ObjectiveTo explore clinical characteristics of fatality cases of hand foot and mouth disease caused by enterovirus 71 (EV71),and to improve the diagnosis and treatment of the disease.Methods Sixteen children infected with EV71 were retrospectively reviewed.Clinical manifestation,laboratory data and death causes were analyzed.ResultsAll cases were younger than four years,and the mean age was 18.9 months.Seasonal variations in incidence were observed,with a peak in incidence during the summer season.These cases typically presented with a brief duration of febrile illness,nonspecific neurological signs including headache,vomiting,limb tremor and convulsions.After two to four days,they all got sudden deterioration,manifested with tachycardia,poor peripheral perfusion,tachypnea and transient hypertension.After intubation,they all had pink frothy or blood from the endotracheal.Tweleve of them died from pulmonary edema or pulmonary hemorrhage,and acute refractory cardiac dysfunction.The other four of cases died from brain stem encephalitis.Atypical presentation such as absence of skin rash should alert the physician.Total white cell count,blood glucose and cardiac troponin I were raised significantly.The protein raised in cerebrospinal fluid.ConclusionHand foot and mouth disease caused by EV71 progresses rapidly.The primary site of attack is the central nervous system,particularly the brainstem,and the cause of death are neurogenic pulmonary edema and/or hemorrhage,acute refractory cardiac dysfunction.

Objective To improve the diagnosis and treatment of epidemic cerebrospinal meningitis in children.Methods A retrospective review was performed and a total of 69 cases of children epidemic cerebrospinal meningitis were collected and classified into ordinary and fulminant epidemic cerebrospinal meningitis from 1999 to 2011.Disease prevalent season,age,clinical characteristics,laboratory examination,treatment,prognosis and risk factors were analyzed.Results The mean age(33 male and 36 female) was (6.85 ±5.12)years old,ranging from 56 days to 15 years old.A total of 60 cases began on January to May; 6 cases began on June to October; 3 cases began on November to December.All of the 42 cases of ordinary epidemic meningitis were recovered; 7 cases of fulminant epidemic meningitis(n =27) were dead.All of the patients had fever; 64 cases(92.75％) had Petechiae petechial skin; 36 cases(52.17％) had headache; 49 cases(71.01％) vomited; 65 cases(94.2％) had positive neck resistance; 15 cases(21.74％) had convulsion; 35 cases(50.72％) had drowsiness or coma; 32 cases (46.38％) had positive pathological signs and 24 cases (34.78％) had low blood pressure or shock.Blood tests revealed that 63.77％ of the patients leukocytes raised and 8.70％ of the patients reduced; 42.03％ of the patients platelet reduced; 55.07％ of the patients had electrolyte disturbance and 89.86％ of the patients had coagulation disorders,among which 46.38％ fibrinogen reduced.The rash printed piece and cerebrospinal fluid smear tests found that Gram-negative bacteria positive rate were 12.5％ and 19.35％ respectively; the positive rate in bacterial culture of cerebrospinal fluid and blood culture were 12.90％ and 7.25％ respectively.Drug sensitive test showed that penicillin and ceftriaxone were sensitive to bacteria.The differences of age,leukocyte and platelet counts,fibrinogen and altered mental status between ordinary and fluminant epidemic meningitis were significant (P ＜ 0.05).Conclusion The prevalent season is from January to May and the prevalent age is less than 5 years for children with epidemic cerebrospinal meningitis.Ceftriaxone or penicillin should be the preferred choice;age,lower leukocyte and platelet counts,lower fibrinogen and altered mental status should be used to predict the severity of the disease.

AIM:To study the inhibitory effect of Compound Liuyuexue(Tarphochlamys affinis(Giff) Bremekhu,Herba Hedyotis,Raidx Gardeniae,etc.)(CLYX) on HBV in vitro.METHODS:The serum containing CLYX was added to cultured HepG2.2.15 cells,and HepG2.2.15 cells were cultured in medium containing the serum with CLYX for 72 h and 144 h.The culture media were collected for determining the levels of HBsAg and HBeAg by ELISA.RESULTS:The serum containing CLYX could markedly inhibit HBsAg and HBeAg expressions in the HepG2.2.15 cells(P

Objective To analyse the clinical manifestations of mycoplasma pneumoniae pneumonia(MPP) with 23SrRNA A2063G gene mutation,and improve the ability of diagnosis and treatment of patient infected with MPP.Methods MP-DNA was detected by fluorescent quantitative real-time PCR in sputum specimens from 36 children with MPP,then we detected the drug resistance gene mutation sites by nest-PCR and DNA sequencing,on this basis we classified into two groups of macrolide-resistant MP and macrolide-sensitive MP,and compared the clinical manifestations,laboratory findings,chest imagings and treatment between two groups.Results Of these 36 cases of MPP,24 cases had macrolide-resistant gene mutation with an A2063G transition in domain V of the 23SrRNA,12 cases had no macrolide-resistant gene mutation.Compared to macrolide-sensitive MP group,macrolide-resistant MP group had longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and had higher white blood cells counts and CRP.In the macrolide-resistant MP group,the temperature subsided within 5 days after macrolide treatment alone of 12 cases,3 cases needed switch to fluoroquinolones therapy,10 cases combined with glucocorticoids and 6 cases combined with intravenous immunoglobulin,all 24 patients had good outcomes.While in macrolide-sensitive MP group,the temperature susided between 12 hours to 3 days after macrolide treatment of 8 cases.Conclusions Compared to patients infected by macrolide-sensitive MP,those mycoplasma pneumoniae pneumonia patients with 23SrRNA A2063G gene mutation have longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and have higher white blood cells counts and CRP.Some macrolide-resistant MPP patients have good response to macrolide antibiotics treatment,while the severe cases need combined with glucocorticoids and immunoglobulin,or should change antibiotics.

AIM:To study the isolation and composition of Cliffbean(Millettia pulchra kurz)polysaccharide.METHODS:Cliffbean was extracted by boiling water.The polysaccharide in the filtrate was precipitated fractionally by alcohol.The protein in the product was removed by Sevag method,and was further purified by DEAE ion-exchange cellulose(DEAE-52).The component of the saccharide was determined by GC and TLC.RESULTS:The polysaccharide obtained in this way didn't contain protein and nucleic acid.It showed a single polysaccharide when identified by means of Sephadex G-75 column or High Performance Gel Permeation Chromatography(HPGPC).It was composed of glucose and arabinose.CONCLUSION:Cliffbean polysaccharide was first isolated from its root and was one of the important components.

Objective The Improved segmental arch technique can effectively intrude incisors and correct deep overbites. To research its biomechanical characteristics, we reconstruct 3D nonlinear finite element model of mandibular teeth with improved segmen-tal arch, study the biomechanical characteristics and the suitable loading force of intrusion arch. Methods Combined with the re-sults of previous research, we complete the reconstruction of 3D nonlinear finite element model of mandibular teeth with improved seg-mental arch.Then, we set loading force of intrusion arch five conditions from 0.2 N~0.6 N, calculate the movement trend and stress distribution of improved segmental arch. Results In the five conditions of improved segmental arch, lateral incisors and canines in-truded and tipped labially, first molars tipped distally and rotated. In addition, the moment the initial loading force of intrusive arch in-creased, the movement of these teeth increased. However, other teeth did not move clearly. When the initial loading force of improved segment arch was 0.5 N, it can achieve appropriate intrusion of anterior teeth. Conclusion Under an appropriate intrusive force, improved segment arch can effectively intrude incisors and control the extrusion of posterior teeth. It can be used to correct the deep overbites, especially with high mandibular planes, gummy smile or adult stage.

OBJECTIVE: To study the inhibitory effects of traditional chinese medicine Compound Liuyuexue (CLYX) on hepatitis B surface antigen(DHBsAg) and hepatitis B e-antigen(DHBeAg).METHODS: One-day old guangxi brown spotted ducks infected with DHBV were used as the hepatitis B virus infected animal model. Positive ducks were detected by PCR at 13 days after the infection of DHBV, and were randomly divided into five groups: the high dose group, middle dose group and low dose group of Compound Liuyuexue(CLYX), model group, and positive control group, with 10 ducks in each group. CLYX was given ig.for 14 days. Serum sampling was scheduled at 0, 7, 14 days respectively and 3 days after drug withdrawal, and the contents of DHBsAg and DHBeAg in serum were measured by ELISA. RESULTS: The serum DHBsAg and DHBeAg contents in high dose and middle dose groups of CLYX were decreased significantly(P

Objective To explore disinfection efficacy of anerdian using swab and spray disinfection methods.Methods Hands of 30 subjects were randomly divided into the swab group and the spray group.The samples of before and after disinfection in each group were collected separately and observed their disinfection effect.Results The number of bacteria showed no significant difference between the two groups.The passing rate of disinfection reached 100％.The time of disinfection in the spray group was (2.58±0.32)s,significantly less than that in the swab group,(12.26±1.48)s,however,the drying time in the spray group was (42.37±1.79)s,significant longer than that in the swab group,(26.24±1.46)s.A subject hand disinfection used 0.5ml 0.2％ anerdian in the spray group,and 0.75ml 0.2％ anerdian and two cotton buds was used in the swab group.Conclusions There is identical disinfection efficacy between spray and swab methods.Spray disinfection method has short operating time,less use of disinfectant without using cotton buds,it is able to replace swab disinfection and will play an important role to reduce medical waste and health care costs.

Aim To observe the effects of the L-dopa methyl ester (LDME) on the pattern visual evoked potentials (P-VEP) and the expression of c-fos mRNA in neurons of the visual cortex of kittens with strabismic amblyopia, and explore the therapeutic effect of L-dopa methyl ester on amblyopia and its action mechanism.Methods 30 normal kittens were randomly divided into 6 groups: low dose of L-dopa methyl ester (20 mg·kg~(-1)), medium dose of L-dopa methyl ester (40 mg·kg~(-1)), and high dose of L-dopa methyl ester (80 mg·kg~(-1)),positive control (L-dopa 40 mg·kg~(-1)),normal control, and model control group.The surgery for producing iatrogenic convergent strabismus was performed on 4 weeks old kittens(normal control group excluded). After the confirmation of the development of amblyopia by pattern visual evoked potential,L-dopa methyl ester,L-dopa and normal saline were given to the corresponding animals, respectively. The P-VEP of amblyopia eyes was observed after one month, and the technique of in situ hybridization was used to detect the expression of c-fos mRNA.Results L-dopa methyl ester could reduce obviously the length of P100 peak latency of the cat strabismic amblyopes, and increase the amplitude of P100. The positive staining cells of strabismic cat visual cortex were less than those of normal cats, whose difference was significant (P<0.01).Positive staining cells in the treatment group were significantly increased when compared with that of the model group (P<0.01).Conclusion L-dopa methyl ester can significantly improve the conduction and sensory function in the model of strabismic amblyopia cats. The mechanism may be related to the increased amount of L-dopa methyl ester into the cerebral cortex and regulation of the expression of c-fos mRNA.

It has been previously shown that Taraphochlamys affinis possessed anti-hepatitis B virus (HBV) activities. To identify the active ingredients, the total saponins (TSTA) were isolated from T. affinis and the inhibitory effect of TSTA on HBV in the duck HBV model was examined. The results showed that serum levels of DHBV-DNA decreased in all ducks treated with TSTA (1.0 and 2.0 g x kg(-1) x d(-1)) and lamivudine (3TC) (50 mg x kg(-1) x d(-1)) during treatment, but 7 days after the cessation of treatment (p7) with 3TC, the viral replication level returned to the pretreatment baseline. Contrariwise in ducks treated with TSTA, the effect of DHBV DNA inhibition lasted. Compared with model control group,the alanine aminotransferase (ALT), aspartate aminotransferase (AST) and duck hepatitis B surface antigen (DHBsAg) values of 1.0 and 2.0 g x kg(-1) x d(-1)-dose TSTA groups were significantly lower on 7, 14 days after the treatment (d7, d14) and p7, and at p7, the ALT and DHBsAg levels of 2.0 g x kg(-1) x d(-1)-dose TSTA group was significantly lower than that of 3TC group. Furthermore, significant histological improvement was noted in ducklings of TSTA treatment group 7 days after the withdrawal. The study results demonstrate that TSTA possesses potent anti-HBV activity.
Animals ; Antigens, Surface ; blood ; Antiviral Agents ; administration & dosage ; isolation & purification ; pharmacology ; DNA, Viral ; blood ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Hepadnaviridae Infections ; drug therapy ; virology ; Hepatitis B Virus, Duck ; drug effects ; immunology ; Hepatitis, Viral, Animal ; drug therapy ; virology ; Liver ; drug effects ; metabolism ; pathology ; Liver Function Tests ; Saponins ; administration & dosage ; isolation & purification ; pharmacology ; Virus Replication ; drug effects