The incidence of invasive fungal infection in critically ill patients is increasing year by year. Its clinical manifestation lacks specificity which is difficult for early diagnosis. It′s hard to identify inva-sive fungal infection with fungal colonization in clinical practice. We need to find out the way to distinguish them.

Objective To investigate the current work situation of senior clinical nurses to provide some advices for the nursing management .Methods The self-made questionnaires were adopted to investigate the work situation of 60 senior nurses for conduc-ting the descriptive analysis .Results The senior nurses′ satisfaction degrees to the professional self -identity ,the chief nurse′s scheduling ,the current work environment ,the approval by hospital and the emphasis degree by the department were not high .They thought that the suitable position for them was the office nurse and the second was the responsibility group leader .Whereas ,the un-dertaking key post at present was the responsibility group leader and the second was the office nurse .Conclusion Due to the partic-ularity of nursing work and the physiological and psychological change ,the senior nurses are unsuitable to the busy front -line work ;the senior clinical nurses have the rich clinical experience ,the stronger communicational and organizational coordination abili-ty ,and are more suitable for the posts of the office nurse and health education nurse ,and second is the post of responsibility group leader .

OBJECTIVE Making knowledge of the marine medication animal species distribution and the resource situation in Zhoushan sea area. METHODS According the experiment explored, the marine animal specimen collected, checked, corrected. RESULTS There were about 103 species marine animal for medicating, included 4 species of Coelenterata, 3 species of Annelida, 14 species of Arthropoda, 21 species of Mollusca, 55 species of Vertebrata, 6 species of Echinodermate . CONCLUSIONS The reliable base of protecting ecological environment of marine organisms and exploiting resources of marine medicinal animals rationally were founded.

Objective To investigate changes in cerebral white matter after transplantation of neural stem like cells (MS-NSCs) derived from the bone marrow mesenchymal stem cells, in rats with severe acute carbon monoxide poisoning. Method Forty Sprague-Dawley rats weighing 200 ～ 250 g were divided randomly into 4 groups: the normal control group, the poisoned control group, the BMSCs transplanted group and the MS-NSCs transplanted group (each group 6 rats). BMSCs were harvested from whole bone marrow in vitro, and then differentiated into MS-NSCs under the cock tail of certain growth factors, followed by BrdU labelling. The seed cells were infused into the brain via the left internal carotid artery 24 hours post poisoning. Remodelling of cerebral white matter was assessed using H & E staining, myelin staining and immunohistochemitry assay after 5 weeks later. Results Cellular transplantation improved the compactness and orderliness of cerebral white matter. BrdU-positive cells were found in the focal insulted areas of sparse white matter; and greater numbers of Brdu-Positive ceus were observed in the MS-NSCs group thar in the BMSCs group (P ＜0.05). Conclusions MS-NSCs participates in the remodeling of cerebral white matter in rats with severe acute carbon monoxide poisoning, and shows promising evidence as seed cells transplanted for brain tissue regeneration.

Objective To investigate cerebral functional remodeling of the rat with severe acute carbon monoxide poisoning transplanted with neural stem-like cells derived from bone marrow mesenchymal stem cells (MS-NSCs) . Method Forty Sprague-Dawley rats weighing 200 ～ 250 g were divided randomly into 4 groups: the normal control group, the poisoning control group, the bone marrow mesenchymal stem cells(BMSCs) transplantation group and the MS-NSCs transplantation group. BMSCs were harvested from whole bone marrow in vitro, then were differentiated into MS-NSCs under certain growth factors cocktail,and were followed by BrdU labelling.Twenty-four hours after poisoning, the seed cells were infused into brain via left internal carotid and the functional remodeling of cerebrum was assessed by neurological severity score(NSS) and Morris water maze(MWM) tests. Results There was no significant differences in NSS test between groups after transplantation. However, the differences in MWM test were very significant between 5 weeks after transplantation ( P < 0.01). Conclusions Transplantation of MS-NSCs may improved cerebral function of rats after severe acute CO poisoning. Moreover, the cultured and idfferentiated MS-NSCs induced in vitro preliminarily is potentially more efficient than directly transplanted BMSCs without culture and differentiation.

Objective To investigate the effection of Shenfu Injection (Ginseng-radix aconitum Injection)to the blood coagulation system and its prognosis in the patient of multiple trauma complicated with shock.Methods We prospectively studied 90 patients of multiple trauma complicated with shock,who came from the emergency center of the Second Affiliated Hospital of Medicine' s college of Zhe-Jiang University and emergency department of Lishui People' s Hospital from February 2007 to December 2011,and excluded those suffered with the dysfunction of coagulation system and uncontrolled ongoing bleeding before trauma.And then these eligible patients were randomly divided into two groups:treatment group ( 45 cases ) and control group (45 cases),the control group were received the routine treatment,the treatment group were received Shenfu Injection in early stage based on the routine treatment.The two groups were measured the platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (FIB) before treatment and 3,7 days after treatment.Results The differences of the PLT,PT,APTT,TT,FIB between the treatment group and control group at 3,7 d after the treatment was statistically significant (P ＜ 0.05 ). Conclusions Shenfu Injection has positive regulation to the coagulation system in the patient of multiple trauma complicated with shock.

Objective To study the echocardiographic characteristics and its diagnosis value on congenital supravalvular aortic stenosis (SVAS) in children. Methods Thirty-one patients with SVAS diagnosed by multiplane echocardiography were enrolled in the study. Their echocardiographic characteristics were compared with cardiac catheterization, operation, and gene detection results. Echocardiographic changes were mainly observed in aortic valve, supravalve, descending aortic arch, pulmonary artery valve, main pulmonary artery and its branches,and coronary artery. Results Of the 31 patients,26 had hourglass type SVAS,4 hypoplastic type,and 1 membranous type; 2 patients had extremely mild stenosis (defined as a Doppler gradient <25 mm Hg) ,20 mild (25～49 mm Hg) ,5 moderate (50～75 mm Hg) ,and 4 severe C>75 mm Hg) ones. Nineteen patients were diagnosed with Williams syndrome by gene detection. Three patients were associated with aortic valve stenosis including one missed at the initial diagnosis; 10(32.26%) patients with pulmonary stenosis, including pulmonary valve stenosis in 6, left and right pulmonary artery stenosis in 3 ,and branch stenosis in 1:6 patients with coronary stenosis. Conclusions The sternal border and five chamber apical views are the best to detect SVAS. Williams syndrome patients are prone to SVAS.Pulmonary stenosis echocardiography forms a great proportion of the SVAS patients. Routine examination is necessary for coronary stenosis in cases of SVAS.

Objective To develop a HPLC-DAD method for the simultaneous determination of 20 synthetic pigments in dyed Traditional Chinese Medicine. Methods The samples were extracted with ultrasonic by 70% methanol, separated on a Agilent TC-C18 column ( 4. 6 mmí250 mm, 5 μm ) by gradient elution using a mobile phase made up of methanol and 0. 02 mol·L-1 ammonium acetate, and detected at 210-650 nm. The retention times and ultraviolet absorption spectrums were used to text and verify. Results The twenty red and orange synthetic pigments were separated and detected. OrangeIIsodium salt and 808 scarlet were detected in some batch of Croci stigma and Cinnabaris. Conclusion The method is simple, rapid, accurate, repeatable for determining twenty synthetic pigments in dyed Traditional Chinese Medicine.

OBJECTIVE:To optimize the extraction technology of Paeonia lactiflora. METHODS:The surface figure made by mixed uniform design combined with the quadratic polynomial stepwise regression equation is adopted to optimize the extraction technology of P. lactiflora by using the content of paeoniflorin as index,with extraction solvent,the amount of extraction solvent, extraction time,extraction times as factors. RESULTS:The optimal extraction technology of P. lactiflora was as follows as 90%ethanol,12-folds extraction solvent,extracting for 150 min,extracting for 2 times. The measured value of 3 validation tests were 2.848 4%,2.795 7%,2.841 9%(RSD=0.82%,n=3),which was close to the predicted value 2.848 4%. CONCLUSIONS:The method is convenient and accurate,and can be used for the extraction of P. lactiflora.

Objective To explore risk factors for coronary artery aneurysms (CAA) in children with Kawasaki disease (KD),and reduce the rate of serious sequelae of cardiovascular diseases.Methods All the patients were diagnosed as KD in Children’s Hospital Affiliated to Medical College of Zhejiang University from January 2009 to January 2014.A total of 679 cases was included,and 42 with concurrent CAA,181 with concurrent coronary artery expansion (CAD),and 456 without coronary artery damage cases (non-coronary artery lesion,NCAL).Coronary artery damage was related to factors such as gender,age,fever,white blood cell count (WBC),hemoglobin (Hb),platelet count (PLT),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),alanine aminotransferase,serum potassium,plasma amino terminal brain natriuretic peptide precursor (NT-proBNP),and acrylic ball resistance.SPSS 18.0 software package was used for risk factor analysis.Qualitative data using chi-square test,was used to analyze the high risk factors of CAA group,and logistic multivariate regression analysis was also used.Results Chi-square test showed that male,with febrile days ＞ 14 d,NT-proBNP ≥ 1 000 ng/L,immunoglobulin resistance was more likely to have KD concurrent CAA (P ＜ 0.05).Multiple Logistic regression analysis showed that male [OR =4.092,95％ CI (1.514,11.060),P =0.004],febrile days ＞14 d [OR =12.436,95％ CI (4.599,33.631),P =0.000],NT-proBNP≥ 1 000 ng/L [OR =3.305,95％ CI (1.401,7.794),P =0.005],and immunoglobulin resistance [OR =3.842,95 ％ CI (1.562,9.453),P =0.000] were independent risk factors for KD concurrent CAA.Conclusions Male children,febrile days ＞ 14 d,NT-proBNP≥ 1 000 ng/L,and immunoglobulin resistance were independent risk factors of CAA.