Clinical analysis of candidemia in immunocompetent patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate the etiological and clinical characteristics of immunocompetent patients with candidemia.@*METHODS@#The clinical and microbiological data of patients diagnosed as candidemia admitted in Peking University Third Hospital from January 2010 to June 2016 were retrospectively analyzed. Underlying diseases, Candida spp. colonization, clinical manifestations, microbiological data, treatment and the outcome were compared between the HIV-negative immunocompromised (IC) and nonimmunocompromised (NIC) patients.@*RESULTS@#A total of 62 cases diagnosed as candidemia were analyzed including 36 men and 26 women, with 16 to 100 years of age [(66.02±17.65) years]. There were 30 NIC and 32 HIV-negative IC patients respectively. In the NIC patients, there were 19 cases (19/30, 63.33%) with admission in intensive care unit (ICU), 21 (21/30, 70.00%) associated diabetes mellitus or uncontrolled hyperglycemia and 22 (22/30,73.33%) receiving invasive mechanical ventilation, while in the HIV-negative IC patients, there were 8 (8/32, 25.00%), 13 (13/32, 40.63%) and 7 (7/32, 21.88%) respectively (P<0.05). The NIC patients had higher acute physiology and chronic health evaluation (APACHE II) scores and sequential organ failure assessment (SOFA) scores both at admission (19.98±5.81, 6.04±6.14) and candidemia onset (25.61±6.52, 12.75±8.42) than the HIV-negative IC patients (APACHEII 15.09±5.82, 22.15±5.98) and SOFA 2.87±2.73, 7.66±5.64 respectively (P<0.05). In the NIC patients, twenty-one cases (21/30, 70.00%) died in hospital, while 14 cases (14/32, 43.75%) in HIV-negative IC. The crude mortality was significantly different between the two groups (P<0.05). By blood culture, Canidia albicans remained the the most prevalent isolates in all the patients. Clinical manifestation, Candida spp. colonization, etiology and drug susceptibility were also similar between NIC and HIV-negative IC patients (P>0.05).@*CONCLUSION@#Candidemia in NIC patients tends to occur in those who are much more critically ill, more often admitted in ICU, and more frequently have diabetes mellitus or uncontrolled hyperglycemia and receive invasive mechanical ventilation than HIV-negative IC patients. NIC patients also have poorer prognosis than HIV-negative IC patients. Clinical manifestations, and microbiological characteristics are similar between HIV-negative IC and NIC patients.

Application of fluoride releasing flowable resin in pit and fissure sealant of children with early enamel caries / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinical effect of fluoride releasing flowable resin used in treatment of early enamel caries of children compared with conventional sealant.@*METHODS@#Seventy-six patients, including fifty-two couples of permanent first molars and thirty couples of premolars were selected for this trial. Both sides of all the molars and premolars were diagnosed as early enamel caries based on International Caries Detection and Assessment System (ICDAS) dental caries diagnostic criteria. Using the contralateral control, the teeth were randomly divided into two groups. Molars/premolars in the experimental group were sealed with a fluoride releasing flowable resin; the contralateral molars/premolars were sealed with a conventional fissure sealant as a control group. The retention rate and progress of caries were evaluated at the end of 3, 6, 12 and 24 months.@*RESULTS@#There was no fissure sealant loss or caries progression in both groups 3 and 6 months after sealing the premolars by fluoride releasing flowable resin or conventional fissure sealants. At the end of 12 and 24 months, only one case of fissure sealant loss was observed in conventional fissure sealant group. There was no statistical significance between the two premolar groups. In the first molar group, fluoride releasing flowable resin showed 100%, 98.08%, 90.38% and 88.46% complete retention at the end of 3, 6, 12 and 24 months, respectively. The conventional fissure sealant retention rates were 96.15%, 92.31%, 76.92% and 73.08% at the corresponding time points. The data at the end of 24 months showed that fluoride releasing flowable resin had significantly higher retention rate than the conventional fissure sealant group (P<0.05). The incidence of caries progression at the end of 6, 12 and 24 months were 1.92%, 5.77% and 7.69%, respectively, in the fluoride releasing flowable resin group. In the conventional fissure sealant group, the incidence was 5.77%, 19.23% and 25.00%, respectively. At the end of 12 and 24 months, more significant decrease of caries progress incidence was observed in the fluoride releasing flowable resin group than in the control group, and there was statistical difference between the two groups (P<0.05).@*CONCLUSION@#Compared with conventional fissure sealant, using fluoride releasing flowable resin as a fissure sealant in children enamel caries of permanent molars can improve the sealant preservation rate and effectively prevent enamel caries progress.

Effects of polydatin on ALT, AST, TNF-alpha, and COX-2 in sepsis model mice / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the protective effects of polydatin on sepsis-induced acute liver injury (ALI) in mice, and to preliminarily study its mechanisms.</p><p><b>METHODS</b>The sepsis model was established using cecal ligation and puncture (CLP).A sham-operation control group was also set up. Polydatin (50, 100, and 300 mg/kg, respectively) was administrated to mice 1 h before CLP. The survival and liver injury were evaluated subsequently per 6 h after CLP. The survived mice were scarified 24 h later. The serum and the liver tissue sample were collected. The serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected by colorimetric method. The content of tumor necrosis factor-alpha (TNF-alpha) was assayed by ELISA. The cyclooxygenase-2 (COX-2) expression in the liver tissue was detected by Western blot. The pathological changes of the hepatic tissue were analyzed by hematoxylin and eosin stain.</p><p><b>RESULTS</b>The mortality of mice reached as high as 50% at 24 h after CLP. The biochemical indices and the pathological changes of the liver tissue showed obvious lesion. The success rate of modeling was 90%. Compared with the sham-operation control group, the serum ALT,AST activity, the TNF-alpha content, and the hepatic COX-2 protein expression markedly increased in the CLP group (P < 0.01). Polydatin improved the sepsis-induced mortality dose-dependently, inhibited increased ALT, AST activity and TNF-alpha, decreased the hepatic COX-2 protein expression, and attenuated the pathological injury of the liver (P < 0.05).</p><p><b>CONCLUSION</b>Polydatin could effectively protect sepsis-induced ALI, which might be achieved possibly through inhibiting serum TNF-alpha production and hepatic COX-2 expression.</p>

Anti-inflammatory mechanism of total glycosides of Acanthopanax Giraldii / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the anti-inflammatory mechanisms of total glycosides of Acanthopanax Giraldii (TGA).</p><p><b>METHODS</b>The changes of prostaglandin E(2)(PGE(2)), tumor necrosis factor (TNF-alpha), nitric oxide (NO), and expressions of COX-1 mRNA and COX-2 mRNA in BALB/c mouse macrophages were observed by the radioimmunoassay, ELISA and nitric acid reduction and RT-PCR in the presence or absence of TGA.</p><p><b>RESULTS</b>(1) TGA could significantly decrease the production of PGE(2)and NO in mouse peritoneal macrophages. The inhibitory rate to LPS-induced PGE(2)production was 87% (TGA 100 mg/L, P<0.05, vs. LPS) and 62% (TGA 20 mg/L, P<0.05, vs. LPS), respectively. The inhibitory rate of NO production in mouse peritoneal macrophages was 49% (TGA 100 mg/L, P<0.05, vs. LPS) and 21% (TGA 20 mg/L, P<0.05 vs. LPS), respectively. TGA could not inhibit LPS-induced TNF-alpha production in mouse peritoneal macrophages. (2) TGA also inhibited the expression of COX-1 and COX-2 mRNA in RAW264.7 cells. The inhibitory rate of TGA to COX-1 mRNA was 22% (TGA 100 mg/L, P<0.05, vs. blank). The inhibitory rate of TGA to COX-2 mRNA was 55% (TGA 20 mg/L, P<0.05, vs. LPS) and 100% (TGA 100 mg/L, P<0.01 vs. LPS), respectively.</p><p><b>CONCLUSION</b>The anti-inflammatory mechanisms of TGA for inhibiting the production of NO and PGE(2)are through inhibiting COX-2 mRNA expression without TNF-alpha changes.</p>