Objective To explore the clinical characteristics and diagnosis of Epstein-Barr(EB) virus encephalitis(EBE) in children. Methods The verification of EBE was based on detection of EBV DNA in cerebrospinal fluid (CSF) by fluorogenic quantitative PCR(FQ-PCR) and Nest-PCR. The clinical and CSF changes of 27 EBE cases and 26 controls were analyzed and compared. Results EB-DNA in CSF by FQ-PCR of 13 cases of EBE was (2.82?2.03)?10 3copies.There was no significant difference in clinical manifestations between EBE and HSE groups, except that WBC in CSF of EBE was lower than those of HSE.Conclusions EBE is not infrequent, about 10 % of encephalitis in children. EBE is always present independently, which is not a complication of infectious mononucleosis(IM).Detection of EBV-DNA in CSF is a sensitive and specific test for diagnosing of EBE. Early treatment may be beneficial to the prognosis of EBE.

Objective To apply a hand function laserimager to evaluate the effect of acupuncture on hand dysfunction after stroke. Meth-ods From January to June, 2016, 18 stroke patients with upper limb dysfunction were divided into control group (n=9) and acupuncture group (n=9). The control group received routine medication and rehabilitation, while the acupuncture group received acupuncture in addi-tion. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) of upper limb motor function and modified Bathel Index (MBI) before and after three-week treatment, while the region of interest (ROI) of their hands was tested with the hand func-tion laserimager. Results The scores of MAS and FMA improved after treatment in both groups (t>4.44, P<0.01), and improved in the score of MBI in the acupuncture group (t=3.95, P<0.01). The scores of MAS, FMA, and MBI improved more in the acupuncture group than in the control group (t>3.17, P<0.01). Meanwhile, the scores of ROI decreased in the affected hands after treatment (t>7.78, P<0.001), and de-creased more in the acupuncture group than in the control group (t=-2.23, P<0.05). No significant difference was observed in the scores of ROI of the unaffected hands (t=-0.11, P>0.05) between groups. Conclusion The hand function laserimager, which responds to the blood perfusion of the hand, can be used as a tool to evaluate the hand function.

OBJECTIVETo study therapeutic effects between hook plate fixation and modified Weaver-Dunn surgery for the treatment of acromioclavicular joint dislocation.

METHODSForty patients with fresh acromioclavicular joint dislocations of type III according to Rockwood classification were reviewed. All the patients were divided into two groups: hook plate fixation group and modified surgery group. There were 20 patients in hook plate fixation group, including 13 males and 7 females, with an average age of (37.45 +/- 14.29) years old; 12 patients had injuries in the left and 8 patients had injuries in the right; preoperative Constant-Murley score was 40.75 +/- 10.40. And there were 20 patients in modified surgery group,including 11 males and 9 females, with an average age of (41.65 +/- 14.83) years old; 11 patients had injuries in the left and 9 patients had injuries in the right; preoperative Constant-Murley score was 42.75 +/- 8.18. The Lazzcano standard, Constant-Murley score and imaging changes were used to evaluate shoulder joint function before and after surgery.

RESULTSAll the patients were followed up,and the duration ranged from 7 to 32 months,with an average of 24 months. According to Lazzcano evaluation, 16 patients got an excellent result,3 good and 1 poor in modified surgery group with no re-dislocation, and 1 patient had pain more than middle degree; while in hook plate fixation group, 9 patients got an excellent result, 7 good and 4 poor, 1 patient had re-dislocation, and 3 patients got pain more than middle degree. The therapeutic effects of modified surgery group were better than those of hook plate fixation group. Constant-Murley scores:preoperative 42.75 +/- 8.18 vs 93.40 +/- 4.04 at the latest follow-up in modified surgery group; preoperative 40.75 +/- 10.40 vs postoperative 88.40 +/- 4.81 and 92.05 +/- 4.49 at the latest follow-up in hook plate fixation group. The postoperative scores all improved compared to preoperative scores in two groups. And there was no statistical difference of scores at the latest follow-up between two groups.

CONCLUSIONThe surgery of allograft tendon transplantation combined with anchor fixation to strengthen coracoclavicular ligament, as well as part transposition of acromiocoracoid ligament and resection at the distal part of clavicle may got safety fixation and less postoperative complications compared with hook plate internal fixation.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Clavicle ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Treatment Outcome ; Young Adult

Hepatocytes ; immunology ; Liver Transplantation ; immunology

OBJECTIVETo compare the difference in the efficacy on thoracic facet joint disorder between the combined therapy of electroacupuncture and manual reduction and the simple manual reduction.

METHODSOne hundred and sixty patients were randomized into an electroacupuncture and manual manipulation group (group A) and a simple manual manipulation group (group B), 80 cases in each one. In the group A, Ashi points and three pairs of Jiaji (EX-B 2) bilateral to the painful sites were selected. The perpendicular puncture was used at Ashi points, the oblique puncture was used at Jiaji (EX-B 2) and connected with electric stimulation for 20 min, additionally, the corresponding manual reduction was adopted at the sites of facet joint disorder. In the group B, the simple manual reduction was applied to the affected sites. Acupuncture was given once every day, the manual reduction was applied once every 10 days. The treatment of 10 days made one session. The efficacy was analyzed statistically at the end of two sessions of treatment. Before and after treatment, McGill pain scale was adopted for the value statistical analysis. PRI score, VAS score and PPI score of patients were calculated before and after treatment and compared in the two groups. The efficacy was compared between the two groups.

RESULTSThe curative rate was 56.3% (45/80) in the group A, which was better than 18.8% (15/80) in the group B (P< 0.01). The total effective rate was 95.0% (76/80) in the group A, which was better than 76.3% (61/80) in the group B (P<0.01). The scores of PRI, VAS and PPI after treatment were all improved significantly in the two groups (all P<0.05), in which, the results in the group A were better than those in the group B (PRI: 4.00 +/- 0.97 vs 5.44 +/- 1.16, VAS: 3.29 +/- 0.72 vs 3.87 +/- 0.81, PPI: 1.07 +/- 0.74 vs 1.64 +/- 0.90, all P<0.05).

CONCLUSIONThe combined therapy of electroacupuncture and manual manipulation achieves the superior efficacy on thoracic facet joint disorder as compared with the simple manual manipulation. The combined therapy relieves the symptoms of thoracic facet joint disorder and reduces the severity of disorder.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Thoracic Diseases ; therapy

Objective To evaluate the diagnostic performance of a point-of-care testing for sensitive cardiac troponin Ⅰ (POCT-cTnI) in early diagnosis of chest pain patients who had a high pretest probability of acute myocardial infarction (AMI).Methods Total of 127 patients with new-onset chest pain at the emergency department were enrolled.Blood samples were drawn for the routine blood test,and determined POCT-cTnI and central laboratory testing for high sensitive cardiac troponin T (CLT-hscTnT) at admission,three and then at six hours after admission.All patients were divided into AMI group and non-AMI group according to the final diagnosis,which was adjudicated independently by two physicians who reviewed all available medical records for the 90-day follow-up period,and they were unaware of the results of the investigational assays of cardiac troponins.The receiver operating characteristic (ROC) curves were constructed to assess and compare the diagnostic performance of AMI of two cardiac troponin assays.The comparison of areas under the ROC curves (AUC) was performed by DeLong test,and the sensitivity,specificity,negative predictive values (NPV) and positive predictive values (PPV) for the target markers were calculated by applying a maker-specific cutoff value.Results The final diagnosis of AMI was made in 40 of 127 patients (31.5 ％).The diagnostic accuracy of the two assays oBtained at presentation,as quantified by AUC,was no statistically differences (AUC for POCT-cTnⅠ,0.901,95％ CI,0.901 to 0.947;and for CLT-hscTnT,0.907,95％ CI,0.842 to 0.951;Z =0.235,P =0.745).The AUC for POCT-cTnI at 3 hours after admission was significantly higher than that on admission (0.931 vs.0.858;Z =-2.038,P =0.042),while there was on further improvement at 6 hours after admission (0.931 vs.0.949;Z =-1.435,P =0.151).With use of POCT-cTnI (cutoff value 0.023 ng/mL,which was the 99th percentile upper reference limit) on adimission,the clinical sensitivity was 77.5％,and the specificity was 94.2％.A single sample of POCT-cTnI at 3 hours after admission improved the diagnostic accuracy,with a sensitivity of 96.4％,a specificity of 92.0％,and a NPV of 98.6％,a PPV of 81.8％.While,with use of CLT-hscTnT (cutoff value 0.014 ng/mL,was the 99th percentile upper reference limit) at 3 hours after admission,the NPV reached to 100％.Conclusions The use of a POCT-cTnI assay in chest pain patients can identify and exclude the AMI rapidly and exactly at three hours after admission,and the diagnostic performance is equivalent to CLT-hscTnT.

The traditional fermentation engineering experiment requires a reform on the experimental con-tents and teaching pattern. According to the production process of industrial enzymes, we set up a two-week comprehensive experiment. The students designed and prepared the experiment by themselves. Moreover, the pattern of self-management was used in the process and the experiment scores included the self-assess-ment and objective assessment. It was proved that the new teaching pattern increased the study interesting of students, inspired their initiative and trained their spirits of team cooperation. The teaching effect was im-proved markedly and good ideas are also put forward to solve the possible problem.

ObjectiveTo investigate the clinical characteristics of the inpatients suffering from dengue fever in order to provide references for better diagnosis and treatment.Methods The clinical data of 158 dengue fever patients admitted to the First Affiliated Hospital of Sun Yat-Sen University from July 23rd to October 31st, 2014 during the 2014 epidemic in Guangzhou area were retrospectively analyzed, including general clinical manifestations, conventional examinations, pathogenesis, and prognosis.Results The mean age of the 158 patients was (56±20) years, with half of them over 60 years old (79 cases). Among them, 94 (59.49%) were male.① The common manifestations included fever (100%), headache (70.89%), myalgia/bone soreness (62.03%), and skin rash (54.43%). Bleeding and plasma leakage were found in 25.95% and 14.56% of the patients respectively.② Laboratory examination:leucopenia (75.32%) and thrombocytopenia (77.85%) were found, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated in 57.59% and 77.85% of the patients respectively. However, elevation of blood hematocrit was rare (1.27%).③ It was found that in the acute phase (0 - 5 days of the onset), serum dengue virus antibody IgM (DF-IgM) was positive in 63.54% of the patients (61/96), and 92.62% (113/122) of patients were dengue virus RNA (DENA-RNA) positive.④ The rate of comorbidity in this study was 55.06% (87/158), including hypertension (27.22%) and type 2 diabetes (15.82%), which were the two most common co-morbidities.⑤ All the patients were given supportive therapy to prevent complications. They were also isolated for more than 5 days after onset, and at least for 24 hours after subsidence of fever in addition.⑥ The criteria for the diagnosis of severe dengue were fulfilled in 18 patients (11.39%). One patient died of massive hemorrhage from gastro-intestinal tract, and 1 patient voluntarily left hospital with untreated multiple organ dysfunction syndrome (MODS). Another 2 patients of dengue fever died from primary cardio-cerebrovascular disease, and the remaining 154 patients (97.47%) fully recovered with supportive therapy and complication prevention measures.Conclusions The clinical manifestations of inpatients with dengue fever in this study were typical, and they manifested a higher incidence of severe illness. DENA-RNA could be a sensitive indicator for early pathogenic diagnosis. With symptomatic and supportive therapy, most patients had a good outcome. However, early diagnosis and clinical interventions of severe dengue still need further studies.

Objective Observe the response and adverse effects of impact dose recombination human erythropoietin(rhEPO)in the breast cancer patients with anemia induced by chemotherapy.Methods 43 breast cancer patients with anemia induced by chemotherapy were randomly divided into two groups,treatment group(23 patients)and the control(20 patients).The treatment group received rhEPO for 10 days and oral iron therapy,while the control group was oral iron therapy only.Results After 4 weeks,the hemoglobin level, hematocrit,reticulocyte and quality of life be revaluated,the treatment group was significantly better than the control.The adverse effects was tolerable.Conclusion The impact dose rhEPO is effective and tolerable in the breast cancer patients with anemia induced by chemotherapy.

Objective:To observe the clinical effect of acupoint sticking of Chinese medicine at Shenque (CV 8) for preventing spleenstomach disharmony caused by venous analgesia pump.Methods:A total of 120 post-surgery patients using venous analgesia pump and also conforming to the inclusion criteria were randomized into 2 groups by the random number table.There were 58 patients in the control group who received conventional post-surgery nursing care,and there were 62 patients in the treatment group who received acupoint sticking at Shenque (CV 8) on the basis of conventional nursing care.After treatment,the incidences of postoperative nausea and vomiting,and abdominal bloating were measured.Results:The total incidence of nausea,vomiting and abdominal bloating in the treatment group was 11.3％,versus 39.7％ in the control group,and the difference of the incidence between the two groups showed a statistical significance (P＜0.05).In comparison of the severity of spleen-stomach dishormony which happened during 72 h after surgery,cases in the treatment group showed lower severity than those in the control group (P＜0.05).Conclusion:Acupoint sticking at Shenque (CV 8) can effectively prevent spleen-stomach disharmony caused by venous analgesia pump,which will alleviate sufferings of the patients.