Objective To investigate the application and correlation of enterovirus 71(EV71)and Coxsackie virus A16(CA16)antibody screening in the hand,foot and mouth disease(HFMD).Methods The method of enzyme linked immunosorbent assay was used to test the serum antibody of EV71-IgM and CA16-IgM in 281 patients(142 male and 139 female)with HFMD.Results The positive rate of EV71-IgM antibody was 51.2％(144/281),the positive rate of CA16-IgM antibody was 32.0％(90/281).Seventeen patients(6.0％,17/281)had dual positive of EV71-IgM and CA 16-IgM antibody.The total detection rate was 77.2％(217/281).The positive rate of EV71-IgM and CA16-IgM antibody had significant difference(x2 =21.35,P ＜ 0.01).The positive rate of EV71-IgM and CA16-IgM antibody in male had significant difference compared with female[95.1％(135/142)vs.71.2％(99/139),P＜ 0.01].Conclusions At the beginning of the illness should use the joint detection of EV71-IgM and CA16-IgM antibody diagnose HFMD.It has significance in diagnosing and monitoring.

Objective Probing into a way to reform the assessment indexing of diagnosis and treatment in clinical specialties, to help with objective assessment and ranking among hospitals in terms of the performances of their respective specialties. Methods Treatment outcomes of the diseases pinpointed by heart physicians and urology surgeons of three hospitals in 2005 as the criteria to calculate the adjusted value for fatality rate and cure rate. Results The adjusted value of fatality rate for the heart physicians is CFR≥1, and that of cure rate for the urology surgeons is CFR≤1. A trial assessment is made based on these figures, and a ranking is achieved on the diagnosis and treatment outcomes of the clinical medicine specialties in these three hospitals as a result. Conclusions Diseases as the assessment levels for medical quality of clinical medicine specialties and relative risks as the core computation adjusted factor, may help yield the indexes and methodology for clinical medicine specialties in line with China's specifics.

Objective To investigate the progress and effectiveness of water-improving defluoridation projects comprehensively in control of fluorosis in drinking-water-borne endemic fluorosis areas in Hubei Province,and to provide a scientific basis for making strategies in prevention and control of endemic fluorosis.Methods All villages affected by fluorosis in drinking-water-borne endemic fluorosis areas were selected in Hubei Province,in which the progress and effectiveness of water-improving and defluoridation projects were investigated in 2015.Those villages were chosen to determine fluoride content of drinking water,and to check the prevalence of dental fluorosis of children 8 to 12 years old.Water fluoride content was tested with fluoride ion-selective electrode,and dental fluorosis was diagnosed by the Dean method.Results The water improvement projects were completed in 197 villages in the 30 disease affected counties (cities) with accomplishment rate 100.00％ (197/197),geometric mean of water fluorine 0.36 mg/L,qualified rate of water fluorine 100.00％ (197/197) and normal operation rate of the water-improvement projects 95.94％ (189/197).Totally 14 856 children aged 8-12 were examined their dental fluorosis.The prevalence rate was 1.78％ (265/14 856) and the dental fluorosis index was 0.04,which meant epidemic strength was negative.Totally 29 out of the 30 disease affected counties (cities) had met the disease control standards.Conclusion The prevalence of drinking-water-borne endemic fluorosis in Hubei Province has been under control,but management and monitoring of the water improvement projects still should be strengthened.

Identifying the origin of body fluids left at a crime scene can give a significant insight into crime scene reconstruction by supporting a link betw een sample donors and actual criminal acts. How ev-er, the conventional body fluid identification methods are prone to various limitations, such as time con-sumption, intensive labor, nonparallel manner, varying degrees of sensitivity and limited specificity. Re-cently, the analysis of cell-specific messenger RNA expression (mRNA profiling) has been proposed to supplant conventional methods for body fluid identification. Since 2011, the collaborative exercises have been organized by the European DNA Profiling Group (EDNAP ) in order to evaluate the robustness and reproducibility of mRNA profiling for body fluid identification. The major advantages of mRNA profil-ing, compared to the conventional methods, include higher sensitivity, greater specificity, the ability of detecting several body fluids in one multiplex reaction, and compatibilitywith current DNA extraction and analysis procedure. In the current review ,we provided an overview of the present know ledge and detection methodologies of mRNA profiling for forensic body fluid identification and discussed its possi-ble practical application to forensic casew ork.

Objective To study the disease trend of Keshan in Hubei Province and provide a basis for scientifically making control and prevention strategy.Methods According to Chinese Surveillance Plan of Keshan Disease,physical examination and electrocardiogram were done for surveillance subjects and suspected patients were filmed chest X-ray in Keshan disease areas.Results Totally 4 822 people were monitored from 2007-2014.The numbers of females (2 589,53.69％) were more than those of the males (2 233,46.31％).The group of people under the age of 15 accounted for 52.47％ (2 530/4 822) which was higher than that of the group over the age of 55 (19.14％,923/4 822).The rate of electrocardiographic abnormality was the highest in 2011 (61.33％,268/ 437) and the lowest in 2014 (5.61％,23/410).In the eight years,only potential type of Keshan disease patients were detected,and the incidences from 2007 to 2014 were all lower than 3％ and had a decreasing trend yearly.No Keshan patient was detected in 2012-2014.Ninety-one suspected cases were taken chest X-ray.Most of the suspected cases (63.74％,58/91) had normal cardiothoracic ratio.The cardiothoracic ratio increased,excepting one,other 32 were all potential type Keshan disease patients.Conclusions The disease trend of Keshan disease in Hubei Province is weak.Nevertheless,surveillance and health education are indispensable,in case the disease relapses.

Objective To investigate the effects of salmeterol/fluticasone (seretide) combined with community intervention on lung function and quality of life of chronic obstruetive pulmonary disease (COPD) patients in the stable period.Methods 96 cases with COPD in the stable period were divided into two groups randomly:Group A was treated only by seretide for six months,group B was treated by seretide combined with community intervention (health education,psychological intervention,exercise training,and nutritional guidance).6 months later,the lung function was determined and the quality of life was assessed by SGRQ.Results The lung function and the score of the quality of life in two groups after treatment [Group A:(1.78 ±0.16)L,(65 ±9)％ and 40 ± 18,36 ± 16,125 ±40;group B:(2.05 ±0.28)L,(73 ±9)％ and 21 ± 10,20 ± 11,58 ± 28,respectively] were improved than those before treatment [Group A:(1.59 ±0.15),(58 ±7) and 63 ±22,50 ±24,167 ±68;group B:(1.61 ±0.14)L,(58 ± 8)％ and 62 ±22,48 ± 22,163 ± 67,respectively] (P ＜ 0.05 );The lung function and the score of the quality of life in B group were improved than those in A group after treatment ( P ＜ 0.05 ).Conclusions Using community intervention combined with seretide in treatment of COPD patients has better effect than the single use of seretide therapy,it improves lung function and quality of life.It is a safe treatment method and worthy to spread widely.

Objective To study the effectiveness and safety of different endoscopic papillary balloon dilation time in treatment of common bile duct stones. Methods 45 patients with common bile duct stones received ERCP treat﹣ment, and they were randomly divided into short-term and long-term balloon dilatation group, then compared opera﹣tive time, intraoperative and postoperative complication rate, hospitalization days and the total cost of hospitalization between the two groups. Results Short-term group included 22 people, the long term group included 23 people, there were no significant difference in stones' size, number and diameter of common bile duct between the two groups (P> 0.05), however, the success rate of surgery, time of stones' extraction, intraoperative complications and postoperative fistula were significant differences (P<0.05). Conclusion Long-term balloon dilation during ERCP for treatment of common bile duct stones can improve the success rate of stone removal and reduce complications.

Objective To assess the quality of international studies on using aldosterone to renin activity ratio (ARR) to diagnose primary aldesteronism. Methods We searched the Cachrane Library (1962-2007.12), PubMed(1970-2007.12) ,VIP(1989-2007.12) ,Wan Fang database(1982-2007.12) ,CBMdisc(1978 -2007.12) systematically. Language was limited to Chinese and English. The Quality Assessment of Diagnostic Accuracy Studies(QUADAS) was used to assess the quality of induced diagnostic studies by two reviewers inde-pendently. Results Fourteen studies were included and assessed. We found that most of the studies were not met with QUADAS items. Nine studies didn't chose correct cases that included miscellaneous cases and confused ca-ses. Eight studies didn't describe internalized or exclusive references clearly. The gold standard in three studies could not discriminate whether the diagnosis of patients was confirmed or not. Thirteen studies did not use blind trial to compare the diagnostic test and the gold standard. Conclusions The studies using ARR to diagnose pri-mary aldesteronism should be improved in patients selection, the gold standard selection, comparison of blind trial and bias control.

Objective To retrospectively overview the malaria death cases reported in Henan Province and analyze the cause of death. Methods The data including basic information,epidemiological survey and medical records of malaria death cases in Henan Province from 2010 to 2015 were collected and analyzed. Results In the six years,a total of 14 malaria pa?tients were dead. All the death patients were adult males and imported from Africa. They had definite histories of living in malaria?epidemic areas and the symptoms of fever. Twelve patients were diagnosed as malaria after at least twice diagnoses. The average time from symptom appearing to correct diagnosis was 6.5 d. The causes of deaths were misdiagnosis and delayed treatment. Con?clusions The major reasons of malaria death cases in Henan Province are the failure of correct diagnosis and prompt treatment. Health education of malaria prevention and diagnosis and treatment training of malaria should be strengthened in order to im?prove the public awareness and the diagnosis ability of clinical doctors for malaria,which can prevent the death of imported ma?laria cases.

Objective Through the dynamical monitoring of the water improvement projects operation,we intend to understand the prevalent trends of endemic fluorosis of children aged 8 to 12 in Hubei,to evaluate the effect of control measures and to provide the basis for making preventive measures.Methods In Hubei,ten surveillance counties were selected,and three epidemic villages were selected as fixed monitoring villages in each county from 2010 to 2014.In those villages,the operation situation of water improvement projects and the fluoride content in drinking water were detected,and the dental fluorosis of children aged 8 to 12 was diagnosed.Results From 2010 to 2014,the normal operation rate of water improvement projects was 75.61％-100.00％,the average of water fluorine content did not change,the differences were not statistically significant (F =2.00,P ＞ 0.05).The numbers of water improvement projects with water fluorine content in excessive amount was increased in the past five years which was only one project in 2010-2012 and was increased to two projects in 2013 and 2014.In 2010-2014,the dental fluorosis prevalence rate of whole children was 9.45％ (525/5 557),the dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was 42.40％ (92/217),the dental fluorosis prevalence rate of qualified villages was 8.11％ (433/5 340).The children's dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was higher than that in qualified villages;the differences were statistically significant (x2 =282.60,P ＜ 0.05).Conclusions The operation rate of water-improving projects is mostly higher than 90％,and so is the qualification rate of fluoride content in drinking water.The operation condition and water quality of the water-improving projects in Hubei need to be improved.The prevalence of children dental fluorosis of affected villages has dropped significantly after low fluoride water is provided continuously.