EV71感染手足口病严重程度与IL-6、IL-1β基因多态性的相关性研究

目的 探讨炎性细胞因子白介素-6(IL-6)、IL-6R、IL-1β、IL-1RN基因多态性与肠道病毒71型(EV71)感染手足口病(HFMD)的严重程度的相关性,为重症HFMD的早期发现和患病风险的评估提供依据。方法 以西安市儿童医院和西安交通大学第二附属医院感染科收住的180例EV71 HFMD患儿为研究对象,其中重症组108例,普通组72例。采用SNPscan^TM多重SNP技术检测上述样本IL-6 rs1800796、rs2069837,IL-6R rs2228145、rs4845617,IL-1β rs16944、rs1143627,IL-1RN rs315952、rs9005位点的基因分型。结果 180例EV71感染患儿中,IL-6 rs1800796 G等位基因的重症化风险升高(OR=1.312,95%CI:1.041~1.653),IL6-R rs2228145 C等位基因重症化风险升高(OR=1.330,95%CI:1.064~1.663),而IL-1β rs1143627 G等位基因是保护因素(OR=0.790,95%CI:0.635~0.981)。IL-6 rs2069837、IL-6R rs4845617,IL-1β rs16944、IL-1RN rs315952、rs9005的基因多态性与疾病严重程度无明显相关性。结论 IL-6 rs1800796、IL-6R rs2228145、IL-1β rs1143627基因多态性与EV71 HFMD患儿严重程度相关联。     

TLR3基因多态性与儿童肠道病毒71型脑炎的关系

目的 探究Toll样受体3(TLR3)基因多态性与儿童人肠道病毒71(EV71)型脑炎的关系。方法 选取2016年5月-2021年9月于郴州市第一人民医院北院儿童神经内科接受治疗的EV71型脑炎患儿93例设为EV71组，同时选取90名健康儿童设为健康组；统计所有患儿的TLR3-1377位点基因型、疾病严重程度、炎症因子浓度等指标，探究TLR3-1377位点基因与EV71型脑炎发生、发展的关系。结果 EV71组、健康组两组间TLR3-1377位点基因型差异无统计学意义，重度EV71型脑炎患儿TLR3-1377位点的TT基因型、T等位基因比例高于中、轻度脑炎患儿(P<0.05);携带TT基因型患儿的发热时间长于CC、CT基因型患儿(P<0.05),血清干扰素γ(IFN-γ)低于其他基因型(P<0.05),白细胞介素-4(IL-4)、IL-6、神经元特异性烯醇化酶(NSE)、内皮生长因子(VEGF)高于CC、CT基因型(P<0.05)。结论 TLR3基因多态性与儿童EV71型脑炎的发病无显著关系，但TLR3-1377位点携带T等位基因的患儿疾病严重程度更高，临床中可结...     

肠道病毒71型感染患儿IL-18基因rs1946518位点多态性对感染的影响

目的探究肠道病毒71型(EV71)感染患儿IL-18水平,分析IL-18基因rs1946518位点多态性与肠道病毒71型感染易感性。方法选择2018年1月-2019年3月浙江大学附属第一医院消化内科收治的EV71感染手足口病患儿80例作为EV71感染组,根据病情严重程度,将患儿分为轻症组46例和重症组34例,选取同期于浙江大学附属第一医院消化内科行体检的健康儿童30名作为对照组,采用ELISA法检测血清IL-18水平,采用散射比浊法检测血清IgG、IgA、IgM及补体C3,C4含量。应用SNaPshot技术检测IL-18基因rs1946518位点多态性。结果 EV71感染组的rs1946518位点AA、AC、CC基因型频率分别为28.75%、48.75%、22.50%,与对照组比较差异显著(P0.05)。重症组的AA基因型频率高于轻症组及对照组(P=0.035、P=0.032);轻症组的CC基因频率与对照组无明显差异,但高于重症组(P0.05); EV71感染组的rs1946518位点A等位基因频率53.13%、C等位基因频率46.87%,重症组A等位基因频率显著高于轻症组及对照组(P=0.012、P=0.05); EV71感染组的血清IL-18水平显著高于对照组(P0.05);重症组的血清IL-18水平显著高于轻症组(P0.05); EV71感染组的血清IgA、IgG水平显著低于对照组,血清IgM、C3、C4水平显著高于对照组(P0.05);重症组的血清IgA、IgG水平显著低于对照组,血清IgM、C3、C4水平显著高于轻症组(P0.05)。结论手足口病严重程度与机体的免疫水平有关,IL-18可能参与病情的发生发展过程。IL-18基因rs1946518位点多态性可能与肠道病毒71型易感性有关,A基因可能为易感基因,C基因为保护基因。     

肠道病毒71型感染手足口病患儿TLR7、α干扰素、IL-6水平及TLR7基因多态性

目的分析肠道病毒71型(EV71)感染手足口病患儿Toll受体7(TLR7)、α干扰素(Interferon-α, IFN-α)、白细胞介素-6 (Interleukin,IL-6)表达水平变化及TLR7基因多态性。方法选择2016年3月-2019年3月医院门诊和住院EV71感染手足口病患儿508例,其中无中枢神经系统并发症患儿327例作为轻症组,合并中枢神经系统并发症患儿181例作为重症组,选择同期在医院儿童保健科门诊体检儿童305名作为对照组。检测各组受试儿童TLR7、IFN-α以及IL-6 mRNA相对表达量,并分析TLR7 rs179019和rs3853839基因位点单核苷酸多态性。结果 EV71病毒感染患儿TLR7 mRNA、IFN-αmRNA以及IL-6 mRNA表达均显著高于对照组(P0.05),其中重症组患儿上述指标表达量均高于轻症组(P0.05)。轻症组、重症组及对照组TLR7 rs179019基因位点基因型分布及C、A等位基因分布差异均无统计学意义,TLR7 rs3853839基因位点基因型及G、C等位基因分布比较差异具有统计学意义(P0.05),其中重症组C等位基因分布率高于轻症组和对照组(P0.05)。结论 TLR7、IFN-α、IL-6参与EV71病毒感染过程中,可能是EV71感染并发展成为重症感染的关键因子,同时TLR7 rs3853839位点基因多态性与患儿EV71重症感染密切相关。     

肠道病毒71型感染手足口病患儿血浆可溶性人类白细胞抗原-G表达水平的研究

目的 通过检测肠道病毒71型(EV71)感染手足口病(HFMD)患儿血浆可溶性人类白细胞抗原-G(sHLA-G)及白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平,探讨其与儿童EV71感染的关系.方法 采用酶联免疫吸附试验(ELISA)检测EV71感染HFMD患儿及正常对照儿章血浆中sHLA-G水平;采用ELISA检测EV71感染HFMD患儿及正常对照儿童的血浆IL-6、IL-10水平;根据卫生部《手足口病诊疗指南》(2010年版)的诊断标准,将患儿组分为普通病例组21例、重型组97例、危重型组19例,同时选取EV71病毒核酸检测阴性的健康体检儿童146例为对照组.结果 患儿血浆sHLA-G水平135.1 U/ml明显高于正常对照组的19.82 u/ml,差异有统计学意义(P＜0.01);血浆sHLA-G水平轻型组、重型组、危重型组分别为123.03、118.30、180.20U/ml,差异有统计学意义(P＜0.01),其中危重型组的血浆sHLA-G水平高于轻型组和重型组(P=0.000);各组血浆IL-6、IL-10水平差异均有统计学意义(P＜0.05),危重型组血浆IL-6、IL-10水平高于重型组和轻型组(Z=-3.057,P=0.002;Z=-2.656,P=0.008).结论 sHLA-G参与了EV71感染的发生发展过程,血浆sHLA-G水平可作为EV71感染的辅助诊断指标.     

IL-2-330基因多态性与慢性乙型肝炎病毒和/或丙型肝炎病毒感染及不同临床转归的关系

目的 研究乙型肝炎病毒(HBV)和/或丙型肝炎病毒(HCV)感染及其不同临床转归者IL-2基因多态性(SNP).方法 对河北省赵县某农村HBV和/或HCV感染者及对照共277人采集空腹静脉血.用ELISA检测抗-HBV、抗-HCV生物标志物,筛出HBV重叠HCV感染79例、单纯HBV感染69例、HCV感染55例和对照74例.用RT-nPCR检测HCVRNA,BeckmanLX-20全自动生化仪检测肝功能丙氨酸氨基转移酶(ALT),RFLP-PCR技术检测IL-2-330 SNP,分析IL-2-T330G SNP与HBV和/或HCV感染、不同临床转归、ALT和HCVRNA表达的关系.结果 (1)不同感染类型即单纯HBV、HCV感染和重叠感染者IL-2-330 TT频率明显高于对照,-330 GG频率明显低于对照(χ2=14.24,P=0.03),OR值(95%CI)分别是7.14(2.13～23.81)、3.46(1.17～10.02)、2.93(1.15～7.46),各感染类型间差异无统计学意义(χ2=2.09,P=0.72);各感染组-330T频率明显升高,-330G频率明显降低(χ2=12.33,P=0.01),OR值(95%CI)分别是2.26(1.39～3.69)、1.82(1.09～3.03)、1.73(1.10～2.73)倍.(2)不同临床转归即轻型、中重型肝炎和肝硬化组IL-2-330 TT频率明显高于对照组、-330 GG频率明显低于对照组(χ2=13.52,P=0.04),OR值(95%CI)分别是3.33(1.75～6.32)、3.31(1.75～6.26)、11.23(3.09～40.76).不同临床转归组-330T频率明显升高,-330 G频率明显降低(χ2=12.32,P=0.01);OR值(95%CI)分别是1.86(1.32～2.63)、1.71(1.27～2.31)、2.77(1.57～4.89)倍.(3)IL-2-330基因型和等位基因频率与HCV的病毒复制无统计关联(χ2=0.83,P=0.66;χ2=0.20,P=0.66),与ALT水平亦无统计关联(χ2=1.10,P=0.58;χ2=0.08,P=0.78).结论 IL-2-330 T/G SNP与HBV和/或HCV感染者慢性化及不同临床转归有一定关联,IL-2-330TT/T能增加HBV和/或HCV感染及其临床转归的危险,-330 GG/G则减低其感染和临床转归风险.     

儿童EBV感染与IL-10启动子基因多态性的相关性

目的探讨白细胞介素-10(Interleukin-10,IL-10)启动子基因-1082A/G、-819T/C、-592A/C位点多态性与儿童EB病毒(Epstein-Barr virus, EBV)感染易感性及肝功能损害相关性。方法选取杭州师范大学附属医院儿科2019年1月-2019年12月收治EBV感染所致传染性单核细胞增多症(Infectious mononucleosis, IM)患儿87例纳入感染组,其中肝功能损害52例(肝损组),无肝功能损害35例(无肝损组),并选取同期未感染EBV的健康儿童78名为对照组。应用Sanger双脱氧链终止法检测IL-10启动子基因-1082A/G、-819T/C、-592A/C位点的基因多态性。结果 IL-10-1082A/G、IL-10-819T/C、IL-10-592A/C位点在感染组与对照组之间基因型及等位基因比较差异无统计学意义;IL-10-1082A/G基因型与等位基因在肝损组及无肝损组之间无统计学差异,IL-10-819T/C的CC基因型频率与IL-10-592A/C的CC基因型频率在肝损组中更高(P0.05),但两者的等位基因在肝损组及无肝损组中无明显统计学差异;IL-10-819T/C与IL-10-592A/C两个位点基因高度连锁。结论 IL-10启动子基因-1082A/G、-819T/C、-592A/C位点多态性与杭州地区儿童EBV易感性无关,IL-10-819T/C位点及IL-10-592A/C位点的CC基因型可能是IM患儿肝功能损害的影响因素之一,但需要更多检验。-819T/C基因型与-592A/C基因型高度连锁。     

2型糖尿病并发Hp感染患者胃溃疡易感性与白细胞介素8和核因子κB1基因多态性

目的分析白细胞介素(IL)-8和核因子κB1(NF-κB1)的基因多态性与2型糖尿病(T2DM)并发幽门螺杆菌(Hp)感染患者胃溃疡易感性的关系。方法选取2017年8月-2020年8月焦作市人民医院内分泌科收治的93例T2DM并发Hp感染患者,根据患者是否发生胃溃疡分为胃溃疡组32例和无溃疡组61例。检测所有患者白细胞计数(WBC)、血清肿瘤坏死因子-α(TNF-α)、IL-6和IL-8水平,PCR检测IL-8基因rs4073(A/T)、rs2227306(C/T)和NF-κB1基因rs3774963(C/G)、rs28362491(-94ins/delATTG)位点多态性。结果胃溃疡组患者IL-8基因位点rs4073携带等位基因T的频率明显高于无溃疡组(P0.05),NF-κB1基因位点rs3774963携带等位基因G的频率明显高于无溃疡组(P0.05),rs28362491位点-94insATTG的频率明显高于无溃疡组(P0.05),且血清TNF-α、IL-6、IL-8水平明显高于无溃疡组(P0.05)。结论 IL-8基因rs4073位点等位基因T、NF-κB1基因rs3774963位点等位基因G和rs28362491位点-94insATTG可以增加T2DM并发Hp感染患者胃溃疡的易感性。     

胸腔镜肺叶切除术后肺部感染与TNF-α和CYP1A2基因多态性的关联性

目的分析肿瘤坏死因子-α(TNF-α)及细胞色素P450酶1A2(CYP1A2)基因多态性与胸腔镜肺叶切除术后肺部感染的关系。方法选择2017年11月-2019年11月于承德市中心医院行胸腔镜肺叶切除术患者156例为研究对象,根据术后是否并发肺部感染将患者分为肺部感染组(n=62)和无肺部感染组(n=94),采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)分析法检测TNF-α及CYP1A2基因单核苷酸多态性(SNPs)位点多态性,采用Logistic回归分析探讨TNF-α及CYP1A2多态性位点与胸腔镜肺叶切除术后肺部感染的相关性。结果肺部感染组TNF-α基因rs1800629位点GG基因型、G等位基因频率分别为62.90%、77.42%低于无肺部感染组(P0.05),GA、AA基因型和A等位基因频率分别为29.03%、8.06%和22.58%高于无肺部感染组(P0.05),rs1800630位点CC、CA、AA基因型和C、A等位基因频率以及rs361525位点GG、GA、AA基因型和G、A等位基因频率与无肺部感染组比较差异无统计学意义;肺部感染组CYP1A2基因rs762551位点CC基因型和C等位基因频率分别为27.42%、51.61%低于无肺部感染组(P0.05),CA、AA基因型和A等位基因频率分别为48.39%、24.19%和48.39%高于无肺部感染组(P0.05);TNF-α基因rs1800629位点A等位基因与胸腔镜肺叶切除术后肺部感染风险存在明确相关性(P0.05),显性模型rs1800629位点多态性差异有统计学意义(P0.05);CYP1A2基因rs762551位点A等位基因与胸腔镜肺叶切除术后肺部感染风险存在明确相关性(P0.05)。结论 TNF-α基因rs1800629位点A等位基因以及CYP1A2基因rs762551位点A等位基因与肺癌患者胸腔镜肺叶切除术后肺部感染风险有关。     

绍兴地区手足口病门诊患儿病原学及其T细胞亚群及IL-13变化

目的分析绍兴地区手足口病(hand foot and mouth disease,HFMD)门诊患儿病原学特点及其与T淋巴细胞亚群、白细胞介素-13(Interleukin-13,IL-13)水平的关系。方法选择2017-2019年绍兴市妇幼保健院收治的1323例HFMD门诊患儿为研究对象,采用流行病学方法对病例及标本检测情况进行描述性分析,并比较不同类型病毒感染患儿T淋巴细胞亚群、IL-13水平变化。结果1323例HFMD门诊患儿检出病毒阳性1227例(92.74%),其中肠道病毒71型(Enterovirus 71,EV71)感染749例(61.04%)、柯萨奇A组16型(Coxsachie virus,Cox A16)感染355例(28.93%)、其他肠道病毒感染123例(10.02%);1227例患儿年龄1~5岁占比最高为59.41%、男性占59.49%、发病时间4~6月占47.76%、散居患儿占58.60%;危重症、重症、普通占比分别为0.81%、21.11%、78.08%;三组患儿病情严重程度比较差异显著(Z=30.540,P<0.001);Cox A16感染、其他肠道病毒感染、EV71感染患儿T淋巴细胞CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺水平逐渐降低,CD₈⁺、IL-13水平逐渐升高,三组比较差异有统计学意义(P<0.05)。结论HFMD患儿以EV71感染为主,Cox A16次之,在4~6月发病率最高,好发于1~5岁儿童,散居儿童为主,EV71重症患儿占比较高,EV71引起的免疫紊乱、炎性反应高于其他病毒。     

Children's representations of relationships with mothers,teachers, and friends,and associations with social competence

This study describes the use of story stems in order to determine children's representations of relationships with mothers, teachers, and friends, and how these representations are related to mother- and teacher-rated social competence. Thirty preschool-aged children were administered the story stem tasks featuring three different interactional partners, which were then coded for quality of the portrayed relationship. Mothers and teachers were also asked to rate children's social competence. Findings suggest that children generally have similar, but not identical, working models of their relationships with mothers and teachers which are related to internal working models of their relationships with friends. Furthermore, elements of children's narratives about teachers and friends were related to teacher's ratings of children's social competence. Findings from this study demonstrate the dynamic and interactive nature of children's representations of relationships with their mothers, teachers, and friends.     

Practice with people with severe mental illness: rewards, challenges, burdens

The authors surveyed a random sample of 1,200 NASW members in post-master's practice in mental health to identify their attitudes toward practice with people with severe mental illness. Contrary to the literature that claims social workers have abandoned vulnerable populations or have negative attitudes toward this population, the authors found that the majority practice with this clientele and find their practice rewarding. Most of the respondents' frustration and obstacles in practice were related to systemic problems, not client-related problems. Respondents' recommendations for education of future practitioners are presented.     

Cyclosporiasis associated with imported raspberries, Florida, 1996

OBJECTIVES: Until 1995, infection with Cyclospora cayetanenis, a parasite that causes gastroenteritis, was diagnosed in the US primarily in overseas travelers; its modes of transmission were largely unknown. In 1995, 45 cases of cyclosporiasis were diagnosed in Florida residents who had no history of recent foreign travel, but an investigation could not pinpoint a source for the parasite. In 1996, a North American outbreak of cyclosporiasis resulted in more than 1400 cases, 180 of them in Florida. The authors investigated the 1996 Florida outbreak to identify the vehicle of transmission. METHODS: The authors conducted a matched case-control study in which each of 86 laboratory-confirmed sporadic cases was matched with up to four controls. They also investigated nine clusters of cases associated with common meals and attempted to trace implicated foods to their countries of origin. RESULTS: In the case control study, eating raspberries was strongly associated with cyclosporiasis (matched odds ratio = 31.9; 95% confidence interval [CI] 7.4, 138.2). In the cluster investigation, raspberries were the only food common to all nine clusters of cases; a summary analysis showed a strong association between consumption of raspberries and confirmed or probable cyclosporiasis (risk ratio = 17.6; 95% CI 1.9, 188.8). Guatemala was the sole country of origin for raspberries served at six of nine events. CONCLUSIONS: Guatemalan raspberries were the vehicle for the 1996 Florida cyclosporiasis outbreak. Cyclospora is a foodborne pathogen that may play a growing role in the etiology of enteric disease in this country as food markets become increasingly international.     

Parents with Physical,Systemic, or Visual Disabilities

There are over ten million families with children living in the home in which a parent has a disability. When discussing a group as large and heterogeneous as parents with disabilities, it is important to keep in mind the diversity of this population. We cover three areas, including (a) the main problems in previous research on parents with disabilities, (b) research in a new key, i.e., from a disability culture and community perspective, and (c) an overview of the clinical and research work at Through the Looking Glass, a nonprofit agency serving families with disabilities since 1982.