Invasive pulmonary aspergillosis is the most common type of pulmonary aspergillosis. This paper reported a patient with pulmonary aspergillosis secondary to obstructive pulmonary disease and other underlying diseases. The clinical manifestations included wheezing, cough, fever and wheezing rale in the lungs. Diagnosis was ultimately confirmed through pathogens targeted next generation sequencing and pathological examination of respiratory coughs. Following comprehensive treatment that included antifungal therapy, the patient was cured and discharged with a good prognosis.

Invasive pulmonary aspergillosis is the most common type of pulmonary aspergillosis. This paper reported a patient with pulmonary aspergillosis secondary to obstructive pulmonary disease and other underlying diseases. The clinical manifestations included wheezing, cough, fever and wheezing rale in the lungs. Diagnosis was ultimately confirmed through pathogens targeted next generation sequencing and pathological examination of respiratory coughs. Following comprehensive treatment that included antifungal therapy, the patient was cured and discharged with a good prognosis.

Objective To investigate the value of radiological and clinical features in predicting preoperatively spread through air spaces(STAS)in early-stage lung adenocarcinoma,and to provide patients with early-stage lung adenocarcinoma the reference in choice of the operation method.Methods The radiological and clinical data of 264 patients with resection of the pulmonary nodules were analyzed retrospectively,and the spicule sign,pleural indentation sign,vessel convergence sign,lobulated sign,vacuole sign,consolidation-to-tumor ratio(CTR)and general clinical data were analyzed.Results There were 110 cases with STAS positive and 154 cases with STAS negative.There were significant differences in smoking history,spicule sign,pleural indentation sign,and CTR between STAS positive and STAS negative(P＜0.05).CTR≥18.2％was an independent risk factor by logistic analysis.Conclusion CTR≥18.2％is an independent risk factor of STAS positive,while pulmonary nodules with spicule sign,pleural indentation sign and CTR≥18.2％are highly suspected STAS positive in smoking history patients,providing evidence in surgical method choice for patients with early-stage lung adenocarcinoma.

ObjectiveTo investigate the effects of aerobic exercise on sleep-deprived rats positioning cruise and space exploration activities, synaptic mechanism, involving hippocampal neuron morphology, dendritic spine density, synaptic related proteins and cyclic adenosine phosphate reactive element binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway. MethodsA total of 48 Sprague-Dawley rats were randomly divided into control group (n = 12), model group (n = 12), model-exercise group (n = 12) and exercise group (n = 12). The model-exercise group and the exercise group accepted aerobic exercise with treadmill for four weeks. After exercise intervention, the model group and the model-exercise group were continuously deprived sleep for 72 hours with a multi-platform water environment. They were assessed with Morris Water Maze of positioning cruise and space exploration. The morphology and density of dendritic spines in hippocampal neurons were observed with HE staining and Golgi staining. The expression of hippocampal proteins of postsynaptic density protein 95 (PSD95), synapsin (SYN), growth-associated protein 43 (GAP43), Rac1, BDNF, p-CREB and CREB were measured with Western blotting. ResultsCompared with the control group, the latency and the total swimming distance increased in the model group (P < 0.05); the number of crossing the platform, the target quadrant residence time and distance decreased (P < 0.05); the neurons in the hippocampal CA1 region were disordered, the total density of dendritic spines per unit length and the density of mature, immature and filamentous pseudopodia dendritic spines decreased (P < 0.05); and the expression of PSD95, SYN, GAP43, Rac1, BDNF, p-CREB and CREB decreased (P < 0.05). Compared with the model group, the latency and total swimming distance of the model-exercise group decreased (P < 0.05); the target quadrant residence time and distance increased (P < 0.05); the number of neurons in the hippocampal CA1 region increased and arranged neatly; the total density of dendritic spines per unit length and the density of mature, immature and filamentous pseudopod dendritic spines increased (P < 0.05); and the expression of PSD95, SYN, GAP43, Rac1, BDNF, p-CREB and CREB increased (P < 0.05). ConclusionAerobic exercise can alleviate the learning and memory impairment of sleep-deprived rats, which may relate to the regulation of CREB/BDNF signaling pathway in hippocampus for improvement of synaptic plasticity.

National education, medical industry demand and external environment all put forward the demand of training "medical + X" compound medical talents. In recent years, the development of "medical + X" has provided a foundation for the establishment of related majors in the undergraduate stage. This paper analyzes the current situation of medical interdisciplinary development at home and abroad, summarizes the existing "medical + X" training model at the undergraduate level, and argues that the new "medical + X" majors should be supported by optimizing the system design and focusing on the interdisciplinary frontier. At the same time, the setting of new majors of "Medical + X" should also pay attention to the three characteristics of livelihood, faculty and employment.

Objective:To explore the changes of neuron specific enolase (NSE) concentration in serum samples of patients with silicosis.Methods:In January 2020, 455 cases of silicosis diagnosed in Yantaishan Hospital from January 2018 to December 2019 were collected, and 60 healthy cases and 120 cases of lung cancer were selected as the healthy group and the lung cancer group. The serum levels of NSE were detected by chemical immunofluorescence assay and compared.Results:The serum NSE level of silicosis patients was [(22.88±7.86) ng/ml], higher than that of healthy group [(17.96±4.42) ng/ml] ( P<0.05) . Serum NSE levels in the first, second and third stage silicosis groups were higher than those in the healthy group ( P<0.05) , but there was no statistically significant difference between the silicosis groups at different periods ( P>0.05) . The serum NSE level of silicosis patients was lower than that of the small cell lung cancer group ( P<0.05) , but there was no statistically significant difference between silicosis group and non-small cell lung cancer group ( P>0.05) . The area under curve of silicosis NSE was 0.718 ( P<0.01) when the cut-off was 17.49 ng/ml, the sensitivity and specificity of NSE was 78% and 57% respectively. Conclusion:The serum NSE level of patients with silicosis is significantly increased, which can be used as an important reference index for the diagnosis and the differential diagnosis of silicosis.

Objective:To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria.Methods:In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed.Results:There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group ( P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant ( P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups ( P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion:The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.

Objective:To analyze the clinical data of acute copper sulphate poisoning, and discuss the timing and prognosis of the treatment.Methods:The clinical data of a case of acute copper sulphate poisoning treated in Yantaishan Hospital in May 2020 were analyzed, and CNKI, Weipu database and Wanfang database were retrieved with "copper sulfate""poisoning" and "blood purification" as search terms respectively. Such as "copper sulphate/cupric sulfate""poisoning" and "blood purification " were respectively tested in the PubMed database and reviewed the literatures.Results:The patient was admitted to hospital due to "oral copper pentahydrate for 14 h". Plasma exchange and continuous venous hemofiltration were performed on the 2nd day of poisoning, and the liver enzymes and creatinine indexes were normal. The patient recovered and left the hospital after 10 days. After literature retrieval, 13 literatures were screened out, a total of 14 cases were reported. All recovered after blood purification, copper displacement and liver protection.Conclusion:When acute copper sulphate poisoning occurs with multiple organ function damage mainly caused by hemolysis and kidney injury, the treatment with blood purification has a good prognosis while removing copper and organ support.

Objective:To explore the changes of neuron specific enolase (NSE) concentration in serum samples of patients with silicosis.Methods:In January 2020, 455 cases of silicosis diagnosed in Yantaishan Hospital from January 2018 to December 2019 were collected, and 60 healthy cases and 120 cases of lung cancer were selected as the healthy group and the lung cancer group. The serum levels of NSE were detected by chemical immunofluorescence assay and compared.Results:The serum NSE level of silicosis patients was [(22.88±7.86) ng/ml], higher than that of healthy group [(17.96±4.42) ng/ml] ( P<0.05) . Serum NSE levels in the first, second and third stage silicosis groups were higher than those in the healthy group ( P<0.05) , but there was no statistically significant difference between the silicosis groups at different periods ( P>0.05) . The serum NSE level of silicosis patients was lower than that of the small cell lung cancer group ( P<0.05) , but there was no statistically significant difference between silicosis group and non-small cell lung cancer group ( P>0.05) . The area under curve of silicosis NSE was 0.718 ( P<0.01) when the cut-off was 17.49 ng/ml, the sensitivity and specificity of NSE was 78% and 57% respectively. Conclusion:The serum NSE level of patients with silicosis is significantly increased, which can be used as an important reference index for the diagnosis and the differential diagnosis of silicosis.

Objective:To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria.Methods:In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed.Results:There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group ( P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant ( P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups ( P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion:The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.