Zinc supplementation can reduce the mean duration,the recurrence rate and mortality of diarrhea.Nonetheless,it has no effect on stool frequency or stool output.Zinc supplementation results in different effort for the difference of the duration of diarrhea,pathogens,zinc type and doses of zinc,and shows no effect in infants younger than 6 months.Using iron as a co-intervention can reduce the effect of zinc,but vitamin A or ORS have a synergistic effect with the meeting.Average baseline zinc levels did not contribute to variations in the effect size.Zinc supplements are unlikely to improve compliance with the treatment for diarrheal disease.Longer course,zinc alone,malnutrition,diarrhea,breast-feeding children are prone to vomiting after oral administration of zinc.

ObjectiveTo investigate the clinical characteristics and epidemic analysis in children with hand foot and mouth disease(HFMD) following acute flaccid paralysis(AFP).Methods30 children with HFMD following AFP in Hunan Province Children's Hospital were surveyed retrospectively.ResultsAll the patients were below 5 years old, 83.34％ were 1～3 years old, 90% from countryside. Besides AFP of limbs, 86.67% complicated with encephalitis. The major clinical characteristics as followed: fever(100.00%), skin rash(100.00%), startle and skip(80.00%), emesis(63.33%), neurogenic pulmonary edema(13.33%) and urinary retention(16.67%). The most palsy occurred in 3～5 days after onset, and the palsy in lower limbs was major, only a few had palsy in upper extremities or tetraplegia. 26 cases were infected with enterovirus type 71(EV 71), 1 case infected other EV, 3 cases were negatively. The EMG showed that the amplitude of active potential lowered in the femoral nervus, tibial nerve, peroneal nerve, axillay nerve and musculocutaneous nerve, or/and the motor conduction velocity slowed down, the damage of proximate nerve was the most common.ConclusionThe most children with HFMD following AFP were infected with EV 71. Encephalitis was the common complication. The symptom of EV 71 was more severious than distribute EV.

ObjectiveTo investigate the effect of early rehabilitation at bedside motor function in children with acute flaccid paralysis （AFP）. Methods45 patients were divided into two groups. The treatment group (n=23) received rehabilitation when the vital signs were stable and nervous symptom did not advance. The control group (n=22) received rehabilitation after acute stage. ResultsThe muscular strength of treatment group recovered more significantly than the control group 2 weeks and 4 weeks after treatment （P＜0.05）.ConclusionEarly rehabilitation at bedside can facilitate the motor function recovery in AFP.

A highly sensitive magnetic enzymE-linked chemiluminescent immunoassay method was developed for the detection of human chorionic gonadotropin(HCG). The monoclonal antibody was covalently coupled on the surface of carboxylated magnetic beads to generate magnetic-biotargeting; Alkaline phosphatase(ALP) was utilized as a labeled reagent of another monoclonal antibody, whereas 3-(2-spimadamantane) 4-methoxy-4-(3-phosphoryloxy)phenyl-1,2-dioxetane(AMPPD) was utilized as the chemiluminescent substrate. Based on this concept, a highly sensitive chemiluminescent immunoassay method was established to test HCG. Then, several modifications were made to optimize the method, and the detection sensitivity and procedure were improved accordingly. The detection of the assay could be fulfilled within 60 min and the test result of HCG concentration was linear over the range of 0.15 150 IU/L with good relativity(r=0.960). The relative standard deviation(RSD) were below 5% and the sensitivity of this method was 0.15 IU/L. The proposed method with wide linear range, simple operation and fast detection showed good prospect in practical application on-site.

The magnetic nanoparticle probe was prepared by specifically connecting the streptavidin-conjugated magnetic nanoparticles and the antibody of analyte via the strong streptavidin-biotin interaction. Based on the magnetic nanoparticle probes, the concentration of human chorionicgonadotropin (HCG) was detected and a new CL method for of hormone was further established. The performances of the magnetic nanoparticle probes were characterized by UV-Vis spectrometry, transmission electron microscopy and dynamic light scattering. The experimental conditions that affected the chemiluminescence were optimized. The optimal concentrations of luminal and H_2O_2 were 2×10~(-4) mol/L and 8×10~(-4) mol/L, respectively, and optimal pH was 13. Under the optimized experiment conditions, a linear response of chemiluminescence intensity to HCG concentration was obtained with a correlation coefficients of 0.9924. The linear range was from 0.5 to 250 μg/L and wider than the conventional ELISA method (5-200 μg/L). The relative standard deviation was 3.8%. Correlation analysis showed that there was significant correlation between the method of magnetic nanoparticle probes and ELISA in 34 clinical samples. The proposed method with characters of sensitive, effective, fast response and wide detection range provided good application prospect in analysis of other ultra-micro protein.

Objective To investigate the application of CT in the diagnosis of cardiac lipoma.Methods Retrospective analysis of 6 patients with cardiac lipoma confirmed by operation and pathology was done. Four patients had singles slice electron beam CT plain and contrast and movie scan. Two patients had 64-slice CT plain and enhanced scan. Results (1) One patient was isolated intracavitary lipoma in the right artium, 1 patient was isolated intrapericardial lipoma and 4 patients were intramural lipomas. Of the 4 intramural lipoma, 2 were infiltrative lipomas located in the left ventricle wall or the right ventricle and septum, 2 patients were isolated in the atrio-ventricular septums. (2) CT and three-dimensional reconstruction could depict the location, shape, size, margin and characteristic fat density of lipoma,indicating the diagnosis and classifications. The displacement of coronary artery, pulmonary inflammation and effusions of pericardium and pleural cavity could also be revealed. Conclusion Cardiac lipoma can be accurately diagnosed and classified by CT.

Objective To summarize the clinical characters, diagnostic and therapeutic strategy of the cured patient with human H5N1 avian influenza pneumonia in mainland of China,and to provide effective experiences for the physicians to diagnose human avian influenza infection.Methods The clinical data of the cured patient with H5N1 avian influenza infection in China was analyzed.Results The patient was treated with short-term symmetrel and ribavirin for antiviral therapy companied with the lowdosage and long-term(4 weeks) glucocorticoid therapy.The CPAP assistant ventilation was used and the airway was kept unobstructed.The antibiotic was used to prevent and control the followed infection.The supportive treatment was applied to protect the organ′s function of the patient.The pathogenetic condition of the patient became better with the hemogram risen and the lungs pathological changes absorbed gradually.The chest CT reexamined at the 7th day of the hospitalized-term suggested that the left lung fibrosis started to be absorbed and it was obviously absorbed at the 16th day.The breath function and all the internal organs functions became better.The patient convalesced and left hospital at the 46th day.Conclusion In the human avian influenza infection,the pathogenetic condition may progress quickly after the pneumonia appears.The lung injury and lung fibrosis as well as the multi-organs dysfunction were emerged in the patient rapidly.The progression of disease can be controlled and the prognosis can be improved by the prompt and correct treatment.

Objective: To evaluate the efficacy and safety of Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea (AAD) in infants and young children. Method: From November 2012 to September 2013, ten research units of large teaching hospitals or children′s hospitals participated in this multicenter randomized controlled clinical trial. Hospitalized young children aged between 1 month and 3 years (nongastrointestinal infection and antibiotic therapy required)were involved in our study. The children were randomly divided into control group and prevention group by means of block random allocation method. The control group received antibiotic therapy and other conventional treatment. The prevention group was given additional Saccharomyces boulardii (250 mg/d) orally. Diarrhea rates of two groups were compared both during the usage of antibiotics and within 14 days after the antibiotics withdrawal. The adverse reactions of Saccharomyces boulardii were observed all through this study. The results were analyzed by χ² test or Kruskal-Wallis test or t test. Result: Totally 408 cases (213 cases in prevention group and 195 cases in control group) were enrolled. The age ranged from 1 month to 3 years, with an average age of 1.14 years. The basic diseases were parenteral infections: 368 cases with different kinds of respiratory tract infections or pneumonia, 10 cases of bacterial meningitis, 9 cases with septicemia or sepsis, 6 cases with pertussis or pertussis like syndrome, 5 cases with urinary infection, 5 cases with skin or subcutaneous tissue infections, 3 cases of Kawasaki disease, one with scarlet fever and one with congenital syphilis. During the administration of antibiotics, the incidence of AAD in prevention group was 10.3% (22 cases), which was significantly lower than that of control group (57 cases, 29.2%, χ²=23.296, P<0.05). Within 14 days after the discontinuation of antibiotics, the percent of new diarrhea cases in prevention group (2.4%, 5/213) was also significantly lower than that in control group (16.4%, 32/195, χ²=23.4, P<0.05). Further analysis revealed that the rate of AAD in children less than or equal to 1 year old (25.1%, 52/207) was significantly higher than that of over 1 year old (13.4%, 27/201, χ²=8.922, P<0.05). The incidence of AAD in children treated with antibiotics for more than 5 days was 22.2%(60/270), which was significantly higher than that of less than or equal to 5 days (13.8%, 19/138, χ²=4.180, P<0.05). Although no significant difference was observed, the AAD rate of patients with combined use of two antibiotics was higher than that of using one. During the antibiotic therapy, compared with the control group, the risk of AAD in children under 1 year old was reduced by 52% (χ²=9.217, P<0.05), and 91% (χ²=20.35, P<0.05) in the children over 1 year old in prevention group. The risk of AAD of prevention group decreased by 66% (χ²=13.67, P<0.05) in patients treated with one antibiotics, and 65% in children with combined use of antibiotics (χ²=10.57, P<0.05). In patients treated with antibiotics for less than or equal to 5 days, the risk of AAD decreased by 74% in prevention group (χ²=7.38, P<0.05); and 63% if the course lasted for over 5 days (χ²=16.87, P<0.05). Within 14 days after the withdrawal of antibiotics, compared with the control group, the risk of diarrhea in the prevention group decreased by 82% (χ²=13.35, P<0.05) in infants (≤1 year old) and 93% (χ²=12.00, P<0.05) in children (>1 year old); the risk of diarrhea was reduced by 86% (χ²=9.57, P<0.05) and 87% (χ²=17.71, P<0.05) respectively in prevention group with single and combined use of antibiotics. In patients treated with antibiotics for more than 5 days, the risk of diarrhea in prevention group was reduced by 63% (χ²=22.79, P<0.05), while there was no significant difference if the antibiotics course was less than or equal to 5 days (χ²=2.97, P>0.05). No adverse effects related with Saccharomyces boulardii were observed in our study. Conclusion Saccharomyces boulardii is effective and safe to prevent AAD of infants and young children both during the usage of antibiotics and up to 14 days after drug discontinuance. It can be one of the drugs of for choice prevention of AAD in infants and young children. Trial registration Chinese Clinical Trial Tegister, ChiECRCT-2012-25.

Objective:To evaluate the efficacy and safety of oliceridine for treatment of moderate to severe pain after surgery with general anesthesia in patients.Methods:The patients with moderate to severe pain (numeric pain rating scale ≥4) after abdominal surgery with general anesthesia from 14 hospitals between July 6, 2021 and November 9, 2021 were included in this study. The patients were assigned to either experiment group or control group using a random number table method. Experiment group received oliceridine, while control group received morphine, and both groups were treated with a loading dose plus patient-controlled analgesia and supplemental doses for 24 h. The primary efficacy endpoint was the drug response rate within 24 h after giving the loading dose. Secondary efficacy endpoints included early (within 1 h after giving the loading dose) drug response rates and use of rescue medication. Safety endpoints encompassed the development of respiratory depression and other adverse reactions during treatment.Results:After randomization, both the full analysis set and safety analysis set comprised 180 cases, with 92 in experiment group and 88 in control group. The per-protocol set included 170 cases, with 86 in experiment group and 84 in control group. There were no statistically significant differences between the two groups in 24-h drug response rates, rescue analgesia rates, respiratory depression, and incidence of other adverse reactions ( P>0.05). The analysis of full analysis set showed that the experiment group had a higher drug response rate at 5-30 min after giving the loading dose compared to control group ( P<0.05). The per-protocol set analysis indicated that experiment group had a higher drug response rate at 5-15 min after giving the loading dose than control group ( P<0.05). Conclusions:When used for treatment of moderate to severe pain after surgery with general anesthesia in patients, oliceridine provides comparable analgesic efficacy to morphine, with a faster onset.