ABSTRACT
We report a case of chromoblastomycosis caused by , which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with strain KX078407. The susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 μg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.
Subject(s)
Animals , Humans , Male , Middle Aged , Rats , Chromoblastomycosis , Laser Therapy , Lasers, Solid-State , Rats, Wistar , Terbinafine , Treatment OutcomeABSTRACT
Diabetic nephropathy (DN) is one of the most important microvascular complications of diabetes, which is one of the most important causes of death in diabetic patients. Because of its high efficiency and few adverse reactions, TCM has been widely studied and used in the treatment of DN, with unique advantages. The recent research showed that a variety of TCM polysaccharides have the effects of reduce blood sugar and protect kidney. This article reviewed the research on TCM polysaccharides on the prevention and treatment of DN, which can provide references for further study and application.
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Objective To analyse the differences of indirect immuno‐fluorescence (IIF) ,enzyme‐linked immunosorbent assay (ELISA) and immunoblotting technique(IBT) for the determination of anti‐dsDNA antibody ,and evaluate the value of joint detec‐tion of the three methods for diagnosing systemic lupus erythematosus(SLE) .Methods From January 2012 to March 2015 ,50 ca‐ses of patients with SLE ,100 cases of patients with other autoimmune disease(AID)and 100 healthy individuals were selected .Ser‐um levels of anti‐dsDNA antibody were detected by using IIF ,ELISA and IBT respectively .Then ,compared the sensitivity and spe‐cificity of the three methods ,and analysed the sensitivity and specificity of joint detection .Results The IIF method had the highest specificity(99 .5% ) ,while ELISA had the highest sensitivity(74 .0% ) .There were statistically significant differences in the positive detection rates of serum anti‐dsDNA antibody in patients with SLE between IIF and ELISA ,IIF and IRT ,ELISA and IBT(χ2 values were 11 .435 ,13 .994 and 4 .539 ;P<0 .05) ,and the Kappa values were 0 .411 ,0 .522 and 0 .278 respectively .The specificity of three methods joint in series was increased to 99 .5% ,and the sensitivity of parallel combined detection of the three methods was in‐creased to 82 .0% .Conclusion Among the three methods for detecting anti‐dsDNA antibody ,ELISA has the highest sensitivity , and IIF has the highest specificity .Moreover ,joint detection could increase the sensitivity and specificity .
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Objective To investigate the relationship between the related indexes with rheumatic heart disease (RHD) and its clinical significance .Methods The medical records information in 236 patients with rheumatic fever caused cardiac were collected and divided into the RHD group ,simple rheumatic fever group and normal healthy control group .The levels of related indiexe such as Mb and cTnI were detected in the three groups .Results The Mb ,cTnI and CK‐MB and NT‐proBNP had statistical differences between the RHD group and simple rheumatic fever groups (P<0 .05);the levels of ESR ,RF ,CRP ,cTnI ,Mb ,CK‐MB ,CK and NT‐proBNP had statistically significant differences between the RHD group and healthy control group (P<0 .05);With the NT‐proB‐NP level of 136 .17 pg/mL as the critical value ,the sensitivity ,specificity ,positive predictive value and negative predictive value of NT‐proBNP for diagnosing RHD were 95 .48% ,90 .15% ,86 .7% and 97 .86% respectively .Conclusion The levels of blood cTnI , Mb and CK‐MB in the patients with RHD are significantly higher than those in the normal controls ,so detecting the serum NT‐proBNP concentration is a sensitive indicator for early diagnosis of RHD .
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Objective To establish reference ranges of venous blood cell parameters in Lanzhou area ,through investigating 1 880 cases of healthy people .Methods Retrospective analysis method was adopted ,and changes of 26 venous blood cell parameters were observed by using Sysmex XE‐5000 automatic hematology analyzer .Results Some parameters ,including platelet(PLT) and hemo‐globin(Hb) ,were close to normal distribution ,while most of parameters were skewed distribution .In the 6 parameters of white blood cells ,except for percentage of lymphocyte and neutrophi ,the 95% CI of the rest of parameters had statistically significant differences between male and female(P0 .05) .In some parameters ,there were significant differences between 95% CI observed in this study and reference ranges currently used .Conclusion There are sig‐nificant differences between 95% CI of these parameters and original reference ranges ,so the original reference ranges are lack of ac‐curacy and applicability ,which indicates that it is necessary to scientificlly and rationally establish reference ranges of blood cell in region .