Viral encephalitis is a common pediatric infectious disease of the nervous system,the correct diagnosis, treatment and quality control has always been a challenge;America, British, European, Australia had issued guidelines for the diagnosis and treatment of encephalitis in 2008-2015 ,which had important reference value for guiding clinicians dealing with viral encephalitis, this article integrated above guides and introduced the definition, classification, etiology, accessory examination, handling procedures and treatment of viral encephalitis in children, and the quality control program in the diagnosis and treatment of viral encephalitis in children was preliminarily discussed.

Bone remains the predominant site of metastasis in advanced breast cancer. Bone metastases dramatically decrease the quality of life. Moreover, pathologic fractures and other skeletal-related events (SREs) caused by bone metastases could result in higher mortality risk in patients with breast cancer. Palliative radiotherapy is a crucial element in bone metastases treatment. The present review discusses the emerging evidence in bone metastases of breast cancer, focusing on optimized radiotherapy strategies and multidisciplinary management.

Objective To explere the curative effects of L-carnitine on neonates with myocardial injury caused by asphyxia.Methods Ninety-one neonates with myocardial injury caused by asphyxia were randomly divided into L-carnitine treatment group(48 cases) and control group(43 cases).The patients in control group were received routine treatment;the patients in treatment group were given L-carnitine 0.1 g/(kg?d) on the basis of routine treatment for 10 days.Symptoms and physical signs were observed pretreatment and during the time of therapy.Before and after the treatment,serum MB isoenzyme of creatine kinase(CK-MB) and aspartate aminotransferase(AST) were mea-sured with immunosuppression and enzyme rate respectively,and serum albumin and prealbumin were detected with the method of bromcresol green chromatometry and immunoturbidimetry,respectively.Results Clinical effective rate of the treatment group(91.67%)was higher than that of control group(74.42%)(P

Carotid Body Tumor ; diagnosis ; therapy ; Humans

AIM:To explore the roles of Akt ( also called protein kinase B ) and active caspase-3 in the leptin-mediated chronic morphine antinociceptive tolerance in rats .METHODS: A model of chronic morphine antinociceptive tolerance was established in the SD rats .The protein levels of spinal Akt and cleaved caspase-3 were tested by Western blotting.The technique of immunohistochemical staining was used to detect the immunoreactivity positive cells of phospho -rylated ( p)-Akt and cleaved caspase-3 in the spinal cord .Double staining of immunohistochemistry was used to examine the cellular location of the p-Akt and cleaved caspase-3 positive cells.RESULTS: The chronic intrathecal injection of morphine (15 μg) for 7 d markedly upregulated the spinal protein levels of p-Akt and cleaved caspase-3 in the rats.Thirty min before injection of morphine , intrathecal injection of leptin antagonist (3μg) for 7 d significantly attenuated the upreg-ulation of the protein levels of p-Akt and cleaved caspase-3 induced by chronic morphine treatment .The p-Akt was exclu-sively observed in the spinal neurons .The cleaved caspase-3 was only localized with the spinal astrocytes .Intrathecal injec-ting the inhibitors of leptin , Akt and caspase-3 ameliorated the chronic antinociceptive tolerance .CONCLUSION: The spinal Akt pathway and active caspase-3 are involved in the leptin-mediated chronic morphine antinociceptive tolerance in rats.

Objective To investigate the methods of X-ray diagnosis of various displacement of unstable pelvic fracture in three-dimensional space and its instructive significance in closed reduction.Methods A normal adult pelvic specimen was selected and fixed in a wood-frame at supine position after soft tissue rejection and ligament preservation.With the breakage at the unilateral anterior-posterior ring,models of hemipelvic rotation in the transverse and sagittal planes and hemipelvic vertically upward displacement were induced.Anteroposterior radiographs of the pelvic specimen were made and picture archiving and communication system (PACS) was used to measure width of iliac wing,suprainferior diameter of hemipelvis,vertical displacement of iliac crest,acetabulum roof,pubic tubercle and sciatic tuber and area of obturator foramen.Methods of X-ray diagnosis of various displacements of hemipelvis were concluded and applied in treatment of 43 patients with unstable pelvic fractures.Operation time and intraoperative blood loss were recorded.Postoperative images were evaluated by Matta standard.Results Hemipelvic rotation in transverse plane included eversion and inversion.Width of iliac crest was enlarged and area of obturator foramen was shrunk while extroversion ; on the contrary,an opposite result was observed while inversion.Sagittal rotation included pronation and supination.Pubic tubercle had obvious downward shift,iliac crest presented no change or slight upward shift,suprainferior diameter of hemipelvis was lengthened,iliac roof and sciatic tuber remained their position unchanged and area of obturator foramen was shrunk while pronation; on the contrary,pubic tubercle had obvious upward shift,iliac crest presented no change or slight downward shift,suprainferior diameter of hemipelvis was shortened,iliac roof and sciatic tuber remained their position unchanged and area of obturator foramen was enlarged while supination; iliac crest,acetabular roof,pubic tubercle and sciatic tuber presented equidistant upward shift while the hemipelvis displaced upward vertically.Average operation time was 55 minutes (range,15-85 minutes) and intraoperative blood loss was 26 ml (range,10-50 ml).According to Matta standard,pelvic radiography evaluation at postoperative 3 days was excellent in 31 cases and good in 12 cases,with excellent and good rate of 100％.Conclusion Pelvis X-ray films are able to diagnose various three-dimensional displacement of unstable pelvic fractures and guide closed reduction timely and rapidly to achieve satisfactory result.

Objective To establish an expression system of TCRγ9/δ2-Fc protein by baculovirus vector ex-pression system and identify biological function of expressed TCRγ9/δ2-Fc protein. Methods γ9Fc and 82 (OT3) Fc gene fragments were amplified by overlap PCR and inserted into expression vector pBACp10ph. The recombinant plasmid pBACp10ph-γ9/δ2(OT3)-Fc and the baculovirus DNA were co-transfected into st9 cells. The expression position of TCRγ9/δ2 (OT3)-Fc was identified by Western blot and the expression efficiency of γ9Fc and δ2 (OT3) Fc was tested by flow cytometry (FCM). Furthermore, the binding activity of TCRγ9/δ2 (OT3)-Fc protein with SKOV3 ceils and MNS protein was evaluated with laser scanning confocal microslopy and surface plasmon resonance (SPR). Results The recombinant vector pBACp10ph-γ9/δ2(OT3)-Fc was constructed and TCRγ9/δ2(OT3)-Fc protein was expressed in sf9 ceils. However, the expression efficiency of γ9Fc and 82 (0T3) Fc was quite differ-ent. It was proved that purified TCRγ9/δ2 (OT3)-Fc protein can bind with SKOV3 cell and MNS protein. Conclu-sion TCRγ9/δ2-Fc protein is successfully expressed in baculovirus vector expression system and TCRγ9/δ2-Fc protein can simulate the binding activity of TCR in vitro.

Objective To investigate the expression of glucocorticoid receptor(GR), GR? mRNA and GR? mRNA in peripheral blood mononuclear cells(PBMC)of patients with multiple sclerosis(MS) and healthy controls and investigate the relationship between GR protein, GR? mRNA, GR? mRNA and intravenous injection methylprednisolone(IVMP)effect.Methods GR in PBMC was measured by radioligand assays in 20 patients with relapsing-remitting MS(RRMS), 6 with the second progressive MS (SPMS)and 26 healthy controls.Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR)was used to detect the expression of GR? mRNA and GR? mRNA in PBMC of patients with MS and healthy controls.The effect of IVMP was evaluated by the expanded disability status scale(EDSS). Results(1)Before IVMP, GR in PBMC of MS was significantly lower(RRMS:(3.8?0.2)?10~3 site/cell;SPMS:(1.6?0.2)?10~3 site/cell)than those of controls((4.2?0.8)?10~3 site/cell, P

Objective To test the reliability and validity of the brief International Classification of Functioning, Disability and Health (ICF) core sets for Chinese stroke patients using Rasch model analysis. Methods The body functions of 38 Chinese stroke patients were measured using the brief ICF core sets. The qualifiers of the 20items were measured by two raters and analyzed using FACETS statistical software. The intra-rater reliability and validity were tested by using the separation index and separation reliability and fit analysis. Results The brief ICF core sets had good internal consistency and reliability (person separation index = 6.02, person separation reliability = 0.94 ) with these Chinese patients. The raters showed significantly different strictness in rating, but their ratings had good internal self-consistency. The construct validity was good for the body functions of the ICF component ( separation index = 10.50, separation reliability = 0.80) , but misfitting and overfitting were found in items b117, b152and b755. Conclusion The body function of the brief ICF core sets has good reliability and validity for Chinese stroke patients. A many-facet Rasch measurement model can provide comprehensive information and has good application prospects for testing the reliability and validity of ICF core sets.

ObjectiveTo study the technique and therapeutic effect of percutaneous cannulate screw fixation to treat the traumatic diastasis of the pubic symphysis.MethodsFrom February 2003 to December 2010,46 patients (27 men and 19 women,mean age of 34.6 years) with unstable pelvic fractures and diastasis of the pubic symphysis were admitted.All the patients were treated by closed reduction and percutaneous cannulate screw fixation of the symphysis pubis.Then to complete the fixation of posterior ring,by percutaneous screw inserted through the sacroiliac joint or posterior iliac wing.According to Tile's classification,the patients were classified into type B1.1 in 4 cases,B1.2 in 7,B2 in 2,B3 in 2,C1.1 in 7,C1.2 in 7,C1.3 in 10,C2 in 5 and C3 in 2.All patients were performed posterior ring fixation except 4 cases of type B1.1.Anteroposterior,inlet and outlet X-ray radiographs and CT scans of the pelvis were taken preoperatively to evaluate the stability and deformities,and after surgery the plain radiographs and CT scans were taken to evaluate the reduction and the location of screws.ResultsThe average operative time was 45 min (range,15-65 min),and the average intraoperative blood loss was 25 ml (range,15-50 ml).Each patient was inserted one screw in the symphysis pubis.Thirty-five patients underwent postoperative pelvic CT scan and 3screws of them penetrated the wall of symphysis pubis.The average follow-up period was 23.5 months (range,5-48 months).In the follow-up period,no infection and displacement were found.The last follow-up result:according to Matta and Tornetta's standard,the result was excellent in 43 cases and good in 3.Among all patients,31 cases (67.39％) had returned to their original works,6 were to give up their original works as complicating injuries; 28 cases had no pain,13 cases had slight pain of the symphysis pubis while to make an effort,5 cases had pain of sacroiliac joint.There were no iatrogenic injury of nerve.ConclusionClosed reduction and percutaneous cannulate screw fixation of the traumatic diastasis of the pubic symphysis is a safe,feasible and easy manipulated method.The operative injuries is small and the clinical outcome is satisfactory.