The Effectiveness of Different Doses of Intravenous Immunoglobulin on Severe Hand, Foot and Mouth Disease: A Meta-Analysis.

OBJECTIVE: To conduct a meta-analysis of evidence from randomized controlled trails (RCTs) of different doses of intravenous immunoglobulin (IVIG) in children with severe hand, foot and mouth disease (HFMD) to provide the scientific basis for clinical practice. METHODS: A search of PubMed-Medline, CNKI, Wanfang, and VIP database (until June 30, 2017) was performed and Software RevMan5.3 was used to evaluate the effect of different doses of IVIG on HFMD in RCTs. We used random-effects models (or fixed-effects models) and generic inverse variance methods to process quantitative data, followed by a leave-one-out method for sensitivity analysis. RESULTS: From a total of 420 entries identified via searches, 8 RCTs involving 1,450 patients were included in the final analysis. The results of the meta-analysis showed that compared with conventional therapy alone, conventional therapy combined with IVIG had shorter fever clearance time, shorter rash regression time, and shorter clinical cure time. Subgroup analyses showed that the high-dose group (1 g/kg/day) had shorter fever clearance time (p < 0.05), shorter rash regression (p< 0.05), shorter remission time of neurological symptoms (p < 0.05), but longer clinical cure time (p > 0.05). CONCLUSION: The high-dose group has a better prognosis; however, the advantages and disadvantages should be carefully considered when deciding the doses in the treatment of severe HFMD.

[Association between IL-19 gene polymorphisms and hepatitis B virus susceptibility in children].

OBJECTIVE: To study the association between the single nucleotide polymorphisms (SNP) of interleukin (IL)-19 and susceptibility to hepatitis B virus (HBV) infection in children. METHODS: A case-control study was performed, and 136 children with positive HBsAg（case group） and 297 healthy children with negative HBsAg（control group） were enrolled. PCR and DNA sequencing were used for genotyping. RESULTS: There were significant differences in the frequencies of genotypes of IL-19 rs1798 between the case and control groups. The case group also had a significantly higher proportion of children with CG genotype than the control group (p<0.05). There were significant differences in the frequencies of genotypes and alleles of IL-19 rs2243191 between the HBV infection and non-infection groups among children who born to HBV-positive mothers. The infection group had significantly higher proportions of children with TC and CC genotypes and C allele than the non-infection group (p<0.05). CONCLUSIONS: The SNP of IL-19 rs1798 may be associated with susceptibility to hepatitis B in children, and the SNP of IL-19 rs2243191 may be associated with susceptibility to breakthrough HBV infection in children at a high risk of HBV infection.

[Efficacy of hepatitis B immunoprophylaxis in children at high risk of hepatitis B and risk factors for mother-to-child transmission of hepatitis B virus].

OBJECTIVE: To investigate the risk factors for mother-to-child transmission of hepatitis B virus (HBV) and the efficacy of hepatitis B immunoprophylaxis in children at high risk of hepatitis B. METHODS: A questionnaire survey was performed on 539 HBsAg-positive mothers and their 551 children (aged from 6 months to 5 years) at high risk of hepatitis B. Serum markers of hepatitis B in the children at high risk of hepatitis B were measured. Univariate logistic regression analysis was used to investigate the risk factors for mother-to-child transmission of HBV. RESULTS: The rate of hepatitis B vaccination in the children at high risk of hepatitis B was 100%, and 96.6% received injections of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG). The HBsAg positive rate showed no significant differences between different age groups. The HBsAb positive rate gradually decreased with the increasing age (P<0.01). The children born to HBsAg- and HBeAg-positive mothers had a significantly higher hepatitis B infection rate than those born to HBsAg-positive mothers (15.1% vs 0.2%; P<0.01). The high-risk children who received hepatitis B vaccination alone had a significantly higher hepatitis B infection rate than those who received both hepatitis B vaccine and HBIG injections (28.6% vs 2.8%; P<0.01). CONCLUSIONS: The HBsAb positive rate gradually decreases with the increasing age in children at high risk of hepatitis B. Maternal HBsAg and HBeAg positivity and the absence of HBIG combined with hepatitis B vaccine injections for children at high risk of hepatitis B are the risk factors for mother-to-child transmission of HBV.

[Association between ameloblastin gene polymorphisms and the susceptibility to dental fluorosis].

OBJECTIVE: To study the distribution of ameloblastin (AMBN) gene polymorphism in coal-fire caused fluorosis (CFCF) in Chongqing municipality and the relationship between AMBN gene polymorphism and the susceptibility to dental fluorosis. METHODS: Under a case-control study, 100 children aged 8 - 12 and 30 adults with dental fluorosis were enrolled in Wushan and Fengjie counties of Chongqing from December 2010 to February 2011. Another 100 children aged 8 - 12 and 30 adults with non-dental fluorosis were chosen as internal control groups together with 50 children and 30 adults without dental fluorosis were selected as external control groups in the non-epidemic area of Yubei district. DNA was extracted from peripheral blood sample of these people. Genotype of AMBN gene 7 extron 538_540delGGA, 10 extron 657A > G and 13 extron 986C > T loci were detected using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. RESULTS: The rates of 7 extron 538_540delGGA loci among case, internal and external control groups were as follows: GGA/GGA-/- 61.2% (74/121), 78.5% (102/130), 74.3% (52/70) ; GGA/-: 24.0% (29/121), 15.4% (20/130), 22.9% (16/70) ; -/-: 14.8% (18/121), 6.1% (8/130), 2.8% (2/70), the difference was statistically significant (χ(2) = 14.353 P < 0.05). The AA appeared to be 86.8% (105/121), 93.1% (121/130), 91.4% (64/70) and AG were 13.2% (16/121), 6.9% (9/130), 8.6% (6/70), with difference not statistically significant (χ(2) = 2.972, P > 0.05). CC appeared as 81.0% (98/121), 90.0% (117/130), 87.1% (61/70) while CT as 19.0% (23/121), 10.0% (13/130), 12.9% (9/70), with difference not statistically significant (χ(2) = 4.319, P > 0.05). In comparing with the two control groups, the frequency of GGA/GGA was decreasing (χ(2) values were 8.957, 3.405, respectively, P < 0.05) while the frequency of -/- was increasing (χ(2) values were 5.134, 6.833, respectively, P < 0.05). RESULTS: from the univariate analysis showed that the individuals who were carrying -/- genotype had an increased risk of suffering from fluorosis (OR values were 2.7, 5.9, respectively, P < 0.05). When compared with the internal control group, the CT genotype of case group showed an increase (χ(2) = 4.139, P < 0.05) while individuals that carrying CT genotype had an increased risk of suffering from fluorosis (OR = 2.1, P < 0.05), in epidemic-area. CONCLUSION: Our results showed that the 7 extron 538_540delGGA and the 13 extron 986C > T loci polymorphism in AMBN gene might serve as the susceptibility factors causing the coal-fired fluorosis.

[Analysis on the frequency of urinary iodine in a population-based intervention study].

OBJECTIVE: Through a two-year follow up program, this study was to analyze the urinary iodine frequency of a cohort in the intervention trial, concerning different doses of salt ionization, so as to explore the selection of appropriate concentration of salt ionization. METHODS: A multistage cluster sampling method was used to select three townships in two countries for community intervention with different doses [(15±5) mg/kg, (25±5) mg/kg, (35±5) mg/kg] of salt ionization. RESULTS: After intervention, the median of urinary iodine was reduced among the population. The urinary iodine frequencies of (15±5) mg/kg and (25±5) mg/kg among groups of children were mainly concentrated in 100-200 µg/L and 200-300 µg/L paragraphs in A county. While the 300 µg/L paragraph had an overall decline in B county, the 100 µg/L and 200 µg/L paragraph ratio increased but the trend seemed to be slow. The 100-300 µg/L paragraph of the four treatment groups took a larger proportion and kept smooth in a more ideal state. However, the control group still maintained at above 250 µg/L level. CONCLUSION: The iodine supplementation should be gradually implemented in Chongqing. The doses of salt ionization should be reduced from the current (35±15) mg/kg to (25±5) mg/kg in the economically developed areas. At the same time, we need to continuously follow the changes of the condition.

[Study on the association between environmental chemical elements and fluorosis caused by coal-fire pollution].

OBJECTIVE: To understand the distribution of chemical elements in soil. To investigate the differences between patients under different state of fluorosis and normal population after preventive measurement was implemented to get rid of some chemical elements and to lower the urine fluoride levels so as to illustrate the pathogenesis of the disease. METHODS: Both ecological and comparative studies had been used to analyze the rates and levels of chemical elements. Teeth and skeletal from the patients with fluorosis and controls were taken and florin ion-selective-electrode method was used to determine urine the content of fluorine. Atomic Absorption Spectrometry was used to determine the copper, zinc, calcium, magnesium and iron contents in the whole blood. Differences of contents were analyzed. RESULTS: In Wushan county, the soil contents of nickel (r = 0.553, P = 0.050), iodine (r = 0.571, P = 0.041), fluorine (r = 0.303, P = 0.005), pH value (r = 0.304, P = 0.005) and the rates of fluorosis showed weaker positive relationship. In Fengjie county, the soil contents of mercury (r = 0.285, P = 0.001), nickel (r = 0.212, P = 0.00) and the rates of fluorosis also showed weaker positive relationship. In Wushan county, the urine fluoride level in the patients group [(0.64 ± 0.34) mg/L] was higher than that in the control group [(0.44 ± 0.59) mg/L], (P < 0.05). In Fengjie county, copper [(29.63 ± 3.32) µmol/L] and urine fluoride [(0.83 ± 0.37) mg/L] levels in the patients group showed higher than that in the control group [(26.76 ± 3.63) µmol/L, (0.53 ± 0.23) mg/L], (P < 0.05). zinc (Zn) [(76.13 ± 11.24) µmol/L], calcium (Ca) [(1.87 ± 0.25) mmol/L], magnesium (Mg) [(1.41 ± 0.18) mmol/L] and fluoride[(0.83 ± 0.37) mg/L]levels in urine of the patients in children were higher in Fengjie than that in Wushan [(71.95 ± 7.53) µmol/L, (1.43 ± 1.34) mmol/L, (1.34 ± 0.15) mmol/L, (0.64 ± 0.34) mg/L], (P < 0.05). Mg [(1.56 ± 1.96) mmol/L], ferrum [(8.15 ± 1.00) mmol/L] and fluoride [(2.17 ± 0.99) mg/L] levels among adult patients were significantly higher than in the control group [(1.46 ± 0.16) mmol/L, (7.64 ± 1.00) mmol/L, (1.44 ± 1.22) mg/L] (P < 0.05). CONCLUSION: Soil, rich in alkaline and fluorosis could increase the intake of fluorine while nickel, cadmium, iodine content in soil might relate to the occurrence of fluorosis. Residents living in endemic areas where anti-fluorine elements as Zn, Ca and Mg were in shortage, might be affected by these chemical elements that related with fluorosis.

[AIDS-related knowledge, attitudes and behaviors: a prevalence survey among 309 homosexual men in a Chinese city].

OBJECTIVE: To gain an insight into the demographic characteristics and AIDS-related knowledge, attitudes and behaviors of men who have sex with men (MSM) in a Chinese city, and to offer a base for preventive measures against AIDS. METHODS: We carried out a prevalence survey, using "snowball" methods to set up survey sites in the "comrade" community, the "comrades" looking for the respondents by various means. RESULTS: Among 309 respondents, 265 (85.8%) were younger than 30 years, 187 (60.5%) received college education or above, 187 (60.5%) were government officials or employees, and 91 (29.4%) were students; 299 (96.8%) were willing or very willing to get knowledge about HIV prevention and treatment, 201 (65.1%) considered themselves as MSM, 76 (24.6%) admitted bisexuality, 117 (37.9%) had insertion sex with at least three men in the past six months, 61 (19.7%) had two or more regular male sexual partners, 140 (45.3%) used condoms on >80% occasions and 34 (11.0%) occasionally or never used them during vaginal sex in the past six months. CONCLUSION: MSM in the city showed the characteristics of younger age, higher education, stable employment and income, more than one sexual partner, high frequency of high-risk behavior, and negligence of condom-use, and most (96.8%) of them are willing or very willing to obtain AIDS prevention knowledge, which deserves particular attention from relevant institutions.

[Study on the change of urinary iodine of different salt concentrations among the target population in an intervention trial].

OBJECTIVE: To analyze the change of urinary iodine in a cohort of intervention trial and to observe the role of different doses on salt iodization and related impact factors on nutritional condition of iodine. METHODS: Multistage cluster sampling was used to sample three townships in two counties for community intervention with different doses (15 ± 5, 25 ± 5, 35 ± 5) mg/kg. RESULTS: Compared to the (35 ± 5) mg/kg group, the urine iodine levels of three experimental townships were gradually declining in county B when time went on, and the (15 ± 5) mg/kg group showed an obvious results, at 6, 12, 18 and 24 months, with the urine iodine level as 180.00, 186.10, 150.04, 191.28 µg/L respectively, which were in accordance with the WHO standard and reached to appropriate range (187.96 µg/L) at the 18 month. The townships at county Y under intervention had declined slightly, but the urine iodine levels did not reach the WHO standard. The thyroid volume declined from 3.65 ml to 3.40 ml in two counties and the difference between them was statistically significant. CONCLUSION: To some extent, reducing the iodine concentration in salt, had a role of lowering the urine iodine level and reducing the strumous rate.