Objective To analyze the clinical characteristics of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease (HFMD).Methods The clinical data of 94 patients with herpangina during outbreak of HFMD were collected.Enteroviruses 71 (EV71) and Coxsackie virus A16 (CA16) were detected by real-time polymerase chain reaction.And relevant indicators of two groups were compared.Results There were 34 cases EV71 positive (36.17％,34/94,EV71 positive group) and 31 cases CoxA 16 positive (32.98％,31/94,CoxA 16 positive group) from the results of pathogen detection.The level of white blood cell count,glucose,erythrocyte sedimentation rate,hypersensitive C-reactive protein were increased obviously than normal,while no significant difference was found between two groups (P ＞ 0.05).The level of myocardial enzymes,creatinine,blood urea nitrogen were in the normal range and no significant difference was found between two groups (P ＞ 0.05).There was no significant difference between two groups in the incidence of age ＜ 3 years old,persistent high fever (P ＞ 0.05).The abnormalities performance in the nervous,respiratory,circulatory system of the EV71 positive group were significantly higher than those in CoxA 16 positive group [26.47％ (9/34) vs.6.45％ (2/31),23.53％ (8/34) vs.3.23％(1/31),20.59％ (7/34) vs.3.23％ (1/31) separately],and there were significant differences between two groups(P ＜ 0.05).There were 11 severe cases (11.70％,11/94) in the 94 cases of children with herpangina,and 9 cases belonged to the EV71 positive group,2 cases belonged to the CoxA16 positive group.Two cases died of lung hemorrhage,1 case occurred of paralysis,all of them were detected EV71 positive.Conclusions The pathogen of herpangina might be same as the pathogen during the outbreak of HFMD.Children with herpangina during outbreak of HFMD should be incorporated into the management of HFMD.EV71 positive children are serious than CoxA16 positive cases,and detecting pathogens will be helpful to determine the prognosis.

As a principal part of foreign exchange activities of traditional Chinese medicine, government organizations played a crucial role. At present, there are relatively rare researches on foreign exchange activities of traditional Chinese medicine in government organizations. In this article, we defined related government organizations and their functions, analyzed the features of the foreign exchange activities of traditional Chinese mdicine among government organizations in the past nearly 30 years. And based on this analysis, SWOT theory model in management science was introduced to discuss the reasons of government behaviors and put forward suggestions for the future development.

Through making a summary of using the portable X-ray machine in the earthquake relief,the equipment of the advantages and disadvantages in the field are analyzed and introduces the problems and solutions in application,and gives some improved suggestions for tripod.

OBJECTIVE To investigate the associated risk factors for the infected patients in respiratory intensive care unit(RICU) and to study the resistance of isolates.METHODS To study the bacterial spectrum and drug resistance test of all the patients with hospital acquired infection from Jan to Dec 2005.Identification and antimicrobial susceptibility were determined with the methods of API and K-B,respectively.RESULTS A total of 265 strains were isolated from 117 patients,the rate of isolation of Gram-negatives was the highest(74.3%),the species were predominated by Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumoniae,the rates of isolates were 28.68%,23.02% and 5.66%,respectively.The predominated species of Gram-positives was Staphylococcus aureus.Gram-negative bacilli were susceptible to imipenem and meropenem,there were not vancomycin-resistant strains.CONCLUSIONS It is important to realize the associated risk factors of infected patients in RICU and to promote the rational use of antimicrobial agents.

OBJECTIVE To investigate the resistance of Staphylococcus aureus,includ MRSA and MSSA,to antimicrobial agents in intensive care unit(ICU),and to provide basis for clinical therapy.METHODS K-B disk diffusion method was used to determine the drug susceptibility of 171 strains of S.aureus,and meticillin-resistant S.aureus(MRSA) was detected by using the disk diffusion method according to NCCLS/CLSI.RESULTS In ICU,S.aureus was isolated mostly from the respiratory tract,urine tract and blood.MRSA made up 57.89%.For MRSA and MSSA,no resistance against vancomycin and norvancomycin was observed.The resistance rates of MRSA to other agents were as follows: chloramphenicol 20.45%,and minocycline 20.45%.While the resistance rates of MSSA to other agents were as follows:cefazolin 6.25%,and amikacin 6.25%,minocycline 9.38%.CONCLUSIONS MRSA shows the multidrug resistance.Pathogenic monitoring,keeping the patients apart,rational utilization of antibiotics,medical facility sterilization strictly and intensive hand hygiene are very important to prevent MRSA infection.

Objective To explore the safety and efifciency of oral iron therapy and intravenous iron therapy in anemia patients with maintenance hemodialysis,in order to gain experience for clinical treatment of this disease. Methods 88 cases collected in the ifrst people's hospital of Changshu city from July 2010 to March 2013 were divided into research group(n=44) and control group(n=44) by random number table. Control group was given oral iron therapy, and research group was t given intravenous iron. The differences of hemoglobin (Hb), reticulocyte, serum ferritin content, superoxide dismutase (SOD) and serum malondialdehyde (MDA) before and after treatment between two goups were recorded and compared. Results The differences of Hb, serum ferritin and reticulocyte numerical before treatment between two groups were not signiifcant, but signiifcant four weeks after treatment, with higher level in research group(P<0.05).The difference of oxidative stress status before treatment between two groups was not signiifcant, but after treatment, the MDA level in research group was higher than control group(P<0.05),while SOD level was lower than control group(P<0.05). Conclusion Compared with oral iron therapy, intravenous iron has better results in improving anemia, but easy to induce oxidative stress reaction.

Objective Construction of a predicting model of uncertainty in illness based on Mishel's theories of uncertainty in illness in a sample of the postoperative patients with digestive system tumors undergoing chemotherapy.Methods By convenient sampling method,MUIS-A,MSAS,SSRS were used to evaluate 484 postoperative patients with digestive system cancer during chemotherapy period,and then AMOS 17.0 software was used to perform analysis.Results The score of uncertainty in illness of postoperative patients with the digestive system cancer undergoing chemotherapy was in the medium level (89.86+11.84) points; Structure provider (social support,economic income) could not only reduce the uncertainty directly,but also had an indirect effect on the uncertainty by stimuli frame (symptoms pattern,event familiarity).Conclusions Structure equation model can be applied to the uncertainty in illness model construction,so as to help medical staff manage uncertainty in illness pertinently.

Objective Demonstrate the implication of Emergency Severity Index (ESI) in pediatric emergency room (ER). Method ESI categories of 21 904 visitors to ER of Beijing Children's Hospital's international department were reviewed. SPSS statistic software was employed to compare the results of ESI categories by doctors and nurses separately using x2 analysis. Results There are highly consistency in ESI categories by doctors and nurses. ESI is an easy-learned and effective triage method. Conclusions ESI is capable in pediatric emergency room regarding recognizing serious cases and saving clinical resources.

Objective To analyze the structure of leadership questionnaire for nursing managers.Methods A total of 184 head nurses in Anhui were investigated with the leadership questionnaire for nursing managers.SPSS13.0 and AMOS17.0 software were used to test the reliability and validity.Results The correlations between the items and total scale ranged from 0.431-0.687(P＜0.05 or P＜0.01) and the Cronbach' sα was 0.841.Single factor analysis results indicated that all factor loadings to their items were 0.542-0.782(P＜0.05).The multiple factor analysis results showed that first-order factors model and second-order factors model of leadership for nursing managers fitted well.Conclusion The leadership questionnaire for nursing managers is proved to have good psychometric characteristics and can be used to assess the leadership of nursing managers.