Three cases of vulvovaginal candidiasis due to Candida nivariensis.

Candida nivariensis is emerging as a highly resistant species of the Candida glabrata complex causing invasive and mucocutaneous infections. In this study, three cases of vulvovaginal candidiasis caused by C. nivariensis are described and identified by Internal Transcribed Spacer 1-2 sequencing. All isolates were susceptible in vitro to anidulafungin, micafungin, caspofungin, 5-flucytosine, posaconazole, voriconazole, itraconazole, amphotericin B, and showed dose-dependent susceptibility to fluconazole. In two patients, three doses of oral fluconazole were effective, while one patient developed clinical fluconazole resistance with a new relapse after 6 months. Increasing the weekly dose of fluconazole showed to be effective in this patient.

First detection of Trichophyton indotineae causing tinea corporis in Central Vietnam.

Trichophyton indotineae, a new species of dermatophytes, has become a significant concern in treating dermatophytosis due to the high level of terbinafine resistance reported in this organism. This is the first report of Trichophyton indotineae infection in Central Vietnam. Antifungal susceptibility testing showed that this isolate was susceptible to itraconazole, voriconazole, and terbinafine. Therefore, the patient was successfully treated with oral itraconazole and ketoconazole topical cream.

Nannizzia incurvata in Hue city - Viet Nam: Molecular identification and antifungal susceptibility testing.

BACKGROUND: Nannizzia incurvata, a species belonging to the Nannizzia gypsea complex, is considered a neglected pathogen. OBJECTIVE: To detected N. incurvata isolates from dermatophytosis patients in Hue city - Viet Nam, and test the antifungal susceptibility of this species. Moreover, fungal capability to produce hydrolytic enzymes was evaluated. METHODS: Patients' samples were collected and cultured on Sabouraud-chloramphenicol-cycloheximide medium. Dermatophytes isolates were initially macroscopically and microscopically identified. ITS PCR-RFLP and ITS rDNA sequences were performed to determine and confirm species. An ITS Neighbor-Joining phylogenetic tree evaluated the genetic relationship among isolates. Fungal hydrolytic enzymes were examined, including lipase, phospholipase and protease. Antifungal susceptibility testing was carried out by the disk diffusion method. MICs of itraconazole, voriconazole, and terbinafine against these isolates were determined by the broth microdilution method. RESULTS: Twelve isolates of N. gypsea complex were preliminary morphologically identified. PCR-RFLP and ITS-rDNA sequencing identified and confirmed dermatophytes as N. incurvata strains, respectively. An evident polymorphism among isolates was highlighted in the phylogenetic tree. All isolates showed the activity of lipase, phospholipase, and protease production. Overall, all N. incurvata isolates were susceptible to itraconazole, voriconazole, clotrimazole, miconazole, and terbinafine. Few isolates were susceptible to griseofulvin, and none of them were susceptible to fluconazole. CONCLUSIONS: There was a presence of polyclonal N. incurvata isolates in dermatophytosis patients from Hue city, identified by PCR-RLFP and confirmed by ITS sequencing. We confirmed PCR-RLFP as a reliable technique to identify this species. Azole and terbinafine are the optimal choices for N. incurvata treatment except for fluconazole.

mCME project V.2.0: randomised controlled trial of a revised SMS-based continuing medical education intervention among HIV clinicians in Vietnam.

BACKGROUND: Continuing medical education (CME) is indispensable, but costs are a barrier. We tested the effectiveness of a novel mHealth intervention (mCME V.2.0) promoting CME among Vietnamese HIV clinicians. METHODS: We enrolled HIV clinicians from three provinces near Hanoi. The 6-month intervention consisted of (1) daily short message service multiple-choice quiz questions, (2) daily linked readings, (3) links to online CME courses and (4) feedback messages describing the performance of the participant relative to the group. Control participants had equal access to the online CME courses. Our primary endpoint was utilisation of the online CME courses; secondary endpoints were self-study behaviour, performance on a standardised medical exam and job satisfaction. RESULTS: From 121 total HIV clinicians in the three provinces, 106 (87.6%) enrolled, and 48/53 intervention (90%) and 47/53 control (89%) participants completed the endline evaluations. Compared with controls, intervention participants were more likely to use the CME courses (risk ratio (RR) 2.3, 95% CI 1.4 to 3.8, accounting for 83% of course use (P<0.001)). Intervention participants increased self-study behaviours over controls in terms of use of medical textbooks (P<0.01), consulting with colleagues (P<0.01), searching on the internet (P<0.001), using specialist websites (P=0.02), consulting the Vietnam HIV/AIDS treatment guidelines (P=0.02) and searching the scientific literature (P=0.09). Intervention participants outperformed controls on the exam (+23% vs +12% score gains, P=0.05) and had higher job satisfaction. CONCLUSION: The mCME V.2.0 intervention improved self-study behaviour, medical knowledge and job satisfaction. This approach has potential for expansion in Vietnam and similar settings. TRIAL REGISTRATION NUMBER: NCT02381743.

A model of transplanting neonatal cardiomycytes into the wall of rat inferior vena cava / 中国胸心血管外科临床杂志

@#Objective     To establish a model of transplanting neonatal cardiomycytes into the wall of rat inferior vena cava. Methods     Neonatal cardiomyocytes (n=6, 5×106cells each, A group) or medium (n=6, B group) only were transplanted into the wall of inferior vena cava in female Fisher rats. At 21 days after transplantation, the contraction of transplanted cardiomyocytes was assessed and the inferior vena cava was processed for histology. Results     Distinct rhythmic beating of the vena cava at the site of cell transplantation before and after the aorties were clamped (at a rate 141± 47 rpm and 88± 44 rpm which was dramaticly lower than aortic beating, with a statistical difference at P value of 0.03). Cardiomyocyte was seen in 6 rats who had neonatal cardiomyocyte transplantation, but not in 6 rats receiving media. Hematoxylin and eosin staining showed viable cardiomyocytes in the wall of the vena cava in 6 rats treated with neonatal cardiomyocytes, but not in 6 rats receiving media. Conclusion     This study shows that neonatal cardiomyocytes can survive, mature and spontaneously and rhythmically contract after they are transplanted in the wall of inferior vena cava.

CT guided embedding of 125I by puncturing tissue through the cutis in patients with metastatic lung tumors / 中华核医学与分子影像杂志

Objective To explore the clinical application and safety of treatment of percutaneous radioactive 125I seed implantation treatment in lung metastases under CT guidance.Methods Twenty-seven lung metastatic malignancy cases (67 nodules) were studied.Eighteen cases (46 nodules) were hepatic cancer,4 cases (9 nodules) were prostate cancer,and 5 cases (12 nodules) were breast carcinoma.Diameters of lung nodules ranged from 0.5 cm to 4.0 cm with an average diameter of 2.1 cm.125I seeds were embedded under CT guidance,using 2 to 33 particles/nodule with an activity of 18.5 to 29.6 MBq/grain for each particle.Tumor matched peripheral dose was 90-120 Gy.Postoperative validation and quality evaluation followed.Results Four months later,24 nodules showed CR,30 showed PR,5 showed NC and 8 showed PD.The total effective rate was 80.6％ (54/67).In the course of treatment,11 patients had pneumothorax,3 had heavy lung compression and 4 had hemoptysis.All conditions were improved by pleural puncture or under close follow-up observation.Conclusion 125I seed implantation is an effective and safe technique in treatment of metastatic lung tumors under CT guidance.

The mechanism of sertraline-induced [Ca2+]i rise in human OC2 oral cancer cells.

Effect of sertraline, an antidepressant, on cytosolic free Ca(2+) levels ([Ca(2+)](i)) in human cancer cells is unclear. This study examined if sertraline altered basal [Ca(2+)](i) levels in suspended OC2 human oral cancer by using fura-2 as a Ca(2+)-sensitive fluorescent probe. At concentrations of 10-100 µM, sertraline induced a [Ca(2+)](i) rise in a concentration-dependent fashion. The Ca(2+) signal was reduced partly by removing extracellular Ca(2+) indicating that Ca(2+) entry and release both contributed to the [Ca(2+)](i) rise. Sertraline induced Mn(2+) influx, leading to quench of fura-2 fluorescence suggesting Ca(2+) influx. This Ca(2+) influx was inhibited by suppression of phospholipase A2, inhibition of store-operated Ca(2+) channels or by modulation of protein kinase C activity. In Ca(2+)-free medium, pretreatment with the endoplasmic reticulum Ca(2+) pump inhibitor thapsigargin or 2,5-di-(t-butyl)-1,4-hydroquinone (BHQ) nearly abolished sertraline-induced Ca(2+) release. Conversely, pretreatment with sertraline greatly reduced the inhibitor-induced [Ca(2+)](i) rise, suggesting that sertraline released Ca(2+) from the endoplasmic reticulum. Inhibition of phospholipase C did not change sertraline-induced [Ca(2+)](i) rise. Together, in human oral cancer cells, sertraline induced [Ca(2+)](i) rises by causing phospholipase C-independent Ca(2+) release from the endoplasmic reticulum and Ca(2+) influx via store-operated Ca(2+) channels.

Biliary stent implantation plus internal or external radiotherapy in malignant obstructive jaundice / 中华全科医师杂志

Thirty patients with malignant obstructive jaundice were treated with biliary stent implantation+brachytherapy+conformal radiotherapy (study group; n=15) or biliary stent implantation alone (control group; n=15). Total bilirubin (TBIL) levels significantly declined within 1 month in both groups. However, at 6 months, TBIL values began to increase in the control group and continuously declined in the study group. Maximum tumor diameter increased in the control group, while decreased in the study group (remission rate, 13/15 ). As for the study group, the survival rate at 0. 5, 1, and 2 years was 15/15,14/15, and 10/15, respectively, higher than the control group (15/15,5/15,and 1/15) . Combining biliary stent implantation with brachytherapy and conformal radiotherapy might be a safe and effective treatment of choice for patients with malignant obstructive jaundice.

Changes of Cellular Immunity after Interventional Treatment of Hepatocellular Carcinoma / 中国医师杂志

0.05). In both A and B groups the number of CD_3~+, CD_4~+, CD_8~+ T cells and NK was signficantly higher after treatment than before treatment(P0.05). The amount of CD_3~+,CD_4~+ T cells and NK was obivously lower after treatment than before treatment in C group, and CD_8~+ T cells amount significantly increased after treatment compared with before treatment(P