在CGB培养基上生长的A型和D型新生隐球菌

新生隐球菌是临床上重要的致病真菌,在免疫缺陷的患者如艾滋病患者中引起播散性脑膜炎。新生隐球菌有两个变种,并分为5个血清型。文献报道新生隐球菌新生变种的血清型为A、D和AD型,在CGB培养基上不生长;格特变种的血清型为B和C型,能够在CGB培养基上生长。作者报告了3株来自鸽排泄物,能在CGB培养基上生长,血清型为A或D型的新生隐球菌。     

新生隐球菌28S rDNA的基因型特征与序列分析

目的 探讨新生隐球菌各变种、血清型与基因型的关系。方法 新生隐球菌标准株10株、新生隐球菌荚膜缺陷株CAP10以及临床分离株19株,采用变性梯度胶电泳(DGGE)结合DNA序列分析,对以上菌株的28S rDNA片段进行研究。结果 经过DGGE和DNA序列分析,所有新生隐球菌新生变种(A、D型)具有一致的基因带型和序列,格特变种(B、C型)具有不同于新生变种的独特一致的带型和序列;AD型的基因型和序列与格特变种完全相同,新生隐球菌荚膜缺陷株CAP10(D型)的基因型类同于新生变种;19株临床分离菌在DGGE上可分为2型,17株与A、D型完全相同,2株与B、C型相同。结论 DGGE结合DNA序列分析,对于探讨新生隐球菌各变种、血清型的基因型特征、关系具有重要价值;我国非艾滋病隐球菌病感染以新生变种为主,AD型在系统发育上更类同于格特变种,而不是新生变种;本研究不支持A血清型为新生变种以外的新变种即grubii变种的观点。     

新生隐球菌格鲁比变种、新生变种和格特隐球菌的多重聚合酶链反应鉴定

目的 建立一种基于核糖体基因内间隔区（IGS）的多重聚合酶链反应（PCR）,用于快速鉴定新生隐球菌新生变种、格鲁比变种和格特隐球菌。方法 选取新生隐球菌和格特隐球菌IGS中变异度最高的Ⅰ区（IGS1）为靶点,经ClustalW2多重比对,并结合Oligo6软件在不同序列位点设计针对新生隐球菌新生变种、格鲁比变种和格特隐球菌的引物用于多重PCR分析。通过51株新生隐球菌（VNⅠ-VNⅣ和VNB基因型）和41株格特隐球菌（VGⅠ-VGⅣ基因型）对该方法进行验证,并将该方法与已报道的CGB显色培养和采用特异性引物GPA1A、CLA4D和SOD1gattii扩增格鲁比变种、新生变种和格特隐球菌的单一引物PCR方法进行比较。结果 基于IGS的多重PCR分析成功鉴定所有92株新生隐球菌和格特隐球菌,对其他常见致病酵母的扩增均阴性,显示所设计引物较高的特异性;已报道的基于GPA1A和CLA4D引物PCR分别在鉴定2株和1株格特隐球菌时出现假阳性结果;CGB培养基在鉴定1株格鲁比变种和1株新生变种时出现假阳性结果。上述方法在鉴定时均未出现假阴性结果。结论 建立的多重PCR可快速准确地鉴定新生隐球菌新生变种、格鲁比变种、AD杂合子和格特隐球菌,且优于已报道的单一引物PCR 或CGB显色培养法。     

新生隐球菌AD血清型是新生变种?

新生隐球菌根据传统的分类方法和以往的观点,血清型AD型新生隐球菌一直被视为新生隐球菌新生变种\,但事实上,AD型新生隐球菌无论在地区分布、致病特征等方面,均与新生隐球菌新生变种中的A型和D型有明显不同^[2,3].本文采用变性梯度胶电泳(denaturing gradient gel electrophoresis,DGGE)技术和核酸序列分析,首次发现新生隐球菌AD型28S rDNA基因型与新生隐球菌新生变种的A、D型不同,而与新生隐球菌格特变种B、C型完全一致,现报道如下.     

台湾新生隐球菌临床分离株的血清型和交配型

采用刀豆氨酸甘氨酸溴麝香草酚蓝琼脂培养基(CGB)培养法、因子血清分型及交配试验研究了分离自台湾临床患者的21株新生隐球菌。其中交配试验分别采用麦糠琼脂和麦芽汁琼脂两种培养方法。     

印度的新型隐球菌格特变种

18株由临床分离的菌株用 API 20C 法鉴定为新型隐球菌,再测试尿素酶、酚氧化物酶为阳性,全部菌株均不同化硝酸盐。18株中3株可在 CGB 培养基上生长,血清分型为B 型,属格特变种。其它15株血清分型为 AD     

新生隐球菌不同变种所致小鼠原发性皮肤感染的比较

目的：探讨新生隐球菌不同变种在原发性小鼠新生隐球菌皮肤感染中的作用。方法：按照我们建立的原发性皮肤隐球菌感染模型的方法，将新生隐球菌新生变种标准野生株B3501与格特变种标准株ATCC32609分别皮内接种于免疫抑制与非抑制的BALB／c小鼠，皮损真菌培养与组织病理检查确证感染。观察2种隐球菌感染的病程，比较皮损形成与消退的平均时间。结果：2种变种的新生隐球菌皮下接种于BALB／c小鼠后，可以在免疫抑制与非抑制的BALB／c小鼠皮肤上产生丘疹、结节、溃疡、传染性软疣样皮损，皮损可以自愈，真菌培养与病理确证为隐球菌感染。2种菌株只在免疫正常小鼠的皮损形成时间上存在差异。结论：新生变种与格特变种的新生隐球菌均可以造成BALB／c小鼠相似的皮肤感染。推测2种变种对原发性皮肤感染的致病力可能无差异，新生变种发病较多可能与其分布有关。     

作为巴西隐球菌病病原的新生隐球菌变种

83株新生隐球菌分离自12例免疫正常的患者,"例AIDS和5例有免疫抑制的患者,其中80株分离自脑脊液/血液,另2株分别分离自肺组织和痰。使用CGB培养基和分型血清作血清分型,并根据临床资料比较两个变种与临床     

墨西哥隐球菌脑膜炎患者中新生隐球菌格特变种的首次报导

近来据文献报导新生隐球菌格特变种(Cryptococcus neoformans var.gattii)可发生在艾滋病患者及非流行区,且与新生隐球菌新型变种(Cryptococcus neoformans var.neoformans)所致隐球菌脑膜炎的临床经过有所不同,因此有必要对隐球菌脑膜炎的病原体的鉴定、分布和临床特点进行研究。作者对此作了研究。 患者来源于墨西哥国立神经病学、神经外科学研究所。1989～1994年共有20例隐球菌脑膜炎患者,隐球菌从患者脑脊液中分离。用二     

新生隐球菌随机扩增DNA指纹分型研究

目的　用随机引物扩增新生隐球菌临床和环境分离株的DNA ,观察DNA指纹与血清型的关系 ,探索新生隐球菌基因分型标准。方法　采用 3种不同寡核苷酸重复序列 [CN1(GTG) 5、CN2(GACA) 4和CN3(GATA) 4]为引物 ,对从临床和鸽粪中分离到的 2 4株血清A型和 8株四种血清型的新生隐球菌标准株的DNA进行扩增 ,根据扩增产物的电泳带型来对比DNA指纹和血清型之间的关系。结果　 2 4株临床和鸽粪分离的血清A型株中 ,2 0株产生和标准株完全相似的DNA带型 ,1株与标准D型DNA带型相似。 3株的PCR指纹与血清A、B、C、D型均不相同。 2株B型和 2株C型产生几乎完全一致的DNA指纹带型。结论　①大多数血清A型新生隐球菌菌株具有相似DNA指纹带型。②血清B型和C型 (gattii变种 )的DNA带型不易区别。③相同血清型不同的株可能有不同的DNA指纹带型。④PCR法用于新生隐球菌菌株鉴定是一种快速、方便、可行的方法。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.