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 observe the effect of electroacupuncture(EA) in combination with small dose of clozapine on clinical symptoms of refractory schizophrenia patients so as to evaluate its validity and security.Methods Eighty schizophrenia patients were randomized into medication group and EA+medication group(n=40/group).Patients of medication group were treated with conventional oral administration of clozapine(50-100 mg/d to 200-500 mg/d,for 8 weeks) and those of EA+ medication group treated by EA of Baihui(GV 20) and bilateral Taiyang(EX-HN 5) and oral administration of clozapine(50 mg/d to 100-150 mg/d).EA was given to the patients,3 times a week for 8 weeks.Scores of the Positive and Negative Symptom Scale(PANSS) and the Untoward Effect Symptom Scale(TESS) were used to assess the therapeutic effect.Results Following treatment,PANSS scores for positive symptoms and the common psychiatric symptoms of the medication and EA+medication groups all decreased evidently from the 2rd week on(P0.05).But TESS score of EA+medication group was evidently lower than that of medication group(P

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle age group(Group D, 40-60 years old,n=215);and(5)elderly group(Group E,＞60 years old,n=102).All the patients were evaluated with Injury Severity Score(ISS),and the result was≥16 in all of the studied patients.Results The incidence of severe trauma in male in all 5 groups was higher than that in female,and it was significantly higher in Group C,Group D and Group E when compared with that in the other groups(P＜0.01).Traffic accident was the leading cause of injury,and its incidence in Group A,Group B and Group D was higher than that in other groups(P＜0.01).However,injury caused by falling from high places was the second cause of injury,being significantly increased in Group A,while armed fighting and injury during work being significantly increased in Group B,Group C and Group D,slip fall injury being significantly increased in Group E(P＜0.01).Head injury was mainly found in Group A and Group E,extremities injury and/or spinal injury were increased markedly in Group B,Group C and Group D(P＜0.05),abdominal injury was significantly decreased in Group E(P＜0.001).The total mortality was 11.9%(246/2069).The mortality within 24 hours (20.6%,21/102)was significantly higher than that beyond 24 hours(7.8%,8/102)in Group E(P＜0.01).The time of staying in the emergency department differed significantly between the survived patients and those died in all 5 groups (P＜0.01).Conclusion The gender,the incidence and the characteristics of the injury causes and injury sites differed between severely injured patients of various ages.Mortality in the elderly is significantly increased following severe trauma. The idea of“golden one hour”and“platinum ten minutes”,measures of shortening the time of staying in the emergency clinic,early definite operation and damage control operation should be emphasized.

Heterotrimeric G proteins are classes of signal-transducing proteins that bind to guanine nucleotides and possess GTP hydrolase activity. G proteins are composed of three subunits α, β, and γ, and are considered as the "molecular switch" in the GPCR signaling pathway. The abnormal activation of G protein is strongly related to diseases such as uveal melanoma, asthma, et al., making directly targeting G protein as an promising strategy for combating diseases. In this review, the classification and physiological functions of G protein are briefly described, and the research progress of G proteins in diseases, G protein modulators are reviewed.

To study the sesquiterpenoid constituents in the whole plant of Sarcandra glabra, silical column chromatography, Sephadex LH-20, reverse phase ODS column chromatography and preparative HPLC were used to isolate 70% EtOH extract of Sarcandra glabra. The structures were elucidated based on spectroscopic data (HR-ESI-MS, 1H NMR, 13C NMR, HSQC, HMBC and NOESY). Four sesquiterpenoids were obtained and identified as 4alpha-hydroxy-5alphaH-lindan-8 (9)-en-8, 12-olide (1), chloranthalactone E (2), 8beta, 9alpha-dihydroxylindan-(5), 7 (1)-ieb-8alpha, 12-olide (3) and chloranoside A (4), respectively. Compound 1 is a new sesquiterpene lacone.

OBJECTIVE:To improve the electronic prescription prior-review mode and increase the rate of qualified prescrip-tions. METHODS:The electronic prescription prior-review mode of our hospital was established by setting up outpatient and emer-gency electronic prescription review team,review evidence and enforcement measures. Aimed at these problems as low review effi-ciency at initial stage,non-unified standards and untimely feedback,quality control circle and internet tools WeChat were used to improve the mode and evaluate its effects. RESULTS:The electronic prescription prior-review mode of our hospital was improved by optimizing system settings,unifying review standard,one-to-one feedback and communication with WeChat public platform, etc. Average time of prescription prior-review had reduced from 50 s to 30.58 s;the rate of qualified prescriptions had increased from 86.77% to 95.30%;prescription review efficiency and the rate of qualified prescriptions had been improved significantly. CONCLUSIONS:The implementation and continuous improvement of electronic prescription prior-review mode can reduce the rate of unqualified prescriptions and promote rational drug use in outpatient and emergency department.

Objective To evaluate the novel hybrid liver and renal support system the safety and efficacy of the treatment of Tibet mini pig model of renal failure .Methods Five Tibet miniature pig bilateral renal artery ligation approached to construct the models of renal failure ,treatment group was treated with therapy (CRRT mode) of the novel hybrid liver and renal support system after modeling ,while the control group received no treatment .Drawning venous blood endotoxin ,biochemical tests and aerobic anae‐robic culture when in the treatment of 0 ,4 ,8 h;then we observed the changes of biochemical indicators in Tibet mini pigs before and after treatment ;we recorded machine pressure monitoring indicators every 2 hour during treatment .Results The model of renal failure of two experimental animals were successfully constructed .The general condition of treatment group was improved after treated by the novel hybrid liver and renal support system ,while the control groups continued to deteriorate .The experimental ani‐mals did not appear abnormal ECG during the experiment .Two groups of animals showed no statistics significant difference (P>0 .05) in the period of 0 h .In the remaining period ,heart rate and respiratory rate in treatment group was significantly reduced(P<0 .05) ,while oxygen saturation and mean arterial pressure were significantly increased compared to control group(P<0 .05) .There was no differences of biochemical indicators between two groups before modeling (P>0 .05);after modeling both groups biochemi‐cal indicators was significantly increased compared with baseline (P<0 .05);after treatment of the hybrid liver and renal support systems in the treatment group ,the biochemical parameters were significantly decreased compared with baseline ,the difference was statistically significant different(P<0 .05) ,while the control group did not change significantly .Blood endotoxin measured results were less than 0 .5 EU/mL ,arteriovenous end aerobic anaerobic culture showed no bacterial growth .Pathological examination showed significant swelling of the renal tubular epithelium and tubular necrosis .Conclusion The novel hybrid liver and renal sup‐port system for the treatment of Tibet mini‐pig model of renal failure is safe and effective ,and it can be further attempts for clinical trials .

Objective To evaluate the effect of schistosomiasis control in Yunnan Province since achieving the transmission control standards,so as to provide the evidence for formulating the next prevention and control strategy. Methods The schistoso-miasis epidemic monitoring reports,annual reports,relevant information about Oncomelania hupensis snails,and schistosomiasis patient conditions were collected and analyzed for epidemic condition and characteristics of schistosomiasis in Yunnan Province from 2009 to 2012. Results The various epidemic monitoring indicators all decreased. In 2012,compared with 2009,the preva-lence reduced by 33.33%after correction;the number of villages with schistosomiasis patients reduced by 55.56%;the adjusted positive rate of livestock stool tests reduced by 45.45%;the number of villages with infected cow reduced by 42.25%;the actual area with snails reduced by 13.58%;the density of living snails reduced by 25.66%,and no schistosome infected snails were found in 2012. Conclusion There still exist schistosome infections in human and animals in some local areas of Yunnan Prov-ince,and it is difficult to achieve the standard of schistosomiasis transmission interrupted in a short period.

Objective To study senile severe trauma patients admitted to Emergency Surgical Department of the second affiliated hospital of Guangzhou Medical college from October 1997 to October 2004,to investigate constructive suggestions of emergency treatment for urban senile trauma.Method Retrospective analysis on 102 senile severe trauma patients screened out from trauma patients admitted to the Emergency Surgical Department was carried out.Results There were 76 male and 26 female patients,the ratio of male to female was 2.9:1,mean age was 69.2 years old(range 60～83 years),the mean trauma score(TS)was(14.5?2.6),the mean Glasgo Coma Score(GCS)was(11.8?3.1),the mean Injury Severity Score(ISS)was(24.5?10.7),there were 61 patients of multiple injuries,transportation accident 45 patients(43.3 %),tumbling injury 23 case(22.5 %), falling injury 19 patients(18.6%),shock 65 patients.Definitive rescue surgery was carried out in 68 patients. The time from emergency treatment to operation departments was(58?19)minutes for the survival patients and (111?34)minutes for those died,there was significant difference between the two groups(P