Noroviruses are members of Caliciviridae family and are now the most commonly reported cause of outbreaks of nonbacterial gastroenteritis worldwide.Noroviruses gastroenteritis is difficult to control owing to the lack of a suitable antiviral agent or a vaccine to prevent infection.The tremendous disease burden of norovirus-associated gastroenteritis calls for an efficient preventive and therapeutic drugs.This review summarized the anti-noroviruses strategies targeting the nons-structural proteins,structural protein and so on.

Objective To explore nursing methods of postoperative patients with brain stem tumor complicated with stress hyperglycemia. Methods The medical and nursing measures of 56 postoperative patients with brain stem tumor complicated with stress hyperglycemia were analyzed retrospectively. Results Among 56 cases, 48 cases were clinically cured, 6 cases was improved, 2 cases died of multiple organ failure. Conclusions It is especially important to intensify insulin therapy, necessary to closely observe the patients' consciousness, pupils and the change of vital signs. Meanwhile, strengthening nursing on common complications such as infection and gastrointestinal hemorrhage, and paying more attention to patients' dietary, mental state and rehabilitation are also important measures.

Objective To investigate the rehabilitation nursing interventions Disc stepped affect the degree of pain and function in patients with minimally invasive waist. Methods From January 2013 to February 2015, 152 cases accepted minimally invasive surgical treatment of lumbar disc patients in this study, were assigned into two groups by random number table and the control group of 76 patients in the control group received routine care, observation group to take a step rehabilitative intervention. 3 months follow-up were compared pain, Oswestry waist- lower extremity dysfunction score, Japanese Orthopedic Association (JOA) score back pain efficacy, quality of life. Results After one week, one month, the observation group pain scores were (2.01±0.68) points, (1.46±0.32) points which were significantly lower than (2.26±0.76) points, (1.87±0.45) points of the control group (t=2.137, 6.473, P<0.05);after 1 week, 1 month, 3 months when the observation group back-lower extremity dysfunction scores were (5.68 ± 0.74) points, (4.85 ± 0.65) points, (0.67 ± 0.21) points were significantly lower than (7.45 ± 0.86) points, (6.12 ± 0.72) points, (1.28±0.34) points of the control group (t=13.601, 11.324, 13.307, P<0.05), and JOA low back pain scores were (16.71 ± 2.85) points, (26.43 ± 6.32) points, (28.16 ± 2.83) points which were significantly higher than (14.46±2.12) points, (20.65±5.41) points, (25.43±2.65) points of the control group (t = 5.552, 6.057, 6.139, P<0.05). Followed up for 3 months observation group physiological function, bodily pain, general health, vitality, mental health scores were (65.36±7.12) points, (62.65±6.54) points, (72.36±7.24) points, (68.32±7.14) points, (68.36±7.25) points were significantly higher than (53.25±5.42) points, (53.45 ± 5.65) points, (60.65 ± 6.21) points, (60.54 ± 6.85) points, (60.35 ± 6.54) points of the control group (t=6.855-11.798, P<0.05). Conclusions The stepped rehabilitation nursing intervention can reduce the degree of pain minimally invasive lumbar disc herniation, promote postoperative recovery and improve quality of life.

ObjectiveTo obsrve the clinical efficacy of acupuncture, herbal medicine, plus Ethinylestradiol and Cyproterone Acetate tablets in treating infertility due to obesity-type polycystic ovary syndrome (PCOS).MethodA hundred elegible patients were divided into a treatment group and a control group according to their visiting sequence and random number table. The two groups both received oral administration of Ethinylestradiol and Cyproterone Acetate tables for 3 months. Afterwords, the treatment group was given Chinese herbal medication and acupuncture, while the control group received oral administration of Metforminand Clomiphene plus muscular injection of human menopausal gonadotropin(HMG) and human choionic gonadotropin (HCG). Both groups received a 3-month course. Before and 3 months after the intervention, serum sex hormones were detected, including:follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estrodiol (E2), and prolactin (PRL); fasting sugar, sugar tolerance, and insulin release were measured; ovulation, pregnance rate, and total effective rate were calculated.ResultAfter intervention, there were significant differences in comparing LH, LH/FSH, ovulation, and the incidence of follicle hyperstimulating syndrome between the two groups (P<0.05); there were no significant differences in comparing sugar metabolism, insulin release, comprehensive efficacy, dominant follicle count, and pregnancy rate(P>0.05). After intervention, the LH and LH/FSH levels were significantly changed in the treatment group, while the LH and LH/FSH levels, ovulation, and dominant follicle count were significantly changed in the control group (P<0.05), but pregnancy rate and follicle hyperstimulating syndrome were insignificantly changed in both groups (P>0.05).ConclusionCombination of acupuncture, Chinese herbal medicine, and Ehinylestradiol and Cyproterone Acetate tablets can down-regulate the LH and LH/FSH levels, andenhance ovulation, without causing follicle hyperstimulating syndrome.

OBJECTIVE To investigate the clinical distribution and antimicrobial resistance of infections caused by Enterobacter cloacae in our hospital,for guiding the prophylaxis and treatment of these infections in clinical practice. METHODS Antimicrobial susceptibility tests were done by Kirby-Bauer disk diffusions method,the phenotypes of E.cloacae strains harboring AmpC ?-lactamases and extended-spectrum ?-lactamases(ESBLs) were detected by modified three-dimensional extract test. RESULTS A total of 162 strains of E.cloacae were isolated between Jan 2002 and Dec 2004,the percentages of these strains isolated from sputum,urine and wound secretion were 62.3%,11.7% and 9.9%,respectively.73.5% of all strains isolated from intensive care unit(ICU) in every endemic area.AmpC ?-lactamases,AmpC ?-lactamases combined with ESBLs and ESBLs producing strains were detected in 19.1%,11.7% and 14.2% of E.cloacae,respectively.The resistance of AmpC ?-lactamases or ESBLs producer was obviously higher than that of non-AmpC ?-lactamases and ESBLs producer,while the phenomenon of resistance was serious especially in AmpC ?-lactamases combined with ESBLs producer,but all strains were sensitive to imipenem. CONCLUSIONS E.cloacae causes infections of respiratory tract,urinary tract and wound principally in clinic,the most of which occurred in ICU.AmpC ?-lactamases and ESBLs are popular in E.cloacae,the restricted use of ?-lactams is a considerable measure which reduces prevalence of AmpC(?-lactamases) and ESBLs producing strains.The antimicrobial agents for treating infections caused by E.cloacae should be chosen according to the results of the antimicrobial susceptibility tests,imipenem is the first choice for severe infections.

[Summary] This paper reported a case of 4-year-old boy suffered with medial meniscus tear treated by arthroscopic repair in our hospital.After the boy injured his knee , plaster was applied for 4 weeks.Without any symptomatic progress , he was hospitalized with the diagnosis of medial meniscus tear .We performed arthroscopic meniscus repair , using 4.0-mm arthroscopy.At 3-month follow-up, the boy could full-bearing walk with no pain or discomfort , with a range of motion of 0°-135°.The post-operational MRI at the fourth month showed preliminary healing of repaired meniscus .We believe that regular arthroscopic instruments can accomplish meniscus repair in young children .

Objective To construct a prokaryotic expression system of norovirus (NoⅤ) G Ⅱ-4 strain P protein (P particle and P dimer) and to explore its binding activity and patterns with HBGAs receptor.Methods P domain sequence of GZ121 NoⅤ ORF2 gene was cloned and its phylogenic tree was constructed to identify the gene cluster.The pGEX-4T-1-based expression plasmids were constructed respectively by inserting P domain gene fragments with hinge and P-CDCRGDCFC without hinge,and then transformed into BL21 to express fusion proteins,which was induced with 0.6 mmol/L IPTG at 22℃ overnight.P proteins were purified by thrombin cutting and characterized by FPLC.The binding patterns of NoⅤ P protein to HBGAs antigens were analyzed by EIA.Results P region gene of GZ121 belonged to genotype G Ⅱ.4/2004 cluster.SDS-PAGE analysis showed the relative molecular weight of P particle and P dimer was about 36×103,which was consistent with other reports.The peak appeared at 830×103 confirmed the formation of P particle by FPLC.The expression of P protein was further confirmed by Western blot.The EIA results showed that GZ121 P protein could bind to saliva of A-group,B-group and O-group secretors,but not to nonsecretor.The binding affinity of P particle was 80-100 times higher than that of P dimer.Compared with VA387 P particle,it showed stronger binding affinity to O-group,but weaker to A-group.Conclusion The NoⅤ GⅡ-4 GZ121 P proteins including P particle and P dimer were successfully expressed and HBGAs receptor binding assays were established.This pave the way for further studies on the evolution dynamics of NoⅤ G Ⅱ.4 strains and the development of NoⅤ vaccines.

Objective: To study electrocardiogram (ECG) monitoring assisted ultrasound guidance for modiifed seldinger technique (MST) in peripherally inserted central catheters (PICC) and to estimate the accuracy of ECG for presenting catheter tip location. Methods: The patients were connected with ECG monitoring system, the guide wire was connected to RA electrode in ECG monitor for leading out P wave of intracavitary ECG. The location of catheter tip was estimated by P wave characteristics and then, estimated ECG result was further compared with chest X-ray presented catheter tip position. The coherence of catheter tip position between ECG and chest X-ray was compared, the sensitivity and speciifcity of ECG estimation were calculated. Results: There were 100/104 patients showed speciifc P wave in ECG, the coherence to chest X-ray was 96.2%; 4 patients had no speciifc P wave and their chest X-ray presented that the catheter tip position at upper superior vena cava in 2 patients, at lower superior vena cava in 1 patient, at contralateral brachiocephalic vein in 1 patient. The accuracy of 2 methods had no statistic meaning. ECG estimation for PICC catheter tip position had the sensitivity at 99% and speciifcity at 100%. Conclusion: ECG monitoring may determine the catheter tip position for MST in PICC guided by ultrasound. It doesn’t need chest X-ray, without additional trauma and no radioactive contamination, which make PICC catheters get more extensive application in clinical practice.

Objective:To find out the situation of the use of the nutrition support drugs in Peking University Shenzhen Hospital.Method:The method of the use of the nutrition support drugs was adopted to analyze its situation in the hospital during 2005-2006 with respect to the sum of money,frequency of use,increase of charge for medicine and kinds of drugs.Results:The sum of money has been descent 70 000 yuan in 2006 than in 2005,and the frequeacy of use also has been descent 60 000.Conclusion:Parenteral nutrition(PN)drugs were more frequently used than enteral nutrition(EN) drugs.EN was advocated to be used as early as possible so as to maintain the intestinal tract mucosal barrier and recover the intestinal tract function.EN was fit to the physiological need and more scientific than PN.

Objective To explore an alternative method for Her-2/neu analysis in paraffin-embedded ovarian carcinoma.Methods The amplification and expression of Her-2/neu in 69 specimens of ovarian carcinoma was investigated by real-time PCR(RT-PCR) and immunohistochemistry(IHC),respectively.The results were compared and FISH assay was performed to ensure the reliability of the results.Results Based on arbitrary cut-offs of more than 1.5 or 2(ratio of gene copy numbers in tumor cells to gene copy numbers in euploid cells),the amplification rates for the Her-2/neu were 26.1%(18/69) and 15.9%(11/69) by RT-PCR.Twenty out of 69 specimens(28.99%) of Her-2/neu overexpression(++ to +++) were found by IHC.Her-2/neu status assessed by RT-PCR was closely in accordance with the result by IHC.Conclusion RT-PCR is reliable,easy and rapid to perform and represents an alternative technique for establishing Her-2/neu status in paraffin-embedded ovarian carcinoma.