Changes and clinical significance of the child patients with HFMD serum IL6 IL10 IL17 levels毕.docx

Changes and clinical significance of the child patients with HFMD serum IL6 IL10 IL17 levels毕.docx

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ChangesandclinicalsignificanceofthechildpatientswithHFMDserumIL6IL10IL17levels毕

ChangesandclinicalsignificanceofthechildpatientswithHFMDserumIL-6?

IL-10?

IL-17levels

HuangXiaoFeiTanWeipingJiangRunchang

[Abstract][Objective]Toexplorethehand,footandmouthdisease（HFMD）inchildrenwithperipheralinterleukin-6（IL-6）?

Interleukin-10（IL-10）?

Interleukin-17（IL-17）levelinHFMDdevelopmentprocessinthechange?

[method]Inthisstudy,usingdoubleantibodysandwichenzyme-linkedimmunosorbentassay（ELISA）methodforthedeterminationof19casesofHFMDinchildren（acutephase?

recovery）andthesameperiodin20healthychildrenserumIL-6?

IL-10?

IL-17content;andHFMDacutephase?

convalescentandhealthychildrenpairwisecomparison,anunderstandingofIL-6?

IL-10?

IL-17changesinthetheHFMDdevelopmentprocess?

[results]?

childpatientswithHFMDacutephaseofIL-6?

IL-10andIL-17levelsweresignificantlyhigherthanthehealthycontrolgroup（P<0.01）;convalescentIL-6andIL-17levelsandthecontrolgroupshowednosignificantdifference（P>0.05）?

stillhigherthanthehealthycontrolgroup（P<0.01）andIL-10levels?

?

acutephaseofIL-6andIL-10showedanegativecorrelation（P<0.05）;IL-6andIL-17waspositivelycorrelated（P<0.01）;IL-10andIL-17showedanegativecorrelation（P<0.05）?

convalescence:

IL-6andIL-10wasnegativelycorrelated（P<0.05）;IL-6andIL-17showedapositivecorrelation（P<0.01）;correlation（P>0.05）betweenIL-10andIL-17?

[Conclusion]childpatientswithHFMDacuteinflammatorycytokines（IL-6?

IL-17）levelssignificantlyincreasedtheinhibitorycytokineIL-10levelscontinuedintotherecoveryperiod?

[Words]ofhand,footandmouthdiseaseinchildrenwhiteinterleukin

Abstract:

[Objective]Tostudythechangesandclinicalsignificanceofseruminterleukin（IL）-6,IL-10,andIL-17levelsinthechildrenwithhandfootandmouthdisease（HFMD）.[Method]TheserumconcentrationofIL-6,IL-10,andIL-17in19casesofHFMDchildren（acutestageandconvalescence）and20casesofhealthycontrolsweremeasuredbyELISA.Thecytokineslevelswerecompared.[Results]1.Comparedwithhealthycontrols,thelevelsofIL-6,IL-10,andIL-17inacutestageofHFMDweresignificantlyincreasedinHFMDchildren（P<0.01）.TherewasnosignificantdifferenceofthelevelsofIL-6andIL-17betweentheconvalescenceofHFMDandhealthychildren（P>0.05）,HoweverthelevelsofIL-10inconvalescenceofHFMDwerehigherthanhealthychildren（P<0.01）.2.SpearmancorrelationanalysisrevealedthatIL-6andIL-17werenegativelycorrelatedwithIL-10（P<0.05）;IL-6positivelycorrelatedwithandIL-17inacutestage（P<0.01）.InconvalescenceIL-6wasnegativelycorrelatedwithIL-10（P<0.05）,positivelycorrelatedwithIL-17（P<0.01）;IL-10andIL-17havenocorrelativerelation（P>0.05）.[Conclusions]1.ThelevelsofIL-6andIL-17weresignificantlyincreasedinacutestageofHFMDchildren.2.ThepersistentelevationofserumIL-10levelwasfoundinHFMDpatientsafterconvalescence.

Keywords:

:

hand,footandmouthdisease;children;interleukin

Vasculartumorsandvascularmalformationsisacommonclinicaldisease,theclassificationofitscomplexity,thedifferencesinclinicalmanifestations,broughtmanydifficultiestoclinicianschoosethebesttreatmentoptionsinordertobetterunderstandthevasculartumorinsouthernChina?

malformationsofthepatient’ssituation,nowretrospectiveanalysisoftheFirstAffiliatedHospitalclinicaldataof592casesofvasculartumororvascularmalformationinhospitalizedpatients,clinicalpresentation,diagnosis,andtreatmentsummaryanddiscussionofitscharacteristicsofthedisease?

?

1Materialsandmethods

1.1Selectionofcases

ClinicaldatacollectedfromJanuary2006toSeptember2009,theFirstAffiliatedHospitalofSunYat-senUniversityofvasculardiseaseinhospitalizedpatients,whileexcludinglesionsinvolvingtheintracranialorvisceralaswellasduringhospitalizationwerenottreatedcasesget:

hospitalizedpatientsoverthesameperiod856casesselecteddepartmentsincluding:

592cases（involvingvascularsurgery?

OralandMaxillofacialSurgery?

PediatricSurgery?

orthopedics?

dermatology?

plasticsurgery）?

1.2ClassificationofDiseases

Combinationofthepatient’smedicalhistory,physicalexamination,imagingandpathologyresults,withreferencetotheInternationalAssociationfortheStudyofVascularAnomalies（InternationalSocietyfortheStudyofVascularAnomalies,ISSVA）modernclassificationcriteria[1],inourhospitalpathologistguidanceunder,vasculardiseasewerefurtherdividedintovasculartumororvascularmalformationintwocategories?

thevasculartumormicroscopiccharacteristics[1-2]:

endothelialcellhyperplasia,cellswiththecharacteristicsoftheembryonicvascularendothelialendothelialcelldistributionintheformofpelletsorcords,visiblepartofthecellsthenormalmitotic?

malformationsmicroscopiccharacteristics[1-2]:

endothelialflatcellstomature,therearenoorveryfewnormalmitoticfigures,vascularnumbersignificantlyincreasedcomparedwithnormaltissue,andthelumendilatedvascularmalformationstraffic;reducedorlackofpartofthewallofthemiddleoftheelasticfibercomponents,walltensiondecreased,thinning;lesionscanbeindividuallyinvolvedcapillaries?

veins,arteriesorlymphatic,alsoinvolvingavarietyofvasculartype?

1.3Statisticalanalysis

Non-normaldistributionofthedatausingthemedian（Q:

interquartilerange）expression?

UsingSPSS16.0statisticalsoftwaretoanalyzetheresults,thechi-squaretestortheWilcoxonranksumtest,P<0.05DifferenceswereconsideredTherearesignificant?

2Results

2.1Generalclinicaldata

592casesofvasculardisease（M:

F=1:

1.18）,vasculartumorsof187cases（31.6%）,withamedianageofJuly（Q=9months）;vascularmalformationin405cases（68.4%）Themedianagewas17yearsold（Q=21yearsold）?

initialtreatmentofallpatientswithdiseasedurationrangedfrom2weeksto69yearsbefore,themediantimefor1year?

respectivelystatisticsvasculartumorgroupandvascularmalformationsgroupforthefirsttimetreatmentbeforethecourse:

Theformerrangefromtwoweeksto19years,themediantimefromMay;latterrangedfrom1monthto69years,themediantimeforfouryears?

Vasculartumorgroup,theheadandneckisthemostcommon（41.2%）oftheaffectedparts?

Malformationsgroup,lowerextremityofthemostcommon（37.0%）oftheaffectedparts?

Somepatientswithlesionssimultaneouslyaccumulatedtwoormoreparts?

Table1showsthevasculartumorgroupandvascularmalformationsgroupthenumberoflesions?

derivedfromthechi-squaretest:

thetwogroupsshowednosignificantdifference（P>0.05）?

2.2Clinicalmanifestations

Vasculartumorpatientsand30.9%（125/405）ofthe592casesofpatientswithvasculardisease,morethan9%ofpatientsdescribethelesionsinthedevelopmentofthediseaseprocesssignificantlylarger?

8.6%（16/187）ofpatientswithvascularmalformationsThesymptomscausedbythedisease（includinglocalpain,ulceration,bleeding,paresthesia,etc.）?

usingthechi-squaretestdrawn:

theproportionofthedifferencewasstatisticallysignificant（P<0.001）ofthesymptomsinthetwogroups?

2.3lesionsinvolvinglevel

Inadditiontothe35casescannotbedeterminedduetoincompletesurgicalresectionorinformationotherthanlesionsinvolvingthelevelintheremaining557patientswithvasculardisease,themajorityoflesionsinvolvedthetwoormoreoftheorganizationalhierarchy?

Includingsubcutaneoustissueinvolvement422patients（75.8%）,muscletissueinvolvementin243cases（43.6%）,andskininvolvementin152cases（27.3%）,mucosalinvolvementinfourcases（0.7%）,boneandjoint（periosteum,marrowcavity,orjoint）involvementin29cases（5.2%）?

involvingmuscleorboneandjointlesionsclassifiedasdeeplesions,otherwiseclassifiedassuperficiallesions?

Table2showsthevasculartumorgroupshadesandvascularmalformationsgrouplesions:

thelatterlesionsinvolvingdeeptissueratio（60.1%）thantheformer（12.3%）,chi-squaretestdrawn,thedifferencewasstatisticallysignificant（P<0.001）betweenthetwo?

2.4treatment

Thepresentstudy,thevasculartumorpatientsreceivingtreatmentinclude:

completeresection?

Partialnephrectomy?

Resectioncombinedplasticsurgery?

Theresectionjointhardenersurgery?

Thehardenertherapy?

Embolizationtherapy,lasertherapy?

Malformationspatientsacceptedtreatmentinclude:

completeresection?

partialnephrectomy,ligation,excisioncombinedplasticsurgery?

theexcisionjointhardenersurgery?

thejointresectionembolization?

thehardenertherapy?

Embolization?

lasertherapy?

microwavetherapy?

chemotherapytherapy,cryotherapy?

ordertofurtherunderstandtherelationshipbetweenvasculardiseasetypeselectedtreatment,weselectedsixkindsofprimarytreatment（560cases）statisticsandcustomdividedinto3groups（Table3）:

aradicalprogram（completeresection）?

apartialhepatectomyprograms（partialnephrectomy?

embolizationplussurgicalexcision?

surgicalexcision+skingrafting）?

thepalliativeprogramof（simpleligation?

embolizationalone）?

usingtheWilcoxonrankdrawnandinspection:

thedifferencewasstatisticallysignificant（P<0.001）inthevasculartumorgroupandvascularmalformationsgrouptherapy?

2.5intraoperativebloodlossandtransfusion

Linelesionsin592patientswithvasculardisease,552cases（93.2%）resection（resectionincombinationwithothertreatmentmodalities）?

Intraoperativeblood