Complete genome comparative analysis of Coxsackievirus A6 causing hand,foot and mouth disease and herpangina in Yunnan Province in 2018 / 中国生物制品学杂志

@#ObjectiveTo analyze the genome-wide characteristics of 17 strains of Coxsackievirus A6(CVA6)that cause hand,foot and mouth disease(HFMD)and herpangina(HA)in Yunnan Province in 2018,and understand the genetic differences between different pathogenic CVA6.MethodsA total of 1 909 stool samples clinically diagnosed as HFMD and HA in Kunming Children′s Hospital in 2018 were randomly selected for detection using enterovirus group A universal primers and screening of CVA6 positive samples. The CVA6 whole genome sequence was amplified with CVA6 whole genome primers,spliced by BioEdit splicting software,and analyzed for the whole genome characteristics by BioEdit,MEGA 7.0,Simplot,Heml 1.0 and Phyre2softwares.ResultsA total of 929 CVA6 positive samples were screened,and 17CVA6 complete gene sequences were obtained(9 of which were clinically diagnosed as HFMD and 8 were clinically diagnosed as HA). All 17 CVA6 strains were in type IV clade on the whole phylogenetic tree. No significant recombination occurred in HA and HFMD representative strains,while mutations occurred in non-structural protein 3D region. HFMD and HA representative strains showed differences in VP1 loci S597T,Q705L and Q663L. Online predictive analysis showed that the secondary structure of VP1 was consistent with that of CVA6 with no change.ConclusionThe 17 CVA6 strains causing HFMD and HA had high genomic homology,as well as nucleotide and amino acid differences,which may affect the replication and adaptability of CVA6.

Pathogen identification and genotyping of two cluster outbreaks of herpangina in children in Dapeng New District， Shenzhen / 上海预防医学

ObjectiveTo determine the pathogenic characteristics and genotype of two outbreaks of herpangina in children in Dapeng New District， Shenzhen， in May 2021. MethodsA total of five throat swabs from children in the two outbreaks of herpangina were collected and examined for common enteroviruses by real-time PCR. The VP1 region was further amplified by nested RT-PCR. The CLUSTAL W program in MEGA7 software was used to conduct the alignment and reconstruct a phylogenetic tree. ResultsThe pathogen causing the 2 cluster outbreaks of herpangina was coxsackievirus A4 （CVA4）. The sequences of CVA4 VP1 genes revealed that a nucleotide identity of 92% between the strains in the two outbreaks. The three CVA4 strains isolated in kindergarten A had the closest phylogenetic relationship with that isolated in Shenzhen in 2018（MN840533）， with the nucleotide identity of 98.11%. The two strains in kindergarten B had the closest phylogenetic relationship with CVA4 strain isolated in Sichuan in 2018（MW178763）， with the nucleotide identity of 97.88%. The phylogenetic tree showed that all five CVA4 strains in this study belonged to the C2 genotype. ConclusionThe C2 genotype of CVA4 is the causative agent in both outbreaks of herpangina.

The Prediction model of herpangina epidemic trend based on Baidu index and hand, foot and mouth disease / 预防医学

Objective@#To establish a prediction model of herpangina epidemic trend based on Baidu index and hand, foot and mouth disease, so as to provide insights into analyses of communicable disease epidemics with limited or missing surveillance data.@*Methods@#The incidence of hand, foot and mouth disease in Zhejiang Province during the period from the first week of 2015 through the 39th week of 2021 was retrieved from the China Information System for Disease Control and Prevention, and the Baidu index of hand, foot and mouth disease and herpangina was collected via the Baidu search engine during the same period. The correlation between the Baidu index and time series of hand, foot and mouth disease was examined using wavelet analysis. In addition, a random forest training model was created based on the Baidu index and incidence of hand, foot and mouth disease, and the fitting effectiveness was evaluated using the mean percentage error, while the Baidu index of herpangina was included in the model to predict the epidemic trend of herpangina during the study period.@*Results@#The Baidu index of herpangina and hand, foot and mouth disease, and the Baidu index and incidence of hand, foot and mouth disease all appeared two peaks at the 26th and 52th week. The phase difference was less than 0.1 week between the Baidu index and time series of hand, foot and mouth disease, and the mean percentage error of the training model was 13.07%, with high concordance between the predicted number and actual report number of cases with hand, foot and mouth disease. The numbers of herpangina cases were predicted to be 28 822, 27 341, 28 422, 51 782, 52 457 and 5 691 from 2015 to 2020, and there were totally 48 702 herpangina cases reported until the 39th week of 2021. Like hand, foot and mouth disease, the incidence of herpangina peaked between May and July.@*Conclusion@#The random forest training model based on the Baidu index and incidence of hand, foot and mouth disease is feasible to predict the epidemic trend of herpangina.

Research progress on the correlation between herpangina and hand⁃foot⁃mouth disease / 口腔疾病防治

@# As acute enterovirus⁃induced infections, herpangina(HA) and hand⁃foot⁃mouth disease(HFMD) are simi⁃lar in many aspects. Although these diseases vary with time and region, many studies have shown that the viruses caus⁃ing HA and HFMD are consistent, and there is no notable difference in partial VP1 gene sequences between different vi⁃ruses. HA and HFMD also resemble each other in epidemiological features. Both infections show significant summer⁃time seasonality, have a strong connection with certain environmental conditions and are most prevalent in young chil⁃dren and infants. Herpangina is thought to be a mild disease, defined as vesicular enanthem and then ulcers of the fau⁃ces and soft palate with presentation of feve r, sore throat, and decreased appetite. HFMD, which could lead to severe symptoms, is also characterized by oral ulcers, although they are chiefly on the buccal mucosa and tongue, and typical vesicular rashes, which are most commonly found on the hands, feet, knees and buttocks. While HA is generally be⁃ lieved to be self⁃limited and has a favorable prognosis, HA with certain clinical characteristics, such as diarrhea, vomit⁃ing, limb jitter and sleepiness, can evolve into HFMD, according to some literature in recent years. However, HA is an independent risk factor for HFMD, and severe cases only present with herpes appearing at the isthmus of the fauces at an early stage, which indicates a strong correlation between them. Clinical manifestations of HA should be considered by medical staff to identify potential children with HFMD as early as possible to prevent its further development or transformation.

Observation on the effect of Jinqiao-Reduqing granule for hte children with herpetic angina fever / 国际中医中药杂志

Objective To evaluate the effect of Jinqiao-Reduqing granule in the treatment of children with herpes angina fever.Methods A total of 90 children with herpes angina were randomly divided into two groups,with 45 cases in each group.Both groups received the symptom-supported treatment.On this basis,the control group took ribavirin granules,while the observation group took Jinqiao-Reduqing granule.Both groups were treated for 4 days.The symptoms and signs were scored before and after treatment.The fever abatement time,herpes subsidence time,salivation disappearance time and appetite recovery time were observed and recorded.The serum levels of IL-2,IL-6,IL-10 and TNF-α were detected by ELISA,and peripheral blood levels of CD4+,CD8+,CD4+/CD8+ were detected by flow cytometry.Results After treatment,the scores of symptoms and signs in the observation group were significantly lower than those in the control group (3.02 ± 2.89 vs.6.88 ± 2.31;t=6.999,P＜0.01).The time of fever abatement (16.8 ± 3.2 h vs.29.9 ± 4.4 h,t=16.202),herpes subsidence (72.3 ± 5.4 h vs.96.7 ± 6.2 h,t=19.765),salivation disappearance (26.4 ± 2.0 h vs.46.3 ± 3.6 h,t=32.479) and appetite recovery (19.6 ± 4.2 h vs.39.7 ± 4.9 h,t=20.907) were significantly earlier than those in the control group (P＜0.01).After treatment,the serum levels of IL-2,IL-6,IL-10 and TNF-α in the observation group were lower than those in the control group (t were 4.974,4.410,6.447 and 4.767,respectively,all Ps＜0.01);CD4+ levels and CD4+/CD8+ were significantly higher than those in the control group (t were 4.033,6.860,all Ps＜ 0.01),and CD8+ levels was significantly lower than those in the control group (t=4.928,P＜0.01).Conclusions The Jinqiao-Reduqing granule can shorten the time of symptoms subsidence,reduce the level of inflammatory cytokines and improve the immunity of children with herpes angina fever.

Epidemiological characteristics and etiology of herpangina cases in Xi’an, 2016 / 中华实验和临床病毒学杂志

Objective@#To analyze the epidemiological characteristics and etiologic agent of herpangina in Xi’an in 2016.@*Methods@#Herpangina epidemiological data and random stool samples were collected from two sentinel hospitals. The data were statistically analyzed with Excel and SPSS 18.0 and samples were detected and enteroviruses were genotyped using real-time PCR and RT-snPCR.@*Results@#Totally 421 cases were reported and the male-to-female ratio was 1.54∶1, age ranged from 3 month to 13 years, and 90.50% were under three years of age. Herpangina showed semiannual peaks in April to October, of which the highest was in June (23.75%, 100/421). Lab result showed that 71.05% were EV positive out of 152 samples, and further genotyping indicated 60 were non-typable, and other 48 comprised of eight serotypes of EV including EV-A71, CV-A4, CV-A5, CV-A6(6.48%), CV-A10(23.15%), CV-A12, CV-A16 and CV-B3.@*Conclusions@#Male children under 3 years of age were the main population and herpangina cases were most frequently reported in June in Xi’an in 2016. CV-A6 and CV-A10 were more frequently detected in the typable ones.

Efficacy and Safety of Lanqin Oral Liquid for Herpangina in Children ：a Meta-analysis / 中国药房

OBJECTIVE： To systematically evaluate the efficacy and safety of Lanqin oral liquid in the treatment of herpangina in children. METHODS： Randomized controlled trials （RCTs） involving Lanqin oral liquid or routine symptomatic treatment combined with Lanqin oral liquid （trial group） versus routine treatment （control group） in the treatment of pediatric herpangina were retrieved  from PubMed， Embase， CBM， CNKI， Wanfang database， VIP database， etc. Meta-analysis was performed by using Rev Man 5.3 software after literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0. RESULTS： A total of 11 RCTs were included， involving 1 204 patients. Meta-analysis showed that total response rate [RR＝1.17， 95％CI（1.10， 1.24）， P＜0.000 01]， fade time of herpes [MD＝－2.17， 95％CI（－2.63， －1.72）， P＜0.000 01] and fade time of fever [MD＝－1.52， 95％CI（－1.72， －1.31）， P＜0.000 01] in trial group was significantly higher than in control group. There was no statistical significance in the incidence of ADR between 2 groups [RR＝1.00， 95％CI（0.52， 1.93）， P＝1.00]. Subgroup analysis based on rehydration symptomatic treatment showed that without rehydration， fade time of herpes in trial group was significantly shorter than control group [MD＝－1.64， 95％CI （－2.03， －1.26）， P＜0.000 01]； with rehydration， fade time of herpes in trial group was significantly shorter than control group [MD＝－2.79， 95％CI（－2.97， －2.61），P＜0.000 01]. CONCLUSIONS： Lanqin oral liquid can effectively improve therapeutic efficacy of herpangina patients， effectively shorten fade time of fever and herpes， without increasing the occurrence of ADR.

Epidemiological survey of common enterovirus infections among children in Hangzhou ,2016 / 中华传染病杂志

Objective To investigate the prevalence of common enterovirus infections among children in Hangzhou ,2016 .Methods A total of 2977 of throat swabs samples or stool samples from suspected children with enterovirus infection at Hangzhou Children′s Hospital in 2016 were collected . Enterovirus universal nucleic acid ,enterovirus type 71 (EV71) ,Coxsackievirus A (CoxA)16 ,CoxA6 , CoxA4 and CoxA10 were detected by real-time fluorescent quantitative polyoneras chain reaction .The detection positive rates among children with different genders and ages were compared by χ2 test .Results The total enterovirus positive rate of 2977 specimens was 49 .7％ (1480/2977) .Among them ,CoxA6 , EV71 ,CoxA16 ,CoxA4 ,CoxA10 and other enteroviruses accounted for 30 .2％ (447) ,19％ (281) , 10 .2％ (151) ,6 .8％ (101) ,3 .4％ (51) and 30 .3％ (449) ,respectively .Among 1480 enterovirus positive children ,882 cases were male and 598 were female ,with no statistical significance (χ2 = 4 .564 , P=0 .471) .The detection rates of enterovirus in children with hand ,foot and mouth disease (HFMD ) , herpangina and other diseases were 64 .4％ (1051/1632) ,52 .4％ (323/616) and 14 .5％ (106/729) , respectively .The difference among groups was significant (χ2 =503 .387 , P<0 .01) .The prevalences of CoxA6 ,EV71 and CoxA16 in enterovirus-positive HFMD children were 36 .7％ (386) ,25 .3％ (266) and 12 .4％ (130 ) , respectively . The prevalences of CoxA4 , CoxA6 and CoxA10 in enterovirus-positive herpangina children were 20 .1％ (65 ) , 14 .9％ (48 ) and 8 .7％ (28) , respectively , and those of entrovirus ,CoxA4 and CoxA6 in other enterovirus-positive specimens were 59 .4％ (63) ,14 .2％ (15) and 12 .3％ (13 ) , respectively . The enterovirus constituent ratios among children with HFMD , herpangina and other diseases was statistically different (χ2 =399 .758 ,P<0 .01) .The positive rates of enterovirus among different age groups were statistically different (χ2 = 142 .899 , P< 0 .01 );the constituent ratios of enterovirus among different age groups were also statistically different (χ2=106 .160 , P<0 .01) .Conclusion The enterovirus detection rate of CoxA6 is highest ,followed by EV71 and CoxA16 among children in Hangzhou ,2016 .

Clinical effect of Reduning in the treatment of children with herpangina and its influence on serum creatine kinase (CK), CK-MB activity, CK-MB quality, cTnⅠ / 中国基层医药

Objective To explore the clinical effect of Reduning in the treatment of children with herpangina,and its influence on serum creatine kinase (CK),creatine phosphate kinase isoenzyme (CK-MB) activity,CK-MB quality,cardiac troponin Ⅰ (cTnⅠ).Methods 104 children with herpangina were divided into control group and research group according to the draw method,with 52 cases in each group.The control group was given conventional treatment,the research group was treated with Reduning on the basis of conventional treatment.The clinical curative effect,clinical symptoms disappear time,CK,CK-MB activity,CK-MB quality,inflammation factors,immune function before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the research group was higher thanthat of the control group (98.07％ vs.84.61％),the difference was statistically significant (P ＜ 0.05).Before treatment,the CK,CK-MB activity,CK-MB quality,cTnⅠ of the two groups had no statistically significant differences (all P ＞ 0.05).After treatment,the CK,CK-MB activity,CK-MB quality,cTnⅠ of the research group were lower than those of the control group [(55.87 ± 6.98) U/L vs.(68.42 ± 8.55) U/L,(22.70 ±2.84)U/L vs.(29.45 ± 3.65)U/L,(2.99 ± 0.37) μg/L vs.(4.48 ±0.56) μg/L,(0.16 ± 0.02) μg/L vs.(0.74 ± 0.09) μg/L],the differences were statistically significant (all P ＜ 0.05).The incidence rate of adverse reaction of the research group was lower than that of the control group,the difference was statistically significant(P＜0.05).Conclusion Theclinical effect of Reduning in the treatment of children with herpangina is sure,it can help to relieve clinical manifestations,reduce serum levels of CK,CK-MB activity,CK-MB quality,cTnⅠ,and can alleviate the body's inflammatory response and immune function.

Etiological characteristics of herpangina cases in Guangzhou city in Guangdong province, 2015 / 中华实验和临床病毒学杂志

Objective@#To analyze the etiological of herpangina(HA) in Guangzhou City in 2015, and to provide laboratory data for the epidemic control.@*Methods@#Two hundred and eleven herpangina samples (stool and throat swab) were collected.Real-time (RT)-PCR and semi-nested (Sn)-PCR assays were performed to detect human enteroviruses (HEVs)-positive samples. The human rhabdomyosarcoma (RDa) cell lines were used to inoculate virus from HEVs-positive samples. The entire sequences of viral genes encoding VP1 of CVA6 positive samples or strains were amplified and sequenced. The phylogenetic analysis was performed to analyze the full-length gene sequences encoding VP1 of CVA6 by using DNAStar6.0 and MEGA5.2 software packages.@*Results@#According to the laboratory test results, 115 cases were HEVs-positive and positive rate was 93.50%, eight serotypes of EV including CVA6, CVA10, CVA2, EV71, CVA16, CVB2, Echo14 and Echo30 were detected.The CVA6 positive rate was the highest with a percentage of 60.98%, followed by CVA10 with a percentage of 13.01%. The enterovirus positive rate of stool samples (χ2=29.88, P<0.01) and viruses isolated positive rate (χ2=8.67, P<0.01) were higher than that in throat swab samples. Phylogenetic analysis showed that all CVA6 strains detected in this study belonged to D3 subgenotype, and shared 96.9%-99.9% homologies in nucleotide and 99.0%-100.0% in amino acid.@*Conclusions@#CVA6 of the enterovirus A group accounted for the main pathogen of herpangina in Guangzhou City in Guangdong province in 2015, which belonged to D3 subgenotype.

Clinical observation of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate on treating Herpangina in children / 中国生化药物杂志

Objective To observe the clinical curative effect of aerosol inhalation of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate in treatment children with herpangina. Methods A total of 106 cases of children with herpangina were collected in Zichang County People's hospital from July 2014 to Dec. 2016. All cases were randomly divided into the treatment group (54 cases) and the control group (52 cases) by double blind method. The treatment group was given inhalation treatment of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate, the control group were treated with Xiyanping plus Ribavirin Spray. The clinical efficacy and recurrence rate were compared before and after treatment. Results The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05), and the adverse reactions and recurrence rate were significantly lower than that of the control group (P<0.05). Conclusion Inhalation treatment of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate in children with Herpangina has significant clinical efficacy with less adverse reaction and lower recurrence rate.

Clinical observation of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate on treating Herpangina in children / 中国生化药物杂志

Objective To observe the clinical curative effect of aerosol inhalation of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate in treatment children with herpangina. Methods A total of 106 cases of children with herpangina were collected in Zichang County People's hospital from July 2014 to Dec. 2016. All cases were randomly divided into the treatment group (54 cases) and the control group (52 cases) by double blind method. The treatment group was given inhalation treatment of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate, the control group were treated with Xiyanping plus Ribavirin Spray. The clinical efficacy and recurrence rate were compared before and after treatment. Results The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05), and the adverse reactions and recurrence rate were significantly lower than that of the control group (P<0.05). Conclusion Inhalation treatment of Xiyanping combined with Potassium Sodium Dehydroandroan drographolide Sucinate in children with Herpangina has significant clinical efficacy with less adverse reaction and lower recurrence rate.

Vesiculobullous lesions of the oral cavity

Vesiculobullous lesions are a type of mucocutaneous disease that is characterized by vesicles and bullae or blisters. Both vesicles and bullae are fluid-filled lesions, and they are distinguished by size, vesicles being less than 5–10 mm and bulla being larger than 5–10 mm, In the case of vesiculobullous diseases which are also immune disorders the term immunobullous is sometimes used. This review will provide an overview of vesiculobullous lesions involving oral cavity, their characteristic features and recent developments in the diagnosis of these lesions.

Meta-analysis of Xiyanping Combined with Ribavirin in the Treatment of Herpangina in Children / 中国药房

OBJECTIVE:To systematically review the efficacy and safety of Xiyanping injection versus Ribavirin injection in the treatment of herpangina in children,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,VIP Database,CJFD,Wanfang Database and CBM,randomized controlled trials (RCT) about efficacy and safety of Xiyanping injection versus Ribavirin injection in the treatment of herpangina in children were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extracting and quality evaluating by modified Jadad. RE-SULTS:Totally 14 RCTs were enrolled,involving 1 939 patients. Results of Meta-analysis showed total effective rate [OR=4.69, 95%CI(3.36,6.55),P<0.001],fever clearance time [MD=-1.36,95% CI(-1.60,-1.12),P<0.001],herpes regression time [MD=-1.34,95%CI(-1.61,-1.06),P<0.001],hospitalization time [MD=-1.88,95% CI(-3.68,-0.07),P=0.04] and sali-vation disappearance time [MD=-1.07,95% CI(-1.30,-0.84),P<0.001] of Xiyanping injection were significantly better than Ribavirin injection,there were statistically significant differences. And there was no significant difference in the incidence of ad-verse reactions [OR=0.56,95% CI(0.31,1.03),P=0.06]. CONCLUSIONS:The efficacy of Xiyanping injection is better than Rib-avirin injection in the treatment of herpangina in children,with similar safety.

Clinical significance of the detection of myocardial enzymes and high sensitive C- reactive protein in chil-dren with herpangina / 国际儿科学杂志

Objective To evaluate the clinical significance of myocardial enzymes and high sensitive C-reactive protein( hs-CRP) in children with herpangina. Methods A total of 80 children with herpangina( obser-vation group,n=80),at the same time,50 healthy children as control group(n=50)were assigned for the detec-tion of myocardial enzymes(AST,LDH,CK,CK-MB)and hs-CRP. Results The elevated CRP levels were found in 45(56. 25%)patients of observation group and 2(4%)patients of the control group,showing statistical significance(χ2 =31. 55,P<0. 01). Abnormal myocardial enzyme levels were observed in 59(73. 75%)cases, which included AST 51. 6%, CK 40. 1%, CK-MB 21. 4%, LDH 72. 2%. Abnormal myocardial enzyme levels were observed in 6(12%) cases of control group,which included AST l6%,CK 10%,CK-MB 4% and LDH 12%. The significant differences were observed between the two groups ( P<0. 01 ) . Conclusion Herpangina children may have different degrees of myocardial damage. Myocardial enzymes and hs-CRP are useful indicators for myocardial injury which may effectively provide reference for clinical diagnosis and treatment.

Clinical analysis of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease / 中国医师进修杂志

Objective To analyze the clinical characteristics of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease (HFMD).Methods The clinical data of 94 patients with herpangina during outbreak of HFMD were collected.Enteroviruses 71 (EV71) and Coxsackie virus A16 (CA16) were detected by real-time polymerase chain reaction.And relevant indicators of two groups were compared.Results There were 34 cases EV71 positive (36.17％,34/94,EV71 positive group) and 31 cases CoxA 16 positive (32.98％,31/94,CoxA 16 positive group) from the results of pathogen detection.The level of white blood cell count,glucose,erythrocyte sedimentation rate,hypersensitive C-reactive protein were increased obviously than normal,while no significant difference was found between two groups (P ＞ 0.05).The level of myocardial enzymes,creatinine,blood urea nitrogen were in the normal range and no significant difference was found between two groups (P ＞ 0.05).There was no significant difference between two groups in the incidence of age ＜ 3 years old,persistent high fever (P ＞ 0.05).The abnormalities performance in the nervous,respiratory,circulatory system of the EV71 positive group were significantly higher than those in CoxA 16 positive group [26.47％ (9/34) vs.6.45％ (2/31),23.53％ (8/34) vs.3.23％(1/31),20.59％ (7/34) vs.3.23％ (1/31) separately],and there were significant differences between two groups(P ＜ 0.05).There were 11 severe cases (11.70％,11/94) in the 94 cases of children with herpangina,and 9 cases belonged to the EV71 positive group,2 cases belonged to the CoxA16 positive group.Two cases died of lung hemorrhage,1 case occurred of paralysis,all of them were detected EV71 positive.Conclusions The pathogen of herpangina might be same as the pathogen during the outbreak of HFMD.Children with herpangina during outbreak of HFMD should be incorporated into the management of HFMD.EV71 positive children are serious than CoxA16 positive cases,and detecting pathogens will be helpful to determine the prognosis.

Observation of the curative effect of vidarabine and interferonα-2b aerosol inhalation in the treatment of 58 cases children with infantile herpangina / 中国基层医药

Objective To observed the clinical effect of vidarabine and interferonα-2b aerosol inhalation in the treatment of children with infantile herpangina.Methods 58 children with infantile herpangina were divided ran-domly into the observation group and control group,29 cases in each group.All children were given theroutine nursing and general supportive therapy.The patients in the control group were treated by ribavirin and those in the observation group treated by vidarabine and interferon aerosol inhalation.The fever clearance time,the disappearance time of her-pes,the days of hospitalization and cases of adverse reaction was observed and recorded.Results The cooling time, bleb disappear time and hospital stay of the observation group were lower than those of the control group,the difference were statistically significant(P <0.05).Comparation of the clinical effects of the two groups showed that the test group were significantly better than those in the control group(P <0.05).The total effective rate in the observation group was 96.6%,which was higher than 75.9% in the control group(χ2 =5.22,P <0.05).No obvious adverse e-vents took place in both groups.Conclusion Vidarabine and interferon aerosol inhalation in treating infantile herpan-gina takes a good effect,no obviously adverse reaction and is worth being widely applied in clinic.

Risk Factors for Neurologic Complications of Hand, Foot and Mouth Disease in the Republic of Korea, 2009

In 2009, the first outbreak of hand, foot and mouth disease (HFMD) or herpangina (HP) caused by enterovirus 71 occurred in the Republic of Korea. This study inquired into risk factors associated with complications of HFMD or HP. A retrospective medical records review was conducted on HFMD or HP patients for whom etiologic viruses had been verified in 2009. One hundred sixty-eight patients were examined for this investigation. Eighty patients were without complications while 88 were accompanied by complications, and 2 had expired. Enterovirus 71 subgenotype C4a was the most prevalent in number with 67 cases (54.9%). In the univariate analysis, the disease patterns of HFMD rather than HP, fever longer than 4 days, peak body temperature over 39degrees C, vomiting, headache, neurologic signs, serum glucose over 100 mg/dL, and having an enterovirus 71 as a causative virus were significant risk factors of the complications. After multiple logistic analysis, headache (Odds ratio [OR], 10.75; P < 0.001) and neurologic signs (OR, 42.76; P < 0.001) were found to be the most significant factors. Early detection and proper management of patients with aforementioned risk factors would be necessary in order to attain a better clinical outcome.

A case of Enterovirus 71 Infection Presented with Acute Flaccid Paralysis in Jeju Island / 대한소아신경학회지

Most human enterovirus 71 (EV71) infections present with mild conditions such as hand-foot-mouth disease or herpangina. However, EV71 can invade the central nervous system, causing neurologic diseases such as brainstem encephalitis, meningitis and acute flaccid paralysis despite the near complete eradication of polioviruses. Neurological complications from EV71 infection occur within a few days and can lead to death even though rare. There is no report for EV71 infection with severe neurological manifestation in Jeju Island so far. We therefore report a case of EV 71 infection with bilateral acute flaccid paralysis for the first time in Jeju Island with review of related articles.

Study on Clinical Effect of Interferon Combined with VitAD ,Nystatin and Lidocain in Treatment of Children Herpangina / 中国基层医药

Objective To study the effecticacy of interferon Combined with vitAD,nystatin with lidocain in treatment of children with herpangina. Methods 128 cases with herpangina were divided into two groups. All of them inhaled interferon,68 cases in treatment group were treated with vitAD and nystatin with lidocain. 60 cases in control group were given mengtuoshi. The treating course was two to five days. Results The total curative rate of treatment group ( 100% ) was much higher than that of control group (85 % ) ( P ＜ 0. 01 ). Conclusion Interferon and vi tAD and nystatin with lidocain was safe and efficacious in treatment of children with herpangina.