total DNA content per cell of strains between the lung cancer and normal control groups. The cell proportion of S phase and PI in lung cancer group were remarkably higher than those in control group (P=0.040, P=0.038).

CONCLUSIONSThe cell proportion at DNA composition phase of the main pathogen-Candida albicans significantly increases, the proliferation activity gets strengthened and the pathogenicity changes in deep fungal infection of patients with lung cancer.

Adult ; Female ; Humans ; Male ; Pedigree ; Tuberous Sclerosis ; diagnosis