Abstract：Objective To investigate the morphological features of the Pneumocystis jirovecii, in order to facilitate early detection and rapid diagnosis of this rare pathogen from a morphology point of view by laboratory technicians. By analyzing the laboratory features and application value of different pathogen detection methods in the diagnosis of Pneumocystis jirovecii pneumonia, we aim to provide the most reliable diagnostic basis for rapid diagnosis of Pneumocystis jirovecii pneumonia.Methods A retrospective analysis was conducted on the test results of bronchoalveolar lavage fluid samples from a comprehensive hospital in Zhangqiu District, Jinan City, Shandong Province, and a hospital in Changde City from April 2022 to October 2022. Five confirmed cases of Pneumocystis jirovecii pneumonia were detected. Its clinical manifestations, laboratory results, and morphological characteristics of pathogens under different stains were analyzed to discuss the advantages and disadvantages of different detection methods. Results Cytological examination of bronchoalveolar lavage fluid found the trophozoites and cysts of Pneumocystis jirovecii by Wright's-Giemsa staining in 4 cases (80%), and the cysts of Pneumocystis jirovecii by Silver hexamine staining in 4 cases (80%), while the metagenomic next-generation sequencing confirmed all the 5 positive results. All 5 patients had different degrees of reduction in the absolute count of peripheral blood lymphocytes, and the serum lactic dehydrogenase and (1-3)-β-D-Glucan were increased. Among the 5 patients in this study, 4 were treated with sulfamethoxazole combined with caspofungin, and 1 was treated with sulfamethoxazole. Three patients were cured and discharged from hospital after treatment, but two died. Conclusions The method of Wright's-Giemsa staining for the cytological examination of bronchoalveolar lavage fluid to find Pneumocystis jirovecii has the unique and irreplaceable advantages as silver staining. Metagenomic next-generation sequencing can further increase the positive detection rate of Pneumocystis jirovecii. The combination of cytological examination of bronchoalveolar lavage fluid with metagenomic nextgeneration sequencing is a powerful diagnostic method for rapid diagnosis of Pneumocystis jirovecii pneumonia, which can diagnose accurately and reduce missed diagnosis.

Objectives To study application efficiencies of two types of intestinal ostomy in the treatment of elderly patients with obstructive sigmoid colon cancer and colorectal cancer.Methods 62 elderly patients with obstructive sigmoid colon cancer and rectal cancer from January 2013 to January 2016 in our hospital were chosen.The patients were divided into loop ileostomy group(n=32) and colostomy group(n=30)depending on the type of therapy.And the stage Ⅰ and Ⅱ operative time,hospital stay,postoperative fasting time and postoperative complication incidence rates were compared between the two groups.Results The postoperative fasting time was significantly shorter in loop ileostomy group than in colostomy group during stage Ⅰ surgery(2.5 ± 0.5)d vs.(4.6 ± 0.6)d(t=14.3644,P =0.0000).In stage Ⅱ surgery,the operative time,hospital stay,postoperative fasting time (2.9 ± 0.6)d vs.(4.9 ± 0.4)d,(1.4 ± 0.4)d vs.(2.5 ±± 0.3)d,(6.3± 1.4d)vs.(8.8±1.2)d were significantly lower in the loop ileostomy group than in the colostomy group(t=-15.2762、-10.9714、-7.6601,all P =0.0000).Conclusions Compared with colostomy technique,the loop ileostomy has advantages including shorter operation time,lower incidence of postoperative complications and quicker recovery after surgery for elderly patients with obstructive sigmoid colon cancer and colorectal cancer.

BACKGROUNDEpstein-Barr virus (EBV) commonly infects the general population and has been associated with nasopharyngeal carcinoma (NPC), which has a high incidence in certain regions. This study aimed to address how EBV variations contribute to the risk of NPC.

METHODSUsing logistic regression analysis and based on the sequence variations at EBV-encoded RPMS1, a multi-stage association study was conducted to identify EBV variations associated with NPC risk. A protein degradation assay was performed to characterize the functional relevance of the RPMS1 variations.

RESULTSBased on EBV-encoded RPMS1 variations, a single nucleotide polymorphism (SNP) in the EBV genome (locus 155391: G>A, named G155391A) was associated with NPC in 157 cases and 319 healthy controls from an NPC endemic region in South China [P < 0.001, odds ratio (OR) = 4.47, 95% confidence interval (CI) 2.71-7.37]. The results were further validated in three independent cohorts from the NPC endemic region (P < 0.001, OR = 5.20, 95% CI 3.18-8.50 in 168 cases vs. 241 controls, and P < 0.001, OR = 5.27, 95% CI 4.06-6.85 in 726 cases vs. 880 controls) and a non-endemic region (P < 0.001, OR = 7.52, 95% CI 3.69-15.32 in 58 cases vs. 612 controls). The combined analysis in 1109 cases and 2052 controls revealed that the SNP G155391A was strongly associated with NPC (P(combined) < 0.001, OR = 5.27, 95% CI 4.31-6.44). Moreover, the frequency of the SNP G155391A was associated with NPC incidence but was not associated with the incidences of other EBV-related malignancies. Furthermore, the protein degradation assay showed that this SNP decreased the degradation of the oncogenic RPMS1 protein.

CONCLUSIONSOur study identified an EBV variation specifically and significantly associated with a high risk of NPC. These findings provide insights into the pathogenesis of NPC and strategies for prevention.

Adult ; Aged ; Carcinoma ; Case-Control Studies ; China ; epidemiology ; Epstein-Barr Virus Infections ; complications ; epidemiology ; virology ; Female ; Genetic Association Studies ; Genome, Viral ; Herpesvirus 4, Human ; genetics ; isolation & purification ; Humans ; Incidence ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; epidemiology ; virology ; Neoplasm Proteins ; genetics ; Pilot Projects ; Polymorphism, Single Nucleotide ; Risk Assessment ; methods ; Tumor Cells, Cultured ; Viral Proteins ; genetics

Objective To determine the activity concentration of radionuclides for 137Cs and 40K in edible wild mushrooms,and to evaluate the extent of radioactive contamination and ingestion doses to adults from consumption of these wild mushrooms.Methods A total of 33 samples for 18 edible wild mushroom species were collected from natural forest Mangshi,Yunnan province.The activity concentrations of 137Cs and 40K were analyzed by using high-purity germanium (HPGe) gamma spectrometry.Results Except.for one sample that was below the MDA,137Cs artificial radionuclides were detected in other 32 samples,with activity concentration of 137Cs in the range of 0.45-339.58 Bq/kg (dry weight) and an average of 25.47 Bq/kg (dry weight).In regards to 40K in edible mushrooms,all species presented the activity concentrations for this radionuclide and the levels varied from 453.4 to 1 882.6 Bq/kg (dry weight),with an average of 815.1 Bq/kg (dry weight).After species of mushroom with only one sample were eliminated,there was significant difference for 137Cs(F =21.13,P ＜ 0.05) among 6 species of mushroom named Gomphus floccosus (Schw.) Sing.,Boletus edulis bull,Boletus edulis bull,Tylopllus bolloul (Peck) Sing.,Lentinus edodes (Berk.) Sing.and Boletus brunneissimus W.F.Chin,but without significant difference for 40K.Conclusions These 6 different mushroom species have different capacity to retain radionuclides of 137Cs in soil.These wild mushrooms,such as Gomphus floccosus (Schw.) Sing.and Lentinus edodes (Berk.) Sing.have large affinity ability for radionuclides137Cs.The effective dose to adults attributable to consuming these kinds of mushrooms is small and below the level that could cause harm.

Objective To observe the efficacy and safety of liver decanoic sulfonic sodium in the treatment of elderly patients with acute coronary syndrome (ACS).Methods84 ACS patients over 70 years were randomly divided into the treatment and control groups.Two groups were treated on the basis of general,treatment 40 cases of liver of dibutyl sebacate with sodium sulfonated added 2.5 mg subcutaneous injection parumbilical,day 1,course 8 d ; control group 44 cases combined with low molecular weight heparin calcium 0.4 ml,2 times/day 1 time every 12 hours,according to body weight adjusted dose,Parumbilical shot in course of 8 days,observing the clinical effect of two groups during the treatment,as well as 4 weeks and bleeding during the treatment the incidence of cardiovascular events.Results The clinical effects of treatment and control groups was no significant difference (95％ and 91％,P ＞0.05) ; None of the two sets of death,myocardial infarction and recurrent malignant ventricular arrhythmia; none of the two sets of bleeding occurs,treatment of minor bleeding rates were significantly lower than those of control groups (7.5％ and 25％,P ＜ 0.05).Conclusion The study of dibutyl sebacate with sodium heparin and low molecular weight heparin calcium in the treatment of ACS are valid,but the former which significantly reduce the incidence of minor bleeding.Liver decanoic sulfonic sodium for acute coronary syndrome ACS)anticoagulation can not only effectively reduce cardiovascular events,but also significantly reduce bleeding risk,regardless of the patient's age,gender,renal function and risk stratification,especially for bleeding in high risk elderly patients with safe and clinical promotion.

This study was purposed to evaluate the safety and curative effect of autologous cytokine induced killer cells (CIK) combined with low-dose IL-2 regimen containing immune enhancement of thymic peptide on elderly patients with B-cell chronic lymphocytic leukemia (B-CLL). Thymic peptide α1 was subcutaneously given as the immunoenhancement agent at a dose of 1.6 mg/d, 14 days as one cycle. Peripheral blood mononuclear cells (PBMNC) from 5 patients with B-CLL were isolated once a week to induce ex vivo CIK cells through culture in the context of interferon (IFN)-γ, interleukin (IL)-2 and anti-CD3 monoclonal antibody. The PBMNC were separated from patients before and after 14 days as one cycle of thymic peptide α1 administration. Parameters of amplification ability, effector cells quantity, lymphocyte subgroups percentage and antitumor cytotoxicity were compared before and after thymic peptide administration. The 5 patients were treated with CIK cells combined with low-dose IL-2 regimen immediately after injection of thymic peptide α1. The CIK cells plus low-dose IL-2 regimen containing thymic peptide enhancement was defined as: thymic peptide α1 1.6 mg/d was subcutaneously administered once every other day; (4 - 6) ×10(9) of CIK cells were transfused followed by IL-2 subcutaneous administration of 1 mU/d on days 1-10, 28 days as one cycle. Clinical evaluation parameters including cellular immunity function, CLL related biomarkers, disease state and infectious frequency and degree were investigated before and after CIK cells infusion puls IL-2. The results showed that the amount of amplified CIK cells, the percentage and amplification times of effector cells and antitumor cytotoxicity more significantly increased after thymic peptide α1 treatment than before its use (P < 0.05). The total 46 cycles of CIK cells infusion plus IL-2 were completed in the 5 CLL patients. No adverse reaction was observed. After treatment of CIK cells plus IL-2, the general conditions of 5 CLL patients were to different extent improved. Simultaneously, percentages of CD3(+), CD3(+)CD8(+), and CD3(+)CD56(+) cells in peripheral blood remarked by raised (P < 0.05), the serum level of β2 microglobulin was significantly declined (P < 0.05), and the frequency and degree of infection was also decreased (P < 0.05). Following CIK cells plus IL-2 therapy, the transformation of disease state from partial remission (PR) to complete remission was seen in 3 patients, from stable disease (SD) to PR in 1 patient, and from progress of disease to SD in 1 patient. It is concluded that the regimen of autologous CIK cells combined with low-dose IL-2 containing immune enhancement of thymic peptide is safety and effective for the treatment of elderly patients with B-CLL.
Aged ; Aged, 80 and over ; Cytokine-Induced Killer Cells ; immunology ; Humans ; Interleukin-2 ; administration & dosage ; therapeutic use ; Leukemia, Lymphocytic, Chronic, B-Cell ; therapy ; Male ; Thymosin ; immunology

Objective To detect artificial radionuclide content in the spinach and soil in open air vegetable garden in Beijing during Fukushima nuclear accident and to study the radioactive contamination characteristics of the samples.Methods 6 spinach samples and 3 soil samples in open air vegetable garden were obtained through continuously sampling.High-purity germanium (HPGe) γ spectrometry was used to analyze activity concentrations of artificial radionuclide131 Ⅰ etc in these samples.Results Artificial radionuclide 131Ⅰ was detected in the 6 open air spinach samples.Artificial radionuclide 137Cs was detected in 3 vegetable garden soil samples,trace amount of 131 Ⅰ was detected in 1 open-air surface soil sample alone.Conclusions Following the Fukushima nuclear accident,spinach in Beijing's open-air vegetable garden was slightly polluted by artificial radionuclide 131 Ⅰ,with the highest values of pollution appeared around April 4,2011,but it could not cause harm to human health.

Objective To determine the artificial radionuclides levels in environmental samples collected in some areas of China following the Japanese Fukushima nuclear accident,and to evaluate the extent of radioactive contamination.Methods A total of 118 samples including aerosol,water,soil and biological samples were collected and the activity concentrations of 131I, 137Cs and other artificial radionuclides were analyzed by using high-purity germanium (HPGe) γ spectrometry.Results Artificial radionuclides 131I,134Cs,137Cs and 136Cs were detected in the aerosol samples on 2 April,2011 and the activity concentrations were 1720,247,289,and 23 μBq/m3,respectively.Trace amount of 131I was detected in one sample of rain water and two samples of surface soil with concentrations of 2.08 Bq/L,1.82 and 0.59 Bq/kg,respectively.131I was also detected in 18 vegetable samples which were collected from 2 April to 13 April with the range of 0.55 -2.68 Bq/kg.Neither abnormal concentrations of 131I nor 137Cs was detected in milk,drinking water,sea water and marine products samples.Conclusions During the Fukushima nuclear accident,although minute quantities of radionuclides were detected in some samples collected in China,the effective dose for adults attributed to the nuclear accident is extremely small and significantly below the level that could cause harm to the public.

Objective To test a full range of processes of sample collection,preparation,measurement and analysis by conducting the intercomparison of gamma-ray spectrometry measurement and analysis of radionuclides among key laboratories,so as to facilitate the development of gamma-ray spectrometry measurement and analysis technology.Methods To complete the collection and preparation of soil samples by Chinese Center for Disease Control and Prevention (CDC) laboratory and to measure and analyze the content in two soil samples of 214Pb,214Bi,208TI,228Ac,40K and 137Cs by three laboratories using gamma-ray spectrometry.Results The value calculated by any two laboratories were less than 1 in terms of assessment standards agreed by these three laboratories and based on the activity concentrations and the total uncertainty reported from them.The measurement results from our lab were acceptable.Conclusions Measurement results from these three laboratories are in agreement to some extent.This intercomparison activity has tested the analytical ability of the three laboratories and raised the level of our laboratory in testing homogeneity of sample preparation.

Objective To explore the effeetiviness of the method of LabSOCS(Laboratory sourceless calibration software)efficiency calibration in laboratory rapid analysis for emergency monitoring of nuclear incidents.Methods The detection efficiency of three kinds of environmental samples in emergency monitoring Wag calculated bY using the LabSOCS efficiency calibration method,and compared with the values that were obtained by way of radioactive source calibration method.Results The maximum relative deviation of the detection efficiency between the two methods was less than 15%,and the values with relative deviation less than 5%accounted for 70%.Conclusions The LabSOCS efficiency calibration method might take the place of radioactive source efficiency calibration method,and meet the requirement of rapid analysis in emergency monitoring of the nuclear incidents.