ObjectiveTo explore clinical characteristics of fatality cases of hand foot and mouth disease caused by enterovirus 71 (EV71),and to improve the diagnosis and treatment of the disease.Methods Sixteen children infected with EV71 were retrospectively reviewed.Clinical manifestation,laboratory data and death causes were analyzed.ResultsAll cases were younger than four years,and the mean age was 18.9 months.Seasonal variations in incidence were observed,with a peak in incidence during the summer season.These cases typically presented with a brief duration of febrile illness,nonspecific neurological signs including headache,vomiting,limb tremor and convulsions.After two to four days,they all got sudden deterioration,manifested with tachycardia,poor peripheral perfusion,tachypnea and transient hypertension.After intubation,they all had pink frothy or blood from the endotracheal.Tweleve of them died from pulmonary edema or pulmonary hemorrhage,and acute refractory cardiac dysfunction.The other four of cases died from brain stem encephalitis.Atypical presentation such as absence of skin rash should alert the physician.Total white cell count,blood glucose and cardiac troponin I were raised significantly.The protein raised in cerebrospinal fluid.ConclusionHand foot and mouth disease caused by EV71 progresses rapidly.The primary site of attack is the central nervous system,particularly the brainstem,and the cause of death are neurogenic pulmonary edema and/or hemorrhage,acute refractory cardiac dysfunction.

Objective To improve the diagnosis and treatment of epidemic cerebrospinal meningitis in children.Methods A retrospective review was performed and a total of 69 cases of children epidemic cerebrospinal meningitis were collected and classified into ordinary and fulminant epidemic cerebrospinal meningitis from 1999 to 2011.Disease prevalent season,age,clinical characteristics,laboratory examination,treatment,prognosis and risk factors were analyzed.Results The mean age(33 male and 36 female) was (6.85 ±5.12)years old,ranging from 56 days to 15 years old.A total of 60 cases began on January to May; 6 cases began on June to October; 3 cases began on November to December.All of the 42 cases of ordinary epidemic meningitis were recovered; 7 cases of fulminant epidemic meningitis(n =27) were dead.All of the patients had fever; 64 cases(92.75％) had Petechiae petechial skin; 36 cases(52.17％) had headache; 49 cases(71.01％) vomited; 65 cases(94.2％) had positive neck resistance; 15 cases(21.74％) had convulsion; 35 cases(50.72％) had drowsiness or coma; 32 cases (46.38％) had positive pathological signs and 24 cases (34.78％) had low blood pressure or shock.Blood tests revealed that 63.77％ of the patients leukocytes raised and 8.70％ of the patients reduced; 42.03％ of the patients platelet reduced; 55.07％ of the patients had electrolyte disturbance and 89.86％ of the patients had coagulation disorders,among which 46.38％ fibrinogen reduced.The rash printed piece and cerebrospinal fluid smear tests found that Gram-negative bacteria positive rate were 12.5％ and 19.35％ respectively; the positive rate in bacterial culture of cerebrospinal fluid and blood culture were 12.90％ and 7.25％ respectively.Drug sensitive test showed that penicillin and ceftriaxone were sensitive to bacteria.The differences of age,leukocyte and platelet counts,fibrinogen and altered mental status between ordinary and fluminant epidemic meningitis were significant (P ＜ 0.05).Conclusion The prevalent season is from January to May and the prevalent age is less than 5 years for children with epidemic cerebrospinal meningitis.Ceftriaxone or penicillin should be the preferred choice;age,lower leukocyte and platelet counts,lower fibrinogen and altered mental status should be used to predict the severity of the disease.

Objective To analyse the clinical manifestations of mycoplasma pneumoniae pneumonia(MPP) with 23SrRNA A2063G gene mutation,and improve the ability of diagnosis and treatment of patient infected with MPP.Methods MP-DNA was detected by fluorescent quantitative real-time PCR in sputum specimens from 36 children with MPP,then we detected the drug resistance gene mutation sites by nest-PCR and DNA sequencing,on this basis we classified into two groups of macrolide-resistant MP and macrolide-sensitive MP,and compared the clinical manifestations,laboratory findings,chest imagings and treatment between two groups.Results Of these 36 cases of MPP,24 cases had macrolide-resistant gene mutation with an A2063G transition in domain V of the 23SrRNA,12 cases had no macrolide-resistant gene mutation.Compared to macrolide-sensitive MP group,macrolide-resistant MP group had longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and had higher white blood cells counts and CRP.In the macrolide-resistant MP group,the temperature subsided within 5 days after macrolide treatment alone of 12 cases,3 cases needed switch to fluoroquinolones therapy,10 cases combined with glucocorticoids and 6 cases combined with intravenous immunoglobulin,all 24 patients had good outcomes.While in macrolide-sensitive MP group,the temperature susided between 12 hours to 3 days after macrolide treatment of 8 cases.Conclusions Compared to patients infected by macrolide-sensitive MP,those mycoplasma pneumoniae pneumonia patients with 23SrRNA A2063G gene mutation have longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and have higher white blood cells counts and CRP.Some macrolide-resistant MPP patients have good response to macrolide antibiotics treatment,while the severe cases need combined with glucocorticoids and immunoglobulin,or should change antibiotics.

This study was aimed to observe the effect of Compound Shi-Chang-Pu (CSCP) granula on behavior, structure changes of hippocampus with epileptic seizure of mice induced by pentyenetetrazole (PTZ). Sixty Kunming mice, which were half male and half female, were randomly divided into 6 groups, which were the blank control group, animal model, phenytoin (PHT) group, high-dose CSCP (4 000 mg·kg-1) group, middle-dose CSCP (2 000 mg·kg-1) group and low-dose CSCP (1 000 mg·kg-1) groups. The blank group and model group were given intragas-tric administration the same volume of saline, the others animals treated with continuous oral administration of drugs for 7 days. Intraperitoneal injection of PTZ (80 mg·kg-1) was given 1 h after the last medication to establish the a-cute epilepsy model (expect the blank control group). Observation was made on the influence of CSCP on incubation period, behavior degree and times of epileptic seizure among PTZ induced epilepsy mice, the structure changes of mice were detected by the brain tissue HE staining. The results showed that CSCP can improve the degree of seizure attack, prolong the incubation period of mild attack, and decrease Ⅳ and Ⅴ degree epileptic seizure, the PTZ in-duced epilepsy mice could damage the structure of hippocampus, reduce the number of cells, PHT and CSCP could ameliorate these changes. It was concluded that CSCP had certain inhibition on epileptic seizure mice induce by PTZ and ameliorate the damage of hippocampus. The antiepileptic mechanism still requires futher study.

Continuous medical imaging education is important for radiologists to improve their image diagnosis ability.In order to adapt to the development of medical education,the department of radiology in Tangdu hospital had built a set of teaching-picture archiving and communication system (TPACS) with its own intellectual property rights based on its own advantages.This system was actively put into use for scholar radiologists and the efficiency and quality of education as well as the development of continuous education for scholar radiologists were improved and promoted conspicuously.

Objective To explore the relationship between the HLA-G 14 bp insertion/deletion polymorphism and the infection of Epstein-Barr virus(EBV) for children.Methods The study genotyped HLA-G 14 bp insertion/deletion polymorphism of 102 infectious mononucleosis children and 165 normal controls by PCR-PAGE,detected the plasma sHLA-G level of 51 infectious mononucleosis children and 146 normal controls by ELISA.Results A significant difference was observed for the frequencies of the HLA-G 14 bp genotype between the two groups( x2 =6.742,P=0.034 ),and a significant difference was also observed for the 14 bp allele frequencies between the two groups( x2 =6.672,P=0.01 ).The plasma sHLA-G levels in the infectious mononucleosis children were dramatically higher than that in normal controls,and a significant difference was observed between the two groups( Z=-9.472,P＜0.01 ).Among the infectious mononucleosis children,levels of sHLA-G was find a significant difference between the three genotypes of HLA-G 14 bp insertion/deletion polymorphism( H=6.09,P =0.048 ),and the level of s HLA-G with 14 bp+/+ genotype was markedly lower than that of the two other genotypes (Z=-2.376,P=0.01 8).Conclusion There was a relationship between the HLA-G 14 bp insertion/deletion polymorphism and the susceptibility to the infectious mononucleosis for children.Children who carried the 14 bp-/- genotype or deleted the 14 bp allele may have a significantly increased risk of the infection of EBV.The plasma sHLA-G might be considered as an index for auxiliary diagnosis infectious mononucleosis.

Objective To investigate the influences of UVA on the secretion and expression of chemokine CXCL11/I-TAC by HaCaT cells induced by interferon γ (IFN-γ) and tumor necrosis factor α (TNF-α). Methods HaCaT cells were cultured in the presence of IFN-7 and TNF-a and irradiated with UVA of 2, 4 and 8 J/cm~2, respectively; those cells receiving neither treatment with IFN-γ or TNF-α nor UVA irradiation served as the negative control, and those receiving only cytokine treatment but no irradiation as the positive control. After another 24-hour culture, enzyme-linked immunosorbent assay (ELISA) was performed to detect the protein levels of CXCL11/I-TAC in the supernatant of HaCaT celb, real time PCR to measure the mRNA expression of CXCL11/I-TAC in these HaCaT cells. Results As far as the negative control HaCaT cells were concerned, there was a minor secretion of CXCL11/I-TAC protein and expression of CXCL11/I-TAC mRNA. After treatment with IFN-7 and TNF-a of 10 μg/L, the protein and mRNA expressions of CXCL11/ I-TAC were synergistically upregulated, whereas the induced secretion and expression of CXCL11/I-TAC by HaCaT cells were dose-dependently inhibited by UVA irradiation. Conclusions UVA irradiation inhibits the secretion and expression of CXCL11/I-TAC by HaCaT cells, which in turn suppresses the chemotaxis of Th1/ Tel cells in some degree.

Because of the anomalous points distributed in the image, gene chip is hard to be distinguished effectively in fact. This article offers some arithmetic of image processing by VB such as increasing contrast, self-adapt thresholds, two-values and searching for spares and disperse templet which can distinguish all kinds of gene chip quickly, well and truly.
Algorithms ; Image Processing, Computer-Assisted ; methods ; Oligonucleotide Array Sequence Analysis ; Software Design

Objective To investigate the inhibitive effect of siRNA(small interfering RNA,siRNA) on the phosphodiesterase type 5(PDE5) in smooth muscle cells of human corpus cavernosum,and provide experimental groundwork for the gene therapy of erectile dysfunction (ED). Methods Small interfering RNAs targeting PDE5 gene were systhesized by using web design software provided by Ambion,there siRNAs and control siRNA were systhesized by Ambion. SiRNAs were transfected into smooth muscle cells of human corpus cavernosum by using siPORTTM Lipid reagent;down-regulation of PDE5 mRNA was detected by RT-PCR;the inhibitive effect of PDE5 was detected by Western Blotting. Results The results of RT-PCR indicated siRNA1、siRNA2 and siRNA3 made down-regulations of PDE5 mRNA expression in the transfected groups 58.2%、14.9% and 11.8%;the PDE5 expression decreased 70.5%、19.8% and 17.3%;however the expression did not have different in control siRNA and frank group. Conclusions The synthesized siRNAs in vitro were able to down-regulate the expression of PDE5.There were different capabilities of the specific siRNAs down-regulation.It was suggested that the siRNA technique provide not only an extremely powerful tool for the functional analysis of genome but also a new method for ED gene therapy.

Objective To discuss the genetic diversity of Coptis chinensis.Methods The genetic diversity of 78 individuals from seven populations was analyzed by inter-simple sequence repeat(ISSR).Results Twelve primers were selected to produce highly reproducible ISSR bands.Among 106 amplified bands,72 showed polymorphism,the percentage of polymorphic bands reached to 67.92%.Nei's gene diversity index(H)was 0.180 3,Shannon information index(I)was 0.283 2,Gst was 0.681 5.The genetic distance coefficient and genetic similarity were 0.089 4—0.184 6 and 0.832 1—0.912 7,respectively.ConclusionC.chinensis holds high genetic diversity and the majority of genetic variation occurs among the populations.By cluster analysis,the geographical distribution is very obvious.The ISSR marker could be used for the analysis of the genetic diversity and genetic variation of C.chinensis.