Objective To investigate the value of brainstem auditory evoked potential (BAEP) in early diagnosis of severe hand,foot and mouth disease (HFMD) with the nervous system damage.Methods BAEP was performed in 297 cases with HFMD.The patients were divided into 4 groups by the HFMD clinical classification and their ages.Group A included the general cases who were younger than three years (n =80).Group B included the severe cases who were younger than three years(n =94).Group C included the general cases who were three years or older(n =38).Group D included the severe cases who were three years or older(n =85).The electroencephalogram (EEG) and MRI results of patients in the groups were retrospectively studied and the results were compared with that of BAEP.Results (1) The BAEP abnormal rate of group B (18/94,19.15％)was higher than that of group A (3/80,3.75％),and the BAEP abnormal rate of group D (13/85,15.29％) was higher than that of group C (1/38,2.63％) (P ＜ 0.05).(2) The EEG abnormal rate in group B was low(2/94,2.13％) and there was no case with abnormal EEG in group A.(3) The EEG abnormal rate of group D (49/85,57.65％) was higher than that of group C (6/38,15.79％) (P ＜0.05),and higher than the BAEP abnormal rate of group D.(4) The MRI abnormal rate of group B (9/94,9.57％) was higher than that of group A (1/80,1.25％) (P ＜ 0.05),and the MRI abnormal rate of group D (9/85,10.59％)was higher than that of group C (0).(5) The BAEP abnormal rate of the children with severe HFMD (31/179,17.32％) was higher than the MRI abnormal rate (18/179,10.06％) (P ＜0.05).Conclusion BAEP has clinical significance for early diagnosis of severe HFMD with nervous system damage,and can provide objective basis for the diagnosis.

0.05) were found between 2 method s. A modified in vitro inhibi tion assay without refreshing medium during a period of 72 h is established by r eduction of initial parasitemia from 1% to 0.2% 0.5%.

The transcranial doppler ultrasonography (TCD) is a non-invasive detection methods of evaluating intracranial artery.Since the 1980s,TCD has been extensively used in various fields of clinical work.Because of its simple operation,good repeatability,and the continuous bedside observation of patients,TCD is especially suitable for severe patients.Increased intracranial pressure is one of the important reasons for the deadly disease in children,it can make the cerebral blood flow perfusion decreased,causing serious consequences,such as brain dysfunction,so intracranial pressure monitoring has important clinical significance.TCD as a noninvasive monitoring tool,can monitor the patients with increased intracranial pressure dynamically,according to the blood flow velocity,the related parameters and the wave of cerebral hemodynamics,so as to achieve the purpose of monitoring intracranial pressure change.This article focused on the TCD application progress in several common children's diseases of increased intracranial pressure.

Hepatitis, Autoimmune ; Humans ; Immunoglobulin G

Nocardia is a genus of gram-positive,weakly acid-fast,filamentous aerobic actinomycetes,which mainly causes infection in immunocompromised persons. We reported a successfully treated fatal case of severe pneumonia caused by Nocardia farcinica in a hospital,then reviewed 25 domestic and abroad case reports about nocardiosis combined with severe pneumonia occurred since 2006,so as to improve health care workers'cognition on clinical manifestations,image features,pathogenic characteristics,and diagnostic and treatment schemes of se-vere pneumonia caused by Nocardia farcinica.

Objective To explore the effects of total flavonoids from portulaca against liver fibrosis in rats by detecting TGF-β1 gene and protein expressions. Methods A total of 48 SD rats were randomly divided into normal control, model control, glucyrrhizin aqueous,and total flavonoids groups,with 12 rats in each group. Except those in the normal control group, rats in other groups were intraperitoneally injected with 2 mL · kg-1 · d-1 carbon tetrachloride to induce liver fibrosis. Rats in glucyrrhizin aqueous group and total flavonoids ones were intragastrically administered with 15. 75 mg · kg-1 of glycyrrhizin aqueous solution or 35. 6 mg·kg-1 of total flavonoids aqueous solution,respectively. The normal and model control groups were administered with equal volume of aqueous solution. Thirty days later,rats were sacrificed by anesthesia. Livers were obtained to detect TGF-β1 gene and protein expressions by RT-PCR and Western-Blot. Results Relative gene expression of TGF-β1 in the normal control,model control,glucyrrhizin aqueous and flavonoids groups was 0. 725±0. 130,7. 493±1. 410,3. 016±1. 240,and 2. 668±1. 150,respectively. Total flavonoids from portulaca significantly reduced the gene (P<0. 01) and protein (P<0. 01) expressions of TGF-β1 . Conclusion Efficacy of total flavonoids from portulaca in treating hepatic fibrosis may be related to decreased TGF-β1 expression in rats.

Objective:To analyze the influences of azithromycinantibiotic combined glucocorticoids on the levels of erythrocyte sedimentation rate (ESR),serum lactate dehydrogenase (LDH) and inflammatory cytokines levels as well as the clinical effect of severe pneumonia mycoplasma.Methods:112 children with severe pneumonia mycoplasma who were treated in our hospital were selected and randomly divided into the control group and the observation group with 56 cases in each group.The patients in the control group were treated with azithromycinantibiotic,while the patients in the observation group were treated with glucocorticoid on the basis of the control group.Then the levels of ESR,LDH,isoenzyme MB (CK-MB),creatine kinase (CK),aspertate aminotransferase (AST),c-reactive protein (CRP),interleukin 6 (IL-6),tumor necrosis factor-o (TNF-α),CD4+ and CD8+,the clinical efficacy and adverse reactions between two groups were observed and compared before and after the treatment.Results:The effective rate in the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).After treatment,the levels of ESR,LDH,CK-MB,CK,AST,CRP,IL-6,TNF-α and CD8+ in the two groups decreased,which were lower in the observation group than those of the control group (P＜0.05).After treatment,the levels of CD4+ in both groups increased,which was higher in the observation group than that of the control group (P＜0.05).The disappearance time of fever,cough relief,lung rale of observation group were shorter than those of the control group(P＜0.05).There was no statistically significant difference in the adverse reactions between the two groups (P＞0.05).Conclusion:Azithromycin combined with glucocorticoids was more effective than azithromycin alone in the treatment of severe mycoplasma pneumonia with high safety,which could obviously relieve the myocardial injury and inflammatory response,enhance the immune function.

Objective: To determine the potential diagnostic value of miRNA-29 (miR-29) for malignant tumor. Methods: A systematic search of literature regarding miR-29 was performed in three English databases (PubMed, Web of Science, and Embase) and two Chinese databases (Chinese National Knowledge Infrastructure [CNKI] and WanFang). The retrieval was ended until September 15, 2018. Search terms included miRNA-29 (miR-29), tumor, cancer, serum, plasma, diagnosis, etc. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was carried out to evaluate the quality of the selected articles. STATA12.0 was used to calculate the combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR). Subgroup analysis and Meta-regression analysis were carried out to explore the origin of heterogeneity. Results: Twenty eligible articles were selected from 1 172 literatures related to tumors and miR-29. The combined sensitivity was 0.76 (95%CI: 0.68-0.83), combined specificity was 0.83 (95%CI: 0.74-0.89), combined PLR was 4.5 (95%CI: 2.7-7.4), combined NLR was 0.28 (95%CI: 0.20-0.41), DOR was 16 (95%CI: 7-35), and theAUC was 0.86 (95%CI: 0.83-0.89). The combined specificity of plasma samples was higher than that of serum samples, and the difference was statistically significant (P<0.01). There was a higher diagnostic value of miR-29 for breast cancer and pancreatic cancer (DOR=101.52, 11.22), but lower diagnostic value for colorectal cancer and non-small cell lung cancer (DOR=5.05, 6.57); miR-29b showed a high diagnostic value for cancer (DOR=60.91). The publication bias was not obvious in this study (P>0.05). Conclusion: This systematic review and Meta-analysis suggests that miR-29 family is a potential biomarker in the diagnosis of cancers with great sensitivity and specificity.

A case of ulerythema ophryogenes (UO) is reported.A 12-year-old boy presented with erythema and follicular papules on the eyebrows and cheeks for 7 years.The lesions started as follicular papules surrounded by erythema,then spread symmetrically to the cheeks and forehead followed by the loss of eyebrows.There was no complaint of pruritus.Physical examination showed pinhead- to grain-sized,smooth,slightly indurated follicular hyperkeratotic papules surrounded by erythematous halo on the eyebrows,forehead and cheeks.Both eyebrows were nearly completely lost.Histological analysis of lesions from eyebrows revealed dilated follicular infundibulum with orthokeratotic plugs,sparse perivascular and perifollicular lymphohistiocytic infiltrate,widened and sclerotic collagen fibers in the dermis.According to the clinical manifestations and histopathological findings,the patient was diagnosed with ulerythema ophryogenes,and given oral vitamin A 2.5 million unit once a day,vitamin E 100 mg once a day,topical vitamine E cream twice a day,0.025％tretinoin ointment once at night.Two weeks later,the lesions improved.

Objective:To examine the pathological change and intima thickness of thoracic aorta, detect the serum concentration of hypoxia-inducible factor-1α(HIF-1α), oxidized LDL (ox-LDL), and pentraxin 3 (PTX3) in the rat model of chronic intermittent hypoxia (CIH), and to determine the effect of CIH on endarterium injury and its possible pathway.Methods:Twenty-four male Sprague-Dawley (SD) rats were divided into 4 groups:a CIH+N-acetylcysteine (NAC) group, a CIH+normal saline (NS) group, a CIH control group and a control group. CIH rats were subjected to alternating cycles of hypoxia (6%-8%O2 in N2 for 20-25 s) and normoxia (21%O2 in N2 for 2 min) every 180 s for 7 h/d. Rats in the control group were not treated. Rats in the CIH+NAC group were treated with NAC [800 mL/(kg.d)] intraperitoneal injection, and rats in the CIH+NS group were treated with NS [5 mL/(kg.d)] intraperitoneal injection. Atfer 42 day treatment, the rats were sacriifced, blood taken, and thoracic aorta cut off. hTe serum concentration of HIF-1α, ox-LDL, and PTX3 were detected by ELISA. hTe thickness of intima was taken by computer digital image analysis. Results:Vascular endothelial cell injury and detachment were found in the thoracic aorta in the CIH and the CIH+NS group. The intima in the CIH and the CIH+NS group was thicker than that in the control and the CIH+NAC group (P<0.001). The serum concentration of HIF-1α, ox-LDL, and PTX3 in the CIH and the CIH+NS group was higher than that in the control and the CIH+NAC group (P<0.001). The serum concentration of HIF-1α, ox-LDL, and PTX3 was pairwise positive correlation, and the serum concentration of ox-LDL and PTX3 was positively correlated with the thickness of intina (P<0.001). Conclusion:hTe vascular endothelial cell injury and endarterium thickening can be induced by CIH. It is an important pathway that CIH activates oxidative stress and elevates the levels of HIF-1α, ox-LDL, and PTX3.