Objective To investigate the value of brainstem auditory evoked potential (BAEP) in early diagnosis of severe hand,foot and mouth disease (HFMD) with the nervous system damage.Methods BAEP was performed in 297 cases with HFMD.The patients were divided into 4 groups by the HFMD clinical classification and their ages.Group A included the general cases who were younger than three years (n =80).Group B included the severe cases who were younger than three years(n =94).Group C included the general cases who were three years or older(n =38).Group D included the severe cases who were three years or older(n =85).The electroencephalogram (EEG) and MRI results of patients in the groups were retrospectively studied and the results were compared with that of BAEP.Results (1) The BAEP abnormal rate of group B (18/94,19.15％)was higher than that of group A (3/80,3.75％),and the BAEP abnormal rate of group D (13/85,15.29％) was higher than that of group C (1/38,2.63％) (P ＜ 0.05).(2) The EEG abnormal rate in group B was low(2/94,2.13％) and there was no case with abnormal EEG in group A.(3) The EEG abnormal rate of group D (49/85,57.65％) was higher than that of group C (6/38,15.79％) (P ＜0.05),and higher than the BAEP abnormal rate of group D.(4) The MRI abnormal rate of group B (9/94,9.57％) was higher than that of group A (1/80,1.25％) (P ＜ 0.05),and the MRI abnormal rate of group D (9/85,10.59％)was higher than that of group C (0).(5) The BAEP abnormal rate of the children with severe HFMD (31/179,17.32％) was higher than the MRI abnormal rate (18/179,10.06％) (P ＜0.05).Conclusion BAEP has clinical significance for early diagnosis of severe HFMD with nervous system damage,and can provide objective basis for the diagnosis.

The transcranial doppler ultrasonography (TCD) is a non-invasive detection methods of evaluating intracranial artery.Since the 1980s,TCD has been extensively used in various fields of clinical work.Because of its simple operation,good repeatability,and the continuous bedside observation of patients,TCD is especially suitable for severe patients.Increased intracranial pressure is one of the important reasons for the deadly disease in children,it can make the cerebral blood flow perfusion decreased,causing serious consequences,such as brain dysfunction,so intracranial pressure monitoring has important clinical significance.TCD as a noninvasive monitoring tool,can monitor the patients with increased intracranial pressure dynamically,according to the blood flow velocity,the related parameters and the wave of cerebral hemodynamics,so as to achieve the purpose of monitoring intracranial pressure change.This article focused on the TCD application progress in several common children's diseases of increased intracranial pressure.

0.05) were found between 2 method s. A modified in vitro inhibi tion assay without refreshing medium during a period of 72 h is established by r eduction of initial parasitemia from 1% to 0.2% 0.5%.

Objective To explore the effects of total flavonoids from portulaca against liver fibrosis in rats by detecting TGF-β1 gene and protein expressions. Methods A total of 48 SD rats were randomly divided into normal control, model control, glucyrrhizin aqueous,and total flavonoids groups,with 12 rats in each group. Except those in the normal control group, rats in other groups were intraperitoneally injected with 2 mL · kg-1 · d-1 carbon tetrachloride to induce liver fibrosis. Rats in glucyrrhizin aqueous group and total flavonoids ones were intragastrically administered with 15. 75 mg · kg-1 of glycyrrhizin aqueous solution or 35. 6 mg·kg-1 of total flavonoids aqueous solution,respectively. The normal and model control groups were administered with equal volume of aqueous solution. Thirty days later,rats were sacrificed by anesthesia. Livers were obtained to detect TGF-β1 gene and protein expressions by RT-PCR and Western-Blot. Results Relative gene expression of TGF-β1 in the normal control,model control,glucyrrhizin aqueous and flavonoids groups was 0. 725±0. 130,7. 493±1. 410,3. 016±1. 240,and 2. 668±1. 150,respectively. Total flavonoids from portulaca significantly reduced the gene (P<0. 01) and protein (P<0. 01) expressions of TGF-β1 . Conclusion Efficacy of total flavonoids from portulaca in treating hepatic fibrosis may be related to decreased TGF-β1 expression in rats.

Hepatitis, Autoimmune ; Humans ; Immunoglobulin G

Nocardia is a genus of gram-positive,weakly acid-fast,filamentous aerobic actinomycetes,which mainly causes infection in immunocompromised persons. We reported a successfully treated fatal case of severe pneumonia caused by Nocardia farcinica in a hospital,then reviewed 25 domestic and abroad case reports about nocardiosis combined with severe pneumonia occurred since 2006,so as to improve health care workers'cognition on clinical manifestations,image features,pathogenic characteristics,and diagnostic and treatment schemes of se-vere pneumonia caused by Nocardia farcinica.

Objective:To analyze the influences of azithromycinantibiotic combined glucocorticoids on the levels of erythrocyte sedimentation rate (ESR),serum lactate dehydrogenase (LDH) and inflammatory cytokines levels as well as the clinical effect of severe pneumonia mycoplasma.Methods:112 children with severe pneumonia mycoplasma who were treated in our hospital were selected and randomly divided into the control group and the observation group with 56 cases in each group.The patients in the control group were treated with azithromycinantibiotic,while the patients in the observation group were treated with glucocorticoid on the basis of the control group.Then the levels of ESR,LDH,isoenzyme MB (CK-MB),creatine kinase (CK),aspertate aminotransferase (AST),c-reactive protein (CRP),interleukin 6 (IL-6),tumor necrosis factor-o (TNF-α),CD4+ and CD8+,the clinical efficacy and adverse reactions between two groups were observed and compared before and after the treatment.Results:The effective rate in the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).After treatment,the levels of ESR,LDH,CK-MB,CK,AST,CRP,IL-6,TNF-α and CD8+ in the two groups decreased,which were lower in the observation group than those of the control group (P＜0.05).After treatment,the levels of CD4+ in both groups increased,which was higher in the observation group than that of the control group (P＜0.05).The disappearance time of fever,cough relief,lung rale of observation group were shorter than those of the control group(P＜0.05).There was no statistically significant difference in the adverse reactions between the two groups (P＞0.05).Conclusion:Azithromycin combined with glucocorticoids was more effective than azithromycin alone in the treatment of severe mycoplasma pneumonia with high safety,which could obviously relieve the myocardial injury and inflammatory response,enhance the immune function.

Objective: To determine the potential diagnostic value of miRNA-29 (miR-29) for malignant tumor. Methods: A systematic search of literature regarding miR-29 was performed in three English databases (PubMed, Web of Science, and Embase) and two Chinese databases (Chinese National Knowledge Infrastructure [CNKI] and WanFang). The retrieval was ended until September 15, 2018. Search terms included miRNA-29 (miR-29), tumor, cancer, serum, plasma, diagnosis, etc. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was carried out to evaluate the quality of the selected articles. STATA12.0 was used to calculate the combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR). Subgroup analysis and Meta-regression analysis were carried out to explore the origin of heterogeneity. Results: Twenty eligible articles were selected from 1 172 literatures related to tumors and miR-29. The combined sensitivity was 0.76 (95%CI: 0.68-0.83), combined specificity was 0.83 (95%CI: 0.74-0.89), combined PLR was 4.5 (95%CI: 2.7-7.4), combined NLR was 0.28 (95%CI: 0.20-0.41), DOR was 16 (95%CI: 7-35), and theAUC was 0.86 (95%CI: 0.83-0.89). The combined specificity of plasma samples was higher than that of serum samples, and the difference was statistically significant (P<0.01). There was a higher diagnostic value of miR-29 for breast cancer and pancreatic cancer (DOR=101.52, 11.22), but lower diagnostic value for colorectal cancer and non-small cell lung cancer (DOR=5.05, 6.57); miR-29b showed a high diagnostic value for cancer (DOR=60.91). The publication bias was not obvious in this study (P>0.05). Conclusion: This systematic review and Meta-analysis suggests that miR-29 family is a potential biomarker in the diagnosis of cancers with great sensitivity and specificity.

Objective To describe the analgesic effect of low-flow rate oxygen inhalation with intravenous mannitol injection for patients after nasal operation and seek for effective method for allevia-tion of pain.Methods 160 patients were divided into group A,B,C and D with 40 cases in each group.Group A received intravenous injection of 125 ml of 20%mannitol and group B got low-flow rate oxygen inhalation through nasal canulas.While group C were given the combination of treatment in that of group A and group B.Group D was named the control group and only adopted routine nursing.The pain alleviation effect was observed by McGill pain evaluation method.Results The score of pain in group C was lower than those in group A and B.While the scores of pain in group A and B were lower than that in group D(P<0.01).Conclusion The nasal swelling in group C lightened compared with those of group B (P<0.01)and group A(P<0.05).The nasal swelling in group A was lighter than that of group D but no difference Was seen between group B and group D

Objective To explore the risk factors in disease progression and the significance of vascular endothelial growth factor ( VEGF ) and vascular intercellular adhesion molecule-1 ( VCAM-1 ) in hand foot and mouth disease ( HFMD) combined with encephalitis .Methods Altogether 92 subjects with HFMD were enrolled in the study and were divided into four groups , including group A ( ordinary group with no complication ) , group B ( severe group with complication ) , group C ( critical group with complication ) , group D ( recovery group with complication ) .Concentrations of VEGF and VCAM-1 in serum and cerebro-spinal fluid were detected by double antibody sandwich ELISA method .Multiple factors logistic regression analysis was performed to analyze main risk factors in disease progression for two combinations , one for ordi-nary group and severe group , the other for severe group and critical group .The results were analyzed by SPSS16.0 statistical software.Results The concentration of VEGF and VCAM-1 in serum and cerebrospi-nal fluid had statistically significant differences among the four groups , but there was no significant difference between group A and group D , and between group B and group C .In addition , the statistically significant factors for prediction of disease progression were duration of fever , limb shaking, cerebrospinal fluid WBC , cerebrospinal fluid protein and EV 71 IgM between ordinary group and severe group , and cerebrospinal fluid WBC, respiratory rate and heart rate between severe group and critical group .The multiple factors logistic regression analysis revealed that limb shaking , cerebrospinal fluid protein , VEGF and VCAM-1 in serum were the main risk factors for disease progression from ordinary to severe (P=0.071, 0.019, 0.020, 0.025 and OR=147.629, 26.572, 5.958, 6.345).And increased heart rate indicated the progression from se-vere to critical with P value of 0.001 and OR value of 2.69.Conclusion (1) Compared with group A, VEGF and VCAM-1 in serum and cerebrospinal fluid were highly expressed in patients with HFMD combined with encephalitis .Therefore , VEGF and VCAM-1 could be used as diagnostic criteria for auxiliary diagnosis of encephalitis in patients with HFMD and reflect the severity and prognosis to a certain extent .( 2 ) Risk factors like limb shaking , cerebrospinal fluid protein , VEGF and VCAM-1 in serum would be helpful to early diagnosis of severe patients .Increased heart rate would be a significant factor for identification of patients with critical disease , according to which a timely treatment would be provided to prevent from worse .