The first metatarsophalangeal joint fusion combined with lateral toe rotation Weil osteotomy for hallux valgus with severe metatarsal adduction / 中国骨伤

OBJECTIVE@#To explore clinical effect of the first metatarsophalangeal joint fusion combined with lateral toe rotation Weil osteotomy in treating hallux valgus with severe metatarsal adduction.@*METHODS@#From March 2017 to August 2021, 37 patients ( 69 feet ) with severe plantar adductor hallux valgus were treated with the first metatarsophalangeal joint fusion combined with rotational Weil osteotomy were retrospectively analyzed, including 8 males(11 feet) and 29 females (58 feet), aged from 67 to 83 years old with an average of (70.03±2.87) years old;3 cases on the left side, 2 cases on the right side and 32 cases on both sides. Visual analogue scale(VAS) was used to evaluate degree of pain relief before operation, 6 weeks after operation and at the final follow-up. American Orthopaedic Foot and Ankle Surgery (AOFAS) forefoot score was used to evaluate function of the affected foot before operation and final follow-up. Hallux valgus angle(HVA) and intermetatarsal angle(IMA) were measured before operation and at the final follow-up.@*RESULTS@#Thirty-seven patients(69 feet) were followed up from 12 to 48 months with an average of(22.8±0.6) months. Bone healing was achieved at the first metatarsophalangeal joint from 7 to 10 weeks with an average of (8.00±1.21) weeks after operation, without delay and nonunion. HVA was increased from (44.30±2.84)° before operation to (15.20±2.13) °at the final follow-up, and had statistical difference(t=65.781, P<0.05);while no difference in IMA before and after operation(P>0.05). VAS was decreased from (6.73±1.48) points to (2.78±0.71) points at 6 months after operation(t=3.279, P<0.05), and had difference compared with the latest follow-up(1.16±1.12)(t=4.859, P<0.05). AOFAS forefoot score increased from (52.14±5.78) preoperatively to (86.70±4.86) at the fonal follow-up, and 25 feet got excellent results, 40 feet good and 4 feet fair.@*CONCLUSION@#The first metatarsophalangeal joint fusion combined with lateral toe rotation Weil osteotomy in treating severe plantar adduction hallux valgus could significantly relieve pain and appearance of forefoot, stabilize the first sequence, and significantly improve walking function.

Current financing in disease control and prevention institutions in China / 上海预防医学

Objective To analyze the current situation of financing in disease control and prevention constitutions in China, to identify existing problems, to explore potential reasons, and to make policy recommendations accordingly. Methods Financial related indicators, including revenue and expense of disease control and prevention institutions, were collected through questionnaire survey. Moreover, some disease control and prevention institutions were selected for on-site survey. Results The proportion of public health institutions in the Total Health Expenditure had fallen from 7.0% in 2014 to 5.6% in 2018. The proportion of financial compensation in the operation of disease control and prevention institutions was less than 50%. The gap between revenue and expenditure had not been covered completely after the cancellation of three categories of administrative charges. In addition, financing mechanism of public health service funds remained unclear. Conclusion We recommend the strategies, including optimizing financing structure, increasing investment in disease control and prevention, increasing the level of financial guarantee, improving the mechanism of public health service funds, and multi-channel financing.

Reaserch Advances in the Treatment of Primary Immune Thrombocytopenia--Review / 中国实验血液学杂志

Primary immune thrombocytopenia (ITP) is a blood system disease mediated by autoimmune mechanism. Currently, the goal of treatment for primary ITP is to keep patients' peripheral platelet count at a safe level to prevent severe bleeding. Recently, avatrombopag and fostamatinib have been approved by the FDA for the treatment of primary ITP in adults, while new drugs such as rozanolixizumab, efgartigimod, PRTX-100, decitabine and atorvastatin have shown efficacy in early clinical trials. This review summarizes the current accepted therapies for the clinical treatment of primary ITP in adults, and briefly discuss the progress of new therapies.

Preliminary Study of Chidamide Combined with Hematopoietic Stem Cell Transplantation in the Treatment of Childhood Acute T-Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and safety of combination chidamide and hematopoietic stem cell transplantation (HSCT) in the treatment of childhood acute T lymphoblastic leukemia (T-ALL).@*METHODS@#Seven children with acute T lymphoblastic leukemia received hematopoietic stem cell transplantation in SUN Yat-Sen Memorial Hospital of SUN Yat-Sen University were selected. 7 cases of T-ALL were divided into 2 groups: HSCT plus chidamide-treated group (4 cases) and traditional HSCT-treated group (3 cases) as control. The incidence of GVHD and other related complications, as well as implantation, recurrence and survival were compared between the two groups, and the side effects of chidamide were observed. All the patients were follow-up until January 2019.@*RESULTS@#All the 7 patients were alive and, there was no difference in the incidence of acute GVHD between the HSCT plus chidamides treated group and the traditional HSCT-treated group. The implantation rate of HSCT was 100%, and there were no recurrence occurred. During the application of chidamide, 3 cases showed adverse reactions, of which 2 cases had adverse reactions of grade 3 or higher, and 2 cases were hematological adverse reactions (neutropenia, thrombocytopenia), other adverse reactions were non-hematologic adverse reactions (transaminase elevation, fatigue, nausea, vomiting), there were no serious adverse reactions occurred. In the HSCT plus chidamide-treated group, 2 cases were found that mature lymphocytes were not expressed by tumors, during examing for minimal redidaul disease (MRD). Compared with the immunophenotype and TCR rearrangement at first diagnosis, the results did not support the source of residual T-ALL tumor cells. During the review of MRD, it was found that the abnormal T cells showed an increasing trend, indicating that chidamide might induce leukemia cell differentiation through some pathways.@*CONCLUSION@#Hematopoietic stem cell transplantation is still an effective method to cure children's T-ALL. In some cases, abnormal T-cell nonclonal amplification occurs during the application of chidamide, and the children with T-ALL can tolerable adverse reactions of chidamide.

Effect of different interfaces on FiO_2 and CO_2 rebreathing during noninvasive positive pressure ventilation / 中国实用内科杂志

OBJECTIVE: To investigate the effect of different interfaces on FiO_2 and CO_2 rebreathing(ViCO_2) during noninvasive positive pressure ventilation. METHODS: The Active Servo Lung respiratory simulation system was used to simulate a hypercapnia COPD patient received NPPV through injection of CO_2 gas from the place closest to the outlet of simulated lung to maintain end-tidal carbon dioxide partial pressure at 80 mmHg,and oxygen delivery during NPPV was simulated by means of injection of 5 L/min oxygen through the hole of interface. FiO_2 and ViCO_2 were integral calculated through the synchronous collect real-time pressure, flow rate, oxygen concentration and CO_2 concentration. The effect of different type and models of interfaces on FiO_2 and ViCO_2 were compared, and the bivariate correlation analysis was applied to investigate the correlation of FiO_2 and ViCO_2. RESULTS: The inner volume, leak volume and leak position of different interfaces were different. The FiO_2 of the oral-nasal mask and nasal mask were significantly different(P<0.05), which were(39.81±9.06)% and(43.91±6.33)%,respectively. The FiO_2 of the different models of interfaces was significantly different(P<0.05), the FiO_2 of the No.4 oral-nasal mask was the lowest(28.29±0.08)%, and the FiO_2 of the No. 10 oral-nasal mask was the highest(53.83±0.63)%. The ViCO_2 of the oral-nasal mask and nasal mask wasn't significantly different(P=0.19), which was(15.26±1.27)mL and(14.79±2.21)mL, respectively. The ViCO_2 of the different models of interfaces was significantly different(P<0.05), the FiO_2 of the No.8 nasal mask was the lowest(12.48±0.29%), and the ViCO_2 of the No. 10 nasal mask was the highest(18.38±0.31)%. There was a significant correlation between FiO_2 and ViCO_2(r=0.41, P<0.05), and the general linear equation was Y=14.51+1.82 X(R~2=0.168). CONCLUSION: Different interfaces have significant effects on FiO_2 and ViCO_2 during NPPV,and FiO_2 and ViCO_2 are positively correlated.

Network toxicology and LC-MS-based metabolomics: New approaches for mechanism of action of toxic components in traditional Chinese medicines / 中草药·英文版

Network toxicology combined with metabonomics is of great significance for the study of the toxic mechanism and prediction of toxicity of traditional Chinese medicines (TCMs). In this study, we reviewed the application of network toxicology based on LC-MS metabolomics, mainly in the study of toxic components and the toxicity mechanism of TCMs, which provides new ideas and methods for the further study of the toxicity mechanism of TCMs.

lncRNAs involved in the development and diseases of eyes / 国际眼科杂志(Guoji Yanke Zazhi)

·Long non-coding RNAs (lncRNAs) refer to a kind of non-coding RNA which is longer than 200 nucleotides, with the characteristic of its numerous, diversity of types and modes of action. The biological functions of lncRNA involved in genomic imprinting, chromatin remodeling, translational control of mRNA, cell cycle and cell differentiation control, immune surveillance, constituting the skeleton of nuclear sub structure, etc. LncRNA plays an important role in individual development and human diseases. This paper mainly reviewed those lncRNAs that have been published, and closely related to eye development and diseases.

Comparative study of fungal culture and in vivo confocal microscopy in the diagnosis of non-primary fungal keratitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare fungal culture and in vivo confocal microscopy ( IVCM ) in the diagnosis of non- primary fungal keratitis.?METHODS:The clinical data of 31 cases (31 eyes) with non- primary fungaI keratitis from September 2016 to February 2017 in our HospitaI were retrospectiveIy reviewed. The positive rate of the two methods was compared by chi-square test.?RESULTS: The positive rate by fungal culture was 58％(18/31 ) and IVCM was 19％ ( 6/31 ); the positive rate comparison difference was statistically significant between fungal culture and IVCM (x2=7. 56,P<0. 01). In the 13 eyes with positive culture results, 2 eyes were positive by IVCM;in the 25 positive IVCM eyes, 14 eyes were positive in culture.?CONCLUSION: The positive rate of fungal culture in non-primary fungal keratitis is higher than that of IVCM. Fungal culture is an essential auxiliary examination in the diagnosis of non - primary fungal keratitis. With the characteristics of fast, noninvasive and repeatable, IVCM also plays an important role in the diagnosis of non-primary fungal keratitis. The combination of the two methods can improve the positive rate of diagnosis.

Lapidus operation combined with bone setting manipulation in treatment of hallux valgus in elderly patients / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of Lapidus operation combined with bone setting manipulation of traditional Chinese medicine in treating hallux valgus in elderly patients.@*METHODS@#From March 2013 to October 2017, 53 elderly patients (87 feet) with hallux valgus were treated with Lapidus operation combined with bone-setting manipulation of traditional Chinese medicine, including 12 males (18 feet) and 41 females (69 feet), ranging in age from 65 to 92 years old, with an average of (76.3±4.8) years old. Visual analogue scale(VAS) was used to evaluate the degree of relief of foot pain before and 26 months after operation. American Orthopaedic Foot and Ankle Society(AOFAS) was used to evaluate the function of foot pain. The changes of hallux valgus angle(HVA angle), interphalangeal angle (IMA angle) and metatarsal wedge angle(MCA angle) were compared on X-ray films.@*RESULTS@#All the patients were followed up, and the duration ranged from 12 to 42 months, with an average of(26.0±2.7) months. In all patients, the first metatarsal joint reached bone fusion within 6 to 8 months, with an average of 4.7 months. The preoperative VAS score was 8.06±1.44, which was significantly different from 2.14±1.98 at 26 months(<0.05). The preoperative AOFAS score was 53.90±7.89, which was significantly different from 92.80±2.78 at 26 months(<0.05). The HVA, IMA and MCA were significantly improved from preoperative(38.60±2.72)°, (21.90±1.91)° and(20.90±2.20)° to the latest follow-up(17.80±1.94)°, (9.70±2.56)° and(11.70±0.48)°(<0.05). According AOFAS score, 74 feet got an excellent result, 11 good and 2 fair.@*CONCLUSIONS@#Lapidus operation combined with bone-setting manipulation of traditional Chinese medicine on the treatment of hallux valgus foot in elderly patients has satisfactory clinical effects, shortens the time of osteotomy and fixation, protects the soft tissue around the osteotomy end and promotes the bone fusion on the most satisfactory position.

The application of acoustic pharyngometry in diagnosis and treatment of OSAHS / 临床耳鼻咽喉头颈外科杂志

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common clinical disease that seriously threatens human health and life. Accurate location of the upper airway obstruction is the key to the diagnosis and treatment of OSAHS. Acoustic pharyngometry uses sound reflection to quickly assess the cross-sectional area and volume of the upper airway. Acoustic pharyngometry represents a simple, quick, non-invasive method for measuring upper airway dimensions which could predict sleep apnea risk. In this article we sought to introduce the application of acoustic pharyngometry in the diagnosis and treatment of OSAHS.

Finite element simulation of contact stress on a novel total knee prosthesis during gait cycle / 医用生物力学

Objective To perform finite element analysis on a type of newly designed total knee prosthesis, and investigate the influence from changing twist angle of the lateral condyle surface on mechanical environment of the knee joint. Methods Based on CT measurement data from a volunteer, 3 artificial knee prostheses with the same medial condyle were established. In Model 1, the twist angle of lateral condyle surface was 0°, while 10° and 20° in Model 2 and Model 3, respectively. The prosthesis models were imported into finite element software and applied with gait cycle data to simulate the motion of knee prosthesis during the gait cycle. The simulated stress results in the knee joint were then compared with the calculated results, which were obtained from theoretical formula of contact mechanics. Results The maximum stress of 3 models appeared at 13% of the gait cycle, when the axial force (2.6 kN) was also the maximum. The maximum stresses of medial and lateral condyle in Model 1, Model 2 and Model 3 were 35.5 and 30.6 MPa, 38.4 and 32.6 MPa, 38.3 and 43.1 MPa, respectively. The stress curves of Model 2 and Model 3 during the gait cycle were relatively smooth compared with those of Model 1. The simulated stress trend was basically similar to the theoretical calculation, except at a few moments in the gait cycle. Conclusions The mechanical environment of the total knee prosthesis can be improved by twist angle of the lateral condyle surface. This newly designed prosthesis can preserve implants from abrupt change of the stress during the gait cycle and prolong the service life of prostheses.

Identification and analysis of the calcium signaling system genes responding to continuous cropping injury in Rehmannia glutinosa L / 药学学报

Calcium signaling plays a critical role in response to various abiotic and biotic stresses in plants. Preliminarily evidence showed that calcium signaling perceived and transduced the harmful signaling generated from continuous cropping stress in R. glutinosa. To investigate the roles of calcium signaling in continuous cropping injury formation, the key genes involved in calcium signaling transduction were identified in R. glutinosa transcriptome through bioinformatic methods. Furthermore, the calcium ion concentration in both normal and continuous cropping R. glutinosa root cells were measured by potassium pyroantimonate precipitation and calcium fluorescence method. As a result, a set of 84 calcium signaling-related genes, including 5 CaMs, 12 CBLs, 21 CDPKs, 21 CIPKs, 16 CMLs, and 9 CRKs were captured in R. glutinosa transcriptome. The analysis of expression profile in continuous cropping compared to normal growth R. glutinosa indicated that continuous cropping stress significantly increased the expression of calcium signaling-related genes in continuous cropping R. glutinosa. At the same time, the abundance levels of 12 calcium signaling-related genes quantified by qPCR further validated the high expression of calcium signaling-related genes presented in continous cropping R. glutinosa. In addition, the continuous cropping condition significantly promoted the accumulation of intracellular calcium ions in R. glutinosa based on two methods of potassium pyroantimonate precipitation and calcium fluorescence. This study verified the possible roles of calcium signaling in the formation of continuous cropping injury on molecular and cellular level, which lays a solid foundation for illuminating formation mechanism of continuous cropping injury on molecular level.

Finite element simulation of contact stress on a novel total knee prosthesis during gait cycle / 医用生物力学

Objective To perform finite element analysis on a type of newly designed total knee prosthesis,and investigate the influence from changing twist angle of the lateral condyle surface on mechanical environment of the knee joint.Metheds Based on CT measurement data from a volunteer,3 artificial knee prostheses with the same medial condyle were established.In Model 1,the twist angle of lateral condyle surface was 0°,while 10° and 20° in Model 2 and Model 3,respectively.The prosthesis models were imported into finite element software and applied with gait cycle data to simulate the motion of knee prosthesis during the gait cycle.The simulated stress results in the knee joint were then compared with the calculated results,which were obtained from theoretical formula of contact mechanics.Results The maximum stress of 3 models appeared at 13％ of the gait cycle,when the axial force (2.6 kN) was also the maximum.The maximum stresses of medial and lateral condyle in Model 1,Model 2 and Model 3 were 35.5 and 30.6 MPa,38.4 and 32.6 MPa,38.3 and 43.1 MPa,respectively.The stress curves of Model 2 and Model 3 during the gait cycle were relatively smooth compared with those of Model 1.The simulated stress trend was basically similar to the theoretical calculation,except at a few moments in the gait cycle.Conclusions The mechanical environment of the total knee prosthesis can be improved by twist angle of the lateral condyle surface.This newly designed prosthesis can preserve implants from abrupt change of the stress during the gait cycle and prolong the service life of prostheses.

Regulations of berberine on gene expression of BMP4 transcriptional pathways to improve visceral white adipose tissues insulin resistance in type 2 diabetic hamsters / 中国中药杂志

To study the effects of berberine on the gene mRNA expressions of BMP4 transcriptional pathways and brown/white adipose tissue conversion transcriptional pathways in visceral white adipose tissues(VWAT) in type 2 diabetic hamsters and explore the relevant mechanisms. The obese insulin-resistant hamster model were induced by using high-fat diet, and then the type 2 diabetic hamster model was created through injection with low-dose streptozotocin in the obese insulin-resistant hamster model. After the modeling, the hamsters were randomly divided into normal control, obese insulin-resistant, type 2 diabetic and berberine-treated diabetic groups. After the nine-week treatment, real-time quantitative PCR was used to measure the changes in gene mRNA expressions of VWAT BMP4 transcriptional pathways, brown/white adipose tissue conversion transcriptional pathways and their target genes in different groups. The results showed that the gene mRNA expressions of BMP4, BMPRⅡ, BMPRlA, Smad1, Smad5, Smad8, p38/MAPK, ATF2, PRDM16, C/EBPβ, PGC1α, PPARγ and brown adipose tissue-specific genes was decreased and that of Smad6, Smurf1 and white adipose tissue-specific genes was increased in VWAT of model hamsters. Treatment with berberine regulated BMP4 transcriptional pathways and brown adipose tissue transcriptional pathways and induced the gene mRNA expression of brown adipose tissue-specific genes in VWAT to develop browning gene phenotype of white adipose tissues, and then improved fat-induced insulin resistance. These findings indicated that BMP4 transcriptional pathways involved in the formation of fat-induced visceral white adipose tissues insulin resistance (FIVWATIR) and the browning molecular mechanism of white adipose tissues induced by berberine.

Observation of prime position and driving zones in process of tuberous root expanding and expression analysis of phytohormone relative genes in Rehmannia glutinosa / 中国中药杂志

In order to study the development characteristics of Rehmannia glutinosa tuberous root expansion and reveal the regulation mechanism of the genes related to hormones in this process, R. glutinosa "wen-85" was used as the experimental material in this study. R. glutinosa tuberous roots of different developmental stages were collected to observe phenotype and tissue morphology using resin semi-thin sections method. The genes related to hormone biosynthesis and response were chosen from the transcriptome of R. glutinosa, which was previously constructed by our laboratory, their expression levels at different development stages were measured by real-time quantitative PCR. The results showed that the root development could be divided into six stages: seeding, elongation, pre-expanding, mid-expanding, late-expanding and maturity stage. The anatomic characteristics indicated that the fission of secondary cambium initiated the tuberous root expansion, and the continuous and rapid division of secondary cambium and accessory cambium kept the sustained and rapid expansion of tuberous root. In addition, a large number oleoplasts were observed in root on the semi-thin and ultra-thin section. The quantitative analysis suggested that the genes related to biosynthesis and response of the IAA, CK, ABA,ethylene, JA and EB were up-regulated expressed, meanwhile, GA synthesis and response genes were down-regulated expressed and the genes of GA negative regulation factors were up-regulated expressed. The maximum levels of most genes expression occurred in the elongation and pre-expansion stage, indicating these two stages were the key periods to the formation and development of tuberous roots. Oleoplasts might be the essential cytological basis for the formation and storage of the unique medicinal components in R. glutinosa. The results of the study are helpful for explanation of development and the molecular regulation mechanism of the tuberous root in R. glutinosa.

Lyme Borreliosis-associated Risk Factors in Residents of Beijing Suburbs: a Preliminary Case-control Study / 生物医学与环境科学（英文）

A population-based case-control study was conducted to evaluate the relative factors in the environments, agricultural works, outdoor activities, and the effectiveness of Lyme borreliosis (LB)- associated personal protective measures in Beijing. Thirty-four cases and 272 controls were personally interviewed by well-trained interviewers. Venous blood samples were taken from each subject. Sowing or harvesting in summer (OR=2.571, 95% CI: 1.109-5.962), living in house with weeding in the yard (OR=2.247, 95% CI: 1.062-4.755), and residence at the plain area (OR=2.630, 95% CI: 1.050-6.588) were the independent relative factors for seropositive LB. Wearing long pants and clothes with cuffs was the only protective behavior against tick bite (OR=0.186, 95% CI: 0.041-0.846). The findings showed that local farmers were easily infected with LB and almost no protective measure was taken against LB infection. Infection with LB was easier in residents of plain regions. Pets raising and outdoor activities were not the risk factors for infection with LB. Further studies are needed to fully understand the risk of infection with LB in China.

Study on the risk factors of diarrhea-related behaviors among adults in Beijing / 中华流行病学杂志

Objective To study the risk behaviors on diarrhea among the adults of Beijing.Methods 13287 adults aged over 18 years in Dongcheng,Xicheng,Haidian,Changping,Huairou and Tongzhou districts in Beijing were selected with a multi-stage stratified sampling method.Information on the demographic characteristics,with or without symptoms on diarrhea in the last year,and behaviors related to diarrhea,were collected through a self-designed questionnaire.Results The reported total prevalence of diarrhea symptoms in the last year was 17.6％ and,in urban areas as 16.8％,in rural areas as 18.2％ respectively.The differences on the reported prevalence rates of diarrhea in different age groups,background of education and occupations groups among urban residents were statistically significant (P＜0.05).Items as eating raw seafood or freshwater products,using the same chopping block and knife at the time when processing raw and cooked food,not being used to regular physical exercise etc.were the risk factors to diarrhea among adults from urban areas,with OR (95％CI) as 1.26 ( 1.07-1.48),1.37 (1.16-1.63) and 1.38 ( 1.20-1.59),respectively.The reported diarrhea prevalence rates related to sex,age,education background and occupations among rural residents did not show significant differences (P＞0.05).Without hand-washing habit before eating or after toilet-using,eating raw seafood or freshwater products,using the same chopping block and knife at the time when processing raw and cooked food,not being used to regular physical exercise etc.seemed to be the risk factors on diarrhea among adults in the rural areas with the OR(95％CI) as 1.85 (1.51-2.25),1.39 (1.17-1.67),1.44 (1.24-1.67) and 1.46 (1.27-1.67),respectively.Conclusion The prevalence reported on diarrhea symptoms among adults from the rural areas was higher than the urban adults.Diarrhea was related to health-related habits,eating habits and regularity of taking physical exercises.

Etiological detection of severe hand-food-mouth disease and related genetic characteristics of enterovirus type 71 infection in Beijing,2010 / 中华流行病学杂志

Objective To study the etiological detection on samples from severe hand-footmouth disease (HFMD) cases and the genetic characteristics of enterovirus type 71 (EV71) isolates lrom severe patients in Beijing,2010.Methods Real-time RT-PCR was used to detect EV71 and Coxsackievirus A16 (CoxA16) and RD cells were used to separate virus strains from samples.Homogeneity of EV71 isolated strains were also analyzed. Results Four hundred and fourty-two severe cases were detected and 253 were positive,taking up 57.24％ of the total (253/442).The overall positive detection rate on EV71 was 54.55％ (138/253),with CoxA16 as 5.93％(15/253),and with other enterovirus group was 39.53％(100/253).The nucleotide homogencity of VP1 within these 12 strains was 97.2％ 100.0％,and with Beijing strains in 2007-2010,Shandong strains in 2007 and Anhui Fuyang strains in 2008 and the Guangdong strains in 2008 as 94.0％-99.9％.Conclusion Severe HFMD cases were most oftenly caused by EV71 but less caused by CoxA16 or other cnterovirus.The HFMD in 2010 in Beijing was mainly caused by EV71 subgenotype C4a with 4 transmission chains.Twclve isolated EV71 strains had high homogeneity with strains isolated from severe cases in Anhui Fuyang in 2007.

Comparisons of epidemiological and clinical characteristics in children with hand-foot-mouth disease caused by Enterovirus 71 and Coxackievirus A16 / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the differences of epidemiological and clinical characteristics in children with hand-foot-mouth disease (HFMD) caused by Coxsackievirus A16 (CA16) and Enterovirus 71 (EV71).</p><p><b>METHODS</b>The samples of vesicle fluid and throat swabs of 108 children with HFMD were collected and detected for enterovirus by RT-PCR. The clinical data of children with EV71 and CA16 infection were retrospectively reviewed and compared.</p><p><b>RESULTS</b>The total positive rate of enterovirus was 97.2% (105/108). Of the 105 cases, 56 cases were positive for EV71 (51.9%), 39 cases were positive for CA16 (36.1%), 2 cases were positive for other enterovirus (1.9%), and 8 cases were co-infected by EV71 and CA16 (7.4%). There were no significant differences in age and sex between EV71 and CV16 infected cases. The univariate analysis showed that the incidences of herpes of mouth, erythra of knees, and nose running in children infected by CA16 were higher than in those infected by EV71. The multivariate logistic regression analysis showed that the HFMD children who had erythra of knees had higher probability of CA16 infection.</p><p><b>CONCLUSIONS</b>EV71 should be considered as the pathogen in children with HFMD who have no herpes of mouth, erythra of knees, and nose running.</p>

Application of dynamic contrast-enhanced magnetic resonance imaging in evaluating liver fibrosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the value of time-signal intensity curve (TIC) in dynamic contrast-enhanced magnetic resonance imaging (DEC-MRI) in the evaluation of liver fibrosis.</p><p><b>METHODS</b>Thirty-six consecutive patients and healthy volunteers were divided into 4 groups according to the stages of fibrosis, namely the normal group (n=9), mild fibrosis group (n=5), moderate to severe fibrosis group (n=7), and liver cirrhosis group (n=15). All the subjects underwent conventional and DEC-MRI, and the TIC was generated automatically to evaluate the peak height, TTP, MSI and MSD. The correlations between the TIC parameters and the stage of fibrosis were assessed. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the value of the TIC parameters in the evaluation of fibrosis stage.</p><p><b>RESULTS</b>Moderate but significant inverse correlations of the peak height, MSI, and to fibrosis stage were noted in these patients (P<0.05); the peak time was positively correlated to the fibrosis stage (P<0.05). In patients with a fibrosis stage ≥1, the AUC of the measured TIC parameters ranged from 0.747 to 0.783, with the MSD of the spleen had the highest AUC (0.783). For a fibrosis stage ≥3, the AUC of the indices ranged between 0.728 and 0.877, highest for liver MSI of the arterial phase, followed by the portal vein MSI, liver MSI of portal venous phase, liver MSD, splenic MSI of arterial phase and splenic MSD. In the diagnosis of liver cirrhosis, the AUC (range 0.742-0.821) decreased in the order of liver MSI of the portal venous phase, liver MSD, liver MSI of the arterial phase, the portal vein MSI, splenic MSI of the arterial phase and splenic MSD.</p><p><b>CONCLUSION</b>TIC of DEC-MRI can be used to evaluate hemodynamic changes in the liver, and may serve as a practical non-invasive functional imaging modality for assessing the severity of liver fibrosis.</p>