Complete Genome Sequences of Four Coxsackievirus A16 Strains Isolated from Four Children with Severe Hand, Foot, and Mouth Disease.

Here, we report the complete genome sequences of four coxsackievirus A16 strains isolated from four children with severe hand, foot, and mouth disease. Three of them were assigned to subgenotype B1b based on phylogenetic analysis of the VP1 gene, and the other one belonged to subgenotype B1a.

[A logistic regression analysis on the factors influencing effect of cardiopulmonary resuscitation in emergency department].

OBJECTIVE: To look for the independent factors influencing the effect of cardiopulmonary resuscitation (CPR) in emergency department. METHODS: The data of patients involved in the study were retrieved from 72 network emergency hospitals in Shenzhen from September 2004 to January 2009. The data base was set up with EpiData software, according to questionnaires about cardiopulmonary arrest (CA) patients treated with CPR, and analyzed with SPSS 13.0 software. The binary Logistic regression was carried out with 8 factors which had emerged statistical significance through single factor analysis. RESULTS: A Logistic regression analysis on the factors influencing return of spontaneous circulation (ROSC) in emergency department showed the ventrical fibrillation [VF, odds ratio (OR)=3.071, P=0.000, 95% confidence interval (95% CI)=2.019-4.670] and pulseless electric activity (PEA, OR=1.730, P=0.036, 95% CI=1.036-2.890) were protective factors compared with asystole; electric shock was a protective factor (OR=1.574, P=0.015, 95% CI=1.093-2.265); adrenaline ≤4 mg group had higher likelihood of obtaining ROSC compared with group receiving ≥5 mg of adrenaline (OR=1.483, P=0.037, 95% CI=1.024-2.147); duration of CA before CPR was a risk factor (OR=0.961, P=0.000, 95% CI=0.946-0.976). A Logistic regression analysis on the factors influencing survival to admission in emergency department showed the VF was a protective factor compared with asystole (OR=2.013, P=0.002, 95% CI=1.299-3.121); adenine ≤4 mg group had higher likelihood of survival to admission compared with group ≥5 mg (OR=2.289, P=0.000, 95% CI=1.487-3.524); duration of CA before CPR was a risk factor (OR=0.951, P=0.000, 95% CI=0.933-0.969). CONCLUSION: Rhythm of heart, the duration of CA, electric shock and accumulated adrenaline dosage were independent influencing factors for ROSC in emergency department. Rhythm of heart, the duration of CA and accumulated adrenaline dosage were independent influencing factors for survival to admission in emergency department.

Pedunculated hepatocellular carcinoma and splenic metastasis.

Only a few cases of pedunculated hepatocellular carcinoma (P-HCC) have been reported in the literature. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes, kidney, bone marrow and adrenals. Metastasis to spleen is mostly via hematogenous metastasis, direct metastasis to spleen was very rare. We report a case of P-HCC presenting as a left upper abdominal lesions which involved the spleen that was actually a P-HCC with splenic metastasis. This case is unique as P-HCC directly involved the spleen which is not via hematogenous metastasis.