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Objective@#To analyze the hand-foot-mouth disease (HFMD) enterovirus 71 (EV-A71) infection epidemic characteristics of Guangdong Province from 2011 to 2015.@*Methods@#We colleted data on common cases of hand-foot-mouth disease infected with EV-A71 reported from eight sentinel hospitals in Guangdong Province from January 2011 to December 2015, through the "Guangdong Province Acute Infectious Disease Surveillance Information Platform System" , including the age and incidence of cases. Time and etiological data, etc.We also collected data on the number of reported cases of HFMD disease and the number of laboratory-confirmed cases, through the "China Disease Prevention and Control Information System" , including data on common cases of HFMD disease, data on epidemics of severe cases and deaths, and the age, onset time, and pathogens of cases. Learning data, etc.The data from two sources were used to estimate the incidence of HFMD in EV-A71 and describe its distribution characteristics.Chi-square test was used to compare the positive rate of HF-A71 infection in hand-foot-mouth disease and the difference in estimated incidence among different age groups and months.@*Results@#Eight sentinel hospitals from 2011 to 2015 reported a total of 1 855 common cases of EV-A71 infection, of which the highest was in 2014 (31.6%, 605/1 916) and the lowest was in 2015 (6.8%, 134/1 971) (χ2=521.85, P<0.001).According to the Disease Surveillance Reporting Information System, 1 772 516 cases of HFMD disease were reported from 2011 to 2015 in Guangdong Province, and 1 902 cases of severe and fatal cases of EV-A71 infection.The composition ratio of EV-A71 infected was 72.6% (1 775/2 444) and 97.0% (127/131) of severe HFMD disease in Guangdong province during 2011-2015.The average annual incidence of HF-A71 infection in all age groups showed a decreasing trend with age (χ2trend=990 273.20, P<0.001), and it was the highest in the 1-year-old group, which was 1 697.67/100 000, and the lowest in the 4-year-old group, which was 705.46/100 000. The difference of monthly average incidence of EV-A71 infection in HF-A71 in each month was statistically significant (χ2=401.23, P<0.001), the highest in May at 15.51 per 100 000, and the lowest in July at 9.42 per 100 000.@*Conclusion@#EV-A71 infection rate of ordinary HFMD varies in different years. The most severe and death cases of HFMD were EV-A71 infected. 1 year old children were the high-risk group of infected with EV-A71 HFMD. April was the epidemic months of EV-A71 HFMD infection.
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Objective To evaluate the feasibility and the clinical value of MRI in the diagnosis of small-bowel disease. Methods Sixty-three patients with suspected small-bowel diseases and 3 volunteers without signs of small bowel disease underwent MRI examination. Thirty-one patients whose diagnoses were confirmed by pathology or clinical results were categorized into two groups (neoplastic and normeoplastic). The conspicuity of bowel wall, the sensitivity of MRI in detecting small-bowel lesions, and the accuracy rate of diagnosis were calculated. The average bowel wall thickness between the two groups was assessed by using Wilcoxon signed-rank test. Enlarged mesenteric lymph nodes, mesenteric infiltration, and small-bowel stenosis were analyzed by using Fisher's exact test in each group respectively. Results MRI examinations of all 66 subjects were successfully performed. Images were rated on a continuous 4-peint scale. Sixty-two cases (93.9%) were scored as 2 or 3. The diagnoses of 31 patients (neoplastic group (n = 10) and nonneoplastic group (n = 21) were confirmed by pathology or clinical results. The sensitivity, accuracy of MRI in identifying small bowel diseases were 100% (31/31) and 77.4% (24/31) respectively. The average bowel wall thickness of the two groups was 23 mm(7.0-65.0 mm) and 5 mm(2.0-35.0 mm) respectively, and there was a statistically significant difference between the two groups (Z = - 2.949, P < 0.01). Enlarged lymph nodes in mesentery were found in 7 cases in neoplastic group and 4 cases in nonneoplastic group, and there was a statistically significant difference between the two group (P < 0.05). Small-bowel stenosis was depicted in 10 cases in both groups and there was a statistically significant difference between the two groups (P <0.01). The mesenteric infiltration sign was seen in 5 cases and 17 cases respectively, and showed no significant difference between the two groups (P > 0.05). Conclusion MRI can depict the location and extension of the small-bowel disease accurately and it is an effective method in the diagnosis of small-bowel disease.
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Objective To investigate the MRI features of progressiv e mu scular dystrophy (PMD), and evaluate the diagnostic value of MRI for PMD. Methods Thirty-three biopsy-proved PMD patients underwent MRI of face, scapular, thigh, and leg, including 16 cases of Duchenne muscular dystrophy (DMD), 2 cases of Beck er′s muscular dystrophy, 5 cases of limb-girdle muscular dystrophy, and 10 c ases o f facioscapulohumeral muscular dystrophy. Spin echo sequence, fast spin echo seq uence, and STIR sequence were utilized. Results The signal inte nsity of disease d muscle with DMD, limb-girdle muscular dystrophy, and Becker′s muscular dystr op hy was hyperintense on both T_1-weighted images(T_1WI) and T_2-weighted ima ges (T_2WI). Gracilis muscle of 21 cases, sartorius muscle of 19 cases, semiten dinosus mus cle of 19 cases, and tibialis posterior muscle of 20 cases were relatively spare d. Ten cases with facioscapulohumeral muscular dystrophy displayed two kinds of a bnormal signals: hyperintense on T_2WI and hypointense on T_1WI in all 10 ca ses;hyperintense on both T_2WI and T_1WI in 7 cases. Conclusion The MRI findings in PMD show certain characteri stics: (1)the involved muscles are mainly replaced by fat. (2)On the lower extre mi ty, Gracilis muscle, sartorius muscle, semitendinosus muscle, and tibialis poste rior muscle were relatively spared in DMD, limb-girdle muscular dystrophy, and B ecker′ muscular dystrophy.(3) Facioscapulohumeral muscular dystrophy displays t wo kinds of abnormal signals which represent fat replacement and inflammatory edem a lesion. MRI can provide objective data for clinical diagnosis, therapeutic eva luation, and follow-up. It can also help to decide the accurate localizations f or biopsies.