Objective To analyze the clinical features of severe hand-foot-mouth disease (HFMD)combined with encephalitis.Methods The cases with HFMD in our hospital from September 2009 to September 2010 were divided into two groups including the ordinary case group(n =235) and the encephalitis group (n =88).Clinical manifestations were analysed between the two groups.Results There were significant differences in number of oral ulcers,degree and duration of fever between two groups (P ＜ 0.05).Eighty percent cases of the ordinary group had multiple or dense herpes or ulcers,which was more than that of the encephalitis group.But there were no significant differences in WBC and its classification in peripheral blood between two groups (P ＞ 0.05).There were obvious differences in CK,CK-MB,AST,GLU of blood between two groups (P ＜ 0.05).The contents of protein,glucose and chloride in cerebrospinal fluid have no differences between two groups (P ＞ 0.05),besides the cell count.The cell count in cerebrospinal fluid of cases with enterovirus infected encephalitis was significantly higher than those with CoxA16 infection(P ＜ 0.05).Conclusion The patients with few rash,less oral herpes,ulcers or high levels of CK,CK-MB,GLU should be closely observed to vigilant merger encephalitis.The cases with severe H-FMD have middle or high fever and duration of fever are more than 4 days.The increased cell count in cerebrospinal fluid may imply encephalitis with enterovirus 71 infection.

0.05). A relatively low negative correlation was found between P~(2+) content in outer layer of dentin and dfs (r=-0.415 96, P=0.043 2). Conclusions:P~(2+) content in different part of deciduous teeth is different and it is not related to caries status.

Objective To observe the effect of acupuncture therapy of regulating Yin and Yang for the treatment of stroke,and to investigate the influence on plasma levels of calcitonin gene-related peptide(CGRP) and vascular endothelin(ET).Methods One hundred and twenty stroke patients were equally randomized into 3 groups: group A received acupuncture therapy of regulating Yin and Yang,group B received traditional body acupuncture therapy,and group C received scalp acupuncture therapy.One and a half months constituted one treatment course,and the treatment lasted 2 courses.The therapeutic effect was evaluated and the changes of plasma CGRP and ET levels were observed.Results The total effective rate was 95.0% in group A,85.0% in group B,and 82.5% in group C,the difference being significant between the three groups(P0.05).Conclusion Acupuncture therapy of regulating Yin and Yang exerts a certain effect for the treatment of stroke,and can up-regulate plasma CGRP level and decrease ET level.

Objective To establish a liquid chromatography-tandem mass spectrometry ( LC-MS/MS) method for the quantification of creatinine-correctedsarcosine in urine for the prostate cancer diagnosis and treatment.Methods It performed the method establishment and evaluation in this study.Random unrine samples were collected from 36 subjects with prostate cancer, 15 subjects with benign prostatic hyperplasia and 76 healthy people receiving medical examination.Urine samples mixed with [ 2 H3 ]-labeled sarcosine were treated by precolumn derivation using dansyl chloride, then analyzed by LC-MS/MSsystem in multiple reaction monitor ( MRM) mode.Sarcosine and creatinine were quantified by the isotope internal standard method and the standard curve was employed with a series of calibration.The limit of detection, precision and recovery were also evaluated in this study.The results of this methodology were compared with those of the enzymatic method.Results Sarcosine could be distinguished against its isomers completely. The linear equation of sarcosine was Y=2.045 6X+0.068 9, R2 =0.994.The limit of detection and limit of quantity were 8 ng/ml and 25 ng/ml respectively.The intraassay and interassay coefficients of variation were both below 6%.The recovery ratio of sarcosine ranged from 96.8%to 105.1%.The results from the ID-LC-MS method correlated with those from enzymatic method (R2 =0.815, P <0.01).Compared to enzymatic method, the average bias of sarcosine was -37.1%.Conclusions It established a LC-MS method for urinary sarcosine quantification with good specificity, sensitivity and repeatability.This method can provide a reliable platform for the diagnosis of prostate cancer.

OBJECTIVE To explore the disinfection methods for ophthalmology and to strengthen the measures of disinfection.METHODS The disinfection methods of the environment,equipment and operation field in ophthalmology were investigated and analyzed,and the good disinfection methods were summarized.RESULTS Due to strictly control the disinfection measures in ophthalmology,strengthen management,the hospital infection was reduced.In 2006 eye hospital infection rate was 0.CONCLUSIONS Good disinfection methods can effectively prevent eye hospital infection.

Objective To study prospectively the safety and efficacy of the thromblytic therapy in acute submassive pulmonary thromboembolism (PTE) without randomized control.Methods A total of consecutive 177 patients with acute submassive PTE admitted to the emergency intensive care unit were screened from June of 2005 to May of 2012.After a comprehensive screening,102 patients were treated with thrombolytic therapy (TT group),and 75 with anticoagulation therapy (AT group).Clinical signs and physical examination findings were recorded 2 hours,24 hours and 7 days after treatment.Echocardiography (ECG) was repeated 24 hours later.Lung perfusion scan and CT pulmonary artery (CTPA) were repeated on the 7th day.All data was analyzed by paired t test and Chi-square test.Results ①Bleeding happened in 6 patients of TT group and in 1 patient of AT group (P ＞ 0.05),and no lethal hemorrhage occurred in the two groups.There were no statistically significant differences in demographics and clinical history of patients between TT group and AT group (P ＞ 0.05).②There were statistically significant changes in respiratory rate,heart rate and systolic blood pressure in the TT group 2 hours after treatment and great changes in systolic pressure of pulmonary artery (SPAP) and tricuspid regurgitation at 24 hours after treatment (P ＜0.01),whereas obvious change in respiratory rate in AT group was found 24 hours after treatment.③In the TT group 7 days after treatment,significant efficiency rate and total improvement of the deep vein thrombosis (DVT) identified by ultrasonography were 83.0％ and 96.2％ respectively,and those of CTPA and lung perfusion scan were 66.7％ and 98％ respectively.The efficiency of TT was significantly superior over AT in this respect (P ＜ 0.01).④The efficiency of TT given within 3 days after onset of PTE was significantly higher than that of TT conferred over 3 days after onset of PTE (P ＜ 0.01).Conclusions ①Thrombolytic therapy is safe and effective for the submassive PTE,but atypical cerebrovascular accident must be rule out first.②Thrombolytic therapy can improve the symptom of the patient in 2 hours compare with AT.③ Thrombus burden can be reduced more obviously in TT group after 7 days treatment compare with the AT group.④The effect of thrombolytic therapy depends on the time as ti given during the course of disease,the earlier administration the better efficacy.

Objective:To design and construct the replication-deficient recombinant adenovirus Ad-siCTGF which can silence the expression of connective tissue growth factor (CTGF) by RNA interference and verified its function. Methods:A specific sequence, which was verified to be able to silence CTGF gene with high efficiency, was cloned into pSES-HUS vector to produce the shuttle plasmid pSES-siCTGF. The plasmid after Pme Ⅰ linearization was cotransduced with pAdEasy into BJ5183 E.coli strains to construct recombinant vector Ad-siCTGF. After linearization treatment with Pac Ⅰ enzyme digestion Ad-siCTGF was transfected into HEK293 cells via liposome mediation. The recombinant adenovirus was packaged. The titer of the Ad-siCTGF was increased after three times of cross-infection. 4T1 cells were infected with the adenovirus. The silencing efficiency was tested by real-time fluorescence quantitative (RFQ)-PCR and Western blotting.Results:Pac Ⅰ enzyme digestion electrophoresis indentified that recombinant adenovirus was successfully constructed. The titer of the recombinant adenovirus Ad-siCTGF was 2.6×10~(10) pfu/mL after amplification and purification. The CTGF mRNA and protein expression in 4T1 cells were decreased by 36.27% and 31.56%, respectively, compared with the control groups.Conclusion:The recombinant adenovirus which can silence the expression of CTGF was successfully constructed. It laid a good foundation for further investigation of the action mechanism of CTGF in tumor cells.

Objective To evaluate the imaging features of benign fibrous histiocytoma (BFH).Methods Imaging data were retrospectively collected and reviewed in 11 patients with pathologically proved BFH.Of the 11 patients,X-ray was performed in all patients,MR scans in 6 patients,and CT scans in 4 patients.Results ALL lesions detected were a solitary lesion.The distribution of BFH was in the tibia (n =5 ),femur ( n =3),fibula ( n =1 ),sacrum ( n =1 ),and thoracic vertebrae ( n =1 ).X-ray features included eccentric osteolytic lesions in 7 patients and centric in 2 patients,with clear boundary and thinning of the cortex,and 7 patients with varying degrees of ossified border were found. CT scan shows bone destruction with density similar to soft tissue.The majority of lesions ( n =3 ) were observed in the expanding shell of bone,2 patients in the tibia and 1 patient in the thoracic lesions with cortical bone perforation.The thoracic lesion as soft tissue mass was detected. All of the lesions detected in CT showed no periosteal reaction.In patients with MR images,hypo to isointense signal intensity on T1WI and hyperintense signal intensity on T2WI was found. All lesions on post-contrast T1WI were detected with homogeneous or heterogeneous lesion with moderate or significant enhancement.Conclusion Imaging features were typical for MFH which is useful tool helping correct diagnosis of MFH.

Objective To evaluate the effect of stellate ganglion block (SGB) on postoperative synaptic structure in hippocampal CA3 region in aged rats.Methods Seventy-two male Sprague-Dawley rats,aged 20-22 months,weighing 550-650 g,were randomly divided into 3 groups (n =24 each) using a random number table:control group (group C),operation group (group O) and SGB + operation group (group SGB).Group SGB received right SGB with 0.25％ bupivacaine 0.15 ml.Groups O and SGB underwent 30 min of exploratory laparotomy starting from 15 min after the end of administration.Y-maze test was performed on 1 day after operation in 6 rats chosen from each group for assessment of cognitive function.The frequency of standard training and standard time were recorded.Six rats were chosen from each group on 1,3 and 7 days after operation and sacrificed and the hippocampal CA3 region was isolated for microscopic examination and for measurement of synaptic structure.Results Compared with group C,the standard time was significantly prolonged,and the frequency of standard training was increased in groups O and SGB,the width of synaptic cleft was increased,the thickness of post-synaptic density was decreased,the length of active zones was shortened,and the curvature of the synaptic interface was decreased on 1,3 and 7 days after operation in group O (P ＜ 0.05),and no significant changes were found in each synaptic structure parameter in group SGB (P ＞ 0.05).Compared with group O,the standard time was significantly shortened,the frequency of standard training was decreased,the width of synaptic cleft was decreased,the thickness of the post-synaptic density was increased,the length of active zones was prolonged,and the curvature of the synaptic interface was increased on 1,3 and 7 days after operation in group SGB (P ＜ 0.05).Conclusion The mechanism by which SGB improves the postoperative cognitive dysfunction in aged rats may be related to inhibition of changes of synaptic structure in hippocampal CA3 region.

Objective To evaluate the efficacy of oxycodone for patient-controlled intravenous analgesia (PCIA) after hip arthroplasty in elderly patients.Methods Sixty patients of both sexes,aged 65-85yr,weighing 42-89 kg,of American Society of Anesthesiologists physical status Ⅰ or]Ⅱ,scheduled for elective unilateral hip arthroplasty under general anesthesia,were divided into 2 groups (n =30 each) using a random number table:morphine group (group M) and oxycodone group (group O).Parecoxib sodium 40 mg was injected intravenously at 30 min before induction of anesthesia,followed by induction and maintenance of anesthesia.PCIA pump was connected at the beginning of skin closure.PCIA solution contained morphine 0.6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group M and oxycodone 0.6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group O.The PCA pump was set up with a background infusion at 2 ml/h,a 0.5 ml bolus dose and a 15 min lockout interval in both groups.Visual analogue scale score was maintained ≤ 3,and postoperative analgesia lasted until 48 h after operation.When analogue scale score ≥ 4,pethidine 50 mg/kg was injected muscularly as rescue analgesic.The requirement for rescue analgesic and occurrence of adverse effects were recorded.Results Ten percent patients required rescue analgesics in group M,and no patients required rescue analgesics in group O.Compared with group M,the requirement for rescue analgesics and incidence of nausea,vomiting and pruritus were significantly decreased in group O (P＜0.05).Conclusion Oxycodone provides reliable efficacy for PCIA after hip arthroplasty in elderly patients with fewer adverse effects,indicating that oxycodone produces good analgesic efficacy for severe somatalgia.