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2015 Vol. 45, No. 10 Published: 2015-10-25   703 Preparation of human cytomegalovirus latency-associated determinant pUL138 and evaluation of its preliminary use in the serodiagnosis of HCMV infection CHEN Wenjing1, HUANG Chongan2, CHEN Jing3, GUO Gangqiang4, XIE Wangkai2, LIN Kezhi5, SHEN Xian1, XUE Xiangyang4.  Objective: To prepare latency-associated protein UL138 of human cytomegalovirus, determine its antigenicity and evaluate its preliminary use as an antigen in the serodiagnosis of HCMV infection. Methods: Bioinformatics methods were used to analyze the transmembrane domain of UL138 protein, and the complete coding region of pUL138’s cytoplasmic domain was optimized by the usage of the favorite codons in E.coli, amplified by PCR and cloned into the expression vector pET21a(+). The constructed pET21a(+)/UL138 plasmid was transformed into E.coli BL21 cells and induced by IPTG. The recombinant protein pUL138 was purified by Ni-NTA affinity chromatography and confirmed by SDS-PAGE and Western blot analysis. Then the purified UL138 protein was coated on plates as a diagnosis antigen and an indirect ELISA method was established and optimized to investigate the HCMV-specific IgG. Finally serum samples from 173 healthy individuals were detected by the established method, and Roche’s electrochemiluminescence detection kit was considered as the golden standard to evaluate its significance in the serodiagnosis of HCMV infection. Results: HCMV UL138 protein was successfully expressed in prokaryotic system and highly purified by affinity purification. The positive rate of specific IgG against HCMV was 99.4% by the established ELISA, with no statistically significant difference between the result of pUL138-based ELISA and that of Roche’s detection kit (x2=0.5, P>0.05), and the sensitivity and coincidence rate of the ELISA method were 100.0% and 98.8%. These two results had good coherence (Kappa=0.496, P<0.001). Conclusion: Latency-associated protein UL138 is a potential candidate antigen for HCMV detection and can be useful for development of new techniques for the serodiagnosis of HCMV infection. 2015 Vol. 45 (10 ): 703- [Abstract] ( 634 ) HTML (1 KB)  PDF (1422 KB)  ( 941 ) 709 Antimicrobial activity of tannic acid and its effect on biofilms of clinical isolates YU Xiao1, HOU Yuanbo1, ZHOU Tieli2, CHEN Huale2, LI Bin2, DU Jia2, CAO Jianming1 Objective: To analyze the antimicrobial activity of tannic acid against clinical isolates and its effect on biofilms. Methods: Nine kinds of common clinical isolates, including Staphylococcus aureus, Staphylococcus epidermidis, Hemolytic staphylococci, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were collected. All kinds of antimicrobial agents were evaluated with agar dilution method for the minimal inhibitory concentrations (MIC). According to the results of susceptibility testing, 9 kinds of clinical isolates were divided into multidrug-resistant (MDR) group or non-multidrug-resistant group (nMDR). Thirty strains from each group were randomly selected  as experimental strains. Agar dilution method was used to detect tannic acid MIC of the strain. The difference of the 2 groups to reflect the tannic acid antibacterial activities of common clinical isolates was compared. The effect on the biofilm formation was detected by adding tannic acid into the biofilm culture medium. Results: Tannic acid showed strong antibacterial activity to the 9 kinds of clinical isolates, antibacterial activity to the Staphylothermus bacteria was significantly greater than those for the other bacteria (P<0.05). Tannic acid could inhibit the bacterial biofilm formation. Conclusion: Tannic acid has antibacterial effect to common clinical isolates and can influence the formation of biofilm. 2015 Vol. 45 (10 ): 709- [Abstract] ( 974 ) HTML (1 KB)  PDF (1382 KB)  ( 926 ) 713 The correlative research between mtDNA 12026A/G polymorphism in ND4 gene and T2DM risk: a case-control study and meta-analysis HANG Yuning1, YANG Xunjun1, SHEN Feixia2, LYU Jianxin1. Objective: To investigate the role of mitochondrial DNA 12026A/G (Mt12026) polymorphism in NADH-dehydrogenase subunit 4 (ND4) gene in T2DM. Methods: In order to detect 12026A/G polymorphism in ND4 gene, we used PCR and Sanger sequencing among 551 diabetic patients and 757 controls who were enrolled from the First Affiliated Hospital of Wenzhou Medical University. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). We searched through electronic database PubMed, Embase, China National Knowledge Infrastructure (CNKI) and Wanfang, a meta-analysis was employed based on the publications which described the association of the Mt12026A/G polymorphism with T2DM to evaluate the association between T2DM susceptibility and mitochondrial polymorphism in 12026A/G. Results: In our research, the genotype of mitochondrial DNA 12026G in 551 diabetic patients was 4.49% and 12026G genotype in 757 controls was 4.75%, no significant association between diabetic patients and the controls for 12026A/G polymorphism (OR=0.94, 95%CI 0.57～1.57, P=0.82) in Zhejiang province was found. But meta-analysis suggested that m.12026A/G polymorphism was associated with increased risk of T2DM (OR=1.95; 95%CI 1.14～3.33, P=0.01). Conclusion: The Mt12026A/G polymorphism is associated with an increased risk of T2DM in Chinese Han population, but differences are existed among different populations. 2015 Vol. 45 (10 ): 713- [Abstract] ( 643 ) HTML (1 KB)  PDF (2620 KB)  ( 879 ) 718 Curcumin inhibits JAK2/STAT signaling through increasing the expression of SOCS in myeloproliferative neoplasms XING Chongyun, ZHOU Lin, ZHUANG Qiang, TANG Liyuan. Objective: To investigate the mechanism of curcumin in inhibiting JAK2/STAT signaling through increasing the expression of SOCS1/3 in myeloproliferative neoplasms. Methods: JAK2/STAT signaling and protein levels of SOCS1/3 were detected by Western blotting in HEL and 32D. Acetylation of histone in the regions of SOCS1/3 promoter was detected by immunoprecipitation assay. Furthermore, HDAC enzyme activity was detected by colorimetric HDAC activity assay kit. Results: Curcumin inhibited JAK2/STAT signaling in HEL and 32D cells in vitro. Curcumin could inhibite HDAC enzyme activities and decreased the levels of HDAC1, 3 and 8. Curcumin elevated the mRNA and protein levels of SOCS1/3 via triggering acetylation of histone in the regions of SOCS1/3 promoter. Conclusion: Taken together, our data uncover a regulatory mechanism of SOCS1/3 through inhibition of HDAC activity by curcumin. 2015 Vol. 45 (10 ): 718- [Abstract] ( 711 ) HTML (1 KB)  PDF (1582 KB)  ( 1216 ) 723 Serum secretory Klotho protein estimating the calcification degree of coronary artery in patients on maintenance hemodialysis ZHENG Shubei, JIN Lingwei, ZHENG Yu, ZHOU Zhihong. Objective: To observe the relationship between serum secretory Klotho protein and coronary artery calcification in maintenance hemodialysis (MHD) patients, and to explore the possibility of estimating calcification of coronary artery using Klotho protein. Methods: MHD patients were selected. Serum secretory Klotho protein was detected with ELISA, and multi-slice spiral CT (MSCT) was used to detect coronary artery calcification score (CACs). Spearman correlation coefficient was used to analyze the relationship between Klotho protein and CACs. logistic regression analysis was used to determine the risk factors of calcification of coronary artery in MHD patients. Results: 132 MHD patients were recruited, their average age was 62.98±15.38 years old and the median of dialysis vintage was 51.00 months. Coronary artery calcification was detected in 69.70% patients with the median CACs of 83.47 (0～585.09). The median Klotho protein was 374.76 (336.55, 426.60) pg/mL. Correlative analysis showed that Klotho protein was negatively correlated with CACs (r=-0.294, P=0.001). logistic regression analysis showed that the risk of moderate-severe coronary artery calcification increased in association with the decreased level of Klotho protein. When Klotho protein combined with the CKD-related cardiovascular risk factors and the traditional cardiovascular risk factors, the prediction of moderate-severe coronary artery calcification became more powerful for MHD patients. Conclusion: The lower serum secretory Klotho protein is independently associated with coronary artery calcification. Serum secretory Klotho protein combined with cardiovascular risk factors may be used to predict the moderate-severe coronary artery calcification in MHD patients. 2015 Vol. 45 (10 ): 723- [Abstract] ( 554 ) HTML (1 KB)  PDF (2485 KB)  ( 1087 ) 728 Contrastive analysis between depression with chief complaint of xerostomia and Sjögren’s syndrome WANG Xiaodong, CHEN Jian, LIU Jian, XIONG Junhui, DING Zhenhua Objective: To investigate the difference between depression with chief complaint of xerostomia and Sjögren’s syndrome (SS) by analyzing the clinical characteristics. Methods: The peripheral blood white cells, neutrophilic granulocytes, lymphocytes, CRP, immune globulin (Ig), auto antibodies, labial salivary gland biopsy, and parotid gland ECT in depression with chief complaint of xerostomia group, SS group, SS complicated with depression group and healthy people were evaluated respectively. Statistical analysis was used to find the difference between each group. Results: The peripheral blood white cells was lower in the depression group than that in the healthy control group (P<0.01), and the depression play a main effect on peripheral blood white cells. The CRP was higher in the depression group than the healthy control group (P<0.01), while there was no significant difference between the other two groups. The IgG level was the lowest in the four groups (P<0.05). The IgA and IgM level was higher in SS group and SS with depression group (P<0.01). SS played a main effect on increasing IgM and IgA. Although the positive rate of RF was lower in the depression group than that in SS and SS with depression group, there was no significant difference. The pathdogical examination did not find of small labial positive in the depression and healthy control group. Conclusion: In patients with the chief complaint of xerostomia with depression humoral immune abnormalities and acute inflammation also exists. These patients may be misdiagnosed as SS, if necessary, we must do small labial gland biopsy to be identified. 2015 Vol. 45 (10 ): 728- [Abstract] ( 826 ) HTML (1 KB)  PDF (1323 KB)  ( 1261 ) 734 Effect of long-term and low-doses roxithromycin on airway local immune in patients with moderately severe COPD LIU Xianbing, LI Fang, CHEN Xiaoping, TIAN Mingqing, YE Jianxian, ZHU Lifen. Objective: To discusses effect on the airway local immune of long-term and low-dose roxithromycin and clinical significance of patients with moderately severe chronic obstructive pulmonary diseases (COPD). Methods: Sixty patients with moderately severe COPD were randomly divided into two groups (n=30): the roxithromycin and basic group. Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation combined with totropium Bromide Powder for Inhalation were used as the foundation treatment. The roxithromycin group combined with roxithromycin 150 mg, 1/d, oral. Both groups were followed up for a year, once every three months. Sixty cases of healthy check-up were as healthy controls. The CAT score, FEV, seurm lgG, lgA, lgM and induced sputum CD3+, CD4+, CD4+/CD8+, etc were tested and compared. Results: Compared with healthy group, the lgA, IgG of COPD group was decreased, serum induced sputum CD3+, CD4+, CD4+/CD8+ value was decreased, CD8+ increased (P<0.05). There was no significant difference between two groups of COPD (P>0.05). After three months, the lgA, IgG and induced sputum CD3+, CD4+, CD4+/CD8+ of roxithromycin group was increased, CD8+ decreased (P<0.05). CAT score decreased and FEV1 improved (P<0.05). Peak reached after six months of treatment (P<0.05). There was no significant difference both nine months and twelve months of treatment (P<0.05). In roxithromycin group, induced sputum CD4+/CD8+ and IgG, IgA, FEV1 had positive correlation (r=0.567, 0.587, 0.556, P<0.05), and the CAT score had negative correlation (r=-0.507, P<0.05). Conclusion: Long-term and low doses of roxithromycin use can improve the body airway partial immunity and quality of life of COPD patients. Long-term use of roxithromycin benefit is bigger. 2015 Vol. 45 (10 ): 734- [Abstract] ( 639 ) HTML (1 KB)  PDF (1289 KB)  ( 1127 ) 738 Correlation among interferon-gamma gene polymorphism, viral load high-risk human papilloma virus remains and prognosis after loop electrosurgical excision procedure for CIN patients CHEN Yan, LIN Lin, JIA Zhiqiang, CHEN Niya Objective: To investigate the association of interferon-gamma gene polymorphisms and the correlation between viral load remains and recidivation after loop ment for CIN patients. Methods: Performed gene analysis was used for detection of polymorphisms in interferon-gamma gene in 439 HPV positive patients undergone the LEEP treatment for CIN and 120 HPV negative normal controls, reviewed high-risk HPV DNA and cervix uterus TCT were reviewed in 3, 6, 9 and 12 months after treatment. Results: That the individuals with the TT genotype showed statistically significant had protection against HPV infection (OR=0.471, 95%CI=0.283～0.783; x2=8.702, P=0.003). That the individuals with the AA genotype showed statistically significant increased risk for HPV infection (OR=1.688, 95%CI=1.108～2.572; x2=6.005, P=0.014). The viral load before and after 3 months LEEP treatment of high-risk HPV was a risk factor of remains or recidivation after LEEP treatment (P<0.05). In the analysis of Kaplan-Meier, the cumulative HPV negative rates of AA and TT genotype exhibited significantly different (log-rank=15.414, P<0.001). The cumulative HPV negative rate of AA genotype was the lowest, the remains or recidivation rate of AA genotype was 45.65%. Conclusion: The viral load before and after 3 months LEEP treatment of high-risk HPV is related to CIN and the prognosis for CIN patients. Interferon-gamma gene rs2430561 polymorphisms affects the susceptibility to HPV infection. Women with AA genotype exhibited higher risk of infection and inclined to be continuous status and recurrence after HPV infection. 2015 Vol. 45 (10 ): 738- [Abstract] ( 626 ) HTML (1 KB)  PDF (1690 KB)  ( 1007 ) 744 Value of ultrasound elastography in the diagnosis of Graves disease and Hashimoto’s thyroiditis YANG Meiqin, LIU Guilin, FANG Ming, HONG Yuanyou Objective: To investigate the value of ultrasound elastography in the diagnosis of Graves disease and Hashimoto’s thyroiditis. Methods: One hundred and twelve patients with Graves disease and 108 patients with Hashimoto’s thyroiditis (HT) were included in this study between May 2011 and November 2013 in our hospital. Thyroid size, shape, echo characteristics, blood condition were observed and recorded by color Doppler ultrasound. In addition, elastic score, the average value of the relative strain (MEAN) and the blue area ratio (AREA) were gained by ultrasound elastography. The diagnostic accuracy of color Doppler ultrasound and ultrasound elastography were compared. Results: No significant difference was detected in thyroid size, echo characteristics and blood flow classification (P>0.05). Graves group was mainly charactered by scattered hypoechoic echo-based distribution, and HT group was mainly charactered by diffuse hypoechoic echo-based distribution. PSV, EDV in Graves group were significantly higher than those in HT group (P<0.05). Elastic score and %AREA in HT group were significantly higher, but MEAN in HT group was significantly lower. The diagnostic accuracy of color Doppler ultrasound combined elastography was significantly higher than that of color Doppler ultrasound (P<0.05). Conclusion: Color Doppler ultrasound combined with ultrasound elastography may play a role in the diagnosis of Graves disease and Hashimoto’s thyroiditis. 2015 Vol. 45 (10 ): 744- [Abstract] ( 723 ) HTML (1 KB)  PDF (2468 KB)  ( 1145 ) 748 Study on the relationship between hypoglycemic scheme and the number of circulating endothelial progenitor cells ZHANG Aiming1, SHEN Lizhen2, LI Chaiwei1, GAO Saisai1 Objective: To investigate the effects of different hypoglycemic programme on the influence of the number of circulating endothelial progenitor cells (EPCs) in patients with primary type 2 diabetes. Methods: Forty-five newly diagnosed type 2 diabetes hospitalized patients were selected through the inclusion and exclusion criteria. The age, gender, height, weight, waist circumference and calculated body mass index (BMI) were recorded for each patient. The level of fasting blood glucose (FPG), fasting insulin (FINS), 2 hour postprandial blood glucose (PPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL) were measured. The newly diagnosed type 2 diabetes mellitus patients (mentioned above) were randomly divided into three groups according to the different hypoglycemic treatment. group A (n=15): patients were treated with twice per day of premixed insulin therapy (Humalog 25 pin) after 2 weeks of subcutaneous insulin pump therapy (CSII insulin aspart). group B (n=15): patients were treated with oral hypoglycemic drug (Diamicron MR 30-120 mg/d); group C (n=15): patients were treated with premixed insulin (Humalog 25 pin twice perday). After determination of general clinical data, the level of EPCs labled with CD34 and KDR double positive before and after 4 weeks of treatment were measured with flow cytometry. The number of EPCs before and after treatment and three groups after 4 weeks treatment were compared to investigate the short-term effects of different hypoglycemic therapy effects of intensive treatment in newly diagnosed type 2 diabetic patients on the number of EPCs. Results: The clinical indexes and the number of EPCs in the A, B, C three groups showed no difference before treatment (P>0.05). However, treatment significantly increased the number of EPCs in A.C groups was higher than B group after 4 weeks treatment. However no difference observed between A and C group. Meanwile, the number of EPCs and HbA1c had obvious negative linear correlation through mulitiple linear regression analysis. Conclusion: Altogether, these results suggest that the insulin strengthening treatment is better for newly diagnosed patients with type 2 diabetes mellitus. This treatment can relief of “glucotoxicity” rapidly and increase the number of EPCs, which may alleviate the endothelial dysfunction induced by diabetes and may prevent or delay the diabetes chronic vascular complication incidence. Meanwile, the level of blood glucose has a direct impact on the number of EPCs in patients of diabetes. Our result is consistant with published reported that the higher HbA1c usually accompany with the less the number of EPCs in diabetes. 2015 Vol. 45 (10 ): 748- [Abstract] ( 529 ) HTML (1 KB)  PDF (1294 KB)  ( 874 ) 753 Assessment of hemodymamics of perihematoma after the subacute hypertensive intracerebral hemorrhage with CT perfusion imaging ZHOU Jiejie, CHEN Weijian, YANG Yunjun, LI Jiance, DUAN Yuxia, CAO Objective: To study the perihematomal hemodynamics changes in patients with subacute hypertensive intracerebral hemorrhage using 320-row volume CT perfusion imaging. Methods: CTPI was performed in twenty-one patients from 4 days to 14 days after the onset of HICH. The volume of the hematomas was measured, and the perfusion parameter values of the marginal zone and outer zone of the intracerebral hematoma and contralateral mirror were measured, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time-to-peak (TTP), and rCBF, rCBV, rMTT and rTTP were calculated by ipsilateral/contralateral value. The differences of perfusion parameter values between the marginal zone or the outer zone and the mirror area, and the differences of relative perfusion parameters values between marginal and outer zone were analyzed by paired samples t test. Relationships between the volume of hematomas and the time from the onset to the CTPI performance and rCBF, rCBV, rMTT and rTTP of marginal and outer area were analyzed by Pearson correlation analysis. Results: ①Compared with the mirror area, the CBF and CBV of the marginal zone showed lower perfusion and there was significant statistical difference (tCBF=-4.442, PCBF<0.01; tCBF=-4.139, PCBV<0.01), the TTP was more delayed in the marginal zone, and there was significant statistical difference (tTTP=4.030, PTTP<0.01), and the MTT of marginal zone was shorter but there was no significant statistical difference (tMTT=-1.631, PMTT>0.05); The CBF of the outer zone presented lower perfusion than the mirror area and there was significant statistical difference (tCBF=-2.196, PCBF<0.05), MTT was longer than that of the mirror area, there was significant statistical difference (tMTT=-2.093, PMTT<0.05), and there was no statistically difference between the CBV or TTP of outer and mirror area (tCBV=-0.776, PCBV>0.05 and tTTP=0.336, PTTP>0.05). The rCBF and rCBV in the marginal zone were lower than those in the outer zone, and there was significant statistical difference (trCBF=-2.688, PrCBF<0.05 and trCBV=-3.124, PrCBV<0.01 respectively). rMTT was significantly shorter (trMTT=-2.770, PrMTT<0.05) than it in the outer zone, but rTTP was more delayed in the marginal zone (trTTP=3.574, PrTTP<0.01). ②There was no significant relationship between the volume of subacute hematomas and rCBF, rCBV, rMTT of the marginal zone and the outer zone or rTTP of the outer zone, and there was significant relationship between that and rTTP of the marginal zone. There was also no significant relationship between the time from onset to the CTPI performance and rCBF, rCBV, rMTT of the marginal zone or the outer zone and rTTP of the marginal zone, and there was significant relationship between that and rTTP of the outer zone (r=0.441, P<0.05). Conclusion: Hypoperfusion still remained in perihematomal region of subacute hypertensive intracerebral hematoma, furthermore there is no significant correlation between rCBF and rCBV of perihematoma and the volume of hematoma and the time from onset to CPTI performance. 2015 Vol. 45 (10 ): 753- [Abstract] ( 540 ) HTML (1 KB)  PDF (1547 KB)  ( 1001 ) 758 The correlative analysis analysis between thyroid-stimulating hormone levels and metabolic syndrome during pregnancy ZHOU Qingdiao1, ZHENG Xiaodong1, LI Xiumei1, HU Yanjun1, LV Jieqiang2. Objective: To investigate the relationship between thyroid-stimulating hormone (TSH) levels and metabolic syndrome during pregnancy. Methods: Nine hundred and eleven single pregnant women who accepted regular obstetrical inspection and delivered in Wenzhou People’s Hospital were enrolled. One hundred and forty-nine cases with subclinical hypothyroidism (TSH>3.0 mIU/L) were divided into study group and other 762 pregnant women with TSH<3.0 mIU/L were as controls. Information Including age, gestational weeks, body weight before pregnancy and biochemical indicators, including total cholesterol (CHOL), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and thyroid-stimulating hormone levels were recorded. The levels of serum lipid, the prevalence of pregnancy induced hypertension, gestational diabetes mellitus and pregnancy metabolic syndrome were compared between the two group. Results: The levels of triglyceride in the subclinical hypothyroidism group were much higher than that in the controls. The difference was statistically significant (P<0.05). The incidence of GMS and pregnancy induced hypertension was much higher than that in the controls. There was no correlation between TSH and GMS (P>0.05). The TSH seemed to have relationship in the morbidity between pregnancy induced hypertension and normal (P<0.05). Conclusion: There is a significant correlation between TSH levels and triglyceride and pregnancy induced hypertension.The levels of TSH is also associated with pregnancy hypertension, but not related to GMS. 2015 Vol. 45 (10 ): 758- [Abstract] ( 607 ) HTML (1 KB)  PDF (1282 KB)  ( 1001 ) 762 Comparison of the pregnancy outcomes of frozen blastocyst transferred 4 hours after being thawed or 20 hours after being cultured overnight XI Haitao, GE Hongshan, CHI Haihong, CHEN Hua, ZHU Chunfang, ZHANG Fan, LYU Jieqiang Objective: To compare the pregnancy outcomes when frozen blastocyst was transferred 4 hours after being thawed or 20 hours after being cultured overnight. Methods: For the 5 days freezing thawing blastocysts transplantation cycle, all the cycles are divided into two groups based on different culture time before transfer, those blastocysts transferred 4 hours after being thawed were labeled as A group (n=157) and those cultured overnight before being transferred the next day were included in B group (n=227). The pregnancy outcomes were compared between the two groups. Results: The proportion of thawing cycles leading to no transfer did not differ between groups (1.2% versus 2.2% for A and B, respectively). However, the proportion of hatched blastocysts derived from B group was significantly higher than that from A group (41.7% versus 86.5%, respectively, P<0.001). All differences of the clinical pregnancy rate, implantation rate, miscarriage rate and multiple pregnancy rate between two groups have not yet reached the statistical significance. Conclusion: Overnight culture of thawed blastocyst before transfer does not affect the main pregnancy outcomes. For blastocyst thawing time, operators will have more choices. 2015 Vol. 45 (10 ): 762- [Abstract] ( 634 ) HTML (1 KB)  PDF (1284 KB)  ( 1054 ) 765 Clinicial analysis of chronic pulmonary aspergillosis in 28 cases DONG Shuangxia1,2, ZHENG Jiyang2, DAI Xinjian2, HUANG Xiaoying1. Objective: To study the clinical features and method of diagnosis and treatment in chronic pulmonary aspergillosis. Methods: Twenty-eight cases of chronic pulmonary aspergillosis from May 2010 to Feb 2015 in Wenzhou Central Hospital were retrospectively analyzed. Results: Twenty-four cases had basic disease or mildly immunodepression, in whom the most common was pulmonary tuberculosis and the followed by was bronchiectasis. There was no specificity in clinical manifestations, the common presentations included productive cough, haemoptysis.Imaging examination showed the diseased region mainly located in upper lobe, the main characteristic lesion, were pulmonary cavity with aspergills ball, inflitrating shadows around, pleural thickening, and the air crescent sign founded in 10 cases. Nine cases were pathologically diagnosed by surgery or lung puncture, and 19 cases were diagnosed by bronchoalveolar lavage fluid or sputum culture. The antifungal therapy was given in 19 cases, which improved symptoms in 17 cases and cured in 2 cases. Surgery treatment performed in 6 cases, and 4 cases of them with good prognosis. Conclusion: Lacking specificity of clinical manifestations, it is easy to be misdiagnosed and missed diagnosis. Imaging examination plays an important role in disease diagnosis, and making a definite diagnosis requires pathological or etiological foundation. Patients with complete lesion resection and in good condition recommended surgery as soon as possible, others needed the anti-fungal treatment to improve the outcome.   2015 Vol. 45 (10 ): 765- [Abstract] ( 580 ) HTML (1 KB)  PDF (1361 KB)  ( 943 ) 769 Clinical and pathological features of elder patients with idiopathic membranous nephropathy CHEN Yu1, CHEN Xinxin2, HUANG Chaoxing2. Objective: To investigate the clinical and pathological features of elder patients with idiopathic membranous nephropathy (IMN). Methods: One hundred and fifty patients with IMN were diagnosed by renal biopay in our hospital from Jun 2006 to Dec 2013, the relationship between clinical and pathological features were retrospectively analyzed on the basis of age, including older age group (≥60 s) 86 cases and jnvenile group (≤35 s) 64 cases. Results: Compared with jnvenile group, there were high incidence rates of hypertension, edema, renal insufficiency, diabetes and infections in the older age group. There were also significant statistical differences among course of disease, BUN, Scr, UA, Alb, TC, Fib, and Ccr in two groups. Most cases were classified as stage I or II membranous lesions in pathology. Compared with jnvenile group, there were high incidence rates in focal segment glomerulosclerosis, tubule-interstitial pathological changes, arterioles sclerosis and arteriole hyaline degeneration in the older age group. Conclusion: Elder IMN patients usually have complications with hypertension, diabetes, renal insufficiency, infections and tubule-interstitial and arterioles chronic pathological changes. More attentions should be paid to early diagnosis of IMN in elder patients, and take pertinence actions. 2015 Vol. 45 (10 ): 769- [Abstract] ( 626 ) HTML (1 KB)  PDF (1281 KB)  ( 762 )

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