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Objective:To investigate the expression and clinical significance of Beclin-1 and cytochromes C (CytC) in patients with hand, foot and mouth disease (HFMD).Methods:Sixty children with HFMD were classified into two groups of severe group and common group with 30 cases in each group. Another thirty children who underwent circumcision and had no underlying disease were selected as control group. Serum Beclin-1, CytC and S100B levels were detected before and after treatment. The levels of Beclin-1 and CytC in cerebrospinal fluid (CSF) of children with severe HFMD were detected before and after treatment. Receiver operating characteristic (ROC) curve was used to evaluate the prediction efficiency of Beclin-1 and CytC for the severity of HFMD.Results:Serum Beclin-1 and CytC levels in the severe group were higher than those in the other two groups ( P<0.01), and the common group showed significantly increased serum Beclin-1 and CytC levels as compared with the control group ( P<0.01). After treatment, the serum Beclin-1 and CytC levels decreased in both severe and common groups ( P<0.05). Compared with the common group, the severe group had remarkable increases in the levels of Beclin-1 and CytC in CSF ( P<0.01), which decreased significantly after treatment ( P<0.01). Serum Beclin-1 and CytC levels were positively correlated with the level of S100B protein. In the prediction of severe HFMD, serum CytC had the highest Youden value of 0.533 at the cut-off value of 38.785 ng/ml with a sensitivity of 56.67% and a specificity of 96.67%; serum Beclin-1 had the highest Youden value of 0.467 at the cut-off value of 6.560 ng/ml with a sensitivity of 46.67% and a specificity of 100.00%. Combined measurements of these two parameters had the highest predictive value for severe HFMD with a sensitivity of 76.67% and a specificity of 96.67%. Conclusions:Serum Beclin-1 and CytC levels were conducive to predict the severity and treatment outcomes of HFMD. Combined measurements of these two parameters had a higher predictive value for severe 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.