Objective To analyze the change of serum levels of neuron‐specific enolase (NSE) and C reactive protein (CRP) and their early diagnostic value in hand‐foot‐mouth disease (HFMD) complicating encephalitis .Methods One hundred and twenty cases of HFMD and 50 healthy children(healthy control group) served as the research subjects and the HFMD cases were divided into the common HFMD group (n=70) and HFMD complicating encephalitis group (n=50) according to the clinical manifesta‐tions .The enterovirus 71 (EV71) in throat swab was detected by quantitative PCR .The NSE and CRP levels were detected by en‐zyme linked immunosorbent assay (ELISA) ,and white blood cell (WBC) count was measured by hematology analyzer .The NSE and CRP levels were compared and their diagnostic values were analyzed .Results The serum NSE and CRP levels in the HFMD complicating encephalitis group were higher than those in the HFMD common group and control group ,the differences were statis‐tically significant (P< 0 .05) ,and which in the EV71 positive group were significantly higher than those in the EV71 negative group ,the differences were statistically significant (P<0 .05) ,but WBC count had no statistically significant difference (P>0 .05) . The serum NSE level was positively correlated with the CRP level (r=0 .43 ,P<0 .01) .The area under ROC curves (AUC) and 95% CI of NSE and CRP were 0 .893(95% CI:0 .833 -0 .952) and 0 .867(95% CI:0 .799 -0 .934) ,the optimal operating points (OOP) were 11 .6 ng/mL and 14 .15 mg/L respectively ,the sensitivity and specificity of NSE and CRP for diagnosing HFMD com‐plicating encephalitis were 80 .0% ,86 .00% and 81 .4% ,78 .6% respectively ,while which of their combined detection were 88 .0%and 85 .7% ,AUC and 95% CI was 0 .927(95% CI:0 .845-0 .969) .Conclusion The NSE and CRP levels in children patients with early HFMD complicating encephalitis are significantly increased ,especially which in the patients with EV71 positive is more signif‐icant .The combined detection of serum NSE and CRP levels can be used as the early sensitive indicators for diagnosing HFMD complicating encephalitis .

Objective To explore the effect of medical assessment on the rehabilitation training of children with autism spectrum disorders (ASD). Methods There were 67 children with ASD selected from special education schools .Their developmental level , ability of social life and social communication were evaluated by child health care physicians .There were 48 children classified as intervention group:individualized rehabilitation training targets were designed based on the assessment results and individualized rehabilitation training program was carried out .The other 19 children were served as controls and routine rehabilitation training was carried out .All children were reevaluated by physicians with the same methods after training for one year . Results The adaptability , language level and communication ability of children in the intervention group improved better than the control group , with statistically significant difference. Conclusion It is beneficial to develop training programs for children with ASD on the basis of medical assessment which can promote the development level of ASD children , social life ability and communication ability .

Background The surgery for congenital idiopathic nystagmus has make great progression recent year,but the influence of surgery on visual function is closely concerned.Objective This work was to study the surgeries for congenital idiopathic nystagmus with or without strabismus and explore the effect of horizontal rectus muscle surgery on the visual function and ocular movement in congenital idiopathic nystagmus.Methods This was a case-observational study.Sixty cases with idiopathic congenital nystagmus were enrolled assigned to four groups as follows:The patients of group Ⅰ appeared the head postures of less than 15 ° and heterotropia less than 15△underwent extraocular proprioceptiou resection,and those of group Ⅱ presented with the head postures of less than 20° and heterotropia more than 15△ underwent extraocular proprioception resection and stabismus surgery.In the group Ⅲ,the patients had the head postures of more than 15° and heterotropia less than 15△ underwent Park's surgery and part of them underwent extraocular proprioception resection) and the cases in group Ⅳ were selected with the head postures of more than15° and heterotropia more than 15△ underwent Park' s surgery and strabismus surgery ( part of them underwent extraocular proprioception resection).Baseline and follow-up evaluations included the best distance and near corrected visual acuity,head posture,ocular movement and Titmus stereotest.The examination results were compared between before and after operation.Results One year after operation,monocular and binocular distance visual acuity improved significantly in all four groups ( monocular:t =6.00,8.94,11.76,16.41,P =0.00 ; binocular:t=4.81,P=0.01 ; t =6.27,4.25,4.18,P =0.00 ),but monocular and binocular near visual acuity improved significantly only in groups Ⅲ and Ⅳ after operation compared with before operation ( monocular:t=2.91,P=0.01 ; t =5.32,P =0.00 ; binocular:t =3.36,t =4.30,P =0.00 ).The compensatory head posture from 39 subjects was disappeared after operation,showing an evident difference between before and after surgery ( group Ⅲ:t =29.90,P=0.00;group Ⅳ:t=16.91,P=0.00).Strabismus were corrected rightly for 24 patients and undercorrection for 2 patients.( group Ⅱ:t =29.15,P =0.00 ; group Ⅳ:t =36.79,P =0.00 ).The binocular visual function of 23 cases with the age below 12 years were improved throughout the follow up duration ( t =12.06,P =0.00).Conclusions Park' s surgery,extraocular proprioception resection and strabismus corrective operation can improve the visual function and head posture in congenital idiopathic nystagmus patients.

Background Congenital nystagmus is a common disease threatening visual function.The clinical description of congenital nystagmus is still not enough now. Objective The aim of this study was to report the motor and sensory characteristics of congenital nystagmus. Methods A retrospective clinical case analysis was designed.The clinical data of 376 patients with congenital nystagmus were collected.These patients were diagnosed in Henan Eye Institute from January,2005 to August,2011.The clinical characteristics of patients,including age,pedigree analysis,nystagmus classification,ocular alignment,visual acuity,refractive error,stereoacuity and oscillopia,was summarized.Informed consent from all patients and custodian were obtained. Results The age distribution of most patients was ＞5-10 years and ＞ 15-20 years,with the percentage 24.73％ and 24.20％,respectively.Of 376 patients,sensory defect nystagmus was 172 cases,and that of motor sensory defect was 204 cases.The most common inheritance pattern was autosomal dominant.Conjugate uniplanar horizontal oscillations were found in 73.94％patients,and strabismus was found in 66.36％ in this study.Sensory defected subjects did not show a statistically significantly higher strabismus incidence when compared with the idiopaths (x2 =3.048,P =0.081 ).The binocular distance vision in all the subjects was declined in comparison with normal eyes,the best corrected vision was 0.27 ±0.11 and 0.50± 0.13 in sensory defected nystagmus and idiopaths nystagmus respectively,showing a significant difference( t =16.495,P =0.000 ).The incidence of refractive error in this study was 77.62％.Incidence of astigmatism(75.17％ ) was higher than that of myopia and hyperopia ( 39.03％ and 36.12％ ).No significant difference was seen in refractive error incidence between the sensory defected and the idiopaths (x2 =1.337,P =0.248).Patients of 65.18％ displayed non-stereoacuity or very gross acuity levels (3000) in this study,and the patients with idiopathic nystagmus showed better stereoacuity level in comparison with sensory defected ones (x2 =7.058,P =0.008 ).Five of 313 patients existed experienced oscilopla under binocular viewing conditions.Conclusions Autosomal dominant inheritance is the most common pattern of congenital nystagmus.Conjugate uniplanar horizontal oscillation is thought to be a common type of nystagmus.Incidence of strabismus is higher,and visual acuity and stereoaeuity are worse in congenital nystagmus than in common population.Oscillopia is seldom found in congenital nystagmus.

Objective To investigate the clinical value of measurement of phrenic nerve conduction function.Methods Evoked potentials of the phrenic nerve were measured in 292 patients with brachial plexus injuries.According to the normal value that was established in the electromyogram in our hospital,we divided them into normal and abnormal evoked potential groups,and then,the latent period and wave amplitude in the two groups were compared.Results Compared to those in the normal potential group,the latent period in abnormal group was significantly high and wave amplitude low(P＜0.05).Conclusion Measurement of phrenic nerve conduction is convenient,safe,and reliable to evaluate the conduction function of the phrenic nerve.

Objective To study the clinical profile of patients with central nervous system (CNS) involvement in relapsing polychondritis (RP).Methods Clinical data of five patients of RP with CNS lesions were collected,and compared with those from the literatures.T test and Fisher exact test were used for statistical analysis.Results Among 205 patients with RP in Peking Union Medical College Hospital,five cases (2.4％) had CNS damage.All 5 cases presented an active onset and occurred in the active phase of RP.All of them manifested as meningoencephalitis,complicating cranial neuropathies in 2 cases (2/5).Cerebrospinalfluid examination revealed non-specific meningeal inflammation,and magnetic resonance image (MRI) showed long T2 signals in brain lesions.Four patients (4/5) showed good response to high-dose glucocorticosteroid plus immunosuppressive agent combined therapy.The average age of our patients was younger than those in the literatures [(44± 14),(58± 11) years,respectively; t=2.547,P＜0.05],while other clinical features was not significantly different between the two groups.Conclusion CNS involvement is a rare condition in RP patients,and usually occurrs in the early course of active RP.Meningoencephalitis/ meningitis is the major clinical manifestations.MRI and cerebrospinal fluid examination may help to confirm the diagnosis.Treatment with corticosteroid and immunosuppressant can result in favorable response.

Objective: To observe the clinical effects of moxibustion at abdominal acupoints for slow transit constipation (STC) due to yang deficiency of the spleen and kidney. Methods: A total of 52 cases with slow transit constipation in conformity with the inclusion criteria were selected and divided into a control group and an observation group according to their visit order and random digital table, 26 cases in each group. Patients in the control group received routine nursing guide. Besides the same routine nursing guide, patients in the observation group received moxibustion at the abdominal acupoints, once every day. The course of the treatment was 4 weeks in the two groups, and the 3-month follow-up was given after the course was finished, for comparing the clinical symptoms, results of colon transit tests, scores of depression/anxiety scale and nursing satisfaction. Results: The total effective rate was 92.3% in the observation group and 69.2% in the control group, with a significant difference between the two groups. After the treatment and during the follow-up checks, the scores of Chinese medical symptoms in the two groups were remarkably decreased than those before the treatment (all P<0.01); the scores of the observation group were obviously lower than those in the control group (all P<0.01). The discharge rates of the markers in the two groups were remarkably increased than those at the same time period before the treatment; moreover, the discharge rates of the markers at various time periods were remarkably better in the observation group than those in the control group (P<0.01). SDS and SAS scores were remarkably decreased after the treatment in the two groups (P<0.01). In comparison of SDS score between the two groups after the treatment, the difference was statistically significant (P<0.01). In comparison of SAS score between the two groups after the treatment, the difference was statistically significant (P<0.05). The nursing satisfaction was 96.2% in the observation group after the treatment, obviously better than that in the control group (73.1%). The recurrence rate was 8.3% in the observation group, remarkably lower than that in the control group (33.3%). Conclusion: Moxibustion at the abdominal acupoints plus routine nursing can remarkably improve the colon transit functions and anxious and depressive emotion in patients with STC, and the therapeutic effects are remarkable. Not only the clinical satisfaction is higher, but the recurrence rate is obviously lower than that of routine nursing.

Fish oil is an important nutrient component in rainbow trout bone, and the optimization of extraction by enzymatic hydrolytic method is of great significance.This study selected the alkaline protease as the hydrolytic enzyme, and optimized the process conditions of enzymatic hydrolysis of rainbow trout fish using single factor analysis method.Effects of several factors on the extraction of fish oil were studied, including the ratio of material to liquid, pH, enzymatic hydrolysis time, enzymatic hydrolysis temperature and amount of enzyme.Fatty acids were identified by gas chromatography-mass spectrometry (GC-MS).Results showed that the optimum extraction parameters of enzymatic hydrolysis were as follows: 2000 U/g alkaline protease, ratio of material to liquid of 1∶1 (w/w), pH 7.5, and extraction at 55℃ for 3h.It was found that the main composition of rainbow trout bone oil was unsaturated fatty acid with the content of 80.4% (w/w).The relative content of monounsaturated fatty acid and polyunsaturated fatty acid was about 76.9% (w/w) and 23.1% (w/w), respectively.The total content of EPA and DHA was 3.4% (w/w).This study optimized the extraction method of rainbow trout fish oil, analyzed and identified the main volatile compounds, and identified the main substances contributing to fish oil flavor.The method thus was of significance for the analysis and identification of fish oil products.

This paper aims to construct a Bayesian(BN) fault diagnosis model of traditional Chinese medicine dry granulation based on the failure model and effect analysis(FMEA), effectively control risk factors and ensure the quality of granules.Firstly, the risk ana-lysis of dry granulation process was carried out with FMEA, and the selected medium and high risk factors were taken as node variables to establish corresponding BN network with causality.According to the mathematical reasoning method of probability theory, the model was accurately inferred and verified by Netica, and the granule nonconformance was used as the evidence for reversed reasoning to determine the most likely cause of the failure that affected the granule quality.The BN fault diagnosis model of traditional Chinese medicine dry gra-nulation was established based on the medium and high risk factors of process, prescription and equipment screened out by FMEA, such as roller pressure, raw material viscosity, clearance between rollers in the paper.The fault diagnosis of traditional Chinese medicine dry granulation process was then carried out according to the model, and the posterior probability of each node under the premise of nonconforming granule quality was obtained.This method could provide strong support for operators to quickly eliminate faults and make decisions, so as to improve the efficiency and accuracy for fault diagnosis and prediction, with innovation in its application.
Bayes Theorem ; Medicine, Chinese Traditional ; Probability

OBJECTIVETo study the effect of total saponins of Panax ginseng (TSPG) on the expression of granulocytemacrophage colony-stimulating factor (GM-CSF) from human endothelial cells and monocytes and the relationship between TSPG and human granulocytopoiesis and monocytopoiesis modulation.

METHODSAdopting the hematopoietic progenitor cells culture in vitro, hematopoietic growth factor biological assay, immunocytochemistry and nucleic acid in situ hybridization, the GM-CSF expression in the endothelial cells and monocytes were detected.

RESULTSThe conditioned cultural media of endothelial and monocytes induced and prepared by TSPG, could significantly promote the proliferation and differentiation of human colony forming unit-granulocyte macrophage (CFU-GM), and enhance the protein and mRNA expression of GM-CSF in endothelial cells and monocytes.

CONCLUSIONTSPG could possibly through direct or indirect route, promote hematopoietic, induce endothelial cells and monocytes in the microenvironment to synthetize and secrete GM-CSF, so as to further promote the proliferation and differentiation of human CFU-GM.

Bone Marrow Cells ; cytology ; metabolism ; Cells, Cultured ; Culture Media, Conditioned ; Endothelial Cells ; metabolism ; Ginsenosides ; pharmacology ; Granulocyte-Macrophage Colony-Stimulating Factor ; biosynthesis ; genetics ; Hematopoiesis ; drug effects ; Humans ; Monocytes ; metabolism ; Panax ; chemistry ; Saponins ; pharmacology