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Objective To analyze the distribution and type characteristics of human papillomavirus (HPV) infection in women in Shiyan, Hubei region, so as to provide a basis for the prevention and treatment of HPV infection. Methods From January 2019 to December 2020, a sample of 3,180 women in XX region who had sexual intercourse experience were randomly selected, and their HPV genotypes were tested using flow-through hybridization, then the distribution characteristics and types of HPV infection in women of different ages were observed. Results Among of 3 180 patients, HPV infection was predominant in women aged 31-50 years , with 25.85% (822/3 180) aged 31-40 years and 22.08% (702/3,180) aged 41-50 years. HPV infection was the least prevalent in the ≤25 and >60 years age groups, with 428 cases and 289 cases respectively. HPV infection occurred in 1 310 out of 3 180 women , with a positive infection rate of 41.19% (1 310/3 180). HPV infection was most prevalent in the ≤25 years and ≥60 years age groups, accounting for 56.78% and 67.13% respectively. Single infection was the main infection type in all age groups, accounting for 76.03%. Twenty-one HPV genetic subtypes were detected in the subjects, out of a total of 1 918 strains of the virus. The main high-risk subtypes for single infection were HPV16, HPV52 and HPV58, accounting for 13.92%, 13.87% and 12.57% respectively, followed by HPV53 and HPV33, accounting for 7.61% and 5.58% respectively. The predominant low-risk subtypes for single infection were HPV11, HPV8 and HPV6, with accounting for 7.51%, 5.47% and 5.01% respectively. Conclusion HPV infection in women in Shiyan, Hubei region is predominantly in the ≤25 and ≥60 years age groups, and early clinical screening and preventive measures such as vaccination for high-risk HPV typing are of vital importance.
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Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in Shijiazhuang City from 2009 to 2021, and to provide scientific evidence for the prevention and control of HFMD. Methods The epidemic data and etiological data of HFMD in Shijiazhuang City from 2009 to 2021 were collected, and descriptive epidemiological methods were used for data analysis. Results The reported incidence of HFMD in Shijiazhuang showed a fluctuating downward trend from 2009 to 2021, with a high incidence every other year in most years. The proportion of severe cases and the mortality rate showed a decreasing trend (χ2severe cases=282.09, P2mortality=51.33, P2=4 507.84，Pr=-2.85，P22 =521.86，P2proportion of severe cases=93.71，P=0.000，χ2mortality rate=26.62，P=0.000，χ2proportion of EV71=1060.86，P=0.000). Conclusion The incidence of HFMD in Shijiazhuang presented a declining trend, and the dominant etiological changes of different cases were different. It is necessary to continue to strengthen the etiological monitoring, health education and EV71 vaccination for the prevention and control of HFMD.
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@#Hand-foot-mouth disease(HFMD) is an infectious disease that seriously affects the health of infants and young children and has become a major public health problem worldwide,especially in the Asia-Pacific region.HFMD can be caused by a variety of enteroviruses,the most common being enterovirus 71(EV71) and Coxsackievirus A16(CVA16).In recent years,with the significant increase of HFMD caused by Coxsackievirus A6(CVA6) infection,CVA6 has gradually become the main pathogen of HFMD in many countries and regions around the world.CVA6 is not only susceptible to children,but also infects adults with normal immune function.The paper reviewed the CVA6 related etiology,epidemiology,clinical symptoms,laboratory diagnosis and development of vaccine.
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ObjectiveThis study aimed to understand the epidemiological characteristics of hand-foot-mouth disease （HFMD） in Minhang District， Shanghai from 2009 to 2020， and provide a scientific basis for the prevention and control of HFMD. MethodsThe case information of HFMD was collected from the National Notifiable Infectious Diseases Reporting System of Chinese Center for Disease Control and Prevention. We used descriptive epidemiological methods to analyze the population characteristics， temporal and spatial distribution of HFMD， the pathogen composition of the case and its changing trend. ResultsFrom 2009 to 2020， a total of 66，198 cases of HFMD were reported in Minhang District， Shanghai， including 377 severe cases （severe case rate 0.57%） and 3 deaths （severs case fatality rate 0.80%）. There were more cases of HFMD in boys than in girls （1.5∶1）. HFMD patients aged under 5 years predominated， accounting for 88.91% of all cases. Majority of the cases （91.42%） were in scattered children （55.80%） and children in kindergartens （35.62%）. The incidence showed a cyclical trend， with low incidence years and high incidence years appearing alternately. The peak period was from April to July， and sometimes there were small peaks during October to December. A total of 12 years time-space scanning analysis revealed 3 clusters. The cluster centers were located in Wujing Town， Huacao Town and Xinzhuang Town， respectively. The proportion of EV71 in common cases was generally decreasing， and reduced to zero in 2019. The proportion of CoxA6 had increased year by year， and reached 75.00% in 2020. CoxA6 became the dominant pathogen in recent years. The number of severe cases had decreased year by year since 2010， and the dominant pathogen was EV71 （90.03% on average） in severe cases. ConclusionThe incidence of HFMD in Minhang District of Shanghai has a downward trend from 2014. The dominant pathogen changes from EV71 to CoxA6， and the dominant pathogen in severe cases is EV71. The discovered temporal and spatial clustering pattern is helpful for in-depth understanding of the distribution and epidemic trend of HFMD in Minhang District， and provides a scientific basis for epidemic prevention and control.
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OBJECTIVES@#To investigate the epidemic situation of hand-foot-mouth disease (HFMD) in Hunan Province, China, from 2008 to 2019, as well as its spatial autocorrelation characteristics and spatial-temporal clustering, and to provide a reference for the prevention and control of HFMD in Hunan Province.@*METHODS@#Spatial autocorrelation and spatial-temporal clustering analyses were used to analyze the monitoring data of HFMD in Hunan Province from 2008 to 2019.@*RESULTS@#The epidemic situation of HFMD in Hunan Province from 2008 to 2019 showed obvious seasonal distribution, with a low incidence rate in January to March and a high incidence rate in April to July. As for population distribution, children aged 0-5 years had the highest number of HFMD cases and accounted for 95.89% (1 460 391/1 522 910) of all cases, with a mean annual incidence rate of 2 197.784/100 000, and scattered children had the highest number of cases and accounted for 82.59% (1 257 739/1 522 910) of all cases. The global spatial autocorrelation analysis showed that the onset of HFMD in Hunan Province showed a significant clustering distribution, and the local spatial autocorrelation analysis showed that the high clustering areas of HFMD were mainly the districts and counties of Changsha, Zhuzhou, and Yueyang cities. Time-space scanning showed that clustering time was mainly April to July; the cases were clustered in the northeast of Hunan Province from 2008 to 2010 and in the central part of Hunan Province from 2011 to 2019.@*CONCLUSIONS@#The high incidence rate of HFMD is observed in April to July in Hunan Province. Children under 5 years of age are at a high risk of this disease. Spatial-temporal clustering is observed for the epidemic of HFMD, mainly clustered in the northeastern and central areas of Hunan Province. It is suggested that the results may be used as guidance to determine the key areas for HFMD prevention and control in Hunan Province and optimize the allocation of health resources.
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Child , Child, Preschool , Humans , Infant , China/epidemiology , Cluster Analysis , Hand, Foot and Mouth Disease/epidemiology , Incidence , Spatio-Temporal AnalysisABSTRACT
ABSTRACT Hand, foot, and mouth disease (HFMD) is an acute viral infection occurring mostly in infants and children. Enterovirus 71 (EV71) infection mostly occurs in children < 5 years of age. Severe cases, however, are usually encountered in children under the age of 3 years, and exceedingly rare in teenagers > 14 years and adults. In this report, we present the case of an 11-year-old boy presenting with a hand, foot and mouth disease typical of HFMD.
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Humans , Female , Child , Hand, Foot and Mouth Disease/diagnosis , Hand, Foot and Mouth Disease/drug therapy , Histamine Antagonists/administration & dosageABSTRACT
@# 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.
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Objective To understand the epidemic characteristics of different virus types of hand, foot and mouth disease (HFMD) in Zhaotong City, and provide guidance and recommendations for the prevention and control of HFMD, and to analyze seasonal characteristics of different virus types of HFMD in Zhaotong City. Methods The epidemiological characteristics of different virus types of HFMD in Zhaotong City from 2014 to 2017 were analyzed using the concentration and circular distribution methods. Results The main pathogens detected were EV71, Cox A16 and other enteroviruses, which were 216, 182, and 294, respectively, accounting for 57.45%, 73.44%, and 67.11%. M was 0.86, indicating that EV71 had strong seasonality. The Rayleigh test showed statistically significant differences (Z = 99.53, P <0.001). ā = 157 °, the peak day of onset was May 10, similar to untyped (May 16), the peak period was April 21-June 1, and the epidemic period was April 1-June 21. Conclusion According to the incubation period of hand-foot-mouth disease and the period of time during which the vaccine develops protective effects, vaccination of hand-foot-mouth disease vaccine at the peak period has a good guiding significance for the timeliness and pertinence of vaccination.
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Hand-foot-mouth disease (HFMD) is a common infectious disease caused by enterovirus in children. It has a high incidence and can cause fatal complications such as pulmonary edema, myocarditis and aseptic meningitis, seriously threatening the health of children. At present, some core problems such as the pathogenesis of disease, the relationship between different genotypes of pathogenic viruses, the pharmacodynamic evaluation methods, and the antiviral mechanism of drugs are still unclear. The construction of disease animal models with simulation performance of human exposure is the key to solve the above problems. Researchers both at home and abroad have established a variety of animal models for HFMD, of which enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are most common and most widely used. Both EV71 and CA16 are enterovirus A in picornavirus family, so they have similarities in terms of pathogenicity, infection and replication characteristics, clinical symptoms caused by infection and immune response, but also have significant differences in age of susceptibility, method of infection, as well as neurotoxicity, clinical symptoms and signs, and degree of tissue and organ damage. Therefore, researchers shall select and establish proper animal models based on actual conditions, which is critical to the reliability of the results. In this paper, the different types of HFMD animal models established by EV71 and CA16 viruses were reviewed, especially on the species strains, virus strain types, infection methods, and characteristics of viral infections in each model, and the characteristics and clinical symptoms of HFMD induced by EV71 and CA16 were also investigated to provide reference for related research.
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Objective@#To understand the situation of inoculation and influencing factors of children in the Xicheng District of Beijing after the enterovirus 71（EV71）vaccine was marketed .@*Methods@#A questionnaire survey was conducted among the parents of children aged 6 to 35 months in the vaccination clinics in Xicheng District from May to September 2017. Demographic characteristics,awareness of hand-foot-mouth disease and EV71 vaccine,the access to these knowledge,acceptance of the vaccine price and advice on the management were collected. The influencing factors for EV71 vaccination were analyzed by multivariate logistic regression .@*Results@# There were 1 850 out of 1 885 parents investigated,with the effective rate of 98.14%. The EV71 vaccination rate of children aged 6 to 35 months was 27.03%. The awareness rate of hand-foot-mouth disease and EV71 vaccine in parents was 55.95%. The results of logistic regression analysis showed that the parents with the annual household income of 50 000 yuan and above （OR50 000 yuan- =2.665,95%CI：1.535-4.628;OR100 000 yuan-=4.732,95%CI：2.830-7.914;OR200 000 yuan-=3.576,95%CI：2.084-6.135）,with acceptance of 100 yuan and above in the price of the vaccine （OR100 yuan-= 9.487,95%CI：6.873-13.096;OR200 yuan-=5.940,95%CI：3.465-10.183;OR300-500 yuan-=2.415,95%CI：1.183-4.933）,with more than two sources of the information for EV71 vaccine （OR=3.062,95%CI：2.306-4.065）,without the care about the management of the EV71 vaccine（OR=1.650,95%CI：1.156-2.356）were more likely to have their children vaccinated;while the parents who lived in bungalows and cabinets （OR=0.589,95%CI：0.386-0.899）,who were medical staff（OR=0.240,95%CI：0.118-0.487）,who were not residents of Beijing（OR=0.587,95%CI：0.399-0.863）,who had more than one children （OR=0.338,95%CI：0.236-0.483） were less likely to have their children vaccinated .@*Conclusion@#The parents of children aged below three years in Xicheng District of Beijing should improve their awareness of hand-foot-mouth disease and EV71 vaccine. The vaccination rate of EV71 were mainly related to the registration,occupation,number of children, household income,the access to the information about vaccine,acceptance of the vaccine price and advice on the management in parents.
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INTRODUCCIÓN: Las alteraciones ungueales en niños provocan gran ansiedad en los padres y múltiples consultas en su mayoría innecesarias. La onicomadesis corresponde al despegamiento completo e indoloro de la lámina ungueal desde el pliegue proximal. Este hallazgo ungueal autoresolutivo se ha descrito como una complicación tardía de la enfermedad pie-mano-boca, exantema viral frecuente en la edad pediátrica. OBJETIVO: Reportar un caso pediátrico clásico de enfermedad pie-mano-boca que evolucionó con onicomadesis y revisión de la literatura. CASO CLÍNICO: Paciente masculino de 3 años de edad, con cuadro agudo de microampollas eritematosas, peribucales en un comienzo, luego brazos y manos, glúteos, muslo y pies, asintomático y sin compromiso del estado general. Se reali za diagnóstico clínico de enfermedad pie-mano-boca. Evoluciona con resolución total de lesiones cutáneas , pero al mes, desprendimiento completo de uñas, las que se recuperan con posterioridad. CONCLUSIÓN: El reconocimiento de la asociación entre enfermedad pie-mano-boca con onicomadesis nos permite orientar a los padres sobre un fenómeno benigno y transitorio que puede ocurrir como parte de la evolución de esta virosis, evitando así la ansiedad, derivación y tratamientos innecesarios.
INTRODUCTION: Nail alterations in children are an important cause of parent anxiety and derive in multiple and unnecessary consultations. The onychomadesis corresponds to the complete and pain less detachment of the nail plate from the proximal fold. This self-resolving nail finding has been described as a late complication of hand-foot-mouth disease, a frequent viral exanthema in the pedia tric age. OBJECTIVE: To describe a classic pediatric case of hand-foot-mouth disease with subsequent onychomadesis. CLINICAL CASE: A 3-years-old male patient with an acute presentation of acute erythe matous perioral papulovesicles, which extend to upper extremities and hands, buttocks, thighs and feet, asymptomatic, and without compromising general condition. Skin lesions resolve completely, but after one month, he develops detachment of the nails, with subsequent complete recovery. CONCLUSIONS: The recognition of this association will allow primary care physicians to guide the parents about a benign and self-resolving process that may occur as part of the evolution of hand-foot-mouth disease, thus avoiding unnecessary anxiety, referral and treatments.
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Humans , Male , Child, Preschool , Hand, Foot and Mouth Disease/diagnosis , Nail Diseases/etiology , Hand, Foot and Mouth Disease/complicationsABSTRACT
Objective To study the spatial-temporal dynamical features of hand-foot-mouth disease (HFMD) in Shaanxi Province,so as to provide evidence for the development of relative prevention and control programs on HFMD.Methods Surveillance data of HFMD was collected from the China Information System for Diseases Control and Prevention from 2009 to 2013.Related data on population and gross domestic product (GDP) was obtained from Shaanxi Statistical Yearbook.Statistical tools as R3.4.1,ArcGIS 10.2 and SaTScan 9.2 software were used to describe the spatialtemporal distribution of the disease.Power-law method on spatial-temporal-multicomponent model was used to analyze the spatial-temporal evolution of the HFMD epidemics in Shaanxi Province.Results A total of 229 904 cases of HFMD were reported in Shaanxi Province from 2009 to 2013,with an average annual incidence as 122.50 per 100 000.Obvious seasonal characteristics were noticed,with 71.71％ of the total cases identified between April and July.Counties with high incidence were mainly distributed in the mid-and east parts of Guanzhong area.Through temporal and spatial scan statistics,we identified that Class Ⅰ clustering area was fixed to the central and southeast regions of Shaanxi province which were around Xi'an City between 2009 and 2013,with the relative risk (RR)as 2.24,ranging from 2.18 to 3.08.Results from Power-law analysis showed that the continuous follow-up impact from the previous HFMD epidemics appeared strong in Tongguan,Pucheng districts of Weinan City and Weiyang district of Xi'an,with autoregressive components as 1.14,0.97 and 0.89,respectively.The risk of HFMD seemed high in Huayin city,Changan and Yanta districts and with the endemic components as 5.08,4.12 and 4.08,respectively.Impact of the epidemics on nearby districts was largely seen in Lianhu district of Xi'an,Wugong district of Xianyang and Gaoling district of Xi'an with epidemic components as 2.12,2.08 and 1.77,respectively.The etiological constituents of HFMD were mainly Enterovirus 71 between 2009 and 2012,while HFMD was mainly caused by other entero-viruses,in 2013.Conclusion Significant spatial-temporal heterogeneity of HFMD was seen in Shaanxi province,which called for specific strategies to be developed in the highly endemic areas.
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Objective To explore the clinical application value of muscle enzymes and high sensitivity cardi-ac troponin T(hs-cTnT)in children with hand foot mouth disease complicated with myocardial injury.Meth-ods 100 children with hand foot mouth disease admitted to the hospital from April 2016 to January 2017 were divided into ECG normal group(n= 40)and ECG abnormal group(n= 60)by electrocardiography.At the same time,50 healthy people were selected as the research group to compare the serum concentration and myo-cardial enzyme index of myocardial enzyme(CK-MB),creatine kinase(CK),α-hydroxybutyrate dehydrogenase (α-HBDH),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST),and high sensitivity cardiac troponin T(hs-cTnT)in three groups.The hs-cTnT and the indexes of myocardial enzymes in acute and re-covery stages of abnormal electrocardiogram for children with hand foot mouth disease were compared.Results The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cTnT,etc.in the ECG abnormal group of hand foot mouth disease were significantly higher than those of ECG normal group and control group.The differ-ence was statistically significant(P<0.05).The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cT-nT,etc.in the ECG normal group of hand foot mouth disease were significantly higher than those of control group.The difference was statistically significant(P<0.05).The abnormal rate for the indicators of CK-MB, CK,α-HBDH,LDH,AST and hs-cTnT,etc.In the ECG abnormal group of hand foot mouth disease were sig-nificantly higher than those of ECG normal group and normal control group.The difference was statistically significant(P<0.05).The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cTnT,etc.Of hand foot mouth disease ECG abnormal group in acute stage were significantly higher than those of recovery stage.The difference was statistically significant(P< 0.05).Conclusion One of the serious complications in children with hand foot and mouth disease is myocardial injury.It is of great clinical value to monitor hs-cTnT and my-ocardial enzymes in the diagnosis of the disease.
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Objective To analyze the viral load and complications in children patients with severe hand-foot-mouth disease(HFMD) caused by enterovirus type 71(EV71) .Methods The clinical data in 320 children patients with severe HFMD caused by EV71 treated in this hospital from January 2013 to December 2016 were retrospectively analyzed .The viral load in children patients with severe EV 71 caused HFMD was detected by adopting the fluorescence quantitative polymerase chain reaction (Q-PCR) ,and its correlation with the compli-cations was analyzed .Results The viral load in the children patients with critical type HFMD was significant-ly higher than that in the children patient with severe type HFMD ,the difference was statistically significant (P<0 .05) .Compared with severe HFMD ,the incidence rate of nervous system damage ,respiratory failure , circulatory failure and myocardial damage in critical type HFMD were significantly increased ,the difference was statistically significant (P<0 .05) .Compared with the EV71 viral load in the children patients with asep-tic meningitis ,the EV71 viral load in the children patients with brainstem encephalitis and acute flaccid paraly-sis were increased significantly ,moreover the EV71 viral load in the children patients with acute flaccid paraly-sis was significantly higher than that in the children patients with brainstem encephalitis ,the difference was statistically significant (P<0 .05) .Conclusion The viral load in children patients with severe HFMD caused by EV71 is correlated with severity of disease condition and complications ,and the viral load detection is con-ducive to disease condition monitoring and guidance of clinical treatment .
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Objective To analyze the clinical efficacy of Yupingfeng Granules combined with nutrition support for the treatment of children with hand-foot-mouth disease (HFMD) reinfection. Methods A total of 100 children with reinfection of HFMD were randomly divided into treatment group and control group. The treatment group was given Yupingfeng Granule or oral liquid combined with individualized nutritional support on the basis of routine treatment, while the control group was given routine treatment only. Results There was no significant difference in total effective rate between the treatment group and the control group in 50 children with reinfection of HFMD (P > 0.05). But fever subsided time, rash subsided time, and recovery in treatment group were shorter than those in the control group, the difference was statistically significant (P < 0.05). Conclusion Yupingfeng combined nutrition support has good clinical effects on children with HFMD reinfection.
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Objective To explore the value of time series analysis and model construction in predicting hand-foot-mouth disease(HFMD). Methods By analyzing the data of HFMD in a hospital in Zhengzhou from January 2009 to October 2016,a seasonal autoregressive moving average(ARMA)model was established according to the time series analysis. At the same time ,the model was evaluated to determine the fitting precision between the measured values and fitted values. Results After the parameter exploration ,the best fitting model was finally determined as ARIMA(1,0,1)(1,0,1)12,with a stationary R2 of 0.734,a statistic value of Ljung-Box Q(18)of 10.497,P Value of 0.725. The two curves of the fitted values and the measured values were close,suggesting that the model has good fitting ability. Conclusion Time series analysis and the seasonal ARMA model have good predictive ability in predicting HFMD.
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Objective To retrospectively analyze the effect of Brighton Pediatric Early Warning Score (Brighton PEWS) on the disease identification of children with hand-foot-mouth disease(HFMD). Methods Collected the hospital medical records of the children from January 2016 to July 2017 in our hospital, then compared the identification of the Brighton PEWS with the real outcomes, and analyzed the prediction effect of the Brighton PEWS by plotting the ROC curve. Results The study retrospectively analyze 619 cases of medical records, The area under the ROC curve of the Brighton PEWS was 0.838 (P<0.01), when the cut-off was 1.5, the maximum Youden value was 0.532, the sensitivity was 63.4%, and the identification was 89.8%. Conclusions The Brighton PEWS had a good identification when the cut-off was 1.5, but the sensitivity was low, we need to improve the sensitivity of the Brighton PEWS by combining with the characteristics of HFMD.
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Objective To explore the levels of water channel protein 4 (aquaporin-4,AQP-4) in the serum and the cerebrospinal fluid of patients with severe hand-foot-mouth disease (HFMD) and its clinical significance.Methods Children with the critical HFMD (clinical stage 3) admitted to Xuzhou Children's Hospital from February 2017 to November 2017 were recruited(critical group).In the same period,another 25 cases of common HFMD (central nervous system infection excluded in cerebrospinal fluid examination,common group),the other 25 cases of severe HFMD (clinical stage 2,severe group) were taken as the controls.The levels of AQP-4 in the serum and and cerebrospinal fluid were measured in all children and the levels of AQP-4 in cerebrospinal fluid were checked again in the critical and severe cases after treatment.The levels of interleukin-6 (IL-6),norepinephrine (NE) and neuron-specific enolase (NSE) in the serum were examined simultaneously and the correlation between them was analyzed.Results Before treatment,the levels of AQP-4 in the serum of critical group were (54.42 ± 19.86) μg/L,which were significantly higher than common group[(8.02 ± 1.59) μg/L] and severe group[(22.04 ± 8.14) μg/L] (F =36.684,P ＜0.01).Compared with before treatment,the levels of AQP-4 in the serum of critical and severe group were significantly lower after treatment (P ＜ 0.05).Before treatment,the levels of AQP-4 in the cerebrospinal fluid of critical and severe cases were respectively (9.81 ±2.27) μg/L and (8.58 ± 1.92) μg/L,which were significantly higher than common group (6.56 ± 1.79) μg/L (F =6.713,P ＜ 0.05).After treatment,the levels of AQP-4 in the cerebrospinal fluid of critical and severe cases were (8.41 ± 1.63) μg/L and (7.14 ± 1.69) μg/ L separately,which were significantly lower than before treatment (t =6.340,5.073,all P ＜ 0.01).The levels of IL-6,NE and NSE in serum were significantly different among the three groups (P ＜ 0.01).The above indicators were positively correlated with the levels of AQP-4 in the serum(r =0.734,0.810,0.729,all P ＜ 0.01)and were also positively correlated with AQP-4 in the cerebrospinal fluid (r =0.299,0.431,0.363,all P ＜ 0.05).Conclusion AQP-4 may participate in pathophysiological processes of HFMD.The levels of AQP-4 in serum can be used as an indicator for judging the severity and monitor prognosis of HFMD.
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Objective To explore the changes and clinical significance of interleukin-1β (IL-1 β) and aquaporin 4 (AQP4) in children with hand-foot-mouth disease (HFMD) combined with encephalitis.Methods From January 2014 to June 2016,30 cases of HFMD patients without encephalitis in Wuxi Children's Hospital were selected as the general group,at an average age of (2.1 ± 1.1) years,including 13 male and 17 female.Thirty cases of HFMD combined with encephalitis were selected as the observation group,at an average age of (2.4 ± 1.2)years,including 12 male and 18 female.Twenty-six non-HFMD patients who underwent minor operations for inguinal hernia or hydrocele of testis were selected as the serum control group,including 25 male and 1 female.Twenty-six patients with non-infectious neurological disorders in the neurology department in the same period were selected as the cerebrospinal fluid control group,including 10 male and 16 female.The levels of AQP4 and IL-1β in children were detected by adopting enzyme-linked immuno sorbent assay(ELISA).Results The levels of IL-1β in cerebrospinal fluid in the acute phase and recovery phase of the observation group were (95.04 ± 20.06) ng/L and (77.63 ±14.51) ng/L respectively,while the levels of AQP4 in cerebrospinal fluid were (16.87 ± 10.02) ng/L and (9.13 ±6.64) ng/L respectively.The levels of IL-1β in serum in the acute phase of the observation group and the general group were (82.40 ± 18.56) ng/L and (50.20 ± 24.22) ng/L respectively.The levels of IL-1β,AQP4 in cerebrospinal fluid were significantly higher in the acute phase of the observation group compared with the controls,and the differences were statistically significant(all P ＜ 0.05).The levels of IL-1β and AQP4 in the recovery phase were lower than those in the acute stage,and the differences were statistically significant(all P ＜ 0.05).The levels of IL-1β in serum was significantly higher in the acute phase of the observation group compared with the general group,and the difference was statistically significant (P ＜ 0.05).The level of IL-1β in serum were significantly higher in the general group compared with the controls,and the difference was statistically significant (P ＜ 0.05).Conclusions AQP4 and IL-1β may participate in the pathological course of HFMD combined with encephalitis by promoting brain edema,which can be used as one of the laboratory indicators for early diagnosis of the severity of the disease.
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Objective A fluorescence PCR methods was developed to detect EV71 and CoxAl6 and other enteroviruses simultaneously,which used for hand,foot and mouth disease (HFMD) viruses in the clinical rapid diagnosis.Methods Designed specific primers and probes of the enteroviruses gene which represents one of the highly conserved regions of the virus gene,and optimized the detection system of real-time quantitative RT-PCR.The positive control template and the standard curve were constructed.Researched the limit of detection,repeatability and specificity of the products,and tested 26 positive samples and 10 negative samples which collected on June 2015.Results The results showed that this experiment obtained positive recombinant plasmid,the range of the linear relation was from 8 × 102 to 8 × 108 copies/μl,and the detection result within this range was fine.The optimal concentrations of EVUN upstream and downstream primers were 0.50 μmol/L and the MGB probes were 0.30 μmol/L,RT-PCR reaction conditions as follows:42℃ 30 min,95℃ 3 min.95℃ 5 s,60℃ 35 s,45 cycle.The limit of detection reached to 800 copies/μl.The CV of the repeatability assay was no more than 5％.Specificity was good,and no cross reaction with other infectious viruses.26 clinical positive samples and 10 negative samples were detected in this experiment,detection rate of positive samples was 100 ％ (26/26) and negative samples was 100 ％ (10/10) by fluorescent quantitative RT-PCR detection method.Conclusion The experiment demonstrated that the detection method of the fluorescent quantitative PCR for hand-foot-mouth viruses could be used for the rapid diagnosis in clinical application.