Clinical data of 150 patients with mild and 38 patients with severe confirmed influenza A/H1N1 were collected and retrospectively analyzed in this paper with descriptive epidemiology. Mild patients mainly presented with symptoms similar to seasonal influenza with few complications, however,persistent high fever, cough with bloody sputum expectoration, chest distress and short of breath manifested in severe patients with respiratory failure and acute respiratory distress syndrome in some cases. Proportion of obesity and underlying diseases in severe patients, who were at high risk for severe influenza A/H1N1, was higher than that in mild ones (P＜0. 05). Average course of the illness spanned five to 11 days in patient with mild influenza A/H1N1 with all cured, and 34 of severe cases discharged with better recovery and other four died with a case-fatality of 10. 5 percent.

Chronic Disease ; Humans ; Liver Diseases

Objective To observe the efficacy ,safety and patient acceptance of the artificial airway with the oro‐pharyngo‐laryn‐gead airway cap(OPLAC) for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia .Methods Sev‐enty eight cases of patients receiving the hip replacement surgery were included ,42 patients were to be adopted to establish artificial airway with the OPLAC for intravenous‐inhalation combined anesthesia ,another 36 patients treated with heath side‐lying position hypobaric spinal‐epidural anesthesia .There are two groups ,the oro‐pharyngo‐laryngead airway cap group(OPLAC ,n=42) and hy‐pobaric combined spinal‐epidural anesthesia group (CESA ,n=36) .Monitor the changes of respiratory and circulatory parameters of the two groups before the start of anesthesia ,anesthetic after 10 min ,30 min ,1 h ,and handling marrow ,observing occurrence of complications (delirium ,sore throat ,nausea ,vomiting ,deep vein thrombosis) ,following up the degree of satisfaction of patients and surgeons for anesthesia .Results The respiratory and circulatory parameters of the OPLAC group during anesthesia induction and maintenance were relatively stable ,on the other hand ,significant cyclic inhibition (blood pressure and heart rate decresing ) and re‐spiratory rate declining were observed in the CESA group after anesthesia ,cases with the use of atropine and dopamine significantly more than OPLAC group .The circulation and breath in the OPLAC group were relatively stable when handling marrow ,while cir‐culation fluctuating Significantly in the CESA group (blood pressure decreasing and heart rate increasing ) .The incidence of delirium in the CESA group was significantly higher than OPLAC group .The patient satisfaction of the OPLAC group was significantly bet‐ter than the CESA group .Conclusion The artificial airway with OPLAC for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia is safe ,effective ,and satisfactory .

This paper reviews the contents, mechanism of action, operating principles and application effects of sensory stimulation program in the rehabilitation of critically ill neurologic patients with disorders of consciousness. It points out that the operating standards of sensory stimulation program need to be unified. In the future, more large-sample, multi-center randomized controlled studies of sensory stimulation program in the rehabilitation of critically ill neurologic patients with disorders of consciousness need to be carried out to provide a reference for clinical implementation of sensory stimulation program.

OBJECTIVETo perform a comparative assessment of the performance of FibroTouch and FibroScan in patients with hepatitis B.

METHODSA total of 211 patients with hepatitis B, including cases of chronic hepatitis B (CHB) and of compensated cirrhosis, were enrolled for study between June and November of 2013. The patients underwent FibroScan testing (group 1) and FibroTouch testing (group 3), after which the operator examined a time motion ultrasound image from the FibroScan test and located a specific liver portion for focused FibroTouch testing (group 2). The consistency between the two tests' results was investigated by Pearson's correlation analysis, and the difference of liver stiffness between CHB patients and compensated cirrhosis patients was investigated by the two independent samples t-test or Mann-Whitney U test.

RESULTSThe values of liver stiffness were 5.30 (4.30,8.65) in group 1,6.10 (4.70,8.90) in group 2, and 5.70 (4.50, 8.00) in group 3 (all P < 0.05); the Pearson correlation coefficients were all more than 0.8 (P < 0.05) and there was no statistically significant difference found between the results from FibroScan and FibroTouch.The values of liver stiffness were significantly different between the CHB patients and the compensated cirrhosis patients (P < 0.05). The rates of successful detection were 100% for FibroTouch and 97% for FibroScan.

CONCLUSIONFibroTouch and FibroScan have good consistency in the evaluation of the degree of liver fibrosis. FibroTouch has a higher rate of successful detection than FibroScan.

Objective To analyze the expressions of cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) in the peripheral blood of patients with active tuberculosis (ATB ) or latent tuberculosis infection (LTBI) ,and to evaluate its diagnostic value in differentiation of ATB and LTBI .Methods Forty-eight patients including 18 ATB cases and 30 LTBI cases were continuously enrolled from Wuxi No . 5 People′s Hospital and Huashan Hospital affiliated to Fudan University from January 2011 to March 2013 .Flow cytometry was applied to detect the CTLA-4 expression in CD4+CD25+ FoxP3+ T cells in the peripheral blood of the 48 subjects .CTLA-4 levels were compared using non-parametric Mann-Whitney U test .Results The median percentage of CTLA-4+ Treg in CD4+ CD25+ Foxp3+ Treg cells of ATB patients was 18 .95％ (quantile range :13 .86％ ,27 .73％ ) ,and that in LTBI patients was 6 .67％(quantile range :5 .74％ ,9 .59％ ) ,which was statistically significant (U=18 .0 , P< 0 .01) .Receiver operating curve (ROC) based on the CTLA-4 expression indicated that the area under the curve was 0 .96 , with the optimum cut-off value of 13 .25％ .Thus ,the sensitivity and specificity for the diagnosis of ATB were 86 .7％ and 94 .4％ ,respectively .Conclusion CTLA-4 has highly sensitivity and specificity for the differential diagnosis of ATB and LTBI whose interferon-gamma releasing assays are all positive ,which may also provide meaningful clue for the study of pathogenesis of ATB .

Objective:To investigate the diagnostic values of interleukin-22 (IL-22), interferon-γ(IFN-γ)and macrophage migration inhibition factor (MIF) in pleural effusion for tuberculosis pleurisy.Methods:From April 2018 to May 2019, a total of 77 patients including 45 cases of tuberculous pleurisy, 19 cases of malignant pleurisy, 13 cases of parapneumonia and 13 cases of healthy control in Wuxi Fifth People′s Hospital were enrolled. The levels of IL-22, IFN-γ and MIF in plasma and pleural effusion were detected by enzyme linked immunosorbent assay (ELISA). Mann-Whitney U test was used for statistical analysis.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic values of IL-22, IFN-γ and MIF for tuberculous pleurisy. Results:The median levels of IL-22, IFN-γ, MIF and adenosine deaminase in 45 cases with pleural effusion in tuberculosis pleurisy group were 396.8 ng/L, 2 200.0 ng/L, 241.3 μg/L and 70.8 U/L, respectively, which were all significantly higher than 32 cases with non-tuberculosis pleurisy group, including 19 cases with malignant pleurisy and 13 cases with parapneumonia (52.8 ng/L, 232.3 ng/L, 179.6 μg/L and 17.0 U/L, respectively). The differences were all statistically significant ( U=179.000, 118.500, 287.000, 162.000, respectively, all P<0.05). The median levels of IL-22 and IFN-γ in plasma of tuberculosis pleurisy group were 20.0 ng/L and 45.9 ng/L, respectively, which were both higher than healthy control group (14.3 ng/L and 33.4 ng/L, respectively). The level of MIF was 96.2 μg/L, which was lower than healthy control (159.5 μg/L). The differences were all statistically significant ( U=74.000, 13.000 and 73.000, respectively, all P<0.05). The areas under ROC curve (AUC) of IL-22, IFN-γ and MIF in pleural effusion for the diagnosis of tuberculosis pleurisy were 0.876, 0.917 and 0.682, respectively.The sensitivities were 93.75%, 100.00% and 63.64%, respectively; the specificities were 82.22%, 91.11% and 65.85%, respectively. The median levels of IL-22 and IFN-γ in plasma in tuberculosis pleurisy group at two months of follow-up after anti-tuberculosis therapy were 16.0 ng/L and 33.9 ng/L, respectively, which were both lower than baseline (20.0 ng/L and 44.7 ng/L, respectively). The differences were both statistically significant ( U=2.156 and 2.221, respectively, both P<0.05). Conclusion:IFN-γ and IL-22 in pleural effusion could be used as effective indicators to identify tuberculous pleurisy, and the dynamic monitoring of IL-22 in patients′plasma could be an important biomarker in evaluating the efficacy of anti-tuberculosis treatment.

The incidence of gastrointestinal dysfunction is high in critically ill patients with enteral nutrition. This article describes the concepts related to gastrointestinal dysfunction, risk factors, monitoring methods and enteral nutrition strategies based on the monitoring of gastrointestinal dysfunction, with a view to providing reference for improving the quality of enteral nutrition in critically ill patients.

Objective: To study the preventive effect of Timosaponin BⅡ (T-BⅡ) -loaded temperature/ion-sensitive nasal in situ hydrogels (ISGs) on Alzheimer's disease (AD), its preparation technology, characteristics and in vivo effects were evaluated.Methods: The morphological and rheological properties were evaluated. The preventive effects of T-BⅡ ISG on scopolamine-induced AD in mice were determined with the index of muscarinicreceptor 1 (M1) expression and pathological changes. Results: Results revealed that T-BⅡ ISG significantly increased the content of M1 choline receptors in the hippocampus of mice and ameliorated the damage incurred to the hippocampal cornu ammonis 1 (CA1) area. Conclusion: T-BⅡ ISGs is a reasonable and convenient method of exerting an obvious preventive effect on mice with AD induced by scopolamine. This, thereby, lays forth a new treatment option for preventing AD.

Objective:To investigate the diversity and structural characteristics of fungal communities on lesions of the face, upper limbs and back in patients with atopic dermatitis (AD) .Methods:Samples were collected from the lesions on the face, upper limbs and back of 10 AD patients, who visited the Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College from September to October in 2015, and collected from the corresponding body sites of 10 healthy controls. DNA was extracted from the samples, and subjected to MiSeq high-throughput sequencing for diversity index analysis, species composition analysis and principal component analysis. Statistical analysis was carried out by using two-independent-sample t test for comparisons between two groups, one-way analysis of variance for comparisons among multiple groups, and least significant difference- t test for multiple comparisons. Results:Diversity index analysis showed that Shannon index was significantly higher in the samples from the lesions on the face, upper limbs and back of the AD patient group than in those from corresponding body sites of the healthy control group ( t = 2.67, 2.37, 3.34 respectively, all P < 0.05) . Species composition analysis showed that Malassezia was predominant in the skin samples from the face, upper limbs and back of the AD patient group and healthy control group, and the total abundance of Malassezia globosa and Malassezia restricta was about 80%. The abundance of Candida and Aspergillus in the total samples was significantly higher in the AD patient group than in the healthy control group ( t = 3.515, 2.137 respectively, both P < 0.05) . There was no significant difference in the abundance of major fungal genera on the face between the AD patient group and healthy control group (all P > 0.05) ; the abundance of Candida in the upper limbs was significantly higher in the AD patient group than in the healthy control group ( t = 3.186, P < 0.05) , and the abundance of Aspergillus in the back was significantly higher in the AD patient group than in the healthy control group ( t = 2.736, P < 0.05) . In either the AD patient group or the healthy control group, there was no significant difference in the abundance of major fungal genera among samples from the face, upper limbs and back (all P > 0.05) . Moreover, no significant difference in the abundance of major fungal genera was observed among the mild, moderate and severe AD patient groups (all P > 0.05) . Principal component analysis showed that fungal communities in the samples from the lesions on the face, upper limbs and back of the AD patient group were not clustered by the disease severity. Conclusions:The diversity of fungal communities is significantly higher in the lesions on the face, upper limbs and back of the AD patients than in the normal skin at the corresponding body sites of the healthy controls. Malassezia is the dominant fungal genus in both lesions of the AD patients and normal skin of the healthy controls at the above body sites. The composition of fungal communities in lesional samples may be uncorrelated with the disease severity in AD patients.