Objective To explore the clinical significance of detecting hand-foot-and-mouth disease (HFMD) children's cardiac enzymes and neuron-specific enolase (NSE).Methods One hundred and fiftytwo HFMD children were selected as observation group,and 56 cases of healthy children were selected as control group.Cardiac enzymes and NSE levels were compared between two groups.Results The levels of aspartic transaminase(AST),creatine kinase(CK),creatine kinase isozyme-MB(CK-MB),lactate dehydrogenase (LDH),alpha-hydroxybutyric dehydrogenase (α-HBDH),and NSE in observation group were (40.4 ± 14.8)U/L,(109.9 ± 87.5) U/L,(47.0 ± 29.4) U/L,(316.9 ± 119.2) U/L,(256.2 ± 96.1) U/L,(30.9 ± 18.2) μ g/L,and in control group were (24.5 ± 9.2) U/L,(77.4 ± 32.5) U/L,(15.4 ± 7.4) U/L,(134.0 ± 34.4) U/L,(131.1 ± 37.7)U/L,(9.8 ± 4.6) μ g/L.The differences between two groups were statistical significance(P ＜ 0.01).Conclusion The heart and nervous system lesions of HFMD children can be found through detecting cardiac enzymes and NSE early,which provide evidence for early diagnosis and treatment.

Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.

Background Given the increasing number of patients who require dual antiplatelet (DAP) therapy and electrophysiological device (EPD) placement, perioperative antiplatelet management is a current challenge. In this study, we investigated the incidence of pocket hema-toma formation after EPD placement in patients undergoing DAP therapy or an alternative low-molecular-weight heparin (LMWH) regimen. Methods This clinical observational study was performed from July 2010 to July 2012. In total, 171 patients were enrolled in the analysis after meeting the inclusion criteria. These patients were divided into two groups: 86 patients were treated with DAP therapy at the time of device implantation, and the DAP therapy was discontinued for 5 to 7 days and replaced with enoxaparin before device implantation in the other 85 patients. Adenosine phosphate (ADP)-mediated platelet aggregation and arachidonic acid-induced platelet aggregation were tested preoperatively. We compared the incidence of pocket hematoma between the two groups and the association of pocket hematoma develop-ment with ADP-mediated platelet aggregation and arachidonic acid-induced platelet aggregation.Results The incidence of pocket hema-toma in the patients who continued DAP was lower than that in the patients who replaced the dual antiplatelet regimen with LMWH (3.49%vs. 16.47%, respectively;X2 = 6.66,P < 0.01). Among the patients who continued DAP therapies, the rate of ADP-mediated platelet aggre-gation inhibition in patients with pocket hematomas was higher than that in patients without pocket hematomas. None of the patients under-going DAP or enoxaparin therapy developed pocket infection, thromboembolic events, or other serious complications. Multiple logistic re-gression analysis revealed that LMWH therapy was an independent risk factor for the development of pocket hematoma (RR = 0.054, 95%CI = 0.012-0.251). Furthermore, patients undergoing LMWH therapy were 5.1-fold more likely to develop pocket hematomas than were DAP-treated individuals.Conclusion Continuance of DAP therapy does not increase the risk of pocket hematoma formation after EPD placement.

Objective:To investigate the value of flexible bronchoscopy and neck ultrasound in percutaneous dilatational tracheotomy (PDT) in infants.Methods:The clinical data of 24 patients, who underwent flexible bronchoscopy and neck ultrasound assisted PDT in the Center for Respiratory Intervention, Children′s Hospital Affiliated to Shandong University from December 2018 to May 2021, were retrospectively analyzed.Of the 24 cases, 12 were male and 12 female.The male to female ratio was 1∶1.The age range was 21 days to 2 years (median: 5 months). The median mass was 5.8 kg.During the PDT, neck ultrasound was used to assess the thyroid position and vascular shape of vessels.After determining the puncture approach and marking the tracheostomy site, the PDT was performed under the guidance of flexible bronchoscopy.Results:Before surgery, 19 children (79.2%) had received continuous endotracheal intubation mechanical ventilation support, 2 children (8.3%) were treated by intermittent endotracheal intubation mechanical ventilation support therapy, and 3 children (12.5%) were supported by the non-invasive ventilator.There were 9 cases (37.5%) of congenital upper respiratory tract malformation, 8 cases (33.3%) of bilateral vocal cord paralysis, 3 cases (12.5%) of upper respiratory tract neoplastic diseases, 2 cases (8.3%) of surgical evacuation difficulties, and 2 cases (8.3%) of neuromuscular disease.All 24 patients successfully completed the operation within 30 min, with bleeding volume less than 5 mL and no intraoperative complications.Conclusions:Flexible bronchoscopy and neck ultrasound can assist in the successful PDT in infants, significantly reduce the difficulty and improve the safety of PDT.

Objective:To explore the effects of home-based telerehabilitation guidance on physical function and activities of daily living for stroke patients. Methods:From September, 2015 to March, 2018, 240 stroke recovering patients from three community health service centers in Fengtai District, Beijing for outpatient rehabilitation were randomly divided into control group (n = 120) and tele-rehab group (n = 120). Both groups accepted routine rehabilitation for six months, while the tele-rehab group received telerehabilitation guidance in addition. They were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and after treatment. Results:The scores of FMA and MBI improved after treatment in both groups (|t| > 14.536, P < 0.001), and improved more in the tele-rehab group than in the control group (|t| > 2.200, P < 0.05). Conclusion:Home-based telerehabilitation guidance may enhance the effect of community-based outpatient rehabilitation for stroke patients.

Peptides are a particular molecule class with inherent attributes of some small-molecule drugs and macromolecular biologics, thereby inspiring continuous searches for peptides with therapeutic and/or agrochemical potentials. However, the success rate is decreasing, presumably because many interesting but less-abundant peptides are so scarce or labile that they are likely 'overlooked' during the characterization effort. Here, we present the biochemical characterization and druggability improvement of an unprecedented minor fungal RiPP (ribosomally synthesized and post-translationally modified peptide), named acalitide, by taking the relevant advantages of metabolomics approach and disulfide-bridged substructure which is more frequently imprinted in the marketed peptide drug molecules. Acalitide is biosynthetically unique in the macrotricyclization via two disulfide bridges and a protease (AcaB)-catalyzed lactamization of AcaA, an unprecedented precursor peptide. Such a biosynthetic logic was successfully re-edited for its sample supply renewal to facilitate the identification of the in vitro and in vivo antiparkinsonian efficacy of acalitide which was further confirmed safe and rendered brain-targetable by the liposome encapsulation strategy. Taken together, the work updates the mining strategy and biosynthetic complexity of RiPPs to unravel an antiparkinsonian drug candidate valuable for combating Parkinson's disease that is globally prevailing in an alarming manner.

Objective: To observe the evaluation function of gated equilibration ventriculography for the changes of left ventricular function in breast cancer with targeted therapy. Methods: From February 2016 to December 2017, a total of 60 female breast cancer patients (age: 28-65 (48.7±9.4) years) were included prospectively. Patients were divided into 2 groups: lapatinib combined with taxeme-based chemotherapy group (group A; n=25, age: 29-65 (47.8±11.3) years) and lapatinib monotherapy group (group B; n=35, age: 31-62 (51.1±8.5) years). All patients underwent gated equilibration ventriculography before treatment and 6/12 months after treatment. The parameters of left ventricular function including left ventricle ejection fraction (LVEF), peak ejection rate (PER), peak filling rate (PFR), 1/3 ejection fraction (EF), 1/3 filling fraction (FF), time to peak ejection rate (TPER) and time of peak filling rate (TPFR) were observed. Repeated measurement analysis of variance, independent-samples t test and Wilcoxon rank sum test were performed. Results: In group A, the PER at 12 months after treatment ((3.11±0.48) end-diastolic volume (EDV)/s) was lower than that before treatment ((3.60±0.62) EDV/s; F=3.447, t=0.60, P<0.05), while there was no statistical difference between PER at 6 months after treatment ((3.34±0.57) EDV/s) and that before treatment (t=0.51, P>0.05); the PFR at 6 months ((3.07±0.71) EDV/s) and 12 months after treatment ((2.84±0.54) EDV/s) declined significantly compared with that before treatment ((3.57±0.81) EDV/s; F=5.345, t=0.82 and 0.75, both P<0.05). In group B, the PFR at 12 months after treatment ((2.86±0.55) EDV/s) declined significantly compared with that before treatment ((3.23±0.87) EDV/s; F=3.214, t=0.84, P<0.05). The decrease of PFR at 6 months and 12 months after treatment in group A was greater than that in group B (-0.37(-0.78, 0.15) vs -0.13(-0.44, 0.17) EDV/s; z=-1.569, P<0.05). Conclusions The gated equilibration ventriculography can effectively monitor the left ventricular function of breast cancer patients after targeted therapy. PER and PFR may be more sensitive than other parameters to assess heart function changes. The lapatinib combined with taxeme-based chemotherapy can affect diastolic function more and earlier than lapatinib monotherapy.