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Objectives To compare the difference between multipoint inoculation and routine method for isolation of pathogenic fungi from nail samples of onychomycosis,and to analyze the epidemiology of pathogenic fungi in those patients.Methods The nail clipping samples from each patient were inoculated onto the plates with Sabouraud's agar,Sabouraud's agar without cycloheximide and medium containing rapeseed oil,respectively,by an approach of at least seven inoculating points in each plate (multipoint inoculation),and onto medium slope in tubes with the same media as above mentioned (routine method).In the multipoint inoculation method,plates with more than 3 colonies were taken for further identification of pathogenic fungi based on morphological and biochemical properties.Results Based on the data from 150 samples of onychomycosis,significant differences were found between multipoint inoculation method and routine method (P
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Objective To examine the distribution of Malassezia species in follicular contents and perifollicular superficial skin in patients with Malassezia folliculitis and search for its causative agent. Methods A total of 120 patients with Malassezia folliculitis were investigated. Follicular lesions at three different anatomic sites were selected in each patient. Perifolliclar superficial skin specimens were taken by sterile adhesive tape, and the follicular contents of the same follicle were taken by sterile haemostatic forceps. The above specimens were cultured respectively on media containing rapeseed oil. The isolated colonies were identified by their physiological and morphological characteristics. Results Out of 319 isolates obtained from the perifollicular superficial skin, 247 isolates (77.43%) were identified as M. sympodialis, 40 isolates (12.54%) as M. furfur, 27 isolates(8.46%) as M. globosa and 5 isolates(1.57%) as M. obtusa. Out of 314 isolates obtained from follicular contents, 252 isdates(80.25%) were identified as M. globosa, 57 isolates(18.15%) as M. sympodialis, 4 isolates(1.27%) as M. furfur, and 1 isolate(0.32%) as M. obtusa. There was statistical difference in species distribution between the follicular contents and the perifolliclar superficial skin (P
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Objective To investigate the significance of immunostainning for Ber EP4and EMA in the diagnosis of basal cell carcinoma and squamous cell carcinoma of the skin.Methods Immunohisto-chemical stainning for Ber EP4and EMA was performed on115cases of basal cell carcinoma,squamous cell carcinoma,Bowen' s disease,actinic keratosis,basosquamous cell carcinoma,seborrheic keratosis,and verruca vulgaris.Specimens were taken from neoplastic tissues as well as the surrounding skin and ap-pendages.Results Ber EP4was positively stained in all cases of basal cell carcinoma and basosquamous cell carcinoma,but negatively stained in squamous cell carcinoma,Bowen's disease,actinic keratosis,sebor-rheic keratosis and verruca vulgaris.Expression of EMA was found in most cases of squamous cell carcinoma and Bowen' s disease,and a few cases of actinic keratosis,and in none of basal cell carcinoma,basosqua-mous cell carcinoma,seborrheic keratosis and verruca vulgaris.Conclusions Routine immunohistochemical staining with both Ber EP4and EMA is helpful for distinction of skin basal cell carcinoma,squamous cell carcinoma,precancerosis and benign hyperplastic dermatoses.
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Objective: To observe the clinically curative effect of Jiangtong Xifeng liquid (JTXFL,降通 熄风液)combined with conventional therapy of western medicine on acute cerebral hemorrhage.Methods:Ninety cases were randomly divided into 2 groups.The treated group (n=60) was treated by JTXFL combined with conventional therapy of western medicine.The control group (n=30) was treated with conventional therapy alone.Before an d after therapy the changes in scores of neural functional defect,state of cons ciousne ss,blood pressure,and CT and the curative effects were observed for both groups.Results:The total effective rate was 88.3% in treated group,but it was 76.7% in contro l group, so that it in treated group was significantly superior to that in contr ol group (P<0.05). Conclusions:The curative effects of JTXFL combined with conventional therapy of western med icine on acutely cerebral hemorrhage is very obvious.
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Objective To investigate the effect of Candida albicans and its components on the expression level of human beta-defensin-2 mRNA (HBD-2) in keratinocytes in vitro. Methods Different components of Candida albicans were isolated by lyticase, repeated freezing and thawing, sonication, and centrifugation. The keratinocytes and HaCaT cell lines were co-cultured with Candida albicans and its cellular components for 24 h. The expression level of HBD-2 mRNA was detected by reverse-transcription polymerase chain reaction (RT-PCR). Results Low expression level of HBD-2 mRNA in the unstimulated keratinocytes and HaCaT cells was detected. The HBD-2 mRNA expression levels in the keratinocytes stimulated by Candida albicans, the extract of its cell wall, and pure mannan were significantly increased (P 0.05). Conclusions Candida albicans, the extract of cell wall of Candida albicans, and commercial mannan can increase the expression level of HBD-2 mRNA in keratinocytes.
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Objective To evaluate the efficacy and safety of topical retinoids in the treatment of acne vulgaris compared with placebo, antibiotics, benzoyl peroxide and sulfur preparation. Methods According to the Cochrane reviewer′s handbook, randomized controlled clinical trials were selected for the systematic review. Results Up to 2002, 15 clinical trials (2,439 patients) that met the inclusion criteria were selected. There were four clinical trials which showed that topical retinoids were more effective than that of placebo (RR=1.87, and 95% CI: 1.13 ~ 3.11),especially for noninflammatory lesions (RR=12.70,and 95% CI : 4.09 ~ 39.40). There were 3 clinical trials which showed that topical retinoids had better efficacy than that of sulfur preparations (RR=1.75, and 95% CI: 1.42 ~ 2.16). For 7 clinical trials of retinoids compared with benzoyl peroxide, and 3 clinical trials of retinoids compared with antibiotics, no conclusion could be drawn. All the clinical trials showed that there were local side effects, including erythema, and scaling etc in the patients using topical retinoids, but no systematic side effects were observed, however, pregnant women had to be very cautious. Conclusions Topical retinoids are effective for acne vulgaris, and has better efficacy than sulfur preparation does, but there is not enough evidence to clarify that the efficacy of topical retinoids is better than that of benzoyl peroxide and antibiotics.
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Objective To isolate and observe Pityrosporum yeasts from a patient with onychomycosis. Methods The involved nail specimens were investigated by means of culture, pathological and scanning electron microscopic examination and 20% KOH preparation. Results Physical examination showed that each finger and toe nail appeared brownish black, rough and thick, some of the fore part of the nail plate detached from the nail bed. Fingernail specimen's culture results showed that Trichophyton rubrum grew on Sabouraud's dextrose agar and Pityrosporum ovale grew on the medium containing rapeseed oil. The pathological examination revealed P.ovale yeast involvement in the fissure of the nail plate. Under the scanning electron microscopy, a lot of P.ovale yeasts with characteristic collarette structure inserted in the nail tissue was noticed. In the 20% KOH preparations of nail incubated at 56℃for 1h and stained with Quink Parker ink, spores and hyphae were identified morphologically with P.ovale and T.rubrum respectively. The patient received intermittent pulse therapy with itraconazole, the color of the nails became much brighter 1 to 2 months after the fourth cycle of therapy, but no further improvement was observed afterwards. P.ovale and T.rubrum grew again 6 months after treatment when the clippings of the fingernail were cultured. Conclusion This is the first document of onychomycosis related with P.ovale in China.
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Objective To report a case of disseminated cryptococcosis with cutaneous manifestations and osteomyelitis. Methods and Results A 33 year old female was admitted due to multiple nodules and ulcers on the upper arms, shoulders, buttocks and thighs for one year. The patient was pregnant when admitted, and gave birth to a premature baby during her illness. The nodules increased half a month after delivery, which was suspected to be hematogenously disseminated pulmonary tuberculosis and was given anti tuberculous therapy for three months but failed. Physical examination showed there were 39 nodules or ulcers on the face, gum, trunk, buttocks and extre mities. The bone structure of the left tibia and fibula destroyed and a sinus developed on the left fibula. Microbiologic examination showed that lots of spores were seen in the smear of pus and necrotic tissues, which produced yeast like colonies in culture with positive urease and caffeic acid test. Cryptococcus neoformans, serotype A was identified by API yeast reaction band and serology. Inoculation with mice and rats showed that their brains, lungs and livers were involved easily. Further identification as C.neoformans var.neoformans was obtained based on sequence analysis of ribosomal internal transcribed spacer region 2. The anti tuberculous therapy was stopped and anti fungal therapy was initiated at once. Intravenous and topical amphotericin B in combination with fluconazole were chosen in the initial therapy and itraconazole for maintenance. The nodules disappeared after 30 days and the last ulcer in the left tibia healed completely after 200 days. The anti fungal therapy was discontinued after 277 days and the patient was completely cured.