A study on the optimal dilution of serum to detect anti HBc-IgM with ELISA. was carried out. Samples were diluted to 10-1to 10-7. Among 26 samples of normal individuals, 22 were negative, but two samples of 10-1 dilution, one sample of 10-2, and one sample of 10-1-10-3 were positive though the control wells were all negative. 42 samples of the patients with variours types of hepatitis B were examined. It was found that when serum dilution was 10-1, only 6 cases were positive; when the dilution was 10-2, 20 cases were positive; when the dilutions were 10-3, 5?10-3, and 10-4, high positive rates were obtained and they were 88.1%, 78.5%, and 69% respectively; and when the samples were further diluted, the positive rate decreased.In order to get goodfresults and minimize false results, either false negative or false positive, it is suggested that 5?10-3 be the optimal dilution.

Objective To apply the theory basis for effectively preventing and treating rotavirus infection by studying on specific humoral immune response in children with rotavirus diarrhea. Methods Seventy-five patients of children (diarrhea group ) and 45 controls (control group) were selected. The antigen and specific antibody in plasma and stool were detected by ELISA method;the type of viral gene was confirmed by reverse transcription PCR method;the expression of mRNA in peripheral blood mononuclear cell was measured by fluorescent light quantitation PCR method. Results In diarrhea group, rotavirus G typing to G3 dominated, accounting for 77.3% (58/75), P sub-type to P8 mainly, accounting for 82.7% (62/75). Rotavirus-specific antibody titers of plasma in diarrhea group were significantly higher than those in control group, IgA antibody titers of stool increased significantly, not only higher than that in control group and plasma. The percentage of CD19+ cells in diarrhea group [(30.8 ± 7.9)%] was significantly higher than that in control group [(23.1 ± 7.7 )%] (P = 0.009 ). And the proportion of CD4+ cells decreased significantly (P = 0.005 ), the expression level of IL- 12p40 mRNA in the entire process in diarrhea group was significantly higher than that in control group(P＜ 0.01 ). Conclusion Children with acute rotavirus infection early in the immune response to specific humoral immunity, especially mucosal immune to significantly improve the main features.

Objective To explore the rehabilitation for dysphagia in young patient after tracheotomy and cricopharyngeal achalasia with-out cough reflex. Methods A child was reviewed, who accepted tracheotomy after resection of cerebellar pilocytic astrocytoma for dyspha-gia. The features characterized as severe silent aspiration and failure of cricopharyngeus muscle relaxation. Therapies included Passy-Muir valve placement, breathing exercises, balloon dilatation, surface electromyography biofeedback, and electrical stimulation. Results The aspi-ration was observed when she drank thin liquid with weak cough reflex, and disappeared as eating thick liquid and paste food, with complete cricopharyngeus muscle opening, 7 weeks after treatment. She was removed the tracheotomy tube and nasal feeding tube 11 weeks after treatment, and got sufficient nutrition by fully oral intake. Conclusion The application of Passy-Muir valve and comprehensive swallowing training is helpful for patient post tracheotomy with silent aspiration in decreasing the risk of aspiration, improving cough reflex and prompt-ing swallowing function.

This paper is to report the result of using ELISA to detect HBsAg-IgM complex in the serum of patients with viral hepatitis B. A series of serum samples of 35 patients,including 29 acute,2 subacute severe and 4 chronic active cases were tested. 28 normal individuals were also tested as control.HBsAg-IgM complex was discovered in the sera of all the patients in the first one or two weeks of hospitalization. It disappeared from the sera of 24 patients (among whom 10 have been followed up for more than 3 to 6 months) who recovered completely after 4 weeks of treatment. The disappearance of the complex occurred long before the clearance of HBsAg and the returning to normal levels of other biochemical parameters. In 5 cases of acute hepatitis with the tendency to be chronic and in those subacute and chronic cases,HBsAg-IgM complex delayed to disappear and could be found in the sera even 6 months later. All the normal controls were negative.It is suggested that the detection of HBsAg-IgM complex in the serum of hepatitis B patient may be used not only as a criterion to evaluate the prognosis of acute cases but also as an index to determine whether the patient is suffering an active disease process.

Objective To evaluate clinical effects of the treatment of tibial fractures through compression reduction and osteosynthesis with common plate. Methods From March 2001 to September 2003, 48 cases of tibial fractures were treated through compression reduction and osteosynthesis with common plate. Results All the cases were followed up for 6 to 24 weeks (averaging 14 weeks). The healing time was 12 to 16 weeks (averaging 5 weeks). No delayed union, non union, infection, or ineffective internal fixation occurred. Conclusion Compression reduction and osteosynthesis with common plate to treat tibial fractures is a kind of biomechanical fixation that facilitates fracture healing.

Objective To develop a quality of life scale suitable for aphasic Chinese stroke patients by translating and evaluating the psychometric properties of the original 39-generic version of the Stroke and Aphasia Quality of Life scale (SAQOL-39g).Methods The SAQOL-39g was translated into Chinese and edited.The well edited and translated self-rated and non-self-rated scales were used to test 86 aphasia patients and their caretakers to evaluate the feasibility,internal consistency,test-retest reliability,content validity,and construct validity of the scale.Results The feasibility of the Chinese version of the SAQOL-39g scale was sufficient,with 97％ of the ques tionnaires completed.The average time taken to complete the self-report version was (21.4±4.37) minutes,with (13.25±5.61) minutes needed for the proxy version.The Cronbach's alpha values for the overall survey ranged from 0.879 to 0.950 and for the subdomains from 0.863 to 0943 for both forms,suggesting satisfactory internal reliability.The test-retest coefficients for the two forms ranged from 0.804 to 0.974 and from 0.861 to 0.987.A total of 3 common factors were extracted using factor analysis,and the cumulative contribution rate was 59.7％.The consistency between the self-reports and the proxy-reports was good.Conclusion The Chinese version of the SAQOL-39g scale demonstrates good feasibility,reliability and validity,and good consistency between the self-reported and proxy-reported versions.It seems suitable for assessing the quality of life of Chinese stroke patients with aphasia.

Objective To explore effective precautions and interventions for choking in dysphagia patients.Methods Clinical data on f dysphagia patients hospitalized from September 1,1996 to Aug 8,2014 were retrospectively analyzed to correlate choking with gender,age,consciousness,type of aspiration,food-intake pathway and food texture.Results Only 0.17％ of the patients (n =8) were found to have choked,and 6 of them were men.Children,teenagers,the middle-aged and the aged constituted 25％,12.5％,37.5％ and 25％ of the patients respectively.75％ were conscious and 62.5％ displayed silent aspiration.6 cases used oral intake and 2 used nasogastric tube feeding.Among the 8 choking patients,half ate solid food,2 semisolid and 2 liquid food.Six survived and 2 died.Conclusion The risk factors for choking include silent aspiration and oral intake of solid or semisolid food.The successful rescue rate for choking is relatively low,so clinicians should be aware of and try to eliminate these risk factors.

Blood Replenishing Angelica Decoction [Danggui Buxue Tang (DGBXT)]is a wellknown TCM prescription composed of Radix Angelicae Sinensis and Radix Astragali with the actions ofinvigorating "Qi" and enriching blood. Its action to curtail endothelial permeability induced by histaminewas studied. Endothelial cells isolated from the aorta of neonatal calf were cultured on polycarbonate mi-croporus filter membrane to develop a confluent endothelial monolayer. After purfused with either plainHank's balanced salt solution or that containing 5 g/L albumin, the monolayer was treated with 10-4 mol/L histamine for 30 min either with or without preincubation for 60 min with 10-4 g/mL of DGBXT. Fluidfiltration coefficient (Kf), filtration volume (Jv) and osmotic reflective coefficient (σ) of protein were thenmeasured. The findings showed that DGBXT could curtail the lowering of Kf and Jv and elevation of σ in-duced by histamine, indicating that DGBXT could inhibit the action of histamine on endothelial permeabili-ty, but its mechanism of action needs further study.

Objective To analyze temporal and kinematic parameters of video fluoroscopic images of swallowing using a digital acquisition and analysis system and to verify the reliability of this method.Methods Eighteen patients with dysphagia were requested to completed six swallows (3 ml and 5 ml of thin liquid, thick liquid, and paste mixed with 600 kg/m3 barium sulfate suspension) in the natural sitting position.Video fluoroscopy was used to measure the oral transit times, soft palate elevation times, hyoid movement times, laryngeal closure times, cricopharyngeal muscle opening times, hyoid anterior movement (HAM) , hyoid superior movement (HSM) , cricopharyngeal muscle opening diameter and pharyngeal constriction rate.Each was extracted from the videos four times by two raters working separately with an interval of 4 weeks between the sets of evaluations.Results Reliability varied among the different observations.HAM and HSM showed inter-rater reliability between 0.41 and 0.60 and intra-rater reliability between 0.61 and 0.80.The other observations all demonstrated acceptable reliability.Conclusion The self-designed digital acquisition and analysis system tested showed acceptable reliability and could be applied to analyze swallowing function clinically.

Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.