Objective To analyze the epidemiological and etiological characteristics of hand,foot and mouth disease(HFMD)in Honghe Prefecture,Yunnan Province from 2013 to 2021,and provide basis for the development of prevention and control strategies for HFMD. Methods The case data of HFMD in Honghe Prefecture,Yunnan Province from 2013 to2021 were extracted from the“China Disease Prevention and Control Information System”. Descriptive epidemiological analysis method was used to analyze the incidence rate,severe rate,mortality rate. The nucleic acids of enterovirus-A71(EV-A71)and Coxsackievirus-A16(CV-A16)were detected by Real-time PCR in throat swabs,anal swabs or stool samples from 16 586 cases of HFMD,and the etiological characteristics were analyzed. Results A total of 78 356 cases of HFMD were reported from 2013 to 2021 in Honghe Prefecture,Yunnan Province,with 354 severe cases and 11 deaths. The average annual incidence rate of HFMD was 187. 47/100 000,with an upward trend from 2013 to 2015,and reached the first peak in 2015,which showed a downward trend from 2016 to 2017,while increased,reached the second peak,and then gradually decreased and tended to be flat in 2018. The severe and death rates have been declining since 2015. The age group of 0～7 years old showed high incidence,which accounted for 97. 85%(76 670/78 356)of the total incidence,and the average annual incidence of 1～2 years old group was the highest(4 397. 98/100 000). Generally,the time distribution showed a bimodal distribution,which were from April to July(summer peak)and from October to December(autumn peak),and the peak in summer was higher than that in autumn. The number of cases and severe cases in males were significantly higher than those in females（χ~2= 1 154. 436 and 5. 183,respectively,each P < 0. 05）. The average annual incidence and severe rate in the northern part of Honghe Prefecture were significantly higher than those in the southern part（χ~2= 18 573. 742 and 11. 036,respectively,each P < 0. 05）. Among 16 586 HFMD cases,EV-A71,CV-A16 and other enteroviruses accounted for 18. 71%,20. 38% and 60. 91% of cases,respectively,with significant difference（χ~2= 5 426. 965,P < 0. 05）. The dominant pathogen was EV-A71 in 2013 and 2015,while CV-A16 in 2014,and other enteroviruses became the dominant pathogens in 2016 — 2021. Conclusion The epidemic trend of HFMD in Honghe Prefecture,Yunnan Province from 2013 to 2021 was seasonal and regional,with children under the age of 7 being the key population,and other enteroviruses have become the dominant pathogens after 2016. HFMD prevention and control knowledge publicity should be strengthened,good hygiene habits should be advocated,and parents' awareness of disease prevention should be raised. EV-A71 vaccination should be strengthened to reduce EV-A71 infection and effectively prevent severe cases and deaths.

There aren't official standards on syllabus,content,teaching materials and teaching methods of curriculum on three-year rehabilitation therapy specialty in the higher vocational education yet.This paper discussed the course of traditional rehabilitation therapy based on the characteristics,objectives and the actualities of traditional rehabilitation teaching in the vocational college.

Objective:To evaluate our self-made distraction reductor used in the percutaneous minimally invasive treatment of calcaneal fractures.Methods:A retrospective study was conducted of the 32 patients (37 feet) who had been treated at Department of Orthopaedics, The First Affiliated Hospital to Chongqing Medical University from January 2017 to December 2019 for calcaneal fractures. They were 26 males and 6 females, aged from 20 to 67 years (average, 46.5 years). The height and length of the calcaneus were restored by our self-made tri-plane distraction reductor in all patients; the displaced fracture blocks were reset in a minimally invasive manner in patients with intra-articular fracture; final fixation was performed with a minimally invasive plate and screws. Time for reductor installation, operation time and intraoperative blood loss were recorded; complications, fracture union and reduction were observed; height, length and width of the calcaneus, ankle-hindfoot scores of American Society of Foot and Ankle Surgery (AOFAS), Maryland scores, and visual analogue scale (VAS) were recorded at the last follow-up; B?hler and Gissane angles were compared between pre- and post-operation.Results:All patients were followed up for 12 to 36 months (average, 17.2 months). Time for reductor installation averaged 5.0 min (from 3 to 8 min), operation time 91.5 min(from 70 to 110 min), and intraoperative blood loss 25.2 mL (15 to 50 mL). Superficial infection of traction track occurred in one patient and sural nerve injury in one patient. All fractures united without any reduction loss by the last follow-up. On average, the last follow-up observed a calcaneal height of 39.3 mm, a calcaneal length of 70.6 mm, a calcaneal width of 32.7 mm, an AOFAS score of 87.8, a Maryland score of 86.7 and a VAS score of 2.2. The calcaneal B?hler angle was recovered significantly from 3.7°±13.7° preoperatively to 25.8°±6.4° at the last follow-up, and the calcaneal Gissane angle from 112.2°±21.3° preoperatively to 125.8°±5.7° at the last follow-up ( P< 0.05). Conclusion:In percutaneous minimally invasive treatment of calcaneal fractures, application of our self-made tri-plane distraction reductor can lead to fine clinical efficacy.

Objective To study the effect of chronic electrical stimulus at a low physiological frequency on the expression of myosin heavy chain (MHC) in genioglossus of rabbits with chronic hypoxia.Methods Twenty-four adult rabbits,weighing 2.3?0.1kg,were randomized into control group (A),chronic hypoxia group (B),10 Hz electrical stimulus group (C),and 10+40 Hz electrical stimulus group (D).Rabbits in groups C and D received electrical stimulus of genioglossus at a frequency of 10 Hz and 10+40 Hz,respectively,while those in group B received no electrical stimulus,after they were placed in a hypobaric hypoxia cabin,8 h a day for 5 weeks,with free access to food and water.Expression of MHC in genioglossus of rabbits in the 4 groups was detected by SDS-PAGE and semi-quantitative inverse transcription RT-PCR,respectively.Results The expression level of MHCⅠand MHCⅠmRNA was significantly lower while that of MHCⅡa was significantly higher in group B than in group A [(0.69?0.07)% vs (17.48?4.00)%,(0.69?0.07)% vs (1.05?0.06)%,and (79.89?5.09)% vs (73.33?4.17)%,P

Objective To investigate the influence of controlling multiple cardiovascular risk factors on early renal impairment in patients with metabolic syndrome. Methods 619 in-patients were categorized, according to the diseases they were suffering from into essential hypertension group (EH, 144 cases, m/f=74/70), type 2 diabetes mellitus group (T2DM, 134 cases, m/f=79/55), and metabolic syndrome group (MS, 341 cases, m/f=167/174). The effects of controlling the blood pressure, blood glucose and plasma lipid on early renal impairment were evaluated. Results 1. There were more than one half of the patients in MS and EH with blood pressure above 140/90 mmHg, more than one half of the patients in MS and DM with HbA1c above 7.0%, and more than one half of the patients in MS with triglyceride≥1.7mmol/L with or without high density lipoprotein

Rehabilitation evaluation was an important special basic course of healing cure specialty in the higher vocational college. It was a key to improve teaching quality of training students' occupation capacity. The establishment of aim, class teaching contents and outline, the preparation of teaching data, the innovation of teaching methods and measures, the reinforcement of practical teaching, and etc. were discussed in this paper. Considerations and experiences on the practical teaching reform and construction of rehabilitation evaluation courses were put forward in the higher vocational colleges.

Objective To evaluate the efficacy of entecavir treatment on hepatitis B patients with acute-on-chronic liver failure. Methods Eighty-four hepatitis B patients with acute-on-chronic liver failure were treated with entecavir 0.5 mg daily and Other routine drugs. Another 99 hepatitis B patients with acute-on-chronic liver failure were treated with only routine drugs as control. The survival, liver functions, hepatitis B virus (HBV) DNA level, prothrombin time (PT) were observed. The survival rates of patients with early, middle or late stage of liver failure were analyzed. The comparison of rates were done using chi-square test. The numeration data were compared by t test. The survival rates were compared using Kaplan-Meier method. Results Among patients with early stage of acute-on-chronic liver failure, the survival rate in treatment group was 63.3% (31/49), which was significantly higher than that in control group (39.7%, 23/58) (χ2=5.923, P=0.015). Among patients with middle stage of acute-on-chronic liver failure, the surviral rate in treatment group was 63.0% (17/27), which was significantly higher than that in control group (35.1%, 13/37) (χ2=4.854, P=0.028). Among patients with late stage of acute-on-chronic liver failure, four out of eight cases survived in treatment group, while one out of four cases survived in control group. In patients with serum total hilirubin (TBil) level > 342 μmol/L, the survival rate was 56.0% in treatment group, which was significantly higher than that in control group (26.8%) (χ2=9.351,P=0.002). At week 4 of the treatment, the HBV DNA reduction in treatment group was 3. 95 lg copy/mL, which was higher than that in control group (1.78 lg copy/mL) (t=5.847, P=0.001). Conclusions Entecavir treatment could improve the survival rate of hepatitis B patients with early or middle stage of acute-on-chronic liver failure. And the further study with larger population is needed in patients with late stage of liver failure. In addition, entecavir therapy could also improve the survival rate of patients with TBil >342 μmol/L.

Objective To observe the effects of combined penebyclidine hydrochloride-ketamine-propofoi intravenous anesthesia with local anesthesia in transcatheter occlusion of congenital heart diseases (CHD).Methods Eighty-six patients suffered in CHD scheduled for transcatheter Amplatzer occlusio were divided randomly and averagely into two groups with 43 cases each.Group A received combined ketamine--propofol ina'avenous anesthesia with local anesthesia. Group B received combined hydrochloride-ketamine-propofol intavenous anesthesia with local anesthesia.Results The rate of upper airway obstruction of child patient that was caused by increased oral secretion in group B (4.7%) was significantly lower than that in group A(14.0%) (P ＜ 0.05 ).The upper airway obsa-uction was removed by aspirating sputum and oxygen therapy in group A,while removed "by decreasing anesthetic depth in group B.The rate of arrhythmia in operation,the time of operation and wake-up time were not significantly different between two groups [37.2%,(2.65±1.85)h,(45.4±15.2)min in group A,but 34.9%,(2.58±1.74)h,(50.2±17.3)rain in group B (P＞0.05)].Conclusion The combined penehyclidine hydrochloride-ketamine-propofol intravenous anesthesia with local anesthesia is feasible and safe in transcatheter occlusion of congenital heart diseases.

Objective To quantitatively evaluate the influence of fluid attenuated inversion prepared recovery (FLAIR) on apparent diffusion coefficient (ADC) and its clinical application value. Methods The data of DWI and FLAIR-DWI of 139 stroke were retrospectively reviewed. Paired t-test was used to analyze DWI (ADCCON ) and FLAIR-DWI (ADCFLAIR) values at varying time points from hyperacute to chronic stage. All of the lesions were further divided into cortex involved infarction and subcortical infarction. The ADCCON and ADCFLAIR values in the lesion sides and the contralateral sides were compared separately. Results The mean ADCCON values for lesions less than 6 hours, 7--12 hours, 13--24 hours, within 2 days, 3-4 days, 5-7 days and 8--14 days were not significantly different from those of the ADCFLAIR values(P >0.05) [ADCCON were (0.55±0.07), (0.50±0.09), (0.50±0. 13), (0.50 ± 0. 13), (0.62 ± 0. 14), ( 0. 60 ± 0. 12), (0. 72 ± 0. 20) × 10-3 mm2/s; ADCFLAIR were ( 0. 53 ± 0. 09 ), (0.49±0.06),(0.49±0.10),(0.48±0.08),(0.58±0. 14), (0.60±0.09),(0.73±0.15) × 10-3 mm2/s]. Lesions of 15 to 30 days [ (0. 95±0. 21 ) × 10-3 mm2/s and ( 1.02±0. 27) × 10-3 mm2/s for ADCFLAIR and ADCCON ] and the chronic stage ( >31 days) [ ADCFLAIR and ADCCON were (1.10 ± 0. 30) × 10-3 mm2/s and (1.36±0. 41 ) × 10-3 mm2/s respectively], had a significantly lower ADCFLAIR than those of the ADCCON (P <0. 01 ). For patients with a symptom duration of less than 14 days, the mean ADCFLAIR values of the cortex involved and subcortical lesions were all not significantly different from the mean ADCCON (P > 0. 05 ) [ ADCCON were ( 0. 55 ± 0. 16 ), ( 0. 61 ± 0. 14 ) × 10-3 mm2/s ; ADCFLAIR were (0.53±0. 14), (0.60±0. 13) × 10-3 mm2/s]. For patients with a symptom duration of longer than 14 days, the mean ADCFLAIR values of the cortex involved and subeortical lesions were all significantly lower than those of the mean ADCCON values [ ( 1.16±0. 36) × 10-3 mm2/s vs. ( 1.35±0. 48) × 10-3 mm2/s for cortex involved lesions and (0. 97±0. 19) × 10-3 mm2/s vs. ( 1.15±0. 33) × 10-3 mm2/s for subcortical lesions ] (P < 0. 01 ). The ADC values of the normal contralateral sides were significantly decreased after the fluid inversion prepared pulse was conducted [ ADCFLAIR, ( 0. 76 ± 0. 05 ) × 10-3 mm2/s and ADCCON, (0. 82 ± 0. 11 ) × 10-3 mm2/s ] ( p < 0. 01 ). Conclusions The FLAIR significantly decrease the absolute ADC values of the ischemic lesions 14 days later after the stroke onset, which may be helpful in determining individual lesion age. Meanwhile, the application of FLAIR can have a more accurate relative ADC value by reducing the free fluid partial volume effect of the normal contralateral side, and hence enhance the ability of detecting the subtle ischemic pathophysiological changes.

Objective To investigate whether the combination of hydroxyapatite/tri-calcium phosphase (HA/TCP) and distraction osteogenesis technique would greatly reduce the time for the treatment of bone defects and enhance bone consolidation.Methods Osteotomy was made in the left tibia of all the 36 rabbits (age 20-24 weeks,body weight 2.2-2.8 kg),and a 1.0 cm length of the tibial shaft was removed below the tibiofibular junction.All rabbits were randomly divided into 3 groups,12 per group.Group A:The 1.0 cm defect gap was immediately reduced with the tibia shortened for 1.0 cm.Group B:The 1.0 cm defect gap was immediately filled with 1.0 cm restorable porous HA/TCP cylindrical block.Group C:The 1.0 cm defect gap was immediately reduced with the tibia shortened for 0.5 cm,and the remaining 0.5 cm defect gap was filled with 0.5 cm restorable porous HA/TCP cylindrical block.Then all the tibia was fixed with unilateral lengthener.For Group A and Group C,the lengthening started on the seventh day postoperatively,and lasted for 10 days and 5 days respectively.Group B didn't perform lengthening.All the rabbits wore terminated on the 37th days postoperatively.Serial radiographs were taken on the day of surgery,12,17,27 and 37 d postoperatively.The excised bone specimens were subject to micro-CT,mechanical testing,and histological examinations.Results Compared with the other two groups,the results in Group C were better in the terms of bone mineral content 454.44 ±89.98 mg,tissue mineral content 454.40±89.97 mg,maximum torque,maturity of regenerate bone,and the speed of bone consolidation and remodeling.Complete bone healing was achieved in the Group C within 37 days,but not in the Group A and B within 37 days.Conclusion The combination of HA/TCP and distraction osteogenesis technique can reduce the treatment time and promote bone consolidation compared with single treatment.