1.Pathogen detection and genetic characteristic analyses of hand-foot-and-mouth disease in Dehong Prefecture of Yunnan Province in 2023
Zhuoya GAO ; Jiangli ZHU ; Dingfu LUO ; Bingjun TIAN ; Kang YANG ; Zengjiao DUAN ; Runbo ZHANG ; Yinghao CHEN ; Zhuo SHEN
Shanghai Journal of Preventive Medicine 2026;38(6):446-452
ObjectiveTo genotype the specimens from hand-foot-and-mouth disease (HFMD) cases in Dehong Prefecture, Yunnan Province in 2023 by gene sequencing, and to analyze the genetic characteristics of Coxsackievirus A4 (CVA4), CVA6, CVA10, CVA16 and enterovirus A71 (EV-A71), so as to clarify the serotypes of enteroviruses causing endemic HFMD and the genotype composition of CVA4, CVA6, CVA10, CVA16 and EV-A71 prevalent in HFMD, and to provide baseline genotype data for monitoring the dynamic changes of the five virus genotypes. MethodsStool specimens from HFMD cases in Dehong Prefecture in 2023 that tested positive for EV-A71, CVA16 and other enteroviruses by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) were first subjected to gene sequencing and typing of the VP4/VP2 junction region to determine the viral types. Subsequently, the complete VP1 gene of each virus was amplified in two segments using group-specific VP1 gene primers corresponding to enterovirus groups (i.e., enterovirus group A, B, and C) and sequenced (group A virus: primers 486/488 and 487/489, group B virus: primers 490/492 and 491/493, group C virus: primers 494/496 and 495/497). The representative reference sequences of VP1 genes for CVA4, CVA6, CVA10, CVA16 and EV-A71 were downloaded from the literature, and the VP1 gene phylogenetic tree was constructed using MEGA 6.0 software for genetic characterization. ResultsA total of 256 stool specimens were collected from HFMD cases in Dehong Prefecture in 2023, of which 94 tested positive for nucleic acid by RT-qPCR, yielding a positive rate of 36.72%. Of the 94 positive specimens, 83 were identified as group A viruses, and were classified into 5 serotypes (17 strains of CVA4, 3 of CVA6, 6 of CVA10, 49 of CVA16, and 8 of EV-A71). Nine strains were group B viruses, comprising 2 serotypes: 2 strains of echovirus type 3 (E3) and 7 strains of Coxsackievirus B type 5 (CVB5). The remaining 2 strains were group C viruses, both identified as poliovirus type 3 (PV3). Genetic analyses of the VP1 region showed that all 17 CVA4 strains were identified as subgenotype C2, all 3 CVA6 strains as subgenotype D3a, all 6 CVA10 strains as genotype C. Among the 49 CVA16 strains, 46 were identified as subgenotype B1a and 3 as subgenotype B1b, and all 8 EV-A71 strains were identified as subgenotype C4a. ConclusionIn 2023, group A viruses dominated the pathogenic spectrum of HFMD in Dehong Prefecture. Among them, CVA16 had the highest positivity rate. Genetic characteristic analyses showed that CVA4, CVA6, CVA10 and EV-A71 were each composed of a single genotype (subgenotype), while CVA16 was composed of two subgenotypes (B1a and B1b), with B1a being the predominant one. It is recommended that molecular epidemiological surveillance of HFMD pathogens, particularly group A viruses, be continuously strengthened in Dehong Prefecture.
2.Application of 3D-CRT for cervical cancer stage of ⅠA-ⅡA after radical operation
Qiufang WU ; Dingfu ZHANG ; Xi TANG
Journal of Regional Anatomy and Operative Surgery 2016;25(7):507-509,510
Objective To investigate the clinical effect and safety of three dimensional conformal radiotherapy (3D-CRT)for patients with cervical cancer after radical operation in stage ⅠA to ⅡA.Methods The data of 119 patients of cervical cancer in ⅠA-ⅡA with postoperative radiotherapy in our hospital were analyzed retrospectively.Of which 56 patients were treated with 3D-CRT radiotherapy (3D-CRT group),63 patients were treated with conventional radiotherapy (conventional group).The differences radiation reactions and quality of life between two groups were compared.Results The local control rate of 3D-CRT group in the first 12 and 18 months after surgery were 87.50% and 82.14%,respectively,which were significantly higher than those of conventional group(71.43%,65.08%),the difference was statistical significance(P <0.05).The survival rate of 3D-CRT group after 1 year,2 years,3 years were respectively 91.07%,83.93%, 71.43%,compared with the conventional group (84.13%,73.02%,65.08%),the difference was not statistically significant (P >0.05). Patients of 3D-CRT group were followed up for 3 years,the median survival time was 34.29 months,which was longer than the 31.08-month of conventional group,the difference was statistically significant(χ2 =4.116,P =0.042).Quality of life of 3D-CRT group (60.81 ±4.28) point was lower than that of conventional group (63.75 ±5.03)point,and the difference was statistically significant(P <0.05).The rate of early radiation reaction(rectal reaction,vaginitis)and late radiation reaction (mild or moderate radiation proctitis)in 3D-CRT group were lower than those in the conventional group,the difference was statistically significant(P <0.05 ).Conclusion The 3D-CRT has effect on the long-term prognosis of patients with cervical cancer in stage ⅠA-ⅡA,which can significantly reduce the radiation reaction and improve the quality of life of patients.

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