In order to study the status of cell apoptosis in psoriatic epidermis, we have investigated the changes of the lesions in various stages in patients with psoriasis vulgaris by using terminal deoxynueleotidyl transferase-mediation dUTP-biotin nick end labelling (TUNEL). The results showed that the highest frequency of apoptotic keratinocytes was observed in the early scaling papular lesions, and the frequency was reduced in the progressive maculo-papular lesions and the coalescent plaques successively. The frequency of hyperproliferation of epidermis was in the reverse order in comparison with the above results. These results suggest that increased apoptosis of keratinocytes is the initial change of psoriatic epidermis, then hyperproliferation of keratinoeytes follows.

Objective:To explore the clinical effect of glucocorticoid methylprednisolone combined with the conventional treatment on severe hand-foot-mouth disease ( HFMD) in children. Methods:One hundred and twenty children with severe HFMD from our hos-pital were randomly divided into the hormone group and non-hormone group with 60 cases each. The non-hormone group was treated with western routine therapy, and the hormone group was treated with glucocorticoid methylprednisolone 2mg·kg-1 ·d-1 additionally. The changes in such symptoms as fever, rash, surprised and chatter, drowsiness and shock were recorded in all cases. The disappear-ance time of febrile, shock and herpes and hospital stay were compared between the two groups. Results:The clinical effect of the hor-mone group was better than the non-hormone group;it could shorten the disappearance time of febrile, shock, herpes and pharyngeal buccal redness (P<0. 05), while showed no effect on the hospital stay. Conclusion:Glucocorticoid combined with the routine thera-py in the treatment of severe HFMD in infants exhibits better clinical effect.

Objective:To explore the impact of special rectification on antibiotics application in the patients during perioperative period with gynecologic typeⅡincision in our hospital. Methods:The antibiotics type, use frequency, expense, administration time, dosage, treatment course and combined medication were retrospectively compared between April to September in 2011(before the recti-fication) and April to September in 2013 (after the rectification). Results: After the special rectification, the total DDDs was de-creased from 1 564. 5 to 419. 3, the expense for antibiotics and all drugs was respectively decreased from (297. 5 ± 47. 1) yuan to (108. 3 ± 29. 6) yuan and (806. 4 ± 63. 1)yuan to (498. 1 ± 70. 2) yuan, the proportion of antibiotics was decreased from (36. 9 ± 9.1) % to (21.7 ±6.8) %, and the treatment course was reduced from (3.7 ±1.4)d to (1.5 ±0.6)d(P<0.05). The rational rate of administration time, dosage and combined medication was respectively increased from 67. 7% to 98. 6%, 81. 5% to 100. 0%and 41. 1% to 80. 7%(P<0. 05). Conclusion:Special rectification can effectively improve the rational antibiotics use in gynecology department of our hospital during perioperative period of type Ⅱincision.

ACKGROUND:Autism is a kind of neurobiological disease.The increase of plasma concentration of 5 hydroxytryptamine(5 HT) is considered to be one of study results,which is the most definite and has the best repetition,for the biological investigation of autism. Whether the season of birth and maternal mood during pregnancy are correlated with the occurrence of autism? OBJECTIVE:To compare the differences of the plasma concentration of 5 HT,season of birth and the maternal mood during pregnancy between autistic and normal children,and probe into the cause of increased 5 HT in autism. DESIGN:An observational comparative study taking autistic and normal children as the subjects. SETTINGS:A clinical psychological department of a university hospital;Mental Health Institute of the Xiangya Second Hospital;A rehabilitation center for dumb children of city grade. PARTICIPANTS:Children in the autistic group(n=54),who were in accordance with the diagnostic criteria of autism in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV) and had the total score of social adaptive ability scale(SAAS) over 40, were selected from the Outpatient Clinic for Children of the Mental Health Institute,Xiangya Second Hospital of Central South University and the training class of autism of Shenzhen Special Education School;Children in the normal control group,who had no obvious somatic and neurological diseases,and developing delay detected by physical,neurological and mental status examinations, rough detection of developing level,were selected from the primary school and kindergarten in Changsha and Shenzhen cities. INTERVENTIONS:The plasma level of 5 HT was examined, season of birth and maternal mood during pregnancy were investigated in autistic and normal children.The children with autism were accessed with SAAS. MAIN OUTCOME MEASURES:The plasma level of 5 HT,the season of birth and the maternal mood during pregnancy in both groups. RESULTS:The score of SAAS in children with autism was 67.65± 1.67.The plasma level of 5 HT was(0.78± 0.32) μ mol/L in the autistic group,which was significantly higher than that in the normal control group [(0.62± 0.16) μ mol/L](t=3.17,P=0.002). There were 17 children with autism had increased 5 HT.Compare with normal children,most children with autism were born in winter and spring,and their mother had obvious mood problems during pregnancy. CONCLUSION:The 5 HT level is higher in children with autism than in normal children.Most children with autism were born in winter and spring,and their mother had obvious emotional problems during pregnancy.There are phase of high functioning of 5 HT in mother in key period of fetus cerebra development that may be one of the causes of hyperserotonemia in autism,and that is possibly one of the etiologies of autism.

BACKGROUND: It is not a report concerning utilization of artificial intelligence combined with artificial neural network in mental health domain, rather than that combining artificial intelligence, artificial neural network and simulating human brain thinking mode for diagnosing child mental health disorders. OBJECTIVE: Using computer to simulate thinking modes of human brain, to establish an artificial intelligence expert system for diagnosis and treatment of child mental health disorders based on artificial neural network and expert system.METHODS: The expert system involves in child psychiatry, child psychology, psychological measurement, psychological therapy, and computer science, and so on. The diagnosis system combines the diagnosis standard of ICD 10, DSM IV, CCMD-2, the epidemiological data, and the clinical data with senior psychiatrist knowledge. The clinical data were obtained from 14 epidemiological and outpatient department, and 1 125 valid data were harvested for the system compilation.RESULTS AND CONCLUSION: The system can diagnose 61 kinds of child mental health disorders. It includes more than 95% child mental health disorders. After diagnosis, the computer will give a treatment suggestion. Comparing the diagnosis by computer with diagnosis by the senior child psychiatrists, the consistent rate is 99%. The research can help the younger doctors to learn abundant clinical experiences of senior child psychiatrists and can help children of mental health disorders throughout the country.

Malaria vaccines are being developed against different stages in the parasite's life cycle. Although not directly protective ,the sexual stage vaccines would induce antibodies that would prevent infection of mosquitoes when ingestedin a bloodmeal containing sexual stage parasites. pfs25 has been tested to be an important candidate antigen for malarial transmission blocking vaccine . In this report we analyzed the complete code of pfs25 gene of Plasmodium falciparum PFD-3/YN isolate. The result shows that the gene encoding pfs25 of PED-3/YN isolate has a mutant which generates a PstI endonuclease restriction site and shares 99.2％ nucleotide homology with that of NF4 isolate.

Objective To investigate the anesthesia and perioperative blood management of patients with Marfan syndrome (MS) undergoing scoliosis surgery.Methods The clinical data of MS patients underwent scoliosis surgery from January 2013 to December 2015 in Peking Union Medical College Hospital were collected and compared with patients received the same surgery but without MS.Perioperative information and data on anesthesia and blood management were analyzed.Results Compared with control group,MS patients were found with more preoperative comorbidities with statistical significance,including eye disease,echocardiographic abnormalities,and ventilatory defects.MS patients had significantly more blood loss,more intraoperative and postoperative allogeneic and autologous blood transfusion.The operation time,anesthesia time,and length of postoperative hospital stay were all significantly longer in MS patients.Conclusions MS patients are common with multi-system involvement and comorbidities.Considering the high risk of perioperative bleeding,the anesthesia and blood management for MS patients undergoing scoliosis surgery should be with extra caution.Blood management should be applied and appropriate invasive monitoring methods should be considered when necessary.

Objective To explore the role of a new apoptosis related gene TFAR 19 in the pathogenesis of systemic lupus erythematosus (SLE) and the relationship between TFAR 19 and SLE.Methods ELISA was used to test if there is relation between TFAR 19 and SLE.Results It was found that in active SLE patients there was higher titer of TFAR 19 antibody than that in stability patients and normal controls.No significant difference was seen between stability patients and normal controls.Conclusion It is first put forward that TFAR 19 may be related with SLE pathogenesis and disease activity.

ObjectiveTo investigate the modification method of Cervical Spine Injury Severity Score System and discuss diagnosis and treatment strategy of lower cervical spine injuries.Methods Treatments of lower cervical spine injuries were selected according to the injury severity graded by the modified Moore' s classification system.Conservative therapy could be adopted for the patients with stability quantification rating ＜ 3 points or for the those with stability quantification rating =3 points but without spinal cord or nerve root compression.Surgical treatment was recommendable for the patients with stability quantification rating =3 points and with spinal cord or nerve root compression.Surgical therapy could be required for the patients with stability quantification rating ≥4 points and with risk of lower cervical instability.The higher the stability quantification score implied the stronger the surgical indications.Lower cervical spine injury combined with spine cord or nerve root compression had absolute surgical indications.At the same time,therapies were selected based on patients' other factors.ResultsBased on basic principles of the modified Moore' s classification system together with opinions of the patients and their relatives,14 patients were managed with surgical treatment and 16 with conservative treatment.Among the patients with complete spinal cord injury (Grade A),two patients treated surgically showed no obvious signs of spinal function recovery,but their nerve root irritation symptoms disappeared; the other one patient who needed surgery but received conservative treatment had no change of the spinal cord function and nerve root irritation.The patients with incomplete spinal cord injury (Grades B,C and D) treated surgically obtained certain degree of spine cord function recovery,with their American Spinal Injury Association (ASIA) score raised by 0.5 grade on average.However,the patients who needed surgery but received conservative treatment gained average increase of ASIA score for 0.5 grade.Imaging examination showed that patients without combined spinal injuries obtained interbody fusion after surgery,with normal alignment and height of the cervical vertebra but without presence of vertebral shift or instability. ConclusionsThe modified Moore' s classification system takes patients' spiaal injury condition and other factors into consideration in selection of conservative or surgical treatment,which improves the Cervical Spine Injury Severity Score System to some extent and has prospect of clinical application.

AIM: To clarify the role of new apoptosis-related gene, TF-1 cell apoptosis-related gene 19(TFAR19), in the pathogenesis of systemic lupus erythematosis (SLE) and the relationship between TFAR19 and SLE. METHODS: DNA Ladder detection, Western blotting, immunological fluorescence method, ELISA and so on were used to test if ultraviolet B(UVB) could induce HaCaT cell apoptosis and TFAR19 expression. RESULTS: HaCaT cell apoptosis could be detected after 24 hours of 30 mj/cm 2 UVB irradiation. Also, we found that in active SLE patients, the TFAR19 antibody was increased, but not significant compared to the normal control. CONCLUSION: TFAR 19 is involved in the process of UVB induced ketatinocyte line HaCaT apoptosis and SLE pathogenesis.