Objective To analyze and evaluate the clinical characteristics of imported falciparum malaria cases and the antimalarial effect of artemisinin-based drugs, to promote rational and standardized drug use, and to improve the clinical cure rate of falciparum malaria. Methods A total of 116 imported cases of falciparum malaria admitted to the provincial malaria designated hospital in Wuhan were collected, and the clinical characteristics of the patients and use of artemisinin, and the therapeutic effects of the artemisinin-based drugs were retrospectively analyzed. Results The clinical manifestations of imported falciparum malaria were complicated and varied and had many complications, including mainly fever, anorexia, anemia, and jaundice, etc. The symptoms were alleviated or disappeared after treatment with artemisinin, without obvious adverse drug reactions. The median time of fever reduction was 2 days, the median time of Plasmodium becoming negative was 3 days, and the median time of clinical symptom relief was 3 days. 109 cases of common falciparum malaria were treated by oral artemisinin compound or artesunate injection combined with oral artemisinin compound, including 30 cases of oral artemisinin compound treatment for 1 to 4 days (1 case relapsed) and 79 cases of artesunate injection combined with oral artemisinin compound for 4 to 6 days (4 cases relapsed). Seven severe cases were cured after long-term and high-dose treatment with artesunate injection combined with oral multiple artemisinin compounds, and the total cure rate was 95.69% (111/116). Conclusion The present study demonstrates that the treatment of falciparum malaria by oral injection of artemisinin is safe and effective, and the cure rate is high. However, some patients have recurrence of the malaria parasite after stopping artemisinin drugs. It is necessary to ensure the use of artemisinin-based drugs in a ^“standardized, full-process, and adequate^” way to contain the risk of severe illness and drug resistance.

【Objective】 To detect the abnormal expression of Th9, Thl7, Treg cells, interleukin-9 (IL-9), interleukin-17 (IL-17) and transforming growth factor-β(TGF-β) in patients with multiple myeloma (MM), and to explore their roles in primary diagnosis of MM. 【Methods】 The level of Th9, Th17 and Treg cells in peripheral blood of 54 MM patients with(patient) and 45 healthy volunteers (control) were measured by flow cytometry, and the levels of IL-9, IL-17 and TGF-β were detected by ELISA. 【Results】 The percentages(%) of Th9, Thl7 in MM patients increased significantly in comparison to controls [1.37±0.39 vs 0.79±0.26; 2.02±0.41 vs 1.18±0.32] (P<0.05). The proportion(%) of CCD4⁺ CD25⁺ FoxP3⁺ Treg cells in patients was significantly lower than those in controls (4.92±0.83 vs 7.04±1.85, P<0.05). The expression levels (%) of IL-9 and IL-17 in the peripheral blood of patients were significantly higher than those in controls (25.74 1±7.33 vs 16.82±5.58; 11.01±3.71 vs 7.68 ± 2.57, P<0.05). The levels of TGF-β in patients and controls were (3.73±1.44)% vs (6.95±2.12)%, showing a significant decrease (P<0.05). 【Conclusion】 The abnormal percentage of Th9, Thl7, Treg cells and the abnormal expression levels of IL-9, IL-17, TGF-β in MM patients may play an important role in the initial diagnosis of MM.

Objective To investigate and analyze the capabilities of Plasmodium microscopic examinations in medical and health organizations in Dongxihu District,Wuhan City,so as to provide evidences for achieving the standard of malaria elimina?tion and malaria control in the future. Methods The basic information of the laboratorians and the hardware facilities in 15 mi?croscopic examination stations of Plasmodium were collected and analyzed from 2010 to 2015. Meanwhile,the quality of mak?ing,dyeing,cleanliness of all the negatives blood smears were evaluated,and all the positive smears were re?checked in the dis?trict during the period above mentioned. Results Totally,there were 28 laboratorians and 9 qualified microscopes in 15 micros?copy stations in Dongxihu District. The age of the laboratorians in the first?level and third?level organizations was mainly from 40 to 50 years old,but the age of those in the second?level organizations was from 20 to 30 years old. The years for microscopic ex?amination working of most of the laboratorians in the first?level and third?level organizations were more than 15 years,while the working years of those in the second?level organizations were mainly less than 10 years. The education level of the laboratorians in the first?level organization was mainly(50.00%)junior college,while the education levels of those in the second and third or?ganizations were mainly bachelor. From 2010 to 2015,8 561 blood smears were produced and 539 of them were reviewed,the co?incidence rates of review were all 100%,and the average qualified rates of making,dyeing,and cleanliness of the negative blood smears were 82.08%,79.92%and 83.33%,respectively. All the rates mentioned above in 2015 were higher than those in 2010(χ2=26.45,16.85,13.93,all P<0.01). Conclusion The capability of microscopic examinations of Plasmodium has improved obviously in Dongxihu District,but the human resources construction and hardware input in this district should be im?proved,meanwhile,the check on the quality control of microscopic examinations of Plasmodium should be continued,so as to guarantee the sustainable and healthy development of malaria control work in this district.

Objective To observe the effectiveness of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.Methods Seventy patients (17 males,53 females,aged 20-65 years,ASA grade Ⅰ or Ⅱ) undergoing laparoscopic cholecystectomy were randomized to receive either dexmedetomidine (group R,n=35) or dexamethasone (group D,n=35).The patients in the group R received 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine before intubation.The patients in the group D received 8 mg dexamethasone before intubation.The BP and HR were recorded at the following points: on arrival in the operating room (T1),before intubation (T2),5 minutes after intubation (T3),5 minutes after the beginning of the operation (T4),30 minutes after the beginning of the operation (T5),at the end of operation (T6) and 5 minutes after extubation (T7).The inhaling concentration of sevoflurane,extubation time,operation time and anesthesia time were recorded.The incidence of nausea and vomiting were recorded at 8,24,48 hours after operation.Results The incidence of nausea and vomiting at each point were similar between two groups.The HR at T2-T7 in group D was significantly lower.But MAP was similar between two groups.Conclusion 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy,similar to dexamethasone.

OBJECTIVE: To explore the influence of clinical practice on mental health of male nursing college students,and to investigate the effects of psychological intervention. METHODS: Using the cluster sampling method,408 clinical practice male nursing students from 5 medical colleges in Jilin Province were randomly divided into intervention group and control group. The male nursing students were investigated with Chinese Perceived Stress Scale(CPSS),M to R sections of Cornell Medical Index(CMI) and Symptom Checklist 90(SCL-90). After the first questionnaire survey in the 9 weeks of clinical practice(before psychological intervention),male nursing students in intervention group received psychological intervention,while those in control group received no action. The investigation were then performed in the 20th(11 weeks of intervention) and 30 th weeks(21 weeks of intervention) of clinical practice. RESULTS: In the 11 and 21 weeks of intervention,the positive rates of CPSS,M-R and mental symptoms in intervention group were lower than those of timematched control group(P < 0. 01),and were significantly lower than those before intervention(P < 0. 01). Before intervention,the scores of CPSS,M-R and SCL-90 in two groups had no statistical significance(P > 0. 05). After the 11 and 21 weeks of intervention,the scores of CPSS,M-R and SCL-90 in intervention group were lower than those of control group(P < 0. 01). With the increasing time of intervention,the scores of CPSS and M-R in intervention group decreased(P < 0. 01). After the 11 and 21 weeks of intervention,the scores of SCL-90 in intervention group were lower than those before intervention(P < 0. 01). CONCLUSION: The results suggest that clinical practice is a stress for the mental health of male nursing college students. Psychological supporting system can be used to improve students' psychological health.

Objective To evaluate the effects of an optimized resuscitation bundle on prognosis of emergency patients with septic shock.Methods 65 patients with septic shock,admitted into emergency intensive care unit (ICU),were randomly divided into the treatment group(treated by an optimized resuscitation bundle)and the control group(treated by surviving sepsis campaign classics methods)by using random number table.The scores of sepsis-related organ failure assessment(SOFA) scores,the vasoactive agent application times,the mechanical ventilation times,the stay days of ICU,and 28-day mortality of the two groups were observed and compared.Results 3,7 day after erollment the SOFA score of the treatment group was (9.1 ± 2.5) points,(8.2 ± 2.8) points,respectively,which was lower than that of the control group[(10.1 ± 3.3) points,(9.5 ± 3.1) points] at the same time(t =4.52,3.99,all P ＜ 0.05) ; 8-day mortality rate of the treatment group was 28.1％,which was lower than that of the control group (48.5％) (x2 =12.84,P ＜ 0.05).Conclusion Application of an early optimized resuscitation bundle can significantly improve the prognosis of emergency patients with septic shock.

Objective To study the polysomnography(PSG) indexes which can reflex the severity of anoxia in obstructive sleep apnea-hypopnea syndrome(OSAHS) more comprehensively. Methods Sixtythree OSAHS patients' PSG indexes, including the apnea-hypopnea index (AHI), apnea time/total sleeping time (AM), hypoventilation time/total sleeping time (HM), mean oxygen saturation (MSaO2),the lowest oxygen saturation (LSaO2) and the longest apnea time (LAT) were analyzed retrospectively. Results In patients with OSAHS,the AHI was positively correlated with AM, HM and LAT(P ＜ 0.01 or ＜ 0.05 ), and was negatively correlated with MSaO2 and LSaO2(P ＜ 0.01 ). The AHI had linear regression relationship with AM,HM and LSaO2 (F =202.264,P ＜0.01). Conclusions Among the PSG indexes,AM is intimately associated with AHI. Therefore,compared with LSaO2,AM and HM can reflex the severity of anoxia in patients with OSAHS more accurately.

Objective To study the changes of serum high-sensitivity C-reactive protein (ha-CRP) and depression in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and investigate the relationship between them.Methods Thirty healthy volunteers (control group) and 54 OSAHS patients (OSAHS group) were recruited for the study.The level of serum hs-CRP was determined by scatter rate nephelometry,and the state of depression was assessed by self-rating depression scale (SDS).Results The level of serum hs-CRP and SDS score were higher in OSAHS group than those in control group [(48.8 ± 12.7) scores vs.(36.3 ± 6.3) scores,(3.3 ±0.7) mg/L vs.(1.4 ± 0.4) mg/L](P＜0.01).SDS score and the level of serum hs-CRPwere positively correlated to apnea-hypopnea index(AHI) (r = 0.636,0.628 ;P<0.01) and negatively related to the MSaO2 (r =-0.509,-0.614;P <0.01) and LSaO2 (r =-0.607,-0.512;P <0.01).The level of serum hs-CRP was positive correlation to SDS score (r = 0.536,P<0.01).SDS score was related to the AHI,the level of serum hs-CRP and LSaO2 in multiple linear regression(F= 33.31,P = 0.002).Conclusion Depression is correlated to AHI and the level of serum hs-CRP in patients with OSAHS.

Objective To evaluate the characteristics of abdominal aorta wall motion in different stages of rats atherosclerosis with velocity vector imaging (VVI) technique. Methods Twenty-four healthy SD rats were on high-fat feeding after one week ordinary diet. Abdominal aortic intima-media thickness (IMT), end-systolic blood vessel diameter (Ds), peak systolic velocity (Vs), resistance index (RI), pulsatility index (PI) were measured before and at the end of 8th and 12nd week. Artery wall peak velocity (V_(max)), maximum tangential strain (S_(max)) and the maximum tangential strain rate (SR_(max)) were caculated with VVI. Results Abdominal aortic intima was rough and a small amount of foam cells were found under the light microscope at the end of 8 weeks of high-fat feeding. The values of Smax and SRmax measured at the end of 8th week of high-fat feeding decreased significantly than those of before high-fat feeding (P<0.05). At the end of 12nd week, abdominal aortic intimal was thicker and atherosclerotic plaque appeared somewhere. There were significant differences in artery IMT, Ds, Vs, RI, PI between before and the end of 2nd week of high-fat feeding (P<0.05);the values of V_(max), S_(max), SR_(max) decreased significantly than those of before and at the end of 8th week of high-fat feeding (P<0.05). Conclusion VVI can quantitatively evaluate the vessel wall elasticity in different stage of arteriosclerosis rats.

Objective To investigate the incidence of postoperative intubation-related complications and the need for measurement and adjustment of cuff-pressure of endotracheal tube. Methods Five hundred and nine patients of either sex undergoing elective surgery under general anesthesia with tracheal intubation were divided into 2 groups: control group (group C)and cuff-pressure measured group (group CPM). Operation time and duration of endotracheal tube were recorded. Twenty patients with the duration of endotracheal tube 120-180 min in each group were selected. Their tracheal mucous membrane was examined by fiberoptic bronchoscopy at the time of withdrawal of endotracheal tube. Postoperative complications including cough and bloody sputum were also recorded at 24 h after extubation. Results The two groups were comparable with respect to age, sex, operation time and the duration of endotracheal tube. The incidence of sore throat and bloody sputum was significantly higher in group C than in CPM group. The incidence of sore throat and bloody sputum was significantly increased as the duration of endotracheal tube was prolonged in control group while in CPM group only the incidence of sore throat was increased. Varying degrees of injuries to tracheal mucous membrane were observed with fiberoptic bronchoscope.The injuries were more serious in group C than in CPM group. Conclusion Measurement of intracuff pressure is helpful for reducing the tracheal intubation-related complications.