Objective To study and analyze the efficacy and safety of caspofungin in the treatment of acute exacerbation of chronic obstructive pulmonary disease patients complicated with pulmonary fungal infections.Methods 62 patients of acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary fungal infec-tions were randomly divided into study group and control group,31 cases in each group.Study group was intravenously given caspofungin,with an initial dose of 70mg/d,follow 50mg/d.The control group was intravenously given liposomal amphotericin B,dose control in 3mg? kg-1 ? d-1 .After treatment lasted symptoms 5d,clinical efficacy and side effects of two groups were recorded.Results The effective rate of the study group was 67.74%,which was signifi-cantly higher than 41.93% of the control group, the difference was statistically significant ( χ2 =2.0251, P =0.0429).The incidence rate of adverse reactions of the study group was 16.13%,which was significantly lower than 48.39% of the control group,the difference was statistically significant(χ2 =2.6948,P =0.0070).After treatment, liver and kidney function parameters in the control group such as ALT,AST,BUN,Cr had significant differences com-pared with before treatment (P <0.05).Conclusion For chronic obstructive pulmonary disease patients complicated with acute exacerbation of pulmonary fungal infection,the treatment efficacy and the incidence of adverse reactions of caspofungin therapy are significantly better than liposomal amphotericin B,and has small renal damage,which is wor-thy of clinical application.

As quantum dots( QDs),an advanced porduct of nanotechnology,have been widely used in bio-medicine due to their unique photoelectric properties. QD safety evaluation has become a hot area of research. So far,some researchers have expressed concern about the neurotoxic potential of QDs because the central nervous system was confirmed to be one of the target organs. Several studies found that QDs could enter the central nervous system by crossing the blood brain barrier and following neural pathways and produce some neurotoxic effects,such as damaging the structure and function of neural cells and impairing synaptic plasticity. The potential toxicity mechanisms could include oxidative stress,inflammation and change of ion channels.

Physiologically based pharmacokinetic (PBPK) modeling is established based on the information of existing human or other animal anatomy, knowledge of physiology and biochemical data. The model uses mathematical methods to simulate chemicals′process of absorption, distribution, metabolism and excretion in the body, in order to achieve the dose and interspecific extrapolation and to predict the chemical level in the specific organ at the specific time. In studies on toxicology of nanomaterials, the PBPK models in the silver nanoparticles, zinc oxide nanoparticles, titanium dioxide nanoparticles and polymer nanomaterials are gradually established. PBPK modeling can not only provide information on the dynamic change of nanomaterials in the body, but is of great significance for to quantitative evaluation of biological safety of nanomaterials. PBPK modeling will be a hot spot for research in the field of nanotoxicology.

The paper gives an account of the four systems that are currently used for evaluating hospital quality in America, viz. America's Best Hospitals, Solucient 100 Top Hospitals, International Quality Indicator Project, and the Joint Commission on Accreditation of Healthcare Organizations. The "America's Best Hospitals" methodology takes into account three factors, infrastructure, process and outcome. Hospitals are first ranked in specialties, then the index of hospital quality is calculated by means of weighted indexes, and after that the best hospitals are selected according to the specialty rankings and the number of the hospitals. The "Solucient 100 Top Hospitals" methodology selects 100 top hospitals among hospitals of the same size on the basis of hospital quality and safety indexes. The evaluation indexes include eight items, such as index of risk-adjusted mortality rates, index of complications, and disease severity-adjusted average length of hospital stay. The methodologies of "International Quality Indicator Project" and "the Joint Commission on Accreditation of Healthcare Organizations" are used in many countries to evaluate clinical efficiency and enjoy high reputation in monitoring and promoting medical quality.

Objective To investigate the attitude of medical students towards standardized resident training in Shanghai and to provide references for policy adjustment.Methods Self-made questionnaire was used to investigate the attitude of 267 clinical medical students towards standardized resident training in Shanghai.Reference reviewing and expert consultation were also performed.Results Nearly eighty percent of students believed that they had basic knowledge of the training.Two thirds of students hold objective attitude towards the policy.Conclusions Income and pressure in finding jobs are the main reasons why students object the policy.Standardized resident training program need to improve in aspects of advertisement,incoming,quality of teaching staff,connection between medical education and training.

Adult ; Endometriosis ; complications ; metabolism ; Endometrium ; metabolism ; Female ; Humans ; Infertility, Female ; etiology ; metabolism ; Leptin ; metabolism

Objective To study inductively coupled plasma atomic emission spectrometry(ICP-AES) used to determine blood boron(B),and to investigate the level of B in blood of children in Nanjing.Methods ICP-AES was applied to determine the level of B in the blood of 1032 healthy children and 1364 children patients after using 1mol/L HNO_(3) to treat whole blood.Results Precision of this method was 1.60%-4.31%,and recovery ratio was 93.3%-98.9%.The level of B in blood of the 1032 healthy children was(41.8?16.7)?g/L and that in blood of the 1464 patients was(25.1-58.5)?g/L(77%).Conclusion Precision and recovery ratio determined by the method are high,so it can be used as a reference method to detect the level of B in blood.And it preliminarily determines the reference levels of blood B of children in Nanjing as ranging from 25.1-58.5?g/L(except children below 1 year old).

Objective To analyze the differences of coagulation parameters between patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis under different degrees of liver function,so as to provide the evidence for further guidance of judging clinical condition and prognosis. Methods Sixty?three patients with advanced schistosomiasis cirrhosis and eighty pa?tients with hepatitis B induced cirrhosis hospitalized in Jingzhou Central Hospital from January 2014 to June 2016 were served as an advanced schistosomiasis cirrhosis group and a hepatitis B cirrhosis group,respectively,and ninety?six gastropathy pa?tients excluded from other diseases that might affect coagulation in the same period were served as a control group. The levels of PT,INR,Fib,TT,APTT,and PLT of the patients among the above 3 groups and the cirrhosis patients with different Child?Pugh classes were detected and compared. Results The differences of the levels of PT,INR,Fib,TT,APTT,and PLT among the 3 groups were statistically significant(F=84.512,81.672,37.612,104.475,52.497,102.233;all P<0.05). The further analysis showed that PT,INR,TT,and APTT of both the advanced schistosomiasis cirrhosis and hepatitis B induced cirrhosis groups were longer than those of the control group,and the PLT levels of both the former 2 groups were lower than that of the con?trol group(all P<0.05). Compared with the advanced schistosomiasis cirrhosis group,PT,INR,TT,and APTT of the hepati?tis B induced cirrhosis group were longer,and the levels of Fib and PLT were lower(all P<0.05). Among those with the liver function of Grade A,the reduced degree of PLT in the patients with hepatitis B induced cirrhosis was more serious,while for those with the liver function of Grade B and C,the difference between the patients with advanced schistosomiasis cirrhosis and hepatitis B induced cirrhosis was not statistically significant(both P > 0.05). Under all the grades of liver function,TT and APTT of the hepatitis B induced cirrhosis group was longer than those of the advanced schistosomiasis cirrhosis group ,and the Fib level of the former was lower than that of the latter. Among those with the liver function of Grade A and B ,PT and INR of the hepatitis B induced cirrhosis group were longer than those of the advanced schistosomiasis cirrhosis group;while for those with the liver function of Grade C,the difference between the two groups was not statistically significant(all P > 0.05). Conclu?sions There exist differences of the damage degrees of coagulation function between the patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis. When the damage degree of the liver function is lighter,the coagulation function in the pa?tients with hepatitis B cirrhosis decreases more significantly;when the damage degree becomes more severe,APPT in the pa?tients with hepatitis B cirrhosis extends more significantly,while the differences of PLT and PT between them are little.

OBJECTIVE To investigate dynamics of bacteria in biliary tract infections and their sensitivity to antibiotics.METHODS All bile specimens were collected from surely patients with biliary infection by endoscopic nasobiliary drainage or surgery in Union Hospital affiliated to Fujian Medical University,from Jan 2002 to Dec 2005.All specimens were cultured,and followed by bacterial identification and antibiotics resistance assay.RESULTS The ratio of Gram-negative bacteria in all bacteria of biliary tract infections was decreased(r=-0.983,P