Objective The purpose of this study was to help diagnose severe Hand-foot-and-mouth disease (HFMD) cases at early stage. Methods This research employed a retrospective analysis approach and analyzed a number of severe HFMD cases based on the clinical records. Results The results showed that 86. 7% of severe HFMD cases happened among infants under the age of three,and there were more boys than girls; patients' conditions tended to deteriorate within one to five days after its outbreak,the rashes were not typical,and they were mostly small and few,sometimes none,the complications mostly concerned the nervous system and clinically manifested as Meningitis, brain stem encephalitis,acute flaccid paralysis,and neurogenic pulmonary edema etc. at the early stage of HFMD, 73. 3% of the cases involved symptoms of quivering of the pantomimes or hyperarousal,69. 3% of the cases showed listlessness,coma,or fidget,37. 3% of the cases invloved increase of peripheral cytometry,30.0% of the cases involved vomiting,20. 0% involved rising of respiration and cardiac rates, 15. 0% involved eclampsia, 10.0% involved coldness of the four limbs,6.5% involved constant high fever. The analysis showed that at the early stage of the disease, methylprednisolone and megadoses of IVIC could effectively contain .patients' conditions, and the cure rate reached as high as 93. 3%. Conclusions Complications concerning the nervous system usually happened to severe HFMD infected infants. Once there was early-stage clinical symptoms of nervous complications, and appropiate doses of adrenal cortical hormone and IVIG intervention could effectively block or defer the conditions.

Objective:To study the expression of CXCL 8 in the serum and CXCL8 mRNA in the peripheral blood mononuclear cells(PBMCs) of the children with Mycoplasma pneumoniae pneumonia (MPP) and its clinical significance.Methods: Forty-eight children(severe cases 12,light cases 36) with MPP were recruited from October 2013 to March 2015 in the Maternal and Child Health-Care Hospital of Huainan.The concentration of the CXCL8 in serum and the level of CXCL8 mRNA in the PBMCs were measured by enzyme linked immunosorbent assay ( ELISA) and polymerase chain reaction ( PCR).Taking GAPDH as the internal reference ,the ratio of lgcDNA/lgGAPDH was regarded as the extreme level of CXCL 8 mRNA.Results: The serum level of CXCL8 and expression of CXCL8 mRNA in PBMCs in the children with MPP were ( 298.917 ±51.860 ) pg/ml and ( 1.848 ±0.525 ) lgcDNA/lgGAPDH.Compared with the normal control ,there were significant differences between the two groups ( P<0.05 ) .Further observation showed that the levels of CXCL8 in serum were no significant difference between in light cases and severe illness (P>0.05).However, the expression of CXCL8 mRNA in peripheral blood of the children with severe illness was significantly higher than those in light cases (P<0.05).Intravenous infusion of Erythromycin was provided in the acute phase for seven to ten days ,so that the children′s condition could be significantly controlled , and the symptoms of pulmonary inflammation were also relieved .Followed by the use of sequential therapy of Azithromycin for about two to three weeks ,the children′s condition were gradually from acute stage to recovery stage .At this time,the CXCL8 and its mRNA levels in peripheral blood of the sick children were all significantly decreased comparing with those in the acute stage(P<0.05).Conclusion: The expression of CXCL8 and its mRNA were increased in the peripheral blood of the sick children with Mycoplasma pneumonia ,and also correlated with the severity of the disease .CXCL8 can participate in the pathogenesis of Mycoplasma pneumonia ,and has a certain cue effect on the severity and prognosis of the disease .Azithromycin can reduce the content of CXCL8 in serum of the sick children via the pathway of inhibiting the proliferation of Mycoplasma pneumoniae ,and down regulate the expression of mRNA ,so that the immune injury mediated by Mycoplasma pneumoniae may be gradually inhibited .

OBJECTIVETo understand the molecular characteristics of a dengue virus outbreak in China-Myanmar border region, Yunnan province, 2015 and provide etiological evidence for the disease control and prevention.

METHODSSemi-nested RTPCR was conducted to detect the capsid premembrane (CprM) gene of RNA of dengue virus by using dengue virus NS1 positive serum samples collected in Mengdin township, Gengma county, Yunnan province in July, 2015. Some positive samples were then detected by using PCR with specific primers to amplify the full E gene. The positive PCR products were directly sequenced. Then sequences generated in this study were BLAST in NCBI website and aligned in Megalign in DNAstar program. Multiple sequence alignments were carried out by using Mega 5.05 software based on the sequences generated in this study and sequences downloaded from GenBank, including the representative strains from different countries and regions. Phylogenetic trees were constructed by using Neighbor-Joining tree methods with Mega 5.05 software.

RESULTSTwenty one of 25 local cases and 10 of 14 imported cases from Myanmar were positive for DENV-1. Eight serum samples were negative for dengue virus. A total of 13 strains with E gene (1485 bp), including 8 local strains and 5 imported strains, were sequenced, which shared 100% nucleotide sequence identities. Twelve strains with CprM gene (406 bp) from 9 local cases and 3 imported cases shared 100% nucleotide sequence identities. Phylogenetic analyses based on E gene showed that the new 13 strains clustered in genotype I of dengue virus and formed a distinct lineage.

CONCLUSIONSThis outbreak was caused by genotype I of DENV-1, which had the closest phylogenetic relationships with dengue virus from neighboring Burma area. Comprehensive measures of prevention and control of dengue fever should be strengthened to prevent the spread of dengue virus.

Capsid Proteins ; China ; epidemiology ; DNA Primers ; Databases, Nucleic Acid ; Dengue ; epidemiology ; virology ; Dengue Virus ; genetics ; Disease Outbreaks ; Genotype ; Humans ; Myanmar ; epidemiology ; Phylogeny ; Polymerase Chain Reaction ; Sequence Alignment ; Software