Objective:To analyze the relationship between serum inflammatory factors and prognosis in children with severe hand, foot and mouth disease (HFMD).Methods:According to the severity of the disease, 100 children with HFMD-treated in the Xingtai Third Hospital from June 2022 to December 2023 were divided into severe group (38 cases) and mild group (62 cases), and 52 children admitted for physical examination during the same period were selected as the control group for retrospective analysis. Serum levels of inflammatory factors in the three groups were compared, Pearson correlation was used to analyze the relationship between the severity of the disease and the levels of inflammatory factors in the three groups, the levels of inflammatory factors in the mild group and the severe group with different prognosis after treatment were compared, and the factors affecting the prognosis of the children with HFMD were analyzed by multivariate logistic regression.Results:The levels of interleukin 2, 6, 10, 17 (IL-2, IL-6, IL-10, IL-17), tumor necrosis factor-α (TNF-α), interferon-α (IFN-α), interferon-γ (IFN-γ) in the severe group before treatment [(7.89±2.04)ng/L, (59.15±14.21)ng/L, (81.54±12.54)ng/L, (59.63±12.17)ng/L, (33.74±9.55)ng/L, (91.37±23.44)ng/L, (116.48±15.77)ng/L] were higher than those in the mild and the control groups ( P<0.05). The levels of IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ in the mild group [(4.77±1.12)ng/L, (28.68±8.12)ng/L, (45.41±11.28)ng/L, (36.77±10.29)ng/L, (22.45±6.68)ng/L, (68.42±15.99)ng/L, (39.58±9.45)ng/L] were higher than those in the control group (all P<0.05). Pearson correlation analysis showed that the severity of HFMD was positively correlated with IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ (all P<0.05). After treatment, the levels of serum IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ of the children with poor prognosis in the mild and severe groups were higher than those of the children with good prognosis (all P<0.05). Logistic regression analysis showed that IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α, IFN-γ were the risk factors affecting the prognosis of children with severe HFMD ( OR=2.370, 1.937, 2.065, 2.344, 2.264, 2.370, 2.020, all P<0.05). Conclusions:With the occurrence and aggravation of HFMD, the level of inflammatory factors in children shows an increasing trend, which is a risk factor affecting prognosis and can predict the therapeutic effect to a certain extent.

Objective:To analyze the relationship between serum inflammatory factors and prognosis in children with severe hand, foot and mouth disease (HFMD).Methods:According to the severity of the disease, 100 children with HFMD-treated in the Xingtai Third Hospital from June 2022 to December 2023 were divided into severe group (38 cases) and mild group (62 cases), and 52 children admitted for physical examination during the same period were selected as the control group for retrospective analysis. Serum levels of inflammatory factors in the three groups were compared, Pearson correlation was used to analyze the relationship between the severity of the disease and the levels of inflammatory factors in the three groups, the levels of inflammatory factors in the mild group and the severe group with different prognosis after treatment were compared, and the factors affecting the prognosis of the children with HFMD were analyzed by multivariate logistic regression.Results:The levels of interleukin 2, 6, 10, 17 (IL-2, IL-6, IL-10, IL-17), tumor necrosis factor-α (TNF-α), interferon-α (IFN-α), interferon-γ (IFN-γ) in the severe group before treatment [(7.89±2.04)ng/L, (59.15±14.21)ng/L, (81.54±12.54)ng/L, (59.63±12.17)ng/L, (33.74±9.55)ng/L, (91.37±23.44)ng/L, (116.48±15.77)ng/L] were higher than those in the mild and the control groups ( P<0.05). The levels of IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ in the mild group [(4.77±1.12)ng/L, (28.68±8.12)ng/L, (45.41±11.28)ng/L, (36.77±10.29)ng/L, (22.45±6.68)ng/L, (68.42±15.99)ng/L, (39.58±9.45)ng/L] were higher than those in the control group (all P<0.05). Pearson correlation analysis showed that the severity of HFMD was positively correlated with IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ (all P<0.05). After treatment, the levels of serum IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ of the children with poor prognosis in the mild and severe groups were higher than those of the children with good prognosis (all P<0.05). Logistic regression analysis showed that IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α, IFN-γ were the risk factors affecting the prognosis of children with severe HFMD ( OR=2.370, 1.937, 2.065, 2.344, 2.264, 2.370, 2.020, all P<0.05). Conclusions:With the occurrence and aggravation of HFMD, the level of inflammatory factors in children shows an increasing trend, which is a risk factor affecting prognosis and can predict the therapeutic effect to a certain extent.

A 50-year-old male patient grinded his self-purchased blister beetle ( Mylabris) body into powder and then made it into paste for large area external use on his body skin for psoriasis. A few minutes later, the patient developed erythema and blisters on the site of medication; a few hours later, the purplish-red patches and blisters spread throughout the body, epidermis relaxed and exfoliated, and symptoms of systemic poisoning appeared. One day later, the patient developed multiple organ failure, such as respiratory failure, liver injury, kidney injury, severe hypoproteinemia, and abnormal coagulation function. Epidermolysis bullosa induced by externally application of Mylabris was diagnosed, and treatments of high-doses of pulsetherapy methylprednisolone, intravenous infusions of human immunoglobulin and human albumin, bedside hemofiltration, ventilator-assisted ventilation, and etc. were given. However, the patient′s condition deteriorated rapidly and finally he died of multiple organ failure 12 hours later.

A 50-year-old male patient grinded his self-purchased blister beetle ( Mylabris) body into powder and then made it into paste for large area external use on his body skin for psoriasis. A few minutes later, the patient developed erythema and blisters on the site of medication; a few hours later, the purplish-red patches and blisters spread throughout the body, epidermis relaxed and exfoliated, and symptoms of systemic poisoning appeared. One day later, the patient developed multiple organ failure, such as respiratory failure, liver injury, kidney injury, severe hypoproteinemia, and abnormal coagulation function. Epidermolysis bullosa induced by externally application of Mylabris was diagnosed, and treatments of high-doses of pulsetherapy methylprednisolone, intravenous infusions of human immunoglobulin and human albumin, bedside hemofiltration, ventilator-assisted ventilation, and etc. were given. However, the patient′s condition deteriorated rapidly and finally he died of multiple organ failure 12 hours later.

Objective To explore the CT classification of lacerating lung injury in blunt thoracic trauma and its clinical significance. Methods A total of 63 patients with lung lacerating injury were classified using CT features as simple type injury (complete visceral pleura, with no pneumothorax or he-mopneumothorax) and complex type injury (accompanied by visceral pleura rupture, pneumothorax or he-mopneumothorax). A retrospective analysis was done on CT manifestations and clinical data. Results Of 63 patients, 35 patients (56%) had simple type of lacerating lung injury with complete visceral pleu-ra, most of which were focal pulmonary pseudocyst lesions present in the edge of lungs and could be dis-persed quickly after conservative therapy without complications. Mean hospital stay was 16 days. Of pa-tients with complex type of lacerating lung injury, 28 patients (44.4%) were accompanied by visceral pleura rupture with larger extent of pulmonary injury, 20 (71%) by lung eontnsion, 15 (54%) by ate-lectasis or pulmonary atelectasis and three (11%) by local pulmonary infection. Thoracic puncture or closed drainage was performed in 19 patients (69%) and thoracotomy in one (4%), with mean hospital stay of 58 days. Conclusions According to CT manifestations on whether there exists visceral pleura rupture or not, the lacerating lung injury is classified as simple type injury and complex type injury. CT classification of lacerating lung injury may be helpful in selecting clinical treatment protocols and predic-ting early prognosis.

Objective To evaluate the value of the abdominal computed tomography (CT) in diagnosing mesenteric injury. Methods Fourteen patients with mesenteric injury proven by surgery were selected as the study objects. A retrospective analysis was done on the clinical medical records and CT examination results including free intra-peritoneal fluid collection, infiltration of mesenteric fat, intra-mesenteric hematoma, extravasation of contrast media and thickening and enhancement of bowel wall. Meanwhile, in combination with surgical findings, the sensitivity of CT in diagnosis of mesenteric injury was determined. Results CT images showed free peritoneal fluid or hemoperitoneum and infiltration of mesenteric fat in all 14 patients, of which 12 had intra-mesenteric hematoma, two showed thickening and enhancement of bowel wall and one did extravasation of contrast material. CT findings accorded with surgical results. Conclusion CT is sensitive in diagnosis of mesenteric injury and helpful for identification of the injury site.