Objective Enterovirus 71(EV71) is one of the important etiologic agent for young children,which can cause various kind of diseases.EV71 can cause HFMD outbreak in a large scale and encephalmeningitis to death.This review introduced the research method and status of EV71 molecular epidemiology,examined and analyzed the evolution of EV71,summerized all genotype/subgenotype for EV71.the geographic and time distribution.

β-Thalassemia is an inheritance anaemia disease due to the defect in β- globin gene. Gene therapy is considered to be the only method which could cure this disease. Adeno-associated virus type 2 (AAV2) has benn gaining more attention as a vector in human gene therapy for its non pathogenic character and broad host range. Although, the efficacy of recombinant AAV2 (rAAV2) in transducing human hematopoietic stem cells has been investigated by researchers, the results were varied from different laboratory. The view was proposed recently that it may be resulted from helper virus in their packaging system. Respecting this, the packaging system without helper virus was used to produce rAAV2. Human early fetal liver hematopoietic cells not only possess many superior peculiarity compared to hematopoietic cells of bone marrow or cord blood, but also the inherent β-globin gene in the cells is not expressed. Studies on the AAV2 transduction of human fetal liver hematopoietic cells and mediated expression of β- globin gene in vivo were performed and the potential role of AAV2 in β-thalassemia gene therapy was analyzed. The rAAV2 containing a normal human β-globin gene (rAAV2-β-globin) without helper virus contamination were produced. The viral titer, purity and the ability of mediating expression of β-globin gene were detected in vitro. Then, human early fetal liver hematopoietic cells were isolated and were further transducted with the rAAV2-β-globin, followed by transplantation into sublethally irradiated BALB/C nude mice to analyze the β-globin gene expression. The results showed that the high titer and purity of rAAV2-β-globin had the ability of mediating β-globin gene expression in vitro. In 8 recipient BALB/C nude mice, the β-globin gene expression were detected in the 2 mice marrow by RT-PCR. The results suggested that rAAV2 could transduce human fetal liver hematopoietic cells and mediate the β-globin gene expression in BALB/C nude mice, meanwhile the expression level of the gene was still rather low. It is necessary to perform further research on AAV2 biology before applying in β-thalassemia gene therapy.

Enterovirus ; Enterovirus A, Human ; Humans ; Vaccination ; Vaccines

?-Thalassemia is an inheritance anaemia disease due to the defect in?- globin gene. Gene therapy is considered to be the only method which could cure this disease. Adeno-associated virus type 2 (AAV2) has benn gaining more attention as a vector in human gene therapy for its non pathogenic character and broad host range. Although, the efficacy of recombinant AAV2 (rAAV2) in transducing human hematopoietic stem cells has been investigated by researchers, the results were varied from different laboratory. The view was proposed recently that it may be resulted from helper virus in their packaging system. Respecting this, the packaging system without helper virus was used to produce rAAV2. Human early fetal liver hematopoietic cells not only possess many superior peculiarity compared to hematopoietic cells of bone marrow or cord blood, but also the inherent?-globin gene in the cells is not expressed. Studies on the AAV2 transduction of human fetal liver hematopoietic cells and mediated expression of ?- globin gene in vivo were performed and the potential role of AAV2 in?-thalassemia gene therapy was analyzed. The rAAV2 containing a normal human?-globin gene (rAAV2-?-globin) without helper virus contamination were produced. The viral titer, purity and the ability of mediating expression of?-globin gene were detected in vitro. Then, human early fetal liver hematopoietic cells were isolated and were further transducted with the rAAV2-?-globin, followed by transplantation into sublethally irradiated BALB/C nude mice to analyze the?-globin gene expression. The results showed that the high titer and purity of rAAV2-?-globin had the ability of mediating ?-globin gene expression in vitro. In 8 recipient BALB/C nude mice, the ?-globin gene expression were detected in the 2 mice marrow by RT-PCR. The results suggested that rAAV2 could transduce human fetal liver hematopoietic cells and mediate the ?-globin gene expression in BALB/C nude mice, meanwhile the expression level of the gene was still rather low. It is necessary to perform further research on AAV2 biology before applying in ?-thalassemia gene therapy.

Objective To get genetic information of VP 1 coding region of HEV 71 in Beijing in 2008.Methods Enteroviruses were isolated from samples of throat swabs collected from 33 HFMD patients within 3 days after onset by rhabdomyosarcoma(RD) cells and identified by RT-PCR method with specific primers to human enteroviruses,then VP 1 coding region was amplified and sequenced by Sanger dideoxy.Bioedit 7.0.5 and MEGA3.1 were used for the nucleotide sequence alignment and phylogenetic analysis.Results 16 virus strains were isolated from 33 samples,of which 14 strains were identified as HEV 71 and 2 were CVA 16,and 1 was co-infected with CVA 16 and HEV 71.Sequence analysis of VP 1 nucleotide sequences of 10 HEV 71 isolates showed that homologous analysis of nucleotide identity amino acid 95.5%～100% and 98.9%～100% respectively;representative strains of Fuyang in 2008,nucleotide identity was 95.4%～99.1%;with representative strain of C 4 nucleotide identity was over 92%.Phylogenetic analysis of HEV 71 strains for the nucleotide sequence of VP 1 coding region clarified that the HEV 71 isolates in Beijing belonged to C 4a cluster of C 4 sub-genotype and 10 strains formed four relatively separated clusters.Conclusions The HEV 71 viruses isolated from children of HFMD in Beijing belonged to C 4 sub-genotype,and C4a cluster which was the predominant in China since 2004.According to phylogenetic analysis,HEV 71 which belonged to more than 4 different clusters were circulating in Beijing in 2008.More virological suggestion for disease control and prevention,and information of HEV 71 molecular epidemiology need to be collected urgently due to the successive large epidemic of HEV 71 in China.

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.

Background:There have been several studies about peroral endoscopic myotomy( POEM)for treating esophageal achalasia( EA). Although the feasibility,safety and effectiveness of POEM have been demonstrated,comparative studies of full-thickness and circular muscle myotomy were rare. Aims:To evaluate the efficacy and safety of POEM for treating patients with EA. Methods:A total of 216 patients with EA admitted from Aug. 2011 to Nov. 2013 at the Second Xiangya Hospital of Central South University were treated with POEM,of whom 133 received full-thickness myotomy and 83 received circular muscle myotomy. Data about Eckardt ’s score, diameter of esophageal lumen, intra- and post-operative complications and recurrence before and/or during periodical follow-up were collected,and the efficacy of full-thickness and circular muscle myotomy was compared. Results:All the 216 patients successfully underwent POEM with an average operation time of 59. 1 minutes. Average length of tunnel and myotomy were 13. 3 cm and 10. 1 cm,respectively. Symptoms remitted in all of the 216 patients,Eckardt’s score decreased significantly,diameter of esophageal lumen was reduced(pre-treatment vs. 6 months after treatment,53. 7 mm vs. 30. 8 mm,P<0. 001),and complications occurred in 13. 0%(28/216)of the cases. Success treatment was achieved in 99. 1%(214/216)of the cases with a follow-up of 3-30 months( mean 13. 8 months),no recurrence was noted. The operation time,efficacy and complications were comparable between full-thickness and circular muscle myotomy(P>0. 05). Conclusions:POEM is an effective and safe method for treating EA. Full-thickness myotomy did not increase the operation time and procedure-related complications, however,its long-term efficacy and complications need to be further assessed.

Objective To evaluate the efficacy and safety of peroral endoscopic full-thickness myotomy for patients with severe esophageal achalasia.Methods A total of 64 patients with severe achalasia,whose Eckardt's score ≥6,esophageal diameter ≥6 cm or with S-type esophagus,were treated by peroral endoscopic full-thickness myotomy.Data of Eckardt's score,complications,recurrence,gastroscopy and esophageal barium radiography were collected before and during periodical follow-up.Results All the 64 patients underwent peroral endoscopic myotomy (POEM) successfully,mean operation time was 55 minutes,average length of tunnel and myotomy were 14.1 cm and 10.6 cm respectively,and full-thickness myotomy was performed beyond 6 cm near esophagogastric junction.Symptoms remitted in all patients.Eckardt's score decreased significantly [pre-treatment VS post-treatment,(7.4 ± 1.5) VS (0.6 ± 0.8),P ＜ 0.001],the diameter of esophageal lumen reduced[pre-treatment VS post-treatment,(59.7 ± 13.0) mm VS (31.4 ±3.3) mm,P ＜ 0.001),and the diameter of cardia increased [pre-treatment VS post-treatment,(15.6 ± 10.1) mm VS (33.4 ± 8.9) mm,P ＜ 0.001].Complications occurred in 9.4％ (6/64) of the cases,gas-related complications was 6.3％ (4/64).Treatment success was achieved in 98.4％ cases (63/64) with a follow-up of 6 ～20 months (median 12.3 months),with no recurrence cases.Conclusion Peroral endoscopic full-thickness myotomy is an effective and safe method for severe achalasia.Long-term efficacy and complications need further assessment.

Objective To investigate the risk factors and incidence of gas-related complications in peroral endoscopic myotomy for easophageal achalasia.Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected.Potential risk factors for gas-related complications were analyzed by univariate and multivariate analysis.Results The incidence of gas-related complications was 10.2％ (22/216).Univariate analysis showed risk factors for complications were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,tunnel width ≤3 cm,degree of myotomy,and operation time (P ＜ 0.05),while multivariate analysis showed the risk factors were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,and tunnel width ≤3 cm(P ＜ 0.05).Conclusion Simple longitudinal incision for tunnel entry,tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas-related complications in POEM,while myotomy depth is not.

Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.