Objective: To investigate the epidemiological characteristics of hand, foot, and-mouth disease (HFMD) among children under 6 years in Wuxing District, Huzhou City from 2013 to 2021, so as to provide insights into HFMC control among children. Methods : The surveillance on HFMD and enterovirus 71 (EV71) vaccination among children under 6 years in Wuxing District, Huzhou City from 2013 to 2021 were captured from China Disease Prevention and Control Information System, and the temporal, human and spatial distributions of HFMD cases and pathogenic detection results were descriptively analyzed. Results : A total of 14 272 HFMD cases under 6 years were reported in Wuxing District from 2013 to 2021, with an average annual incidence rate of 465.75/104. There were 8 313 male children with HFMD (522.39/104 incidence) and 5 959 female children with HFMD (404.55/104 incidence), and higher incidence of HFMD was seen among male children than among female children (χ2=239.228, P<0.001). Most HFMD cases were found among children at ages of 1 to 3 years (10 006 cases, 70.11%), and the incidence of HFMD peaked during the period between May and July and between October and December each year. High incidence of HFMD was seen in Zhili Township (741.50/104), Yangjiabu Street (546.99/104) and Balidian Township (438.68/104). There were 717 laboratory-confirmed HFMD cases (5.02%), including 106 EV71-positive cases (14.78%) and 177 CoxA16-positive cases (24.69%). A total of 56 288 doses of EV71 vaccines were administered in Wuxing District from 2017 to 2021, with an annual average full-dose vaccination rate of 14.87%. The detection of EV71 infection was significantly lower after EV71 vaccination than before vaccination (4.49% vs. 24.93%; χ2=62.932, P<0.001). Conclusions The incidence of HFMD peaks in summer and winter among children under 6 years in Wuxing District, which predominantly occurs among children at ages of 1 to 3 years. The incidence of HFMD is high in Zhili Township, Yangjiabu Street and Balidian Township, and the number of EV71-positive cases significantly reduces after EV71 vaccination than before vaccination.

Objective To investigate the characteristics of coronary's pathological changes in patients with impaired glucose tolerance. Methods Four-hundred and ninety patients who were suspected with ischemic chest pain were divided into three groups according to their OGTT results: (1) IGT group: n = 161,(2) 12DM group:n = 159, (3) NGT group: n = 170. Serum levels of triglyceride (TG) , total cholesterol (TC) , highdensity lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) and high sensitive Creactive protein (hs-CRP) were detected, their body mass indexes (BMI) were calculated. General clinical information (including gender, age, history of smoking, history of hypertension) were collected. All the CAG results were analyzed and Gensini scores were assessed as well. Results The TG levels in the T2DM group and IGT group ([2. 41 ± 1.70] mmol/L and [2. 26 ± 1. 20] mmol/L) were significantly higher than that of the NGT group (1.95 ± 1.14) mmol/L, the differences were significant (t=0.4610,0.3124, P<0. 01 and 0.05,respectively),whereas there was no significant difference between the IGT group and T2DM group (P >0.05);No significant difference was found among the three groups about TC, HDL-C, LDL-C levels (either P > 0.05). The levels of hs-CRP in T2DM group ([2. 38 ± 1. 76] mg/L and IGT group [2. 33 ± 2. 03] mg/L) were higher compared with the NGT group ([1. 54 ± 1. 32] mg/L), the differences were significant (t = 0. 8391,0. 7815, Ps < 0. 01), whereas there was no significant difference between the IGT group and T2 DM group (P >0.05). BMIs of the IGT group ([25.50 ± 3.04]kg/m2) and T2DM group ([26.09 ± 2.86]kg/m2) were higher than that of the NGT group ([24. 70 ± 3. 27] kg/m2), the differences were significant (t = 0. 8063,1. 3947, P<0. 05 and <0.01, respectively),whereas no significant difference was found between the T2DM group and IGT group (P > 0. 05). The incidence of single coronary pathological changes was 44.7% in the NGT group,it was higher than that of the IGT group (23. 6%) and T2DM group (18. 9%) (x2 = 16. 310,25. 116,Ps < 0. 05), whereas there was no significant difference between the IGT group' and T2DM group (P > 0. 05);The incidences of 2 branches pathological changes in the T2DM group (37. 1%) and IGT group (39. 8%) were higher compared with NGT group (23. 5%) ,the differences were significant (x2 =1. 200,10. 099,Ps <0. 05),whereas there was no significant difference between the IGT group and T2DM group (P >0. 05) ;The incidences of 3 vessels pathological changes in the T2DM group (40.9%) and IGT group (33. 5%) were higher than that of the NGT group (20. 0%) , the differences were significant (x2 = 7. 767,17. 028, Ps < 0.05), there was no significant difference between the IGT group and T2DM group (P > 0. 05). The incidence of subtotal or total occlusion of the T2DM group and IGT group were 22. 6% and 18.0% respectively,both were higher than that of the NGT group(7. 6%) (x2 = 14. 573,8. 019 ,Pa < 0.05) , whereas no significant difference was found between the T2DM group and IGT group (P > 0. 05). The incidences of vascular diffusing pathological change in the IGT group (24. 8%) and T2DM group (30. 8%) were higher compared with the NGT group (12.4%) (x2 =8.583,16.724, Ps < 0.05), whereas there was no significant difference between the IGT group and T2DM group (P >0.05). The Gensini scores in the IGT group (55. 05 ± 22. 99) and T2DM group(56. 15 ± 24. 87) were significnatly higher than that of the NGT group (38. 03 ± 17. 38), the differences were significant ((t =17.0142,18. 1186,Ps <0.01),whereas there was no significant difference between the IGT group and T2DM group (P>0.05). Conclusion The incidences of 2 and 3 vessels pathological changes increase significantly in patients with IGT. Moreover, the incidences of occlusion and diffuse stenosis increase significantly. This is similar to the coronary artery pathological charactersitics in patients with diabetes, which indicates that IGT is closely related to the pathological severity of coronary artery. We should pay much attention to those patients with IGT in the clinical work.

Objective To analyse the differential expression of miRNAs in the brain of offsprings of hypothyroid and normal rats,and to explore the molecular mechanism underlying the effect of hypothyroidism on brain development in the offspring.Methods Forty-eight female Wistar rats were assigned to (1) control group (n =24),and (2) hypothyroid group after complete thyroidectomy (n =24).Serum TSH and Total thyroxine (T4) were measured one month after the surgery.Brain samples of fetal or postnatal rats were obtained during four different developmental stages:embryonic days (E) 13,E17,postnatal days (P) 0 and P7.The hippocampus and cortex were separated on P7.MiRNAs were isolated from tissues and two samples were used at each time point studied to reduce the influence of individual differences.The brain samples were detected by Gene Chip miRNA arrays (Affymetrix).Results In the brain tissues of fetal or neonatal rats of maternal hypothyroid rats,two miRNAs (mir-206,-324-5p) on E13,three miRNAs (mir-34c,-204,-194) in cortex on P7,and five miRNAs (mir-146b,-532-5p,-384-5p,-215,-212) in hippocampus on P7 were up-regulated by over 2 folds.Five miRNAs (mir-200b,-200c,-217,-672,-139-5p) on E17,one miRNA (mir-376-3p) on P0,and four miRNA (mir-672,-204,-335,-376-3p) in hippocampus on P7 were decreased by 50％ or more.Conclusion The miRNA expression profiles in the rat brain of offspring with maternal hypothyroidism are characterized by miRNA arrays.The identification of a subset of brain expressed miRNAs in the brain may explain the brain development abnormalities resulting from maternal hypothyroidism.

Objective To analyze endoscopic ultrasonography (EUS) image of esophageal granular cell tumor (GCT) by computer image analysis software,and to explore its diagnostic and differential diagnostic value.Methods Eight esophageal GCT and eight leiomyomas confirmed by pathological and immunohistochemical examination were collected,mean gray value and gray value standard deviation of EUS image of the leisons were analyzed by computer image analysis software.The comparison of two groups was analyzed by t test.Results The endoscopic and ultrasound images of esophageal GCT and leiomyomas were similar.The mean gray value of EUS image of esophageal GCT and esophageal leiomyomas was 67.51 and 51.76,the difference was statistically significant (t=2.225,P=0.043).However,there was no significant difference in the standard deviation of gray value (13.54 vs 13.12,t=0.225,P=0.825).Conclusion The accuracy of GCT diagnosed by EUS could be increased by comparing the gray values of EUS images of esophageal GCT and leiomyomas.

Objective To explore the impact of modified vacuum sealing drainage (VSD) on prevention of tension blisters during treatment of opening fracture wounds.Methods From March 2015 to February 2016,53 patients with 60 open fracture wounds were treated after surgery by VSD at our department.They were 28 males (33 wounds) and 25 females (27 wounds),aged from 24 to 65 years (average,41.1 years).The patients were divided into 2 groups.Group A (33 wounds) were subjected to traditional VSD after surgery while group B (27 wounds) to modified VSD.The mean time from injury to surgery was 5.2 hours (from 2.0 to 8.3 hours).The VSD dressing was first removed to observe whether any tension blisters would appear surrounding the dressing 5 days after surgery.Results Tension blisters appeared around 9 wounds in group A (with an incidence of 27.3％) but around one wound in group B (with an incidence of 3.7％).The difference between the 2 groups was statistically significant (P =0.037).Conclusion In treatment of open fracture wounds,the modified VSD can effectively prevent formation of tension blisters surrounding the dressing while it is used to cover a wound.

Foot-and-mouth disease virus (FMDV) is a positive-sense RNA virus which has caused severe damage to world-wide livestock industry. The extensive genetic and antigenic diversity observed in the evolution of FMDV is generally the obstacle for controlling the disease. The homologous recombination, as a significant force driving the evolution of virus, has also effect on the epidemiological trait of FMDV. However,the role of homologous recombination in the diversification of FMDV in China has not investigated. So it is necessary to study the homologous recombination underlying the evolution of FMDV to control FMD. Based on a sound evolutionary framework, molecular evolutionary analysis was used to identify the putative recombinants. All complete FMDV genomes from China were respectively retrieved from GenBank. Homologous recombination was identified using Simplot program. Phylogenetic relations were analyzed to determine the recombination events among these FMDV isolates by using MEGA 4. The isolates O/NY00, O/China/1/99Tibet, O/Tibet/CHA/99, O/OMIII and O/ES/2001 among 16 FMDVs were identified as putative recombinants by analyzing the FMDV genomic sequences extracted from GenBank. The recombination events frequently happen between serological type Asia1 and O which are endemic FMDV circulating in China, suggesting frequent cross infection of FMDV in China. This situation further makes controlling FMDV in China more difficult. Moreover, serotypic conversion of FMDV between Asia1 and O was detected to be due to homologous recombination. These results provided clues for understanding the antigenic and genetic diversification in FMDV, and shed lights on the potential vaccination and treatment of FMD.

[Objective]This study was designed to investigate capability of the conditioned media that originated from Renca cells to convert CIM~+ CD25~- T cells into CD4~+ CD25~+ T cells,which can exert immunosuppressive effect on effector T cells in vitro and in vivo.[Methods]The common media were mixed with the conditioned media at different ratios,and fresh enriched CD4~+ CD25~- T cells with MACS were cultured in mixed media for 7 days.At end-point of culture,the cells were collected and detected phenotypes in flow cytometer.Moreover,we detected immunosuppressive effect of converted CD4~+ CD25~+ T cells on effeetor T cells proliferation in one-way mixed lymphocytes reaction by using CCK-8,and we observed survival time and histology of grafts.The delayed type hypersensitivity was determined 14 days after transplantation.[Results]The mixed media could increase ratio of CD4~+ CD25~+ Foxp3~+ T cells in conditioned media ratio-dependent(P＜0.05),compared with control groups,when the mixed media contained no mote than 75% of conditioned media.The converted CD4~+ CD25~+ T cells significantly suppress proliferation of effector T cells in vitro,and prolong survival time of grafts,which were(29.6±1.4)d in converted CD4~+ CD25~+ T cells treated groups(P＜0.05),compared with that in untreated groups(9.8±0.6 d)or PBS treated groups(10.9±0.6 d).Moreover,delayed-type hypersensitivity reaction were conducted at day 14 after transplantation in the recipients,and the results showed that less pad swelling in the group treated with converted CD4~+ CD25~+ T cells than other control groups was found,according to measurement of pad swelling.In addition,progressed to complete necrosis of grafts were exhibited in the mice treated with PBS and untreated mice,whereas better healing of grafts and less lymphocytes infiltration were displayed in the mice treated with converted CD4~+ CD25~+ T cells,which were similar to the mice treated with natural regulatory T cells.[Conclusion]The converted CD4~+ CD25~+ T cells with Renca conditioned media play suppressive role in vitro and in vivo.

Objective To investigate the diagnostic value of endoscopic ultrasonography (EUS) for duodenal cysts.Methods Clinical manifestations, results of conventional gastroscopy and EUS, as well as follow-up, of patients with duodenal cysts were retrospectively analyzed.Results A total of 105 patients with duodenal cysts presented with no lesion-related symptoms, but displayed characteristic imaging changes under EUS, which could reveal the origin, size and nature of duodenal cysts, and differentiate it from other submucosal lesions.A maximum follow-up of 5 years showed no changes in duodenal cysts.Conclusion Duodenal cyst is a benign disease, and EUS plays a very important role in diagnosis of the disease.

Objective: To evaluate the safety and efifcacy of cutting balloon combining main branch single stent cross-over technique for treating the patients with coronary bifurcation lesions. Methods: A total of 113 patients with 121 bifurcation lesions treated in our hospital from 2012-01 to 2014-01 were enrolled. Cutting balloon pre-dilation was applied in both main and side branches followed by drug-eluting stent implantation at main branch. The procedural success rates, side branch blood lfow status and complications were observed. Follow-up studied for MACE occurrence was conducted at 9 months after the operation. Results: Quantitative coronary angiography (QCA) presented that the minimum lumen diameters at pre- and post-operation in main branches were (2.12 ± 1.07) mm and (3.24 ± 0.87) mm, in side branches were (1.44 ± 0.73) mm and (1.82 ± 0.64) mm respectively,P<0.05-0.01, the procedural success rate was 100%. There were 11 (9.1%) lesions with dissection at proximal side branch, 5 (4.1%) lesions with side branch TIMI blood lfow

Objective Gynecologic minimally invasive surgery has become popular in the treatment of tumor therapy in re-cent years, but improper application can result in tumor metastasis.In this paper, we presented 6 uterine neoplasm cases of tumor me-tastasis after minimally invasive surgery and analyzed the causes and the preventive measures. Methods Retrospective analysis was made on the clinical data and pathology characteristics of the 6 uterine neoplasm cases of tumor metastasis after primary minimally inva-sive surgery in our department from January 1, 2013 to 2015 June 30, and related literature were reviewed. Results The ages of 6 patients were 39-52 years old.The primary operation methods included 2 cases of hysteroscopic myomectomy, 3 cases of laparoscopic myomectomy and 1 case of radiofrequency ablation.The pathological diagnosis after primary operations were 4 cases of uterine sarcoma ( low grade endometrial stromal sarcoma in 2 cases and leiomyosarcoma in 2 cases) who were found metastatic tumor at 3-16 months after primary surgery and finally died of the disease and 2 cases of uterine fibroids who were found metastatic tumor in abdominal cavity and puncture hole at 60 months and 108 months respectively after primary operation followed by a good prognosis after the second surgi-cal resection. Conclusion Owing to uterine neoplasm by hysteroscopy, laparoscopy often needs certain pressure and morcellation which may result in easy plantation of crushing tumor tis-sue or metastasis with circulation and puncture under pressure.Ra-diofrequency ablation lack of histopathologic diagnosis has heating effect which is inclined to speed up the spread and transfer of tumor cells once it is diagnosed as malignant.Therefore, clinicians should know the defects and risk of being lack of histopathologic diagno-sis, diagnostic curettage pathology and fast pathology to avoid tumor metastasis induced by minimally invasive surgery.