OBJECTIVE To investigate the current status about fungal infections in hospital and to provide the evidence to clinical treatment by identification,and susceptibility test for 62 strains of fungal infection in target population.METHODS The positive sample of blood culture was detected by Bio-Merieux Bact/Alert 3D fully automated microbial detect system,and the fungus identified by Bio-Merieux API 20C Aux yeast system,VITEK identification system,or YBC identification card.The susceptibility test perform by ATB Fungus 2 INT tip.The fungal strains were cultured with Sabouraud medium.RESULTS Among the 62 fungal strains,61 were Candida which accounted for 88.7%,from them C.albicans was predominan,accounted for 35.5%.Susceptibility rate to fluconazole,amphotericin B,itraconazole and flucytosine was 91.0%,100.0%,91.0%,and 100.0%.The distribution of fungi was higher in ICU accounted for 50.0% than in other wards.CONCLUSIONS The rate of the Candida especially C.albicans infection is increasing in Beijing Hospital.The result of susceptibility test showed that the fungi are good susceptibe to antifungal drugs.Highly resistant strain is rare,therefore,the clinics should choose the appropriate antifungal agents and minimize the incidents of resistance of fungal infections according to the culture and in vitro susceptibility of fungus.

[Objective]This paper summarizes the latest literature,which can offer more choices for making liposome drug.[Methods]This article summarizes the application of liposomes in al aspects and new preparation methods and modification methods and their respective advantages. [Results]Liposome as a new type of drug carrier,which has similarity with biological membrane,has many good qualities and changes the traditional way to give medicine. [Con-clusion]Liposome has the broad application after nearly forty years of research.

Objective To establish the rapid purification of Coxsackievirus A16 using ultracentrifugation .And To prepare and i‐dentify the neutralizing monoclonal antibody against CA16 .Methods The CA16 culture supernatant was harvested and then con‐centrated by 100K capsule .The concentration of CA16 was purified by cesium chloride ultracentrifugation .Purification of CA16 were identified by transmission electron microscopy .BALB/c mice were immunized with inactivated CA16 .Spleen cells were harves‐ted and fused with SP2/0 myeloma cells ,hybridoma cell strain secreting mAb against CA16 were objected to screening .Character‐ization of the prepared mAb were analyzed by ELISA and microneutralization assay .Results The purified CA16 method of cesium chloride gradient ultracentrifugation was established ,TEM analysis was showed that CA16 particles have icosahedral structure ,the diameters of the viral particles were approximately 20-30 nm .Two hybridoma cell strains secreting mAb against CA16 were ob‐tained ,the subtypes of two mAbs were IgG2a ,the binding titers of Anti/CA16/5 and Anti/CA16/10 were 103 and 104 respectively . Neutralizing titer of the two mAbs were 1∶256 and 1∶1 024 respectively .Conclusion Establishment method of cesium chloride gradient ultracentrifugation was performed to purify CA16 ,the two mAbs with neutralizing ability to against CA16 may become ap‐plication of treatment and vaccine .

Patients with advanced lung cancer should be given proper hospice care .Doctors should not only practice protective medicine on the foundation of laws and regulations , informing the patients about their conditions tactfully , but also try their best to provide the patients with optimal therapeutic strategies , taking the patient's physi-cal tolerance, economy, etc.into account and achieving the goal of humanized and individualized therapy .Mean-while, the construction of professional medical -nursing institution is in urgent need .Only providing general nurs-ing in multiple aspects of illness , mental health , social functions , can we relieve the pain both physically and men-tally, and improve the patient's quality of their terminal times .

Objective To explore the measurement of(1,3)-β-D glucan in plasma for the diagnosis of pulmonary fungal infections in pulmonary tuberculosis patients. Methods 40 pulmonary tuberculosis patients with pulmonary fungal infections in Guangzhou chest hospital from January 2015 to December 2015 were enrolled as a test group,among which 35 were confirmed and 5 were suspected pulmonary fungal infections. 52 pulmonary tuber-culosis patients without fungal infections were selected as a control group.(1,3)-β-D glucan content(G test)in this 92 patients plasma were detected. The results of G tests were compared with those from etiological diagnosis to assess the performance of G test. Results 13 strains of candida albicans,13 strains of aspergillus,2 strains of candida tropicalis,2 strains of candida glabrata and 6 strains of other yeast were obtained from patients of test group,but no fungal identified from those of control group. The median of G test in test group and in control group was 126.1 and 29.56 pg/mL,respectively,the level in test group was significantly higher than that in control group (P<0.001). 35 cases were identified as positive and 5 were negative in test group by G test ,while 41 cases were identified as negative and 11 were positive in control group. The sensitivity,specificity,positive predictive value, negative predictive value ,concordance and Youden index of G test were 87.5%,78.85%,76.09%,89.13%, 82.6%and 0.663,respectively. Conclusions Candida albicans and aspergillus are more common pathogens than the other fungi isolated from pulmonary tuberculosis patients with pulmonary fungal infection. G test ,used in pul-monary tuberculosis with pulmonary fungal infections diagnosis,is reliable and fast,and has a higher sensitivity, specificity and accuracy.

Objective To observe the clinical curative effect of Depmas double blood purification system for acute severe organophosphorus pesticide poisoning.Methods Retrospectively study was carried out on 147 patients of acute severe organophosphorus pesticide poisoning.Patients were divided into four groups,the conventional treatment group treated with drug therapy,hemoperfusion group given HA230 hemoperfusion in addition to conventional treatment,plasma exchange combined with hemoperfusion group given HA230 hemoperfusion and plasma exchange therapy in addition to conventional treatment,and Depmas group treated with plasma separation by Baxter blood fiber and then given series HA230 and BS330 hemoperfusion treatment on the separated plasma in addition to conventional treatment.Survival rate,mean survival time of death patients,the concentration changes of cholinesterase and bilirubin in peripheral blood were observed.Results Compared to the conventional treatment group,survival rates of hemoperfusion group,hemoperfusion combined with plasma exchange group and Depmas group were higher,the mean survival time was longer,the cholinesterase concentration in peripheral blood was higher and the elevated bilirubin concentration was decreased with the differences statistically significant (P＜0.01).Compared to hemoperfusion group,the survival rates of hemoperfusion combined with plasma exchange group and Depmas group were higher,the mean survival time was longer,the cholinesterase concentration in peripheral blood were higher and the elevated bilirubin concentration was decreased with the differences statistically significant (P＜0.05).Besides,there were no significant differences between the survival rate,mean survival time,peripheral blood cholinesterase and bilirubin concentration of hemoperfusion combined with plasma exchange group and that of Depmas group (P＞0.05).Conclusions Depmas dual blood purification system has remarkable curative effect for the treatment of acute severe organophosphorus poisoning.

Objective To investigate the current status about the knowledge,attitude and practice of medical staff for fast-track surgery (FTS) in third-grade class-A general hospital in Xuzhou,and provide reference for the popularization of the FTS concept.Methods The self-administered questionnaires were employed to survey 130 medical staff in the general surgical department of one third-grade class-A general hospital in Xuzhou.Results The FTS knowledge score was (20±8).The differences of knowledge scores were statistically significant because of different age,degree of education and positional title.The FTS attitude score was (66±20).And the differences of attitude scores were statistically significant because of different age and degree of education.The FTS practice score was (64.50±13.25).There was no statistical significance on the practice scores between the medical staff with different characteristics.Attitude was correlated with knowledge and practice while knowledge was not correlated with practice.Conclusions The FTS knowledge of medical staff was not rich.The FTS attitude was not so positive,and there were also few clinical practice.Medical staff should study the FTS concept and its contents actively.They also should apply FTS in clinic scientifically in order to better control the iatrogenic injury and promote the rehabilitation of patients effectively.

Objective:To explore the effect of mindfulness therapy on self burden, hope and sleep of middle-aged bladder cancer patients undergoing bladder sparing chemotherapy.Methods:Sixty patients with bladder cancer treated by intravesical instillation chemotherapy with bladder preservation from January 2018 to December 2019 were selected as the study subjects. They were divided into control group and intervention group according to the sequence of chemotherapy time, with 30 cases in each group. Both groups received routine nursing and rehabilitation training in urology, and mindfulness therapy was added to the intervention group for 6 weeks. Before and 6 weeks after the intervention, the sleeping and mental status of the two groups were compared by the Self-Burden Feeling Scale (SPBS), Herth Hope Scale (HHI) and Insomnia Severity Index Scale (lSI).Results:There was no significant difference in SPBS, HHI and ISI scores between the two groups before intervention ( P > 0.05). After 6 weeks of intervention, SPBS score of patients in the intervention group was 47.00±1.41, and that of the control group was 49.50±0.62.After 6 weeks of intervention, the total score of HHI was 32.61±1.94 in the intervention group and 27.22±2.67 in the control group.After 6 weeks of intervention, ISI score of patients in the intervention group was 19.17± 1.72, and that of the control group was 20.67±2.24. The difference between the two groups was statistically significant ( t values were 6.454, -7.042, 2.097, P < 0.01 or 0.05). Conclusions:Mindfulness therapy can effectively improve insomnia and cancer emotional problems in patients with bladder cancer who underwent bladder preservation and perfusion.

BACKGROUND: Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase (RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula (BF) during the treatment of lung cancer patients and summarize the possible causes. METHODS: We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and PubMed for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula." RESULTS: Our literature search produced two case reports (three patients) which, in addition to our three patients. We collated the patients' clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus (DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophago-tracheobronchial fistula. Six patients all died within 6 months. CONCLUSIONS Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.