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    28 October 2017, Volume 12 Issue 5
    论文
    Investigation of the prevalence of Enterocytozoon bieneusi,Encephalitozoon intestinalis and Encephalitozoon cuniculi among diarrheal patients in the southwest of China
    QIU Lu-yao, PING Jing, LI Wen-dao, DING Song-tao, LIU Han-deng
    2017, 12(5):  257-261. 
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    Objective To investigate the prevalence of Enterocytozoon bieneusi,Encephalitozoon intestinalis and Encephalitozoon cuniculi among diarrheal patients in the southwest of China.Methods A total of 124 fecal specimens from patients with diarrhea syndrome were collected.The specimens were stained by modified trichrome (weber) and were examined under microscopy.The extracted DNA samples were evaluated by PCR amplification.Results The prevalence of E.bieneusi was 7.26% (9/124),and that of E.intestinalis was 3.23% (4/124),with E.cuniculi all negative.Conclusion The infection of microsporidia did exist in the southwest of China,and the most common types in this area were E.bieneusi and E.intestinalis.

    Immunophenotype of peripheral lymphocytes in HIV-negative patients with cryptococcal meningitis
    XIE Jing, GE Ying, QIU Zhi-feng, ZHANG Kai-yu, LIU Zheng-yin, LI Tai-sheng
    2017, 12(5):  262-267. 
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    Objective To find if immunophenotypic features of peripheral lymphocytes was associated with risk of cryptococcal meningitis (CM) in HIV-negative individuals.Methods A total of 31 CM patients treated at a tertiary hospital in Beijing,China were included.They were divided into immunocompromised comorbidity group (n=16) and apparently immunocompetent group (n=15).Twenty-one healthy donors were included as control group.Lymphocyte subsets including B,NK,CD4+T,and CD8+T cells,CD28 expression on T cells,and activation markers (HLA-DR and CD38) on CD8+T cells were determined by flow cytometry and compared among the three groups.Results Compared with healthy donors,immunocompromised comorbidity group had dramatically decreased median B cell (223 vs.56/μL),NK cell (280 vs.86/μL),CD4+T cell (695 vs.218/μL),and CD8+T cell (521 vs.164/μL) counts (P values for all four subsets<0.001).Proportions of activated CD8+T cells were significantly increased in immunocompromised patients than that in healthy control.Except for CD8+T cell counts (527/μL),the median B cell (128/μL,P=0.02),NK cell (128/μL,P=0.002) and CD4+T cell (567/μL,P=0.03) were moderately reduced in the apparently immunocompetent group than those in the healthy donors.The levels of HLA-DR and CD38 on CD8+T cells in the apparently immunocompetent group were similar with the healthy donors.CD28 expression on CD4+T and CD8+T cells did not differ among the three groups.Conclusions The immunophenotype of CM patients with im-munocompromised comorbidity was characterized by generalized decreased B,NK,CD4+T,and CD8+T cells.Mild-to-moderate reduce in B cell,NK cell and CD4+T cell counts were observed in apparently immunocompetent patients.

    The proportions of Th1/Th2 and Relevant T lymphocytes in patients with cryptococcal meningitis and its clinical significance
    HUANG Huang, XIAN Ying, PAN Yue-jun, ZHANG Kou-xing
    2017, 12(5):  268-273,267. 
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    Objective This study is to further understanding the mechanism of T helper cells in course of C.neofermans infection from patient's level through measuring the proportions of Th1/Th2 cell factors and NKT cells,γδT cells in peripheral blood between normal adult and patients.Analyze whether the change presents relevance with the disease prognosis.Method The peripheral blood samples were collected from 16 patients with cryptococcal meningitis,and 10 healthy people.The proportions of Th1/Th2 cell factors and NKT cells,γδ T cells were analyzed by flow cytometry (FCM).Results 1.The proportion of Th1 cells in CD4 +T lymphocyte of patients with cryptococcal meningitis before treatment was (13.093±4.618)%,less than that of healthy people (19.582±4.949)%,P<0.01.And the proportion of Th2 cells was (1.769±0.865)%,higher than that of healthy people (0.584±0.202)%,P<0.01.2.Patients who received treatment showed the increased levels of Th1 cells in CD4 +T lymphocyte (16.069±1.516)% which was higher than those in patients before treatment (13.589±2.101)%,P>0.05.The proportion of Th2 cells in the patients had received treatment was (1.499±0.274)%,less than those of patients before treatment (1.673±0.290)%,P>0.05.3.The proportion of NKT cells in T lymphocyte of patients with cryptococcal meningitis before treatment was (11.848±2.936)%,less than those of healthy people (17.918±8.088)%,P<0.05.No significant differences of proportions of γδT in T lymphocyte among patients before treatment and healthy people,P>0.05.4.Patients who received treatment showed the increased levels of NKT cells in T lymphocyte (14.806±1.513)% which was higher than those in patients before treatment (11.830±1.350)%,P>0.05.The proportion of γδT cells in the patients who had received treatment was (6.984±0.843)%,less than those of patients before treatment (8.094±2.037)%,P>0.05.Conclutions 1.The balance of Th1/Th2 falls towards Th2 and the decrease of the proportion of NKT cells among T lymphocytes in patients with cryptococcal meningitis.It suggests that the cell-mediated immunity of patients with cryptococcal meningitis is weakened.2.Once the patients get better after treatment,Th1/Th2 imbalance would be corrected in that the balance turned to Th1 direction.It suggests that the recovery of cell-mediated immunity may improve the prognosis of these disease.

    Retrospective analysis of epidemiology and prognostic factors for 74 fungemia
    YE Min-na, ZHANG Xiao-bing
    2017, 12(5):  274-278. 
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    Objective To analyze the incidence,clinical features and the predisposing factors of fungemia,and investigate the risk factors for death due to fungemia and guide clinical treatment and hospital control.Methods The data of predisposing factors,distribution of fungus,treatment and outcomes of 74 patients with fungemia from January 2014 to March 2015 were analysed,retrospectively.The clinical data of 74 patients with fungal disease were divided into survival group and death group.Based on the results of univariate analysis,the data were analyzed using logistic multiple regression,and then the significant differences of survival group and death group were compared.Results Fungemia had many predisposing factors with high mortality rate (33/74,44.6%).Candida was the most prevalent species isolated.Univariate analysis revealed significant differences between the cured/improved cases and the fatal cases for 6 variables,including advanced age,multiple organ dysfunction syndrome (MODS),diabetes,lung infection,surgery or trauma and parenteral nutrtion therapy.Logistic multiple regression analysis showed that MODS,diabetes,surgery or trauma and parenteral nutrtion therapy were the independent risk factors for fungal septicemia-related death.Conclusion Candida spp.were the major pathogens.MODS,diabetes,surgery or trauma and parenteral nutrition therapy were the independent risk factors for fungemia related death.Isolation of pathogens,antibiotic susceptibility test and correct choice of antifungal agents in high risk patients are critical for the management of patients with fungemia infection.

    In vitro susceptibility testing of eight antifungal agents against pathogenic fungi isolated from superficial mycoses
    WU Wei-wei, WANG Qian, GONG Jie, WAN Zhe, WANG Ai-ping, LI Ruo-yu
    2017, 12(5):  279-282,278. 
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    Objective To investigate the in vitro activity of 8 antifungal agents against 100 strains of pathogenic fungi isolated from patitens with superficial mycoses.Methods The antifungal susceptibility testing was investigated following Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution methods.Eight antifungal agents were evaluated against 45 dermatophyte strains,35 Candida strains and 15 Malassezia strains.Results Our minimum inhibitory concentration (MIC) results revealed that terbinafine (GM MIC,0.011 μg/mL;MIC range,0.004-0.06 μg/mL) had the strongest antifungal activity against Dermatophyte,miconazole (GM MIC,0.147 μg/mL;MIC range,0.015-1 μg/mL) against Candida,and ketoconazole (GM MIC,0.097 μg/mL;MIC range,0.03-1 μg/mL) against Malassezia.Conclusions The in vitro susceptibility testing indicates that common superficial pathogenic fungi exhibit variable susceptibilities to 8 antifungal agents.Ketoconazole has a potent antifungal activity for dermatophyte,Candida and Malassezia.Terbinafine and naftifine were the most active agents for Dermatophyte.

    Histopathological observation of terbinafine hydrochloride gel against dermatophytes infection
    WU Yan, KONG Jian, YUAN Hai-long, ZHANG Fu-cheng
    2017, 12(5):  283-287. 
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    Objective To assess the anti-inflammatory and anti-fungal efficacy of compound terbinafine hydrochloride gel as a topical antifungal drug for common dermatophytosis by pathological methods.Methods Guinea pig skin was infected by Trichophyton mentagrophytes to establish animal model.Treated them with four topical preparations and then investigated the recovery of their affected skin,comparing the therapeutic effect of compound terbinafine hydrochloride gel with other three formulations.Results In terms of curing guinea pig skin infected by Trichophyton mentagrophytes,compound terbinafine hydrochloride gel was more effective than terbinafine hydrochloride gel (P<0.05),triamcinolone acetonide,econazole nitrate cream (P<0.01) and mometasone furoate gel (P<0.01).Conclusions Compound terbinafine hydrochloride gel had better effect in the treatment and relapse prevention of guinea pig skin infection of Trichophyton mentagrophytes.

    First report of Coccidioides posadasii in China
    LIANG Guan-zhao, FU Mei-hua, LV Gui-xia, SHEN Yong-nian, MEI Huan, LIU Wei-da
    2017, 12(5):  288-290,287. 
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    We separated a strain of Coccidioides spp.from a patient with lung infection and it was identified as Coccidioides posadasii (C.posadasii) by both morphological features and molecular biology methods.After literature search,it has not been reported in China,up to now.

    A case of tinea capitis caused by Trichophyton violaceum and supervene of craniofacial herpes zoster in an elderly patient
    RAN Xin, WANG Sheng, WANG Lin, RAN Yu-ping
    2017, 12(5):  291-292,294. 
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    A 62-year-old female patient,whose scalp developed pruritus erythema for 1 month,exacerbated to pustules for 3 weeks,formed scabs for 1 week.KOH direct microscopic examination finds typical hyphae on scalp scales.Culture on Sabouraud Dextrose Agar (SDA),with 25℃ for 25 days,shows purple colonies with reddish periphery.The pathogen's DNA was extracted for PCR amplification and the products was sequenced and identified as Trichophyton violaceum,which confirmed the patient's diagnose of tinea capitis.She was administrated itraconazole 200 mg twice a day taken with milk,combine with 1% naftifine-0.25% ketoconazole cream,after wash with 2% ketoconazole shampoo.Her scalp scales are improved 3 weeks later.However,band clustery tension blisters appeared on right scalp,right ear,right cheek,lips and underjaw,which was diagnosed as herpes zoster.The lesion was controlled after we prescribed brivudine 125 mg daily for 9 days.

    A patient with renal allograft failure and disseminated cryptococcosis:a case report
    ZHU Bo-cheng, PAN-Bo, GE Guo-jun, GAO Quan, LOU Bo-yang, XU Zhi-jie, ZHU Xiao-feng
    2017, 12(5):  295-297. 
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    A case of renal allograft failure with disseminated cryptococcosis was reported.A 56-year-old woman who came to our hospital complained that both of her lower limbs had appeared extensive subcutaneous swollen nodules and low fever for 15 days.She had a 6-year renal transplant history and 3 months of maintenance hemodialysis.Physical examination showed multiple tender,warmth subcutaneous nodules with erythema on her lower limbswhich partially fused.The lesions were more serious on the left thigh.Histopathologic examination of lesions showed numous yeast cells in the dermal and fat tissue.The culture of blood and subcutaneous tissue revealed Cryptococcus neoformans.Cryptococcal polysaccharide antigen in cerebrospinal fluid and serum were positive.The patient got cured by antifungal therapy for 8 months.

    The discussion of tinea pedis of interdigital in Chinese medicine and the treatment experience of using the "KuFan foot bath prescription"
    LI Yuan-yuan, LIU Xia, ZHANG Le-qi, TAN Cheng
    2017, 12(5):  298-300. 
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    Tinea pedis of interdigital often expressed as the erosion,white,itching of skin between the toes,and accompanied by special smell.The treatment often use topical or oral antifungal drugs,but the effect is limitate.It was easy to relapse.Study of literature and clinical practice,as well as laboratory tests showed that there may be three states during the pathogenesis of the tinea pedis of interdigital:fungal infection,bacterial infection,and fungal bacterial infections.For this reason,antifungal agents are often ineffective.Professor Tancheng through years of clinical experience,use self-made "KuFan foot bath prescription" to treat tinea pedis of interdigital,and got outstanding effect.The prescription composited by bitter ginseng,alum,raw rhubarb,soil bark composition,and could add or subtract,not only reduced the symptoms,but also removed the etiology.In addition,the use of "KuFan foot bath prescription" could greatly reduce the abuse of antibiotics,and avoid the adverse reactions.The author want to analysis microbial changes in the process of tinea pedis of interdigital,and summed up the theory of traditional Chinese medicine about the disease,moreover sharing the use experience of "KuFan foot bath prescription".

    Clinical curative effect observation of sertaconazole nitrate cream treating pityriasis versicolor in infants
    MENG Zu-dong, DU Tian-ping, WANG Yu, HUANG Xia, HUANG Sheng-hui
    2017, 12(5):  301-303. 
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    Objective To observe curative effect and safety of sertaconazole nitrate cream for pityriasis versicolor in infants.Method In 50 pityriasis versicolor cases of 0-3 years old children,both mycology examination and clinical diagnosis were performed.Sertaconazole nitrate cream was for external use only,twice daily,1-2 weeks.the mycology changes after treatment and clinical curative effect were observed.Results In 50 Patients underwent treatment,a-week fungal clearance rate was 40%,the clinical effective rate was 48%;2-week fungus clearance rate 96%,clinical effective rate was 92%.No recurrence was observed on 2 weeks after the drug withdrawal.Only 2 cases had mild adverse reactions.Conclusion Sertaconazole nitrate cream is curative on infant pityriasis versicolor with high safety.

    The censorship of translated terms on fungi and responses from the mycological community in Republican China
    LU Di
    2017, 12(5):  304-308,303. 
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    When mycology was actively developing in the Republican period,the censorship and unification of translated mycological terms also received attention from some scientific societies in 1926.The censored terms,not released that year,were then assimilated into the 1935 book Collection of Animal and Plant Terms with Mineral Terms Appended.They were objectively helpful in standardising the use of not few translated mycological terms.However,existing translated mycological terms could not provide even a relatively systematic reference for the Chinese mycological community who,mainly due to the urgent need for developing Chinese mycology,also lacked enthusiasm about the labourious enterprise for translated mycological terms.As a result,there had been a lack of a relatively comprehensive unified system of translated mycological terms in Republican China.

    Molecular regulation on biosynthesis of β-1,3-glucan on cell wall of Aspergillus fumigatus
    ZHANG Xi, HAN Li
    2017, 12(5):  309-311,317. 
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    As a major pathogenic fungus,Aspergillus fumigatus is able to cause the invasive pulmonary aspergilosis with high mortality,or chronic infection and allergic disease.β-1,3-glucan is not only the back-bone of cell wall of A.fumigatus,but also an essential immunogenic factor.β-1,3-glucan synthase is composed of a catalytic subunit,Fks and regulatory subunit,Rho1.Rho1 can bind to Fks and regulate the synthesis of β-1,3-glucan through the transformation and modification of its active state.It also may affect cellular translocation and function of Fks by controlling the actin cytoskeleton rearrangement.

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