Evolution of tinea capitis in the Nanchang area, Southern China: a 50-year survey (1965-2014).

Tinea capitis remains a common public health problem worldwide especially in developing areas. Aetiologic agents and clinical pattern vary with geography and history of socioeconomic conditions. Three community surveys and a prospective study were carried out over the past 50 years (1965-2014) in the Qingyunpu District of Nanchang, Southern China. Clinical presentation and spectrum of aetiological agents were monitored to understand the evolution of tinea capitis. In 1965 favus was highly epidemic and Trichophyton schoenleinii presented as the overwhelming aetiological agents of scalp infection in the study area, with a prevalence of 3.41% of the population. During a governmental campaign to eliminate tinea capitis initiated in mid of 1960s, favus was successfully controlled and the prevalence decreased to less than 0.01% in 1977. After that period, clinical presentation and spectrum of fungi changed with social development. Trichophyton schoenleinii was replaced by Trichophyton violaceum and Trichophyton mentagrophytes. Nowadays, the species corresponds with a dominant black dot type of tinea capitis in the Nanchang area. The prevalence of causative agents of tinea capitis is not only related to geography but also to socioeconomic factors. Multiple factors have to be considered for the management for control of this disease.

Ecological surveys of the Cryptococcus species complex in China.

BACKGROUND: Despite recent reports on the molecular epidemiology of cryptococcal infections in China, clinical isolates have been mostly reported from human immunodeficiency virus (HIV)-negative patients, and environmental isolates from China have rarely been included. The aim of this study was to investigate the ecological profile of Cryptococcus (C.) neoformans and C. gattii in China. METHODS: A survey was performed in 10 cities from 20°N (North latitude) to 50°N and in a Eucalyptus (E.) camaldulensis forestry farm at the Guixi forestry center, China. RESULTS: Six hundred and twenty samples of pigeon droppings from 10 cities and 819 E. camaldulensis tree samples were collected and inoculated on caffeic acid cornmeal agar (CACA). The brown-colored colonies were recultured to observe their morphology, growth on canavanine-glycine-bromothymol-blue (CGB) medium, phenol oxidase and urease activities, serotype and mating type. There were obvious differences in the positive sample rates of C. neoformans in pigeon droppings collected from the different cities, ranging from 50% in the cities located at latitudes from 30°N - 40°N, 29% at 20°N - 30°N and 13% at 40°N - 50°N. CONCLUSIONS: There were no differences in positive bevy rates (approximately 80%) among the three grouped cities. Mycological tests of 101 isolates purified from pigeon droppings revealed that they were C. neoformans var. grubii. We also observed variable capsular size around the C. neoformans cells in colonies with variable melanin production and the bio-adhesion of the natural C. neoformans cells with other microorganisms. One urease-negative C. neoformans isolate was isolated from pigeon droppings in Jinan city. No C. gattii was isolated in this study.

Taxonomic analysis of cryptococcus species complex strain S8012 revealed Cryptococcus gattii with high heterogeneity on the genetics.

BACKGROUND: Initially, Cryptococcus (C.) neoformans was previously divided into two varieties comprising C. neoformans var. neoformans and C. neoformans var. gattii. Currently, taxonomic studies defined C. neoformans as C. species complex, which contains C. neoformans var. neoformans (serotype D), the hybrid isolates (serotype AD), C. neoformans var. grubii (serotype A) and C. gattii (serotypes B and C). However, Liao and his team once isolated a unique C. gattii isolate, namely strain S8012 with unique phenotype from cerebrospinal fluid (CSF) of a 43-year-old male patient in the Shanghai Changzheng Hospital and described as C. neoformans var. shanghaiensis in 1980s. The aim of this study was to explore the genetic background and polymorphism of Chinese clinical C. gattii isolates. METHODS: S8012 was analyzed as representative strain using the M13-polymerase chain reaction (PCR) fingerprinting pattern and multilocus sequence analysis including internal transcribed spacers of rDNA (ITS region), the intergenic spacer 1 regions (IGS1), RPB1, RPB2, CNLAC1, and TEF1 genes. RESULTS: The PCR fingerprinting pattern results showed strain S8012 belonged to molecular types VGI, and phylogenetic analysis suggested strain S8012 was grouped into the cluster of C. gattii environmental isolates originated from Eucalyptus camaldulensis trees in Australia. CONCLUSION: C. gattii isolates from Chinese patients expresses high polymorphism on the phenotype, and molecular type VGI isolates from China have a close genetic relationship with the C. gattii isolates from Australia.

Insoluble beta-glucan from the cell wall of Candida albicans induces immune responses of human THP-1 monocytes through Dectin-1.

BACKGROUND: beta-glucan is the major structure component of Candida albicans (C. albicans) cell wall. It has been demonstrated that Dectin-1 as the principal C-type lectin pattern-recognition receptor (PRR) can recognize fungal beta-glucan and induce immune responses. In this study, we sought to clarify whether insoluble beta-glucan from the cell wall of C. albicans (CaIG) could induce immune responses in human THP-1 monocytes (a human acute monocytic leukemia cell line) and to determine the underlying mechanisms. METHODS: Human THP-1 monocytes were challenged with CaIG in vitro. The mRNA expression of Dectin-1, Toll-like receptors (TLR2), proinflammatory cytokine (TNF-alpha) and chemokine (IL-8) was assayed by real-time reverse transcription polymerase chain reaction (RT-PCR). The secretion of TNF-a and IL-8 were measured by enzyme-linked immunosorbent assay (ELISA). H(2)O(2) release was determined by microplate fluorescent assay. Western blotting was used to analyze IkappaB-a phosphorylation and degradation. RESULTS: Exposure of THP-1 monocytes to CaIG led to increased gene expression and secretion of TNF-alpha and IL-8. CaIG induced H(2)O(2) release in a time-dependent manner. CaIG hydrolyzed with zymolyase failed to induce gene expression and secretion of TNF-alpha, IL-8 and H(2)O(2) release. CaIG up-regulated the mRNA of Dectin-1, whereas the mRNA level of TLR2 was not altered. THP-1 monocytes challenged with CaIG resulted in the activation of NF-kappaB in a time-dependent manner. Dectin-1 inhibitor laminarin blocked the CaIG-induced production of TNF-alpha and H(2)O(2) in THP-1 monocytes, but no such effect was observed in pretreatment with anti-TLR2 neutralizing antibody and the LPS inhibitor (polymyxin B). CONCLUSION: CaIG may play a role in activation of immune responses in human THP-1 cells through Dectin-1, not TLR2.

Risk factors for sebaceous gland diseases and their relationship to gastrointestinal dysfunction in Han adolescents.

Sebaceous gland diseases are a group of common dermatological diseases with multiple causes. To date, a systematic report of the risk factors for sebaceous gland diseases in adolescents has not been published. The aim of this study was to assess the prevalence and risk factors for certain sebaceous gland diseases (seborrhea, seborrheic dermatitis, acne, androgenetic alopecia and rosacea) and their relationship to gastrointestinal dysfunction in adolescents. From August-October, 2002-2005, a questionnaire survey was carried out to obtain epidemiological data about sebaceous gland diseases. Using random cluster sampling, 13 215 Han adolescents aged 12-20 years were recruited from four countries or districts (Macau; Guangzhou, China; Malaysia; and Indonesia). The statistical software SPSS ver. 13.0 was used to analyze the data. The prevalence of seborrhea, seborrheic dermatitis, acne, androgenetic alopecia and rosacea was 28.27%, 10.17%, 51.03%, 1.65% and 0.97%, respectively. Based on multivariate logistic regression analysis, the risk factors for sebaceous gland diseases included: age; duration of local residency; halitosis; gastric reflux; abdominal bloating; constipation; sweet food; spicy food; family history of acne; late night sleeping on a daily basis; excessive axillary, body and facial hair; excessive periareolar hair; and anxiety. There was a statistically significant difference in the prevalence of gastrointestinal symptoms (halitosis; gastric reflux; abdominal bloating; constipation) between patients with and without sebaceous gland diseases (chi(2) = 150.743; P = 0.000). Gastrointestinal dysfunction is an important risk factor for diseases of the sebaceous glands and is correlated with their occurrence and development.

Clinical study on the efficacy and safety of intravenous itraconazole infusion for the treatment of invasive fungal infection in china.

Itraconazole has a broad spectrum of activity against the most common fungal pathogens. Prior problems with absorption in severely ill patients have been overcome with the introduction of an oral solution and an intravenous preparation. An open-labeled, non-competitive, multicenter phase IV study was conducted to investigate the efficacy and safety of itraconazole administered intravenously for the treatment of invasive fungal infections in Chinese patients. Patients were treated with itraconazole intravenously for 2 weeks (200 mg twice daily for 2 days, then 200 mg once daily for 12 days) followed by 28 days of oral capsules (200 mg twice daily). Efficacy evaluation included an assessment of the clinical efficacy, fungal efficacy and total efficacy on days 14 and 42. Of 156 evaluable patients, 35 patients had proven and 62 suspected invasive fungal infections, and 59 patients were treated empirically. On day 14 the total efficacy rate in patients with proven infection was 54.3% (19/35; 95% confidence interval [CI], 37-71%) and on day 42 it was 65.7% (23/35; 95% CI, 48-81%). The most common adverse events were hypokalemia (13.5%), gastrointestinal disorders (12.8%), elevation of liver enzymes (10.9%) and increase of bilirubin (8.3%). Itraconazole intravenously followed by oral capsules is thus tolerated and effective in severely ill patients with proven invasive fungal infection.

Identification of a novel gene, URE2, that functionally complements a urease-negative clinical strain of Cryptococcus neoformans.

A urease-negative serotype A strain of Cryptococcus neoformans (B-4587) was isolated from the cerebrospinal fluid of an immunocompetent patient with a central nervous system infection. The URE1 gene encoding urease failed to complement the mutant phenotype. Urease-positive clones of B-4587 obtained by complementing with a genomic library of strain H99 harboured an episomal plasmid containing DNA inserts with homology to the sudA gene of Aspergillus nidulans. The gene harboured by these plasmids was named URE2 since it enabled the transformants to grow on media containing urea as the sole nitrogen source while the transformants with an empty vector failed to grow. Transformation of strain B-4587 with a plasmid construct containing a truncated version of the URE2 gene failed to complement the urease-negative phenotype. Disruption of the native URE2 gene in a wild-type serotype A strain H99 and a serotype D strain LP1 of C. neoformans resulted in the inability of the strains to grow on media containing urea as the sole nitrogen source, suggesting that the URE2 gene product is involved in the utilization of urea by the organism. Virulence in mice of the urease-negative isolate B-4587, the urease-positive transformants containing the wild-type copy of the URE2 gene, and the urease-negative vector-only transformants was comparable to that of the H99 strain of C. neoformans regardless of the infection route. Virulence of the URE2 disruption stain of H99 was slightly reduced compared to the wild-type strain in the intravenous model but was significantly attenuated in the inhalation model. These results indicate that the importance of urease activity in pathogenicity varies depending on the strains of C. neoformans used and/or the route of infection. Furthermore, this study shows that complementation cloning can serve as a useful tool to functionally identify genes such as URE2 that have otherwise been annotated as hypothetical proteins in genomic databases.

Clinical observation on effect of triptolide tablet in treating patients with psoriasis vulgaris.

OBJECTIVE: To investigate the effects of triptolide tablet in the treatment of patients with psoriasis vulgaris. METHODS: By an open clinical study of 103 patients with psoriasis vulgaris. Psoriasis area severity index (PASI) was measured and recorded before and after treatment for efficacy evaluation. RESULTS: Of the 103 patients, markedly effective was got in 41 (39.7%), improved in 37 (35.8%) and ineffective in 25 (24.5%), the total effective rate being 75.7%, and the adverse reaction was shown only in few patients with decreased WBC during the treatment period. CONCLUSION: Triptolide tablet is effective for the treatment of psoriasis vulgaris during the one-year follow-up.

Mitochondrial DNA analysis of Sporothrix schenckii from China, Korea and Spain.

Sporothrix schenckii isolates from China, Korea and Spain were investigated for mtDNA types based on restriction fragment length polymorphism patterns with HaeIII. Sixty-one isolates from China, 8 from Korea and 11 from Spain were comprised of 7, 2 and 2 mtDNA types, respectively. All the isolates belonged to Group B.