Pneumocystis carinii pneumonia (PCP) is a life-threatening opportunistic infection in immunocompromised patients.In recent years,the incidence of PCP has increased significantly since the application of combined chemotherapy,immunosuppressant and hematopoietic stem cell transplantation,with improved long-term efficacy in pediatric blood disease.This review summarizes the clinical manifestations,laboratory and radiological examination,diagnosis,treatment and prophylaxis.Compound Sulfamethoxazole is the most commonly used agent for prophylaxis.It is recommended for the high-risk patients to take PCP prophylaxis,which could decrease the incidence of PCP.

OBJECTIVE To understand distribution of fungi and condition of drug sensitivity to provide information for preventing nosocomial fungal infection,rational administration and approaching therapeutic strategy.METHODS CHROMagar coloration medium,API20C AUX systemic identification breed,identifying drug selected test chart of Hema-biotech BACT-IST,and susceptibility test were used according to broth micro-dilution antifungal susceptibility test(Mi-AFST) of CLSI M27-A2.RESULTS The major strains isolated from hospital infection samples were Candida albicans(60.04%)and C.tropicalis(22.22%),and mainly from sputa(69.03%),and the key departments were internal respiratory medicine(38.29%),intensive care unit(ICU)(31.91%) and senior cadre ward(16.54%) orderly.According to the sensitivity of antimycotic drugs the flucytosine(97.39%) and amphotericin B(95.27%) were relatively sensitive,the effective rate and resistance rate of antimycotic drugs were 91.00% and 44.00%,respectively,the rate of fungus detected without clinical symptoms was 10.63%.CONCLUSIONS The clinical diagnosis and therapeutic strategy are determined by clinical symptoms and laboratory results of drug sensitivity;and the prevention of fungal infection is also important.

Objective To investigate the correlation between the D-dimer level and the acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods The changes of D-dimer levels in 156 patients (AECOPD group) before and after treatment were measured and compared with the D-dimer levels of 156 healthy subjects(control group).Results The concentration of plasma D-dimer in the AECOPD group was (1.35 ± 1.46) mg/L,which was significantly higher than (0.25 ± 0.16)mg/L in the control group,and the difference was statistically significant(t =9.354,P ＜0.05).The level of plasma D-dimer in the AECOPD group was (0.69 ± 0.87)mg/L,and compared with (1.35 ± 1.46)mg/L before treatment,the difference was statistically significant(t =4.850,P ＜ 0.05).Conclusion D-dimer level is correlated to the condition of patients with chronic obstructive pulmonary disease,it can be used as one of the indicators to diagnose whether a patient is in hypercoagnlable state or suffers thrombotic diseases.

Objective To investigate effects of compound LJZ on antitumor activity and immune function in mice bearing implanted tumor in vivo.Methods The antitumor effects on the sarcoma 180(S180) and hepatoma 22(H22) bearing in mice were evaluated by weight of tumor.The effects of compound LJZ on specific immunity function were observed by delayed-type hypersensitivity(DTH) response induced by 2,4-dinitro-1-fluorobenzene(DNFB)and the effects of compound LJZ on non-specific immunity function were studied by macrophage phagocytosing neutral red.Results Compound LJZ inhibited significantly the growth of S180 and H22 bearing in mice,and showed dose-dependent relationship.Compound LJZ could enhance the phagocytic capacity of macrophage in bearing S180 mice.But it had no effect on DTH.Conclusion Compound LJZ has significant antitumor effects in vivo,and the effects on phagocytic capacity of macrophage maybe one of its antitumor mechanisms.

Objective To understand the fairness of health resources of endemic diseases institutions in Henan Province,to provide evidence for endemic allocation of health resources for the government.Methods Health-related data resources in endemic disease prevention and control institutions were collected in Henan Province,including personnel,business space area,the value of equipment,and health funding,etc.The percentages of population distribution and geographical distribution of health resources were calculated; Lorenz curves of demographic fairness and geographic fairness were drawn.According to Lorenz curve (Gini coefficients of the population and the geographical distribution were calculated based on Lorenz curve),Gini coefficients were used to evaluate the fairness of the endemic disease prevention institutions for health resource allocation.Results As can be seen from Lorenz curve,the population fairness of endemic disease prevention and health personnel was the best,but the number of senior officers was less and the total value of equipment owned was low.The geographical fairness of all the indicators of health resources was poorer,and geographic fairness among senior officers was the worst.The Gini coefficient of health technical personnel,senior personnel,undergraduate or above personnel,value of equipments,area of business room and health funding allocation determined by the population distribution was less than 0.4.The health resources were relatively fair and reasonable according to the distribution of population.The Gini coefficients of all the indicators determined by the distribution of geography were higher than those determined by the distribution of population.Furthermore,the geographic Gini coefficient of senior personnel was above 0.4 which was in the vigilance state.Conclusions The equality of health resources determined by population distribution in the institutions for endemic diseases control in Henan is superior to those determined by geographic distribution.The allocations of health resources of endemic diseases control in different areas are unbalanced.

The submucous plexus of the gastrointestinal tract in 20 guinea pigs were studied by histochemical methods for Nissl bodies and acetylcholinesterase (AChE) and immunohistochemieal technique for somatostatin (SOM). We found that some neurons in the submueous plexus were located against the lymphatic vessels or even protruded toward the lumen, and only a basement membrane separated the endotheliocytes from the neurons. Thus we refer them as "paralymphatic neurons". The neurons were spindle, pear-like or polygonal in shape and all showed AChE positive reaction, but some of them exhibited SOM positive reaction. So, the paralymphatie neurons were different in property. According to the close appositional relationship between the neurons and lymphatic vessels, we infer that this peculiar type of neurons might be similar to the "cerebrospinal fluid-contacting neurons" in the ependyma and might have the function of neurosecretion or reception of the changes of chemical composition in the lymph. Paralymphatie neurons existed mainly in small intestine, rarely in colon and were not seen in gastric corpus and pyloric region. This suggested that the neurons might play a more important role in small intestine.

Objective To investigate the effect and mechanism of cell differentiation agent Ⅱ (CDA-Ⅱ) on the differentiation of human acute mycloid leukemia (APL) HL-60 cells.Methods The cell morphology and differentiation was detected by Wright-Giemsa staining,the expression of cell surface differentiation antigen CD11b of HL-60 was detected by flow cytometry,the differentially expressed genes were screened by gene expression profile chip (NimbleGen).Results The result of Wright-Giemsa staining showed that CDA-Ⅱ induced HL-60 differentiation towards mature stages in a time-dependent manner.After treated with CDA-Ⅱ,the percentage of CD11b-positive HL-60 cells significantly increased in a time-and dose-dependent manner.The result of gene expression profiling indicated differentially expressed genes including 113 up-regulation genes and 140 down-regulation genes.The up-regulation expression genes involved in six pathways including mineral absorption,complement and coagulation cascades,down-regulation expression genes involved in nine pathways including pyrimidine metabolism,RNA polymerase,purine metabolism and so on.Conclusion CDA-Ⅱ can induce HL-60 differentiation and make gene differentially expressed.The data provide the feasibility of CDA-Ⅱ in differentiation induction therapy for APL.

Objective To explore the changes of pubescent immune response in the schizophrenia offspring induced by poly(I:C) during pregnancy and the effects on white matter.Methods The obtained pregnant rats were randomly divided into model group(n=6) and control group (n=5), receiving either poly (I:C) at a dose of 10 mg/kg diluted in 0.9％ NaC1 solution or vehicle solution alone (sterile pyrogen-free 0.9％ NaC1) on gestation day 9 (GD9).Immunohistochemical technique(IHC) was applied to detect the changes of microglias and astrocytes in the prefrontal cortex(PFC) and hippocampus(HC) of partly offsprings in the two groups at the sixth week,as well as Luxol fast blue(LFB) for the changes of white matter.The other offsprings of each group were selected for behavioral assessment at the eighth week.Results The results of prepulse inhibition test showed that PP2, PP4 and PP8 of model groups were significantly lower than that of the control group at young adult(P＜0.01).In passive avoidance test, and the T1 results of model group were significantly higher than those of the control group, the T results of model group were lower than those of control group (P＜ 0.01).Immunohistochemical results indicated that the number of microglias in the model group((264±33)/mm2, (271 ±38)/mm2) was significantly increased in PFC and HC than that in the control group((140±29)/mm2, (169±37)/mm2, P＜0.05) ,which was accompanied with significant morphological changes, while the OD value of astrocyte protein expression in the frontal lobe and hippocampus had no obvious difference between the model group and control group(P＞0.05).The OD value of LFB staining for myelin in the model group(0.29±0.02) was significantly decreased compared with that in the control group(0.33±0.03)(P＜0.01).Conclusion The young adult offsprings with prenatal infection present obvious schizophrenia-like behavior, meanwhile, the microglias activation and demyelination changes in white matter are observed,which provides more evidence for the relationship between immune response and white matter in the pathogenesis of schizophrenia.

Objective To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.Methods The research articles of general practice education published between January 1,1993 and December 31,2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.Results Total 4 281 articles were retrieved and 241 education relevant articles were selected.29.9％ (72/241) of the 241 articles were on on-campus education, 67.6％ (163/241) were on continuing medical education and 4.5％ (11/241) were on post-graduation education.As to the published institutions, 58.5％ (141/241) were from the medical colleges and research institutions, 25.7％ (62/241 were from the tertiary hospitals, 3.7％ (9/241) were from primary care institutions, 1.7％ (4/241 were from the secondary hospitals and 5.8％ (14/241) were from the government departments.The general practice education grants increased from 1 in 2001 to 46 in 2012;20 of which were supported by provincial and ministerial level funds.Conclusion The contents of general medical education literature in China is mainly on on-campus education and continuing medical education;most of which were from the tertiary hospitals and the medical colleges and research institutions.The amount of research grants of general practice education were increasing year by year during 1993-2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.

Objective To investigate the role of visfatin in the pathogenesis of gestational diabetes mellitus (GDM)and its correlation with insulin resistance.Methods The study recruited 58 pregnant women of 24 to 28 gestational weeks in People' s Hospital of Hebei Province from January to June 2013.Among them,30 were patients with GDM (GDM group),28 had normal oral glucose tolerance test and was referred as healthy pregnancy group (NGT group).Fourteen age-matched female who were first-degree relatives (FDR1)of type 2 diabetes mellitus patients,and 27 healthy nonpregnant women with normal oral glucose tolerance test were referred as high-risk group and normal controls (NC),respectively.The fasting plasma glucose (FPG),1 hour and 2 hours postprandial glucose levels were measured by glucose oxidase method.The fasting insulin (FIN)levels were measured by radioimmunoassay and the homeostatic model assessment-insulin resistance index (HOMA-IR)was calculated.The levels of total cholesterol (TC),triglycerdes (TG),high density lipoprotein cholesterol (HDL)and low density lipoprotein cholesterol (LDL)were determined.The visfatin levels were measured by ELISA.Results (1)The levels of FPG were significantly higher in GDM,FDRI and NC group [(5.5±0.7),(5.1±0.6),(5.2±0.4) mmol/L] than that in NGT group [(4.5 ± 0.3) mmol/L],respectively (P＜0.05).(2) The levels of INS [(14 ± 6) mU/L],HO MA-I R (4.0±2.0),1 hour [(10.9± 1.8) mmol/L] and 2 hours [(8.6± 1.8) mmol/L] postprandial glucose levels of GDM group were significantly higher than those in NGT group [(12±4) mU/L,2.0± 1.0,(7.4± 1.3) and (6.2 ±0.9) mmol/L],respectively (P＜0.05).(3)The levels of TC,TG,HDL and LDL levels in GDM group were (5.5±0.9),(2.8±0.8),(1.8±0.4)and(3.3±0.8) mmol/L,and were(5.9 ± 0.8),(2.5 ± 0.7),(1.9 ± 0.4) and (3.4 ± 0.6) mmol/L in NGT group.The levels of lipid in the two groups were significantly higher than those in FDR 1 or NC group,respectively (P＜0.05).(4) The levels of visfatin in GDM group and NGT group [(43 ± 10),(45 ± 12) μg/L] were significantly higher than that in FDR1 or NC group [(29±9),(36±7) μg/L],respectively (P＜0.05),but the visfatin levels in FDR 1 group were significantly lower than that in NC group (P＜0.05).The visfatin levels in GDM group were slightly lower than that in NGT group,but the difference was not statistically significant (P＞0.05).(5)The visfatin levels in NGT group were negatively correlated to the levels of FPG,HOMA-IR and TC(r=-0.38,-0.44,-0.47,respectively,P＜0.05).But the visfatin levels in GDM group were not correlated with the levels of FPG,HOMA-IR,TC (r=-0.16,-0.01,0.33,respectively,P＞ 0.05).While in NC group,the levels of visfatin were negatively correlated with FPG and 2 hours postprandial glucose (r=-0.48,-0.42,respectively,P＜0.05).Conclusion Visfatin may be an important adipokine that involved in the carbohydrate and lipid metabolism in GDM,and is related to the pathogensis of GDM and insulin resistance.