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.

Objective To investigate the changes of liver function and white blood cell of patients with liver cirrhosis,portal hypertension and secondary hypersplenism underwent laparoscopic splenectomy(LS) and open splenectomy(OS).Methods We analyzed 76 clinical data of patients with liver cirrhosis,portal hypertension and secondary hypersplenism,among those 27 underwent LS,49 OS from Mar 2003 to Mar 2006 retrospectively.Blood samples were obtained and analyzed preoperatively and postoperatively on days 1,3, and 7,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),directed bilirubin(DBil) and white blood cell(WBC).Results Between LS and OS,the serum levels of Tbil and Dbil had significant difference on the 1st postoperative day(P

OBJECTIVE To discuss the management experience of protective measures for emergently admitted influenza H1N1 patients in our hospital who were converted from general ward into isolated ward in no more than three hours.METHODS Laying out the guideline of the work,personal training and personal protective measures were taken to manage the staff who working in the isolated ward.RESULTS There was statistically significant difference in hand washing,wearing mask and head wear,taken off gloves,mask and clothes among medical staff who worked in the isolated ward,in comparison with staff from other ward and non-medical staff From 14 points of suruey.there were 8 points were over 80% pass rate.The use of protective equipment was correct.without any cross infection.CONCLUSIONS Management of protective measures plays an important role in control of cross infection in treatment of H1N1 patients.

The development of the minimally invasive targeted ablation tendency creates a new therapy for lung cancer. This treatment is featured with considerably extensive indication ,excellent local control and survival time, low incidence and controllable complications. There are many strong proofs of clinical efficacy and safety in this field presently.

Objective Discuss how to develop nurse arrange in groups mode in basic level hospital, resolve more effectively the problem of nurse delayed on duty to ensure nursing care quality and patients' safety.Methods Divide nurses of different level, different working ability and work experience into several groups to carry on arranges in groups.According to the quantity of patient in ward, the nursing work load, nurse establishment and so on, arrange groups with different number of nurse to attend duty.Results Realized nurse level management, the senior nurse's sense of responsibility strengthened, the work value feeling promoted, nurse delayed on duty rate reduced 89.5%;has realized three satisfactions, namely doctor, nurse, the patient were satisfied.Conclusion Basic level hospital, according with practical work characteristics, develop arranges in groups pattern continuously, and thus has safeguarded the noon and at night patient's safety well, has manifested truly take the patient as the center service idea;reduced times of handover, effectively save time of work, raises the working efficiency, reduces the safe hidden danger;realized nurse level management, enhanced nurse the value feeling.

Hepatitis, Autoimmune ; Humans ; Immunoglobulin G

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

With the increasing demand for liver transplantation,some previously abandoned donors,called marginal donor,started to be involved in clinical liver transplantation,which raises higher requirement on the organ preservation methods.Normothermic perfusion is regarded to be superior to the currently adopted hypothermic perfusion,and plays an important role in the organ preservation of marginal donors.This review will summarize the clinical applications of liver normothermic perfusion in transplantation and repair,as well as its roles in basic research.

The concentrations of berberine (BBR) and 8-cetylberberine (8-BBR-C16) in rat plasma and tissue were determined by RP-HPLC. Both the plasma pharmacokinetics characteristic and tissue distribution differences of BBR and 8-BBR-C16 were compared to provide experimental data for the mechanism research and further drug development. After the oral administrations of BBR and 8-BBR-C16 at the dose of 80 mg x kg(-1) for rats, the pharmacokinetics result showed that compared with BBR, the C(max) and AUC(0-t), of 8-BBR-C16 increased by 2.8 times and 12.9 times respectively, t1/2 extended from 3.61 h to 11.90 h. The tissue distribution result showed that compared with BBR, the concentration of 8-BBR-C16 in various organizations increased and the retention time extended remarkably. The maximum concentration was achieved in lung and the highest concentration in it was 3 731.82 ng x g(-1). After being derived, the C(max) in plasma and bioavailability of 8-BBR-C16 increased remarkably and the circulation time in vivo extended. The drug concentration in tissue increased remarkably, and the distribution ratio changed too, with strong targeting selection in lung.

Objective To analyze the influences of lacrimal secretion and tear film after interferon-alpha therapy in patients with chronic viral hepatitis.Methods Sixty patients with chronic viral hepatitis who would accept the interferon-alpha therapy,including 30 cases of hepatitis B and 30 chronic viral hepatitis C,visited our department of ophthalmology and were enrolled in this study.All cases received eye examination,including medical history,slit lamp examination,corneal fluorescein staining ( FL) ,tear film break-up time ( BUT) and schirmer test before inter-feron-alpha therapy and two months after the therapy.Results In the 60 cases of chronic viral hepatitis,there were 19 dry eye cases (31.67%) and 41 non-dry eye cases (68.33%).In dry eyes group,9 of them (47.37%) were hepatitis B patients and 10 of them were hepatitis C patients (52.63%) .There was significant difference in FL grade (t=-5.288,P<0.05),BUT (t=5.799,P<0.05),Schirmer Ⅰ(t=5.319,P<0.05) test in hepatitis B before and two months after interferon-alpha therapy.Statistical significance had been found before and two months after therapy in FL grade (t=-9.103,P<0.05),BUT (t=5.682,P<0.05),SchirmerⅠtest (t=4.592,P<0.05). The incidence of dry eye syndrome in hepatitis B patients increased from 26.70%to 53.30%two months after treated with interferon-alpha,while the incidence of dry eye syndrome in hepatitis C patients increased from 33.30% to 60.00% two months after treated with interferon-alpha.Conclusion Dry eye syndrome is one of common complica-tions in patients with chronic viral hepatitis.Interferon-alpha therapy would influence the lacrimal secretion and dam-age tear film,which increased the dry symptoms in patients.We should pay attention to the side effects of interferon-alpha therapy.