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 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.

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.

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 explore the application effect of perforator pedicle flap in the wound repair after resection of the medium and large-sized keloids in the trunk.Methods:From January 2018 to January 2019, 10 patients, aged from 20 to 53 years old, with medium and large-sized keloids in the trunk were treated, including 3 cases in the anterior chest, 3 cases in the umbilical region, 4 cases in the lower abdomen, 8 cases were women and 2 cases were men. The size of keloids were 2.0 cm×3.0 cm to 5.0 cm×9.0 cm, and all keloids were accompanied with infection. Scars and infected tissues were removed and contracture was released completely. Pedicled flaps with intercostal perforator artery(3 cases), paraumbilical perforator artery(3 cases) or groin perforator artery(4 cases) were elevated and advanced or rotated to cover the wound. Early radiotherapy was delivered to the scar bed 5-10 Gy each time with a total dose of 15 to 20 Gy over 3 daily fractions after surgery. And other treatments, such as topical silicone gel, corticosteroid intralesional injection and elastic clothing compression were taken as adjuvant therapy. The scars were assessed by the Vancouver Scar Scale, and local morphology, hair distribution, itching, pain and patient satisfaction were analyzed and evaluated after 12 months to 24 months follow-up.Results:All flaps survived and the incisions healed primarily. The local morphology and hair distribution were normal, and the itching and pain were relieved obviously. The Vancouver Scar Scale scores vary from 1 to 6 in 9 patients. Incision hypertrophic scar with the Vancouver Scar Scale score of 9 occurred in one noncompliance patient who didn’t follow up on time and refuse to take the adjuvant treatments. 8 patients were extremely satisfied with the treatment effect, and 2 patients were satisfied with the treatment effect.Conclusions:For medium and large-sized keloids in the trunk, combined modality therapy, including local perforator pedicled flaps transplantation, early radiotherapy, topical silicone gel, elastic compression and etc, will achieve satisfied clinical effects.

Objective:To explore the application effect of perforator pedicle flap in the wound repair after resection of the medium and large-sized keloids in the trunk.Methods:From January 2018 to January 2019, 10 patients, aged from 20 to 53 years old, with medium and large-sized keloids in the trunk were treated, including 3 cases in the anterior chest, 3 cases in the umbilical region, 4 cases in the lower abdomen, 8 cases were women and 2 cases were men. The size of keloids were 2.0 cm×3.0 cm to 5.0 cm×9.0 cm, and all keloids were accompanied with infection. Scars and infected tissues were removed and contracture was released completely. Pedicled flaps with intercostal perforator artery(3 cases), paraumbilical perforator artery(3 cases) or groin perforator artery(4 cases) were elevated and advanced or rotated to cover the wound. Early radiotherapy was delivered to the scar bed 5-10 Gy each time with a total dose of 15 to 20 Gy over 3 daily fractions after surgery. And other treatments, such as topical silicone gel, corticosteroid intralesional injection and elastic clothing compression were taken as adjuvant therapy. The scars were assessed by the Vancouver Scar Scale, and local morphology, hair distribution, itching, pain and patient satisfaction were analyzed and evaluated after 12 months to 24 months follow-up.Results:All flaps survived and the incisions healed primarily. The local morphology and hair distribution were normal, and the itching and pain were relieved obviously. The Vancouver Scar Scale scores vary from 1 to 6 in 9 patients. Incision hypertrophic scar with the Vancouver Scar Scale score of 9 occurred in one noncompliance patient who didn’t follow up on time and refuse to take the adjuvant treatments. 8 patients were extremely satisfied with the treatment effect, and 2 patients were satisfied with the treatment effect.Conclusions:For medium and large-sized keloids in the trunk, combined modality therapy, including local perforator pedicled flaps transplantation, early radiotherapy, topical silicone gel, elastic compression and etc, will achieve satisfied clinical effects.

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.