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Objective:To analyze types of mucosal candidiasis and drug resistance of relevant pathogens in a dermatology outpatient clinic in Taiyuan.Methods:Clinical data were collected from 172 patients with mucosal candidiasis, who had positive fungal culture results, in the dermatology outpatient clinic of Shanxi Bethune Hospital from 2019 to 2020. Pathogens were identified by a molecular biological approach, and in vitro drug sensitivity test was performed. Results:Among the 172 patients with mucosal candidiasis, 142 (82.6%) had vulvovaginal candidiasis, 24 (14.0%) had candidal balanoposthitis, and 6 (3.5%) had oral candidiasis; 3 patients were aged ≤ 18 years, 155 were aged 19 - 59 years, and 14 were aged ≥ 60 years, and the proportion of patients with vulvovaginal candidiasis significantly differed among the above 3 age groups (2/3, 134/155[86.45%], 6/14, respectively; χ2 = 14.29, P < 0.05) . Molecular biological identification showed that all the 172 isolated strains belonged to the genus Candida, including 165 strains of Candida albicans (95.9%) , 5 strains of Candida glabrata (2.9%) , and 2 strains of Candida parapsilosis (1.2%) ; the sensitivity to common antifungal agents including flucytosine, amphotericin B, fluconazole, itraconazole and voriconazole was 95.9%, 100.0%, 62.2%, 47.1% and 56.4%, respectively. Conclusion:In the dermatology outpatient clinic of Shanxi Bethune Hospital, vulvovaginal candidiasis was the most common type of mucosal candidiasis, and the main pathogen was Candida albicans; the Candida isolates showed high sensitivity to flucytosine and amphotericin B.
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Objective To analyze the precipitating factors for,clinical manifestations of,laboratory findings in and therapeutic effect on acute urticaria.Methods Clinical data were collected from 185 inpatients with acute urticaria in Shanxi Dayi Hospital from January 2013 to December 2016.Clinical features,laboratory examination results,treatment,prognosis and adverse reactions were analyzed retrospectively.Statistical analysis was carried out by chi-square test.Results There were 63 male patients and 122 female patients in this study,with an average age at onset of 32.87 ± 14.18 years.Of the 185 patients,78 (42.2％) were able to report the aetiological agents accurately,33 (17.8％) were induced by infection or drug therapy following infection,and 82 (44.3％) had fever.Blood cell analysis showed increased white blood cell count in 132 (71.4％) cases and increased proportion of neutrophils in 128 (69.2％) cases.The level of C reactive protein increased in 118 (69％) of 171 cases.A total of 185 patients received routine anti-anaphylactic treatment.Of 183 cured patients,153 (83.6％) were treated with antibiotics,26(14.2％)with antibiotics alone,and 24(13.1％) with azithromycin.There were 127 (69.4％) patients receiving combined treatment with glucocorticoids,antibiotics,and so on,and the antibiotic used in 111 (60.7％) cases was azithromycin.Of 88 cured patients with simultaneous signs of infection,85 (96.6％) showed increased levels of part or all of infection markers (including the white blood cell count,proportion of neutrophils and level of C reactive protein),and 69 (78.4％) were treated with azithromycin.Of 95 cured patients without signs of infection,83 (87.4％) showed increased levels of infection markers,and 61 (64.2％) were treated with azithromycin.Moreover,there were significant differences in the proportion of patients with increased levels of infection markers and that of patients treated with azithromycin between the cured patients with and without signs of infection (x2 =5.164,4.476,both P ＜ 0.05).Conclusions Infection is a common cause of acute urticaria,and laboratory examinations including white blood cell count,proportion of neutrophils and level of C reactive protein are of important reference value to the diagnosis of infection in patients with acute urticaria.Patients with signs of infection or increased levels of infection markers need to be treated with combined anti-infective therapy,and in the cured patients,the proportion of patients administrating azithromycin was higher than that of those administrating other antibiotics for the treatment of acute infectious urticaria.
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Objective To evaluate the inhibitory effect of mesenchymal stem cells (MSCs) in lesions of patients with psoriasis on T lymphocyte proliferation.Methods Tissue specimens were obtained from the lesions of 15 patients with psoriasis vulgaris (7 at progressive stage and 8 at resting stage) and normal skin of 15 human controls from the Department of Urology and Plastic Surgery,Taiyuan City Centre Hospital.MSCs were isolated from these skin specimens,cultured,and identified using flow cytometry and in vitro differentiation assay.Enzyme-linked immunosorbent assay (ELISA) was performed to detect the concentration of interleukin (IL)-6,IL-1 1,hepatocyte growth factor (HGF) and transforming growth factor (TGF)-β1 in the culture supernatant of third-passage MSCs.Peripheral blood T cells were obtained from a healthy adult and cocultured with the third-passage MSCs for four days.Then,cells were counted and methyl thiazolyl tetrazolium (MTT) assay was conducted to evaluate the proliferation of T cells.One-way analysis of variance (ANOVA) and Student-Newman-Keuls (SNK) test were carried out to compare the proliferation of T lymphocytes,and two independent samples t test to compare the concentrations of cytokines.Results Inverted microscopy revealed that the patient-and control-derived MSCs shared similar morphological properties and multi-directional differentiation capacity,along with the expression of CD29,CD44,CD73,CD90 and CD105,but absence of CD34,CD45 and HLA-DR on cell surface.After coculture with MSCs from the patients and controls for four days,the count of T lymphocytes per milliliter was (1.67 ± 0.34) × 105 and (1.04 ± 0.29) × 105 respectively (P＜ 0.01),and the proliferative activity (expressed as absorbence at 492 nm)was 0.317 ± 0.021 and 0.275 ± 0.007 respectively (P ＜ 0.01).Compared with the control-derived MSCs,the patient-derived MSCs showed a significantly higher level of IL-1 1 ((181.37 ± 31.74) vs.(130.07 ± 29.20) ng/L,t =5.32,P ＜ 0.01),but a lower level of lL-6 ((61.67±17.53) vs.(76.74±18.96) ng/L,t=2.61,P＜0.05)and HGF ((319.24 ± 41.03) vs.(352.35 ± 51.47) ng/L,t =2.25,P＜ 0.05),as well as a similar level of TFG-β1,in the culture supernatant.Conclusions The inhibitory effect of MSCs in psoriatic lesions on T lymphocyte proliferation is diminished,which may contribute to the pathogenesis of psoriasis.