Objective To determine the genetic subtypes and susceptible population of Cryptoccocus neoformans in China. Methods We analyzed 129 strains of Cryptococcus neoformans isolated during the period from 1980 through 2006 in 18 Prov-inces and municipalities of central and eastern China using epidemiological method,PCR fingerprint,and multilocus sequence typing (MLST).Results About 71.5% (91/129)of the clinical strains were isolated from the patients without any recognizable immunodeficiency.Only 8.5% (11/129)of the strains were from AIDS patients.The remaining 20.9% (27/129)were from patients with underlying diseases other than HIV infection.Furthermore,PCR fingerprinting and MLST showed that serotype A strains exhibited a unique VNⅠsubtype,which was distinguishable from the reference VNⅠmolecular types.For convenience we named this unique genotype as VNⅠc.Conclusions People without any recognizable immunodeficiency are the main susceptible population of the 129 clinical strains of Cryptococcus neoformans ,which contrasts with the reports from other countries.The different genetic subtypes of Cryptococcus neoformans between China and other countries may contribute to such a difference.

Polypoidal choroidal vasculopathy(PCV) is a common disease of the retina,the disease is more found in colored race.In China,the mainly nosogenic population is the female about 60 years old.The pathogenesis of PCV is unknown and there is no specific medicine at present.The funduscopic present is orangered lesions,bleed and exudation.Indocyanine green angiography(ICGA) could make a definite diagnosis of PCV.In recent,the main treatment of PCV includes photodynamic therapy,intravitreal anti-VEGF therapy,surgery for treatment of complications and combined therapy.We review the treatment and diagnosis of PCV,and propose the further research direction.

We investigated the Toxop lasma infection prevalence among planned pregnant women in Chongqing ,and to pro‐vide reference for the first level intervention of birth defects in the region .A total of 11 953 planned pregnant women were se‐lected by proportionally stratified multi‐stage random sampling method .Questionnaire survey was given to the women ,and blood samples were collected .Specific IgM and IgG antibodies against Toxoplasma were detected with ELISA .Results showed that among the 11 953 cases surveyed ,Toxoplasma IgM was positive in 71 cases ,with the positive rate of 0 .59% ;IgG was positive in 771 cases ,with the positive rate of 6 .54% .The positive rate of IgM and IgG antibodies in the metropolitan core re‐gion of the city was higher than that in the suburb areas (χ2 =35 .28 ,P<0 .000 1 ;χ2 =82 .65 ,P<0 .000 1) .The positive rate of IgM antibody increased with the educational level (χ2trend=3 .25 ,P=0 .001 1) .The positive rates of IgM and IgG varied in occupations among women (χ2 =13 .93 , P= 0 .016 0;χ2 = 15 .58 ,χ2 =0 .008 1) ,with the highest rate of public officials . Planned pregnant women with the history of abnormal pregnancy outcomes had higher positive rate of T .gondii IgM and IgG antibodies than those in the control (χ2 =6 .85 ,P=0 .008 9;χ2 =59 .25 ,P<0 .000 1) .There was no significant difference of IgM positive rate between the planned pregnancy women who had closed contact to cats and the control group (χ2 =0 .23 ,P=0 .628 6) ,while the positive rate of IgG was higher than that of the control group (χ2 =9 .95 ,P=0 .001 6) .T .gondii infec‐tion rate was on the low level of planned pregnant women in Chongqing .Adverse pregnancy outcomes are related to Toxoplas‐ma infection .

Objective To explore the influence of renal allograft recipient cytokine and cytokine receptor gene polymorphisms on the infection after renal transplantation. Methods (1) 126 cases of cadaveric renal allograft recipients were divided into two groups according to the presence or Absence of infection in 6 months after renal transplantation: infection group and un infection group. The distribution of 22 polymorphisms in 13 cytokines and cytokine receptors gene were compared between two groups as well as latent factors affecting the onset of infection. The production types of IL 10, TNF ?, TGF ?1 and IL 6 were analyzed; (2) All recipients were stratified into two conditions: presence of rejection or Absence of rejection. Previous positive gene polymorphisms were compared between infection group and un infection group under two conditions. Results (1) The incidence of acute allograft rejection was significantly higher in infection group than in un infection group. In infection group, the genotype frequency of IL 1? 889 C/C, IL 1? 511 C/C, IL 1?+3962 C/T or T/T, and the higher production type frequency of TGF ?1 were significantly higher than those in un infection group. (2) In the recipients without acute rejection, the genotype frequency of IL 1? 511C/C was significantly higher in infection group than in un infection group; whereas in those with acute rejection, the genotype frequency of TGF ?1 (codon10 codon 25) CG/TG and frequency of TGF ?1 with high production were significantly higher than those in no infection group. Conclusion This study identified recipient genotype of IL 1? 889 C/C, IL 1? 511 C/C, TGF ?1(codon10 codon 25) CG/TG and higher production type of TGF ?1 gene as major risk factors for the onset of infection after renal transplantation as well as presence of acute allograft rejection, which might affect the action of these gene polymorphisms.

protrusion measured by ultrasound for diagnosing bladder outlet obstruction.Methods A literature search of medline (1966.1-2011.6),embase(1984.1-2011.6),CNKI (1994.1-2011.6) and WEIPU Data (1989.1-2011.6) from 1999 to 2009 was performed by two reviewers independently.QUADAS items was applicated to assess trial quality.Golden standard was BOOI measured by urodynamics (BOOI more than 40 indicates bladder outlet obstruction).Heterogenous studies and meta-analysis were conducted by Meta-Disc 1.4 software.Results Totally 6 studies was included at last,involving 682 subjects.No threshold effect was found,but there was heterogeneity due to other factors.The meta-analysis showed that the sensitivity was 70.8 ％,specificity was 87.6 ％,positive LR was 5.132,negative LR was 0.303,the diagnostic OR was 22.18,the area under SROC curve was 0.8723 and Q index was 0.8028.Conclusions Intravesical prostatic protrusion measured by ultrasound is a good index for diagnosing bladder outlet obstruction in patients with benign prostate hyperplasia when intravesical prostatic protrusion is equal or more than 10mm.

Adolescent ; Female ; Humans ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; injuries ; physiopathology ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures

Objective To study the applications and outcomes of using autogeneic cartilage in hearing recon-struction surgery in patients with chronic otitis media or cholesteatoma .Methods A total of 165 patients (173 ears) in whom autogeneic cartilage was used were analyzed retrospectively .Forty -three patients (48 ears) had simple tympanic membrane perforations ,61 patients (61 ears) had cholesteatomas including 12 retraction pockets ,23 pa-tients (23 ears) had tympanoscleroses and 38 patients (41 ears) had otitis media with granulations .The cartilage grafts were used for tympanic perforation reparing in 133 patients (139 ears) ,for ossiculoplasty in 102 patients (104 ears) ,for attic reconstruction in 31 patients (31 ears) and for canal wall reconstruction of external auditory canal in 3 patients (3 ears) .The auditory outcome (0 .5 ,1 ,2 ,and 4 kHz pure tone average hearing threshold ,the average air-bone gap) and local architecture status were followed up for 1 year after surgery .Results In 133 patients (139 ears) with tympanic perforation ,the rate of successful repair of a tympanic membrame perforation in one -stage was 97 .84% with perforation repair in 136 ears and postoperative perforation in 3 ears .In 102 patients (104 ears) of os-siculoplasty ,there was no ossicular prostheses prolapse .In 31 patients (31 ears) of attic reconstruction ,no local graft shift or collapse was found .In 3 patients (3 ears) of external auditory canal repair ,no canal wall collapse occurred . In myringoplasty group (43 patients ,48 ears) ,preoperative and postoperative air -bone gap (ABG) was 23 .8 ± 3 .1 dB and 11 .6 ± 8 .7 dB ,respectively .In cholesteatoma group (61 patients ,61 ears ) ,preoperative and postoperative ABG were 39 .2 ± 24 .7 dB and 19 .0 ± 12 .1 dB ,respectively .In tympanosclerosis group (23 patients ,23 ears) ,pre-operative and postoperative ABG were 31 .2 ± 12 .4 dB and 19 .8 ± 11 .2 dB ,respectively .In otitis media with granu-lation group (38 patients ,41 ears) ,preoperative and postoperative ABG were 41 .6 ± 9 .9 dB and 15 .3 ± 13 .4 dB ,re-spectively .Conclusion Autogeneic cartilage is very valuable in hearing reconstruction surgery ,especially in compli-cated tympanic perforation ,combination with ossiculoplasty prostheses ,or reconstruction of mastoid cavity or exter-nal call wall defect .

Aim To investigate the effects of leptin on ?1(Ⅰ) collagen mRNA expression and protein production, and the roles of Janus kinase/signal transducers and activators transcription(JAK/STAT) signaling transduction pathway in increased ?1(Ⅰ) collagen mRNA expression stimulated by leptin in activated hepatic stellate cells(HSCs).Methods Firstly, ?1(Ⅰ) collagen mRNA expression and protein production as well as JAK1 and STAT3 phosphorylation induced by leptin at different doses in a human HSC cell line, LX-2 were determined by RT-PCR, ELISA, and Western-blot.Secondly, the effects of JAK1 inhibitor AG490 on JAK1 phosphorylation and ?1(Ⅰ) collagen mRNA expression stimulated by leptin were detected by Western blot and RT-PCR. Thirdly, the roles of AG490 and transfection with STAT3 antisense oligonucleotide(STAT3-ASON) in STAT3 phosphorylation after leptin were detected by Western blot. Finally, the effect of transfection with STAT3-ASON on ?1(Ⅰ) collagen mRNA expression after leptin was measured by RT-PCR.Results Leptin increased ?1(Ⅰ) collagen mRNA expression and protein production in a dose-dependent manner in LX-2, reaching a maximal level at 80 ?g?L-1 leptin. In addition, phosphorylation of JAK1 and STAT3 after leptin exhibited a time-dependent effect. Besides, JAK1 inhibitor AG490 completely blocked JAK1 and STAT3 phosphorylation and increased in ?1(Ⅰ) collagen gene expression after leptin in LX-2. Transfection with STAT3-ASON blocked STAT3 phosphorylation and increased ?1(Ⅰ) collagen mRNA by leptin in LX-2.Conclusion Leptin had a direct action on liver fibrogenesis by stimulating ?1(Ⅰ) collagen mRNA expression and protein production in activated HSC, and JAK/STAT signaling transduction pathway was involved in the process. JAK1 inhibitor AG490 and transfection with STAT3-ASON blocked the transduction pathway effectively in LX-2. Leptin may be an important factor in the development of hepatic fibrosis. Activated JAK1 and STAT3 signaling in human HSC line provided a novel molecular target for therapeutic intervention of liver fibrosis.

Objective To expore the difference between magnetic resonance image ( MRI) expression of spinal tuberculosis and brku-cellare spondylitis. Methods Retrospectively analyzed the clinical data of 10 patients with tuberculous spondylitis and 12 patients with bru-cellar spondylitis from Jan. 2012 to Oct. 2013. All the patients were scanned by MRI, and the expression difference of MRI were compared. Results The vertebral body of spinal tuberculosis was destroyed severely, and it often accompanied by the kyphosis and multiple-level para-vertebral abscess, and even adjacent organs tuberculosis. The vertebral body of brucellar spondylitis was destroyed lightly,and the abscess is often limited. Conclusion We can distinguish spinal tuberculosis and brucellar spondylitis by the typical difference of the expression of MRI.