Objective To analyze the clinical characteristics and treatment methods of recurrence hand,foot and mouth disease (HFMD).Methods The clinical data of 436 HFMD patients were retrospectively analyzed.The characteristics of clinical manifestations,laboratory tests were analyzed.Results There were a total of 211 patients,accounting for 48.4％,the recurrence age was 2 to 5 years old.All relapsed patients rash appeared in the hand,foot and mouth or buttocks,there were 104 cases of rash appeared in elbow and knee,9 cases appeared in the torso.The recurrence patients proned to occur respiratory system,digestive system,cardiovascular system and nervous system complications.Respiratory complications were the most common,accounting for about 76.4％,followed by the digestive system,accounting for 18.5％.The distribution of relapse in children with time to recurrence and recurrence in-terval analysis found mainly in April to June,a total of 251 patients,the total relapse proportion was 57.6％ ;time in-terval was more common between 3 months to 12 months,a total of 326 cases of recurrence,accounting for 74.8％.Conclusion Clinical manifestations are not typical in recurrence HFMD patients,most are ordinary,less critically illpatients,it is easy to merge the respiratory system,digestive system complications.Early detection and diagnosis is the key to the treatment.

[Objective]To evaluate FANCF gene methylation status and its roles in the pathogenesis acute myeloid leukemia (AML).[Methods]Genomic DNA from primary 30 AML patients and 21 AML cell lines were subjected to FANCF methylation analysis by PCR based restriction enzyme digestion assay.FANCF protein expression was detected by Western blot.In addition,FANCF gene methylation status was further analyzed using bisulfate sequencing.[Results] No FANCF methylation was found in primary AML patients.One (4.76 ％) AML cell line contained FANCF methylation in the promoter region.The AML cell line was hypersensitive to MMC with absence of FANCF protein expression.[Conclusion] FANCF methylation is a rare event in AML,and does not contribute to the initiation of AML, but may contribute to the clonal transformation and cellular phenotype maintenance in some AML cell lines.

Objective To investigate the effects of high loading dose of atorvastatin on lipoprotein-associated phospho?lipase A2 (Lp-PLA2) and inflammatory cytokines in patients with acute myocardial infarction (AMI), who underwent emergen?cy percutaneous coronary intervention (PCI). Methods A total of 65 cases with AMI who underwent emergency PCI be?tween October 2011 and August 2013 were randomly divided into two groups:control group (n=32, atorvastatin 20 mg/24 h) and high dose atorvastatin group (n=33, atorvastatin 40 mg/24 h). Two groups of patients were given the same basic treat?ment. Blood samples were obtained before treatment and 72 h after PCI in two groups. Levels of Lp-PLA2, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), alanine transaminase (ALT) and aspartate transaminase (AST) were detected in two groups. The adverse drug reactions were observed. Results There were no significant differences in Lp-PLA2, IL-6, TNF-α, ALT and AST levels between two groups (P>0.05). After PCI, the levels of Lp-PLA2, IL-6 and TNF-αwere significantly increased compared with those of baseline in two groups, and they were more notable in control group than those of high dose atorvastatin group (P<0.05). The levels of ALT and AST were also significantly higher after operation compared with those of basic levels (P<0.05), while there were no significant differences in ALT and AST after PCI between two groups (P>0.05). Conclusion The high loading dose of atorvastatin in AMI patients underwent emergency PCI can de?crease the inflammation and stabilize the plaques in acute stage, and which is safe.

Objective To study the clinical characteristics,treatment and prognosis of neonatal VACTERL association.Method The clinical data of newborns diagnosed with VACTERL association from January 2010 to December 2015 were collected and retrospectively analyzed.Result A total of 33 patients diagnosed with VACTERL association were included,including 23 males and 10 females.Among them,17 cases were term infants,15 cases premature infants and 1 case of overdue birth,with an admission age of 1 to 24 days.The most common deformities were cardiac anomalies (C) in 27 cases (81.8％),followed by anal atresia/anorectal malformation (A) in 25 cases (75.8％),renal deformity (R) in 24 cases (72.7％),limb abnormalities (L) in 20 cases (60.6％),Tracheoesophageal fistula (TEF) in 8 cases (24.2％) and vertebral abnormalities (V) in 3 cases (9.1％).11 cases (33.3％) had other deformities.Among these 33 patients,24 cases had 3 types of malformations and 9 cases had 4 types of malformations.The most common combination was ACR (n =8).20 patients had no abnormalites on chromosome karyotype test including 2 patients had normal gene microarray results.16 patients received surgical treatment during neonatal period and 13 of them recovered and discharged.Among the other 17 cases received no surgery,only 1 patient improved and discharged.A telephone follow-up was proceeded in 14 discharged cases at 1 year old.Among them,13 cases had good prognosis,however,the remaining one was dead.Conclusion VACTERL association is a rare non-random combination of multiple malformations.The early discovery and appropriately treatment after diagnosis will improve the prognosis and prevent death.Doctors should reinforce the ability to detect various types of deformities and examine the chromosome and gene properly.

AIM: To observe the effects and safety of clopidogrel used in percutanous coronary intervention (PCI) while acute occlusions of coronary arteries happened. METHODS: 92 patients with acute occlusions of coronary arteries were treated through PCI and they were randomized equally into following groups: clopidogrel group (CPG group) and ticlopidine group (TCP group). Each patient was treated with clopidogrel 25 mg bid or ticlopidine 250 mg bid for 4 weeks after PCI. RESULTS: Compared with the control group, there was not significantly difference in platelet aggregation ( 45.36 ? 2.98 vs 51.60 ? 2.56 ) and clinical effects ( 97.95 % vs 93.02 %) after 3 weeks. The proportion of patients with adverse events who had to release the treatment was 2.04 % (CPG group) and 16.27 % (TCP group). CONCLUSION: The clinical effect of clopidogrel is similar to ticlopidine and shows less adverse events.

Objective To investigate the effects of ibutilide and amiodarone on the ventricular transmural heteroge-neity of repolarization and ventricular arrhythmia for the treatment of atrial fibrillation. Methods Eighty-seven patients with paroxymal atrial fibrillation at 48 h~7 d were enrolled and randomized to two groups, ibutilide and amiodarone treat-ment groups. The successful rate of cardioversion to sinus rhythm was compared between two groups. The electrocardiograph-ic QT interval and Tpeak-end/QT ratio were also analyzed before and after treatment in two groups. Results The successful rate of cardioversion was significantly higher in ibutilide group than that of amiodarone group (61.7%vs 40.7%, P＜0.05). The QT intervals and Tpeak-end/QT ratio were both significantly increased in ibutilide group (P＜0.05), which were re-turned to the levels before treatment in 2 hours and 1 hour, respectively (P＜0.05). The QT intervals were significantly in-creased in the amiodarone group (P＜0.01), which were continued until 4 h after treatment. There were no significant differ-ences in the Tpeak-end/QT ratios before and after treatment (P>0.05). Conclusion The successful rate of cardioversion to sinus rhythm for atrial fibrillation by ibutilide was significantly higher compared with that of amiodarone. Ibutilide slightly in-creased the transmural heterogeneity of repolarization within the first hour, which may increase the risk of ventricular arrhyth-mia.

Objective To investigate the effect of di-(2-ethylhexyl) phthalate (DEHP) on the postnatal lung development in newborn rats.Methods A total of 60 newborn Sprague-Dawley rats (weighing 5.0-8.0 g) in five age groups were studied in the first experiment.The rats were divided based on the different postnatal ages:postnatal day (PND)I,PND4,PND7 and PND14.A total of 45 newborn Sprague-Dawley rats (weighing 5.0-8.0 g) were randomly divided into three groups according to the dosage of DEHP administered in the second experiment.The newborn rats were administered DEHP through intraperitoneal injection at 10 (low-dose subgroup),100 (medium-dose subgroup) or 750 (high-dose subgroup) mg/kg daily from PND1 to PND13.The rats were sacrificed on PND14.Pups were sacrificed with lethal dose injection of pentobarbital sodium.The lung was removed.The right middle lobes were used for analysis.The tissue was processed for histology and lung sections were stained with HE for light microscopic (LM) morphometric measurement.The analysis was performed by means of a digital image analysis system,including pulmonary interstitial area ratio (IAR) and total length density of all segments.One-way ANOVA,LSD and Dunnet T3 methods were used for statistical analysis.Results In the normal controls,IAR decreased significantly by (31.97±5.03) ％,(30.05±3.57)％,(25.33± 1.83)％ and(22.01 ±2.19)％,respectively,from PND1 to PND14 (P＜0.05 or P＜0.01).IAR in medium-and high-dose subgroups increased significantly by (24.11 ±2.78)％ and (26.53± 3.42)％,respectively on PND 14.The total length density of all segments in unit area lung volume increased significantly by 0.047 8±0.003 7,0.050 0±0.002 9,0.071 2±0.003 0 and 0.084 4±0.004 3,respectively from PND1 to PND14 (P＜0.01).In the DEHP treated animals,when compared with the control group,IAR was significantly higher on PND14 (P＜0.05 or P＜0.01),while the total length density of all segments in unit area lung volume was significantly decreased (P＜0.05 or P＜0.01).Length density in medium-and high-dose subgroups were higher than that of low-dose subgroup by 0.082 9±0.001 8,0.077 2±0.002 0 and 0.071 3±0.003 7,respectively on PND14 (P＜0.05 or P＜0.01).Conclusions Medium-and high-dose DEHP affect the postnatal lung development in rats in a dose-dependent mode.

The aim of this study was to evaluate the efficiency and safety of ultrasound-guided thrombin injection on femoral pseudoaneurysm (FPA) as compared to ultrasound-guided local oppression. Eleven cases of FPA were enrolled and 7 cases received ultrasound-guide thrombin injection (injection group), and the remaining 4 cases were treated with local oppression (oppression group). Efficiency and safety were analyzed by ultrasound and subsequent follow-up. The results showed that 1 case relapsed in oppression group while no relapse occurred in thrombin injection group. Ultrasound-guided thrombin injection is better for treatment of FPA in terms of effectiveness and safety.

Objective:To investigate the clinical characteristics of patients with lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM), and the diagnosis and optimal treatment of LPL/WM.Methods:The clinical data of 13 LPL/WM patients treated in Zhongnan Hospital of Wuhan University from January 2013 to June 2018 were retrospectively analyzed, and the literature was reviewed.Results:The median age of 13 patients was 60 years old (35-79 years old). There were 12 males and 1 female. Initial symptom was fatigue or edema of both lower limbs for majority of patients. All patients had immunoglobulin M (IgM) monoclonal, 3 of them had elevated immunoglobulin G (IgG) level, including 1 patient with monoclonal IgG. LDH was increased in 2 patients. Coombs test was positive in 5 patients. MyD88 gene mutation status was detected in 8 patients, of which gene mutation in 5 patients was positive. Among 13 patients, 1 patient lost follow-up, 3 patients died, 9 patients were alive with the median survival of 36 months (19-81 months).Conclusions:Incidence of LPL/WM is relatively low with a generally indolent evolution, but heterogeneity is not negligible. Few patients have poor treatment response with a quick disease progress. The high-risk patients undergoing hematopoietic stem cell transplantation after remission-induction chemotherapy may improve the prognosis.

Objective:To analyze the short-term and medium-term survival status of children with congenital esophageal atresia, and to provide reference for clinical multidisciplinary management of children with congenital esophageal atresia.Methods:The clinical data of neonates with type Ⅲ congenital esophageal atresia who were operated in our hospital between November 2007 to November 2018 and followed up in this hospital were analyzed retrospectively.Results:Among the 62 cases, 16 cases were discharged automatically, 1 case died, and 45 cases were included in the short-term follow-up. 35 cases were classified as gross Ⅲa, 10 as Ⅲb, 5 as long segment type, 44 patients accepted one-stage surgery, 1 infant accepted delayed operation, 9 infants received second operations. Anastomotic leakage occurred in 8 cases (17.8%), anastomotic stenosis in 11 cases (24.4%), recurrence of tracheoesophageal fistula in 2 cases (4.4%), blood flow infection in 14 cases(31.1%), incision infection in 4 cases (8.9%). The medium-term survival status of 38 cases: 2 cases died of aspiration, 29 cases (76.3%) of anastomotic stenosis underwent esophageal dilatation, 5 cases (13.2%) of dysphagia when 1.5 years old, 6 cases (15.8%) of malnutrition. After multidisciplinary collaboration, the survival rate increased (57.1% vs. 85.3%, P=0.013), and the incidence of anastomotic leakage decreased (46.4% vs. 20.6%, P=0.03). Conclusion:The quality of life of children with congenital esophageal atresia can be improved by multidisciplinary cooperation and standardized postoperative follow-up.