Objective To discuss the clinical features of immunocompetent patients with Penicilliosis marneffei.Methods To analyze and summarize the clinical data of 4 immunocompetent patients with Penicilliosis marneffei.Results Clinical manifestation of patients centered on intermittent slight or mild fever,lymphadenectasis,skin eruptions,osteolytic destruction,anaemia,and leukocytosis.The cultural Penicillium marneffei in specimen such as blood,pus showed a higher positive rate.Amphotericin B and itraconazole was available in treatment.Conclusion Immunocompetent people can be infected by Penicillium marneffei,and they appear nonspecific in clinical manifestation after infection.A timely and effective antifungal therapy can improve the prognosis of patients.

An analysis method for requirement of medical consumptive materials on Kalman filter is put forward.An analysis mathematical model is established at first,its solution process is carried out at same time,and then an example using this solution is given according to the working practice.At last,the shortcomings using classical Kalman filter were discussed and a new method using adaptive Kalman filter was proposed.

Medical consumable is widely used in disease diagnosis,treatment and health care,but its multifarious classifications show its weakness in management.Based on the research and analysis on the existing kinds of classifications,this article unifies practical application in hospital and proposes"null-stock"classification method under the management plan,which seems more scientific and reasonable.

Objective To determine the level of the serum thyroxine in AIDS patients and investigate its content changes and clinical significance. Methods The serum levels of T3 ,T4 ,FT3 ,FT4 and TSH in AIDS patients were determined by chemilumiescence assay. The results were analyzed. Results The serum levels of T3 and FTM3 in AIDS patients of the observation group were significantly lower than that of the control group, showed significantly stiatistical differences [(1.78 ± 0.99) vs (2.43 ± 0.52) nmol/L, (3.75 ± 3.65) vs (5.68 ± 1.83) pmol/L, all P ＜0. 05]. While the levels of T4, FT4 and TSH in those of the observation group was higher than that of the controls without significant difference (all P ＞ 0.05). Conclusion The variations of levels of T3, T4, FT3, FT4 and TSH in AIDS patients had important clinical significance.

Objective By using lung sound spectrum analysis, the clinical efficacy of asthma -relieving manipulation, which is a gentle massage therapy mainly on the acupoints, on acute exacerbation of children asthma was evaluated. Methods We collected the lung sound of 11 children with acute asthmatic attack before and after asthma-relieving manipulation, and then input to the computer for obtaining lung sound spectrum signal data. The sound intensity, average respiratory muscle strength ( RMS) power, total RMS power and the volume of every 25 Hz frequency spectrum were extracted for comparison. Results After asthma-relieving manipulation, the sound intensity, average RMS power, and total RMS power of the children with acute asthmatic attack were significantly lower than those before the manipulation (P<0.01). The results of lung sound spectrum analysis displayed that lung sound volume was significantly lower at frequency band 0~300 Hz after manipulation ( P<0.05 compared with that before the manipulation) . The difference of the lung sound volume was insignificant over frequency band 300 Hz before and after treatment ( P>0.05). Conclusion Lung sound spectrum analysis can be applied to monitor lung function of asthmatic children objectively and quantitatively, and it is a new sensitive method for clinical detection. Asthma-relieving manipulation shows certain effect on acute exacerbation of children asthma.

Objective To observe the efficacy and safety in the postoperative craniocerebral trauma elderly patients us-ing the layered method of sputum suction. Methods Senventy patients aged 60 and above with craniocerebral trauma were divided into the layered method group (group A) and the traditional method group (group B). The vital sign, mu-cosa damage frequency, the times of average daily sputum suction and the incidence of VAP were compared. Results Compared with group B, group A could reduce the vital signs change and the times of average daily sputum suction, with lower airway mucosa damage and the incidence of VAP, the difference was statistically significant(P<0.05). Con-clusion The layered method of sputum suction is safer and more effective than traditional method in treatment of the postoperative elderly patients with craniocerebral trauma.

Objective To evaluate quality control circle (QCC) impacting on Burnout syndrome of emergency nurse and satisfaction of patients in one hospital of Wenzhou.Methods Emergency nurse,who worked at one hospital of Wenzhou during January 2012 to December 2013,were chosen as sampling objects and divided into QCC group (47 nurses) and control group (39 nurses).The nurses of QCC group underwent QCC activities while nurses of the control group received routine management.The QCC activities lasted 3 months,and one week before and after QCC activities,we questionnaired Burnout syndrome,normal population sociology information,frequency of job burnout syndrome,work performance,and patient's satisfaction.Results Before activities,there was no statistical significance for occurrence of Burnout syndrome between two groups (P ＞ 0.05);one week after the implementation of activities,the fatigue,headache,insomnia,negative emotion had statistical significance between two groups (x2 =5.88,6.01,5.88,6.11,respectively;P ＜ 0.05),but the symptom of irritation were not statistical significant (x2 =0.52,P ＞ 0.05).Before activities,the work performance and patient's satisfaction had no statistical significance;one week after the accomplishment of activities,the scores of colleague relationship,work satisfaction,work efficient,patient's satisfaction for nurses in the QCC group were (5.81 ±0.19),(5.13 ±0.29),(5.12 ± 0.80),(5.33 ±0.54) higher than (4.90 ± 0.83),(4.73 ± 0.37),(4.01 ± 0.91),(4.48 ± 0.30) of the control group (t =2.613,2.433,2.695,2.497,respectively;P ＜ 0.05).The intention of turnover was (2.11 ± 0.98) score in the QCC group lower than that of control group (4.85 ± 0.71) score (t =2.946,P ＜ 0.01).Conclusions The QCC can promote the Burnout syndrome of emergency nurses,decrease nurse's intention to turnover,and enhance the enthusiasm nurse's work and patient's satisfaction.

Talent is the foundation of hospital development.Since the independent operation of a third grade children's hospital,it is faced with some difficulties such as imperfect construction of talent echelon,large gap of talent demand,insufficient funds for talent introduction and weak talent training.The Party committee of the hospital adheres to the party management of tal-ents,and on the basis of improving the talent introduction,training and incentive mechanism,builds a"1+1＞2 ecosystem"of Party management talents in view of the difficulties and blind spots in the construction of talent teams,focuses on the introduction and training of talents,quantity and quality,and production capacity input and output,and promotes the"induction and reten-tion"of talent construction to achieve actual results.Lay a talent foundation for the high-quality development of the hospital.

Objective To investigate the effect of acacetin on oxidative stress injury in diabetic cataract(DC)rats and its regulation of sirtuin 1(Sirt1)/adenosine monophosphate-activated protein kinase(AMPK)/nuclear factor-erythroid 2-related factor 2(Nrf2)signaling pathway.Methods Sixty SD rats were randomly divided into the control group,model group,low-dose acacetin group,high-dose acacetin group,and acacetin+Sirt1 inhibitor(EX527)group.DC rat models were constructed except for the control group.Rats in the low-dose and high-dose acacetin groups were injected with 10 mg·kg-1 and 20 mg·kg-1 acacetin subcutaneously through the neck,twice a day,respectively.Rats in the acacetin+EX527 group were injected with 20 mg·kg-1 acacetin subcutaneously through the neck,twice a day;additionally,3.5 mg·kg-1 EX527 was administered subcutaneously through the osmotic micro-pump for 4 weeks.The same amount of nor-mal saline was pumped into rats in the rest groups for 4 weeks.After administration,blood pressure and fasting blood glu-cose(FBG)were measured.The lens opacity was observed under the slit lamp irradiation,and the histopathological chan-ges in the lens were observed after hematoxylin-eosin staining.Enzyme-linked immunosorbent assay was performed to de-termine the serum levels of malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),in-terleukin(IL)-6,and IL-1 β.Western blot was applied to detect the expression levels of Sirt1,phosphorylated AMPK(p-AMPK),AMPK,and Nrf2 proteins.Results Compared with the control group,the lens epithelial cells(LECs)of rats in the model group showed patchy and striped shapes,and migration and aggregation occurred;the systolic blood pres-sure(SBP),FBG,lens opacity score,and the levels of MDA,IL-6 and IL-1 β increased,while the expression levels of SOD,GSH-Px,Sirt1,p-AMPK/AMPK,and Nrf2 proteins decreased(all P＜0.05).Compared with the model group,the migration and aggregation of LECs improved in the low-dose and high-dose acacetin groups,the SBP,FBG,lens opacity score,and the levels of MDA,IL-6 and IL-1 β decreased,while the expression levels of SOD,GSH-Px,Sirt1,p-AMPK/AMPK,and Nrf2 proteins increased(all P＜0.05).Compared with the high-dose acacetin group,the morphological chan-ges and aggregation of LECs in the acacetin+EX527 group were more significant,the SBP,FBG,lens opacity score,and the levels of MDA,IL-6 and IL-1 β increased,while the expression levels of SOD,GSH-Px,Sirt1,p-AMPK/AMPK,and Nrf2 proteins decreased(all P＜0.05).Conclusion Acacetin may protect DC rats from oxidative stress injury by activating the Sirt1/AMPK/Nrf2 pathway.

Objective To investigate the effect of total flavone of Cydonia oblonga on oxidative damage of human lens epithelial cells induced by high glucose and its mechanism.Methods A cell injury model was established by inducing human lens epithelial cells with high glucose.Human lens epithelial cells were cultured in the medium containing 30 mmol·L-1 glucose for 24 h,which was recorded as the high glucose group.Cells in the control group were cultured in a medium con-tainning 5.5 mmol·L-1 glucose for 24 h.Human lens epithelial cells were inoculated into 96-well plates with 5 × 103 cells per well,and treated with mediums containing 10 mmol·L-1,20 mmol·L-1,and 40 mmol·L-1 total flavone of Cydonia ob-longa combined with 30 mmol·L-1 glucose for 24 h.They were recorded as high glucose+low total flavone of Cydonia oblonga group,high glucose+medium total flavone of Cydonia oblonga group,and high glucose+high total flavone of Cydonia oblonga group.Human lens epithelial cells were transfected with anti-miR-NC and anti-miR-370 with Lipo-fectamine2000 transfection reagent,and treated with 30 mmol·L-1 glucose for 24 h,which were recorded as high glucose+anti-miR-NC group and high glucose+anti-miR-370 group.Human lens epithelial cells were transfected with miR-NC and miR-370 mimics,and treated with medium containing 30 mmol·L-1 glucose and 40 mmol·L-1 total flavone of Cydonia oblonga for 24 h,which were labeled as high glucose+total flavone of Cydonia oblonga+miR-NC group and high glucose+total flavone of Cydonia oblonga+miR-370 group.The activities of superoxide dismutase(SOD)and cata-lase(CAT),and the content of malondialdehyde(MDA)were measured by Enzyme-linked immunosorbent assay;flow cy-tometry was applied to detect apoptosis rate;quantitative reverse transcription polymerase chain reaction was applied to detect the expression level of miR-370;Western blot was applied to detect the expression of apoptosis-related proteins.Results Compared with the control group,the activities of SOD and CAT decreased and the content of MDA increased in the human lens epithelial cells of the high glucose group,and the differences were statistically significant(all P＜0.05);compared with the high glucose group,the activities of SOD and CAT significantly increased and the content of MDA signifi-cantly decreased in the high glucose+low total flavone of Cydonia oblonga group,the high glucose+medium total fla-vone of Cydonia oblonga group and the high glucose+high total flavone of Cydonia oblonga group(all P＜0.05).Com-pared with the control group,apoptosis rate,and protein expressions of Caspase-3 and Caspase-9 of human lens epithelial cells in the high glucose group significantly increased(all P＜0.05);compared with the high glucose group,the apoptosis rate,Caspase-3 and Caspase-9 protein expressions of human lens epithelial cells in the high glucose+low total flavone of Cydonia oblonga group,high glucose+medium total flavone of Cydonia oblonga group,and high glucose+high total fla-vone of Cydonia oblonga group significantly decreased(all P＜0.05).The expression levels of miR-370 in human lens epi-thelial cells were 1.00±0.00,4.04±0.36,3.22±0.24,2.42±0.23 and 1.62±0.14 in the control group,high glucose group,high glucose+low total flavone of Cydonia oblonga group,high glucose+medium total flavone of Cydonia oblon-ga group,and high glucose+high total flavone of Cydonia oblonga group,respectively.There was a statistically different significance among the five groups(F=256.138,P＜0.05).Compared with the high glucose+anti-miR-NC group,the ex-pression of miR-370 significantly decreased,the activities of SOD and CAT significantly increased,and the content of MDA significantly decreased in human lens epithelial cells of the high glucose+anti-miR-370 group(all P＜0.001).Compared with the high glucose+anti-miR-NC group,apoptosis rate,and protein expressions of Caspase-3 and Caspase-9 of the hu-man lens epithelial cells in the high glucose+anti-miR-370 group significantly decreased(all P＜0.001).Compared with the high glucose+total flavone of Cydonia oblonga+miR-NC group,the activities of SOD and CAT significantly de-creased,and the content of MDA,apoptosis rate,and protein expressions of Caspase-3 and Caspase-9 significantly in-creased in the human lens epithelial cells of high glucose+total flavone of Cydonia oblonga+miR-370 group(all P＜0.001).Conclusion The expression of miR-370 increases in high glucose-induced human lens epithelial cells.Total fla-vone of Cydonia oblonga can inhibit the oxidative stress and apoptosis of high glucose-induced human lens epithelial cells,and the mechanism may be related to the decreased expression of miR-370.