Objective To explore the clinical and laboratory feature of disseminated Penicillium marneffei(PSM) infection in patients with AIDS and to analysis treatment and prognosis. Methods Study clinical data of eight case with PSM infection in patients with AIDS in our hospital from 1999 were definite diagnosed PSM infection in patients with AIDS. Results (1)Eight patients including five females, at a mean age of 26～53, suffered from the diseases for a period of 1～4 months;(2)The most common clinical presentations include fever, stomatomycosis, lymphadenectasis papular skin lesion, anemia, abdominal pain, hepatomegaly, Plenomegaly, Herpes progenitalis, Subcutaneous nodule, Pleural effusion, bad bone ache. Laboratory examination showed elevated hepatic enzymes,coagulated dysfunction,hemocytopenia. Chest X-ray showed nonspecific include bilateval interstitial or alveolar. (3) Fungus cultured: yeast like cells were found in the culture at 37℃ or in tissues. The fungi outside the host cells were elongated, often curved, Sausage like and with clear cemral septate. When cultured at 25℃,the fungus was mycelia-like and produced a characteristic red Pigment, diffusing into the medium. (4) CD4 cell count was reduced significantly, HIV-RNA was high.(5)Mortality was high. Conclusions Definite diagnosis of disseminated Penicillium marneffei requires culture of the pathogenic fungus from clinical specimens. No specific clinical manifestation for Penicillum marneffei infection was found and Amphotericin B are effective in treating penicillosis marmeffei.

Objective To detect the level of Th1 and Th2 type cytokines of peripheral blood CD+3 T lymphocytes in patients with breast cancer, in order to find out the laboratory evidence of tumor immunotherapy. Methods The peripheral blood lymphocytes were stimulated by stimulator in order to enhance expression of cytokines. Specific fluorochrome-conjugated monoclonal antibody combined with antigen. Cytokines were detected by flow cytometry and ELISA. Results Both the cytokines secreted by CD+3 T lymphocytes and serum cytokines showed that the level of Th1 type cytokines such as interferon-?(IFN-?), interleukin-2(IL-2), interleukin-12(IL-12) were significantly lower in patients of breast cancer than those of normal controls. The level of Th2 type cytokines such as interleukin-4(IL-4), interleukin-10(IL-10) were higher in patients of breast cancer than those of normal controls. There was significant difference between them. The level of tumor necrosis factor ? (TNF-?)in patients were significant higher than normal control. Conclusion Th1/Th2 was imbalance in mammary cancer. Th1 type cytokines were inhibited, and Th2 type cytokines were relatively enhanced, so Th1/Th2 shift to Th2. It maybe the mechanism of tumor arising and transferring by immune escaped from immunosurveillance.

AIM: To investigate the effects of IL-13 on expression of IL-1? in acute renal ischemia/reperfusion injury. METHODS: Fifty-seven male Wistar rats were randomly divided into 8 group: normal group,sham operation group, ischemia group, ischemia/reperfusion injury group(I/R), normal saline(NS)-treated group 1(C-1), NS-treated group 2(C-2),IL-13-treated group1(T-1)and IL-13-treated group 2(T-2).Rats were subjected to 45 min bilateral renal ischemia followed by reperfusion. rmIL-13 (1.5 ?g/50 g body weight )was injected into the renal arteries through the abdominal aorta before ischemia(T-1) or immediately afterischemia(T-2).The serum level of IL-1? and the renal expression of IL-1? were determined in each group at 24 h post-ischemia. In addition, BUN,Cr and renal histology were also measured. RESULTS: (1)The serum level of IL-1? [C-1to T-1: (27.13?5.51) ng/L to (14.05?3.82) ng/L, P

Objective: To observe the efficacy of herbal cake-partitioned moxibustion for lumbar disc herniation (LDH) due to kidney deficiency and blood stasis and observe the influence of this method on lumbar functions and inflammatory factors in patients with this condition. Methods: A total of 120 LDH patients who met the inclusion criteria were randomly divided into three groups, including a herbal cake-partitioned moxibustion group, a flour cake-partitioned moxibustion group, and a Western medication group, with 40 patients in each group. The patients in the Western medication group were treated with diflunisal tablets, 0.5 g per dose, 2 doses a day. Those in the herbal cake-partitioned moxibustion group were treated with additional herbal cake-partitioned moxibustion group at Back-Shu Points and Jiaji (EX-B2) Points once a day. Those in the flour cake-partitioned moxibustion group were treated with the same methods as in the herbal cake-partitioned moxibustion group, except that the herbal cake was replaced by a flour cake. All the patients were treated for 10 d. After treatment, the scores of the visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) and the changes of the interleukin (IL)-6, tumor necrosis factor (TNF)-α, and substance P (SP) levels were observed, and the efficacy was evaluated. Results: After treatment, the VAS score and the levels of IL-6, TNF-α, and SP were lower than those before treatment, and the JOA score was higher than that before treatment in the three groups, indicating intra-group statistical significance (P<0.05). The VAS score and the levels of IL-6, TNF-α, and SP of the herbal cake-partitioned moxibustion group were lower than those of the flour cake-partitioned moxibustion group and the Western medication group, while the JOA score of the herbal cake-partitioned moxibustion group was higher than that of the other two groups, indicating inter-group statistical significance (P<0.05). The total effective rate of the herbal cake-partitioned moxibustion group was 92.5％, higher than that of the flour cake-partitioned moxibustion group (80.0％) and the Western medication group (72.5％), indicating inter-group statistical significance (P<0.05). Conclusion: On the basis of Western oral medication, additional herbal cake-partitioned moxibustion can alleviate the pain and improve the lumbar functions in patients with LDH due to kidney deficiency and blood stasis. The efficacy of the integrated method is better than that of either flour cake-partitioned moxibustion or Western medication alone, which may be related to the reduction of serum inflammatory factors.

Objective To build the early predictive model for chronic kidney disease(CKD)in hypertension and diabetes patients in the community.Methods The CKD patients were recruited from 4 health care centers in 4 urban areas in Kunming.The control group was residents without hypertension and diabetes(n = 1267).The disease group was residents with hypertension and/or diabetes(n = 566).The questionnaire survey,physical examination,laboratory testing,and 5 SNPs gene types in the PVT1 gene.The risk factors,which were filtered with logistics regression,were used to build predictive models.Four machine learning algorithms were built:support vector machine(SVM),random forest(RF),Na?ve Bayes(NB),and artificial neural network(ANN)models.Results Thirteen indicators included in the final diagnostic model:age,disease type,ethnicity,blood urea nitrogen,creatinine,eGFR from MDRD,ACR,eGFR from EPI2009,PAM13 score,sleep quality survey,staying-up late,PVT1 SNP rs11993333 and rs2720659.The accuracy,specificity,Kappa value,AUC of ROC,and PRC of ANN are greater than those of the other 3 models.The sensitivity of RF is the highest among 4 types of machine learning.Conclusions The ANN predictive model has a good ability of efficiency and classification to predict CKD with hypertension and/or diabetes patients in the community.

Objective To investigate the clinical effect of Jiaotai Shugan decoction in adjuvant treatment of type 2 diabetes mellitus(T2DM)complicated with depression with liver qi stagnation type.Methods From June 2022 to June 2023,90 patients with T2DM complicated with depression with liver qi stagnation type treated in the Second People's Hospital of Lishui City were selected,who were randomly divided into control group and observation group,with 45 cases in each group.Both groups were treated with basic treatment of diabetes,control group was given escitalopram to improve the emotion,while observation group was further given Jiaotai Shugan decoction.After 8 weeks,the clinical effective rate were evaluated by Hamilton depression scale-24(HAMD-24)and patient health questionnaire-9(PHQ-9)scores,the levels of 5-hydroxytrytamine(5-HT),noradrenaline(NE),brain-derived neurotrophic factor(BDNF),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG)and haemoglobinA1c(HbA1c)were detected,and adverse reactions were recorded.Results The clinical total effective rates of observation group was higher than that of control group,and the difference was statistically significant(P＜0.05).8 weeks after treatment,HAMD-24 and PHQ-9 scores of observation group were lower than those of control group(P＜0.01).The levels of 5-HT,NE and BDNF of observation group were higher than those of control group(P＜0.01).The levels of FPG,2hPG and HbA1c in observation group were lower than those in control group(P＜0.01);There was no significant difference in adverse reactions between two groups(P＞0.05).Conclusion Modified Jiaotai Shugan decoction is effective in treating T2DM complicated with depression with liver qi stagnation type,can reduce HAMD-24 and PHQ-9 scores,increase the levels of 5-HT,NE,BDNF,and reduce the levels of FPG,2hPG,HbA1c.There was no obvious adverse reactions.

Hyperkalemia is one of the common ion metabolism disorders in clinical practice. Hyperkalemia is defined as serum potassium higher than 5.0 mmol/L according to the guidelines at home and abroad. Acute severe hyperkalemia can cause serious consequences, such as flaccid paralysis, fatal arrhythmia, and even cardiac arrest. The use of renin-angiotensin- aldosterone system inhibitors, β-blockers and diuretics, low-sodium and high-potassium diets, and the presence of related comorbidities increase the occurrence of hyperkalemia. Hyperkalemia risk exist in all clinical departments, but there is a lack of a standardization in the management of multi- department cooperation in hospital. Therefore, a number of domestic nephrology and cardiology department experts have discussed a management model for multi-department cooperation in hyperkalemia, formulating the management standard on hospital evaluation, early warning, diagnosis and treatment, and process. This can promote each department to more effectively participate in nosocomial hyperkalemia diagnosis and treatment, as well as the long-term management of chronic hyperkalemia, improving the quality of hyperkalemia management in hospital.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

BACKGROUND: Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population. METHODS: From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models. RESULTS: (1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity. CONCLUSIONS Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.
Humans ; COVID-19 ; Retrospective Studies ; Lung Neoplasms/drug therapy* ; Incidence ; Pneumonia/etiology*