Objective To investigate the application and correlation of enterovirus 71(EV71)and Coxsackie virus A16(CA16)antibody screening in the hand,foot and mouth disease(HFMD).Methods The method of enzyme linked immunosorbent assay was used to test the serum antibody of EV71-IgM and CA16-IgM in 281 patients(142 male and 139 female)with HFMD.Results The positive rate of EV71-IgM antibody was 51.2％(144/281),the positive rate of CA16-IgM antibody was 32.0％(90/281).Seventeen patients(6.0％,17/281)had dual positive of EV71-IgM and CA 16-IgM antibody.The total detection rate was 77.2％(217/281).The positive rate of EV71-IgM and CA16-IgM antibody had significant difference(x2 =21.35,P ＜ 0.01).The positive rate of EV71-IgM and CA16-IgM antibody in male had significant difference compared with female[95.1％(135/142)vs.71.2％(99/139),P＜ 0.01].Conclusions At the beginning of the illness should use the joint detection of EV71-IgM and CA16-IgM antibody diagnose HFMD.It has significance in diagnosing and monitoring.

Objective Probing into a way to reform the assessment indexing of diagnosis and treatment in clinical specialties, to help with objective assessment and ranking among hospitals in terms of the performances of their respective specialties. Methods Treatment outcomes of the diseases pinpointed by heart physicians and urology surgeons of three hospitals in 2005 as the criteria to calculate the adjusted value for fatality rate and cure rate. Results The adjusted value of fatality rate for the heart physicians is CFR≥1, and that of cure rate for the urology surgeons is CFR≤1. A trial assessment is made based on these figures, and a ranking is achieved on the diagnosis and treatment outcomes of the clinical medicine specialties in these three hospitals as a result. Conclusions Diseases as the assessment levels for medical quality of clinical medicine specialties and relative risks as the core computation adjusted factor, may help yield the indexes and methodology for clinical medicine specialties in line with China's specifics.

Objective To study the disease trend of Keshan in Hubei Province and provide a basis for scientifically making control and prevention strategy.Methods According to Chinese Surveillance Plan of Keshan Disease,physical examination and electrocardiogram were done for surveillance subjects and suspected patients were filmed chest X-ray in Keshan disease areas.Results Totally 4 822 people were monitored from 2007-2014.The numbers of females (2 589,53.69％) were more than those of the males (2 233,46.31％).The group of people under the age of 15 accounted for 52.47％ (2 530/4 822) which was higher than that of the group over the age of 55 (19.14％,923/4 822).The rate of electrocardiographic abnormality was the highest in 2011 (61.33％,268/ 437) and the lowest in 2014 (5.61％,23/410).In the eight years,only potential type of Keshan disease patients were detected,and the incidences from 2007 to 2014 were all lower than 3％ and had a decreasing trend yearly.No Keshan patient was detected in 2012-2014.Ninety-one suspected cases were taken chest X-ray.Most of the suspected cases (63.74％,58/91) had normal cardiothoracic ratio.The cardiothoracic ratio increased,excepting one,other 32 were all potential type Keshan disease patients.Conclusions The disease trend of Keshan disease in Hubei Province is weak.Nevertheless,surveillance and health education are indispensable,in case the disease relapses.

Identifying the origin of body fluids left at a crime scene can give a significant insight into crime scene reconstruction by supporting a link betw een sample donors and actual criminal acts. How ev-er, the conventional body fluid identification methods are prone to various limitations, such as time con-sumption, intensive labor, nonparallel manner, varying degrees of sensitivity and limited specificity. Re-cently, the analysis of cell-specific messenger RNA expression (mRNA profiling) has been proposed to supplant conventional methods for body fluid identification. Since 2011, the collaborative exercises have been organized by the European DNA Profiling Group (EDNAP ) in order to evaluate the robustness and reproducibility of mRNA profiling for body fluid identification. The major advantages of mRNA profil-ing, compared to the conventional methods, include higher sensitivity, greater specificity, the ability of detecting several body fluids in one multiplex reaction, and compatibilitywith current DNA extraction and analysis procedure. In the current review ,we provided an overview of the present know ledge and detection methodologies of mRNA profiling for forensic body fluid identification and discussed its possi-ble practical application to forensic casew ork.

Objective To investigate the progress and effectiveness of water-improving defluoridation projects comprehensively in control of fluorosis in drinking-water-borne endemic fluorosis areas in Hubei Province,and to provide a scientific basis for making strategies in prevention and control of endemic fluorosis.Methods All villages affected by fluorosis in drinking-water-borne endemic fluorosis areas were selected in Hubei Province,in which the progress and effectiveness of water-improving and defluoridation projects were investigated in 2015.Those villages were chosen to determine fluoride content of drinking water,and to check the prevalence of dental fluorosis of children 8 to 12 years old.Water fluoride content was tested with fluoride ion-selective electrode,and dental fluorosis was diagnosed by the Dean method.Results The water improvement projects were completed in 197 villages in the 30 disease affected counties (cities) with accomplishment rate 100.00％ (197/197),geometric mean of water fluorine 0.36 mg/L,qualified rate of water fluorine 100.00％ (197/197) and normal operation rate of the water-improvement projects 95.94％ (189/197).Totally 14 856 children aged 8-12 were examined their dental fluorosis.The prevalence rate was 1.78％ (265/14 856) and the dental fluorosis index was 0.04,which meant epidemic strength was negative.Totally 29 out of the 30 disease affected counties (cities) had met the disease control standards.Conclusion The prevalence of drinking-water-borne endemic fluorosis in Hubei Province has been under control,but management and monitoring of the water improvement projects still should be strengthened.

Objective To know the changing characteristics of residents' iodine nutritional status after eating salt with different iodine concentrations in Hubei Province,according to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD provide a scientific standard for appropriate iodine concentration in edible salt.Methods According to inhabitants' salt and urine surveillance of Hubei in 2010,Xinzhou District,Tianmen City and Changyang County were selected for trial.Salt with two kinds of iodine content was used in 3 trial areas in 4 months for the study of community intervention.Before the intervention,3 months and 4 months after the intervention,urine samples of observed participants(40 from 8-10 old children,40 from pregnant women or lactating women and 40 from adults aged older than 18) were collected and tested.The urinary medians of different groups of people and at different times were calculated and compared.Results Three months and 4 months after the intervention,in those towns using iodized salt of (15 ± 3) mg/kg,the urinary medians of children,declined from 294.2 μg/L to 185.6,195.7 μg/L,respectively.The urinary medians of pregnant women or lactating women dropped from 269.0 μg/L to 141.7,176.1 μg/L.For adults aged 18 and older,the urinary medians changed from 304.9 μg/L to 199.7,202.2 μg/L.In those trial towns of using (25 ± 3)mg/kg iodized salt,the urinary medians of children,pregnant women or lactating women and adults older than 18 all went down from 301.1 μg/L to 229.7,253.8 μg/L,from 261.4.0 μg/L to 196.6 and 206.5 μg/L and from 379.7 μg/L to 244.3,237.4 μg/L,respectively.Conclusions According to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD and the decreasing of urinary iodine median and per capita daily salt intake,salt with 25 mg/kg iodine is suitable as the average level of salt iodine concentration after the adjustment in Hubei Province.

Objective: To prepare monoclonal antibodies (McAb) with cardiac troponin I (cTnI) which was purified from fresh human cardiac muscle within 6 h. Methods: (1) Extraction and purification of human cTnI: cTnI was purified by high salt extraction, saltless precipitation, 65℃ treatment, ammonium sulfate fractionation and DEAE-cellulose chromatography, etc. (2) Preparation of anti human cTnI McAb: The purified cTnI was injected into the spleen of BALB/c mice. The cTnI-primed spleen cells were fused with Sp2/0 myoloma cell. The McAbs anti human cTnI were obtained by screening with indirect ELISA and 3 times clone. (3)The identification of anti cTnI McAb. Results: Five hybridoma cell lines, named 3A7，3A11，3D2，3F10 and 1H9 were developed, which could secret McAb stably. The 5 McAbs all were demonstrated to be IgG2a by double gel diffusion test. The number of hybridoma chromosomes was between 92 to 110 and the chromosomes were mainly telocentric. Five kinds of ascites had no cross-reaction to LDH，CK，CK-MB ，AST and cardiac troponin T(cTnT), and their titers were between 3.2×10-6 to 1.6×10-7. Conclusion: 3D2，3F10 and 3A7,3A11,1H9 react to different epitopes of cTnI.

Objective Through the dynamical monitoring of the water improvement projects operation,we intend to understand the prevalent trends of endemic fluorosis of children aged 8 to 12 in Hubei,to evaluate the effect of control measures and to provide the basis for making preventive measures.Methods In Hubei,ten surveillance counties were selected,and three epidemic villages were selected as fixed monitoring villages in each county from 2010 to 2014.In those villages,the operation situation of water improvement projects and the fluoride content in drinking water were detected,and the dental fluorosis of children aged 8 to 12 was diagnosed.Results From 2010 to 2014,the normal operation rate of water improvement projects was 75.61％-100.00％,the average of water fluorine content did not change,the differences were not statistically significant (F =2.00,P ＞ 0.05).The numbers of water improvement projects with water fluorine content in excessive amount was increased in the past five years which was only one project in 2010-2012 and was increased to two projects in 2013 and 2014.In 2010-2014,the dental fluorosis prevalence rate of whole children was 9.45％ (525/5 557),the dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was 42.40％ (92/217),the dental fluorosis prevalence rate of qualified villages was 8.11％ (433/5 340).The children's dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was higher than that in qualified villages;the differences were statistically significant (x2 =282.60,P ＜ 0.05).Conclusions The operation rate of water-improving projects is mostly higher than 90％,and so is the qualification rate of fluoride content in drinking water.The operation condition and water quality of the water-improving projects in Hubei need to be improved.The prevalence of children dental fluorosis of affected villages has dropped significantly after low fluoride water is provided continuously.

Objective To retrospectively overview the malaria death cases reported in Henan Province and analyze the cause of death. Methods The data including basic information,epidemiological survey and medical records of malaria death cases in Henan Province from 2010 to 2015 were collected and analyzed. Results In the six years,a total of 14 malaria pa?tients were dead. All the death patients were adult males and imported from Africa. They had definite histories of living in malaria?epidemic areas and the symptoms of fever. Twelve patients were diagnosed as malaria after at least twice diagnoses. The average time from symptom appearing to correct diagnosis was 6.5 d. The causes of deaths were misdiagnosis and delayed treatment. Con?clusions The major reasons of malaria death cases in Henan Province are the failure of correct diagnosis and prompt treatment. Health education of malaria prevention and diagnosis and treatment training of malaria should be strengthened in order to im?prove the public awareness and the diagnosis ability of clinical doctors for malaria,which can prevent the death of imported ma?laria cases.

Objective:To investigate the clinical and genetic features of 3-methylglutaconic aciduria, dystonia-deafness, hepatopathy, encephalopathy, Leigh-like syndrome(MEGDHEL syndrome) caused by SERAC1 gene variation. Methods:This study retrospectively described the clinical and molecular features and prognosis of a baby boy who was transferred to Children's Hospital of Fudan University and later diagnosed with MEGDHEL syndrome in August 2016. A summary of the clinical and genetic manifestations of MEGDHEL syndrome cases reported in China and foreign areas was conducted through a literature review.Results:(1) Case report: The 2-day-old patient was transferred to Children's Hospital of Fudan University due to hyperlactic acidemia after birth. Physical examination revealed scattered petechiae and ecchymoses of the skin. Laboratory examination showed coagulation disorders and cranial MRI revealed abnormal signals in both basal ganglia. A homozygous variation of c.442C>T(p.Arg148*) in the SERAC1 gene was detected in the patient, which is a pathogenic variant included in the Human Gene Mutation Database. Both of his parents were heterozygous carriers, thereby the diagnosis of MEGDHEL syndrome was confirmed. Followed up to the age of three years and 11 months, he was found to have psychomotor retardation, spasticity, dystonia, deafness, and loss of language ability. (2)Literature review: Together with the case reported in this study, a total of 88 cases were retrieved, involving 57 different variants. The clinical features were homogenous, with onset mostly in the neonatal period (72%, 62/86), and severe reversible liver dysfunction (49%, 38/77) and neonatal hypoglycemia (44%, 35/80) were the main features. Nervous system was affected since infancy and common symptoms, included hypotonia (86%, 68/79), progressive spasticity (82%, 67/82), dystonia (80%, 66/82), intellectual disability (88%, 58/66) and sensorineural hearing impairment (74%, 59/80). Furthermore, bilateral basal ganglia involvement on cranial MRI (93%,70/75) and 3-methylglutaconic aciduria (98%,80/82) were also seen. Supportive care is currently the main management, however, the prognosis is extremely poor. Conclusions:MEGDHEL syndrome should be highly suspected when reversible neonatal liver dysfunction or hypoglycemia of unknown reasons in neonatal period, followed by progressive deafness-dystonia syndrome in infancy. As the prognosis of these patients is usually poor, genetic testing may provide an early diagnosis in neonatal period.