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 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.

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 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 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.

Objective To establish an appropriate preterm hypoxic-ischemic brain injury animal model. Methods A total of 32 pregnant New Zealand white rabbits at gestational day 25 were selected. The uterine blood supply in pregnant rabbits was blocked for 30, 35, 37, 40 minutes respectively, while in the control group it was not blocked. Then the pregnant rabbits were subjected to cesarean section 24 hours (at embryonic day 26, A group) or 5 days (at embryonic day 30, B group) after the experimental procedure. The general conditions of the newborn rabbits were recorded. The degree of neurobehavioral impairment in newborn rabbits was evaluated. The histological changes of brain tissue were observed. Results In A group, all newborn rabbits survived with ischemia for 30 minutes, while the stillbirth rates increased from 31.0% to 100% with ischemia from 35 to 40 minutes. In survived nowborn rabbits, the brain water content and the number of apoptotic brain cells were increased with prolonged ischemia. All these differences were statistically significant (all P<0.05). In B group, the stillbirth rates increased to 50.0% and 65.7% respectively with ischemia for 35 or 37 minutes. The birth weight of survived newborn rabbits were significantly lower than that in the control group. The neurobehavioral test scores were significantly lower in ischemic groups than that in the control group. All these differences were statistically significant (all P<0.05). The pathological examination of brain tissue found that the white matter damage in B group was more obvious than that in A group. Conclusions Continuous blockage of uterine blood supply in pregnant rabbits at gestational day 25 causes stillbirth, neurobehavioral damages and white matter injury as well as fetal rabbit intrauterine growth restriction, which can be used for the preparation of preterm hypoxic-ischemic brain injury animal model.

Objective To compare the efficacy of ultrasound ablation and laparoscopic lesion resection with uterine artery liga-tion in treating adenomyosis .Methods By using the prospective ,non-randomized controlled clinical study method ,the adenomyosis patients with clinical symptoms and requiring reserved uterus in our hospital from March 2011 to June 2012 were treated by the ul-trasound ablation technique(ultrasound ablation group ,40 cases) and the laparoscopic lesion resection with uterine artery ligation (operation group ,38 cases) .The menstrual blood volume ,dysmenorrhea and treatment satisfaction in postoperative1 ,3 ,6 months were compared between the two groups .Results The menstrual blood volumes in postoperative 1 ,3 ,6 months in the two groups were decreased significantly(P<0 .05) ,the dysmenorrhea symptoms were improved significantly (P< 0 .05) ,the two groups all were satisfied with the treatment effect .The differences between the two groups had no statistical significance (P>0 .05) .Conclu-sion The two methods of the ultrasound ablation technique and the laparoscopic lesion resection with uterine artery occlusion for treating adenomyosis could significantly reduce the menstrual blood volume ,improve dysmenorrheal and obtain higher satisfaction . Both can achieve the same therapeutic effect .

Objective To evaluate the clinical curative effect of using 153Sm-EDTMP in painful bone metastasis of malignant tumor. Methods Eighty patients with bone metastasis of malignant rumor underwent radionuclide bone palliation therapy were analysed.The treatment efficacy was evaluated by visual analogue scale (VAS) and Kamofsky performance scale.Results 68.75% of patients had a positive response.A better analgesic effect was found in cases of lung,prostate and breast carcinoma metastasm compared to metastasis from other malignant lesions.Improvement of performance in Karnofsky scale was found in cases of midrange and heavy range patients.Conclusion The analgesic effects of 153Sm-EDTMP is obvious in painful bone metastasis of malignant tumor.Improvement of life quality is significant in cases of midrange and heavy range patients.The therapeusis is a beneficial supplement of radiotherapy and odynolysis therapy.

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.