Talaromycosis marneffei has been increasing in recent years. Our understanding of this disease has gradually deepened through extensive basic and clinical research, but there are still many limitations. In this article, by incorporating the latest research advancements, we discuss important issues in managing Talaromycosis marneffei trends, aiming to guide effective prevention and control of the disease, improving public health, and reducing the healthcare burden.

Objective:To examine the survival and influential factors of an integrated approach of novel agents, autologous hematopoietic stem cell (auto-HSCT) , and maintenance therapy in patients with multiple myeloma (MM) patients from a single center over the past 15 years.Methods:In our center, 300 MM patients who received an integrated strategy of new agents, auto-HSCT, and maintenance therapy over 15 years were retrospectively and prospectively analyzed.Results:The complete remission rates (CR) and ≥very good partial remission rates (VGPR) following induction therapy, transplantation, and maintenance therapy were respectively 35.3% and 55.2% , 72.4% and 80.0% , 89.2% , and 93.4% . When compared to patients receiving double-drug induction, the ≥VGPR and ORR of patients receiving triple-drug induction were improved. No difference existed in CR, ≥VGPR, and ORR between the PAD (bortezomib + liposome doxorubicin+ dexamethasone) and RAD (lenalidomide + liposome doxorubicin + dexamethasone) regimens, but the benefits speed differed. The negative rate of flow minimal residual disease following induction, transplantation, and maintenance was 18.8% (54 cases) , 41.4% (109 cases) , and 58.7% (142 cases) , respectively. The median time to progress (TTP) was 78.7 months and the median overall survival (OS) was 109 months. The median TTP for RISS-Ⅰ-Ⅲ patients were 111.8 months, 77.4 months, and 30.6 months, and the median OS was 118.8 months, 91.4 months, and 48.5 months, respectively. At various points during treatment, the TTP and OS of patients obtaining CR and MRD negative were longer than those of patients who did not obtain CR and MRD negative. TTP was noticeably shorter in high-risk cytogenetic patients compared to standard-risk patients even when CR was acquired during induction. There was no difference in TTP between patients with high-risk cytogenetics and those with standard-risk cytogenetics if MRD negative was acquired during induction. According to a multivariate analysis, the R-ISS stage was a poor predictor of TTP and OS at various treatment intervals. Therapeutic effectiveness was a newly independent prognostic factor following treatment.Conclusion:A median survival of almost 10 years is possible for MM patients who receive an integrated strategy of induction regimens followed by auto-HSCT and maintenance therapy, which significantly improves prognosis. However, this approach did not significantly benefit high-risk cytogenetic MM patients.

Objective: To study the efficacy, safety and long-term outcomes of integrated strategy of bortezomib-based induction regimens followed by autologous hematopoietic stem cell (ASCT) and maintenance therapy in Chinese multiple myeloma (MM) patients. Methods: 200 MM patients receiving integrated strategy of bortezomib--based induction regimens followed by ASCT and maintenance therapy were retrospectively and prospectively analyzed from December 1. 2006 to April 30. 2018. Results: The complete remission rates (CR) and better than very good partial remission rates (VGPR) after induction therapy, transplantation and maintenance therapy were respectively 31% and 75.5%, 51.8% and 87.7%,73.6% and 93.4%. There was no difference between 4 cycles and more than 5 cycles induction chemotherapy. The negative rate of MRD detection by flow cytometry was 17.6% and 38.2% respectively after induction and 3 months after transplantation. The negative rate of MRD gradually increased during the maintenance therapy. The success rate of high dose CTX combined with G-CSF mobilization was 95.5% and transplantation related mortality (TRM) was zero. The median time to progress (TTP) was 75.3 months and the median overall survival (OS) was 99.5 months. TTP of patients obtaining CR and negative MRD after induction were longer that those of no CR and positive MRD. TTP and OS of patients receiving triple-drug induction and ASCT in early stage were longer than those of double-drug induction and ASCT in late stage. LDH≥240 U/L, high risk cytogenetics, ISS II+III stage and HBsAg positive were prognostic factors at diagnosis. However, only MRD and high risk cytogenetics were independent prognostic factors after transplantation and maintenance therapy. The clinical characteristics of patients of TTP ≥6 years were listed below: light-chain type M protein, ISS I stage, normal level of hemoglobin and platelet, normal LDH, HBsAg negative, chromosome 17p-negative, good response and sustained good response. Conclusions Integrated strategy of bortezomib-based induction regimens followed by ASCT and maintenance therapy can significantly improve the short-term and long-term efficacy. The prognostic factors of TTP in different disease stages were different. Response to treatment, especially MRD, played a more important role in prognostic factors.

DNA copy number variation is an important pathogenic factor of human diseases and might be involved in the pathogenesis and pathological process of inflammatory bowel disease (IBD).Aims: To investigate the copy number variation of CNTNAP3 gene and its significance in Crohn''s disease (CD).Methods: A total of 101 active CD patients admitted from Jul.2009 to Dec.2010 at Renji Hospital, School of Medicine, Shanghai Jiao Tong University were enrolled.Eighty healthy subjects were served as controls.Peripheral blood or intestinal mucosa samples of CD patients were collected, and the copy number variation of CNTNAP3 gene was screened and validated by array-based comparative genomic hybridization (aCGH, n=8) and real-time PCR (n=93);expression of CNTNAP3 encoding protein was determined by ELISA (n=55).Results: A large fragment copy number amplification was revealed by aCGH at chromosome 9p13 region (including CNTNAP3 gene) in untreated CD patients.Real-time PCR confirmed that the copy number of CNTNAP3 gene was amplified in peripheral blood of CD patients, especially steroid-naive patients as compared with the normal controls (208 616.4±126 984.7 and 233 453.3±113 520.8 vs.161 750.2 ±53 940.3, P<0.05 and P<0.01).In the clinical parameters analyzed in this study, only smoking was significantly correlated with CNTNAP3 copy number amplification (P<0.05).However, there was no significant difference in plasma CNTNAP3 level between CD patients with amplified copy number and normal controls (P>0.05).Furthermore, the plasma CNTNAP3 level in CD patients with amplified copy number was not correlated with the simplified endoscopic score for CD (P>0.05).Conclusions: Copy number amplification of CNTNAP3 gene might be involved in the pathogenesis of CD in Chinese population.Glucocorticoid treatment and smoking might affect the copy number variation of CNTNAP3 gene.Plasma CNTNAP3 level cannot discriminate CD patients from healthy subjects.Conclusions of this study needs to be further demonstrated and discussed.

Objective To explore the effects of rural family nursing intervention on psychological status of patients with cerebral apoplexy hemiplegia.Methods This community area was randomly divided into the intervention group and the control group, and 42 stroke patients with hemiplegia were randomly selected in each group. Patients in the intervention group were given family rehabilitation nursing intervention for 12 months by community nurses who received training and evaluation, while patients in the control group received original care mode, regular blood pressure measure, and routine follow up. Patients' psychological status before and after intervention were investigated.Results After 12 months' family rehabilitation nursing intervention, the psychological status of patients in the intervention group was significantly improved, and the differences between two groups were statistically significant (P<0.01).Conclusions Rural family rehabilitation nursing intervention can significantly improve the psychological status of patients with stroke, promote patients' recovery, and improve the quality of life of patients.

OBJECTIVE:To establish a method for the contents determination of triamcinolone acetonide acetate and tretinoin in Dimensional ointment. METHODS:HPLC was performed on the column of Diamonsil C18 with mobile phase of methanol-0.1%Phosphoric acid solution(87:13,V/V),detection wavelength was 254 nm(0-5 min)and 350 nm(5-20 min),at a flow rate of 1.0 ml/min,column temperature was 25℃,and volume injection was 10 μl. RESULTS:The linear range was 0.5-5 μg/ml for triamcin-olone acetonide acetate(r=0.999 9)and 4.96-49.6 μg/ml for tretinoin(r=0.999 8);RSDs of precision,stability and reproducibility tests were lower than 1%;recoveries were 98.37%-100.03%(RSD=0.58%,n=6)and 98.21%-100.38%(RSD=0.78%,n=6). CON-CLUSIONS:The method is simple,accurate and fast,and suitable for the contents determination of triamcinolone acetonide ace-tate and tretinoin in Dimensional ointment.

OBJECTIVETo investigate the effect of combined immunization with recombinant Sap2 and dendritic cells (DCs) against systemic Canddida albicans infection.

METHODSWe constructed a prokaryotic expression vector carrying Sap2 of Candida albicans to obtain Sap2 protein. Murine DCs were sensitized by pulsing with Candida albicans spores and rope. Five groups of mice were immunized with recombinant Sap2 protein and sensitized DCs, sensitized DCs, naive DCs, Sap2, or PBS alone for 3 times, and the effect of the immunization against systemic Candida albicans infection were assessed by observing the survival of the mice, detecting the percentages of CD4⁺ and CD8⁺ cells, CFU in the kidney homogenate, and examining renal pathologies.

RESULTSImmunization with Sap2 and sensitized DCs and with DCs or Sap2 alone all prolonged the mouse survival and produced obvious effect in renal protection and immune enhancement, but such effects were more obvious with the combined immunization.

CONCLUSIONCombined immunization with Sap2 protein and DCs offers strong immunoprotection against systemic Candida albicans infection in mice, which provides experimental evidence for the development of new combined vaccines for immunoprotection.

Animals ; Aspartic Acid Endopeptidases ; immunology ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Candida albicans ; Candidiasis ; immunology ; Dendritic Cells ; immunology ; Fungal Proteins ; immunology ; Immunization ; Mice ; Recombinant Proteins ; immunology

Objective To understand the Helicobacter pylori ( Hp) infection eradication rate of standard tri-ple therapy in Guangdong Meizhou and the drug resistance situation for metronidazole ,clarithromycin ,amoxicillin and levofloxacin ,in order to look for the treatment countermeasures in Hp eradication failure .Methods 297 cases of Hp positive patients because of gastrointestinal symptoms to our hospital examined from April 2011 and March 2013,were randomly assigned into three standard triple therapy groups:A ( OCA ) group and B ( OCM ) group and C ( OCL ) group.The Hp eradication rate was analyzed .Patients with primary treatment failure were selected as group D (OBAL),proceed to (PPl+B+A+L)7 d therapy,the Hp eradication rate was analyzed .230 Hp strains were isola-ted and cultured from 297 cases received the first eradication therapy and 87 cases received again eradication therapy . The minimum inhibitory concentration (MIC) of metronidazole,clarithromycin,amoxicillin and levofloxacin were tested by E-test,in order to determine the resistance of these four antibiotics in clinical isolated Hp strains .Results With intention-to-treat(ITT) analysis,the Hp eradication rates of group A (OCA),group B(OCM) and group C(OCL) were 72.0%(72/100),63.0%(63/100) and 72.2%(70/97),respectively.With per-protocol(PP) analysis,the Hp eradication rates of group A (OCA),group B(OCM) and group C(OCL) were 72.7%(72/99),64.3%(63/98),73.7%(70/95),respectively.The eradication rate among three standard triple therapy groups had no obvi-ous difference (ITT:P=0.278,PP:P=0.288,P>0.05).With ITT analysis,the Hp eradication rate in the quadrup-le therapy group D(OBAL) was 92.0%(80/87).With per-protocol(PP) analysis,the Hp eradication rate in the quadruple therapy group D(OBAL) was 97.6%(80/82),which was higher than that of the three standard triple ther-apy groups(ITT:P=0.000,PP:P=0.000).In 230 clinical isolated Hp strains,the resistant rates of levofloxacin,amoxicillin,clarithromycin and metronidazole were 6.08%(14/230),6.52%(15/230),25.65%(59/230), 70.87%(163/230),respectively.Of those 37 strains were mixed resistance,the mixed resistant rate was 16.09%(37/230).The resistant rate of metronidazole was higher than levofloxacin , amoxicillin and clarithromycin ( P =0.000,P<0.01),the resistant rate of clarithromycin was higher than levofloxacin and amoxicillin (P=0.000),no statistically significant difference between amoxicillin and levofloxacin (P=0.848).Conclusion The Hp resistance is similar to the national average in Guangdong Meizhou ,the eradication rate of standard triple therapy is lower than 80%,contain bismuth agent of quadruple therapy is good rescue therapy .

Objective To investigate the effect of combined immunization with recombinant Sap2 and dendritic cells (DCs) against systemic Canddida albicans infection. Methods We constructed a prokaryotic expression vector carrying sap2 of Candida albicans to obtain Sap2 protein. Murine DCs were sensitized by pulsing with Candida albicans spores and rope. Five groups of mice were immunized with recombinant Sap2 protein and sensitized DCs, sensitized DCs, naive DCs, Sap2, or PBS alone for 3 times, and the effect of the immunization against systemic Candida albicans infection were assessed by observing the survival of the mice, detecting the percentages of CD4+and CD8+cells, CFU in the kidney homogenate, and examining renal pathologies. Results Immunization with Sap2 and sensitized DCs and with DCs or Sap2 alone all prolonged the mouse survival and produced obvious effect in renal protection and immune enhancement, but such effects were more obvious with the combined immunization. Conclusion Combined immunization with Sap2 protein and DCs offers strong immunoprotection against systemic Candida albicans infection in mice, which provides experimental evidence for the development of new combined vaccines for immunoprotection.

Objective To investigate the effect of combined immunization with recombinant Sap2 and dendritic cells (DCs) against systemic Canddida albicans infection. Methods We constructed a prokaryotic expression vector carrying sap2 of Candida albicans to obtain Sap2 protein. Murine DCs were sensitized by pulsing with Candida albicans spores and rope. Five groups of mice were immunized with recombinant Sap2 protein and sensitized DCs, sensitized DCs, naive DCs, Sap2, or PBS alone for 3 times, and the effect of the immunization against systemic Candida albicans infection were assessed by observing the survival of the mice, detecting the percentages of CD4+and CD8+cells, CFU in the kidney homogenate, and examining renal pathologies. Results Immunization with Sap2 and sensitized DCs and with DCs or Sap2 alone all prolonged the mouse survival and produced obvious effect in renal protection and immune enhancement, but such effects were more obvious with the combined immunization. Conclusion Combined immunization with Sap2 protein and DCs offers strong immunoprotection against systemic Candida albicans infection in mice, which provides experimental evidence for the development of new combined vaccines for immunoprotection.