Objective:To analyze the clinical characteristics and outcomes of non-aspergillus molds infection (NAMI) patients who underwent allogeneic stem cell transplantation.Methods:Total 24 patients diagnosed as proven or probable non-aspergillus molds infection after allo-HSCT at the Peking University Institute of Hematology from January 2010 to December 2016 were retrospectively reviewed.Results:Among the 24 non-aspergillus molds infection patients, 22 (91.6%) underwent haploidentical stem cell transplantation, while 1 (4.2%) underwent matched-sibling donor transplantation, and 1 (4.2%) underwent HLA-matched unrelated donor transplantation. Ten (41.7%) patients were diagnosed as proven NAMI, and 14 (58.3%) were probable NAMI. The median time to NAMI diagnosis was 188 (2-856) d after transplantation. Five (20.8%) patients had Mucorales infection, 14 (58.3%) Rhizopus infection, 3 (12.5%) had Absidia orchidis infection, and 2 (8.3%) had Scedosporium apiospermum infection. The response rate at was 38.9% (7/18) in 18 patients who adjusted antifungal therapy based on the etiology. After a median 229 (2-2280) days follow-up after diagnosis, the 2-year overall survival was (24.0±14.5) %.Conclusion:The major pathogen of NAMI after allo-HSCT was Rhizopus, and the mortality of NAMI after allo-HSCT was very high due to lack of early effective therapy.

We aimed to identify the effect of positive stool cultures (PSCs) on the clinical outcomes of patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT) (n = 332). PSCs were observed in 61 patients (PSC group, 18.4%). Enterobacteriaceae in stool specimens was associated with a higher risk of bloodstream infection, and Candida in stool specimens was related to a higher risk of platelet engraftment failure. The cumulative incidence of infection-related mortality 1 year after haplo-HSCT in the PSC group was higher than that of the patients who showed persistently negative stool cultures (NSC group; 19.2% vs. 8.9%, P = 0.017). The probabilities of overall survival (71.4% vs. 83.8%, P = 0.031) and disease-free survival (69.6% vs. 81.0%, P = 0.048) 1 year after haplo-HSCT for the PSC group were significantly lower than those for the NSC group, particularly for patients who had Candida in their stool specimens. In multivariate analysis, Candida in stool specimens significantly increased the risk of mortality and was associated with poorer survival. Our results showed that PSC influenced the clinical outcomes after haplo-HSCT, particularly those who had Candida in their stool specimens.

In order to study whether Paris forrestii could be developed as a substitute of Paridis Rhizome, chemical compositions of P. forrestii and P. polyphylla var. yunnanensis were investigated by UPLC-Q-TOF MS. In addition, the contents of eight primary steroidal saponins in 77 batches of P. forrestii samples from different habitats were simultaneously determined by HPLC-UV. The results showed that P. forrestii and P. polyphylla var. yunnanensis have similar chemical compositions, and all 22 major common peaks were identified as steroid derivatives. Meanwhile, there were some differences in the contents of saponins in P. forrestii samples from different habitats. The contents of 4 steroidal saponins in Chinese Pharmacopoeia ranged from 0.068% to 3.30%, and the highest content of the 8 kinds of steroidal saponins was 6.18%, while the lowest was just 0.71%. Moreover, 78% of P. forrestii samples were in conformity with the requirements of Chinese Pharmacopoeia, indicating that P. forrestii samples had relatively stable quality and could be further studied as a substitute for Paridis Rhizome.

The study was established an HPLC method for simultaneous determination of 8 steroidal saponins (polyphyllins Ⅶ, H, Ⅵ, Ⅱ, Ⅰ, and Ⅴ, dioscin, and gracillin) in Paridis Rhizoma, and made an evaluation by determining steroidal saponins in 15 kinds of genus Paris. The analysis was performed on a Waters Acquity H-ClassTM UPLC ultrafine liquid chromatography system coupled with a PDA detector. The chromatographic separation was achieved through a CAPCELL PAK ADME (4.6 mm× 250 mm, 5 μm) column and the optimal mobile phase consisted of acetonitrile and water. The column was maintained at 21 ℃, and the flow rate was 0.8 mL•min ⁻¹. The UV detection wavelength was 203 nm. The results showed that ① the detected components can be well separated and all with good correlation coefficients. The standard calibration curves were linearly good (R2>0.999 9). The linearity was obtained over 0.041 70-3.812 00 μg. The average recoveries ranged from 95.91% to 103.8%. ② there are significant differences in the content of steroidal saponins from different species. The steroidal saponins are low content or almost none in P. mairei, P. polyphylla var. stenophylla, and P. delavayi have low content or almost did not contain, so these species are not suitable for medicinal use. The contents of steroidal saponins in P. polyphylla var. chinensis are varied from different places. There were high content of steroidal saponins in P. polyphylla var. yunnanensis, P. forrestii, P. daliensis, and P. axialis, even up to 5.0%, which indicated that they had the potential pharmic value of development.

Objective To evaluate perioperative nutritional support for patients with acute abdomen in enhanced recovery after surgery (ERAS) programme.Methods A total of 490 patients with acute abdominal disease were collected,287 in ERAS group and 203 in conservative perioperative management (CPM) group.Biochemical and clinical markers of the 2 groups were compared.Results ERAS group had higher plasma albumin level,quicker bowel function recovery,lower postoperative complications,shorter hospital stay,and a lower WHO pain rating scale (all P ＜ 0.05).Conclusion With perioperative nutritional support,ERAS programme can accelerate recovery after emergency surgery,reduce the rate of overall complications,promote bowel function recovery,and decrease morbidity in the perioperative period for patients with acute abdominal disease.

Objective To discuss the effects of PBL teaching mode training on the core capability of new nurses .Methods Totally 27 nurses recuited from October 2014 to September 2015 in Xuhui District Central Hospital of Shanghai ,were selected as the observation group , while 26 nurses recuited from Semptember 2013 to August 2014 were selected as the control group .Nurses in the observation group received a 12-month PBL teaching mode training on the basis of traditional teaching method .While nurses in the control group received traditional teaching method .The core abiity and theoretical operation score of nurses in two groups were compared after training .Results Before the intervention , there is no significant difference in the score of items of nurses′core capability and the achievements of theoretical operation between two groups ( P>0.05) .After the intervention , each individual item score of nurses′core capability was as the following: assessment and intervention ( 3.20 ±1.11 ) , communication ( 4.25 ±1.25 ) , critical thinking ( 2.65 ±0.58 ) , interpersonal communication (4.85±1.89), comprehensive knowledge (3.58±1.02), management (2.10±1.29), leadership (2.10±1.29) and teaching (3.08±1.12); while the scores of those items in the control group were (2.21± 0.36), (3.68±1.31), (2.10±0.65), (4.21±1.02), (2.85±0.62), (1.65±0.35), (1.65±0.35) and (2.51± 0.39) (t=6.230,9.187,5.102,2.587,10.526,2.580,2.580,3.815;P<0.05).After the training, the score of theoretical operation in the observation group was (87.74±2.21), while the score in the control group was (75.15±1.59) ( t=7.023,P<0.05).Conclusions PBL teaching mode training can effectively improve the core ability and theoretical operation of new nurses .

Through the combination of science and technology and humanities :thinking on independent set of general education in medical colleges , pointed out that:set the idea of medical humanismmedical education;general medicine education content and method should have compatible science and technology and humanities ;general education should re-turn to traditional Chinese medicine and also to the world;experience both at home and abroad for reference to build the medicine and the humanities general education courses to strengthen comprehensive combination of science and technology and humanities , to further promote the improvement of the medical college general education .

Objective Through summaring all the randomized controlled trials published in Chinese Acupuncture & Moxibustion during the last 30 years,to investigate clinical researching situation of acupuncture in home and to provide objective and reliable data for other researchers.Methods All clinical research papers published in Chinese Acupuncture & Moxibustion from 1981-2010 was categorized and scored accordingto the size of sample,methods of grouping,and having or not having international or national diagnostic criteria,and then made a comprehensive analysis and comparison.Results ① RCT articles published in Chinese Acupuncture & Moxibustion has increased annually.②The methods of grouping has become more and more normative,which indicates that the level of RCT has been elevated.Of them,randmon digital table has been put into use the most frequently.Conclusion The quality of acupuncture clinical research papers are improving continuously,but the descriptions of the process need to be standardized.

Objectives To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing.Methods Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing.The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender,area,occupation and marital status among people aged between 25-45 years old.Results A total of 3489 cases were identified during 2007 to 2009 with acute coronary events ( male:3183,female:306),with a mean age of (40.5 ± 4.3 ) years old.The 3-years' overall mortality was 26.0％,with female's higher than male's (51.0％ vs 23.6 ％,P ＜ 0.05 ) ; and it was higher in rural area than in urban areas (28.9％ vs 22.9％,P ＜0.05).Ninety-five percent of death due to acute coronary events occurred prehospital,with the proportion of 95.2％ in male and 94.2％ in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death.Majority of prehospital deaths (64.8％ ) occurred at home.Conclusion More than 90％ of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital,and the site of prehospital deaths was mainly at home.

Objective: To observe the effect of Angong Niuhuang Bolus on prognosis of diffuse axonal injury (DAI), and to explore awaking and body-temperature-reducing actions of Angong Niuhuang Bolus in the patient of DAI. Methods: 30 cases of DAI were treated by routine western medicine therapy plus Angong Niuhuang Bolus as treatment group, and other 30 of DAI were treated by only routine western medicine therapy as control group. Their prognosis was estimated and analyzed by Glasgow Coma Scale(GCS)and Glasgow Outcome Scale(GOS)and mortality. Results:The total effective rate of 80% in the treatment group was significantly better than 56. 7% in the control group(P