Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection

Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei (PM) infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results (1) The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture. All the 12 cases (100%) had irregular fever (38-41 ) and enlarged lymph nodes, 8 cases (66%) had skin rashes; 8 cases (66%) had hepatomegaly; 9 cases (75%) had splenomegaly while 8 cases (66%) had anemia. (2) Imaging manifestation: Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 cases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung, and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS (CD4 T lymphocytes <50/ u L) with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver, spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of "cakes".

Clinical Observation and Experimental Study on Compound Hypoglycemic Decoction for Hyperglycemia

Purpose: To observe the clinical efficacy of Compound Hypoglycemic Decoction (CHD) and its effect on serum total cholesterol in model mice. Method: The paired t test was used to analyze the data recorded before and after administration of drugs for hyperglycemia induced by intraperitoneal injection of 75% egg yolk emulsion in experimental mice. CHD and Fenofibrate were administered as prevention measures. Results: The total effective rate of serum total cholesterol (TC) decrease in 60 cases of hyperglycemia was 86.66% and that of serum total triglyceride (TG) decrease was 81.81%. The total effective rate of high-density lipoprotein-cholesterol (HDL-C) increase was 75%. The decrease in TC and TG, and the increase of HDL-C after treatment by in-group comparison were all significant (P<0.05). 21.9% and 22.2% decrease in the total cholesterol was respectively found in the CHD and Fenofibrate groups (both P<0.05), with no significant difference. Conclusion: The hypoglycemic action of Compound Hypoglycemic Decoction was remarkable in clinical practice, and it is very effective in preventing hyperglycemia in experimental mice.

Acquired immunodeficiency syndrome associated disseminated Penicillium Marneffei infection: report of 8 cases

Penicillinosis Marneffei （PSM） is a rare fungal disease caused by systemic infection of Penicillium Mameffei （PM）. Disseminated PSM is one of the most common opportunistic infections in patients with acquired immunodeficiency syndrome （AIDS） living in Southeastern region during the endstage of disease. Sporadic and individual cases have been reported recently in China and there appeared a tendency of increase of PM infections because of the increase of AIDS cases. To improve our understanding of this disease, we report here 8 cases of AIDS associated PSM.

Sialoadenitis progression in nonobese diabetic mice and its correlation with expression of apoptosis-associated proteins in salivary glands and serum IgG levels

Background Sjogren syndrome （SS） is an autoimmune disorder characterized by chronic lymphocytic infiltration and decreased secretion in salivary glands. Apoptosis is one of the possible mechanisms involved in acinar epithelial destruction in SS. The role of apoptosis in the initiation and effect phase of sialoadenitis is still controversial. The aim of this study was to observe the roles of apoptosis-associated proteins and serum IgG levels in sialoadenitis progression in nonobese diabetic （NOD） mice. Methods 2-, 5-, 10-, 15-, 20-week female NOD and matched BALB/c control mice were selected. Saliva and tear flow rate were measured. Serum IgG level was tested by enzyme-linked immunosorbent assay （ELISA）. Number of lymphocyte foci （NLF） in submandibular glands （SMGs） was counted under routine hematoxylin/eosin-stained sections. Expression of Fas, Bcl-2 and procaspase3 proteins as well as apoptotic cells in the SMGs were detected by immunohistochemical staining and by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling （TUNEL） assay respectively. Results Decreased stimulated total flow rate （STFR） and lymphocyte foci in SMGs were first observed in the 10-week NOD group. STFR was negatively correlated with NLF （P〈0.05）. Serum IgG in NOD mice was significantly higher than that of the control group （P〈0.05） and showed a positive correlation with NLF （P〈0.05）. Fas expression in SMGs acinar cells in NOD mice increased with age and was significantly higher compared with that in the control group. Bcl-2 expression and procaspase3 expression in SMG acinar cells in each NOD group were lower compared with those of the age-matched control mice. Conclusion Abnormal expression of Fas and Bcl-2 in the SMGs and higher level of serum IgG may contribute to the initiation of sialoadenitis and cause the glandular destruction in NOD mice.

Effects of Ganoderma lucidum spores on sialoadenitis of nonobese tiabetic mice

Background Sjǒgren syndrome （SS） is a systematic autoimmune disease, on which traditional therapeutic agents show limited effect. More effective agents with longer-lasting and fewer side effects are needed in the clinic. The aim of this study was to investigate the effects of Ganoderma lucindum spores （GLS） on sialoadenitis of nonobese diabetic （NOD） mice. Methods Thirty-two female NOD mice were assigned randomly into 4 groups： low-dose GLS-treated （L-GLS） group and high-dose GLS-treated （H-GLS） group, a dexamethasone group, and a normal saline （NS） control group. Stimulated total saliva flow rate （STFR）, area of lymphocytic infiltration in submandibular glands and ratios of CD4^＋ and CD8^＋ T lymphocytes and B lymphocytes in peripheral blood as well as apoptosis of these subsets and serum IgG level were tested after 10 weeks of treatments. Differences among the groups were analyzed by one-way analysis of variance （ANOVA）, Student-Newman-Keuls Test （SNK） was used between each two groups and a P 〈0.05 was considered statistically significant. Results STFR of the high-dose GLS group increased significantly after a 10-week treatment compared with those of the NS control group （P 〈0.05）. The incidence of sialoadenitis in GLS-treated NOD mice groups showed no significant difference compared with the control group （P 〉0.05）, but the area of lymphocytic foci in both the H-GLS and L-GLS groups decreased significantly to 50% of the NS control group （P 〈0.05）; the ratio of CD4^＋/CD8^＋ T lymphocytes and apoptosis of B lymphocytes of NOD mice with sialoadenitis were less and apoptosis of CD4^＋ and CD8^＋ T lymphocytes were significantly increased compared with the control group （P 〈0.05）. After pretreatment with H-GLS before sialoadenitis onset, the ratio of CD4^＋/CD8^＋ T lymphocyte and the serum IgG levels of NOD mice decreased significantly （P 〈0.05）. Conclusions Pretreatment with H-GLS can relieve symptoms of sialoadenitis in NOD mice. GLS has some protective effects on sialoadenitis in NOD mice through increasing STFR and decreasing the area of lymphocytic foci by regulating the ratio of CD4^＋/CD8^＋ T and apoptosis of B lymphocytes.