Objective To analyze the clinical features of children with EV71 positive hand,foot,and mouth disease(HFMD)and EV71 vaccination,and to explore the relationship between the occurrence of severe disease and the preventive effect of EV71 vaccine.Methods From January 1,2020 to December 31,2022,the clinical data of 131 children with HFMD diagnosed with EV71 infection in Kunming Children's Hospital were retrospectively analyzed.The stool samples of patients with clinically confirmed HFMD were selected for enterovirus nucleic acid detection.The clinical data and EV71 vaccination status of children with universal enterovirus positive and EV71 positive HFMD were analyzed.Results Among the 131 positive cases detected,there were 116 mild cases and 15 severe cases.Among the 80 children who received phone consultations about their EV71 vaccine status,17 were vaccinated,and 63 were not vaccinated.The vaccinated children were all mild cases,while among the unvaccinated children,6 were severe cases.From 2020 to 2022,the period from April to September each year is the peak period for detecting EV71-positive hand,foot,and mouth disease(χ2 = 125.705,P = 0.000).The positive detection rate for children under 1 year old and over 5 years old was higher than that for children aged 1 to 5 years(χ2 = 8.765,P = 0.033),and there was no significant difference in the positive detection rate between boys and girls(χ2 = 1.221,P = 0.269).Conclusion EV71 vaccine is of great significance in reducing the occurrence of severe cases.Combined with the current low vaccination rate in Kunming,Yunnan Province,it is suggested that relevant institutions should continue to increase the publicity of EV71 vaccination.

Objective:To explore the clinicalfactors related to allograft fibrosis after pediatric liver transplantation.Methods:The clinical data were respectively analyzed for 94 pediatric recipients from January 2013 to December 2016 at Tianjin First Central Hospital.The Patients were assigned into fibrotic and non-fibrotic groups based upon the results of protocol liver biopsies. Univariate and multivariate Logistic regression analyses were performed for examining the risk factors of fibrosis after pediatric livertransplantation. Then Logistic regression model was established to obtain the predicted value of combined predictive factors.Thereceiver operating characteristic curve (ROC) was conducted to evaluate the predictive value of combined predictive factors.Results:A total number of 54(57.5%) patients occurred fibrosis among the 94 patients. There weresignificant differences in cold ischemia time (Z=2.094), warm ischemia time (Z=2.421), biliary stricture( χ2=4.560), drug-induced liver injury ( χ2=7.389), hepatic artery thrombosis and rejection ( χ2=6.955)between two groups ( P<0.05). Logistic regression analysis showed that cold ischemia time (OR=1.003, 95%CI: 1.000~1.007, P=0.044), biliary stricture(OR=6.451, 95%CI: 1.205~33.295), rejection(OR=2.735, 95%CI: 1.057~7.077)and drug-induced liver injury (OR=4.977, 95%CI: 1.207~20.522, P=0.026) were independent risk factors for fibrosis 5 years after liver transplantation. The area under the ROC curve was 0.786(95%CI: 0.691~0.881), for predicting patient outcome.If using 0.311as a cutoff Value, the sensitivity was 90.70%, and the specificity was 60.00%. However, through the ROC curve comparison, there was statistical significance between combined predictive factors and the other independent risk factors ( P>0.05). Conclusions:The incidence of fibrosis 5 years after pediatricliver transplantation is 57.5%. Prolonged cold ischemia time, biliarystricture, rejectionand drug-induced liver injury after liver transplantation are independent risk factors for fibrosis 5 years after pediatric liver transplantation.And the combined predictive factors have a high predictive value forallograftfibrosis.