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Objective:To analyze and compare VP1 and VP4 genetic characteristics of human enterovirus 71(EV71) isolated from children with severe and mild hand-foot and mouth disease(HFMD).Methods:EV71 strains isolated from severe HFMD patients (6 cases) and mild HFMD patients (6 cases) in Taizhou district, Zhejiang province were included during 2016.Total virus RNA was extracted by Viral RNA Mini Extraction Kit, and reverse transcription polymerase chain reaction(RT-PCR) was used to amplify the sequence of the VP1 and VP4 genes of EV71.And then the sequencing results were compared with those of A, B, C genotype reference EV71 strains from GenBank by nucleotide alignment and amino acid alignment analysis.Results:There were no statistically significant differences in sex and age between the two groups(χ 2=14.51, t=2.82, all P<0.05). The homogeneity between EV71 strains from severe patients and mild patients was 95.8%~99.6% and 99.1%~100.0% for VP1 nucleotide sequences and amino acid sequences, respectively, while 95.0%~99.9% and 99.0%~100.0% for VP4 nucleotide sequences and amino acid sequences, respectively.The twelve EV71 strains isolated from HFMD patients in Taizhou shared the highest identity with EV71-genotype C, especially genotype C4a.In addition, compared with the mild patients, three respective strains from severe HFMD patients showed mutations at the residue 170 in the VP1 protein(V→L), residue 293 in the VP1 protein(A→S) and residue 7 in the VP4 protein(T→A). Conclusion:All EV71 strains isolated from severe and mild HFMD patients in Taizhou district share high homology of nucleotide and amino sequence, and all of them belong to subgenogroup C4a.The mutations in the VP1 and VP4 of EV71 might be related to HFMD disease severity.
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Objective To investigate the changes of B type natriuretic peptide(BNP) and interleukin(IL)-33 levels and their clinical diagnostic values in different heart function classification of patients with heart failure.MethodsFrom January 2016 to January 2017,286 patients with heart failure in our hospital were selected as the heart failure group,while 106 healthy people were selected as the control group.The heart failure group was divided into New York Heart Association(NYHA)Ⅰ(n=76), NYHA Ⅱ(n=129), NYHA Ⅲ(n=61) and NYHA Ⅳ(n=20) according to the NYHA heart function classification criteria.The BNP and IL-33 levels were compared between heart failure group and control group,as so as the different heart function classification groups.And analyzed the factors related to heart failure by single factor and multivariate logistic regression.The diagnostic value of BNP and IL-33 in heart failure were analyzed by receiver operating characteristic(ROC) curve.ResultsThe level of BNP in heart failure group was significantly higher than that in control group(P<0.05),while IL-33 level was significantly lower than that in control group (P<0.05).The BNP levels in heart function classification groups had significant difference(P<0.05),but there was no significant difference in IL-33 level among them.Univariate analysis showed that both BNP and IL-33 were associated factors of heart failure, but multivariate logistic analysis showed that only BNP was an independent factor of heart failure.ROC curve showed that the area under the curve(AUC) of heart failure diagnosed of BNP was bigger than that of IL-33,the difference was statistically significant (P<0.05).ConclusionBNP and IL-33 can both effectively diagnose heart failure, but BNP is more diagnostic value.Besides, BNP can effectively reflect the cardiac function, the degree of disease and prognosis, witch can more scientifically guide the clinical treatment.