Objective To prepare and characterize caspofungin acetate-loaded solid lipid nanoparticles using glycerol monostearate （CAS-SLNs）, and investigate the antifungal effect of potentiation on Candida albicans in vitro and in vivo. Methods A high performance liquid chromatography method was established for the determination of caspofungin acetate （CAS）. CAS-SLNs were prepared by the melt-emulsification method and characterized. The minimum inhibitory concentration （MIC） and the inhibitory effect on Candida albicans biofilm were determined. A systemic infection model of Candida albicans was established in mice, and the growth curve models for body weight and fungal load of kidneys of the animals were investigated after intravenous infection. Results The retention time of CAS was 6.8 min. The calibration curve showed good linearity, and the precision and stability met the requirements of the assay. Transmission electron microscopy revealed that CAS-SLNs were spherical, with a particle size of （135.97±1.73） nm. The Zeta potential was （19.33±0.37） mV, drug loading was （7.55±0.68）%, and encapsulation efficiency was （67.71±1.74）%. CAS-SLNs showed significant in vitro antifungal inhibition with a MIC of 9.78×10⁻⁴ g/ml, which was significantly better than CAS group and the physical mixture group of CAS and GMS, as well as the same biofilm inhibition was observed （P<0.001）. Pharmacodynamic studies demonstrated that CAS-SLNs maintained stable body weight gain compared to the control （P<0.01） and CAS groups in Candida albicans invasive infection model, and that CAS-SLNs significantly reduced renal fungal burden load relative to the CAS group （P<0.05）. In vivo study revealed that a stable body weight was maintained in CAS-SLNs group compared to the control group （P<0.01） in Candida albicans invasive infection model. CAS-SLNs also significantly reduced renal fungal load compared to the CAS group （P<0.05）. Conclusion CAS-SLNs significantly enhanced the antifungal effects of CAS in vitro and in vivo, which provided a valuable insight for the research of new formulation of CAS.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:Grasp the status of Zhejiang entry standards, controls and calibrators in recent years and problems.Methods:Through descriptive statistics, cross-tab chi-square, and comparation of means method , we collected and sorted out relevant information about standard products, quality control products and calibrators of the Zhejiang Provincial Biomedical Special Articles Entry Centralized Supervision Platform, and analyzed the basics of standard products, quality control products and calibrators situation, degree of dependence and utilization.Results:The standard products and quality control products imported into Zhejiang province are mainly used for scientific research of biomedical device enterprises. 76.6% of imported standard products, quality control products and calibrators cannot be domestically produced. The main origin of imported standard products and quality control products is the United States, and the main origin of standard products is the United Kingdom.Conclusions:The standard products, quality control products and calibration products imported into Zhejiang province are currently lacking in domestic production capacity. It is recommended to support the research and development and production of domestic standard products, quality control products and calibration products.

Objective:The results of the two interferon-gamma release assay tests were compared, so as to provide reference for the laboratory to choose the detection method.Methods:Double blood samples of 96 suspected TB patients hospitalized in Civil Aviation General Hospital from July 2018 to December 2019 were collected, providing for TB specific antigen stimulation test by QIAGEN kit and Autobio kit respectively. ELISA and chemiluminescence were used to detect interferon-gamma, and the results were determined according to the manufacturer′s instructions. Based on the clinical or bacteriological evidence for diagnosis of tuberculosis, the consistency of the two kits was compared, and the diagnostic efficacy of tuberculosis was evaluated. At the same time, 60 samples of plasma stimulated by TB specific antigen in QIAGEN kit were randomly selected to detect interferon-gamma by ELISA and chemiluminescence respectively, and the consistency between the two interferon-gamma detection systems was compared. The Kappa coefficient were used to measure the consistency of the results. The ordinary linear regression and Bland-Altman plots were performed to show the differences of IFN-γ data between assays.Result:In 96 samples, the sensitivity and specificity of QIAGEN test were 81.82% (18/22) and 74.32% (55/74), and that of Autobio test were 72.73% (16/22) and 70.27% (52/74), respectively. The results of the two systems were consistent, Kappa value was 0.847, P<0.05. The area under ROC curve of QIAGEN test for diagnosis of tuberculosis was 0.807 (95% confidence interval: 0.702-0.911), while that of Autobio test was 0.765 (95% confidence interval: 0.640-0.889). Comparing the results of two systems for detecting interferon-gamma in the same plasma, the results of two systems were in good agreement ( R2=0.97, P<0.05); but there were significant differences in the levels of interferon-gamma in the same patient sample after stimulation with different negative and positive tubes ( R2=0.41, P<0.05). Conclusion:The results of γ-interferon release assay test of Autobio system and QIAGEN system are in good agreement, and the results of γ-interferon release assay test of the two systems are also in good agreement. Different amount of antigen coating, titer and test system may be responsible for the different release of interferon-gamma.

Objective To investigate the expression level of hyper sensitivity C-reactive protein (hsCRP) in children infected with different pathogens in order to enhance the application value of hsCRP .Methods One hundred and one children patients with infection from March 2010 to March 2015 were selected as the research subjects and divided into the bacterial infection group (67 ca-ses) and mycoplasma infection group (34 cases) according to the hematology and bacterial culture results .Contemporaneous 50 healthy children were selected as the control group .Venous blood was collected for detecting hsCRP ,white blood cell(WBC) and neutrophil percentage(NEUT% ) .Results The levels and abnormal rates of hsCRP and WBC in the bacterial infection group were significantly higher than the those in the mycoplasma infection group and control group (P<0 .05);NEUT% and abnormal rate in the mycoplasma infection group was higher than that in the other two groups (P<0 .05) .The levels and abnormal rates of hsCRP and WBC after treatment in the bacterial infection group were lower than those before treatment ,the difference was statistically sig-nificant(P<0 .05);the area under the ROC curve of hsCRP for diagnosing bacterial infection wa maximal ,which was 0 .68 ,the sensitivity and specificity were 89 .9% and 88 .3% respectively .Conclusion The hsCRP level detection has early diagnostic value for child bacterial infection and can dynamically reflects the curative effect .

Objective To investigate the effect of electroacupuncture on acupoint local extracellular ionized atom concentrations under physiological status and provide a basis for exploring the mechanism of action of electroacupuncture. Method Twenty male SD rats were selected. Rat point Zusanli (ST36) was given electroacupuncture (1 mA, 0.2 ms and 2 Hz) for 60 min. Meanwhile, local tissue fluid was collected at point Zusanli and non-acupoints using a microdialyzer. The collection by molecular probe membrane sampling lasted 4 hrs: 60 min physiological status before electroacupuncture, 60 min electroacupuncture, 60 min after electroacupuncture and 120 min after electroacupuncture. Real-time analysis of the sample was made by electrolyte analysis to observe local changes in concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- at point Zusanli. Result Local Ca﹢﹢concentrations at point Zusanli increased significantly during electroacupuncture (P=0.003, vs before electroacupuncture), rose gradually afterwards and reached the peak at 60 min after electroacupuncture (P=0.75, vs during electroacupuncture). Ca﹢﹢concentrations decreased at 120 min after electroacupuncture; there was a statistically significant difference comparedwith during electroacupuncture (P=0.04). Acupoint local extracellular concentrations of Na ﹢ and Cl- also increased significantly during electroacupuncture (P<0.001, P=0.007, vs before electroacupuncture) but decreased gradually during 60 min after electroacupuncture and to (71.81±15.09) mmol/L and (57.42±14.30) mmol/L, respectively, at 60 min after electroacupuncture (P=0.09, P=0.07 vs during electroacupuncture). Acupoint extracellular K ﹢concentrations had a tendency similar to those of Na﹢and Cl- but there was no statistically significant difference. Non-point electroacupuncture slightly increased extracellular concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- but there were no statistically significant differences compared with before electroacupuncture (P>0.05). Conclusion Rat point Zusanli electroacupuncture can induce significant increases in acupoint local extracellular concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- . Ionized atom concentrations decrease in different degrees after electroacupuncture. These provide an experimental basis for studying the physiological mechanism of electroacupuncture treatment.

Objective To master the distribution and drug resistance of gram positive bacteria in hospital infection of elderly cancer patients in Wuzhou area.Methods The clinical data of 136 cases of nosocomial infection with gram positive bacteria were summarized from May 2015 to April 2010 in Wuzhou area,and the distribution and drug resistance of pathogenic bacteria were summarized.Results Gram positive cocci Staphylococcus accounted for 64 strains(47.06％),45 strains of Streptococcus(33.09％),Enterococcus accounted for 27 (19.85 ％) strains of bacteria were gram positive cocci;pathogen mainly from throat swabs,sputum,drainage and blood,83.83％ of the total,Department sources to ICU,Radiology,Medical Oncology,the most common,accounting for 71.32 ％ of all,and the same group of other items had significant difference(P＜0.05);drug resistance,Staphylococcus to nitrofurantoin,tigecycline and vancomycin sensitivity was 100.00 ％,the other resistance was more than 55.00 ％;chain coccus of teicoplanin and vancomycin susceptibility 100.00 ％,more than 57.89 ％ other isolates were resistant to linezolid;Enterococcus faecalis sensitivity was 100.00％,which occurred in 1 cases (7.69％) resistant to vancomycin,other antimicrobial drug resistance was 54.55％ Above.Conclusion Elderly patients with tumors of gram positive cocci mainly come from respiratory tract infection ICU,interventional radiology is the hardest hit,there are serious drug resistance,vancomycin resistant Enterococcus faecalis in clinical,to strengthen the management of antimicrobial agents.

Parenting competence is a new index to evaluate the parents′ ability to take care of their children and it gradually becomes a new research focus in the field of nursing. It not only meets the demand for child care, but also significantly reduces the occurrence of various medical problems during perinatal period by improving parents′parenting competence so as to enhance the level of maternal and child health care. So this paper aims to state the factors of sense of competence and provide a reference for clinical nursing staff.

Objective To study the expression of TFIIB-related factor 2 (BRF2) in hepatocellular carcinoma(HCC) and to determine its clinical significance.Methods 80 HCC patients who received ‘curative' hepatectomy at the Qilu Hospital were studied.Immunohistochemistry analysis was performed to examine the expression of BRF2 and CD34 (microvessel density) in tumor tissues,matched paraneoplastic tissues,and normal liver tissues.Statistical methods were performed to analyse the relationships of expressions of BRF2 and CD34 with clinicopathologic factors.Results BRF2 protein was expressed at a high rate of 61.3％ in HCC tumor,which was significantly higher than that in normal liver tissues and matched paraneoplastic tissues (31.6％,28.8 ％,respectively,P ＜ 0.05).BRF2 was significantly associated with tumor differentiation,number of nodules,tumor encapsulation,TNM stage,and microvessel density.Prognosis of the high expression BRF2 group was poor.The recurrence and metastasis rates in the high expression group were significantly higher than the low expression group (P ＜ 0.05).The survival rate in the high expression group was significantly lower than the low expression group (P ＜ 0.05).Conclusions The expression of BRF2 increased in HCC tissues,and its expression was closely associated with pathological features and prognosis of patients,indicating that it can be used as a predictor in assessing prognosis of patients with HCC.

To meet the needs of the society and improve the competitiveness of nursing students , many nursing school carried out nursing English courses .Among the related practice and researches , the nursing English teaching methods studies were more active .To investigate the current application and research situation of nursing English teaching methods in China , we reviewed and analyzed the literature based on the modern foreign language teaching methods .We hope this paper can provide the evidence for the future direction of nursing English teaching practice and research .