Objective:To investigate the clinical significance of early detection of serum procalcitonin in children with hand-foot-and-mouth disease complicated by bacterial infection and provide reference for clinical diagnosis of the disease in children.Methods:A total of 126 children patients with hand-foot-and-mouth disease who received treatment in the First People's Hospital of Taizhou between December 2017 and December 2018 were included in this study. They were assigned into viral plus bacterial infection group and simple viral infection group ( n = 63/group) according to whether they suffered from bacterial infection. An additional 20 healthy children who concurrently received physical examination in the First People's Hospital of Taizhou were included in the control group. Serum levels of interleukin-6, interleukin-10, white blood cell count, C-reactive protein, and procalcitonin were compared among the three groups and bacterial infection was analyzed. Results:Serum levels of interleukin-6, interleukin-10 and C-reactive protein in the simple viral infection group were (3.75 ± 0.76) ng/L, (55.31 ± 11.27) ng/L, (10.91 ± 1.16) mg/L, respectively, which were significantly higher than those in the control group [(1.39 ± 0.41) ng/L, (11.72 ± 9.58) ng/L,(2.16 ± 0.65) ng/L, t = 8.040, 16.982, 7.825, all P < 0.05]. Serum levels of interleukin-6 and interleukin-10 in the bacterial plus viral infection group were (4.10 ± 1.09) ng/L and (66.64 ± 7.42) ng/L, respectively, which were significantly higher than those in the control and simple viral infection groups ( t = 13.088, 9.053, 10.031, 15.021, all P < 0.05). Serum C-reactive protein level in the bacterial plus viral infection group was significantly higher than that in the simple viral infection group [(26.28 ± 4.35) mg/L vs. (10.91 ± 1.16) mg/L, t = 21.938, P < 0.05]. Serum procalcitonin level and white blood cell counts in the bacterial plus viral infection group were (0.63 ± 0.04) μg/L, (15.12 ± 3.97) × 10 9/L, respectively, which were significantly higher than those in the control group [(0.13 ± 0.02) μg/L, (7.93 ± 1.91) × 10 9/L, both P < 0.05] and simple virus infection group [(0.07 ± 0.01) μg/L, (8.78 ± 1.12) × 10 9/L, both P < 0.05]. The infection rates of enterovirus 71 and universal enterovirus in the simple viral infection group were significantly lower than those in the bacterial plus viral infection group ( χ2 = 20.329, 31.924, both P < 0.05). Conclusion:Serum procalcitonin level is highly specific and accurate for the diagnosis of hand-foot-and-mouth disease. Serum procalcitonin level and white blood cell can be used together as a sensitive index to identify whether bacterial infection occurs in children with hand-foot-and-mouth disease.

OBJECTIVE: To establish a micellar electrokinetic capillary chromatography-based method for identification and quantitative detection of interleukin-12 (IL-12) and analysis of its unfolding process. METHODS: An uncoated fused-silica capillary (inner diameter 50 μm) with a total length of 48.5 cm (40 cm to the detector) was used for the experiment. The factors influencing the separation efficiency of IL-12 were analyzed, and a standard curve of IL-12 concentration was established. The mixture of IL-12 and anti-IL-12 antibody was incubated in a water bath at 38 ℃ for 40 min, and capillary electrophoresis was then performed under the same conditions. The results were compared with those of IL-12 and anti-IL-12 antibody to identify IL-12. IL-12 and dithiothreitol (DTT) were incubated at 60 ℃ in water bath for different lengths of times, and the unfolding process of IL-12 was analyzed based on electrophoresis results of IL-12 in different states. RESULTS: A micellar capillary electrophoresis on-line sweep method was established with 80 mmol/L borate (pH=9.3) containing 30 mmol/L sodium dodecyl sulfate (SDS) as the buffer solution. This system showed a good linear relationship between the peak area and the mass concentration of IL-12 with a linear correlation coefficient of 0.9991 within the linear range of 2 to 120 ng/L. As the incubation time of IL-12 and DTT prolonged, the disulfide bond of IL-12 gradually opened and resulted in distinct changes in the protein peak. CONCLUSIONS This capillary electrophoresis-based method is simple and sensitive for IL-2 analysis and allows rapid detection of changes in IL-12 content in the setting of tumors and analysis of the possible causes.

Objective To investigate the clinical effect of ibuprofen on preventing intracranial hemorrhage in premature infants and its influence on the levels of NT-proBNP and ET-1.Methods From January 2016 to December 2017,112 premature infants in Taizhou Hospital were selected as study objects after screening by inclusion and exclusion criteria.The infants were randomly divided into observation group and control group according to the digital table,with 56 cases in each group.The control group was treated with routine therapy,and the observation group was given ibuprofen prophylaxis.The incidence of intracranial hemorrhage,clinical index and serum NT-proBNP,ET-1 levels were compared between the two groups.Results There was significant difference in the incidence rate of intracranial hemorrhage between the observation group (17.86％) and the control group (30.36％)(x2 =12.472,P ＜0.05).The serum levels of NT-proBNP and ET-1 in the observation group were significantly lower than those in the control group(all P ＜ 0.05).There were no statistically significant differences in liver function,renal function,coagulation abnormality and oliguria between the two groups (all P ＞ 0.05).There were no statistically significant differences in feeding intolerance and gastric hemorrhage between the two groups (all P ＞ 0.05).Conclusion The application of ibuprofen suspension can effectively prevent intracranial hemorrhage in premature infants,which is worthy of clinical use.

Objective To summarize the prenatal diagnosis and genetic counseling of Turner syndrome fetuses with 46,X,i(X)(q10).Methods Two gravidas admitted to the Obstetrics and Gynecology Hospital of Dalian were enrolled in this study.One gravida,who was admitted in October 2016,was classified as high risk of Down syndrome based on prenatal serologic screening and systematic ultrasonography,which found remarkably shorter humeri and femora than fetus of the same gestations.The other was suggested to be monosomy X after non-invasive prenatal testing and admitted in November 2017.Fluorescence in situ hybridization (FISH) and karyotyping were performed for prenatal diagnosis.Peripheral blood karyotyping was also offered to the two women and their partners.Results FISH test for amniotic fluid did not find numerical abnormality in 13,18,21,and sex chromosomes in these two fetuses.Karyotype analysis showed that the two fetuses were both 46,X,i(X) (q10),while their parents were normal.Both cases were terminated after genetic counseling.Conclusions Prenatal serological screening,systematic ultrasonography and non-invasive prenatal testing may help to identify Turner syndrome fetus of 46,X,i(X) (q10).Timely and accurate prenatal diagnosis may prevent the affected fetus from being born.

One hundred and fifty eight post-stroke patients in the recovering period were divided into intervention group (78 cases) and control group (80 cases).Patients in intervention group received home rehabilitation service provided by general practitioners (GP) for 6 months,while patients in control group received routine rehabilitation.After 6-months,the scores of self-rated health measurement scale (SRHMS) in intervention group were significantly higher than those of control group (P ＜0.01);the visiting time and frequency,medical costs and time of caregiving were decreased (P ＜ 0.01);and the satisfaction score of the patients in intervention group was 97％.The results show that home rehabilitation service can improve effectiveness of rehabilitation for post-stroke patient in recovering period.

Objective To evaluate the clinical effect and efficacy of endoscopy treatment for isolated gastric varices 1 with tissue glue and metal clips. Metheds The clinical date of 21 patients who treated tissue glue and metal clips were retrospectively analyzed from Jan 2015 to Dec 2016. Results The treatments were completed successfully and reviewed by endoscopy after 1 week, 1 month, 3 months, 6 months. The gastric varices were reduced, and the serious complications of bleeding, embolism were little. Conclusion The endoscopy treatment for isolated gastric varices 1 with tissue glue and metal clips is contributed to clinical effect, and the treatment provides a reference for clinical treatment.

[Objective] To analyze the clinical curative effect of 20G and 23G vitrectomy for posterior segment intraocular foreign bodies,to explore the differences of their efficacy and safety.[Methods] This was a retrospective case study.Select 71 patients (71 eyes) who suffered from posterior segment intraocular foreign bodies and underwent different ways of vitrectomy,according to the way of vitrectomy,the patients were enrolled into 20G vitrectomy group (20G group,37 patients,37 eyes) and 23G vitrectomy group (23G group,34 patients,34 eyes).All patients were given wound suture,and patients complicated traumatic cataract should underwent cataract surgery;then were given 20G/23G vitrectomy and extraction of intraction foreign bodies,and (or) be given retinal laser photocoagulation,cryocoagulation,and endotamponade during the procedure.Extraction of intraction foreign bodies and the location of retinal,surgical time,postoperative inflammation and stimulus syndrome,length of hospital stay,the best corrected acuity (BCVA) and other complications after surgery were registered.Minimum follow-up was 6 months.[Results] The rate of extraction of intraction foreign bodies and early retinal reattachment rate were 100％ of the two groups.Comparing the complications after surgery between the two groups,the differences had no statistical significance (all P ＞ 0.05) except the incidence of postoperative ocular hypotenison.The significant difference was found in the comparison of surgical time,average hospitalizcd days,postoperative inflammation score and stimulus syndrome between the two groups,and there were significant differences when the vision distribution before and after surgery in two groups were self-compared (P ＜ 0.05).At lastest follow up,the differences had no statistical significance when comparing the cases of unplanned surgical reoperation,the location of retinal and the vision distribution between the two groups (P ＞ 0.05).[Conclusion] 20G and 23G vitrectomy are both safely and effectively performed in patients with posterior segment intraocular foreign bodies,the efficacy and safety of them are comparable.There is higher incidence of postoperative ocular hypotension in 23G group,and it has an ascendant than 20G group in shorter surgical time and length of hospital stay,lighter postoperative inflamnation and stimulus syndrome.

Objective To explore the treatment experience and surgical strategy in papillary thyroid carcinoma (PTC) patients with parapharyngeal lymph node metastasis. Methods A retrospective review was performed on ten patients with PTC metastasis to parapharyngeal lymph node from January 2005 to August 2014. The treatment experience and surgical strategy were analyzed. Results Three patients accepted initial treatment and 7 patients had a history of surgical treatment prior to PTC. Parapharyngeal lymph node metastasis was diagnosed by imaging examination or fine needle aspiration cytology. Resection of lymph node metastasis was performed via transcervical approach and transmandibular approach. Total thyroidectomy and neck dissection were performed synchronously. All patients received 131I therapy after surgery and did not have recurrence in neck or parapharyngeal space. During follow-up, 3 patients died in 5 years because of lung metastasis, 3 patients survived with tumor , and 4 patients survived without recurrence. The 5-year overall survival rate was 7/10 and the 5-year disease-free was 4/10. Conclusions Parapharyngeal lymph node metastasis from PTC may occur in patients with previous neck dissection or widespread cervical metastases. CT and MRI is helpful for establishing the diagnosis. Surgical resection remains the mainstay of treatment for this disease. PTC patients with parapharyngeal lymph node metastasis have a poor prognosis.

Objective:To observe the clinical curative effect of integrated traditional Chinese and western medicine in the treat-ment of patients with ocular herpes zoster. Methods:Seventy patients with ocular herpes zoster in our hospital were selected during De-cember 2011 to December 2013. According to random number table,the patients were divided into two groups. The patients in the con-trol group were treated with ganciclovir 5. 0 mg·kg-1 ·h-1 , ivd, qd and ganciclovir ophthalmic gel, qid. The patients in the observa-tion group were treated with Banlangen granules and acupuncture additionally. The clinical efficacy, the time of blistering, pain and crusting and adverse reactions in the two groups were observed and compared. Results:After the treatment, the effective rate of the ob-servation group was 94. 29% , while that of the control group was 77. 14% (P<0. 05). The time of blistering, pain and crusting in the observation group was significantly shorter than that in the control group (P<0. 05). The incidence of adverse reactions of the ob-servation group was 2. 86%, while that of the control group was 11. 43%(P>0. 05). Conclusion:The clinical efficacy of integrated traditional Chinese and western medicine in the treatment of ocular herpes zoster is obviously better than that of western medicine treat-ment alone with fewer adverse reactions and shorter time of blistering, pain and crusting.

BACKGROUND:Understanding the difference of miRNA-34s expression in normal tissue and tumor tissue wil contribute to screen out a miRNA with high sensitivity as the specific tumor molecular marker.
OBJECTIVE:To investigate the differential expression of miRNA-34s (miR-34a/b/c) between normal skin and keloid tissue using real-time fluorescent quantitative PCR, and to evaluate the role and mechanisms of miRNA-34s in keloid formation and development.
METHODS:Ten cases of keloid tissue and two cases of normal skin tissue were col ected as specimens. Total RNAs were extracted from keloid and nomal skin tissue by Trizol method, and miRNA-34s were further isolated by Ambion’s miRNA Isolation Kit. Real-time fluorescent quantitative PCR was applied to verify expression levels of microRNA-34s (miR-34a/b/c) in keloid tissue and normal skin tissue.
RESULTS AND CONCLUSION:miRNA-34s (miRNA-34a/b/c) expression was down-regulated in keloid tissue compared with normal skin tissue (P<0.01). The findings showed that miRNA-34s (miRNA-34a/b/c) are involved in keloid formation and development, and down-regulation of the family member may result in neoplastic growth of keloid.