The connotation development of industry and education is the road to advance the development of connotation and the quality of higher vocational and technical education.Based on this and bringing into play the advantages of running a vocational school and combined with cultivating the applied personnel needed by enterprises and professions,the college perfects the personnel cultivation model.carries out the "225" education model,accelerate the development of the teacher,promote its service capacity to enhance constantly the quality of higher vocational and technical education.

Enterovirus A, Human ; Hand, Foot and Mouth Disease ; virology ; Humans

AlM: To evaluate the effectiveness of Spot Vision Screener on vision screening of children without cycloplegia.METHODS:A total of 87 children (174 eyes) aged from 2~9 years old were examined with Spot Vision Screener and optometrist before cycloplegia.RESULTS: Statistical analysis demonstrated that the cylinder diopter and axis, the equivalent spherical diopter in both eyes, and the spherical diaopter in left eye had no significant change ( P>0. 05 ). However, the spherical diaopter in right eye had statistical significance. CONCLUSlON: Spot Vision Screener is a suitable instrument in vision screening of children without cycloplegia.

Objective To construct prokaryotic vector and express human herpes virus 8 (HHV8) small capsid protein open reading frame 65 (ORF65) in Escherichia coli.Methods DNA was extracted from BCB-1 cells (HHV8-positive but EBV-negative).HHV80RF65 coding sequence was amplified by PCR and inserted into the prokaryotic expression vector pThioHisA.Recombinant plasmid was transformed into E.coli BL21 to express fusion protein induced by IPTG.The expressed products were purified by affinity chromatography on Ni-NTA resin.The antigenieity and the specificity of the recombinant proteins was identified by Western blot with HHVS-positive serum samples.ELISA coating with the recombinant proteins was used to screen 568 serum samples,which were simultaneously detected by IFA kit(Biotrin) and ELISA kit(Qiagen).Results Gene sequencing showed that the target gene was identical with that of HHV8 standard species,the 31 500 fusion protein was found in SDS-PAGE.ELISA coating with the recombinant proteins had a good agreement with IFA kit(Biotrin) and ELISA kit(Qiagen).The detection for the clinical samples showed the ELISA kit was feasible,applicable and consistant.Conclusion The recombinant proteins showed good antigenicity,and it is valuable for further study on HHV8 specific antibody detection.

Objective To investigate the effects of ulinastatin on the expression of neutrophil CD_(11b) and CD_(18) during orthotopic liver transplantation(OLT).Methods Forty patients with liver diseases,ASAⅢorⅣ, undergoing OLT were randomly divided into two groups.Ulinastatin group(n=20)received intravenous infusion of ulinastatin 3?10~5 IU in 100 ml normal saline after skin incision and repeated every 4 hours thereafter.Control group received same amount of normal saline instead(n=20).Blood samples were taken immediately before skin incision,120 min after skin incision,30 min of anhepatic phase,60 min of neohepatic phase and at the end of operation for measurement of CD_(11b) and CD_(18) expression of neutrophil by flow cytometry.Results CD_(11b)/CD_(18) expression was increased significantly in control group 60 min of neohepatic phase and at the end of operation compared to the level before skin incision,but in ulinastatin group there was no significant change in CD_(11b)/CD_(18) expression during the whole procedures(P＞0.05).CD_(11b)/CD_(18)expression was significantly lower 60 min of neohepatic phase and at the end of operation in ulinastatin group than in control group(P＜0.01).Conclusion Ulinastatin can inhibit the increase in CD_(11b)/CD_(18)expression during OLT,and be helpful for reducing the inflammatory response.

Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82％. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis of femoral neck fractures is high and the patients with high energy trauma hould be highly paid attention to.Lengthened PFNA conforms to characteristics of biomechanical fixation and presents short operation time and solid fixation. Lengthened PFNA achieves affirmatory effects for treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures.

Objective To explore the clinical significance of serum concentrations of Cystatin C (CysC) in children with kidney disease in different disease courses. Methods The serum concentrations of CysC, creatinine(Cr) and endogenous creatinine clearance rate(Ccr) were determined in 182 children with kidney disease. They were divided into five study groups:normal renal function group (73 cases), compensatory renal disfunction group (44 cases), non-compensatory renal disfunction group (35 cases), renal failure group(22 cases) and end stage of renal failure group(8 cases). Meanwhile 70 healthy children were involved in control group. Relationships among CysC, Cr and Ccr were calculated and the diagnostic efficiency was assessed by comparing the areas under the ROC curves. Results The serum concentrations of CysC increased in different courses of renal function impairment in children and were significantly related to the severity of impairment. CysC was positively correlated to Cr and negatively correlated to Ccr. The areas under the ROC curves of Cr and CysC were 0.764 and 0.725. Conclusions The serum concentrations of CysC can accurately identify different impairment grades of renal function and the function of glomerular filtration. As an indicator of early reduction of renal function, its sensitivities and specificities are superior to Cr and Ccr. CysC can be a sensitive endogenous marker for glomerular filtration rate determination. With simple, convenient and applicable assays methods, CysC is essential for early diagnosis of children kidney diseases.

Objective To explore continuous renal replacement therapy(CRRT) machine for plasma exchange in critical disease in children.Methods Retrospective study of 8 patients(8 month to 14 years,mean 5.7 years) and 32 plasma exchange treatments,after(adowble) lumen catheter inserted into the subclayian venous,using the Baxter BM25 machine with commercially available plasma filters.Results Five patients(3 ABO-incompatibility in bone marrow transplantation,1 thrombotic thrombocytopaenic purpura TTP,1 sepsis) gained full recovery.One systemic lupus erythematosus(SLE) and 1 sepsis experienced moderate improvement while 1 case of acute disseminated encephalomyelitis failed PE treatment.The average total exchange volume was 80-100 mL/kg,achieved at a blood flow rate of 5-10 mL/(kg?min) and a turnover rate of 60-120 mL/(kg?h) over a 3-hours duration.Thirty-one PE treatments were finished smoothly,one of which experienced the serious complication involving plasma filter.Conclusion Plasma exchange therapy is a safe and effective procedure for severe autoimmune abnormalities and pathogen removal in children.

Objective To evaluate the intraoperative opioid?sparing effect of different duration transcutaneous electrical acupoint stimulation ( TEAS ) in video?assisted thoracoscopic lobectomy. Methods Seventy?five patients, aged 18-64 yr, weighing 40-96 kg, of ASA physical status Ⅰ or Ⅱ, scheduled for elective video?assisted thoracoscopic lobectomy under general anesthesia, were randomly divided into 3 groups (n=25 each) using a random number table: control group (group C), 30 min of stimulation before induction of anesthesia group ( group B) , and stimulation throughout surgery ( group T) . In group B, the patients received TEAS ( frequency 2∕100 Hz ) on acupoints Xinshu ( BL15 ) , Feishu (BL13), Neiguan (PC6), Hegu (LI4) on the operated side starting from 30 min before induction of anesthesia until the beginning of induction, and the intensity was the maximum current that could be tolerated. The intensity for Neiguan ( PC6) and Hegu ( LI4) was 6-12 mA, and for Xinshu ( BL15) and Feishu ( BL13 ) was 9-18 mA. In group T, the patients received TEAS on the four acupoints mentioned above starting from 30 min before induction of anesthesia until the end of surgery. The patients had the electrodes applied, but received no stimulation in group C. After anesthesia was induced with propofol?sufentanil?cisatracurium, double lumen endotracheal tube was inserted. Propofol was given by target?controlled infusion to maintain BIS value within the range of 40-60. Cisatracurium was infused continuously to facilitate muscle relaxation. The infusion rate of remifentanil was adjusted to maintain analgesia nociception index value within the range of 50-70. The intraoperative consumption of remifentanil ( the intraoperative consumption of sufentanil was converted to the consumption of remifentanil producing the equivalent effect by 1∶ 10) was recorded. Results Compared with group C, the intraoperative consumption of remifentanil was significantly decreased in B and T groups. The intraoperative consumption of remifentanil was significantly lower in group T than in group B. Conclusion TEAS on Xinshu ( BL15 ) , Feishu (BL13), Neiguan ( PC6) and Hegu acupoints throughout surgery and for 30 min before induction of anesthesia significantly reduces intraoperative opioid consumption in the patients undergoing video?assisted thoracoscopic lobectomy, while TEAS throughout surgery provides better effect.

Objective To investigate the clinical utility of dual-energy virtual non-contrast CT(VNCT)of dual source CT in the di-agnosis and differential diagnosis of solitary pulmonary nodule(SPN).Methods Thirty-six patients with suspected SPN underwent chest plain single energy CT and dual-phase contrast enhanced CT (DECT)(25 and 90 s).The images of dual energy were sent to a commercial workstation for VNC image generation.CT values of SPN on VNC and true non-contrast(TNC),as well as signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were compared.The accuracy of calcification detection was compared according to the diameter and density of the calcification.The TNC images were used as the reference.Results CT values,SNR and CNR of VNC had no statistical difference among TNC and VNC at 25 s and 90 s(P >0.05).DECT VNC(5mm slice)could accurate detected calci-fication(diameter>2 mm,CT value>1 50 HU)in SPN.The 2 mm slice performed significantly better than 5 mm slice VNC images. Conclusion The VNC could provide consistent diagnostic information with TNC.The thin slice DECT VNC images can be used in clinical practice to replace TNC without losing small calcification in SPN,which has potential to reduce the patient radiation dose.