Reinfection hazard of hand-foot-mouth disease in Wuhan, China, using Cox-proportional hazard model.

Hand-foot-mouth disease (HFMD) is an acute infectious disease caused by serotypes of the enterovirus (EV) family. HFMD reinfection occurs commonly in lack of cross-protection between different EV serotypes. In this study, we investigated the hazards of HFMD reinfection using Cox-proportional hazard model. Retrospective data of 95 209 HFMD cases in Wuhan during 2008-2015 was used. Kaplan-Meier survival methods and Cox-proportional hazard model were used to estimate the hazard probabilities. Of the all HFMD cases, about 2% experienced reinfection (1842/95 209). Kaplan-Meier curves revealed the reinfection risk sharply increased before 40 months from first infection. Higher hazards of reinfection were detected among those who were males, aged 3 years and below, scattered children, belonging to urban areas and first infected with coxsackievirus (CV)-A16 compared with their respective counterparts. Cox-proportional hazard model suggested that gender, age, group, living area and serotypes of first infection had significant effect on reinfection even after adjusting for potential confounding effects of other selected factors considered in the study. These results indicate that boys aged 3 years and below, especially those living in urban areas and first infected with CV-A16 are more prone to reinfection. Interventions should be imposed on these high-risk populations.

Model for End-Stage Liver Disease (MELD) score does not predict outcomes of hepatitis B-induced acute-on-chronic liver failure in transplant recipients.

BACKGROUND: Acute-on-chronic liver failure (ACLF) is a severe clinical entity and liver transplantation is the only definitive therapy to salvage these patients. However, the timing of liver transplant for these patients remains unclear. METHODS: Seventy-eight patients undergoing liver transplantation because of hepatitis B ACLF were retrospectively analyzed from June 2004 to December 2010. The areas under the receiver operating characteristic curve (AUC) of Model for End-Stage Liver Disease (MELD) score and Child-Turcotte-Pugh (CTP) score for the post-transplantation outcomes were calculated. RESULTS: The median age was 44 years (range, 25-64 years), serum bilirubin 418.53 µmol/L (range, 112.90-971.40 µmol/L), INR 3.177 (range, 1.470-9.850), and creatinine 70.84 µmol/L (range, 12.39-844.1 µmol/L); the median MELD score was 32 (range, 21-53) and CTP score 12 (8-15). The AUCs of MELD and CTP scores for 3-month mortality were 0.581 (95% confidence interval [CI], 0.421-0.742; sensitivity, 87.5%; specificity, 32.8%) and 0.547 (95% CI, 0.401-0.693; sensitivity, 75%; specificity, 41%), respectively. Meanwhile, there were no significant differences in hospital mortality (P = .252) or morbidity (P = .338) between the patients with MELD score ≥30 and those <30. CONCLUSIONS: MELD score had no predictive ability for the outcomes of patients with hepatitis B ACLF after orthotopic liver transplantation.

Cardiac lymphatic interruption is a major cause for allograft failure after cardiac transplantation.

Cardiac transplantation is one of the most effective treatments of end stage heart failure to date, although it comes with risks. One of the major complications of cardiac transplantation is allograft failure, which is caused by ischemic injuries, pulmonary hypertension and chronic rejection. Recent animal and human studies have demonstrated that cardiac lymphatic obstruction leads to significant myocardial fibrosis and depression in contractile forces. We hypothesize that lymphatic interruption, which is almost inevitable after cardiac transplantation, is a major cause of cardiac allograft failure through direct damages to the myocardium and also through the formation of allograft coronary vasculopathy.

[Comparative study of grind-resistance,corrosion,and adhesion of dental plaque on gallium and amalgam alloy's filling]

The adhesion of plaque on dental restorative between gallium alloy and amalgam alloy were compared.The results showed that plaque index and plaque account of gallium alloy was higher than those of amalgam,there was statistically significance(P<0.01).It was possible that secondary caries of gallium alloy's restorative may be higher than those of amalgam.One the other hand,the surface of restorative polished was necessary to improve the adhesion of plaque and to prevent the secondary caries.

[The measurement of shade of colour on 100 cases permanent teeth in Shanghai.].

With the help of a portable Minolta-CR 100 colour difference meter,measurement of upper incisors' surface colour was for the first time domestically carried out in 100 young and middle-aged Shanghai residents,and their mean parameters were also determined.Our method was met he requirements of CIE1931 XYZ surface colour system as well as that of CIE1976 L*a*b* surface colour system.The meter has a quality of high accuracy and the figures thus obtained are concentrated and representative.