Objective To get genetic information of VP 1 coding region of HEV 71 in Beijing in 2008.Methods Enteroviruses were isolated from samples of throat swabs collected from 33 HFMD patients within 3 days after onset by rhabdomyosarcoma(RD) cells and identified by RT-PCR method with specific primers to human enteroviruses,then VP 1 coding region was amplified and sequenced by Sanger dideoxy.Bioedit 7.0.5 and MEGA3.1 were used for the nucleotide sequence alignment and phylogenetic analysis.Results 16 virus strains were isolated from 33 samples,of which 14 strains were identified as HEV 71 and 2 were CVA 16,and 1 was co-infected with CVA 16 and HEV 71.Sequence analysis of VP 1 nucleotide sequences of 10 HEV 71 isolates showed that homologous analysis of nucleotide identity amino acid 95.5%～100% and 98.9%～100% respectively;representative strains of Fuyang in 2008,nucleotide identity was 95.4%～99.1%;with representative strain of C 4 nucleotide identity was over 92%.Phylogenetic analysis of HEV 71 strains for the nucleotide sequence of VP 1 coding region clarified that the HEV 71 isolates in Beijing belonged to C 4a cluster of C 4 sub-genotype and 10 strains formed four relatively separated clusters.Conclusions The HEV 71 viruses isolated from children of HFMD in Beijing belonged to C 4 sub-genotype,and C4a cluster which was the predominant in China since 2004.According to phylogenetic analysis,HEV 71 which belonged to more than 4 different clusters were circulating in Beijing in 2008.More virological suggestion for disease control and prevention,and information of HEV 71 molecular epidemiology need to be collected urgently due to the successive large epidemic of HEV 71 in China.

BACKGROUND:Closed reduction and interlocking intramedullary nailing can protect blood supply of fractured bone,decrease infection and promote bone healing.which is becoming the first choice for treating femoral shaft fracture However,it is difficult to conduct in closed reduction and keep stabilization of fractured bone.OBJECTIVE:To explore the curative effect of closed reduction and interlocking intramedullary nailing in treating femoral shaft fracture with assist of rubber tourniquet 360°elastic fixation METHODS:From May 2008 to November 2009,18 patients(14 males,4 females;aged 18-65 years)with closed femoral shaft fracture were treated at the Dongguan Hospital of Traditional Chinese Medicine.Body skin was protected by cloth,elastic rubber tourniquet was doubled and 360°wrapped around the fractured bone with the length of 10 cm from up and down.Supracondylar femur was reamed by Kernig-needle;fractured bone was dealt with countertraction and horizontal rotation.Another assistant compressed the fractured bone according to the displacement of fracture,which contributes to bone fracture reduetion and interlocking intramedullary nailing.RESULTS AND CONCLUSION:All 18 patients were followed up postoperatively,no case was found with skim necrosis and damage of nerve and blood vessel.16 cases were bone union with excellent 15 cases,fine 1 case;2 cases were still being followed up.Callus was firstly found 1 month after operation and was obviously found in 3e months postoperatively The result suggested that the treatment of closed reduction and interlocking intramedullary nailing with assist of rubber tourniquet360°elastic fixation is a simple and applicable approach.which reduces the interruption of blood supply for fractured bone and closed reduction gets good result,which reduces the chance of open reduction.

Objective To observe the effect of ultra-low frequency transcranial magnetic stimulation on cerebral blood flow in children with spastic diplegia cerebral palsy. Methods 36 cases of spastic diplegia cerebral palsy were divided into control group (n=21) and obsevation group (n=15), 19 healthy children were as normal group. The control group received conventional rehabilitation training. The obsevation group received the ultra-low frequency transcranial magnetic stimulation in addition. All the children received the check of transcranial color Doppler (TCD). Results Several arterials flow velocity was lower, several arterials pulsatility index and resistance index were higher in the obsevation group than in the normal group before treatment (P<0.05). Compared with the control group, the arterial flow of obsevation group improved, pulsatility index and resistance index decreased in some degrees in the obsevation group after treatment (P<0.05). Conclusion The cerebral blood flow is of low velocity and high resistance in spastic diplegia children, while ultra-low frequency magnetic stimulation could improve the condition of cerebral flow.

Objective To develop the quality of life questionnaire applicable to the Chinese patients with dysphagia by the translation and modification,as well as psychometric evaluation of the original swallowing quality of life questionnaire (SWAL-QOL).Methods The English version of the SWAL-QOL was translated into Chinese according to the well-accepted scale translation procedure.Then 103 patients with dysphagia were tested using the translated Chinese SWAL-QOL.The inter-rater reliability,test-retest reliability,internal consistency reliability,the content validity and construct validity were tested.Results The inter-rater reliability correlation coefficient of the SWAL-QOL was between 0.945-0.990 (P＜0.01).Its test-retest coefficients ranged from 0.965 to 0.992 (P＜0.01).The Cronbach coefficients ranged from 0.708 to 0.933 (P＜0.01).There revealed significant correlation between each item of SWAL-QOL and its domain,with correlation coefficients between 0.723 and 0.982 (P＜0.01).Factor analysis of each item of the 10 domains of SWAL-QOL extracted 10 common factors,which were with a cumulative contribution of 79.029％.Factor analysis of the total score of the 10 dimensions extracted 2 common factors including dysphagia-related quality of life and general quality of life,with a cumulative contribution of 54.718％.Conclusions The Chinese version of SWAL-QOL is reliable and valid.It can be used as an effective measuring tool to evaluate the quality of life of dysphagia patients.

Objective To investigate the incidence,clinical characteristics and risk factors of upper gastrointestinal bleeding (UGIB) in patients with acute coronary syndrome (ACS) who were administrated with aspirin and clopidogrel dual antiplatelet therapy after percutaneous coronary intervention (PCI).Methods ACS patients who had undergone PCI in the cardiovascular institute of Guangdong General Hospital from September 2009 to August 2014 were retrospectively enrolled.The incidence of UGIB and clinical characteristics of ACS patients on dual antiplatelet therapy for 1 year after PCI were analyzed.Risk factors of UGIB were screened in the cohort of patients and sex and age matched controls with ratio 1:3.Results A total of 9 118 ACS patients had undergone PCI and UGIB occurred in 189 patients (2.07％,189/9 118) from September 2009 to August 2014.UGIB patients with history over one year,gastrointestinal tumors or varices or negative endoscopy were excluded.Thus the revised incidence of UGIB occurred was 0.61％ in 56 patients (0.61％,56/9 118) and appeared to decline year by year.Most patients (91.07％,51/56) had melena or stool occult blood positive (OB +),while others had bloody stool or haematemesis.Most UGIB were ulcer-related which was proved by endoscopy,accounting for 67.86％(38/56).There were 24 cases with duodenal ulcer,13 with gastric ulcer and 1 with complex ulcer,while others were gastric erosion,gastritis and duodenitis.The risk factors of UGIB were previous history of peptic ulcer (P ＜ 0.01) and renal impairment (P ＜ 0.01).On the other side,PPI intake was a protective factor (P ＜ 0.05).The incidence of new-onset ACS was 1.44％ (50/3 464) in PPI group,compared with 1.34％(76/5 654) in no PPI group (P ＞ 0.05).PPI use for the prevention of UGIB after PCI didn't increase the recurrence of ACS.Conclusions The incidence of UGIB is 0.61％ in ACS patients on dual antiplatelet therapy (aspirin and clopidogrel) for 1 year after PCI and falls year by year.Administration of PPI after PCI protects patients from UGIB,especially in those with precious history of peptic ulcer and renal impairment.

Objective To analyze the MRI features of Hirayama disease(HD)with cervical natural position and its diagnostic val-ue.Methods The natural position of cervical vertebra with MRI examination was used in 1 5 patients and 40 normal people.The spe-cificity and sensitivity of MRI features were analyzed and the ratio of cervical sagittal diameter/cervical transverse diameter (CSD/CTD)of the lower cervical cord was measured.Results CSD/CTD of the patients and control group had a significant difference (t=7.99,P =0.00).The sensitivity of LOA was 86.7%,and its specificity was 88.4%.The sensitivity of atrophy of the lower cervical cord was 80.0%,and its specificity was 79.5%.The sensitivity of the cervical spine curvature abnormalities was 40.0%,and its spe-cificity was 65.2%.The sensitivity of abnormal signal in the spinal cord was 46.7%,and its specificity was 87.5%.The sensitivity of abnormal signal in the epidural outer cavity was 20.0%,and its specificity was 96.8%.Conclusion MRI features of lower cervical cord in combination with clinical symptoms and signs can be helpful for the accurate diagnosis of HD.

Objective To investigate the relationship between OHSS and FSHR gene polymorphism. Methods Two hundred and two women were enrolled in this study. The FSHR gene polymorphisms at position 307 and 680 were detected. Results The distribution of the allele frequency and genotype frequency of the position 680 in FSHR gene were significantly different between women with OHSS or not. No significant differences of the position 307 in FSHR gene were observed. Conclusion Themutation of Asn680Ser in FSHR might be closely related with OHSS.

OBJECTIVE: To prepare compound ornidazole gel and conduct its quality control. METHODS: The gel was prepared with 0.6% carbopol - 940 as base and with ornidazole and cimetidine as main ingredients. Contents of 2 constituents were determined directely by UV - spectrophotometry. The stability of the finished product was investigated as well. RE-SULTS:The gel obtained was good in appearance, shaping and spreading. The linear ranges for ornidazole and cimetidine were all 0.5-32uuuuuuuuuug/ ml. The average recovery rates of ornidazole and cimetidine were 100.58% (RSD= 1.17%) and 100.59% (RSD=1.61%), respectively. The stability investigation results were in line with the requirement of Chinese Pharmacopeia 2000 version. CONCLUSION:The formula of compound gel is reasonable; its preparation technics is simple and the quality is reliable; and which meets the requirements of clinical medication.

Objective To invosfigate the state of the nursin workforce and supply the evidences for nursing workforce optimization.Methods With questionnaires to survey 25 hospitals in Wuhan,stratified sampling and convenience sampling were used.Results Naming workforce allocation was shortage in Wuhan at present,the age,professional rifle and education background structurewas reasonable. Conclusions We should innovate the mind.pay more attention to nursing,enforce the management on nurse's career planning,provide educational training for nurses continuously,make good plan on nurs human resource,avoid nursing resource waste in order to keep on the hospital's development continually,healthily and harmoniously.

Objective To observe the effect of combining virtual reality technology with occupational thera-py in treating children with spastic hemiplegia resulting from cerebral palsy. Methods Thirty-eight spastic and hemiplegic children with cerebral palsy were randomly divided into a treatment group ( n=18) and a control group ( n=20) . Both groups received occupational therapy, while the treatment group was additionally provided with virtual reality-based treatment. The sessions lasted 30 min, 6 times a week for 3 months. Before and after the treatment the upper extremity motor function of both groups was assessed using the fine motor quotients of the Peabody developmen-tal motor scale, the Caroll hand function scale and a activities of daily life scale. Results Before the treatment there was no significant difference between the two groups in terms of any of the measurements. After the 3 months, significant improvement was observed in both groups, but the improvement of the treatment group was significantly greater than that of the control group. Conclusion Virtual reality technology can further improve the motor function of the upper ex-tremities and ability in the activities of daily life beyond that achievable through occupational therapy alone.