est that childhood wheezing is closely related to genetic factors, and children who carry predisposing genes may suffer from frequent wheezing and subsequent asthma.

Objective To understand the functional exercise situation of the total hip arthroplasty(THA)patients in hospital. Methods Using self-designed functional exercise in patients with TKA outline the structure of observation, observation and collection of Orthopedic Surgery,71 cases (91 hips)received THA in patients with relevant information. Results After the former 3d,22.5% of patients did not exercise;After 14 d continuous passive motion (CPM) ,hip joint exercises were separately accounted for 71.8% and 81.7% ,and static muscle contraction,straight leg raising were accounted for 40.8 percent and 81.7 percent. The four exercise started lately, training methods were not standardized the patients, insisted on a shorter time;single-and double-hip replacement hip replacement in patients with Shimoji routing practice started time respectively, after (6.51 ± 2.90 ) d and ( 10.30 ± 3.21 ) d. In the functional exercise process,CPM was assisted by nurse,in other exercises was assisted by retaining workers and patients families. Conclusion THA patients hospitalized during the actual exercise of the number,frequency,timing and methods vary, nursing staff should be further explored how to ensure that patients really effective rehabilitation exercise to further enhance the effect of patients with rehabilitation exercises.

Objective To evaluate the nursing effect of warming feeding formulation of the enteral nutrition associated diarrhea in the critically ill tube-fed patients. Methods A total of 60 patients with enteral feeding were enrolled and divided randomly into the warming group and the room temperature group with 30 cases in each group by random digits table method. The room temperature group received room temperature oral feeding by nutrition pump. The warming group used nutrition pump and heating rod was placed on the nutritional tube 50 cm far from patient's nose. A semi-quantitative scale based on stool volume and consistency was used for daily assessment of diarrhea. Results Patients were tube-fed for a mean duration of (11.20±2.98) and (10.93±2.69) days, respectively in the room temperature group and the warming group. There was no significant difference in these two groups (U=425.000, P > 0.05). The diarrhea score was 4.88 ±3.41 in the room temperature group and 5.51±4.44 in the warming group. There was no significant difference in these two groups (U=436.500, P > 0.05). The diarrhea per total feeding days was 10.42%(35/336) in the room temperature group and 16.24%(51/314)in the warming group. There was no significant difference in these two groups (χ2=4.862, P < 0.05). Conclusions The airtight enteral nutrition does not need warming when it is infused with the enteral nutrition pump at room temperature.

Objective To investigate the effect of different reference transducer positions measurement on intra-abdominal pressure (IAP) in ICU patients. Methods 31 cases of patients in ICU in need of measuring IAP were studied from January 2015 to July 2015 in this study. In each patient, transvesical and the direct methods were both used to measure IAP. Three sets of IAP measurements were obtained in the supine position, using the different reference levels and kept as IAPpubis, IAPmidax, IAPphlebostatic. The results were compared using Spearman rank correlation,paired t test and Bland–Altman statistics. Results When symphysis pubis was uesd, the result of direct method was (9.82±4.01) mmHg, the result of indirect method was (8.77 ± 4.48)mmHg (P<0.05), the correction between two methods was 0.967, P<0.05. When midaxillary level was uesd to measure, the result of direct method was (11.74 ± 4.71) mmHg, the result of indirect method was (11.65 ± 4.63)mmHg, the correction between two methods was 0.972, P=0.10. When phlebostatic was uesd, the result of direct method was (10.98 ± 4.65) mmHg, the result of indirect method was (10.38 ± 4.75)mmHg, the correction between two methods was 0.970, P<0.05. The calculated bias between IAPmidax and IAPpubis was 2.9 mmHg, 95%agreement of limits was (-0.8-6.5) mmHg, and the maximum difference value was 11 mmHg. The calculated bias between IAPmidax and IAPphlebostatic was1.3 mmHg, 95%agreement of limits was-1.4-4.0 mmHg, and the maximum difference value was 4.2 mmHg. Conclusion In supine position, the value obtained via the bladder can reflect the true IAP, and the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.

Objective To explore the changes in inositol requiring enzyme 1 (IRE1),apoptosis signal regulating kinase 1 (ASK1) and c-Jun N-terminal kinase (JNK) mRNA levels in peripheral blood CD4+ T cells of children with acute paraquat (PQ) poisoning.Methods Blood samples of 30 cases of acute PQ poisoning (PQ group),who visited Tianjin Children's Hospital from June 2014 to June 2016,with 18 male and 12 female,aged from 2 to 14 years old,were collected,and the clinical and laboratory data were documented.Peripheral venous blood samples were collected after paraquat was taken.Thirty healthy children at the same age and of the same sex were selected as a healthy control group,18 male and 12 female,aged from 2 to 14 years old.CD4+ T cells in the peripheral blood were separated,and IRE1,ASK1 and JNK mRNA levels in peripheral blood CD4+ T cells were measured by real time polymerase chain reaction (Real-time PCR) method.Specificity of PCR products was validated through agarose gel electrophoresis.The data were statistically analyzed by SPSS 13.0 software.Results All of the 30 children had mucosal lesions,nausea,vomiting and abdomen pain,19 cases with oliguria and anuria,16 cases with alimentary tract bleeding,12 cases with headache and dizziness,11 cases with short of breath,dyspnea and difficult breathing,8 cases with convulsion,5 cases with jaundice.The IRE1,ASK1 and JNK mRNA levels in PQ group were significantly higher than those in healthy control group (1.70 ± 0.16 vs.1.02 ± 0.18,3.56 ± 0.85 vs.1.05 ± 0.31,5.22 ± 0.87 vs.1.01 ± 0.33,t =15.26,15.21,24.78,all P ＜ 0.01).Conclusions PQ increased the expressions of IRE1,ASK1 and JNK in peripheral blood CD4+ T cells,which may be related to PQ-induced oxidative stress and immune activation and lead to a complex cytokine network via endoplasmic reticulum stress and CD4+ T cell apoptosis and then results in the occurrence and development of multiple organ failure.

Objective To study the prevalence and genotypes of rotavirus (RV) among children,< 5 years old hospitalized with viral diarrhea in Tianjin. Methods Stool specimens were collected from hospitalized diarrhea children in Tianjin children's hospital between May 2008 and April 2009. Detection of rotavirus was employed by Colloidal Gold Device. The detected positives were inoculated to MA-104 cells. The total RNA of virus was extracted after CPE which was caused by rotavirus were observed, The VP7 serotypes were determined by using RT-PCR to amplify the VP7 gene and sequencing the RT-PCR products.The clinical data for each patient were also collected. Results Among 837 specimens, the RV antigen positive rate was 26. 3% (220/837). Among all the children with rotavirus diarrhea, 90. 5% (199/220)were < 2 years old. The prevalence of rotavirus diarrhea in children peaked during Oct. 2008 through Apr.2009. Of the 208 rotavirus positive specimens, 95 were successfully identified by RT-PCR Thirty-five positive strains of RV were sequenced, and the sequencing results showed that 32 positive strains were belonged to rotavirus G1 type, 2 positive strains were belonged to rotavirus G3 type and 1 positive strain were belonged to rotavirus C9 type. Conclusion RV was the dominant etiological agent for infantile diarrhea infection in Tianjin, and the predominant serotype was G1.

Objective To study the pathogenic prevalence and genotypes of astrovirus among children under 5 years old hospitalized with diarrhea in Tianjin. Methods A total 837 stool specimens were collected from children with diarrhea hospitalized in Tianjin children's hospital from May 2008 to April 2009. Astrovirus antigens were detected using ELISA and the postive specimens were inoculated in CaCo-2cells. After the CPE caused by virus were observed, the total RNA of virus was extracted, then the genomc fragments of the strains were amplified by using RT-PCR and confirmed by sequencing of the RT-PCR products. Detection of rotavirus was employed by Colloidal Gold Device. Results Astrovirus antigen was found positive in 3.0% of the patients. The coinfection rate of astrovirus and rotavirus was 0. 7% (6/837).Ninety-six persent of children with astrovirus diarrhea were younger than 2 years of age, Forty-eight persent of children with astrovirus diarrhea were younger than 6 months. The astrovirus infections occurred mainly between August 2008 and April 2009. Of the 21 astrovirus positive specimens, 11 cases were successfully identified by RT-PCR and they were all serotype 1. Conclusion Astrovirus is a major cause of nonbacterical diarrhea between 2008 and 2009 in Tianjin, and the predominant serotype is type 1.

BACKGROUND: There are many species of ceramic bonding systems supplied in market, the mechanical strength is aprerequisite condition for resin cement in clinical use.OBJECTIVE: To study the difference of mechanical strength between Panavia F resin cement and self-made resin cement,DESIGN, TIME AND SETTING: A controlled observational study was performed in the prosthesis laboratory of the FourthMilitary Medical University of Chinese PLA between May 2006 and March 2007.MATERIALS: Panavia F resin cement was sourced from KURARAY MEDICAL INC. (Japan), experimental resin cement wasproduced by College of Stomatological Medicine in the Fourth Military Medical University of Chinese PLA.METHODS: Five cylindrical compressive strength specimens at an 8-mm height and 4-mm diameter were prepared, as well as5 cylindrical diametral tensile strength specimens at a 3-mm height and 6-mm diameter. AGS-500 universal material testingmachine was applied to detect the compressive strength and diametral tensile strength.MAIN OUTCOME MEASURES: The diametral tensile strength test and compressive strength test of the specimens.RESULTS: The compressive strength of Panavia F resin cement was remarkably higher than that of experimental cement[(238.92±24.54), (149.08±12.13) M Pa, P ＜ 0.05]. There were no significances between two resin cements on diametral tensilestrength (P＞ 0.05).CONCLUSION: There were no significance between two resin cements on diametral tensile strength following completecuring. The compressive strength of experimental resin cement can reach the standard of ADA (＞ 70 MPa) although it is lowerthan the compressive strength of Panavia F resin cement.

Human enterovirus 71 (EV71) is one of the major etiological agents for the hand, foot, and month disease (HFMD) and is causing frequent, widespread occurrence in the mainland of China. The single positive-stranded RNA genome of EV71 is translated into a single polyprotein which is autocleavaged into structural and nonstructural proteins. The functions of many nonstructural proteins characterized in the life cycle of virus are potential targets for blocking viral replication. This article reviews the studies of the structures and functions of nonstructural proteins of EV71 and the anti-enterovirus 71 drugs targeting on these nonstructural proteins.

Objective To explore pathogenic composition of hand,foot and mouth disease(HFMD),and the molecular typing of enterovirus in Tianjin Children′s Hospital in 2016.Methods Single center study.A total of 327 samples of HFMD cases which collected from Tianjin Children′s Hospital from March to November in 2016 were tested for nucleotide acid of enterovirus(EV),human enterovirus 71(EV71),Coxsackievirus A 16(CA16)by real-time reverse transcription polymerase chain reaction(RT-PCR),among which 104 sample of other EV positive were selected to amplify and sequence the whole VP1 region by using RT-PCR.Homology was analyzed and phylogenetic tree were constructed by comparison of the sequence with all subgenotype of EV by Chromas1.62 and MEGA6.06.EV positive rate in different age groups were compared by SPSS20.0.Results Of all the 327 HFMD cases tested,there were 272 EV positive cases,the constituent ratio of EV71,CA16 and other EV were 55.1％(150/272),6.6％(18/272)and 38.2％(104/272)respectively.The EV positive rates of different age groups(69.0％-90.9％)were different significantly(x2=15.897,P=0.044),the 3 years-old-group had the highest EV positive rate than that of the other age groups(90.9％,40/44).Of all 104 samples of other EV tested,34 were CA10(12.5％)and 14 were CA6(5.1％).Phylogenetic analysis of 11 EV71 VP1 and 20 CA10 VP1 showed that the EV71 and CA10 strains belonged to genotype C4a and genotype G,respectively.ConclusionsEV71 was still the predominant pathogen in spite of the constituent ratio of other EVs increased markedly in 2016 in Tianjin.It is important to enhance etiological monitoring for control and prevention of HFMD.