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 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.

Objective:To investigate the roles of T helper 17(Th17)cells and regulatory T(Treg)cells, interleukin(IL)-17 levels, and IL-6 levels in the pathogenesis of Henoch-Schonlein purpura(HSP)complicated with Helicobacter pylori(HP)infection in children. Methods:Children diagnosed with acute HSP and/or HP infection by the Department of Pediatrics, Xiamen Maternal and Child Health Care Hospital from January 2017 to December 2018 were enrolled in the study.There were 15 children with HSP complicated with HP infection(HSP-HP group), 26 children with HSP(HSP group), and 21 children with HP infection(HP group). Twenty healthy children of the same age over the same period were included in the healthy control group.The proportions of Th17 cells and Treg cells were tes-ted by flow cytometry(FCM), and concentrations of IL-17 and IL-6 in plasma were measured by enzyme linked immunosorbent assay(ELISA).Results:(1)Compared with that of the healthy control group [(1.42±0.63)%], the proportion of Th17 cells in the HSP-HP group, HSP group and HP group [(2.79±0.78)%, (2.04±0.77)%, (2.08±0.86)%] was significantly increased( F=5.271, P<0.05). The levels of IL-17 and IL-6 in the HSP-HP group [(552.16±121.13) ng/L and (12.36±6.55) ng/L], HSP group [(506.39±113.62) ng/L and(11.82±5.01) ng/L] and HP group [(483.14±121.77) ng/L and (10.19±3.87) ng/L] were significantly higher than those in the healthy control group [(302.96±82.83) ng/L and (7.81±2.04) ng/L]( F=13.113, 6.692, all P<0.01). The proportion of Treg cells in the HSP-HP group [(1.35±0.49)%], HSP group [(1.13±0.86)%] and HP group [(1.09±0.65)%] was significantly lower than that in the healthy control group [(2.31±0.83)%]( F=6.983, P<0.05). (2)The proportion of Th17 cells and the level of IL-17 in the HSP-HP group were significantly higher than those in the HSP and HP groups(all P<0.05). There was no significant difference in the proportion of Th17 cells and the level of IL-17 between the HSP group and HP group(all P>0.05). There was no significant difference in the proportion of Treg cells and the level of IL-6 among the HSP-HP group, HSP group, and HP group(all P>0.05). Conclusions:The imbalance of Th17/Treg cells in peripheral blood may contribute to the development of HSP-HP, HSP and HP infection in children.High expression of Th17 cells and their related IL-17 is more prominent in children with HSP-HP.