The identification and diagnosis of coronavirus disease 2019 (COVID-19) is of great significance in the treatment of COVID-19. Based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 5) issued on February 8, 2020 by the National Health Commission, there is no fungal pneumonia among the disease listed in the identification and diagnosis item. Thus, we reported a case of patient with AIDS associated with pneumocystis carinii severe pneumonia admitted to Shanghai Fourth People′s Hospital affiliated to Tongji University School of Medicine in January, 2020, which was helpful in improving the identification and diagnosis of COVID-19.

Objective To explore the current status of nursing students′ empathy ability in adult education, and analyze its influencing factors, so as to provide references for the reform of further nursing education. Methods Totally 718 nursing students from two campuses of Guangdong Medical University were selected by convenience cluster sampling method, and were investigated in May 2014 by general situation questionnaire and clinical nurses empathy ability assessment scale. The general information of nursing students in adult education were analyzed by univariate analysis. Results The results of investigation showed that: the average total score of empathy ability among nursing students in adult education was (107.68±13.71), the score among adult nursing students of college was (106.31±12.95), and the score among undergraduate nursing students was (108.69±14. 18) (t=-2.22,P<0.05). There were significant differences in the scores of empathy ability among nursing students with different age, working years, marital status, professional titles and jobs (P<0.05). Conclusions The scores of empathy ability score among undergraduates nursing students is slightly higher than that among nursing students of college. Age, working years, marital status, professional title and job are important influencing factors of empathy ability. We should strengthen the cultivation of humanistic care in nursing continuing education, to raise the adult nursing students′empathy ability.

Objective To observe EML4-ALK fusion gene mutation expression rate in serum and cancer tissue of patients with non-small cell lung cancer (NSCLC) in Chinese populations,and the consistency of mutation in serum and cancer tissues,and the feasibility of real-time,dynamic detection of EML4-ALK fusion gene therapy by using FQ-PCR.Methods 123 cases of serum and 98 cases of tissue of NSCLC patients were detected by fluorescence quantitative polymerase chain reaction,and 77 cases of which were matched.The clinical curative effects of ALK inhibitor (crizotinib) were analyzed.Results 13 rearrangement in 123 (10.6％) of the patients'serum samples and 11 rearrangement in 98 (11.2％) tumor tissue.EML4-ALK rearrangement were mainly discovered in adenocarcinoma (x2 =4.083,P =0.036),and non-smokers in NSCLC (x2 =5.326,P =0.019).The consistency of patients with EML4-ALK matched tumor tissue and serum reached 66.7％ (6/9,κ =0.779).The EML4-ALK fusion gene rearrangement in patients receiving ALK inhibitor (crizotinib) treatment achieved significant benefit.Conclusion The EML4-ALK rearrangement mainly exists in the serum and tumor tissue of adenocarcinoma and non-smokers in NSCLC.When tumor tissue samples are unable to be obtained,FQ-PCR can be used to detect serum EML4-ALK fusion gene mutation for selecting NSCLC patients suitable for crizotinib therapy instead of tumor tissue.

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

Objective To compare the phaimacodynamics and circulatory function of domestic and imported rocuronium. Methods This is a five center study of rocuronium. Two hundred and ten ASA Ⅰ or Ⅱ patients aged 18-65 yr undergoing elective surgery under general anesthesia were randomly divided into 2 groups (n = 105 each): domestic rocuronium group (group Ⅰ ) and imported rocuronium group (group Ⅱ ) . Anesthesia was induced and maintained with TCI of propofol (target plasma concentration = 3 mg/L) and remifentanil (target effect-site concentration = 2-4 μg/L) . Tracheal intubation was facilitated with intravenous rocuronium 0.6 mg/kg. The N-M function was assessed by accelerography (TOF-Watch(R) SX, Organon, Netherlands) using TOF stimulation of ulnar nerve. Onset time, clinical duration, 75% recovery time,recovery indexes, the extent of maximal NM blockade and intubation conditions (ease of laryngoscopy, position of vocal cords and airway reaction) were monitored and recorded. BP and HR were also recorded. Results There were no significant differences in the onset time, clinical duration, recovery indexes, the extent of maximal N-M blockade, the intubation conditions, BP, HR and adverse reactions between groups Ⅰ and Ⅱ ( P ＞ 0.05) . The 75% recovery time was significantly longer in group Ⅱ than in group Ⅰ (P ＜ 0.05＝. Conclusion The pharmacodynamics of domestic and imported rocuronium is comparable. The two drugs have no adverse effect on the circulatory function.

Objective To investigate the role of Notch signaling pathway in cerebral ischemic tolenmce induced by clectroacupuncture (EA) preconditioning.Methods Fifty-two adult male SD rats weighing 280-320 g were randomly divided into 2 groups(n=each):control group(group C)and electroacupuncture preconditionig group(group EA).Group C received no treatment.Group EA received EA at the Baihui acupoint (GV20) for 30 min a day for 5 days.Twenty-four hours after the last preconditionig,focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 120 min,followed by 72 h of reperfusion.Notch intracellular domain(NICD)expression was determined by Western blot and expression of Notch1,Notch4,Jag1,and Hes1 mRNA by real-time PCR immediately before iachemia and 24 and 72 h of reperfusion.The neurological deficit was scored at 72 h of reperfusion.The infarct volumes were then determined after evaluation of the neurological deficit score .Results There was no significant difference in Hesl mRNA and NICD expression immediately before ischemia between group EA and C(P>O.05).NICD expression was up-regulated at 24 and 72 h of reperfusion in both groups, and Hesl mRNA expression at 72 h of reperfusion in group C and at 24 h of reperfusion in group EA was up-regulated compared with those immediately before ischemia (P < 0.05). Hes1 mRNA and NICD expression was up-regulated in group C, while down-regulated in group EA at 72 h of reperfusion compared with those at 24 h of reperfusion ( P < 0.05 ). Compared with group C, the expression of Notchl,Notch4 and Jag1 mRNA was up-regulated immediately before ischemia, and Hes1 mRNA and NICD expression was up-regulated at 24 h of reperfusion while down-regulated at 72 h of reperfusion in group EA( P < 0.05). EA preconditioning significantly reduced infarct volumes and increased neurological deficit scores at 72 h of reperfusion (P < 0.05 ). Conclusion Notch signaling pathway may participate in cerebral ischemic tolerance induced by EA preconditioning.