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 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 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 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 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.

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 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.

Objective To investigate the promoter methylation status of SFRP1 and SFRP2 gene in gastric cardia adenocarcinoma (GCA). Methods Methylation specific PCR (MSP) method was used to examine the methylation status of the 5' CpG island of SFRP1 and SFRP2 gene in tumors and corresponding normal tissues. Results Methylation frequencies of SFRP1 and SFRP2 gene in tumor specimens were 87.2 % (82/94) and 83 %(78/94), which was significantly higher than that in corresponding normal tissues (14.9 % and 55.3 %, respectively) (P <0.001). Methylation frequencies of SFRP1 in lymph node metastasis group (96.4 %) was significantly higher than that in no lymph node metastasis group (73.7 %). Methylation frequencies of SFRP1 and SFRP2 gene in poor differentiation group were all higher than that in moderate and poor-moderate differentiation groups, but both of them did not show significant difference(P >0.05). 63 cases of GCA showed both of SFRP1 and SFRP2 gene simultaneous methylation, which including 36 cases of lymph node metastasis group, 27 cases of no lymph node metastasis group. Simultaneous methylation frequencies of SFRP1 and SFRP2 gene in lymph node metastasis group was higher than that in no lymph node metastasis group, poor differentiation group was higher than that in moderate and poor-moderate differentiation groups, but both of them did not show significant difference (P >0.05). Conclusion Promoter methylation of SFRP1 and SFRP2 might be related with oncogenesis of GCA and hypermethylation of SFRP1 gene might be related with the malignant behavior of GCA.

Objective To analyze the changes of varicosis and hemodynamics in cirrhotic patients with portal vein hypertension at different stages after Hassab devascularization, and to evaluate the outcome.Methods Hassab devascularization was performed in 161 patients with portal vein hypertension, who were all evaluated by means of endoscopy, Doppler color imaging and Child-Pugh grading before and 6, 12, 18,24 months after the procedure, respectively.Results The rates of mild esophageal varicosis were 44.0%,34.8% and 28.3% at 6, 12 and 18 months after Hassab devascularization, respectively, which were all significantly higher than that before the operation(7.5%, P ＜ 0.05), while the rates of severe esophageal varicosis were 25.2%, 29.7% and 34.9% at 6, 12 and 18 months after the procedure, which were significantly lower than that before(65.2%, P ＜ 0.05).The incidence of varices in gastric fundus was correlated with the severity of esophageal varices.At 12 months after the operation, the inner diameters of portal vein and its right branch significantly decreased when compared with those before(P ＜ 0.05), the maximal flow rate,volume of portal vein and average flow rate of the left branch also significantly decreased(P ＜ 0.05).At 6 months after the operation, the average flow rate of the right branch slowed down(P ＜ 0.05).Child-Pugh Grade A accounted for 63.5%, 60.6% and 57.9% at 6, 12 and 18 months after the operation, respectively, which were significantly higher than that before(48.4%, P ＜0.05).When evaluated at 24 months after the procedure, all variables were getting close to those before.Conclusion The severity of esophageal varices mitigates in 18 months after Hassab.Hemodynamics of portal vein system decreases in 12 months.The overall liver function improves in 18 months after the operation.

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.