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Objective To investigate dermoscopic features of onychomycosis and nail psoriasis.Methods From March 2017 to March 2018,128 patients with onychomycosis and 128 with nail psoriasis were enrolled from Department of Dermatology,Xiangyang Central Hospital.Dermoscopic images of the lesional nails were compared.Enumeration data were analyzed by chi-square test and Fisher's exact test.Results There were 7 kinds of dermoscopic patterns in onychomycosis,including jagged edge (69/128,53.91％),longitudinal striae (72/128,56.25％),cone-shaped keratosis (30/128,23.44％),nail plate thickening (21/128,16.41％),black dots (5/128,3.91％),onycholysis (26/128,20.31％),and nail discoloration (23/128,17.97％).The jagged edge and longitudinal striae occurred more frequently in distal/ lateral subungual onychomycosis (DLSO) than in the other 3 clinical subtypes of onychomycosis (all P ＜ 0.001),and cone-shaped keratosis occurred more frequently in total dystrophic onychomycosis (TDO) than in the other 3 clinical subtypes of onychomycosis (x2 =42.020,P ＜ 0.001).There were no significant differences in the prevalance of nail plate thickening,black dots,onycholysis and nail discoloration among the 4 clinical subtypes of onychomycosis (all P ＞ 0.05).There were 7 kinds of dermoscopic patterns in nail psoriasis,including pitting corrosion (61/128,47.66％),oil drop sign (41/128,32.03％),splinter hemorrhage (41/128,32.03％),dilated hyponychial capillaries (23/128,17.97％),nail plate thickening (20/128,15.63％),onycholysis (20/128,15.63％),and nail discoloration (13/128,10.16％).The oil drop sign occurred more frequently in psoriasis vulgaris and psoriasis arthropathica than in the other 2 clinical subtypes of psoriasis (P =0.019).The dilated hyponychial capillaries occurred more frequently in pustular psoriasis than in the other 3 clinical subtypes of psoriasis (P =0.047).There were no significant differences in the prevalance of pitting corrosion,splinter haemorrhage,nail plate thickening and nail discoloration among the 4 clinical subtypes of psoriasis (all P ＞ 0.05).Conclusions The dermoscopic features of onychomycosis include jagged edge,longitudinal striae,cone-shaped keratosis and black dots,and the dermoscopic features of nail psoriasis include pitting corrosion,oil drop sign,splinter haemorrhage and dilated hyponychial capillaries.Their common dermoscopic features include nail plate thickening,onycholysis and nail discoloration.
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Ackerman's pattern analysis is an epoch-making leap in the diagnosis of dermatopathology,which embodies a profound understanding of the whole dermatovenereology.To improve the teaching quality of Dermatovenereology for five year clinical medical students,pattern analysis is introduced into course educational practice,and the diseases that scattered throughout the whole textbook and listed in various chapters or sections are reclassified according to its pathological features.Thus the organic connection of related knowledge points and the lateral contrast network between different diseases is constructed by the central tache of dermatopathology,and therefore makes the course more logical and be more beneficial for the undergraduate students to learn and to remember.By the way,the thinking method of pattern analysis will also be an implicit teaching content and imperceptibly instilled to the undergraduate students,and inspired potential and motivation and aroused learning interest,expanded thought train ability to pursue advanced and further studies.
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Objective To investigate the value of Real-time PCR in the diagnosis of invasive aspergillosis(IA) and to compare it with galactomannan antigen assays.Methods A retrospective study was performed on 110 episodes of hospitalization of 88 patients who were at risk of invasive aspergillosis at Peking University First and Renmin Hospital from May 2008 to December 2010.23 cases with diagnosis and clinical diagnosis IA were classified as infection group and 87 cases with suspected diagnosis and non-IA were classified as non-infeciton group according to the international criterion.Real-time PCR and gaiactomannan antigen detections were performed on 257 serum samples.A receiver operating characteristic curve (ROC)was developed based on the quantitative cycle numbers and an optimal cut off value of quantification cycle (Cq) was determined.The sensitivity (Se),specificity (Sp),positive predictive value (PPV) and negative predictive value (NPV) were calculated under different considerations among which McNemar chi-square tests were used for statistical analyze.Results The area under ROC curve of Real-time PCR for the diagnosis of IA was 0.91 (95％ CI:0.825-0.995) and the optimal cut off value of Cq was 39.45.The Se and Sp of one positive PCR,two positive PCR,one positive GM and two positive GM were 87.0％,79.3％ ; 58.3％,97.8％ ; 78.3％,63.2％ ; and 58.3％,82.6％,respectively.When one positive PCR was considered as the diagnostic criterion of IA,Real-time PCR was able to diagnose 100％ and 84.2％ of proven and probable IA cases,respectively.The Sp of one/two positive PCR were statistically higher than one/two positive GM (P ＜ 0.05),respectively.The Sp of two positive PCR was statistically higher than one positive PCR (P ＜0.05).The Se and Sp were 65.2％,89.7％ and 100％,52.3％ for one positive PCR combined one positive GM and one PCR or GM positive,respectively.Conclusions Real-time PCR assays have better sensitivities and specificities than GM in the diagnosis of invasive aspergillosis.When two PCR positive were considered,better specificity and positive predictive value were achieved.
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Objective To explore the relationship of ovulation outcome in patients with polycystic ovary syndrome(PCOS)and related factors.Methods Used Clomifene to induce ovulation in patients with polycystic ovary syndrome,and analyzed the effect of the success of ovulation induction in patients in the ovulation cycle,age,body mass index,base hormone levels,menstrual type,marital status and other factors influence the outcome of their ovulation.Results The influence of age to ovulation outcome in patients with pelycystic ovary syndrome was not significant (P＞0.05).And body mass index,base hormone levels,menstrual type,marital status was significant on the outcome of ovulation(all P＜0.05).Conclusion Clomifene ovulation induction outcome in patients with polycystie ovary syndrome and body mass index,base hormone levels,menstrual status type and other factors were related to marriage and child rearing.
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Objective To study dectin-1 mRNA expression in lung of different immune status mice infected with Aspergillusfumigatus, and to explore the influence of immunosuppressive agent on the expression of dectin-1 and its relationship with the progression of disease. Methods Mice were divided into four groups which were normal control, immuncompromised, immuncompromised with A.fumigatus inoculation and immuncompetent with A.fumigatus inoculation groups. We explored the kinetic mRNA expression of dectin-1 in lung of different groups by real-time quantitative PCR. Pulmonary fungal burden assessment was performed to reflect the progressing of disease during the experimental time course. Results On day 3 after inoculation, pulmonary fungal burden of the immuncompromised mice was higher than that of the immuncompetent group. On day 1 and 3, dectin-I mRNA expression in lung of the immuncompromised group was much lower than that of the normal control. On day 3, dectin-1 mRNA expression in lung of the immuncompetent mice infected with A.fumigatus was much higher than that of the immuncompromised with A.fumigatus inoculation and the normal control groups ( P < 0.05 ). Conclusion During the infection, expression of dectin-1 in lung of the immuncompetent group was strikingly increased, which may play an important role on the defence to A.fumigatus invasion. Cyclophosphamide inhibited the expression of dectin-1 in lung of mice which may be one of the mechanisms of the invasive pulmonary aspergillosis development induced by eyclophosphamide.