Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

Objective:To explore the nursing knowledge of extracorporeal membrane oxygenation (ECMO) in cardiac surgery nurses and analyze its influencing factors, in order to provide a reference for improving the nursing ability of clinical cardiac surgery nurses.Methods:Totally 104 nurses were selected from the Department of Cardiac Surgery, the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2018, and investigated with the self-designed questionnaire of ECMO-related nursing knowledge and attitude. The status quo and influencing factors of ECMO nursing knowledge in cardiac surgery nurses were analyzed.Results:For the content of ECMO-related nursing knowledge, the percentages of nurses giving the 100% correct answers to "bleeding, anticoagulation problems and nursing measures", "nursing measures of the circulatory system", and "management of the catheter" were higher, being 92.31%, 88.46%, and 84.61% respectively, while the dimension to which the percentage of nurses giving 100% correct answers was the lowest was "prevention and control of related nosocomial infections", which was only 65.38%. The total proportion of nurses who gave 100% correct answers was 79.81%. There was no statistically significant difference in ECMO-related nursing knowledge scores between nurses at different ages ( P>0.05) . The difference in ECMO-related nursing knowledge and attitude scores between nurses with different working years, positions, and educational backgrounds was statistically significant ( F/t=96.834, 12.014, 44.726; P<0.05) . Multiple linear regression analysis showed that 1-3 years of working and educational backgrounds were the influencing factors to the difference in ECMO nursing knowledge scores between cardiac surgery nurses ( P<0.05) , and two variables could account for 65.7% of the variance of ECMO-related nursing knowledge scores in cardiac surgery nurses ( R2=0.657, P<0.01) . Conclusions:Cardiac surgery nurses have a good grasp of ECMO-related nursing knowledge, and 1-3 years of working and educational backgrounds were the influencing factors its scores. Cardiac surgery nurses still need to strengthen learning and training in terms of aseptic technical operation practices and related prevention measures for hospital infection.

Objective? To explore the effects of perioperative blood glucose management in orthopedic diabetic patients. Methods? Totally 75 diabetic patients receiving surgery and requiring blood glucose monitoring 7 times a day in the Department of Orthopedics, He'nan Provincial People's Hospital from October 2017 to February 2018 were included in the control group, who received blood glucose management using conventional methods. Another 79 patients of the same type hospitalized between March and June 2018 were selected into the observation group for whom a blood glucose team was built and an intervention protocol of perioperative blood glucose management was developed. Self-efficacy, blood glucose detection missing rate, patient's satisfaction and average length of hospital stay of the two groups were analyzed before and after intervention. Results? The self-efficacy score of the observation group was higher than that of the control group after intervention;the blood-glucose detection missing rate was lower in the observation group than in the control group; the average length of hospital stay was shorter in the observation group than in the control group; and patient's satisfaction was higher in the observation group than in the control group (P＜ 0.05). Conclusions? Blood glucose management in orthopedic diabetic patients helps to optimize the blood glucose management process, improve patients' self-management capability, reduce diabetic patients' operative risk, guarantee patients' safety, and improve the quality of medical service.

Objective To improve the clinical understanding of glucagonoma. Methods A total of 14 cases of glucagonoma were admitted to our hospital, and the clinical features of these cases were retrospectively analyzed. Results (1) The female/ male case ratio was 1 : 1. (2) The median age of onset was 47 years (range 33-61), while the median age at diagnosis was 50 years (range 33-64). (3) The most common initial presentation was necrolytic migratory erythema (7/ 14, 50％). (4) Hyperglycemia was the most common presentation at the time of diagnosis (14/ 14, 100％), followed by necrolytic migratory erythema (13/ 14, 92.9％). (5) The misdiagnosis rate before admission to our hospital was as high as 85.7％ (12/ 14), and the most common misdiagnosis was eczema (7/ 12, 58.3％). (6) The median time from onset of probable symptoms to diagnosis was 4 years. (7) The median plasma glucagon level at diagnosis was 798 pg/ ml (range 200-2853). (8) The median length of the longest tumor diameter of the pancreatic tumors at diagnosis was 4. 0cm ( range 2. 2-8. 0). ( 9) 57. 1％ of primary pancreatic glucagonomas localized in the tail of the pancreas. (10) 57.1％ of patients (8/ 14) had metastases at the time of diagnosis. Conclusions (1)Necrolytic migratory erythema is a relatively sensitive and specific symptom for diagnosis of glucagonoma. (2) The diagnosis for glucagonoma was often delayed, and misdiagnosis was common. ( 3) Most glucagonoma patients had metastases at the time of diagnosis.

Japanese encephalitis virus (JEV) is a mosquito-borne, zoonotic flavivirus causing viral encephalitis in humans and reproductive disorder in swine. JEV is prevalent throughout China in human; however, spatiotemporal analysis of JEV in Chinese swine herds has not been reported previously. Herein, we present serological and molecular epidemiological results and estimates of prevalence of JEV infections among swine herds in various regions of China. The results suggest that JEV infections are widespread and genotype I and III strains co-exist in the same regions. Therefore, there is an urgent need to monitor JEV infection status among swine herds in China.
Asian Continental Ancestry Group ; China ; Encephalitis Virus, Japanese ; Encephalitis, Japanese ; Encephalitis, Viral ; Flavivirus ; Genotype ; Humans ; Molecular Epidemiology ; Prevalence ; Spatio-Temporal Analysis ; Swine

Objective Discuss the efficacy of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage.Methods Selecting 220 cases patients with gastrointestinal hemorrhage.They were divided into two groups randomly.The observation group (115 cases) was given pantoprazole combined with octreotide.The observation group (105 cases) was given pantoprazole.The efficacy of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage was evaluated by efficacy,perioperative index,SF-36 scores and adverse reaction during 1 month follow-up.Results The effective rate of observation group was significantly higher than that of the control group (P ＜ 0.05).The bleeding time of observation group was shorter than that of control group (P ＜ 0.05).The blood transfusion of observation group was less than that of control group (P ＜ 0.05).The hemoglobin level and pH value observation group was higher than that of control group (P ＜ 0.05).Before treatment,there were no statistical significance on SF-36 scores.After 1 months treatment,physiological function,physical function and pain scores of observation group was higher than that of control group(P ＜ 0.05).During 1 months follow-up,there were no statistical significance on adverse reaction between two groups.Conclusion The pantoprazole combined with octreotide had a good therapeutic effect on gastrointestinal hemorrhage.It could stop bleeding quickly,reduce blood loss and blood transfusion.It could improve the quality of life and use safely with worthy of clinical use.

Cushing's syndrome in pediatrics is very rare. In most child patients, the onset of Cushing's syndrome is insidious. The most common presenting symptom is growth retardationin inconsistant with the weight gain. The most common cause of Cushing's syndrome in children is exogenous administration of glucocorticoids and Cushing' s disease. Here we present a case of pediatric Cushing' s syndrome; the diagnosis and treatment are discussed.

Objective To observe the clinical effect of modified laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways.Methods Forty patients,21 males and 1 9 females,aged 30-55 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective general anes-thesia surgery after failure to direct laryngoscope two attempts were randomly divided into two groups,20 cases in each group.Patients in group LMA-FOB underwent intubation with modified la-ryngeal mask airway combining fiberoptic bronchoscope,and patients in group FOB underwent intu-bation with fiberoptic bronchoscope.The fiberoptic bronchoscope score,the intubation time and the rate of successful intubation at first attempt were recorded.All the patients were followed up postop-eratively for adverse effects.Results The fiberoptic bronchoscope scores (Ⅰ/Ⅱ/Ⅲ/Ⅳ:1 5/4/1/0 vs. 8/4/5/3,P <0.05)and the rate of once successful intubation (90% vs.60%,P <0.05)was signifi-cantly higher,and the intubation time [(75 ± 20)s vs.(105 ± 25 )s,P < 0.05 ]was significantly shorter in group LMA-FOB than that in group FOB.In group LMA-FOB,one patient had blood stain in the LMA and one patient felt slight sore throat.There were no significant adverse effects in the two groups.Conclusion Modified Laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways was effective to improve the grade of the view of the larynn and the success rate of intubation and shorten the intubation time.No significant adverse effect postoperatively was reported. It is relatively safe,effective and promising in patients with difficult airway.

Objective To investigate the effects of Epimedium ,Astragalus ,Radix Puerariae on DMT1 expression in the cere‐bral cortex of APPswe/PS1ΔE9 double transgenic mice model of AD .Methods A total of 60 specific‐pathogen‐free male APPswe/PS1ΔE9 double transgenic mice aged 6 months were equally and randomly assigned to model ,Epimedium ,Astragalus ,Radix puerari‐ae ,compound and DFO groups .An additional 10 6‐month‐old C57BL/6J mice served as negative control group .Using immunohisto‐chemistry and molecular biology methods to investigate the effects of a compound combining the effective components of Epimedi‐um ,Astragalus ,Radix puerariae on DMT1 expression in the cerebral cortex of APPswe/PS1ΔE9 double transgenic mice model of AD . Results Immunohistochemical staining results revealed that DM T 1 positive cell did not show in negative control group .DM T1 ex‐pression was higher in model group compared with the negative control group .DMT1 expression was lower in the compound and deferoxamine groups than in the model group .No significant difference was detected in DM T 1 expression between deferoxamine and compound groups .RT‐PCR ,Western blot and immunohistochemical staining results showed no significant difference .Conclusion These compounds can downregulate DMT1 expression and inhibit iron overload in the cerebral cortex of mice with Alzheimer′s dis‐ease ,reduce iron overload induced impairment of the central nervous system .

Quality control of traditional Chinese medicine is of great importance to ensure its safety and effectiveness in clinic,and is also an obstacle impeding the modernization of traditional Chinese medicine.Though,the complexity of traditional Chinese medicine resulted in some relative weakness of quality standard researches.The critical point need addressing is to establish a sound quality standard system conforming to the characteristics of traditional Chinese medicine in the process of the modernization of Chinese medicine.In this paper,in regard to Dan Hong injection,discriminant strategy of Q-Markers from traditional Chinese medicine injection was clarified from three aspects:what ingredients,which to control and how to control,providing a new vision in the field of the quality standard researches of traditional Chinese medicine.