Aspirin ; administration & dosage ; therapeutic use ; Female ; Fever ; drug therapy ; Humans ; Infant ; Mannitol ; administration & dosage ; therapeutic use ; Meningitis, Aseptic ; complications ; drug therapy ; pathology ; Mucocutaneous Lymph Node Syndrome ; complications ; drug therapy ; pathology

Objective To explore the variation of serum D-lactic acid levels and the correlation between different intestinal viral and intestinal barrier function in children with hand, foot and mouth disease (HFMD). Methods The stools of 129 children with HFMD were collected and were detected by reverse transcription polymerase chain reaction. The children were divided into four groups according the fecal pathogens detection:enterovirus 71 (EV71) positive group, Coxsackie virus A16 (CoxA16) positive group, other intestinal virus positive group (EA positive group), and no intestinal virus group (EA negative group). Two ml venous blood and separation serum was collected in each group of children, and the level of serum D-lactic acid was detected further. Results There were 20 cases of other Coxsackie virus, and they were not grouped. Fifty-seven patients were in EV71 positive group, 26 patients were in CoxA16 positive group, 10 patients were in EA positive group, and 16 patients were in EA negative group. The level of D- lactic acid in four groups was 26.28 (17.02- 58.01), 14.43 (8.93- 20.66), 10.66 (6.64- 18.51) and 14.07 (11.83- 27.46) mg/L. The results of rank test showed the level of D-lactic in EV71 positive group was significantly higher than that in EA positive group (Z=-2.432, P=0.015) and EA negative group (Z=-3.092, P=0.002). Conclusions D-lactic acid level increases significantly in EV71 infection children and suggests that the illness is more serious and the intestinal barrier is damaged. Doctors should pay more attention to monitor and protect gastrointestinal function of children with HFMD.

Objective To observe the clinical curative effect of phentolamine in the treatment of severe hand-foot-mouth disease (HFMD) . Methods We observed the clinical symptoms and related index changes before and after treatment of 62 cases of severe HFMD patients who were treated by the basis of conventional therapy with additional phentolamine. The blood pressure of patients was closely monitored,and the dosage of phentolamine was adjusted. Result The blood pressure and heart rate of sick children who used phentolamine improved significantly, the difference was statistically significant ( <0.05) . Conclusion Phentolamine has significant clinical curative effect in treatment of server HFMD.

Objective To study the prevalence trends and etiology of hand,foot,and mouth disease (HFMD) in hospitalized children.Methods The clinical data of 11 510 cases of children hospitalized with HFMD from 2008 to 2017 in Department of Infection Diseases of Kunming Children's Hospital were collected,and to retrospectively analyze the characteristics,time distribution and pathogen distribution of the cases.Results Of the 11 510 children with HFMD,6 100 were male and 5 410 were female.There were 9 814 cases under 3 years old,1 696 over 3 years old.HFMD occurred throughout the year.The peak months of the disease were April to July,with the time distribution of single peak.There were 4 690 severe cases and 3 452 critical cases,accounting for 70.34％.The main pathogens detected were enteroviruses A71 (EV-A71),coxsackievirus A16 (CV-A16) and other enteroviruses (EV),with 3 803 cases (36.02％),1 122 cases (10.63％) and 3 401 cases (32.21％) respectively.EV-A71 and CV-A16 infections dominated from 2008 to 2013,while EV-A71 and other EV infection dominated from 2014 to 2017.Conclusions EV-A71,CV-A16 and other EV are the main pathogens of HFMD in Kunming.Critical HFMD cases are mainly caused by EV-A71 infection.