Candida spp.are medically important fungi causing severe mucosal and systemic infections,however,not all individuals are at risk to develop Candida infections.With the completion of the human genome project and the development of molecular genetic technology,the genentic susceptibility to Candida infections has attracted the attention of more and more researchers.Severe fungal infections are associated with monogenic primary immunodeficiencies such as defects in STAT1,STAT3 or CARD9.Furthermore,some polymorphisms in genes of the immune system have also been associated with fungal infections such as recurrent vulvovaginal candidiasis and candidemia.The discovery of the genetic susceptibility to Candida infections can lead to a better understanding of the pathogenesis of the disease,as well as the development of novel detection index and therapeutic target.

Objective To survery the epidemiology of pathogenic fungi and clinical patterns of onychomycosis during Mar 2011 to Apr 2012 in Nanjing district. Methods Fungal culture and clinical analysis were performed on 305 cases of onychomycosis with positive direct microscopic examination. Results 165 strains of pathogens were isolated, the positive rate was 54.1%. The most frequently isolated fungus was dermatophytes (91%), followed by non-dermatophytic moulds (4.8%) and yeasts (4.2%). DLSO were the most frequently clinical patterns (48.2%), followed by SWO (24.9%) and TDO (23.3%). Conclusion In Nanjing district, the most frequently pathogenic fungus of onychomycosis was trichophyton rubrum and the most frequently clinical patterns was DLSO.

<正>足癣是由皮肤癣菌引起的足部真菌感染,多发于趾间、足跖及侧缘。目前,常用的足癣治疗方法有局部治疗、系统治疗以及二者联合治疗三种。临床上常用的抗真菌药物包括唑类、丙烯胺类、硫脲类、吗啉类、吡咯酮类等,其中以丙烯胺类和唑类药物应用最广。丙烯胺类的代表药物包括特比萘芬、布替萘芬和萘替芬等,用药方法为每日1～2次,至少用药2周,真菌学治愈率为62%～100%。单纯使用外用药物的局部治疗仅适用于初发或病灶局限的足癣患者。足癣的

Objective To study the impact of HIV-1 V2 L175P mutation on the binding capability of anti-V3 neutralizing antibodies to HIV-1.Methods A series of eukaryotic cell expression plasmids were used to concatenate wild type and mutant env gene of HIV-1 and green fluorescent protein(GFP)gene.The recombinant plasmids were transfected into 293T cells to express HIV-1 gp120 protein on the surface of cells.The successfully transfected cells were screened by GFP florescence marker.Immunostaining and dual fluorescence flow cytometry were performed to test the binding affinity of several common V3 region specific neutralizing antibodies to wild type or mutant gp120 proteins.Results The mean fluorescence intensity(MFI)of mutant gp120-expressing 293T cells were significantly higher than that of negative control cells(expressing GFP).Flow cytometry showed that the curve for mutant gp120-expressing 293T cells was obviously different in shape and peak from that for the negative control,while most parts of the curve for the wild type gp120-expressing 293T cells overlapped with those for the negative control.Conclusion The V2 region mutation may increase the sensitivity of HIV-1 to the neutralization by V3 region specific antibodies.

Objective To explore a new Tween test,according to the disadvantage of traditional Tween test,to improve the accuracy of Malassezia identification.Methods First we prepared 4 kinds of Tween medium in different concentration gradients,then applied the Malassezia suspension to medium surface.After cultivation in 37℃ for 5 days,we counted the spores and calculated the suitable concentration of 4 kinds of Tween (20,40,60 and 80) for Malassezia by variance analysis.The new Tween medium was tested by 7 type strains and 86 clinical strains of Malassezia.Results The most suitable concentration of the 4 kinds of Tween for Malassezia was 2%.The reliability of the new method was well confirmed during the identification of 7 type strains and 86 clinical strains of Malassezia.Conclusion The new Tween medium significantly improves the accuracy,efficiency and economy of Malassezia identification.

<正>随着人们对生存环境及动物保护的热切关注,自动物实验的减少(reduce)、优化(refine)和替代(replace)这一3R原则提出以来,生命科学研究尽量避免使用传统的试验对象---动物,以器官培养、细胞培养、人工器官的构建等等取而代之。在皮肤科领域,各种接触皮肤的外用药物及各类化妆

Objective To identify Mycobacterium marinum (M. marinum) inducing misdiagnosis and treatment failure. Methods The lesional specimen of patient with cutaneous M. marinum were cultivated on Lwenstein-Jensen medium. The isolate was identified by biochemical tests and polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) analysis of the hsp65 gene. Results Smooth and non-pigmented colonies were noted after incubation at 32 ℃ for 2 weeks. The isolate was acid-fast bacilli and confirmed as M. marinum by biochemical tests and PCR-RFLP. Conclusion For a correct diagnosis of cutaneous M. marinum infection, it is crucial for clinicians to have a high index of suspicion, obtain the history of exposure and trauma and understand growth characteristics of the organism. Compared with conventional biochemical techniques, PCR-RFLP analysis is a more rapid, accurate and reliable method for mycobacterial identification to species level.

目的 分析念珠菌酵母相全细胞水解生成的D-葡萄糖与D-甘露糖含量比值。方法 采用双波长薄层扫描法，测定65株8种医学上重要的念珠菌标准株及酿酒酵母标准菌株8株的酵母相全细胞完全酸水解产物中D-葡萄糖与D-甘露糖含量比值。同时测定了46株念珠菌临床分离株，并与标准株进行了比较。结果 经Tukey法统计处理，可将9种菌分成5个同质性亚群。经t检验比较，酿酒酵母和8种念珠菌的结果差异均有显著性；而念珠菌临床分离株与标准株结果差异均无显著性。结论 该比值结果能在属水平区分念珠菌和酿酒酵母，并可将8种念珠菌分为4个同质性亚群；且经临床分离株验证，重复性较好。

Objective To study the clinical application of polymerase chain reaction(PCR)in the detection specimens from patients with suspected deep-seated pathogenic fungal infection.Methods Sixty clinical specimens were detected with pan-fungal PCR,triplex PCR and traditional fungal culture,respectively. Results Nineteen specimens were positive by culture,consisting of 10 strains of Candida albicans,2 strains of Aspergillus fumigatus,2 strains of Cryptococcus neoformans and 5 other strains(2 strains of Candida glabrata,2 strains of Candida tropicalis and 1 strain of Candida krusei);21 were positive by pan-fungal PCR;and 15 were positive by triplex PCR,including 10 strains of Candida albicans,3 strains of Aspergillus fumigatus and 2 strains of Cryptococcus neoformans.There was no statistical significance in the detection rate of fungi between the PCR and culture methods.Conelusion The PCR procedure is rapid,convenient, and reliable for the detection of deep-seated pathogenic fungi with higher specificity and sensitivity,and may be routinely used in clinical laboratory.

Objective T observe the effect of corticosteroids on the growth of skin fungi through in vitro culture in animal model. Methods SDA containing 0.1% triamcinolone was used in experimental group and SDA alone was used in control group. Trichophyton rubrum, trichophyton gypsum and Mcorsporum canis were inoculated in guinea pigs separately for construction of animal model. Then the morphology and clones formed were observed. Results The extent of damage to skin was deteriorated with the use of corticosterioids for treatment a week after infection. Conclusion Corticosteriods shoud not be used alone for treatment of fungal infection for over a period of a week. But it can be used in combination with other anti-funagus drugs within a week.

Disseminated superficial actinic porokeratosis (DSAP) is an uncommon autosomal dominant chronic keratinization disorder,characterized by multiple superficial keratotic lesions surrounded by a slightly raised keratotic border. In previous studies,the disease gene was mapped to 12q23. 2-24.1 (DSAP1), and 15q25. 1-26.1 (DSAP2). In this study,genome-wide scan was performed in two unrelated six-generation DSAP pedigrees to localize and identify the candidate gene(s) of disease. Linkage analysis showed that the cumulative maximum two-point lod score of 8.28 was obtained with the marker D12S84 at a recombination fraction theta of 0.00. Haplotype analysis defined an 8.0 cM critical region for DSAP gene(s) between markers D12S330 and D12S354 on 12q24. 1-q24. 2, which partially overlapped with the region identified for DSAP1. DNA sequencing of the coding exons of six candidate genes (CRY1, PWP1, ASCL4, PRDM4, KIAA0789 and CMKLR1) on the basis of their location in the critical overlap interval, failed to detect any mutation in DSAP patients. Thus, it is likely that these genes are not involved in DSAP.

几年前,有一位大学生,可能是因为男孩的缘故吧,他做事情常常是一副大大咧咧的样子.喜欢运动的他明明知道一个室友惠有脚癣,但他竟然经常借穿那位室友的运动鞋,结果不幸"中招":他也感染上了脚癣.

Objective: To explore the etiology, clinical and histological features and treatment in patients with acute generalized exanthematous pustulosis (AGEP). Methods: Twelve cases of acute generalized exanthematous pustulosis were analyzed retrospectively. Results: Two of these cases were occurred in patients with a history of psoriasis, the ratio of female to male was 3 to 1. The average age was 31.3 years old. Seven cases were drug-induced. four cases were followed virus or bacterial infection. Eleven cases had fever , leukocytosis and neutrophilia. Histopathological examination revealed spongiform superficial pustules and papillary edema. The precipitating factors ( the suspected drug and infection focus) were kept off and low-medium doses of steroids was administered, almost all patients were healed. Conclusion: AGEP is a rare but distinctive entity with the clincal and histopathological features.

Objective To study the relationship between genotypes and phenotypes,geographical distribution,and the sites of infection of Trichophyton rubrum(T.rubrum). Methods The genotypes were determined by Southern blotting with a probe amplified from the small-subunit rDNA and adjacent internal transcribed spacer(ITS)regions.The phenotypes of T.rubrum were determined by conventional method. Results Twenty genotypes(DNA type A to T)and 5 phenotypes(villous,furrowed,granular,powdery,and woolly)were recognized among 49 strains of T.rubrum.Genotype A prevailed in all phenotypes except granular type.Type B represented the most common genotype among the strains of villous type and furrowed type.Type A took the first place in powdery type and woolly type.All of the type A strains were from Dalian.Seven of 9 type B strains were from Nanjing.Six type C strains were all from Nanjing.The majority strains of 21 strains isolated from tinea unguium were type C,most of the16strains isolated from tinea cruris and tinea corporis were type A,8 strains from tinea pedis were type B,and4strains from tinea capitis were type C. Conclusion There are certain possible relationships between genotypes and phenotypes,geographical distribution and sites of infection of T.rubrum. Key words: Trichophyton; Genotype; Phenotype

Objective To rapidly detect and identify pathogenic fungi of some deep fungal infections by PCR.Methods The suspensions of22pathogenic fungi(23strains)were amplified by PCR with fungal universal primers ITS86and ITS4which were labeled by FAM.The precise length of amplified fragments was determined by ABI PRISM TM 377Sequencer and Genescan analysis software,then compared with that of am-plicons of corresponding fungal DNA which were previously extracted.Results(1)Amplification of17pathogenic fungi with ITS4,ITS86resulted in a unique fragment length(except for A.nidulans and A.niger,C.albicans and C.stellatoidea,F.pedrosoi and E.dermatitidis).(2)No significant difference of the length of am-plicons was found between the fungal suspension and control organisms,based on the results of Genescan analysis.(3)The whole process took only6h to complete the detection.Conclusion The combination of fun-gal suspension PCR with ITS fungal universal primers and Genescan analysis might provide an accurate,spe-cific,sensitive,and rapid approach to detect and identify22pathogenic fungi causing deep fungal infections,and hold promise to be applied for the diagnosis of deep fungal infection.

Objective:To set up a rapid and simple PCR assay for Candida detection and identification by using in ternal tran scribed spacer(ITS)universal primers.Methods:Fungal suspensions of7species(8candidal strains)were am pli fied by using two pairs of ITS uni versal primers ITS1,ITS4and ITS86,ITS4.Results:The species-specific DN A bands of7species of Candida in the fungal suspensions could be amplified with two pairs of ITS universal primers within3.5hours.Moreover,the second pai r was more spesies-specific.Conclusions:ITS universal primers combined with P CR assay can detect Can dida rapidly,simply,specifically and sensitively,even can identify some species at the same time.The assay will have potential val ue in the early diagnosis and treatment of deep fungal infections.

Objective To elucidate the genetic base of psoriasis for Chinese patients, the positional candidate loci (D6S273、D6S276、D6S422、D6S299、D6S291、D4S1535、D4S1652、D4S171)previously reported in the regions 6p21.3 and 4q were studied in some carefully examined psoriatic families in order to establish whether the eight reported microsatellites loci(STRs) underlay susceptibility to psoriasis in different populations. Methods Two hundred and five probands with psoriasis vulgaris were identified from outpatients attending the Institute of Dermatology, Chinese Academy of Medical Sciences. Genotypes were generated at 8 polymorphic loci on chromosome 6p21 and 4q in 14 pedigrees. The results were analyzed parametrically by linkage 5.0 software. Results There was evidence for linkage to D6S273 in 6p21.3 (the LOD score was 1.26). No evidence for linkage was obtained at other loci including three loci on chromosome 4q. Conclusion This study confirms the presence of a psoriasis susceptibility locus on chromosome 6p previously studied. It is shown that there may be psoriasis susceptibility locus D6S273 on chromosome 6p21.3 in the Chinese population. Key words: Genes; Chromosomes; Psoriasis

Two cases of fungal keratitis caused by alternaria alternata cured with itraconazole were reported.In the KOH preparation from the specimens of both of the 2cases,brown separate hyphae was seen by direct microscopy.Meanwhile,the c ulture confirmed the growth of alternaria alternata.In addition,experimental infections were also carried out and proved t he causative pathogen as al-ternaria alternata,which caused fungal keratitis in ra bbits' eyes.Both of the 2cases were successfully treated after continuous ad-ministration of itraconazole 0.4g,Qd.for 4weeks .