Successful treatment of a patient with recurrent infection of Chromobacterium violaceum.

BACKGROUND: Chromobacterium violaceum (C. violaceum) is a Gram-negative saprophytic bacterium that is widespread in tropical and subtropical environments, and belongs to conditional pathogenic bacteria. Human infection with C. violaceum is rare, and this can be fatal when the diagnosis and treatment are delayed, especially recurrent infection patients. Since clinicians lack the knowledge for C. violaceum, rapid diagnosis and early appropriate antimicrobial treatment remains challenging. CASE PRESENTATION: A 15-year-old male student was hospitalized for dark abscess, pustules, severe pain in both legs, and fever for 11 days. There were pustules with gray-white pus and red infiltrating plaques on the back, and the subcutaneous nodules could be touched in front of both tibias, with scab, rupture and necrotic tissue of the lower limb. The patient's condition rapidly progressed. Therefore, next-generation sequencing (NGS), pustular secretion and blood culture were concurrently performed. The final diagnosis for this patient was C. violaceum infection by NGS. However, no bacterial or fungal growth was observed in the pustular secretion and blood culture. After 4 weeks of treatment, the patient was discharged from the hospital without any complications associated with C. violaceum infection. CONCLUSION: Rapid diagnosis and early appropriate antimicrobial treatment is the key to the successful treatment of C. violaceum infection, especially in patients with sepsis symptoms. This case highlights that NGS is a promising tool for the rapid diagnosis of C. violaceum infection, preventing the delayed diagnosis and misdiagnosis of C. violaceum infection in patients who tested negative for pustular secretion and blood culture.

[Analysis of 34 cases of systemic lupus erythematosus with decreased platelet count].

OBJECTIVE: To explore the clinical and laboratory examination features of systemic lupus erythematosus (SLE) with decreased platelet count. METHODS: Thirty-four SLE patients with decreased platelet count were analyzed for their initial symptoms, clinical manifestations, involvement of the organs and laboratory findings in comparison with 40 randomly selected SLE patients with normal platelet count. RESULTS: The SLE patients with decreased platelet count were more likely to develop kidney involvement than those with normal platelet, but the incidence of butterfly erythema was significantly lower in the former patients (PP<0.05). Some indices of laboratory examinations, such as CH(50), white blood cell reduction, rate of urine protein, thrombocytocrit and platelet distribution width were significantly higher in SLE patients with decreased platelet count than those with normal platelet count. CONCLUSIONS: The clinical manifestations and laboratory findings in SLE patients with decreased platelet count may differ from those of SLE patients with normal platelet.

[Preparation and characterization of podophyllotoxin-dipalmitoylphosphatidylcholine proliposome].

OBJECTIVE: To prepare podophyllotoxin-dipalmitoylphosphatidylcholine (PPT-DPPC) proliposomes (PPT-DPPC-PL) for improvement of the stability of PPT-DPPC liposome. METHODS: Freeze-drying method was used to prepare PPT-DPPC-PL, and the particle morphology, size range, encapsulation efficiency and stability of PPT-DPPC liposome were investigated. RESULTS: After hydration of PPT-DPPC-PL, PPT-DPPC liposome appeared multivesicular under electron microscope and the particles were distributed homogeneously with an average particle size of 1.45+/-0.38 microm. The encapsulation efficiency of PPT was 72.3%, and after storage at 4 to 40 degrees Celsius; for 1 to 6 months, the proliposome remained stable. CONCLUSION: The prepared PPT-DPPC-PL particles by freeze-drying method are evenly distributed. The preparation method is relatively simple with higher embedding ratio and better stability.

[Preparation of liposome podophyllotoxin chitosan film and determination the podophyllotoxin content in the film by ultraviolet spectrophotometry].

OBJECTIVE: To optimize the formula of liposome podophyllotoxin chitosan film and accurately determine the podophyllotoxin content in the film. METHODS: Liposome podophyllotoxin chitosan films were prepared according to different formula derived from the results of orthogonal design by selecting chitosan, acetic acid and gelatin as the 3 factors for preparation, each factor including 3 levels with liposome podophyllotoxin as the blank factor. Comprehensive evaluation of the formulas was performed on the basis of the conglutination and solubility of the prepared film to select the optimal formula. The content of podophyllotoxin was determined by ultraviolet spectrophotometry at 292 nm. RESULTS: The conglutination and solubility were optimal of the film prepared from 2% chitosan, 1% acetic acid, 2% gelatin and 2.8% liposome podophyllotoxin chitosan, showing good linearity within podophyllotoxin concentration range of 5-25 microg/ml (r=0.999 89) with an average recovery rate of 99.7% (n=5) and RSD of 1.11%. CONCLUSION: The film prepared according to the orthogonal design results conforms to the requirements in terms of conglutination and solubility, and the method we adopted is fast and accurate, yielding qualified film with censored podophyllotoxin content that distributes homogeneously.

Changes in peripheral blood Th1/Th2 cell balance in patients with condyloma acuminatum.

OBJECTIVE: To explore the association of peripheral blood T helper type 1 (Th1) and type 2 (Th2) imbalance with the occurrence of condyloma acuminatum (CA). METHODS: Interferon-gamma(IFN-gamma) and interleukin-4 (IL-4) secreted by CD4(+) T-cells were detected by flow cytometry in 40 patients with CA and 20 healthy volunteers, and significance of Th1/Th2 cell ratio in the etiology of the CA was analyzed. RESULTS: Peripheral blood Th1 cells that secreted IFN-gamma were significantly decreased in number in patients with CA (P <0.05), while Th2 cells producing IL-4 increased (P <0.05). The Th1/Th2 cell ratio was significantly reduced in CA patients as compared with the health control subjects (P <0.01). CONCLUSION: Increases of Th2 cells and decrease of Th1 cells in the peripheral blood of CA patients result in relative Th2 predominance and breach the Th1/Th2 balance, which may play an important role in the etiology and recurrence of CA.

Preparation and comparative analysis of two podophyllotoxin liposomes.

OBJECTIVE: To prepare two different liposome gels containing podophyllotoxin (PPT) and compare their pharmaceutical properties. METHODS: PPT-Dipalmitoylphosphatidylcholine (DPPC) liposome and PPT-soya lecithin liposome were prepared by reverse phase evaporation technique, and optical and electron microscopy were performed respectively for examining the appearances of the 2 liposomes and the diameter of the particles. Gel filtration was employed to assess the embedding ratio of the liposomes. RESULTS: Under optical microscope, PPT-DPPC liposome was observed to be composed of spherical particles with diameter range of 2.05 to 0.825 microm (average 1.45 microm). The diameter range of the particles of PPT-soya lecithin liposome is 7.59 to 1.445 microm (average 3.78 microm). PPT-DPPC liposome appeared multivesicular under electron microscope, with the embedding ratio of 73.8%, and 79.1% for PPT-soya lecithin liposome (n=3). PPT-DPPC liposome had a embedding ratio of 65.2%, 58.8% and 56.4% after preserved 1, 3, 6 months respectively. As for PPT-soya lecithin liposome, the embedding ratios were 70.3%, 60.4%, and 51.3% respectively. CONCLUSION: The PPT in the liposomes prepared by reverse phase evaporation technique is evenly distributed throughout the gel. The preparation is relatively simple with high embedding ratio.

[Therapeutic effects of bifonazole gel on tinea versicolor in infants: analysis of 22 cases].

OBJECTIVE: To evaluate the efficacy and safety of 1% bifonazole gel in the treatment of tinea versicolor in infants. METHODS: Twenty-two infants with tinea versicolor were treated with 1% bifonazole gel for 2 weeks, and the therapeutic effects were evaluated. RESULTS: Total cure was achieved in 16 cases and significant improvement observed in 4 cases, with a total effective rate of 90.91%. The fungi were cleared in 19 cases with the clearance rate of 86.36%. CONCLUSION: Use of 1% bifonazole gel can be effective and safe in treating tinea versicolor in infants.