Fifty-six patients with swallowing dysfunction after cerebral apoplexy were treated by acupuncture and swallowing function training. The curative effect is satisfactory and the total effective rate was 96.4%.

Objective To investigate the changes of follicular regulatory T cells ( Tfr cells) and follicular T helper cells ( Tfh cells) in peripheral blood of children with myasthenia gravis ( MG) . Methods We recruited 28 MG patients and 20 healthy subjects in this study. The percentages of Tfh and Tfr cells in peripheral blood samples were measured by flow cytometry. Real-time PCR was performed to detect the ex-pression of transcription factors and regulatory factors of Bcl-6, c-MAF, Blimp-1 and PD-1 at mRNA level. ELISA was used to detect the levels of IL-2, IL-6, IL-10 and IL-21 in plasma samples and the titers of Ach-Rab and PsMab. Results Compared with the healthy subjects, the MG patients showed higher percentages of Tfh cells and lower percentages of Tfr cells before receiving treatment. The expression of Bcl-6 and c-MAF on CD4+T lymphocytes cells at transcriptional level were significantly enhanced, while the expression of Blimp-1 on CD4+T cells and the expression of PD-1 on Treg cells at transcriptional level were inhibited in the MG patients in comparison with those in healthy subjects. Moreover, decreased levels of IL-2 and increased levels of IL-21 were found in plasma samples collected from the MG patients. Conclusion The decreased percentages of Tfr cells and increased percentages of Tfh cells in patients with MG resulted in abnormal ratios of Tfr/Tfh cells, which might be involved in the immunological pathogenesis of MG. Several changes in the patients with MG might be responsible for the imbalanced ratio of Tfr/Tfh cells, which included changes of IL-2 and IL-21 in microenvironment, enhanced expression of Bcl-6 and c-MAF at mRNA level and inhibited expression of Blimp-1 at mRNA level on CD4+T cells as well as over-expression of PD-1 at mRNA level on Treg cells.

Objective To investigate the influence of IVIG on immunologic function and cytokines levels in children with EV71 infection associated high-risk pulmonary hemorrhage. Methods According to the inclu-sion criteria , 64 children were enrolled and randomly divided into two groups: 39 cases in the IVIG treatment group and 25 cases in the general treatment group. The alternations of blood and immune cytokine markers before and after treatment were detected in the patients. Results (1) Before treatment, the peripheral blood T cells, TH and B cells in the IVIG group were higher than those in the general group , but the peripheral blood IgA was lower than that in the general group(P < 0.05); (2) In the IVIG group, the NK cells and IgG increased and T cells, TH cell and B cells significantly decreased after receiving IVIG therapy (P < 0.05); (3)No significant difference was observed in the levels of IL-6 and IL-10 in the two treatment groups before treatment. However , after IVIG treatment, IL-6 and IFN-γ levels reduced, IL-10 level increased (P < 0.05). After the general treat-ment, no significant difference was found in levels of IL-6,IL-10 and IFN-γ in peripheral blood (P > 0.05). Conclusion Disorders of cellular immunity and humoral immunity appeared in children with EV71 infection-re-lated high-risk pulmonary hemorrhage. It has clinical value to use IVIG timely to regulate the immune disorder.

Objective To investigate the expression of SP 100 protein in ATRA-treated NB4 cells and its effect on pro-liferation in NB4 cells.Methods Q-PCR was employed to measure the expression of SP 100 mRNA;Western blot was used to detect the expression of SP 100 protein; Immunofluorescence was adopted to determine the location of SP100;Cell viability was analyzed by CCK 8;Flow cytometry was used for cell cycle analysis .Results ATRA may induce the expression of mRNA and protein of SP 100.ATRA changes the location of SP100 from a micro-punctate pattern into a punctate nuclear pattern in NB 4 cells.SP100-shRNA promotes the proliferation of NB 4 cells and in-creased the cells in G2/M phase.Conclusions The expression of SP100 was significantly increased in ATRA-treated NB4 cells, and SP100 may be involved in the regulation of proliferation activity of NB 4 cells.

Objective To observe the clinical effects of L-carnitine in myocardial enzyme abnormality caused by enterovirus in children with hand foot and mouth disease (HFMD). Methods 660 HFMD children patients with myocardial enzyme abnormality from May 2013 to June 2016 were enrolled and randomly divided into three groups. Group A(n=220)was treated with 1′6-FDP,group B with L-carnitine and group C with L-carnitine combined with 1′6-FDP. All groups were given routine anti-virus and symptomatic treatment. The clinical efficacy was compared across the three groups in terms of myocardial enzyme spectrum,heart rate,ECG,severe conver-sion rate before and after treatment. Results (1)Before treatment,there was no significant difference between the three groups in gender,age,course of disease,heart rate,myocardial enzyme spectrum and other indicators. (2)After treatment,the cure rate of HFMD in group B and group C were significantly higher than that in group A (both P<0.05);the rate of severe cases and the ECG normal rate in group B and group C were significantly lower than those in group A(both P<0.05),the time for heart rate resuming to normal in group B and in group C was all significantly shorter than that in group A(both P<0.05). There were no significant differences between group B and group C in clinical cure rate,severe conversion rate,recovery rate of ECG and heart rate recovery(all P>0.05).(3)In comparison with group A,after treatment,the levels of myocardial enzyme in group A and group B were decreased significantly(P < 0.05)and the recovery rates of myocardial enzyme in group A and the group B were significantly higher (P < 0.05),but no significant difference were observed between group A and group B (P>0.05). Conclusions For HFMD children with myocardial enzyme abnormality caused by enterovirus ,L-car-nitine together with myocardial nutritional therapy can significantly improve the myocardial enzyme indexes and electrocardiogram abnormality. It reduces the rate of severe cases and improve the prognosis.

Objective To evaluate the effect of using"metronome"to guide chest compression in the new nurse training of cardiopulmonary resuscitation(CPR). Methods From 2015 to 2016,385 new nurses were enrolled and randomly by random number table divided into four groups based on Solomon four-group design:control group 1(96 nurses),sudy group 1(89 nurses),control group 2(104 nurses) and study group 2(96 nurses),Control group 1 and control group 2 accepted normal training plus "chest compressions operation formula" training,study group 1 and study group 2 got "metronome" guiding based on the frequency training.Control group 1 and study group 1 took a baseline test before the training started,while control group 2 and study group 2 didn't.Four groups took part in an operational test after the seven days of training. Results There was no statistical difference between the baseline test scores of control group 1 and study group 1(P>0.05).After the training,the score of study group 1 was 93.4±3.5, which was significantly higher than 91.6 ± 4.7 of control group 1(t=-2.870, P<0.01).Through covariance analysis,after removing the impact of the baseline test score,the score of study group was statistically significant higher than that of control group 1 (F=7.33, P=0.007).Furthermore,there was no statistically significant interaction between the baseline test score and training method (P>0.05).Meanwhile,after training,study group 2 scores was 93.5±3.5,which was statistically higher than 92.1±4.0 of control group 2(t=2.670,P=0.008).Control group 1 were combined with control 2 to form control group,as well as study group 1 with study group 2 to form study group.A comparison between these two new groups indicates that the new study group surpasses the new control group with lower error frequencies in the position,depth and frequency of external cardiac compression (t=4.701 8, 12.488 9, 11.993 9, P<0.05).In addition,the study group also showed a better performance, when taking into consideration of the region and skills of compression and the observation of complexion,while there was no statistical difference between the error frequencies in these three aspects of these two new groups(P>0.05). Conclusions In the CPR training of new nurses,using a 100 times/min"metronome"can help new nurses grasp the accurate compression rates and depth, improve the overall quality of this procedure,making it a simple and effective training method,which is worthy of popularization.

Objective To explore the relationship between organizational innovation atmosphere and nurses′job satisfaction in China. Methods 300 nurses were sampled during January-February 2018 using convenience sampling method, for a questionnaire survey with the general information questionnaire, nurse organizational innovation atmosphere scale and Minnesota satisfaction scale. Results 282 valid questionnaires were recovered out of 300 questionnaires issued, accounting for 94% of valid recovery rate. The score of organizational innovation atmosphere was 81.35 ± 14.51, and that of job satisfaction was 69.85 ± 14.91, proving a correlation between organizational innovation atmosphere and job satisfaction (P<0.01). A hierarchical regression analysis showed that, with demographic data under control, the regression model can explain 52% of the variance in nurses′ job satisfaction.Conclusions Organizational innovation atmosphere and nurses′ job satisfaction of the hospital are both at a higher level. Good organizational innovation atmosphere contributes to higher job satisfaction of nurses.

Mycoplasma pneumoniae pneumonia is an important component of community-acquired pneumonia, which can cause severe extrapulmonary complications of digestive, cardiovascular, blood, urinary and other systems.Accurate and effective biomarkers are significant for the diagnosis and treatment of Mycoplasma pneumoniae pneumonia.Recent studies have shown that new biomarkers such as IL-35, IL-17, neutrophil to lymphocyte ratio(NLR) and S100 protein are involved in the development of Mycoplasma pneumoniae pneumonia.In order to provide reference for the clinical diagnosis and treatment of Mycoplasma pneumoniae pneumonia, this paper reviews the progress of new biomarkers in Mycoplasma pneumoniae pneumonia.

A case with mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency(HMGCSD)was related and foreign and domestic reported cases were reviewed.The female proband was 7 months and 16 days old, and admitted to the hospital due to acute onset of " fever for 4 days, wheezing for 3 hours, dyspnea and moaning for 2 hours" . She was mainly manifested as encephalopathy, hepatomegaly, liver function damage, low ketone hypoglycemia, and hyperlipidemia.She died of respiratory and circulatory failure on the third day of hospitalization.Two compound he-terozygous variants in HMGCS2 gene were found by total exome sequencing, namely, c.1061+ 1 G> C and c. 476 G> T. HMGCSD could be diagnosed by gene detection in combination with clinical features of the patient. Thirteen literatures related to HMGCSD were collected, including 26 patients in total, with the age of onset ranging from 3 months to 6 years. The main cause of the disease was insufficient intake, mainly manifested as hypoglycemia accompanied by low ketone, hepatomegaly, liver damage, etc. A high level of urinary 4- hydroxy-6- methyl-2- pyrone might be a strong indicator of HMGCSD. Three died during the acute attack. Up to now, there were 32 mutations in HMGCS2 reported in 26 patients, and the main type was missense mutation. In this article, the second case of HMGCSD in China was identified, and 2 novel variants of HMGCS2 were found, which extended the clinical phenotype and mutation spectrum of HMGCSD.

Objective:To explore the clinical significance of serum Chromogranin A (CGA) level in predicting the prognosis of children with severe hand, foot, and mouth disease (HFMD) and complicating neurogenic pulmonary edema (NPE).Methods:A total of 162 patients with HFMD admitted in our hospital from January 2017 to December 2019 were enrolled in the study; and 40 age-matched healthy children were selected as controls. According to the disease severity and complication the patients were divided into three groups: mild group ( n=88), severe without NPE group ( n=46) and severe with NPE group ( n=28). In 72 severe HFMD patients 16 cases died (fatal group) and 56 cases survived (survival group) within 28 days of hospitalization. The serum CGA, LAC, GLU, WBC, PCT, IL-6, cTnT were measured in all subjects. SPSS 23.0 software was used for data analysis, and the receiver operating characteristic (ROC) curve was used to evaluate the various indicators for predicting the prognosis of severe HFMD combined with NPE. Results:The serum CGA, GLU, LAC, IL-6 and cTnT levels in severe HFMD group with NPE significantly higher than those in the other three group ( H=61.554, 79.031, 86.994, 36.477, 75.021, all P<0.05 ). The serum CGA, LAC, GLU and IL-6 levels in the fatal group were significantly higher than those in survival group ( Z=-6.094, -4.621, -4.283, -5.504, all P<0.05). There was no significant difference in the levels of WBC, PCT and cTnT between the survival group and the fatal group ( P>0.05). The area under the receiver operating curve (AUC) of serum CGA was 0.890 (95% CI: 0.833-0.947) for predicting the prognosis of patients and the best cut-off value was 120.59 μg/L. Conclusion:The detection of serum CGA levels may be beneficial for the early diagnosis of severe HFMD with NPE, and can be used as one of the predictors of death from severe HFMD.