Objective To study the factors influencing epidemiological characteristics and virulence of Enterovirus 71 (EV71) in Guangdong province from 2008 to 2010. Methods RNA was extracted from collected samples or cultured virus , then reversing transcription into cDNA. We amplified full-length EV71-VP1 using poly-merase chain reaction technology , then conducted sequence alignment and established phylogenetic tree with MEGA software (version 5.0) to confirm the genotype of EV71. The association between severity of clinical symp-toms and sex, age, viral genotype and VP1 variation was also analyzed using Logistic regression. Results The genotype of the predominant epidemical strain was C4a in Guangdong from 2008 to 2010. However , this subtype had already differentiated into 4 subgroups (C4a1- C4a4). There was no correlation between clinical syndrome and sex or viral genotype; the severity of symptoms was negatively correlated with age: before 4 years old, varia-tion A289T can easily lead to severe cases, increasing the risk of infection (P<0.05, OR = 2.360, 95%CI:1.163~ 4.659). Conclusion The main epidemical EV71 strain is C4a1 in Guangdong province. The emerging differen-tiation and simultaneous prevalence should merit attention to strengthen relevant surveillance; and the protection of the susceptible population should be reinforced during EV71 prevalence.

Objective To study the relationship between APOBEC3G mRNA level in peripheral blood mononuclear cells (PBMC) and serum hepatitis C viral RNA level in patients with chronic hepatitis C infection. Methods TaqMan real-time fluorescence relative quantitative polymerase chain reaction (RT-PCR) was used to quantify APOBEC3G mRNA levels in PBMC from 49 patients with chronic hepatitis C (CHC) and 31 healthy subjects. The relationship between APOBEC3G mRNA level and hepatitis C virus (HCV) viral load was analyzed. SPSS11. 0 statistics software was used for t test and regression analysis. Results APOBEC3G mRNA level in CHC patients [(1.5×10-5±1.9×10-5 ) copy/mL] was significantly lower than that [( 5. 2 × 10-5 ± 5. 5 × 10-5 ) copy/mL] in the healthy control subjects (t=-3.005, P＜0.01). While APOBEC3G mRNA level was not related with HCV viral loads (r=-0.082, P＞0.05). Conclusion HCV has an inhibitive effect on APOBEC3G expression, whereas APOBEC3G doesn't affect HCV replication directly in vivo.

Objective To analyze the characteristics of laboratory test resuits of dengue fever(DF)patients in Guangzhou area.Methods Routine tests were performed in the patients admission to hospital. Serology examination was performed in the patients in acute phase or recovery phase.The clinieal symptoms and teatures were analyzed and positive numbers and positivity ratios were calculated.Results The clinical symptoms of the dengue fever were typieal,with the features of fever,headache,myalgia and rash.The leukopenia rate was 76.0%,and the thromboeytopenia rate was 62.6%.The levels of ALT increased in 56.7%patients,and the levels of AST increased in 84.0%patients.Hypopotassemia was found in 46.1%patients.Dengue virus antibody IgM(DF-IgM)was detected positive from the first day to the 16th day of the onset,and the positive rate was 85.9% on the 8th day.Virus loads were positive by fluorescence real-time PCR in seven acute serum samples(within 3 days of the onset)of 51 cases whose DE-IgM were negative all the time, and the results was 105 -106 copies/ml(＜103 copies/ml means negative).Conclusions Clinical manifestations of this DF epidemic were typical including fever,headache,myalgia and skin rash.Most of the patients had decreased leukocyte and thrombocyte obviously.Liver damage was common but kidney damage was seldom.Halt of the patients got hypopotassemia.DF-IgM appeared in very early and persisted for a long time.The detection of DF-IgM within 7 days of the onset was helpful for diagnosis as early as possible.Viral load detected by real-time PCR could be another indicator of early pathogen diagnosis which provides complementation for antibody detection.

ObjectiveTo explore the differences in clinical characteristics between patients with HBsAg(+) and HBsAg(-)/HBcAb(+) primary hepatic carcinoma (PHC) treated by hepatectomy. MethodsForty-three HBsAg(+) and 18 HBsAg(-)/HBcAb(+) patients who underwent liver resection against PHC from October 2009 to November 2014 in Guangzhou 8th People′s Hospital were selected for the study. The clinical data of the subjects, including sex, age, histological differentiation, intravascular tumor thrombi, and hepatic cirrhosis, were compared, using t test for continuous data, chi-square test for categorical data, and Mann-Whitney U test for non-parametric data. ResultsNo significant differences existed between patients with HBsAg(+) and HBsAg(-)/HBcAb(+) PHC in terms of the age of onset (50.77±12.93 years vs 54.28±9.89 years, t=-1.031, P＞0.05), the incidence of cholangiocarcinoma (2.3% vs 167%, χ2=2.24, P＞0.05), the incidence of hepatic cirrhosis (62.8% vs 44.4%, χ2=1.746, P＞0.05), alpha-fetoprotein level (3638±7869 ng/ml vs 3577±9628 ng/ml, t=0.026, P＞0.05), histological differentiation (Z=-1.085, P＞0.05), and the rate of intravascular tumor thrombi (34.9% vs 22.2%, χ2=0.949, P＞0.05). ConclusionThere are no significant differences in the age of onset and progression of disease between patients with HBsAg(+) and HBsAg(-)/HBcAb(+) PHC treated by hepatectomy. However, given the possibility of occult hepatitis B virus infection, it is necessary to monitor hepatic carcinoma even post HBsAg seroconversion

Acute-on-chronic liver failure (ACLF) is a severe syndrome of liver diseases commonly seen in clinical practice and can lead to severe disorders and decompensation of liver synthesis, metabolism, detoxification, and biotransformation, as well as multiple organ failure and an extremely high short-term mortality rate. Infection can induce or aggravate the condition of ACLF and is an independent influencing factor for patient prognosis. This article describes the mechanism and characteristics of ACLF with infection, summarizes the common types and clinical features of infection, reviews the recommended anti-infective regimens, and emphasizes the importance of early prophylactic treatment. ACLF patients with infection tend to have critical conditions, and early diagnosis and empirical anti-infective treatment is the key to successful treatment.

ObjectiveTo investigate the efficacy and safety of elbasvir/grazoprevir in patients with genotype 1 hepatitis C in the real world. MethodsA total of 35 patients with hepatitis C who received elbasvir/grazoprevir treatment in Guangzhou Eighth People’s Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, and Guangdong General Hospital from August 2018 to March 2019 were enrolled, treated for 12 weeks, and then followed up for 12 weeks after drug withdrawal. The patients were observed in terms of sustained virologic response at week 12 after drug withdrawal (SVR12), biochemical response, and incidence rate of adverse events during treatment and follow-up. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups, and the Mann-Whitney U test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate the risk factors for virologic response in patients with hepatitis C. ResultsAmong the 35 patients with HCV infection, 97.1% (34/35) had genotype 1b HCV and 2.9% (1/35) had genotype 1a HCV; of all patients, 28 (80%) were non-cirrhotic patients with chronic hepatitis C and 7 (20%) had compensated liver cirrhosis. At the end of treatment, the virologic response rate of 100% (28/28) and SVR12 was 94.74% (18/19). In addition, age, sex, baseline HCV RNA load, previous treatment history, presence or absence of liver cirrhosis, renal function, and presence or absence of other diseases did not affect the treatment outcome (all P＞0.05). There were significant changes in the levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and albumin from baseline to the end of 12-week treatment (Z=-7.131, -6.797, -3.060, and -2.875, all P＜0.05). No patient experienced drug withdrawal during treatment. ConclusionThis study confirms that elbasvir/grazoprevir has good efficacy and safety in the treatment of hepatitis C in domestic real-world studies.

Objective: To clarify the predictive power of PBMCs miR-122, as well as other clinical factors, for response to IFNα therapy in chronic HCV infected patients. Methods: A total of 40 patients chronically infected with HCV genotype 1b were enrolled. All the patients received pegylated interferon alpha (PEG-IFN α) in combination with ribavirin for 48 weeks. To perform the analyses, the patients were compared in terms of achieving sustained virological response (SVR) or not (NSVR) at 24th week after antiviral treatment. Results: SVR rate was 72.5% (29/40) and NSVR rate was 27.5% (11/40). SVR group experienced significantly lower HCV viral load, total bilirubin (TBIL), alpha fetal protein (AFP), fibroscan and laminin (LN) compared with NSVR group before treatment (P<0.05). PBMCs miR-122 expression level was also lower in SVR group than that in SNVR group, although the difference was not statistically significant (P>0.05). and there was no significant change of miR-122 level from baseline to the last available measurement between SVR group and NSVR group. However, no significant association was found between baseline PBMCs miR-122 and HCV viral load, body mass index (BMI), alanine transaminase (ALT), aspartate transaminase (AST), degree of liver fibrosis, respectively. Conclusions Our result suggest that PBMCs miR-122 level is not an efficient biomarker to predict response to IFN alpha therapy in chronic HCV patients. However, baseline HCV viral load, TBIL, AFP and fibroscan may serve as predictive factors.

To investigate the influence of five?in?one management mode (standardized asthma treatment, asthma diary, peak expiratory flow (PEF) monitoring, reasonable diet and physical exercise) on disease prevention and control of school children with asthma. Methods From April to October 2018, 70 children with asthma in clinical remission were selected from Affiliated Hospital of Qingdao University using randomized controlled study design. These children were randomly divided into study group and control group, with 35 cases in each group. In the study group, 5 cases were lost to follow?up, and 30 cases were actually enrolled. In the control group, 6 cases were lost to follow?up, and 29 cases were actually enrolled. Children in the control group received routine medication and regular outpatient consultation, and children in the study group received the five?in?one asthma management model. In the first time of seeing a doctor, after 3 months and 6 months of follow?up, asthma control test score, medication compliance index score and lung function index (forced expiratory volume in 1 second (FEV1), PEF were evaluated respectively. Parental satisfaction, asthma acute episodes, weight, height and biochemical index were recorded during the 6 months of follow?up. Pulmonary function index, asthma control score and body mass index of overweight children with asthma were compared with t-test, medication compliance was compared with chi?square test, and the rank sum test was used for the comparison of the number of emergency visits of asthma attacks and parents'satisfaction. Results A total of 59 children with asthma were included, among them 30 were in the study group (8.1 ± 1.5) years old and 29 in the control group (9.2±1.1) years old. After 3 months of follow?up, FEV1, PEF, asthma control score in the study group were (86.3 ± 1.5)% , (83.3 ± 2.4)% , (24.7 ± 2.6) points respectively; and in the control group, FEV1, PEF, asthma control score were (84.4±2.5)%, (82.2±1.9)%, (21.1±1.3) points respectively. The indicators in the study group were higher than those in the control group (t=3.62, 1.97, 6.64, P<0.05). After 6 months of follow?up, FEV1, PEF, asthma control score in the study group were (88.4±2.3)%, (85.4±2.2)%, (26.8±1.8) points respectively; and in the control group, FEV1, PEF, asthma control score were (85.5±1.9)%, (83.2± 1.7)%, (22.5±1.4) points respectively. The indicators in the study group were significantly higher than those in the control group (t=5.34, 4.24, 10.41, P<0.05). During the 6?month follow up, the number of emergency visits of asthma attacks in the study group and in the control group were 0.42(0.36, 0.51) and 0.92(0.72, 1.27) respectively. The indicator in the study group was significantly lower than that in the control group (Z=3.21, P<0.05). After 3 months of follow?up, the proportions of children with good compliance in the study group and control group were 67% (20/30) and 62% (18/29), the proportions of poor compliance were 27% (8/30) and 34% (10/29), the proportions of non?compliance were 7% (2/30) and 7% (2/29). There were no statistically significant differences (χ2=0.14, 0.43, 0.00, P=0.71, 0.51, 0.97). After 6 months of follow?up, the proportions of children with good compliance in the study group and control group were 87% (26/30) and 69% (20/29), the proportion of poor compliance were 10% (3/30) and 28% (8/29), the proportion of non?compliance were 3% (1/30) and 7% (2/29), There were no statistically significant differences (χ2=2.70, 3.00, 0.39, P=0.10, 0.08, 0.53). After 6 months of follow?up, the number of great satisfaction, satisfaction and dissatisfaction in the study group were 20, 10 and 0 respectively, the satisfaction rate was 100%, meanwhile those indicators in the control group were 4, 15 and 10 respectively, the satisfaction rate was 66%, The indicator in the study group was significantly higher than that in the control group (Z=4.60, P<0.05). Conclusions The application of "five?in?one" asthma management model (standardized asthma treatment, asthma diary, PEF monitoring, reasonable diet and physical exercise) for school?age children with asthma can significantly improve lung function, as well as reduce the number of acute asthma attacks. It has a high parent satisfaction, therefore it should be recommended for clinical implementation.

Objective To investigate the genotypes of interleukin (IL) 28B polymorphism and the effect of IL28B genotypes on the responses to therapy in patients with chronic hepatitis C (CHC).Methods A total of 74 patients with CHC were prospectively treated with pegylated interferon α (PEG-IFN α) in combination with ribavirin (RBV) for 48 or 72 weeks.After finishing the therapy,the patients were followed up for 24 weeks and the therapeutic effect was evaluated with rapid virological response (RVR) and sustained virological response (SVR).The IL28B rs8099917,rs12979860 and rs12980275 were identified by sequencing the PCR products amplified from the genome DNA of each participate.The IL28 B genotypes in CHC patients were analyzed and the effect of singlenucleotide polymorphism (SNP) on responses to therapy was assessed.Result rs8099917 TT,TG,GG were 63(85.1％),11(14.9％),0(0％),respectively.rs12979860 CC,CT,TT were 60 (81.1％),14 (18.9％),0 (0％),respectively.rs12980275 AA,AG,GG were 57 (77.0％),17 (23.0％),0 (0％),respectively.In patients infected with HCV genotype-1,only rs12979860 was associated with SVR rate,and the proportion of rs12979860 CC in SVR group was significantly higher than that in non-SVR group (88.4％ vs 58.3％,P ＜ 0.05).In patients infected with HCV non genotype-1,none of the three SNPs was associated with RVR or SVR (P ＞ 0.05).Conclusions The majority of the patients with CHC carry IL28B genotype rs8099917 TT,rs12979860 CC and rs12980275 AA in Guangdong.The genotypes of IL28 B(rs12979860) is closely related to the effect of PEG-IFN α/RBV therapy,and it might be an important predictive factor for SVR before treatment in patients with CHC.