Objective To investigate the changes of T cell subsets including Th1,Th2,Th17 and Treg in the hand,foot and mouth disease(HFMD) patients.Methods 35 EV71 induced HMFD patients and 12 non-infectious children were included in this study.Patients were divided into mild symptoms group and severe symptoms group.The ratios of Th1,Th2,Th17 and Treg were analyzed by flow cytometry.Results Sixteen mild cases and 19 severe cases were included in the 35 patients.No statistical difference of children′s age and sex were found among the groups(P>0.05).The proportion[M(P25,P75)] of Th1 cells of mild and severe groups were 10.65%(8.73%,14.08%) and 15.51% (13.47%,18.31%),respectively,which were significantly higher than normal control group 5.51% (3.61%,8.61%)(P<0.05).The proportion of Th2 cells of mild and severe groups were 4.32%(2.60%,5.32%) and 3.87% (2.34%,5.32%),no significant difference from control group 2.11% (1.02%,5.11%)(P<0.05).The proportion of Th17 cells of mild and severe groups were 8.32%(5.25%,12.33%),7.36% (5.05%,11.9%),significantly higher than that of normal control group 4.23% (2.44%,6.22%)(P<0.05).The proportion of Treg cells of mild and severe groups were 1.46% (0.31%,2.73%),1.59%(0.35%,2.62%),no significant difference from the control group 1.78% (0.31%,2.77%)(P<0.05).Conclusion The Th1/Th2 and Th17/Treg ratios of HFMD patients with EV71 virus infection were changed,and the Th1 and Th17 cells may play an important role in the in the disease and body′s resistance.

We explored the status of Bartonella infection in rodents and the sequence characteristics of Bartonella in Fujian Province.Rodents in Fujian Province were captured by the night trapping method during 2014-2016.Information of the captured rodents on capturing dates and geographic locations,species,gender and ages were recorded.Heart blood samples were collected,from which the fragments of ghA gene and16S-23S rRNA gene of Bartonella were amplified by polymerase chain reaction (PCR).The PCR products were sequenced and the phylogenetic tree was constructed for homology analysis by biological analysis software.Data on infection rate were analyzed with Chi-square or Fisher exact test to indicate statistical significance.Results showed that 5 917 cages were laid and 381 rodents were captured,density of rodent was 6.44％.The overall Bartonella infection rate in rodents was 12.34 ％,while infection rate in domesticated rodents was 10.61％,with 11.30 ％ in Rattus norvebicus and 10.00％ in R.flavipectus.And the infection rate in wide rodents was 13.86％,with a rate of 22.86％ in Rattus losea and 18.00％ in R.fulvescens,respectively.The infection rate was higher in wild rodents than in domesticated rodents,however,no significant difference was found.The Western Fujian and Northern Fujian region had the higher infection rates of 20.00％ and 25.33％,and no infection was found in Southern Fujian region.The statistical analysis result revealed that a significant difference in infection rate among different region and habitats,but no significant difference in infection rate between male and female rodents,or among different ages.The BLAST results revealed the species to be B.tribocorum,B.elizabethae and B.grahamii.In conclusion,Bartonella infection is found in the rodents in Fujian Province and more attention should be paid on its impact on public health in the province.

AMOS-PCR and MLVA were carried out to identify the Brucella strains isolated in Fujian province, which were classified as B. melitensis biovar 2 or 3 by conventional microbiological tests. All these 3 isolates were identified to be B. melitensis by AMOS-PCR. The genetic patterns obtained by MLVA were queried in the Brucella 2007 database and clustered with B. melitensis strains. It is evident that these two molecular assays may be used as the assistant tools in the identification of Brucella strains.

Objective The purpose of this paper is to study the variations of the bone conduction hearing in the patients with chronic suppurative otitis media complicated by bone conduction deterioration after tympanoplasty and to analyze the relative factors. Methods In 54 cases (61 ears) of decreased bone conduction thresholds associat-ed with chronic suppurative otitis media, reviewed retrospectively were the data before the operation and during the follow-ups from 3 to 27 months. The bone conduction thresholds at 0. 5,1, 2 and 4 kHz were studied in relation to the courses of disease, the complications of cholesteatoma, the operation procedures and the reconstructions of os-sicular chains before and after surgeries. Results Before operation the most obvious hearing loss of bone conduction was found at 4 kHz in 61 ears, while after operation the average bone conduction hearing at the 4 frequencies was improved at different degrees with the most at 2 k Hz. Thirty-two of 61 cases (52.50%) were found to have their hearing improved at least by more than 10 dE at two frequencies without any deterioration at the 4 frequencies. Con-clusion The factors of the duration of disease and complications of cholesteatoma are obviously not related to the improvement of hearing after operation. A patient with reconstruction of ossicular chain is markedly superior to one without the reconstruction in improvement of hearing. When the auditory ossicular chains and functions of the oval and/or round windows are damaged, the bone conduction hearing can be affected accordingly. However the hearing of some cases will be improved after tympanoplasty. Also, the possible improvement is also related to different sur-geries in treating patients with middle ear infections.

In this study ,street trains were isolated from brain of suspected rabid dogs via mouse inoculation technique (MIT) and cell culture inoculation technique (CIT) .Virus was identified by FAT ,RT-PCR and sequencing .Then ,the virus’ biological characteristics were analysed .The TCID50 test results demonstrated that viral titers were not high ,which showed the BHK-21 cells was not the best host cell of rabies viral strain .The LD50 test results showed it was a strong strain of rabies virus .These results laid a strong foundation for rabies laboratory research in Fujian .

Objective To investigate the first human brucellosis outbreak in Fujian Province,aiming to identify the source,risk factors of infection,and recommend control measures.Methods Epidemiological investigation was conducted by combining with agricultural sector on human and animal in the incident area of Zhangzhou City of Fujian Province.Respondents included 17 professionals from the outbreak sheep farm,as well as 9 ones from four nearest farms (including 2 pig farms,1 sheep farm and 1 cow farm) in directions of eastern,southern,western and northern.Then information of cognitive level and daily protection on brucellosis among pasture breeding staffs through case studies were got,serum of pasture breeding staffs and animals was collected (including 262 from the outbreak sheep farm and 50 from another sheep farm which nearly 5 kilometres away) to detect brucellosis antibody,and sheep sources were investigated simultaneously.Results A total of 26 people were detected,the infection rate was 26.9％ (17 people,in the epidemic area),the other four farming units without brucellosis infection.In epidemic focus,seven human infections (5 confirmed cases,2 asymptomatic infected) were identified,with an infection rate 41.2％ (7/17) and the brucellosis antibody positive rate among sheep was 46.2％ (121/262),while no positive sheep in the nearest sheep farm (0/50).Both unprotected lamb handling and stillbirth treatment got a 100.0％ infection rate.Among the investigated professional staffs,92.3％ (24/26) had no awareness of clinical symptoms and signs of brucellosis,while 11.5％ (3/26) took protective measures when working.Conclusions Unquarantined sheep is the infection source of this brucellosis outbreak,unprotected lamb handling and stillbirth treatment are the main route of transmission.High sheep infection rate,lack of brucellosis awareness,precaution missing among pasture breeding staffs and animal quarantine are all contributing to this outbreak.

The chronic disease management of rheumatoid arthritis has been popularized and applied in China. This article will review the application and research progress of different chronic disease management models, including chronic care mode, chronic disease self-management, transitional care mode, community-based chronic disease management, and "internet + chronic disease management" in rheumatoid arthritis patients in China, and compare the advantages and disadvantages of different intervention models, in order to provide a theoretical basis for exploring the chronic management of rheumatoid arthritis under different regional medical resources.

Objective To analyze the epidemiological characteristics and spatial distribution of human brucellosis in Fujian province during 2011-2016,and provide evidence for the prevention and control of the disease.Methods The surveillance data of human brucellosis in Fujian during 2011-2016 was analyzed with software R 3.3.1,ArcGIS 10.3.1,GeoDa 1.8.8 and SaTScan 9.4.3.Results During 2011-2016,a total of 319 human brucellosis cases were reported,the incidence increased year by year (F=11.838,P=0.026) with the annual incidence of 0.14/100 000.The male to female rate ratio of the incidence was 2.50 ∶ 1.Farmers and herdsmen accounted for 57.37％.The incidence was 0.40/100 000 in Zhangzhou and 0.32/100 000 in Nanping,which were higher than other areas.The number of affected counties (district) increased from 12 in 2011 to 28 in 2016,showing a significant increase (F=13.447,P=0.021).The Moran' s I of brucellosis in Fujian between January 2011 and December 2016 was 0.045,indicating the presence of a high value or low value clustering areas.Local spatial autocorrelation analysis showed that,high-high clustering area (hot spots) were distributed in Zhangpu,Longhai,Longwen,etc,while high-low clustering areas were distributed in Nan' an and Jiaocheng,etc.Temporal scanning showed that there were three clustering areas in areas with high incidence,the most possible clustering,occurring during January 1,2013-December 31,2015,covered 6 counties,including Yunxiao,Pinghe,Longhai,etc,and Zhangpu was the center,(RR =7.96,LLR=92.62,P＜0.001).Conclusions The epidemic of human brucellosis in Fujian is becoming serious,and has spread to general population and non-epidemic areas.It is necessary to strengthen the prevention and control of human brucellosis in areas at high risk.