This paper reports the clinical characteristics as well as diagnosis and treatment processes of a patient with mixed pulmonary infection of Rhizopus microspores and Aspergillus.The patient had history of type 2 diabe-tes mellitus,and was admitted to the hospital due to diabetes ketoacidosis complicated with pneumonia.Clinical manifestations included cough,expectoration,and fever.Imaging examination showed inflammatory lesions of bila-teral lungs(mainly in the right lung)associated with local consolidation.Bronchoalveolar lavage fluid(BALF)smears and galactomannan antigen test(GM test)were both negative.Nucleic acid sequences of Rhizopus micro-spores and Aspergillus were detected by metagenomic next-generation sequencing(mNGS)at the early stage,while complicated infection of Klebsiella pneumoniae and COVID-19 were also found.The final pathological diagnosis was pulmonary mucormycosis combined with invasive pulmonary aspergillosis.The patient achieved clinical curing through the combination of isaconazole antifungal treatment and lobectomy of the right middle-lower lobes.

This paper reports the clinical characteristics as well as diagnosis and treatment processes of a patient with mixed pulmonary infection of Rhizopus microspores and Aspergillus.The patient had history of type 2 diabe-tes mellitus,and was admitted to the hospital due to diabetes ketoacidosis complicated with pneumonia.Clinical manifestations included cough,expectoration,and fever.Imaging examination showed inflammatory lesions of bila-teral lungs(mainly in the right lung)associated with local consolidation.Bronchoalveolar lavage fluid(BALF)smears and galactomannan antigen test(GM test)were both negative.Nucleic acid sequences of Rhizopus micro-spores and Aspergillus were detected by metagenomic next-generation sequencing(mNGS)at the early stage,while complicated infection of Klebsiella pneumoniae and COVID-19 were also found.The final pathological diagnosis was pulmonary mucormycosis combined with invasive pulmonary aspergillosis.The patient achieved clinical curing through the combination of isaconazole antifungal treatment and lobectomy of the right middle-lower lobes.

Objective:To investigate the efficacy of levodopa and benserazide hydrochloride combined with pramipexole in the treatment of Parkinson's disease in 30 patients and their effects on neurotransmitters and oxidative stress response.Methods:A total of 90 patients with Parkinson's disease admitted to Jinhua People's Hospital from January 2020 to February 2022 were included in this study. They were randomly assigned to undergo treatment with levodopa and benserazide hydrochloride (levodopa and benserazide hydrochloride group), pramipexole (pramipexole group), or their combination (combined therapy group), with 30 patients in each group. All patients were treated for 12 consecutive weeks. Clinical efficacy, levels of brain neurotransmitters (dopamine, 5-hydroxytryptamine, norepinephrine, and substance P), and oxidative stress response (superoxide dismutase, malondialdehyde, homocysteine levels) were compared among the three groups.Results:Total response rate in the combined therapy group was 96.67% (29/30), which was significantly higher than 66.67% (20/30) in the levodopa and benserazide hydrochloride group and 76.67% (23/30) in the pramipexole group ( χ2 = 8.65, P < 0.05). After treatment, dopamine, 5-hydroxytryptamine, norepinephrine, substance P, superoxide dismutase, malondialdehyde, and homocysteine levels in the combined therapy group were (9.05 ± 1.24) ng/mg, (89.49 ± 10.69) μg/L, (15.16 ± 1.36) ng/mg, (102.8 ± 15.36) μg/L, (88.40 ± 10.04) kU/L, (5.5 ± 2.31) μmol/L, and (9.20 ± 3.36) μmol/L, respectively, which were superior to (6.61 ± 1.02) ng/mg, (68.52 ± 9.52) μg/L, (12.33 ± 1.24) ng/mg, (151.64 ± 16.03) μg/L, (74.99 ± 7.28) kU/L, (9.27 ± 3.07) μmol/L, and (13.52 ± 3.64) μmol/L in the levodopa and benserazide hydrochloride group and (7.22 ± 1.09) ng/mg, (79.52 ± 10.20) μg/L, (13.92 ± 1.31) ng/mg, (131.30 ± 15.65) μg/L, (80.59 ± 8.24) kU/L, (7.53 ± 2.93) μmol/L, (11.35 ± 3.71) μmol/L in the pramipexole group ( F = 38.53, 32.05, 35.49, -73.42, 18.42, -22.65, -12.13, all P < 0.05). Conclusion:Levodopa and benserazide hydrochloride combined with pramipexole are highly effective on Parkinson's disease. The combined therapy can effectively improve brain neurotransmitters and regulate oxidative stress response.

Objective: By detecting the expression of interleukin-13 (IL-13) and periostin in the airway of asthmatic patients, the pathological changes and pulmonary functions of airway tissues in asthmatic patients were evaluated, and the role of IL-13 and periostin airway remodeling in bronchial asthma was preliminarily explored. Methods: The bronchial tissues adjacent to tumor nest were obtained from 12 patients with lung cancer complicated with bronchial asthma (asthmatic group) and 12 lung cancer patients without bronchial asthma (non-asthmatic group) after lung cancer resection. Pulmonary function was measured for all subjects before surgery. Pathological changes of airway tissues and degree of airway remodeling were assessed by hematoxylin-eosin (H&E) staining, masson′s trichrome staining, and periodic acid-silver methenamine (PASM) staining of paraffin-embedded sections. The expression of IL-13 and periostin in bronchial tissues were evaluated by immunohistochemistry. Results: Values of the forced expiratory volume in 1 second of the predicted value (FEV1% pred) and FEV1/forced vital capacity (FEV1/FVC%) in asthmatic patients were significantly decreased compared with the non-asthmatic patients (P<0.05), indicating that lung function was impaired in asthmatic patients. There was more severe airway remodeling representing as thickening of basement membranes, collagen deposition, and increasing of goblet cells and fibroblasts in asthmatic patients than in non-asthmatic patients (all P<0.05). The expression of IL-13 and periostin were higher in asthmatic tissues than in non-asthmatic tissues (P<0.05). The immunohistochemical expression of IL-13 and periostin in bronchial tissues were positively correlated with the degree of airway remodeling in asthmatic patients, and the expression of IL-13 and periostin in bronchial tissues were positively correlated with each other. Conclusions The expression of IL-13 and periostin were increased in bronchial tissue in patients with asthma. They work together to promote the occurrence of airway remodeling, which eventually lead to a decline in lung function.

In view of the current situation of the teaching of diagnostics, this paper analyzes the ex-isting problems and deficiencies , and puts forward the teaching reform of the National Medical College Students' clinical skills competition. Through the construction of experimental teaching demonstration center of clinical skills, we set up theclinical skills associationamong the students, boldly try innovative training, strengthen humanistic education and take other measures to improve the quality of clinical practice teaching of diagnostics, so as to achieve the purpose of the competition focusing on promote teaching, learning and using by competition.

BACKGROUND: The direct ratio is formed between the size of osseous defect around implant and the required time of complete repair. It is viewed that bone implantation is suggested if osseous defect is larger than 1 mm, which benefits the bone regeneration and early fixation of implant.OBJECTIVE: To compare the effects between coralline granules and hydroxyapatite (HA) during union after immediate implantation.DESIGN: Group observation and controlled experiment was designed.SETTING: Department of Stomatology Renmin Hospital of Wuhan University.MATERIALS: HA coated implant, HA granule, coralline granule and 3adult mongrel dogs.METHODS: The experiment was performed in Department of Stomatology, Renmin Hospital of Wuhan University from August 2002 to April 2003.Under anesthesia, 6 foramens were drilled on femurs of 3 dogs (3 foramens on each side) to result in osseous defect. Coralline granules were embedded in the osseous defect around the implant in all of proximal ends (coralline granule group, CG group), HA granules were embedded in the osseous defect around the implant in all of distal ends (HA group) and nothing was embedded in the defect around the implant in the center (the control). One dog was sacrificed under anesthesia on the 2nd, 3rd and 4th months after operation successively and the samples were collected from the implanted section in each group for X-ray examination and scanning electronic microscopic observation.MAIN OUTCOME MEASURES: X-ray examination on implanted sections and scanning electronic microscopic observation on samples in each the 4th month, it was observed that implants and osseous tissue were closely integrated in CG group and HA group and there was still partial osseous on samples in each group: on the 4th month, it was discovered that the regenerated osseous tissue was matured completely in CG group and few coralline granule residue was left. In HA group, the regenerated osseous tissue was matured completely, but there was still a large amount of HA granules left and the granules had not been absorbed obviously. In the control group, the space appeared partially in the implanted cervical region.CONCLUSION: The implantation of artificial bone is suggested if the osseous defect around immediate implant is larger than 1 mm. As the implanting materials, coralline granules and HA granules act on the most advantageous guide activity. Coralline granules can be degraded and substituted with osseous tissue,but HA granules cannot be absorbed, which affects osseous reconstruction.