Objective To explore the variation of serum D-lactic acid levels and the correlation between different intestinal viral and intestinal barrier function in children with hand, foot and mouth disease (HFMD). Methods The stools of 129 children with HFMD were collected and were detected by reverse transcription polymerase chain reaction. The children were divided into four groups according the fecal pathogens detection:enterovirus 71 (EV71) positive group, Coxsackie virus A16 (CoxA16) positive group, other intestinal virus positive group (EA positive group), and no intestinal virus group (EA negative group). Two ml venous blood and separation serum was collected in each group of children, and the level of serum D-lactic acid was detected further. Results There were 20 cases of other Coxsackie virus, and they were not grouped. Fifty-seven patients were in EV71 positive group, 26 patients were in CoxA16 positive group, 10 patients were in EA positive group, and 16 patients were in EA negative group. The level of D- lactic acid in four groups was 26.28 (17.02- 58.01), 14.43 (8.93- 20.66), 10.66 (6.64- 18.51) and 14.07 (11.83- 27.46) mg/L. The results of rank test showed the level of D-lactic in EV71 positive group was significantly higher than that in EA positive group (Z=-2.432, P=0.015) and EA negative group (Z=-3.092, P=0.002). Conclusions D-lactic acid level increases significantly in EV71 infection children and suggests that the illness is more serious and the intestinal barrier is damaged. Doctors should pay more attention to monitor and protect gastrointestinal function of children with HFMD.

Objective To explore trajectories of joint function recovery and its influencing factors of patients un-derwent hip arthroplasty. Methods A self-designed questionnaire and Harris Hip Score(HHS) were used to collect data from 80 patients underwent hip arthroplasty for three months. Results Scores of patients' hip joint function were poor,poor,moderate and excellent at baseline,one week,one month and three months after surgery,respectively. The influencing factors included time to start exercise,frequency of rehabilitation exercise and supports from family mem-bers. Conclusion Nurses should take targeted measures according to the characteristics of hip joint function in dif-ferent periods,and provide professional health education to improve patient's hip function and capacity of daily living.

OBJECTIVE To investigate the oropharyngeal bacterial carriage in hospitalized elderly patients without acute infections and the antimicrobial resistance,and the risk factors for the bacterial carriage.METHODS An oropharyngeal swab was taken from each patient after they rinsed their mouths with sterile saline.Bacteria were cultured and identified with routine methods and the antimicrobial susceptibility testing was carried out with disk diffusion method.RESULTS The oropharyngeal bacterial carriage rate was 55.2% in elderly patients.Sixty two pathogens were isolated including 56(90.3%) strains of Gram-negative bacilli,5(8.1%) Gram-positive cocci and 1 Candida albicans.All of 34 strains of Haemophilus spp were susceptible to antimicrobials tested such as ampicillin and cefaclor,a few strains were resistant to gentamicin and ciprofloxacin.Of 10 strains of Klebsiella pneumoniae,4 strains were extended-spectrum ?-lactamases positive and resistant to cefotaxime.Logistic analysis indicated that denture-wearing was the risk factor for the oropharyngeal bacterial carriage in elderly.CONCLUSIONS Oropharyngeal bacterial carriage rate is high in hospitalized elderly patients.The major colonized bacteria are Gram-negative bacilli.Denture-wearing is the risk factor for the oropharyngeal bacterial carriage in elderly.

OBJECTIVE:To investigate the cognition of medical staff's cognition on clinical pharmaceutical care.METHODS:A total of 105 questionnaires collected from the doctors and nurses were subjected to an aggregate analysis in terms of their ultimate educational background,professional title,working lifetime,cognition on clinical pharmaceutical care etc.RESULTS & CONCLUSIONS:Doctors and nurses had positive attitude toward clinical pharmacy care and it is greatly demanded in drug use.Clinical pharmaceutical staff should keep improving their expertise level and strengthen cooperation with medical staff so as to facilitate the development of clinical pharmaceutical care.

Sixty male rats divided into the control and the gelatin group were fed with 20% protein synthetic diet. The diet for the former group contained 24% casein, whereas for the latter 11% gelatin and 12% casein. , Having been fed for some days, all rats were irradiated with 875 rad (LD85-90). The main results were summarized as follows;1. The gelatin group had higher survival rate than the control group. 2. The body weight of gelatin group was less declined than that of control group and then much restored than the latter. 3. The survival time of dying rats within 14 days following the exposure to 875 rad in gelatin group was more longer than that in control group. 4. The gelatin group had less biological lesions than the control group.It was suggested that the gelatin diet had distinctly prophylactic-therapeutic action on acute radiation damage and its mechanism was probably related to the prevention from disturbance of collagen metabolism.

Objective To understand the experiences of patients prior to operation with recurrent glioma based on the Corbin and Strauss chronic illness trajectory framework. Methods Fourteen patients participated in the semi-structure interviews.Data were analyzed with Colaizzi′s phenomenologica l procedure. Results Based on the Corbin and Strauss chronic illness trajectory framework, experiences of patients prior to operation with recurrent glioma were extracted. (1) Illness-related work including severe symptoms of illness and lack of knowledge of illness. (2) Biographical work including loss of biography and identity of self. (3) Everyday life work including change of social roles, complicated mood combined negative experience and positive experience, heavy economic burden. Conclusions Nursing staff should attach importance to experiences of patients, and provide targeted interventions for successful operations and recovery of physical and spiritual healing.

Objective To investigate the prevalence of toxoplasma gondii (Tox),rubella virus (RV),cytomegalovirus (CMV) and herpes simplex virus (HSV) infections (TORCH infections) among childbearing-age population in Henan province.Methods Enzyme-linked immunosorbent assay (ELISA) was applied to detect plasma TORCH IgM and IgG among 3084 childbearing-age men and women from theFirst Affiliated Hospital of Zhengzhou University during July and September,2011.The positive rates of anti-TORCH antibodies were compared among the various age and gender groups by x2 test.Results The total positive rate of anti-TORCH IgM was 5.5％ (170/3084),in which the positive rate of anti-RV IgM was the highest (2.9％),followed by anti-HSV IgM (1.0％).Within positive rate of anti-TORCH IgG,anti-HSV IgG was the highest (90.4％),followed by anti-CMV IgG (89.7％),RV IgG (48.1％) and Tox IgG (0.7％).The positive rate of anti-TORCH IgM was the lowest in individuals aged ＞ 30-40 year old.With the age increasing,the positive rates of anti-Tox IgG,anti-CMV IgG and anti-HSV IgG increased,but the positive rate of anti-RV IgG decreased.Women had higher positive rates of anti-CMV IgG and antiHSV IgG than men (x2 =83.470 and 7.026,P ＜ 0.O1).Conclusions Current infection of TORCH exists in childbearing-age population of Henan province,and the positive rate of anti-RV IgG is low.It is recommended to screen for TORCH infection in childbearing-age men and women.

Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.

Objective To investigate the change of plasma vitamin D, A and E levels in infant with infantile hepatitis syndrome (IHS) and to provide reliable basis for clinical treatment. Methods Seventy-three infant with IHS (IHS group) from January 2015 to May 2016 and 82 cases of physical examination infant (control group) were enrolled in this study.The levels of plasma vitamin D, A and E were tested and compared between two groups. Results The levels of vitamin D, A and E in IHS group were significantly lower than those in control group:(37.871 ± 20.111) nmol/L vs. (97.708 ± 28.827) nmol/L, (1.082 ± 0.657)μmol/L vs. (1.810 ± 0.517)μmol/L, (21.252 ± 7.596)μmol/L vs. (26.647 ± 6.495)μmol/L, P<0.01 or <0.05. The nutritional status of vitamin D, A and E in two groups had significant differences (P<0.01). Conclusions There have obvious deficiency in fat-soluble vitamin D, A and E in infant with HIS , and vitamin D deficiency is the most obvious. The levels of vitamin D, A and E are the dynamic monitoring indicators of treatment, nutritional status evaluation and long-term complications development.

BACKGROUND:Systemic erythematosus lupus (SLE) is closely associated with activity of dendritic cells (DCs) function.DCs derive from hematopoietic precursor cells (HPCs) in vivo and many factors might affect the differentiation and maturation of DCs.The cytokine network was in disturbance and the levels of various cytokines were anomalous in SLE serum.Previous studies mainly addressed effects of single factors.OBJECTIVE:To investigate the effects of joint action of serum interferon (IFN)-α and interieukin (IL)-6 in the serum of SLE patients on the differentiation and maturation of DCs derived from CD34~+ HPCs.DESIGN,TIME AND SETTING:The grouping,controlled and completely random designed study was performed at the Department of Microbiology and Immunology,Nanjing Medical University from May 2006 to October 2008.MATERIALS:Peripheral blood samples were collected from 50 SLE patients from the Department of Rheumatology,First Affiliated Hospital of Nanjing Medical University and 30 healthy volunteers from Nanjing Medical University.Cord blood samples were collected from 15 full-term normal delivery neonates from Nanjing Maternity and Children Health Care Hospital Affiliated to Nanjing Medical University.Informed consent was obtained from all patients and their family members.METHODS:Peripheral blood samples were collected from SLE patients and healthy volunteers.According to serum IFN-α and IL-6 concentrations of normal person,95% reference value range of serum IFN-α and IL-6 concentrations were calculated by the method of percentiles.Above this range represented abnormal increase.Cord blood mononuclear cells were harvested by Ficoll-Hypaque density gradient centrifugation.CD34~+HPCs were purified from cord blood by magnetic cell sorting system (MACS),and cultured to differentiate to DCs.There were 6 groups in this study.Normal serum,SLE serum with elevated levels of IFN-α,SLE serum with elevated levels of IL-6,SLE serum with elevated levels of IFN-α and IL-6,SLE serum with anti-IFN-α and anti-IL-6 neutralizing antibodies,or normal serum with exogenous IFN-α and IL-6 were respectively added to the culture medium in each group.10% volume fraction serum was used in each group,for totally 14 days incubation.MAIN OUTCOME MEASURES:The phenotype of DCs was analyzed by flow cytometry (FCM).Cytokine production was assessed by ELISA.The capacity of DCs to stimulate allogenic T lymphocyte proliferation and to regulate T cell differentiation was evaluated in a mixed lymphocyte reaction (MLR).RESULTS:Compared with normal serum,HLA-DR,CD80 and CD86 expression was significantly increased in the medium containing SLE serum with elevated levels of IFN-α,SLE serum with elevated levels of IL-6,SLE serum with elevated levels of IFN-α and IL-6 and normal serum with exogenous IFN-α and IL-6 (P＜0.05),whereas IL-12 levels were significantly decreased (P＜0.05),and capacity of DCs to stimulate allogenic T lymphocyte proliferation was significantly enhanced (P＜0.05).Above-mentioned indexes recovered to a normal level in the medium containing SLE serum with anti-IFN-α and anti-IL-6 neutralizing antibodies.Compared with normal serum,proportion of both CD3~+CD8~-IFN-γ~+ and CD3~+CD8~+IFN-γ~+ T cell subsets was significantly reduced in the medium containing SLE serum with elevated levels of IL-6 (P＜0.05).However,proportion of both CD3~+CD8~-IFN-γ~+ and CD3~+CD8~+IFN-γ~+ T cell subsets was significantly increased in the medium containing SLE serum with elevated levels Of IFN-α,SLE serum with elevated levels of IFN-α and IL-6,normal serum with exogenous IFN-α and IL-6 (P＜0.05).CONCLUSION:The joint action of IFN-α and IL-6 in SLE serum promotes the differentiation and maturation of DCs derived from CD34+HPCs and affects the DC-mediated T cell differentiation,which might contribute to the pathogenesis of SLE.