Objective To explore the changes and clinical significance of interleukin-1β (IL-1 β) and aquaporin 4 (AQP4) in children with hand-foot-mouth disease (HFMD) combined with encephalitis.Methods From January 2014 to June 2016,30 cases of HFMD patients without encephalitis in Wuxi Children's Hospital were selected as the general group,at an average age of (2.1 ± 1.1) years,including 13 male and 17 female.Thirty cases of HFMD combined with encephalitis were selected as the observation group,at an average age of (2.4 ± 1.2)years,including 12 male and 18 female.Twenty-six non-HFMD patients who underwent minor operations for inguinal hernia or hydrocele of testis were selected as the serum control group,including 25 male and 1 female.Twenty-six patients with non-infectious neurological disorders in the neurology department in the same period were selected as the cerebrospinal fluid control group,including 10 male and 16 female.The levels of AQP4 and IL-1β in children were detected by adopting enzyme-linked immuno sorbent assay(ELISA).Results The levels of IL-1β in cerebrospinal fluid in the acute phase and recovery phase of the observation group were (95.04 ± 20.06) ng/L and (77.63 ±14.51) ng/L respectively,while the levels of AQP4 in cerebrospinal fluid were (16.87 ± 10.02) ng/L and (9.13 ±6.64) ng/L respectively.The levels of IL-1β in serum in the acute phase of the observation group and the general group were (82.40 ± 18.56) ng/L and (50.20 ± 24.22) ng/L respectively.The levels of IL-1β,AQP4 in cerebrospinal fluid were significantly higher in the acute phase of the observation group compared with the controls,and the differences were statistically significant(all P ＜ 0.05).The levels of IL-1β and AQP4 in the recovery phase were lower than those in the acute stage,and the differences were statistically significant(all P ＜ 0.05).The levels of IL-1β in serum was significantly higher in the acute phase of the observation group compared with the general group,and the difference was statistically significant (P ＜ 0.05).The level of IL-1β in serum were significantly higher in the general group compared with the controls,and the difference was statistically significant (P ＜ 0.05).Conclusions AQP4 and IL-1β may participate in the pathological course of HFMD combined with encephalitis by promoting brain edema,which can be used as one of the laboratory indicators for early diagnosis of the severity of the disease.

Objective To analyze the influencing factors of hospitalization costs for cancer patients in a county in Northwestern China, and to provide a theoretical basis for the health department to optimize the allocation of medical resources and improve the diagnosis and treatment of cancer in primary hospitals. Methods Using the data of the tumor registration report of a county hospital in northwestern China, the data of 7 common cancer patients in a county in northwestern China in2014 were collected. Use the R3. 3. 1 statistical software to perform t-tests and logistic regression analysis on the factors that influence the average hospitalization costs. Results The 7 common cancers in a county in northwestern China in 2014 were gastric cancer, lung cancer, liver cancer, esophageal cancer, cervical cancer, breast cancer, and colorectal cancer. The average hospitalization costs for the 7 cancers were 28 270 yuan, 29 630 yuan, and 28 990 respectively. Yuan, 43 950 yuan, 48 810 yuan, 45 620 yuan, 41 340 yuan; The main influencing factors for the average cost of hospitalization for the 7 types of cancer were: hospitalization day, patient age, and location of the patient for medical treatment. Conclusion Accelerating the improvement of the cancer prevention and control system in primary hospitals so that cancer patients can be effectively treated in primary hospitals to reduce personal and socioeconomic burdens.

Objective:To investigate the clinical, imaging and gene variation characteristics of hereditary spastic paraplegia type 74 caused by mutations in IBA57 gene. Methods:A retrospective analysis was performed on 2 cases of autosomal recessive spastic paraplegia caused by mutations in IBA57 gene who visited the Department of Neurology, the Affiliated Wuxi Children′s Hospital of Nanjing Medical University in 2010 and 2021, and the patients′ clinical data were collected. Results:The 2 patients were siblings with onset age of 4 years and 7 months, 1 year and 3 months, respectively. The same compound heterozygous mutations in IBA57 gene were found in the sibling patients [c.473G>C (p.R158P) and c.697C>T (p.R233X)]. Both patients were diagnosed as spastic paraplegia type 74. They had mild to moderate gait abnormalities, optic atrophy, decreased vision, and leukodystrophy with periventricular white matter abnormality, but no obvious growth and mental retardation in developmental assessment. Conclusions:Cases of spastic paraplegia type 74 caused by compound heterozygous mutations in IBA57 gene mainly manifested as childhood onset and slowly progressive inferior spasmodic weakness. The patients did not display significant cognitive impairment, and imaging examinations showed obvious leukodystrophy.