Pneumococcal meningitis is one of the most common infectious diseases of the central nervous system in pediatric period which is characterized by acute fever,unconvulsions,consciousness,in-creased intracranial pressure and meningeal irritation and cerebrospinal fluid pus changes in clinic. With the advent of antibiotics and pneumococcal vaccination,the morbidity and mortality of the disease decline signifi-cantly. But due to the appearance of drug-resistant bacteria and the relative lag of research and development speed of clinical new antibacterial drugs,it still has high mortality and morbidity which are promoting resear-ches of pathogenesis and adjuvant therapy. In this paper,researches of pathogenesis and adjuvant therapy for preumococcal meningitis were reviewed in recent years.

Objective: To study the effect of Shenxiong Xintong Pill(SXP) on cardiac hemodynamics. Methods: Parameters of cardiac hemodynamics were examined in anesthetic chest-opened dogs medicated with various doses of SXP. Results: After intraduodenal administration of SXP of 2.0g/kg, the coronary blood flow was raised, coronary resistance decreased, heart rate slowed and the left ventricular diastolic end pressure fallen in the dogs. No obvious changes were found in the contraction , works and ejection of left ventricle. Conclusion: The mechanism of SXP in relieving angina pectoris was probably related to the dilatation of coronary artery and increase of coronary flow with the increase supply of oxygen.

Objective To establish a 29 Y-STRloci multiplex PC Rsystemfor investigating the genetic polymorphisms and to assess its application value in forensic science. Methods Amultiplex PC Rsystemw as established using a five color fluorescence labeling 29 Y-STRloci (DYS456, DYS389Ⅰ, DYS437, DYS447, DYS389Ⅱ, DYS438, DYS522, DYS460, DYS458, DYS622, DYS390, DYS392, DYS448, DYS449, DYS391, Y-GATA-H4, DYS388, DYS19, DYS385a/b, DYS527a/b, DYS393, DYS459a/b, DYS635, DYS439, DYS570 and DYS627) for multiple amplification and capillary electrophoresis. And its applicability w as validated w ith genetic polymorphismdata of 29 Y-STRof unrelated 2 000 male samples in Shandong Han population. Results Atotal of 1981different haplotypes of 2 000 individuals show ed genotype diver-sity betw een 0.370 0 and 0.965 4. The systemprovided stable and accurate typing w ith high sensitivity of 0.05 ng. It satisfied the needs of variety of routine biological samples. Conclusion The 29 Y-STRloci multiplex PC Rsystemcould be applied for actual cases and establishment of Y-STRdatabase. In addi-tion, it has great significance in forensic science practices and related research.

Objective To establish effective method for large-scale purification of islet cells from pig pan-cress. Methods Pig pancreas tissue was digested with collagenase P followed by purification in a HCA-Fi-coil dis continuous gradient using Cobe2991 cell separator. After isolation, the islet cell yield and purity were evaluated with light microscope with DTZ staining, and the islet function assessed by insulin release as-say in vitro. Results The number of the islets coll ected from each pancreas averaged (275 000±20 895)islet equivalents (IEQ) before purification, and (230 350±26 679) IEQ after the purification with discon-tinuous gradient centrifugation. From each gram of the pancreatic tissue, (2710±229) IEQ were obtained with an average purity of (50.2±1.95) %. The purified islets responded well to high-concentration (16.7 mmol/L) glucose stimulation with a 4. 74-fold increase of insulin secretion over the basal level (3.3 mmol/L, P <0.001). Conclusion The established method can be applicable for large-scale purifi-cation of fully functional islet cells from pig pancreas.

Objective:To explore the use of internet-based continuous visual recognition task (MemTrax test, MTX) as a rapid screening tool for amnestic mild cognitive impairment (aMCI).Methods:Sixty-four patients with aMCI and 64 individuals with normal cognition as healthy controls were enrolled respectively from Department of Neurology and Health Examination Center of the First Affiliated Hospital of Kunming Medical University from August 2018 to December 2019. Montreal Cognitive Assessment (MoCA) scale and MTX were adopted to assess the cognitive function of all subjects. The total adjusted MoCA scale score, correct rate of MTX, reaction time of MTX and MTX score were obtained and statistically analyzed.Results:The adjusted MoCA scale scores of aMCI patients and healthy controls were 19 (14, 24) and 26 (24, 27; Z=6.795), the correct rate of MTX of aMCI patients and healthy controls were 74% (60%, 80%) and 88% (84%, 94%; Z=8.359), and the MTX score of aMCI patients and healthy controls were 51.11±14.07 and 70.56±14.91 ( t=7.590), respectively, all with statistically significant difference ( P<0.001). Reaction time of MTX of aMCI patients and healthy controls was 1.401 (1.253, 1.590) s and 1.277 (1.163, 1.410) s, respectively ( Z=3.083, P<0.01). After adjustment for age, physical or mental occupation, exercise, hypertension, hyperlipidemia, stroke, sleep time, as well as smoke, the linear regression showed that the aMCI patients had a significant decrease of adjusted MoCA score, correct rate of MTX and MTX score ( P<0.001), and an extension of reaction time of MTX ( P=0.071), compared with the controls. By MTX and MoCA scale assessment, the best cutoff value was 81% for correct rate of MTX and 23 for adjusted MoCA scale score respectively for the prediction of aMCI (with sensitivity of 79.7%, 93.8% respectively, and specificity of 68.8%, 82.8% respectively). The area under the curve (AUC) of correct rate of MTX was 0.93 (95% CI 0.89-0.97, P<0.001), and the AUC of adjusted MoCA score was 0.85 (95% CI 0.78-0.91, P<0.001). There was a statistically significant difference in paired comparison of the two AUCs (χ2=4.620, P<0.05). Conclusion:MTX acts better for the detection of aMCI than MoCA scale, and correct rate of MTX<81% can be considered as the existence of MCI.

Objective The aim of this study was to investigate the application of low molecular weight heparin combined with alteplase for thrombolysis in patients with acute myocardial infarction(AMI),and to compare its thrombolysis effect with traditional anticoagulant-general heparin. Methods 35 AMI patients with alteplase intravenous thrombolytic therapy were divided into two groups,among which 15 cases in the study group were treated with 30 mg enoxaparin instant intravenous injection before thrombolysis,40 mg enoxaparin hypodermic injection 15 minutes after thrombolysis,40 mg enoxaparin hypodermic injection every 12 hours for 5 days. The other 20 cases were assigned to the control group and treated with 4 000 u(or 60 u/kg)general heparin instant intravenous injection,then pumped general heparin intravenously in the rate of 800-1 000 u/h. Meanwhile,detected coagulation convention every 3 hours and adjusted the dose of heparin according to the activated partial thromboplastin time(APTT)to keep APTT value within 1.5 to 2.0 times(50-70 s)the standard value. 48 hours later,patients in the control group was given hypodermic injection of 40 mg enoxaparin every 12 hours for 5 days. All cases were given regular treatment as guidelines recommended. Results The patency rate of infarct-related coronary artery assessed by unified clinical criteria was 86.66% and 65.00%,and the average recanalization time was(1.62±0.36)h and(1.81±0.33)h in the study and control groups,respectively. There were no significant differences on patency rate and recanalization time between the two groups(P > 0.05). One case of bleeding complication occurred in the study group(6.66%),while five cases occurred in the control group(25.00%). In the two groups,no cases appeared intracranial hemorrhage and other serious or fatal bleeding occurred. Conclusion The clinical efficacy of low molecular weight heparin was non-inferior to general heparin in AMI patients with alteplas thrombolysis. The application of low molecular weight heparin was simple and easy to operate. It can optimize the procedure of thrombolysis,reduce repetitive coagulation index monitoring and lessen clinical workload,which is worth being promoted to primary hospital and the emergency systems.

Objective To probe into the efficacy and nursing intervention method for simple rib fracture treated by Skeleton Muscle Disease Healing Membrane(SMDHM)combined with TDP irradiation. Methods 120 patients with rib fracture were randomly divided into treatment group and control group. For the treatment group,the patients stuck SMDHM to the place of rib fracture,and then were treated by TDP irradiation. The control group was treated by the conventional method of fixation by rib bandage. Results The fracture healing time of treatment group was short, and antaigic effect was prominent. While, the healing time of control group was long and antaigie effect was poor. For the efficacy observation of the two groups,the statistical difference was extremely significant(P< 0.05). Conclusion The efficacy of SMDHM combined with TDP irradiation for fib fracture is distinctly superior to conventional method. This new treatment is simple,practical and economical, and is easily accepted by patients. Therefore it's worth extensively popularizing in the clinic application.

OBJECTIVE: To carry out genetic testing for two families affected with cobalamin C (cblC) and establish a rapid method for the detection of a hotspot pathogenic variant c.609G>A of the MMACHC gene by using a PCR-high-resolution melting curve (PCR-HRM) method. METHODS: Genomic DNA was extracted from peripheral blood samples of the probands and their parents. Potential variants of the MMACHC gene was analyzed by Sanger sequencing. The c.609G>A variant of the MMACHC gene was screened among 100 healthy children with the PCR-HRM method. RESULTS: Sanger sequencing revealed that proband 1 carried compound heterozygous variants c.394C>T and c.609G>A of the MMACHC gene, while proband 2 carried compound heterozygous variants c.482G>A and c.609G>A of the same gene. PCR-HRM analysis of the two probands and the 100 healthy children were consistent with the Sanger sequencing. CONCLUSION c.609G>A is a hotspot pathogenic variant of the MMACHC gene. The diagnosis of cblC may be rapidly attained through detection by PCR-HRM.

OBJECTIVE: To analyze the clinical and molecular characteristics of a child with very long chain acyl-CoA dehydrogenase deficiency (VLCADD). METHODS: Peripheral blood sample of the patient was collected for the extraction of genomic DNA. Next generation sequencing (NGS) was carried out for the proband. Suspected mutations were validated by Sanger sequencing. RESULTS: The patient, a 12-month-old girl, was admitted for diarrhea, vomiting, fever, poor spirit and decreased blood pressure. During the course of the disease, she also manifested hypertrophic cardiomyopathy, cardiogenic shock, elevated myocardial enzyme kinase, fever and metabolic acidosis, and had died after three days due to ventricular tachycardia and respiratory failure. Genetic testing showed that she has carried heterozygous mutations of of the ACADVL gene, namely c.664G>A (exon 8) and c.1056_1057del (exon 10). Blood screening for metabolic genetic diseases showed increased C12, C14, C16, C18, C14:1, C14:2, C16:1, C4/C3 and C8/C3, accompanied with decreased C0, C0/C16 and C8/C10. VLCADD and secondary carnitine deficiency could not be excluded, which was in keeping with the result of genetic testing. CONCLUSION The child was diagnosed with VLCADD, which may be attributed to the compound heterozygous c.664G>A and c.1056_1057del variants of the ACADVL gene.

Objective To observe the clinical effects of ultrasound-guided median nerve block on carpal tunnel syndrome.Methods A total of 40 patients (69 hands,aged 33-61 years,ASA Ⅰ or Ⅱ,were randomly assigned into ultrasound group (group U) and control group (group C),20 cases in each.The ultrasound group underwent ultrasound-guided median nerve blocking,while the control group did through by anatomic landmark palpation.3 ml of 4.5 mg bupivacaine,5 mg triamcinolone acetonide and 100 μg vitamin B12 was injected in a single shot in the two groups.Symptoms and functions were evaluated by Boston carpal tunnel questiormaire (BCTQ) at the onset and after the treatment.Electrophysiological parameters were recorded at the time of pretreatment and post-treatment.Cases receiving two or more and side effects were also recorded.Results Both the symptom severity scale (SSS) and funcational status scores(FSS) of the BCTQ showed significant decrease 1 month after treatment in the two group (P＜0.05).Compared with group C,SSS of group U showed a significant decrease (P＜0.05),while there was no significance difference in FSS.Compared with pretreatment,MDL,SDL3 showed a significant decrease and SNCV showed significant increase 1 month after treatment in the two group (P＜0.05),while there was no significant change in the MNCV.SNCV was quicker in group U than in group C at 1 month after treatment (P＜0.05),while other electrophysiological parameters were not significantly different between the two groups.Less cases with treatment times≥2 and less side effects were found in group U than in group C (P ＜ 0.05).Conclusion Median nerve blocking under ultrasound guidance effectively improves the symptom in patients with carpal tunnel syndrome and reduces complications.