OBJECTIVE To know the immunate function state when patients with invasive fungal infection appearing peripheral blood plasmacyte.METHODS Twenty cases of invasive fungal,bacterial infection and normal concentrate blood smear if apper plasmacyte and quantity;adopt flow cytometer technology,nephelometry were used to detect lymphocyte subpopulation,immunoglobulin level.RESULTS Concentrate blood smear find plasmacyte in 15 case invasive fungal infect patient,commonly bacterial infect only 1 case.nomal had not find.invasive fungal infection patien lymphocyte subpopulation CD3+:(50.2?6.1)%,CD4+:(23.6?3.5)%,lower than normal CD3+:(66.8?8.0)%,CD4+:(35.2?5.1)%.But CD8+:(33.9?4.5)%,CD19+:(34.2?7.0)% there were hinger than normal CD8+:(26.5?6.5)%,CD19+:(12.0?4.9)%,CD16/56+ parting(18.8?5.1%,18.2?7.0%).There ware no marked difference in two group of invasive fungal infect patients and normal immunoglobulin level parting:IgG 8.35,7.72 g/L,IgA 1.59,0.99 g/L,IgM 1.20,1.07 g/L.CONCLUSIONS Invasive fungal infect patients when concentrate blood smear find plasmacyte,are found with low immune and blood serum immunoglobulin level with NK cell quantity no obvious change;but CD19+ lymphocyte quantity increase.

Objective:To observe the efficacy and safety of Feilike mixture and Xuanfei Zhisou mixture in the treatment of children acute tracheobronchitis bronchitis. Methods:Totally 110 cases of children with infantile bronchitis were randomly divided into Feilike group(37 cases),Xuanfei Zhisou group(37 cases)and the control group(36 cases). The control groups was treated with the conventional therapy including amoxicillin clavulanic acid potassium dispersible tablets with oral administration and hydrochloric acid ammonium bromide injection with atomization inhalation. Feilike group was treated with Feilike mixture additionally,and Xuanfei Zhisou group was treated with Xuanfei Zhisou mixture additionally. The treatment course was 7 d. Fever,cough and rale disappearance time were observed,and the efficacy and adverse reactions were also compared. Results:The total effective rate of Feilike group and Xuanfei Zhisou group was 94. 6% and 91. 9% ,respectively,both were higher than that of the control group(P < 0. 05),while there was no significant difference between the two groups(P > 0. 05). The disappearance time of cough and rale in Feilike group and Xuanfei Zhisou group was shorter than that in the control group(P <0. 05),and the time was shorter in Xuanfei Zhisou group when compared with that in Feilike group(P < 0. 05). No obvious adverse reaction was shown in the three groups. Conclusion:Feilike mixture and Xuanfei Zhisou mixture both show notable curative effect in the treatment of children acute tracheobronchitis bronchitis with good safety.

Objective To investigate the effect of escitalopram on the levels of serum proinflammatory cytokine interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),and IL-18 in a rat model of poststroke depression (PSD).Methods Twenty-four male Sprague-Dawley rats were randomly allocated into sham operation,middle cerebral artery occlusion (MCAO),PSD and escitalopram groups (n =6 in each group).A model of MCAO was induced by the intraluminal suture method,and on this basis,a PSD model was induced by combining with chronic unpredictable mild stress (CUMS) plus lonely upbringing.The rats of both the sham operation group and the MCAO group were neither CUMS nor lonely upbringing,and in the PSD group they were both CUMS and lonely upbringing.The escitalopram group was given escitalopram intervention (10 mg/kg · d,intraperitoneal injection for 3 weeks) at the beginning of CUMS and lonely upbringing.At baseline and on day 7,14 and 21 after CUMS,sucrose solution consumption and wilderness trials were used to assess depression-like behavior.Enzyme-linked immunosorbent assay was used to detect the levels of serum proinflammatory cytokines IL-6,TNF-α and IL-18 on day 21 after CUMS.Results On day 21 after CUMS,the scores of weight,sucrose solution consumption,vertical test and the distance of horizontal activities were all significantly decreased and shortened compared to those of the sham operation group and the MCAO group (all P＜0.01).The weight,sucrose solution consumption,and the distance of horizontal activities of the escitalopram group were significantly increased compared to those of the PSD group (P ＜0.05 or P ＜0.01).On day 22 after CUMS,the serum IL-18 level of the PSD group was increased significantly compared to that of the sham operation group and the MCAO group (P ＜ 0.05 or P ＜ 0.01).The serum IL-18 level of the escitalopram group was decreased significantly compared to that of the PSD group (P ＜0.05).However,there were no significant differences in the levels of IL-6 and TNF-α among all the groups.Correlation analysis showed that on day 22 after CUMS,the serum IL-18 level and sucrose solution consumption (r =-0.415,P =0.044),the distance of horizontal activities in the wilderness trials (r =-0.508,P =0.011) showed a significant negative correlation,however,they did not have significant correlation with the vertical score (r =-0.390,P=0.059) and the body weight (r=-0.216,P=0.311).Conclusions The serum IL-18 level is increased significantly in the PSD rat models.Escitalopram can significantly decrease the serum IL-18 level and improve depression-like behavior of the PSD rats,suggesting that IL-18 may play a role in the pathogenesis of PSD.

Synchronous bilateral primary breast cancer refers to the simultaneous occurrence of primary cancers in both breasts. The overall morbidity is low. However, with the detection of occult breast cancer increasing recently, it shows an upward trend. The pathogenesis is not yet clear, old age, family history of primary breast cancer, sclerosing adenopathy of precancerous lesions and pathological characteristics of first cancer are currently recognized risk factors. Compared with unilateral breast cancer, prognosis for synchronous bilateral primary breast cancer is poor. Raise the risk awareness of high-risk women, check regularly to find non-palpable lesions as soon as possible. By taking various preventive treatments for patients with high-risk unilateral breast cancer, the incidence of breast cancer can be effectively reduced and the prognosis of patients can be improved. By reviewing the literature at home and abroad, it systematically expounds the risk factors, histopathological features, prognosis and preventive treatment of synchronous bilateral breast cancer.

Cardiovascular Diseases ; Humans ; Immunoglobulin G

Cytokinesis ; Humans ; Lymphocytes ; pathology ; Micronucleus Tests ; Neoplasms ; genetics ; Risk Factors

In order to improve work environment for nurses and establish magnet hospital,nursing council was created in year of 2015,consisting of unit-based council,clinical resources council,nursing core council,nursing coordinating council and supportive system,to lead nurses to participate in nursing management and decision-making.After two years' implementation,profession nursing management index was increased from 174.13±43.90 to 170.25±38.98,and nursing management mode was transformed into shared governance,clinical nurses admitted nursing council system,and they believed it improved their awareness of responsibility and interpersonal support.Implementation of nursing council have positive effects on establishment of magnet hospital.

Objective:To understand the current situation of mood disorders in patients with thoracic and lumbar osteoporotic fractures and to preliminarily explore its influencing factors.Methods:A cross-sectional survey method was used to select 212 patients with thoracic and lumbar osteoporotic fractures from Department of Orthopedics, West China Hospital, Sichuan University, from January 2018 to September 2020 as the research subjects. The general information questionnaire, Huaxi Emotional-distress Index, Pittsburgh Sleep Quality Index (PSQI) and pain Visual Analogue Scale (VAS) were used to investigate them.Results:The incidence of mood disorders in patients with thoracic and lumbar osteoporotic fractures was 10.38% (22/212). The results of multivariate regression analysis showed that age, days of injury, PSQI score and pain VAS score were the influencing factors of emotional disturbance in patients with thoracic and lumbar osteoporotic fractures ( t values were -3.72-7.66, all P<0.05). Conclusions:Patients with thoracic and lumbar osteoporotic fractures have mood disorders. Age, injury days, PSQI score and VAS score are related to the occurrence of mood disorders in patients with thoracic and lumbar osteoporotic fractures. More attention should be payed to the influencing factors of mood disorders in patients,and timely measures should be taken for individualized intervention.

Objective To evaluate the safety and drug adherence of tocilizumab(TCZ)in patients with moderate to severe rheumatoid arthritis(RA)in routine clinical practice. Methods This 24 week single center observational study recruited patients with moderate to severe RA. Therapy adherence rate was calculated by actual dosing/expected dosing×100%. Efficacy end points included physician global assessment of disease activity(PGA),patient global assessment of disease activity(PtGA),28-joint disease activity score(DAS28)and so on. Safety was evaluated by recorded adverse events (AEs). Results Sixty patients were enrolled with a mean (SD) treatment adherence of (67±27)%. PGA, PtGA, pain assessment (VAS), TJC and SJC all decreased during this study. At the 12th week, 25%(6/24) and 29%(7/24) of the patients achieved DAS28 remission and EULAR good response,respectively.Eighteen AEs were recorded,of which only 2 were severe AEs(SAEs)and neither was related to TCZ. Conclusion TCZ is a highly safe treatment for decreasing disease activity in patients with moderate to severe RA in China.However,drug adherence still need to be improved.

Objective:To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection.Methods:Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children′s Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection.Results:A total of 12 children were enrolled in this study. The male-to-female ratio was 5∶1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different ( Z or F, P values were 8.33, 0.016; 5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages ( P>0.05). Conclusions:It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.