Hand,foot and mouth disease(HFMD) is a common acute infectious disease in children caused by intestinal viruses.The severe HFMD,mostly caused by enterovirus 71,can lead to meningitis,encephalitis,encephalomyelitis,pulmonaryedema,irculation disorder and high fatality.To investigate the research progress of pathogenesis,hysiopathology,immunoassay and diagnosis of severe HFMD can provide references to the clinical prevention and treatment.

Objective To examine changes infibrinogen (FIB),D-dimer and homocysteine (HCY) levels and their significance in patients with cerebral small vessel disease (CSVD).Methods This was a prospective study consecutively recruiting 116 patients with CSVD from January 2015 to August 2016 at the Second Affiliated Hospital of Bengbu Medical University,including 50 patients with lacunar infarction and 66 patients with leukoaraiosis.As a control group,89 age-matched healthy elderly individuals were enrolled in the study.FIB,D-dimer and HCY levels in the groups were measured and compared.Results Serum FIB,D-dimer and HCY levels in CSVD patients,including the lacunar infarction group and the leukoaraiosis group,were all significantly higher than in the control group[(3.3±0.9)g/L vs.(3.3±1.0)g/L vs.(3.3±0.8)g/L vs.(2.6±0.5)g/L,(631.1± 487.1)μg/L vs.(479.2 ± 277.6)μg/L vs.(750.2 ± 577.4)μg/L vs.(202.8±81.7)μg/L,(20.6 ± 12.8)μmol/L vs.(14.4 ± 4.8) μmol/L vs.(25.4 ± 15.0)μxmol/L vs.(12.8 ± 4.6) μmol/L,all P ＜ 0.05)].Multiple Logistic regression analysis showed that FIB,D-dimer and HCY were independent risk factors for CSVD (P＜0.01).Additionally,multiple regression analysis of lacunar infarction and leukoaraiosis showed that HCY had no significant correlation with lacunar infarction (P ＞ 0.05).Conclusions FIB,D-dimer,HCY may be risk factors for cerebral small vessel disease,which may not carry the same weight for lacunar infarction and leukoaraiosis.

Cerebral small vessel disease (CSVD) refers to the syndromes of clinical,cognitive,radiographic and pathological manifestations caused by intracranial small vessel disease.Due to the insidious onset of CSVD,unknown etiology,diverse clinical manifestations,and better short-term prognosis,it is easily ignored,resulting in misdiagnosis,missed diagnosis,and non-standard diagnosis and treatment.This article reviews the advances in research on clinical manifestations,imaging features,diagnosis and treatment of CSVD.

Objective To investigate the stability of control preparation of blood cells after un-sealing. Methods One vial of red blood cell control preparation was aliquoted in fifteen round bottom centrifuge tube with covers stored at 2-8 "C. Aliquots were tested respectively in modes of whole blood and pre-dilution each day. The test results were filled in the quality control chart. The quality control i- tems included hemoglobin (Hb), mean cell volume (MCV), hematocrit (HCT), white blood cells (WBC) ,red blood cells (RBC) and platelets (PLT). The stability of the blood cell control preparation was also dynamically observed for 15 days with a non-aliquot standard preparation. Results There were no significant differences in the test results among the aliquots tested from day 1 to day 15. The PLT count was significantly increased for the non-aliquoted vial on day 7 (P<0.05). The coefficientvariation (CV) of test results for pre-dilution specimens was 1.3 to 5.5 times as that for whole blood specimens. Conclusion The aliquots of blood cell control materials has the potential to remain viable for at least 15 days under the temperature of 2 ℃-8℃. The whole blood dilution method has preferable reproducibility and accuracy.

Through its high affinity with membrane receptors, growth factors promote tumor growth, metastasis and an-giogenesis, induce the change of tumor microenvironment and regulate immune response. It has been demonstrated that the serum protein levels of epidermal growth factor and its receptor, transforming growth factors and their receptors, insu-lin-like growth factors, and angiogenesis factors may have predictive value for metastasis and prognosis of breast cancer. Detecting serum levels of growth factors and their receptors which have synergistic effect or interaction with each other may be helpful for predicting the metastasis and progression of breast cancer.

Fairness, which is of special importance to health economy policies, has the following three major implications: fairness of the state of health, fairness of the delivery of health services and fairness of health fundraising. Traditional methods for measuring fairness include those of range, Lorentz curve, Jeany coefficient, difference index, and, for measuring unfairness, those of slope index, relative index and comprehensive curve. Recently WHO put forward 3 new fairness indexes and measurement methods, viz. measuring the fairness of residents health via the distribution index of child survival rate and disability adjusted life expectancy; measuring the fairness of the delivery of health services via reactivity; and measuring the fairness of health fundraising via the fairness and reasonableness index for the contributions of funds.

Objective To explore the application value of calcium hydroxide agent in root canal disinfection of patients with chronic periapical periodontitis in stomatology department.Methods 108 cases patients with chronic periapical periodontitis from June 2013 to June 2014 in Cixi Guanhaiwei Zhen Health Centers were randomly divided into study group (n =54) and control group (n=54).The control group received camphor phenol cotton for root canal disinfection, and study group received calcium hydroxide agent.The clinical curative effect between two groups was compared.Results After 7 days’ treatment, the total effective rate was 98.15%in study group, which was significantly higher than 79.63%in control group (χ2 =9.375,P<0.05).After follow up 6 months, the total effective rate was 94.44%in study group, which was significantly higher than 77.78%in control group (χ2 =6.271,P<0.05).The incidence of endodontic interappointment pain (EIP) in study group was 11.11%, which was significantly lower than 25.93%of control group (χ2 =3.93,P<0.05).Conclusion Calcium hydroxide agent has a significant efficacy on in root canal disinfection of patients with chronic periapical periodontitis in stomatology department, could reduce the incidence of EIP and promote healing of chronic periapical periodontitis, which is the first disinfectant in the stomatology department of primary hospital.

Objectives To grasp the situation and fluctuation tendency of Keshan disease in Qujing City,and to scientifically evaluate the control effect of Keshan disease.To provide scientific basis for elimination of Keshan disease in the 12th Five-Year Plan.Methods Cardiomyopathy cases of the past three years were searched,screening suspected cases of Keshan disease.And according to the National Surveillance Program of Keshan Disease (Trial),In Qujing City,2 Keshan disease counties (Huize,Qilin) were selected to carried out focused monitoring,1-2 endemic townships with more patients were selected based on total numbers of cases in each county,1 village with more patients was selected in each township as a monitoring site,the residents of the monitoring sites were examined clinically and electrocardiographic (ECG) tracings recorded and suspicious patients were taken chest radiograph and color Doppler ultrasound echocardiography.Diagnosis was based on the Diagnostic Standard for Keshan Disease.Results Totally 300 cases of cardiomyopathy were found,10 cases were suspected Keshan disease,0 cases of Keshan disease was diagnosed in 2009-2012.In the three villages of the two counties monitored,3 cases of potential Keshan disease were detected of the 1 505 villagers,the detection rate was 0.20％;62 abnormal ECG were found,the abnormal rate was 4.12％.Chest X-ray examination was done in 3 people,cardiothoracic ratio of 0.50 or less were 2 people,and 0.51-0.55 was 1 person.Conclusion The prevalence of Keshan disease in Qujing City is low,but the pathogenesis of Keshan disease remains,therefore,monitoring and intervention of children Keshan disease should be strengthened.

Objective To investigate and compare the clinical value of the elastic grades score evaluation method and ultrasound elasticity imaging strain ratio method in identifying thyroid nodules.Methods A total of 120 cases confirmed by operation and pathology of the patients with thyroid nodules in our hospital were underwent ultrasound elasticity imaging detection,the thyroid nodules were identified with the elastic grades score evaluation method and ultrasound elasticity imaging strain ratio method respectively,and were compared with pathological results separately.Results The sensitivity,specificity and accuracy rate were 79.4％,81.3％,81％ with the elastic grades score evaluation method,the sensitivity,specificity and accuracy rate were 91.2％,90.3％,93.3％ with ultrasound elasticity imaging strain ratio method,of which was significantly higher with ultrasound elasticity imaging strain ratio method than with the elastic grades score evaluation methodby statistical analysis(x2 =28.170,P =0.000;x2 =34.219,P =0.000; x2 =17.928,P =0.000).Conclusion Ultrasound elastography strain ratio and rating score evaluation method can be used as an effective method in differentiating malignant from benign thyroid nodules,which can effectively improve the accuracy rate of the differential diagnosis of thyroid nodules and effectively remedy the diagnostic error band to cognitive differences with traditional ultrasound evaluation.The method of ultrasound elastography strain rate ratio was better with advantages of easy to operate,easy to learn and master,and easily accepted by patients,which is worthy of clinical application.

Objective To explore the development of the research on professional thinking of clinical medicos in China with the purpose of revealing its bibliometric characteristics and rules.Methods With medico and professional thinking taken as the subject terms,relevant literature published in January 2014 was retrieved from CNKI and Wanfang database in reliance on subject retrieval strategy,and then,literature was screened after the enactment of inclusion and exclusion criteria.Finally,all pieces of the included literature were analyzed by bibliometric method.Results Finally,53 papers were included in the paper,among which there were 30 (56.6％) articles published in the year 2007-2014,and priority was given to empirical research;Besides,the research topics were scattered,involving 29 (54.7％) articles of professional attitude,26(49.1％) articles of learning attitude,13 (24.5％) articles of political thought,16 (30.2％) articles of employment and employment,4 (7.5％) articles of medical ethics,12 (22.6％) articles of the idea of professional education,4 (7.5％) articles of the idea of professional,and 21 (39.6％) other topics.Conclusions China hasn't developed a system for the research on the professional thinking of clinical medicos in terms of re-search contents,or elevated the analysis on research result to theoretical level.