Objective To determine in vitro susceptibility of itroconazole,voriconazole,caspofungi,and amphotericin B against 82 clinical strains of filamentous fungi.Methods Etest method was used to test the in vitro susceptibilities of itroconazole,voriconazole,caspofungi,and amphoteriin B against aspergillus fumigatus,A.flavus,A.niger,A.terreus,A.nidulans,et al.Results The MIC range of 4 antifungal agents were 0.03~2.00 mg/L and 0.01~32.00 mg/L against A.fumigatus and A.flavus,respectively.But amphotericin B had higher MIC90 value which was 16mg/L against A.flavus than A.terreus(MIC90 3.00 mg/L),A.fumigatus(MIC90 0.75 mg/L),and A.niger(MIC90 0.25 mg/L).Conclusion Itroconazole,voriconazole,caspofungi,and amphotericin B have different susceptibility patterns against various types of filamentous fungi.It's necessary to identify fungi to level of species and perform antifungal susceptibility test in serious patients.

Objective To investigate the cognition of the monitoring and management of blood glucose critical values among clinical nurses. Method Totally 112 clinical nurses from 28 departments of the hospital were involved in the investigation with a self-designed questionnaire. Results The average score on monitoring and management of blood glucose critical values was (79.69 ± 14.12). 53 nurses (47.32%) were at a medium or lower level. There were significant differences in the scores among the nurses of different age, work experience, education level and professional title (P<0.05). Conclusions The clinical nurses have inadequate knowledge about the monitoring and management of blood glucose critical values. The hospital administration should carry out various training methods for nurses to improve their ability in nursing diabetic patients.

OBJECTIVE:To investigate clinical efficacy of cerebroventricular perfusion and intrathecal perfusion of vancomy-cin assisting with continuous drainage in the treatment of intracranial infection secondary to traumatic brain injury,and its effects on cerebrospinal fluid indexes and intracranial pressure. METHODS:One hundred and eighty patients with intracranial infection secondary to traumatic brain injury selected from Sanya Hospital of TCM during Jan. 2012 to Jun. 2015 were randomly divided into control group and observation group according to lottery,with 90 cases in each group. They were given cerebroventricular perfu-sion and intrathecal perfusion of vancomycin(20 mg dissolved in 5 mL normal saline)in cella lateralis and lumbar cisterna respec-tively combined with continuous drainage,q12 h. Both groups received treatment for 7 d.Clinical efficacy,the time of infection con-trol were compared between 2 groups as well as body temperature,intracranial pressure and cerebrospinal fluid indexes before and after treatment,and the occurrence of ADR. RESULTS:After treatment,total response rate of observation group (95.56%) was significantly higher than that of control group (77.78%),with statistical significance (P<0.05). The time of infection control in observation group [(9.67 ± 1.10)d] was significantly shorter than in control group [(11.84 ± 1.29)d],with statistical significance (P<0.05). Body temperature,intracranial pressure,cerebrospinal fluid protein and leukocyte of 2 groups were significantly lower than before treatment;cerebrospinal fluid glucose level was increased significantly compared to before treatment;above indexes of observation group were significantly better than those of control group,with statistical significance(P<0.05).There was no statisti-cal significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:The intrathecal perfusion of vancomycin as-sisting with continuous drainage in the treatment of intracranial infection secondary to traumatic brain injury can effectively speed up the rehabilitation process,reduce the body temperature and intracranial pressure,and is helpful to improve the relevant cerebro-spinal fluid indexes. Therapeutic efficacy of it is better than that of cerebroventricular perfusion.

Objective To explore the incidence and factors of paranasal sinusitis among nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods Retrospectively evaluated the clinical data of 144 NPC patients without paranasal sinusitis before radiotherapy, including 82 cases in T1/T2 stage and 62 cases in T3/T4 stage treated in the First Affiliated Hospital of Bengbu Medical College from 2000 to 2005. MRI images before and after radiotherapy were compared. The incidence and factors of paranasal sinusitis were analyzed. There were 58 cases of nasal invasion. Nasopharyngeal carcinoma was given at face-neck joint portal with 6 MV X-ray fractionated irradiation 68-78 Gy during 6-8 weeks. The number of patients who received radiotherapy with less than or equal to 70 Gy, more than 70 Gy radiation doses were 89 and 55, respectively. Cervical part were treated with high-energy electron beam, patients with positive neck lymph nodes and with negative neck lymph nodes received 64-74 Gy doses during 6-8 weeks and 50-54 Gy during 4-5 weeks, respectively. Results Among the 144 NPC patients 86.8%(125/144) developed paranasal sinusitis after radiotherapy, the incidence rates of paranasal sinusitis (IRPS) was higher among stage T3 + T4 patients than that among stage T1 + T2 patients (94% vs 82% ,x2=4.32, P ＜0.05). Among patients who were given radiotherapy with more than 70 Gy,less than or equal to 70 Gy radiation doses on the nasopharynx, the IRPS were 95% and 82.0% (x2 = 4.65, P ＜ 0.05 ). The IRPS in patients with nasal cavity infringement was higher than that in others (95% vs. 81% , x2 = 5.46,P ＜0.05). The IRPS at 3, 6, 12 months, and more than 1 year after radiotherapy were 13.6% ,31.2% ,48.8% and 6.4%, respectively (x2 = 70.48, P ＜ 0.001 ). Conclusions The incidence of paranasal sinusitis in NPC patients after radiotherapy was very high, and reached a peak in one year. It was influeneed by invasion of nasal cavity or not, the dose of radiotherapy and T stage.

Objective To investigate the efficacy of standardized protocol,including prenatal diagnosis,perinatal management and treatment,on babies with meconium peritonitis.Methods A standardized protocol with prenatal diagnosis,perinatal management,treatment and follow-up on congenital anomaly was founded by Capital Institute of Pediatrics and several other obstetric hospitals.Thirty neonates diagnosed as meconium peritonitis prenatally from March 15,2006 to August 27,2012 were intervened according to this protoccl.The data of diagnosis,treatment after birth and prognosis were analyzed.Results (1) Prenatal diagnosis:Abnormal meconium peritonitis relative signs were found by ultrasound in all of these 30 cases.Among them,23 cases presented with intestine dilation,15 with polyhydromnios,nine with ascites,four with abdominal cystic mass and four calcification.(2)Diagnosis after birth (n=27):The most common imaging findings in abdominal X-ray were distention (27 cases),dilated intestine with air-fluid levels (22 cases) and calcification (11 cases).The most common imaging findings in ultrasound were obvious intestinal dilation (19 cases),cystic mass (7 cases) and calcification (7 cases).(3) Operation:Except for three cases without symptoms,the other 27 infants received operation at averagely 42 hours after birth (12 h-5 d).Besides the basic treatment as removal of the fuci and dissection of adhesion,peritoneal drainage was performed in one infant,two-stoma enterostomy in seven infants,inverted T-shape enterostomy in eight infants and primary intestinal anastomosis in 11 infants.Among these 27 cases,24 cases were cured,2 cases refused following treatment after surgery and one case was lost to follow up.Conclusions Standardized protocol with prenatal diagnosis,perinatal management and earlier intervention might improve the prognosis of meconium peritonitis.

Objective To evaluate the effects of CHOICE management mode on adherence of adolescents with type 1 diabetes mellitus (T1DM). Methods A total of 49 adolescents with T1DM were elected using convenience sampling method, and divided into the experimental group (26 cases) and the control group (23 cases) by random number table. The experimental group received the CHOICE management for 1 year, while the control group received traditional education management. The patients′self-management behaviors and HbA1c were evaluated before the intervention and 1, 3, 6 and 12 months after the intervention. Results The scores of Control Problems, Attitude Toward Diabetes and Understanding Management Knowledge after 12-months intervention were (2.71 ± 0.43), (3.89 ± 0.60), (3.05 ± 0.71)points in the experimental group, (2.49 ± 0.33),(4.20 ± 0.40),(3.51 ± 0.70)points in the control group, there were significant differences (t=-2.101, 2.129, 2.289, P<0.05). The scores of Diet Adherence after 1 month and 3 months intervention were (2.85 ± 0.0.67), (2.79 ± 0.66)points in the experimental group, (2.39 ± 0.70), (2.38 ± 0.67)points in the control group, there were significant differences (t=2.170, 2.338, P<0.05). HbA1c was(8.29 ± 0.76)％ in the experimental group, (8.85 ± 1.14)％ in the control group, there was significant difference (t=-2.041, P<0.05). There were no significant differences at the others times between two groups (t=- 1.556-- 0.527, P>0.05). Conclusions CHOICE management mode can effectively improve the self-management behavior of adolescents with T1DM.

Objective:To compare the clinical efficacy of camrelizumab and sintilimab in the treatment of advanced non-small cell lung cancer (NSCLC) , and to explore its impact on tumor marker levels and immune function index, as well as to perform safety analysis.Methods:A total of 87 patients with advanced NSCLC who were treated in Hai'an People's Hospital of Jiangsu Province from May 2019 to May 2021 were selected as the research objects. According to the treatment scheme, the patients were divided into camrelizumab group ( n=41) and sintilimab group ( n=46) . The clinical efficacy, prognosis, tumor marker levels, immune function index and immune related adverse reactions of the two groups were compared. Results:There were no statistically significant differences in objective response rate [48.78% (20/41) vs. 39.13% (18/46) , χ2=0.82, P=0.365] or disease control rate [78.05% (32/41) vs. 71.74% (33/46) , χ2=0.46, P=0.499] in both camrelizumab and sintilimab group. The median progression-free survival (PFS) in the camrelizumab group was 9.1 months, and the median overall survival (OS) was 15.4 months. The median PFS in the sintilimab group was 9.7 months, and the median OS was 15.7 months. There were no statistically significant differences in median PFS and median OS between the two groups ( χ2=0.18, P=0.633; χ2=0.15, P=0.697) . Before treatment, there were no statistically significant differences in carcinoembryonic antigen (CEA) [ (47.68±8.12) ng/ml vs. (49.03±8.70) ng/ml, t=0.75, P=0.458], cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) [ (18.06±3.41) ng/ml vs. (17.25±3.78) ng/ml, t=1.05, P=0.299], and carbohydrate antigen 125 (CA125) [ (72.26±21.06) U/ml vs. (74.03±22.10) U/ml, t=0.38, P=0.704] levels between the camrelizumab group and sintilimab group. After treatment, there were no statistically significant differences in CEA [ (28.11±7.68) ng/ml vs. (27.63±5.71) ng/ml, t=0.33, P=0.740], CYFRA21-1 [ (9.29±1.88) ng/ml vs. (9.06±1.80) ng/ml, t=0.15, P=0.814], and CA125 [ (61.39±21.22) U/ml vs. (60.51±11.03) U/ml, t=0.25, P=0.806] levels between the two groups, but CEA, CYFRA21-1, and CA125 levels decreased after treatment compared with those before treatment in both groups (all P<0.05) . Before treatment, there were no statistically significant differences in T cells CD4 + [ (41.15±3.24) % vs. (41.17±2.90) %, t=0.03, P=0.976], CD8 + [ (68.82±3.94) % vs. (70.06±4.08) %, t=1.44, P=0.154], and CD4 +/CD8 + (1.88±0.33 vs. 1.76±0.25, t=1.92, P=0.058) between the two groups. After treatment, there were no statistically significant differences in T cells CD4 + [ (47.08±3.22) % vs. (48.53±5.07) %, t=1.57, P=0.120], CD8 + [ (61.22±1.67) % vs. (61.45±1.66) %, t=0.64, P=0.522], and CD4 +/CD8 + (2.31±0.17 vs. 2.36±0.12, t=1.60, P=0.114) between the two groups, while T cells CD8 + was lower than that before treatment, and CD4 + as well as CD4 +/CD8 + were higher than those before treatment in both groups (all P<0.05) . The overall incidence of adverse reactions in the sintilimab group [10.87% (5/46) ] was lower than that in the camrelizumab group [31.71% (13/41) ], and with a statistically significance ( χ2=5.74, P=0.016) . Conclusion:The clinical efficacy of camrelizumab and sintilimab in NSCLC patients is basically the same, the impacts of which on tumor markers and immune function are comparable, but the safety of sintilimab is better than that of camrelizumab.

Objective To explore the efficacy of moderate dose bromocriptine by one-off oral administration in treatment of patients with non-acute prolactin (PRL) type pituitary adenoma.Methods Forty-three patients with definite diagnosis of non-acute prolactin type pituitary adenoma,admitted to our hospital from January 2016 to December 2017,were chosen in our study.All patients were administrated with 5 mg bromocriptine at 18 pm;the serum PRL levels were examined at 2,3 and 12 h after bromocriptine administration.The curative effects of these patients were judged by decline rate of PRL,and the curative effects of patients with different genders,different initial PRL levels and different ages were compared.Results In these 43 patients,bromocriptine showed excellent effect in 20 patients,obvious effect in 18 and invalid effect in 5.There were statistically significant differences in the efficacy of bromocriptine between different genders (P＜0.05).There were statistically significant differences in efficacy of patients with different genders after taking bromocriptine (P＜0.05).The female patients had obviously higher rate of obvious effect than the male patients.Patients with different initial PRL values had statistically significant differences in efficacy after taking bromocriptine (P＜0.05).Patients with PRL initial value of 40-200 ng/mL had significantly higher rate of obvious effect than patients with PRL initial value of ＞200 ng/mL.There was no significant difference in efficacy between patients ＜ 45 years old and patients＞45 years old (P＞0.05).Conclusion The treatment ofhyperprolactin caused by prolactin type pituitary adenoma with moderate dose bromocriptine by one-off oral administration is effective;female patients have obviously better effect than male patients;and for patients with initial prolactin＞200 ng/mL,the effect is better.

AIM:To investigate the effects of astragalin(AST)on activation status of astrocytes and the ex-pression level of autophagy-related proteins in the cortex of the anterior cingulate cortex of mice with a complete Freund's adjuvant(CFA)-induced inflammatory pain model.METHODS:Twenty-four 6-month-old male C57BL/6 mice were ran-domly divided into four groups:control group,saline group,CFA model group and CFA+60 mg/kg AST administration group,and six mice in each group.Mice in the AST administration group received 60 mg/kg AST by intraperitoneal injec-tion on a body weight basis for 21 d.The paw withdrawal threshold in each group of mice was evaluated by the von Frey test.The expression levels of autophagy-related factors LC3,p62,ATG12 and beclin-1,and astrocyte activation were de-tected by multiplex immunofluorescence staining in the anterior cingulate cortex of mice in each group.Western blot was used to measure the levels of autophagy-related proteins LC3,p62,ATG12 and beclin-1 in the anterior cingulate cortex of mice in each group.RESULTS:Behavioural tests showed that AST significantly increased mechanical pain thresholds in CFA mice(P＜0.05).The results from multiple immunofluorescent staining showed that AST significantly increased the fluorescence intensity of LC3(P＜0.01),ATG12(P＜0.01)and beclin-1(P＜0.05),attenuated the fluorescence intensi-ty of p62(P＜0.05),and inhibited the activation of astrocytes in the anterior cingulate cortex of CFA mice.Western blot results further confirmed that AST significantly increased the expressions of LC3(P＜0.01),ATG12(P＜0.01),beclin-1(P＜0.01),and decreased the expression of p62(P＜0.05)in the anterior cingulate cortex of CFA mice.CONCLU-SION:AST relieves CFA-induced inflammatory pain of mice,and its analgesic mechanism may be related to the inhibi-tion of activation of cortical astrocytes in the anterior cingulate cortex and the promotion of autophagy in CFA mice.

OBJECTIVE： To rapidly identify chemical components of Zhitong huazheng capsules （shorted for “ZTHZC”）， and to provide reference for further elucidating the pharmacodynamic material basis and overall quality control. METHODS： UPLC-Q-TOF/MS method was adopted to separate the chemical components of ZTHZC. By reviewing literatures that related to chemical components of ZTHZC and its single Chinese traditional medicinal crops， the chemical structure of the chemical components was saved into a .mol format file， and supplemented the UNIFI database. The chemical constituents of ZTHZC were qualitatively analyzed by UNIFI database screening， and validated according to their precise molecular mass， characteristic ions， neutral loss， secondary mass spectrometry cleavage， chromatographic retention behavior， combined reference information and literature reports. RESULTS： A total of 70 chemical components were identified in this experiment， including 38 organic acids and organic acid esters， 8 alkaloids， 9 flavonoids， 5 triterpenoid saponins， 5 aldehydes， 2 ketones， 1 quinone， 1 polyacetylene and 1 monoterpenoid. CONCLUSIONS： This study provides a rapid detection and identification method for chemical components of ZTHZC， and also provides a scientific basis for the clarification of ZTHZC’s quality control and pharmacodynamics.