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ObjectiveTo analyze the epidemiological characteristics and etiology of clustered outbreaks of hand， foot， and mouth disease （HFMD） in Pudong New Area， Shanghai from 2017 to 2022， and to provide a scientific basis for the prevention and control of HFMD in the area. MethodsThe data related to HFMD clustered outbreaks from 2017 to 2022 were obtained from the Pudong New Area HFMD outbreak database. Descriptive analysis was conducted to explore the outbreak scope， seasonal characteristics， distribution of occurrence settings， and etiological composition. ResultsFrom 2017 to 2022， Pudong New Area reported a total of 2 547 HFMD clusters， involving 8 884 cases， with an average of 3.49 cases per event. The majority of events （78.52%） had between 2 and 4 cases. The peak reporting periods for clustered HFMD from 2017 to 2019 and in 2021 were during the summer （May‒July） and autumn （September‒November）. The seasonal pattern was less distinct in 2020 and 2022， likely due to the impact of the COVID-19 pandemic. The majority of clustered outbreaks occurred in childcare facilities （44.64%）， followed by households/neighborhood committees （44.21%）， with schools accounting for a smaller proportion （12.39%）. The etiology revealed the coexistence of multiple enterovirus genotypes， with a positive detection rate of 60.46%， and CoxA6 being the dominant strain. ConclusionHFMD clustered outbreaks in Pudong New Area show fluctuating trends， with significant yearly differences in the number of incidents. The predominant seasons for outbreaks are summer and autumn， with CoxA6 identified as the dominant strain. The implementation of prevention and control measures for COVID-19 significantly reduced the occurrence of HFMD outbreaks. Continuous monitoring and focus on large-scale clustered outbreaks in key institutions are essential for the future.
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@#Objective To investigate the ultrastructural changes of brain vessels and cells after alcoholism in rats and the underlying mechanisms.Methods Wistar male rats were given alcohol intragastrically for 4 weeks to induce chronic alcoholism model.To observe the ultrastructural changes related to brain vascular and cells damage after alcohol intoxication in rats by a transmission electron microscope.Results The shape of cerebellar capillary endothelial cells was irregular in the alcohol intoxication group，there were fewer organelles in the cytoplasm.The nuclei are irregularly shaped,the nuclei are not obvious,irregular shape.The mitochondria in the frontal lobes are swollen,crest fracture,reduced number,the ribosomes attached to the crest fall off.The tubular rough endoplasmic reticulum is fractured,the interval between each other is widened,the quantity is reduced,the ribosomes attached to the outer surface of the tube membrane fall off.Mild demyelinating changes were observed in the hippocampus,and the lamellar myelin sheath composed of multiple plasma membranes was slightly detached and damaged.Conclusion Alcoholism can cause the change and damage of the ultrastructure of cerebrovascular and related cells.To provide basic research theories and ideas for subsequent prevention and treatment.
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Background & Objectives: Multiple sclerosis (MS), neuromyelitis optica (NMO) and acute transverse myelitis (ATM) are common diseases in neurology; however their corresponding cervical spinal cord involvements are still ambiguous. The purpose of this study was to demonstrate the utility of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in identifying the injury in cervical spinal cord. Methods: Nine patients and nine healthy volunteers were enrolled in this study. Conventional sequences and DTI scan were performed on each participant. Results: The average fractional anisotrophy (FA) values of the cervical cord in patients with acute cerebral type MS, acute or stationary cerebrospinal type MS, acute NMO, or acute ATM were all significantly decreased relative to the control group (p <0.05). As to the cerebrospinal type MS, the changes in acute-stage patients were more apparent (p <0.05). The average FA value of the cervical cord in acute NMO was decreased more extensively, involving the normal-appearing spinal cord (p <0.05). In patients with MS or NMO, The lesions showed significantly hypointense on FA images and directionally encoded color (DEC) images, nevertheless the pathological areas on DTI images were no significantly different from those on routine sequences. On DTT, the fiber tracts in the lesion-involved regions were all sparser than that in control regions, nevertheless interruption or impairment of fiber tracts could only be noted in NMO patients. Bilateral differences of average FA values in the cervical cord was noted in one case with ATM and another case with MS (p <0.05), and the decrease of FA values was significant in the main side of clinical presentations. Conclusion: DTI and DTT may be a sensitive measure for early cervical injury in MS, NMO and ATM
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Maladies de la moelle épinièreRÉSUMÉ
Objective To explore the related risk factors of cerebrovascular disease induced cerebral microbleeds and its nursing strategies. Methods A total of 393 patients with acute cerebrovascular disease who were admitted to our hospital from January 2012 to January 2014 were selected. 146 patients who were hospitalized due to non-central ner-vous system disease at the period of time were selected as control group. Baseline data of patients were recorded, and regular MRI T2-weighted imaging were given to all patients. Incidence rate of cerebral microbleeds for patients with different types of cerebrovascular diseases was analyzed. Results Among 393 patients with acute cerebrovascular dis-ease, 206 patients were cerebral microbleeds. Incidence rate was different for different diseases. Incidence rate of hy-pertension was 47.20%, cerebral infarction was 45.98%, diabetes was 44.00%, atrial fibrillation was 50.00%, cerebral hemorrhage was 84.00%, TIA was 25.00%, and leukoencephalopathy was 63.24%. The incidence rate in the control group was 13.70%, except for TIA, the differences between the control group and other groups were statistically signifi-cant (P<0.05). Cerebral microbleeds were taken as dependent variables, and other risk factors were taken as independent variables. Leukoencephalopathy, hypertension, high cholesterol, asymptomatic lacuna cerebral infarction, cerebral bleeding and cerebral infarction were risk factors for cerebral microbleeds, in which low density lipoprotein was a pro-tective factor. 206 patients with cerebral microbleeds were given nursing care. 20 patients recovered and discharged, 129 patients got better, 40 patients were not recovered, 7 patients were transferred to other hospitals, and 10 patients died. The hospitalization time was 1 to 33 days, with an average of (15.3±2.3) days. Conclusion Incidence rate of cere-bral microbleeds for patients with cerebral infarction, cerebral bleeding and leukoencephalopathy is relatively high, and low density lipoprotein is the protective factors for cerebral microbleeds. Hypertension, asymptomatic lacuna cerebral infarction, cerebral bleeding, cerebral infarction, high cholesterol and leukoencephalopathy are risk factors for cerebral microbleeds. Scientific and proper nursing care for patients with cerebral microbleeds is able to significantly improve patients' recovery rate, which is worthy of further clinical promotion and application.
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Objective To clearify the features of an outbreak of Guillain-Barré syndrome (GBS) from Shuangyang district of Changchun city, Jilin province, China.Methods Serum samples obtained were tested serologically for antibodies to chlamydia, coxsackie virus, cytomegalovirus, and hepatitis B virus.Stool samples obtained were cultivated to search Campylobacterjejuni.Electrudiagnostic studies were done 1 day after onset to 10 days.Results Twenty-two patients (12 males and 10 females, aged 15-71 years) were from Shuangyang district, a suburb of Changchun, during a 2-week period in June to July 2007.An illness in the preceding 4 weeks was reported in 17 patients, 16 gave a history of diarrhoea, 1 patient had symptoms consistent with an "upper respiratory infection" and 1 patient had both.Limb weakness were the earliest symptoms.Respiratory assistance was needed by 3 patients.Tendon reflexes were lost as weakness developed.Eleven patients had raised concentrations of protein in the cerebrospinal fluid ((0.74±0.32) g/L), and the averaged cell count was 3×106/L There were 3 kinds of antibodies of hepatitis B virus positive above 17 GBS patients.Electrodiagnostic studies showed severe reductions in motor evoked amplitudes from distal stimulation in 12 patients.Sensory action potentials were normal.Conclusions The distinctive epidemiologicai, clinical and electromyography characteristics of these patients suggest that the disorder, different from acute inflammatory demyelinating polyneuropathy, is concordant with acute motor axonal neurupathy.The features of Shuangyang GBS was similar to those previously reported in several aspects.