Objective To discuss the application and effect of predictive care in stage divided treatment and salvage of children's persistent status of epilepsy (SE).Methods Sixty-four children with SE were admitted to the First Peoples Hospital of Wenling in Zhejiang Province from December 2014 to December 2016 as the research objects, a controlled study was adopted, in which the stage divided therapeutic method was compared with the conventional method for treatment of SE, and the children were divided into an observation group and a control group, 32 cases in each group. Foresight treatment method was used in the observation group: the first stage of treatment (early treatment or pre-hospital treatment) was intravenous injection of the first-line drugs (benzodiazepines); the second stage of treatment (progressive stage treatment or initial treatment) mainly used epileptic drugs to prevent recurrence; the third stage treatment (referred to after the first-line drug in combination with one second line antiepileptic drug treatment, the disease was still unable to be controlled) adopted the mild hypothermia therapy to reduce the SE attack amplitude and decrease recurrence; in terms of aspects of predictive nursing measures, the respiratory tract nursing, basic nursing, the prediction of complications and their nursing, etc. were implemented. The routine nursing without care about the stages was carried out in the control group. The SE control time, skin lesions, false aspiration, lung infection, tongue bite, cerebral edema, etc. the incidenceof complications were observed in two groups of children.Results The SE control time was significantly shorter in observation group than that in the control group (minutes: 18.13±3.15 vs. 25.19±2.69,P < 0.05), and the incidence of complications was obviously lower in observation group than that in the control group [6.25% (2/32) vs. 28.13% (9/32),P < 0.05]. Conclusion Using different therapy at different stages of children SE combined with predictive care can effectively shorten the SE control time, decrease the incidence of complications and elevate the therapeutic and nursing effects.

Objective:To isolate endophytic fungi from Panax ginseng and study their antifungal and antitumor activities.Methods:Endophytic fungi were isolated from 5-year-old garden ginseng and 15-year-old transplanted ginseng.The antifungal active endophytes were screened with Pyricularia oryzae P-2b model using mircodilution method,and the activities of endophytes against pathogenic fungi were tested in vitro.The antitumor activities of the endophytes were examined by MTT method in vitro.Results:Sixteen(33.3%)of the 48 endophytic fungi fully suppressed the activity of P.oryzae P-2b;11(22.9%)colonies showed satisfactory antifungal activities against Candida albicans,Cryptococcus neoformans,Trichophyton rubrum,and Aspergillus fumigatus;and 5(10.4%)colonies showed satisfactory antitumor activities against tumor cell lines MKN45,LOVO,HepG2,and HL-60.Among the bioactive colonies,Yuan-25 showed best antifungal activity,with its MIC80 aganinst Trichophyton rubrum being 4 mg/L,which was similar to that of fluconazole.Yuan-27 showed the best antitumor activity,with its IC50 similar to that of doxorubicin.Conclusion:Isolated endophytic fungi of Panax ginseng has antifungal and antitumor activities and is worth further exploring.

Objective To observe the effect of fluoxetine on the depression neurologic impairment and activity of daily living after cerebral infarction.Methods 80 patients with acute cerebral infarction following depression were randomly divided into treatment group and control group, 40 cases in each group. Two groups were assessed with Modified Edinburgh-Scandinavia Stroke Scale(MESSS), Hamilton Depression Scale(HAMD) and Modified Barthel Index(MBI) before and after treatment.Results There were no significant difference between the two groups before treatment in HAMD, MESSS and MBI（P＞0.05）, while there were significantly different between the two groups in HAMD, MESSS and MBI 6 weeks after treatment（P＜0.01）. Conclusion Fluoxetine can alleviate depression of patients with acute cerebral infarction and improve the symptom of neurological function and the activity of daily living.

Objective To investigate the correlation between premature beats,atrioventricular block (AVB),heart rate variability (HRV) and age as well as gender among normal children.Methods One thousand five hundred and eighty-one cases of normal children from Beijing were divided into three age groups:3 to 6-year old,～ 10-year old and ～ 12-year old.All children were evaluated with both ECG and Holter to determine arrhythmia and HRV.The arrhythmia incidence and five time-domain values of HRV were analyzed according to age,gender and the existence of ventricular premature contractions.Results (1) Both ECG and 24-hour ECG monitoring (Holter) data showed that the average heart rate (HR),the slowest HR and maximum HR of normal children decreased with age,while PR interval and QTc interval increased with age.The correlation between age and the four indices were statistically significant (P ＜0.01),except the PR interval.(2) The positive rate of arrhythmia with Holter and ECG in normal children had statistically significant difference(x2 =4.810,P ＜ 0.05).(3) The incidence of premature contraction and Ⅰ ° AVB rised or fell with increasing age(P ＜ 0.05).Compared with 3 ～6-year age group,10-year and ～ 12-year old group had highly risk tendency in premature contraction(OR =1.31,2.04).(4) The five time-domain indices of HRV were increases with age.Each age group had statistically significant difference (P ＜ 0.01).(5) The five time-domain indexes of HRV in males were higher than those in females (P ＜0.01).(6) No significant differences were found with five time-domain indexes in children with or without ventricular premature contraction (P ＞ 0.05).Conclusions (1) HR of normal children decreases with age,but QTc interval increases with age.(2) The supraventricular premature contraction is the most common arrhythmia in normal children with Holter.(3) The occurrence of premature contractions increases with age,more obvious during the preadolescence.Ⅰ ° AVB occurs with age growth on a downward trend.Sex has no effect on the same arrhythmia.(4) HRV in normal children has age difference,suggesting that the pediatric cardiac autonomic nervous system (ANS) was immature.(5) The differences of HRV in sex were most significant during the preadolescence,which showed the developmental inconsistencies in cardiac ANS between male and female of preadolescence.(6) In the majority of normal children,the ventricular premature contractions were benign.

Objective To observe the clinical effect ofJiedu-Huayu granule for the Dengue Fever (DF).Methods The patients with DF were randomly divided into the treatment group and control group. Both groups received the conventional treatment, and the treatment group addedJiedu-Huayu granule. The clinical effects were detected.Results At the baseline, the ALT and AST in the treatment were significantly higher than those in the control group (t=2.830,P=0.014;t=2.109,P=0.044). But after treatment, there was no difference between groups. The ALT in the treatment group showed a gradual change and AST recovery time showed short. Compared with control group, the concentration of sVCAM-1 in the treatment group was higher at baseline and the third day (t=2.780,P=0.018;t=2.130,P=0.460), but the concentration of MCP-1 desceased significantly on the 6th day (t=-2.164,P=0.042).Conclusions Compared with the western medicine, the treatment of western medicine andJiedu-Huayu granule could alleviate liver injure, shorten the recovery time, and reduce the concentration of sVCAM-1 and MCP-1.

Objective To study the influence of obesity on outcome of rehabilitation for the hemiplegic post stroke. Methods 118 hospitalized stroke patients were divided into the normal weight, overweight and obesity groups according to the Body Mass Index. All the patients received rehabilitation for 12 weeks. They were assessed with National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after rehabilitation. Results The scores of NIHSS, FMA, BBS and MBI improved significantly after rehabilitation in all the groups (P<0.001), and improved the lest in the obesity group in the scores of NIHSS, BBS and MBI (P<0.05). There was no significant difference in FMA score among groups (P>0.05). Conclusion Obesity influences the outcome of rehabilitation, results in poor functioning.

OBJECTIVETo research the isolation method, identification and screen for bioactivities endophytic fungi from ginkgo.

METHODEndophytic fungi from ginkgo were separated. By means of microdilution method, activities of endophytes against pathogenic fungi were tested. Then, using DPPH, the antioxidant activities were measured.

RESULTNine strains (16.1%) showed antifungal activities against Candida albicans, Cryptococcus neoformans, Trichophyton rubrum and Aspergillus fumigatus. Among these bioactive strains, the growth of T. rubrum was strongly inhibited by T-1-2-1, as the MIC80 was equal to fluconazole, the positive control. Five strains (8.9%) showed antioxidant activities. Among them sample T-3-2-2 and T-6-5-7 showed the strongest antioxidant activities.

CONCLUSIONEndophytic fungi of ginkgo would be potential and rich resources for drug development.

Antifungal Agents ; pharmacology ; Aspergillus fumigatus ; drug effects ; Candida albicans ; drug effects ; Cryptococcus neoformans ; drug effects ; Fluconazole ; pharmacology ; Fungi ; chemistry ; drug effects ; isolation & purification ; Ginkgo biloba ; microbiology ; Microbial Sensitivity Tests ; Trichophyton ; drug effects

Objective To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. Methods A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. Results Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. Conclusion Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.

Objective To evaluate the anti-osteoporotic effect of xanthohumol(XN)in animal and osteoblast.Methods The anti-osteoporotic study on XN was performed with ovariectomized mice model.Serum biochemical indexes,bone mineral density(BMD)and bone histomorphology were measured using Elisa kits and Micro-CT analysis.In vitro test,the effect of XN on osteoblastic proliferation,differentiation and mineralization were assayed.The expression of protein related to bone for-mation was measured by Western blot analysis.Results In vivo experiments,XN significantly increased the estrogen level, reduced the high bone turnover rate,improved the microenvironment and BMD in ovariectomized mice.In vitro experiments, XN protected bone loss not only by promoting osteoblastic proliferation,ALP activity and bone mineralization,but also through increasing the expression of osteopontin(OPN),bone sialoprotein(BSP)and bone morphogenetic protein-2(BMP-2). Conclusion This is the first report to confirm that XN has anti-osteoporotic effect,which provides a new approach for the clin-ical treatment of osteoporosis.

Objective To translate Chinese version of the Family Impact of Childhood Bronchial Asthma-Revised(IFABI-R), and to evaluate its reliability and validity in family caregivers for children with asthma. Methods The English version of IFABI-R was translated into Chinese by means of translation, back translation, expert consultation and cultural debugging to form a Chinese version of the questionnaire. A total of 158 parents of the children with asthma treated in the First Affiliated Hospital of Zhengzhou University from January to June 2016 were investigated by the Chinese version IFABI-R. The reliability and validity was tested. Results The Chinese version of IFABI-R has 14 entries. The content validity (I-CVI) of the items ranged from 0.80 to 1.0, and the content validity (S-CVI) of the total scale was 0.98. Exploratory factor analysis extracted 3 factors, the cumulative contribution rate is 68.362%. The Cronbach's alpha coefficient of the scale was 0.843, and the Guttman split half coefficient was 0.842, with the test-retest reliability 0.796. Conclusions The Chinese version of IFABI-R has good cultural applicability, with good reliability and validity. It can be used to assess the quality of life of parents with asthma in children.