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    28 August 2016, Volume 11 Issue 4
    论文
    The study of mouse bone marrow-derived dendritic cells phagocytosis and cytotoxicity against Candida albicans in vitro
    WANG Qiong, SHI Dong-mei, LIU Wei-da
    2016, 11(4):  193-200. 
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    Objective Mouse bone marrow-derived dendritic cells were isolated and cultured in vitro and co-incubated with Candida albicans,in order to study the phenotype,phagocytosis and cytotoxicity of which against Candida albicans under different concentration and time. Methods Dendritic cells from C57 mouse bone marrow were isolated and cultured under aseptic conditions.The morphological and the growth curve and cell diameter of DC were observed by optical microscope and Cellometer Mini cell counter.The expression levels of CD11c,MHCII,CD40,CD80 and CD86 of DC were measured by flow cytometer.The phagocytosis and cytotoxicity of DC against Candida albicans were detected by microscope,Laser Scanning Confocal Microscope(LSCM) and flow cytometry. Results Typical morphology of DC cells was observed under inverted microscope 10 days after culture.10.2 μm was the most widely distributed diameter of DC as illustrated and the size of DC increased with the extension of incubation time.The growth curve showed that DC increased multiply.After inoculation,2-9 days were logarithmic phase and stagnate phase was from 9 days.The result of immunological phenotype detected by FCM showed that the CD11c and CD80 were highly expressed and MHCII,CD40,CD86 were lower expressed in control group.After stimulated by Candida albicans,the DC were appeared mature phenotype and CD11c,CD80,CD40,CD86 and MHCⅡ were all highly expressed.As the ratio(DC:Candida albicans) reduced(from 2:1 to 1:4),the phagocytosis effects of DC enhanced and the strongest effect appeared when the ratio was 1:4.When the ratio was 1:1,the phagocytosis effects of DC was no significant change(P=0.063) with the extension of co-incubation time(30 min to 1.5 h).But when the ratio were 2:1,1:2 and 1:4,the phagocytosis effects of DC were obviously rised with the extension of co-incubation time(30 min to 1.5 h),a statistically significant difference(P=0.003,P=0.002,P=0.002).When co-incubation time was prolonged,the cytotoxicity of DC was dramatic descend(P=0.000) detected by microscope.When the ratio(DC:Candida albicans) was 1:1,compared with the 2:1 group,the cytotoxicity effects of DC was dramatic declined.But when the ratio of Candida albicans increased within limits(from 1:1 to 1:4),the cytotoxicity was significantly increased(P=0.000),with statistical significance.Conclusion Dendritic cells isolated from mouse bone marrow had high purity and immature cell phenotype.We could obtain 3×107 cells per C57 mouse DC which could meet the requirements of experiments very well.After stimulated by Candida albicans,mature DCs were obvious increased.DC had strong phagocytosis and cytotoxicity against Candida albicans,and the effects of phagocytosis and cytotoxicity enhanced with the ratio(DC:Candida albicans) reduced.When co-incubation time was prolonged,the phagocytosis of DC against Candida albicans was increased and the cytotoxicity was decreased.

    Express of Dectin-1 and related cytokines in skin with eumycetic mycetoma
    WU Fang-pei, HU Xiao-ping, YU Bo, CHEN Chao-feng, LIU Xiao-yun, HUANG Guo-xin
    2016, 11(4):  201-204. 
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    Objective To observe the expression of dectin-1 in the skin with eumycetic mycetoma,and to analyze the role of the pattern recognition receptors dectin-1 when the skin infected with eumycetic mycetoma.Methods There were three experiment al groups,group A included 8 cases of chromoblastomycosis,and group B contained 10 cases of mycetoma.The infection group included group A and B.The normal group contained 18 normal skin tissue.The expression of Dectin-1,IL-4,IL-10,IFN-γ and TNF-α were tested by immunohistochemical method in the paraffin embedded tissues.Results Compared with normal group,the integral optical density values of Dectin-1,IL-4,IFN-γ,TNF-α,IL-10 of the infected group were increased(P<0.05).The integral optical density values of Dectin-1 and IL-4,IFN-γ,TNF-α had no difference between group A and B.Conclusion Increased expression of Dectin-1 of the skin with eumycetic mycetoma,suggested that Dectin-1 might have a certain role on the skin with fungal infection.

    Dynamic changes of galactomannan and the relation with CT image in invasive pulmonary aspergillosis
    GONG Zheng, ZHAN Ming, ZHANG Ling-yun, GONG Ping, WANG Yan-hua, CUI Cong, WANG Yong-quan, XIANG Guang-ming, CHEN Shi-xiong
    2016, 11(4):  205-208. 
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    Objective To observe changes of galactomannan(GM) in bronchoalveolar lavage(BAL) and serum,evaluate relationship between GM and CT feature,neutrophil count in serum for invasive fungal disease(IFD).Methods Sixty patients with IFD and were enrolled in this study.The levels of GM were measured in BAL and serum.Univariate logistic regression analysis was performed with GM in BAL and lung lobe number,air crescent sign,halo sign,in CT feature and neutrophil in serum.Result GM in BAL was higher than the GM in serum(0.62±0.08 mg/L,60.0%;0.51±0.07 mg/L,31.6%) before antifungal treatment,compared with before antifungal treatment,the GM in BAL in 1 m 2 m 3 m 6 m decreasd rapidly after antifungal treatment(P<0.05),but the GM of serum decrease slowly,decreasing only in 3 m,6 m(P<0.05).The positive rate of the GM of BAL was in concerned with the amount of invasive lung lobe and halo sign in CT and neutrophil count in serum.Conclusion GM in BAL might be a important marker for diagnosing and efficacy in IFD,GM in BAL was correlated with CT feature and neutrophil count.

    In vitro antifungal susceptibilities of mycelium phase of Sporothrix globosa in China
    HE Yu, HUANG Yi-jin, ZHAO Mi-mi, ZHOU Xun
    2016, 11(4):  209-212. 
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    Objective To investigate the activities of five antifungal agents on mycelia form of Sporothrix globosa and compare the differences in antifungal susceptibilities in different areas of China.Methods Total 100 isolates which were identified as Sporothrix globosa by molecular identification from Chongqing,Beijing and Jilin were subcultured on 2% potato-dextrose agar plates at 25℃ for 7 d.Then according to modified CLSI microdilution method M38-A2,MICS were measured to evaluate the antifungal activities of potassium iodide(KI),itraconazole(ITC),terbinafin(TRB),fluconazole(FLC),amphotericin B(AmB) to these isolates in vitro.Candida parapsilosis ATCC22019 was used as quality control.Results Potassium iodide showed no antifungal activity against any Sporothrix globosa isolates.TRB gave the lowest geometric mean(GM=0.14 μg/mL) MIC.ITC and AmB showed almost the same activity against all strains tested and the GM was 0.79 μg/mL and 0.63 μg/mL respectively.FLC gave the highest GM MIC(45.89 μg/mL).Seven isolates(four from Jilin,two from Chongqing,one from beijing) were found to be itraconazole-resistant,There was no difference in susceptibility according to the geographical source of the isolates(P>0.05).Conclusion Potassium iodide showed no antifungal activities in vitro.TRB was the most active drug,followed by the ITC and AmB.FLC was the least effective drug.There was no difference in antifungal susceptibilities in different areas of China.

    Chromoblastomycosis with unusual polymorphic sclerotic bodies: case study and review of the literature
    LI Mei-rong, CHEN Ying-dan, YIN Song-chao, WEI Ling, LIU Hui-xian, LU Chun, FENG Pei-ying
    2016, 11(4):  213-216. 
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    Chromoblastomycosis is a chronic(sub) cutaneous mycosis caused by a specific group of dematiaceous fungi,which is characterized by forming brown-colored,thick-walled,and septated structure,namely sclerotic body or muriform cell,in tissue.In this study,we present a case of chromoblastomycosis caused by Fonsecaea spp.on the right ear with unusual laboratory findings.Direct potassium hydroxide examination of skin scrapings from the lesions showed cluster of sclerotic bodies,germinating sclerotic bodies,as well as branching pigmented hyphae,which may easily misdiagnosed as phaeohyphomycosis.Relevant literature was reviewed using relative terms such as "chromoblastomycosis" "scleratic body/muriform cell" "budding /germination" and "pigmented hyphae" to search articles published on PubMed,MEDLINE,CBM,CNKI,VIP and Wangfang databases.Polymorphism of sclerotic bodies was reported in eight cases of chromoblatomycosis.

    A case of invasive pulmonary asperglllosis caused by Aspergillus niger
    ZHOU Ya-bin, CHEN Ping, SUN Ting-ting, WANG Xing-jia, LI Dong-ming
    2016, 11(4):  217-218,216. 
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    To report a case of invasive pulmonary asperglllosis caused by Aspergillus niger.A female patient,36 years old,was suffered from cough and expectoration for 2 months with a history of diabetes mellitus for 2 years.She was diagnosed invasive pulmonary asperglllosiss according to the findings of fungal elements in histopathological examination and the positive fungal culture result of Aspergillus niger.After 2 weeks treatment with voriconazole and amphotericin B for another 2 weeks,the symptoms of cough and expectoration disappeared.

    A case of misdiagnosed tinea faciei caused by Arthroderma vanbreuseghemii
    HUANG Su-yang, KONG Qing-tao, DU Xue, YANG Rui, SANG Hong
    2016, 11(4):  219-220,222. 
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    To report a case of tinea faciei caused by Arthroderma vanbreuseghemii(a teleomorph of Trichophyton interdigitale).A 9-year-old female with 7 months history of erythemas and scaling on her face,accompanying with itching.She was misdiagnosed with erythema multiforme,and treated with corticosteroid.However,the lesion gradually expanded.After fungal examination and culture,she was diagnosed as tinea faciei,and the pathogenic agent was identified as Arthroderma vanbreuseghemii by using PCR.The patient was cured by oral itraconazole.

    Misdiagnosis analysis of a case with facial cutaneous sporotrichosis
    SHI Xi-wu, XU Jing
    2016, 11(4):  223-225. 
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    A 43-year-old female farmer presented papules,nodules,ulceration and scabs on her right face for 5 months.She had been misdiagnosed as acne and verruca vulgaris,and was given medication and cryotherapy with no cure.Based on skin histopathological examination and fungal culture,the case was diagnosed as cutaneous sporotrichosis.After 1.5 months of oral itraconazole combined with 0.25% amorolfine hydrochloride cream,the lesions were significantly improved.

    Observation of the efficacy of 1% luliconazole cream in candidal balanoposthitis
    ZHANG Si-ping, HU Bai, ZHAO Zheng-long, WU Ai-li, LIAO Li-chao, ZHANG Chi, LU Wen-sheng, WANG Juan, XU Gui-xia
    2016, 11(4):  226-229. 
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    Objective To investigate the efficacy and safety of different course of domestic luliconazole 1% cream in the treatment of candidal balanoposthitis.Methods Ninty patients were divided randomly and equally into 3 groups:A group applying luliconazole 1% cream once daily for 1 week;B group applying luliconazole 1% cream once daily for 2 weeks;C group applying ketoconazole 2% cream twice daily for 2 weeks.Efficacy,rates of mycological clearance and adverse reactions were assessed on week 1,2,4 after treatment.Result A total of 90 patients were enrolled and 86 patients were evaluated for efficacy.The clinical response rates in the three group were 69.0%,64.3% and 65.5% respectively(P>0.05),the rates of mycological clearance were 82.8%,85.7% and 86.2% respectively on week 1 after initiation of treatment(P>0.05).The clinical response rates in the three group were 72.4%,78.6% and 75.9% respectively;the rates of mycological clearance were 82.8%,85.7% and 86.2% respectively on week 2 after initiation of treatment(P>0.05).The clinical response rates in the three group were 75.9%,85.7% and 82.8% respectively;the rates of mycological clearance were 86.2%,85.7% and 89.7% respectively on week 4 after initiation of treatment(P>0.05).There were not significant differences in the efficacy and the rates of mycological clearance between three groups on week 1,2,4 after treatment.The incidence of adverse events was very low.All of the adverse events were mild local adverse events.Conclusion Domestic luliconazole 1% cream can be used effectively and safely in the treatment of candidal balanoposthitis,with the efficacy of 1-week regimen equivalent to that of 2-week regimen.

    A clinical study on JUC long-acting antimicrobial material for tinea corporis and cruris, manus and pedis treatment
    WEI Shi-cai
    2016, 11(4):  232-234,239. 
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    Objective To observe the treatment effect of JUC long-acting antimicrobial material on tinea corporis,manus and pedis.Methods Thirty-two tinea corporis and cruris,78 tinea pedis and 34 tinea manus were enrolled in the study.All participants were treated with JUC long-acting antimicrobial material spray,three times per day and the treatment lasted for 4 weeks.Meanwhile,all participants' shoes,socks and towels and clothes were also sprayed with JUC long-acting antimicrobial material,one time per day.Results At the end of treatment,the total clinical cure rate was 95.83%(138 of 144) and the mycology clearance was 72.92%(105 0f 144).The cure rates of tinea corporis and cruris,tinea pedis and tinea manus were 93.75%,96.15% and 97.06% separately.After three months of treatment,recurrence rate was 3.13%(3 of 138).Conclusions Treating tinea corporis and cruris,tinea pedis and tinea manus with JUC long-acting antimicrobial material is safe,effective and able to decrease the recurrence.

    The reason for cavitating lung adenocarcinoma misdiagnosed as pulmonary aspergillus disease
    ZHU Qiang, CHEN Liang-an, YANG Zhen
    2016, 11(4):  235-239. 
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    Objective To conclude the experience and reduce misdiagnosis rate in future by analyzing a case of single lung cancer cavity misdiagnosed as pulmonary aspergillosis cavity on CT.Methods A patient with lung cancer cavity misdiagnosed as pulmonary aspergillosis was retrospectively analyzed and relevant literatures were reviewed.Results Onset with cough and hemoptysis,a 44-year-old male patient was found with a solitary cavity in the lower lobe of right lung,was misdiagnosed as pulmonary aspergillosis for seven months.The clinical symptoms were improved after antifungal treatment,but there was no obvious change on pulmonary cavity by many times chest CT reexamine.The cavity wall became thicker,the nodules within primary cavity disappeared,and many new tiny wall nodules were found.Serrated protrusions and multiple satellite nodules appeared on the cavity margin and around the cavity respectively.The stretch and connection between cavity and pleura became obvious gradually.Then a definite diagnosis of moderately and poor differentiated lung adenocarcinoma in the lower lobe of right was produced through lung puncture biopsy guided by CT.Conclusion There had certain diffculty to make differential diagnosis of solitary lung cavity by radiographic methods.Clinical characteristics and laboratory tests should be combined to help identification.Tissue pathology was the gold standard for diagnosis.So early biopsy might benecessary to avoid the misdiagnosis and mistreatment,provided that there was no obvious tabooes and risk factors.

    Comparison of novel fluorescent staining and KOH microscopic examination in fungal measured by direct microscopy
    HAN De-min, LIU Yuan-zhi, ZHU Jun-hao, LI Li, ZHANG Qiang-qiang
    2016, 11(4):  240-242. 
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    Objective To explore a reliable and rapid method in direct microscopic examination for fungi using novel fungal fluorescent staining.Methods Samples from 600 clinically suspected cases of fungal infection were screened by fluorescent staining and KOH microscopic examination.Results Fungal elements were detected in 97% of the cases by fluorescent staining and 88.5% by KOH.Conclusions Fluorescent staining is a reliable and effective method for fungi microscopic examination.

    Candida glabrata: review of epidemiology and antifungal susceptibility
    HOU Xin, XU Ying-chun, ZHAO Yu-pei
    2016, 11(4):  243-247,242. 
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    Candida glabrata is a pathogenic yeast and the one of the most frequent causative agent of invasive candidiasis.The difficulties arise from its high resistance to azole antifungals.So echinocandins are often used as first-line therapy for C.glabrata invasive infection.However,reports of C.glabrata resistant to both azoles and the echinocandins are of concern.Molecular typing of C.glabrata could provide information on nosocomial transmission and strain variation.Thus,this review intends to present an excerpt of the biology,epidemiology,molecular typing and antifungal susceptibility carried out up to the present.

    Recent advance in the pathogenesis of tinea capitis
    ZHANG Fu-rong, YANG Guo-ling
    2016, 11(4):  252-256. 
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    Tinea capitis is a common superficial fungal infection of the scalp primarily afflicting young children.Epidemiologic data suggest that tinea capitis has been on the rise.The patients sometimes experience atrophic scar and permanent hair loss,especially after longstanding inflammation.So understanding the pathogenesis of tinea capitis is very significant.But at present it is not clear and there are no reviews about it in our country.This report introduced the recent research progress about pathogenesis of tinea capitis after reviewing lots of literatures.

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