Objective To analyze the change of serum levels of neuron‐specific enolase (NSE) and C reactive protein (CRP) and their early diagnostic value in hand‐foot‐mouth disease (HFMD) complicating encephalitis .Methods One hundred and twenty cases of HFMD and 50 healthy children(healthy control group) served as the research subjects and the HFMD cases were divided into the common HFMD group (n=70) and HFMD complicating encephalitis group (n=50) according to the clinical manifesta‐tions .The enterovirus 71 (EV71) in throat swab was detected by quantitative PCR .The NSE and CRP levels were detected by en‐zyme linked immunosorbent assay (ELISA) ,and white blood cell (WBC) count was measured by hematology analyzer .The NSE and CRP levels were compared and their diagnostic values were analyzed .Results The serum NSE and CRP levels in the HFMD complicating encephalitis group were higher than those in the HFMD common group and control group ,the differences were statis‐tically significant (P< 0 .05) ,and which in the EV71 positive group were significantly higher than those in the EV71 negative group ,the differences were statistically significant (P<0 .05) ,but WBC count had no statistically significant difference (P>0 .05) . The serum NSE level was positively correlated with the CRP level (r=0 .43 ,P<0 .01) .The area under ROC curves (AUC) and 95% CI of NSE and CRP were 0 .893(95% CI:0 .833 -0 .952) and 0 .867(95% CI:0 .799 -0 .934) ,the optimal operating points (OOP) were 11 .6 ng/mL and 14 .15 mg/L respectively ,the sensitivity and specificity of NSE and CRP for diagnosing HFMD com‐plicating encephalitis were 80 .0% ,86 .00% and 81 .4% ,78 .6% respectively ,while which of their combined detection were 88 .0%and 85 .7% ,AUC and 95% CI was 0 .927(95% CI:0 .845-0 .969) .Conclusion The NSE and CRP levels in children patients with early HFMD complicating encephalitis are significantly increased ,especially which in the patients with EV71 positive is more signif‐icant .The combined detection of serum NSE and CRP levels can be used as the early sensitive indicators for diagnosing HFMD complicating encephalitis .

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle age group(Group D, 40-60 years old,n=215);and(5)elderly group(Group E,＞60 years old,n=102).All the patients were evaluated with Injury Severity Score(ISS),and the result was≥16 in all of the studied patients.Results The incidence of severe trauma in male in all 5 groups was higher than that in female,and it was significantly higher in Group C,Group D and Group E when compared with that in the other groups(P＜0.01).Traffic accident was the leading cause of injury,and its incidence in Group A,Group B and Group D was higher than that in other groups(P＜0.01).However,injury caused by falling from high places was the second cause of injury,being significantly increased in Group A,while armed fighting and injury during work being significantly increased in Group B,Group C and Group D,slip fall injury being significantly increased in Group E(P＜0.01).Head injury was mainly found in Group A and Group E,extremities injury and/or spinal injury were increased markedly in Group B,Group C and Group D(P＜0.05),abdominal injury was significantly decreased in Group E(P＜0.001).The total mortality was 11.9%(246/2069).The mortality within 24 hours (20.6%,21/102)was significantly higher than that beyond 24 hours(7.8%,8/102)in Group E(P＜0.01).The time of staying in the emergency department differed significantly between the survived patients and those died in all 5 groups (P＜0.01).Conclusion The gender,the incidence and the characteristics of the injury causes and injury sites differed between severely injured patients of various ages.Mortality in the elderly is significantly increased following severe trauma. The idea of“golden one hour”and“platinum ten minutes”,measures of shortening the time of staying in the emergency clinic,early definite operation and damage control operation should be emphasized.

Objective To evaluate the value of neutrophil gelatinase - associated lipocalin (NGAL) for diagnosis of acute kidney injury (AKI) after cardiopulmonary bypass established. Method 120 children undergoing cardiopulmonary bypass were enrolled in this prospectively study. Serial urine samples were analyzed by ELISA for NGAL expression. The primary outcome measure was AKI, which was defined as a 50% or greater increase in serum creatinine from baseline. Result 21 children ( 17.5% ) developed AKI. Urine concentrations of NGAL increased after cardiopulmonary bypass had been established for 2 hours. The concentration of NGAL in urine after cardiopulmonary bypass had been established for 2 hours was used to diagnose AKI. The area under the receiver-operating characteristic curve was 0. 96, the sensitivity was 92%, and the specificity was 91% for the cutoff value of 100ng/mg Cr. Conclusion Concentrations of NGAL in urine might be used as a sensitive and specific biomarker for early prediction of AKI after cardiopulmonary bypass had been established.

Objective To measure the financial burden incurred by hypertension to urban patients in Beijing, Nanjing and Hangzhou cities. Methods Two communities were sampled from the three cities randomly, and 300 hypertension patients were sampled randomly from hypertension control files in each community for questionnaire survey. Results Health expenditure of the families with hypertension patients accounts for 14. 4% of the family's income, and 18. 2% of the family's expenditure, a ratio far beyond the national average (10.6 %). However, the majority of them report the burden as affordable.The basic medical insurance for urban residents helps alleviate the financial burden of hypertension patients and the extent of such burden has a close bearing on the outcome of hypertension treatment and prevention. Conclusion Effective community-based blood-pressure monitoring and control system is key to reducing the financial burden of hypertension. The reimbursement policy for hypertensive patients within the basic medical insurance is expected to be further improved.

The cephalic dystocia education is an important part of obstetric education. According to current educational environment, the teaching method of multimedia combined with problem-based learning is conducive to resolving the dilemma of dystocia education. Dystocia education is designed to follow the cases as the main line and the problem as a guide, with the full integration of theory and practice. This teaching model has been recognized by the majority of foreign students, and it is worth recommending.

control group from the high to the low. When the typeⅢand type Ⅳglomerular function was changed (BUN and BCr in high value),the drainage quantity of the enzymes evidently increased.Conclusions Urine enzyme series can sensitively reflect the damage of renal tubules in early stage, even if BUN and BCr value is on the normal level , and the drainage quantity of these enzymes are changed more or less, which show that renal tubule damage exists. The value of BUN and BCr is positively correlated with the drainage quantity of these enzymes.the more urine enzymes are drained out, the more renal tubule function is involved, therefore, the more renal globe function is damaged.

Objective To explore clinical significence of soluble vascular cell adhesion molecular(SVCAM - 1),immunoglobulin A (IgA) anti- endothelial cells antibodies(AECA) in Henoch-Schonlein purpura(HSP) and their relationships. Methods SVCAM-1 were detected by ELISA between 55 cases with HSP (40 cases in acute stage and 15 cases in recovery) and 20 controls. Results The levels of serum SVCAM - 1 of the HSPN cases were significantly increased compared with the other HSP. In addition, the serum level of SVCAM - 1 in acute stage HSP children was significantly higher than that in recovery stage and normal controls. IgA AECA positive rate in HSPN was higher than that of without nephritis group. The level of serum SVCAM - 1 in IgA AECA positive children was higher than that of IgA AECA negative children. Conclusion SVCAM - 1 and IgA AECA may participate in the pathogegesis of HSP, and the level of molecule is correlated with the progress of HSP.

Objective To study the biodistribution of anti-HER-2/neu monoclonal antibody Herceptin labeled by 131I(131I-Herceptin) in healthy KM mice and nude mice bearing human ovarian cancer xenografts and radioimmunoimaging (RII) of the nude xenografts-bearing mice.Methods 131I-Herceptin was prepared using Iodogen method.The labeling efficiency, radiochemical purity, stability and immunocompetence were measured.The percentage activity of injection dose per gram of tissue (%ID/g) and the radioactivity ratio of tumor to non-tumor tissue (T/NT) were calculated for each time point.The optimal time for imaging was investigated by comparing the 131I-Herceptin SPECT for the nude mouse models bearing ovarian cancer xenografts at different time points.Results The labeling efficiency and radiochemical purity of 131I-Herceptin were 89.8% and 98.4%, respectively.The labeling was stable and had good immunocompetence.131 I-Herceptin was cleared rapidly mainly through liver, spleen and kidneys, consistent with first order two-compartment model.The uptake of 131I-Herceptin in the tumors bearing human SKOV-3 xenografts was much higher than that in nontumor tissue.The% ID/g was 18.08 in the tumor at 24 h post injection.The T/NT ratio increased with time and was 27.27 at 72 h post injection.The tumors in nude mice bearing SKOV-3 xenografts could be visualized on 131I-Herceptin SPECT imaging 2 h post injection; definitely identiffed 48 h post injection and the radioactivity ratio of tumor to contralateral tissue was 11.44 at 120 h post injection.However, the tumor in nude mice bearing HO-8910 xenografts did not show abnormal uptake of 131 I-Herceptin at each time point.Conclusions 131 I-Herceptin is a good radiopharmaceutical targeting SK-OV-3 xeuografts and it may be useful in imaging carcinoma of ovary and target therapy of its metastases with high HER-2/neu expression.

Objective To study senile severe trauma patients admitted to Emergency Surgical Department of the second affiliated hospital of Guangzhou Medical college from October 1997 to October 2004,to investigate constructive suggestions of emergency treatment for urban senile trauma.Method Retrospective analysis on 102 senile severe trauma patients screened out from trauma patients admitted to the Emergency Surgical Department was carried out.Results There were 76 male and 26 female patients,the ratio of male to female was 2.9:1,mean age was 69.2 years old(range 60～83 years),the mean trauma score(TS)was(14.5?2.6),the mean Glasgo Coma Score(GCS)was(11.8?3.1),the mean Injury Severity Score(ISS)was(24.5?10.7),there were 61 patients of multiple injuries,transportation accident 45 patients(43.3 %),tumbling injury 23 case(22.5 %), falling injury 19 patients(18.6%),shock 65 patients.Definitive rescue surgery was carried out in 68 patients. The time from emergency treatment to operation departments was(58?19)minutes for the survival patients and (111?34)minutes for those died,there was significant difference between the two groups(P