The virus of hand, foot and mouth disease(HFMD) damages nerve system.Brainstem is the main site and has some specific receptors.Severe HFMD has a high mortality.The main causes of death are cardiopulmonary and brain failure, so it is very important that risk factors of severe HFMD are timely judged and treated. Pulmonary edema of severe HFMD is mainly caused by neurological damage. At present, although it has still no standardized treatment scheme, the diagnosis and treatment for different stages have a significant effect.

The transport of critical neonates has a high mortality. To reduce the mortality, it is very important to determine the transport indications in advance. Additionally, the neonatal transport is also based on the industrial training, the transport team combined by a variety of profession, the uniform and standard transport equipment and so on. Therefore, this article mainly reviews the education training, team, equipment, indications, the latest skill, air transport and so on.

Objective To study the distribution and changes of the purulent meningitis in gender,age,region,season and pathogens in children during the past 20 years.Methods All the basic clirical features of purulent meningitis patients less than 17 years old in Children's Hospital of Chongqing Medical University from Jan.1993 to Jan.2013 were analyzed retrospectively.A total of 1 855 patients were divided into 2 groups according to their date of admission.Group A included 666 patients admitted from Jan.1993 to Dec.2002,and group B included 1 189 cases admitted from Jan.2003 to Jan.2013.Then,they were divided into 5 groups according to their ages,including neonate group,＞ 1 month-1 year old aoup,＞ 1-3 years old group,＞ 3-10 years old group,＞ 10-17 years old group.Results Of the 1 855 cases,there were 1 054 cases (56.82％) admitted in the spring and summer,and 1 123 cases (60.54％) were younger than 1 year of age.The ratio of male to female cases was 1.82 to 1.00 and that of country patients to urban patients was 1.40 to 1.00.The distributions were female patients (443 cases,37.26％),urban patients (517 cases,43.48％),and the ratio of patients admitted in the autumn (265 cases,22.29％) and patients younger than 1 year of age (606 cases,50.97％) in group B,which were significantly higher than those [215 cases (32.28％),256 cases (38.44％),102 cases (15.32％),272 cases (40.84％)] of group A (x2 =4.62,4.47,25.51,25.52,all P ＜ 0.05).The predominant isolated bacteria from cerebrospinal fluid were coagulase negative staphylococcus (43/196 cases,21.94％),Streptococcus pneumoniae (32/196 cases,16.33％),Neisseria meningitidis (17/196 cases,8.67％) and Escherichia coli (15/196 cases,7.65％).Coagulase negative staphylococcus and Escherichia coli both accounted for higher rates of pathogenic bacteria in 1 year old than that of pathogenic bacteria more than 1 year old (x2 =4.57,14.37,all P ＜ 0.05),while Streptococcus pneumoniae and Neisseria meningitidis both had higher rates of pathogenic bacteria more than 1 year old and more than 3 years old,respectively (x2 =14.93,19.76,all P ＜ 0.05).Onfly cases in group B with Streptococcus pneumoniae were higher than those in group A (x2 =11.78,P ＜ 0.05),while the other common bacteria in each age group were of no difference between group A and group B.Conclusions There had been some changes in the epidemiological distribution of purulent meningitis during the past 20 years.The main risk factors were male in gender,patients in rural areas,onset in the spring or summer and infants in early age.The predominant isolated bacteria from cerebrospinal fluid were some opportunistic pathogens,including coagulase negative staphylococcus,Streptococcus pneumoniae,and Escherichia coli.Streptococcus pneumoniae meningitis was increased during the past 10 years.

Objective To explore the value of MSCT enhanced scanner in diagnosis and differential diagnosis of spleen tumor. Methods The MSCT enhanced feautures of 23 cases of spleen tumor proved by imaging examination,follow-up and pathologically were anlayzed retrospectively,the features of MSCT enhanced scanner in spleen tumor were analyzed.Results All cases included 12 benign tumor (5 cysts,6 hemangiomas,1 lymphangioma).1 1 malignant tumor(2 primary lymphomas,3 secondary lymphomas,6 metastatic tumors).Conclusion MSCT enhanced scanning for the qualitative diagnosis of spleen tumors with high value.

Lung ultrasound has been proven to have high sensitivity and specificity in the application of lung diseases, and significantly reduces the radiation exposure of children, especially in newborns, which makes it widely used in diagnosis, treatment and prognosis of childhood disease.In emergency and intensive care units, lung ultrasound can even replace chest radiographs as a routine examination method for chest lesions.However, the research of children′s lung ultrasound still falls behind the development of adult ultrasound, and there is a lack of standard procedures and specifications for children′s lung ultrasound.Therefore, this study mainly reviewed the research status of children′s lung ultrasound.

Objective This study was to examine the expression of tyrosine kinase receptor(TKRs)C-kit,C-abl and PDGFR?,in ovary carcinoma.Methods The expression of C-kit,C-abl and PDGFR? in tumor tissue of 60 specimens of ovary carcinoma and normal fissue of 20 specimens of overy was examined by immunohistochemistry SP method.Results Immunoreactivity was detected in 79% of the tumor to at least one TKR.The total positive expression rate of C-kit,C-abl and PDGFR? in ovary carcinoma was 58.3%,70%,73.3%,respectively.The positive expression rate of C-kit and PDGFR? is significantly higher in tumor tissues than in normal tissues(P

AIM:In order to study the effect of the extracellular domain of cadherin 5 on the growth of a human breast cancer cell line MDA-MB435.METHODS:Cadherin extracellular domain repeats 1 to 4(CED1-4)was cloned by using RT-PCR technique,and inserted into the plasmid vector pMSCV.pMSCV-CED1-4 was propagated in XL-blue strain of Escherichia coli,extracted and purified.CED1-4 was cut by restriction endonuclease,examined by using agar gel electrophoresis,and finally sequenced.CED1-4 gene was transferred into MDA-MB435 cell line.The expression of CED1-4 gene in MDA-MB435 cell was analyzed by methods of RT-PCR and Western blotting.The effect of CED1-4 on the growth of MDA-MB435 cell was observed by the methods of proliferation experiments in vitro and the experiments in nude mice in vivo.RESULTS:The recombinant vector pMSCV-CED1-4 was successfully constructed.CED1-4 band appeared between the 1 636 bp and 1 018 bp in agar gel electrophoresis.The sequence result showed that CED1-4 had 1 452 bp and codes 484 amino acids.PCR and Western blotting identified that CED1-4 mRNA and protein were expressed in the transfected MDA-MB435 cells.Cell proliferation experiments showed that the proliferation rate of MDA-MB435 cells was lower in the experimental group than that in the experimental control group and the blank control group.The mean volume and weight of tumors in nude mice were lower in the experimental group than those in the experimental control group and the blank control group.CONCLUSION:The growth of a human breast cancer cell line MDA-MB435 is inhibited in vitro and in vivo by cadherin 5 extracellular domain CED1-4.

Objective To investigate the effects of IL-13 on fibrosis in hepatic stellate cells and its molecular mechanism .Methods The effects of IL-13 on the proliferation of hepatic stellate cell line LX-2 were measured by MTT assay .The transcription level of collagen typeⅠ( COLⅠ) in LX-2 cells was detec-ted by RT-PCR.The secretion of COLⅠin LX-2 cells was measured by ELISA assay and hydroxyproline as-say.Western blot assay was used to analyze the effects of IL-13 on the phosphorylation of signal transducer and activator of transcription(STAT6).Results Compared with control group, IL-13 (10 ng/ml, 20 ng/ml and 50 ng/ml ) significantly stimulated the proliferation of LX-2 cells in a dose-dependent manner ( P<0.05).The expression of collagen typeⅠin LX-2 cells at mRNA and protein levels were significantly up-regulated by IL-13 at a concentration of 50 ng/ml (P<0.05), but not affected by IL-13 at low concentra-tions (5 ng/ml, 10 ng/ml, and 20 ng/ml) (P>0.05).The expression of phosphorylated STAT6 protein in LX-2 cells was significantly enhanced upon the stimulation with 50 ng/ml of IL-13 ( P<0.05 ) for60 min or 120 min.C onclusion IL-13 promoted the proliferation of human hepatic stellate cells and up-regulated the expression of COLⅠat mRNA and protein levels .IL-13 might promote the fibrosis in human hepatic stellate cells through activating STAT 6 phosphorylation .

Objective To investigate the data of gene expression microarray by protein interaction network analysis,establish an interaction network of differentially expressed genes between Kashin-Beck disease (KBD) and osteoarthritis (OA) and choose the central nodes of the network.Methods The articular cartilage samples of degrees Ⅱ ° and Ⅲ ° KBD and OA patients were selected according to the national diagnosis criteria for KBD and the Western Ontario and McMaster Universities (WOMAC) for OA.Chondrocytes of 8 patients with KBD and 7 with OA were selected.About 1 000 different genes detected by gene expression microarray were inputted into STRING 9.1 database online for analysis and establishment of the interaction network.The interaction data were imported into Cytoscape 3.2.1 software for screening the central nodes of the network.KEGG database was exploited for pathway analysis and functional study of the central node genes,Real-time PCR (RT-PCR) was used for verification.Results The protein products of 334 differentially expressed genes between KBD and OA had interrelation,forming a complicated interaction network.About 150 central nodes were selected by Cytoscape 3.2.1 that involved in more than ten signal pathways involved in mitochondria,bone metabolism and inflammatory cytokine.Conclusion The interaction network of the differentially expressed genes between KBD and OA,especially the central nodes of this network,can provide clues to the mechanism and early diagnosis and molecular targeted therapy of KBD and OA.

Objective: To evaluate the predictive value for baseline levels of high sensitivity C-reactive protein (hs-CRP) in morbidity of pulmonary embolism (PE). Methods: We conducted a prospective cohort study of 101510 subjects in Kailuan Group by regular physical examination from 2006-07 to 2007-10, and 94314 subjects were enrolled by relevant criteria including 75252 male and 19062 female. The baseline levels of hs-CRP were divided by quartile levels as①hs-CRP<0.3l mg/L,n=25592,②hs-CRP (0.3l-0.77) mg/L,n=21746,③hs-CRP (0.78-1.9) mg/L,n=23504 and④hs-CRP≥2.0 mg/L,n=23472. The subjects were followed-up for (81.5 ± 4.76) months, the morbidity of PE was collected and the predictive value of baseline levels of hs-CRP for PE occurrence was evaluate by multivariable Cox proportional hazard regression analysis. Results: The total PE morbidity was 0.15%, the female subjects were similar with male subjects,P>0.05. As the increased baseline level of hs-CRP, PE occurrence was elevated accordingly,P<0.05. Multivariable Cox proportional hazard regression analysis presented that with adjusted age, gender, smoking, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), fasting blood glucose (FBG), neutrophile granulocyte (NEU), white blood cells (WBC) and heart rate (HR), the subjects in the highest quartile group had 2.84 times higher risk for PE occurrence than the subjects in the lowest quartile group. With the elevated baseline level of hs-CRP, the subjects’ mean age, BMI, SBP, FBG and NEU levels increased accordingly, allP<0.05; while DBP, TG and HR were similar between quartile③ and quartile④ groups, allP>0.05. WBC counts had the increasing trend in quartile①,②,③ groups and had the decreasing trend in quartile④ group, while it was similar between quartile③ and quartile④ groups,P>0.05. Conclusion: Baseline hs-CRP level may predict the risk of PE morbidity; the increased hs-CRP level could be used as one of the predictors for PE occurrence.