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Objective Auricular acupressure (AA) therapy has been widely used in Eastern Asia and Europe to prevent constipation in leukemia patients undergoing chemotherapy. The aim of this systematic review was to review data from randomized controlled trials (RCTs) of auricular acupressure therapy for preventing constipation in leukemia patients undergoing chemotherapy. Methods Databases that were searched from their inception until August 2017 included: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, as well as four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database]. In this systematic review, only RCTs that were related to the effects of auricular acupressure therapy on preventing constipation in leukemia patients undergoing chemotherapy were included. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analyses of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. Results A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in the AA plus routine care group showed significantly greater improvements in the Bristol Stool Form (BSF) [MD = 0.55, 95% CI (0.39, 0.71), p Conclusion Taken together, as a potential safety therapy, only weak evidence supported the hypothesis that AA effectively prevented constipation in leukemia patients undergoing chemotherapy.

Hand, foot, and mouth disease (HFMD) is mainly epidemic in China and Southeast Asian countries. A novel enterovirus 71 vaccine has been available in China for preventing severe HFMD since 2016. Knowledge of the dynamic epidemiology of HFMD in different regions is necessary for appropriate intervention strategies. This study focused on the citywide surveillance data on the epidemiology and etiology of HFMD in Shanghai during 2014–2016. In these 3 years, the total numbers of reported HFMD cases were 65,018, 39,702, and 57,548, respectively; the numbers of severe cases (case-severity ratios) were 248 (0.38%), 35 (0.09%), and 59 (0.10%), respectively. Children

Background A recent cluster of pneumonia cases in China was caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report the screening and diagnosis of corona virus disease 2019 (COVID-19) in our hospital. Methods Developed a procedure for the identification of children cases with COVID-19 in outpatient and emergency department of our hospital, then we observed how this process works. Results (I) There were 56 cases considered suspected cases, and 10 cases were confirmed as COVID-19. (II) Of the 10 confirmed COVID-19 cases admitted in our hospital, 5 were males and 5 were females, aged from 7 months to 11 years, the average age is 6.0±4.2 years, 6 cases were mild pneumonia, the others were upper respiratory tract infection. (III) We followed up 68 patients in isolation at home until symptoms disappeared. Non were missed in the patient's first visit. The sensitivity of this method is 100% and the specificity is 71.3%. Conclusions Our screening process works well, and it is also necessary to establish a screening network in the hospital.

In this paper, the technology, equipment and method used to m easure the mechanical properties of micro-scale new-style intelligent shape memory alloy material were studied. First, two groups of small-scale shape memory alloy samples were made and the suitable micro load device was designed according to samples’ size and force range. Then the strain of the samples were observed with the video microscopy and calculated. Comparing with the corresponding force, the stress-strain curves of the two groups of samples were obtained respectively. After fitting these two curves, the stress-strain curve of the sample material was obtained. Finally, the basic mechanical properties of this shape memory alloy materials were discussed.

Background The significance of ABCB11 variants have been studied in some cholestatic diseases, but this is not clear in transient neonatal cholestasis (TNC). The aim of the present study was to explore the association between ABCB11 variants and TNC. Methods This was a case–control study. A total of 192 children with TNC referred to a tertiary referral hospital in eastern China were enrolled as subjects, and 196 healthy children were selected as controls. Part of the promoter and exons of the ABCB11 gene were sequenced directly. The single nucleotide polymorphism (SNP) site of V444A was tested using fluorescent quantitative polymerase chain reaction. Potential consequences of variants were predicted using bioinformatics software. The biochemistry indices were compared between the patients with or without possibly pathogenic variants/mutations. Results Twenty-eight variants, including 14 novel ones, were detected. Four novel, possibly pathogenic mutations (I416I, K436N, R928Q and IVS7+5G>A) were detected in six subjects. The γ-glutamyltransferase level of these six was lower than in the others (P = 0.054). The genotype distribution of the four common SNP sites, V444A, A535A, A865V and A1082A, was not significantly different between TNC patients and controls. Conclusions Approximately 3% of TNC cases can be attributed to ABCB11 mutations.

Based on ESPI experimental principle and finite element theory, this research obtains the law that the shrink of light-cured composite resin leads to deformation. The out-of-plane displacement of light-cured composite is measured by ESPI experimental system, and then the model corresponding to the test that is built in ANSYS and numerical simulation are building, so that solidified deformation and stress of light-cured composite is studied. These results are compared with each other and the differences between the results are small. It is found that ESPI is a feasible testing method which is suitable to deformation measurement of structure surface. Influence factors of drawdown deformation of composite resin are obtained by ESPI experiment and numerical calculation, some basis is provided for clinical treatment, and direction that improve the performance of light-cured composite resin are provided for manufacturer of this resin.

This paper is referred to other literature on properties of metal fatigue testing methods and data analysis procedure methods. According to high cycle fatigue testing, double-wall-brazed-tube is loaded with different stimulated vibration force by shaking table and is forced to vibrate. In the experience, strain of key parts is measured with Electrical resistance Strain measurement Methods. By curve fitting of experimental data, we gain the fitting function of the specimen’s fatigue life and draw its S-N curve. In accordance with the analysis of experimental data and S-N curves, it is concluded that fatigue properties of metallic materials can not fully reflect fatigue properties of a specimen and that the cross-sectional size of a specimen has much effects on its fatigue life.

Dynamic photoelasticity has been widely utilized to investigate the phenomena generated by impact loading. The dynamic parameters of structures, such as propagation of stress wave and stress concentration, are obtained through this method, which provide guidelines for structure design and optimization. In the previous studies, two-dimensional models are wildly used by researchers. In these models, the inaccuracy of the boundary conditions leads to error amplification during the conversion of the tested results into real ones. In this study of dynamic photoelasticity, three-dimensional models are used. An improved digital dynamic photoelastic system is also adopted to calculate elastic wave propagation in the medium, where the diode-pumped solid-state green laser and high-speed CCD are used as light source luminaries and recording system respectively. Based on these models, where the boundary conditions approach to true value, the resulting data are higher in resolution than is possible with other experimental techniques. This method has been adopted and tested successfully by generating better results with less amplification of errors.

Background Human bocavirus (HBoV) was first reported in 2005. The worldwide presence of HBoV in children with acute respiratory tract infection (ARTI) has been confirmed. This study aimed to understand the prevalence and clinical features of HBoV in children with ARTI in Shanghai and explore the causative implication of HBoV in ARTI. Methods We retrospectively reviewed the medical records of 349 hospitalized children with ARTI between November 2006 and January 2007. From these children, 351 nasopharyngeal aspirate samples were collected; 325 of the samples were obtained from those with community-acquired ARTI and 26 from those with hospital-acquired ARTI. All samples were routinely screened for seven common respiratory viruses by immunofluorescence and further tested for HBoV by polymerase chain reaction. Results HBoV was detected in 16 (4.6%) of the 351 samples, and it was the second most commonly detected virus after respiratory syncytial virus. Three (19%) HBoV-positive samples were dual infection with respiratory syncytial virus or parainfluenza virus type 3. Of the 325 children with community-acquired ARTI, HBoV was identified to be positive in 11 (3.4%), of whom 6 were diagnosed with pneumonia with patchy or interstitial infiltrates in the lung indicated by chest radiography, 3 with bronchitis, and 2 with bronchial asthma exacerbation with attendant lung infection. Out of the 26 children with nosocomial ARTI, 5 (19.2%) had bronchitis which was found to be HBoV positive without co-detection of other viruses. The HBoV-positive children were aged 1.7 months to 43 months and their mean age was 13.7 months. Sixteen (100%) children had cough, 11 (68.8%) had wheezing, and 10 (62.5%) had fever. Conclusions HBoV was circulating in Shanghai during the study period, and which was detected frequently in children with ARTI. HBoV was found to be associated with community-acquired ARTI and may play a pathogenic role in nosocomial ARTI.

Although 24-hour urinary copper excretion is valuable for diagnosis of Wilson's disease, accurate, timed collection entails practical difficulties. This study aimed to investigate the feasibility of morning urinary copper/creatinine or copper/zinc ratio as replacement parameter for diagnosing Wilson's disease.Five random urinary samples collected during 24 hours from two inpatients were used to estimate the consistency of urinary copper/creatinine and copper/zinc ratios. The correlation of the ratios with 24-hour urinary copper excretion was studied in 15 patients with liver diseases. The diagnostic value of morning urinary copper/zinc ratio was further studied in 9 children with Wilson's disease and 22 children with other liver diseases.The coefficients of variation of urinary copper/creatinine and copper/zinc ratios during 24 hours were 12.5% and 9.3% respectively. The morning urinary copper/creatinine ratio, copper/zinc ratio, and 24-hour urinary copper excretion were correlated well. The area under receiver-operating characteristic curve was comparable between the morning urinary copper/zinc ratio and 24-hour urinary copper excretion (0.983 vs. 0.977).Morning urinary copper/zinc ratio seems to be a promising parameter in replacement of 24-hour urinary copper excretion for diagnosis of Wilson's disease.

Background: Progressive familial intrahepatic cholestasis type 2 (PFIC2) is a severe autosomal recessive liver disorder of childhood that can cause cholestasis and progress to end-stage liver disease. ABCB11 gene mutations causing PFIC2 have been reported in some population groups, but not in mainland Chinese. Aims: To elucidate the existence of and characterize ABCB11 gene mutations in mainland Chinese with progressive intrahepatic cholestasis and low γ glutamyltransferase (GGT). Methods: Twenty-four children presenting with progressive intrahepatic cholestasis and low GGT were admitted to a tertiary paediatric hospital in eastern China from January 2004 to July 2007. All encoding exons and flanking areas of the ABCB11 gene were sequenced. Hepatic histopathology results were obtained by review of the medical record. Results: Twelve novel mutations of ABCB11 gene were found in seven patients: three nonsense mutations, six missense mutations, two splicing mutations and one intronic mutation. Giant cell transformation of hepatocytes was demonstrated in all the four patients with ABCB11 mutations and four of 12 patients without mutations in coding sequences of ABCB11 gene who received liver needle biopsy. Conclusions: ABCB11 gene mutations play an important role in Chinese patients with progressive intrahepatic cholestasis and low GGT. The characteristics of ABCB11 gene mutations in Chinese are different from other population groups. Histological examination may be helpful in diagnosis of PFIC2.

Alagille syndrome (AS) is regarded as the most common cause of chronic cholestasis in childhood associated with specific phenotypic features in western countries. This study was undertaken to investigate the significance of AS in Chinese children with chronic cholestasis and to describe its clinical and histological features.From October 2004 to January 2007, 157 children who presented with conjugated jaundice from less than 3 months of age were admitted to a tertiary hospital in Shanghai. Investigations of the heart, spine, eyes and kidneys were conducted in 13 children who experienced prolonged cholestasis beyond 1 year of age after exclusion of biliary atresia and familial progressive intrahepatic cholestasis type 1 or 2. In patients with interlobular bile duct paucity, AS was diagnosed if 3 or more of the following 5 major features were present: cardiac murmur, posterior embryotoxon, butterfly-like vertebrae, renal abnormalities and characteristic faces. In patients without interlobular bile duct paucity or who did not receive liver biopsy, 4 or more features were required for the diagnosis.Of the 13 children, 6 were diagnosed with AS at ages ranging from 1 year and 7 months to 3 years and 11 months. Jaundice was noticed in early infancy and then pruritus developed in all the 6 patients, of whom 5 presented with acholic stool and 4 had been misdiagnosed as having presumed biliary atresia by hepatobiliary scintigraphy or laparoscopic cholangiography. Biochemical examinations demonstrated increased concentration of total bile acid and hyperlipidemia. Interlobular bile duct paucity was demonstrated histologically in 5 patients who received liver biopsy. Vertebral abnormalities, heart murmur, characteristic faces and failure to thrive were found in all the 6 patients. Two patients had evidence of renal involvement. Micropenis, empty scrotum, and gall stone were seen in 1 patient.AS is also an important cause of prolonged cholestasis in Chinese children. It is difficult to differentiate AS from biliary atresia. Liver biopsy and spine X-ray may be helpful in the early detection of AS.

The fiber optic sensor measuring system based on the Mech-Zehnder interferometry is developed in the paper. The system can be used for the strain and vibration measurement of engineering structure, and has the advantages: convenient adjusting, stable performance and strong ability of anti-interference, etc. Therefore the fiber optic sensor has been widely used in the engineering field. First the system is introduced into measuring the frequency and amplitude of the vibration subjected to force of the FRP-concrete beam. The fiber optic sensor measuring system and the electronic measuring system are synchronous used for the measurement. The analysis results of fiber optic sensor measurement approximate to the results of electronic strain gauge. Then the system is introduced into experimental stress analysis on the gas pipe, good results is obtained too. The paper provides new technical equipment for the experimental testing of various engineering structure using fiber optic sensor, also establishes the technical foundation of the research of smart structure.

To investigate the plasma amino acid spectrum in infants more than 1-year-old with neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) in order to identify potential diagnostic markers of NICCD.Infants less than 1 year of age who had been referred to our hospital for investigation of suspected conjugated hyperbilirubinemia between June 2003 and June 2009 were eligible for enrollment. A total of 182 infants were enrolled and divided into three groups: infants diagnosed with NICCD (n = 24), according to gene testing and/or western blotting results; infants diagnosed with biliary atresia (BA; n = 20), according to intra-operative cholangiography findings; and infants diagnosed with idiopathic neonatal intrahepatic hepatitis (INH; n = 138), according to exclusionary findings for diseases affecting the extrahepatic biliary system and no positive serology results to indicate infections with hepatitis B, C, A or E, toxoplasmosis, rubella, herpes simplex, human immunodeficiency virus-1, or syphilis. The plasma amino acid spectrum of each infant was analyzed by tandem mass spectrometry (MS/MS). The concentrations of 18 amino acids, as well as the ratio of each amino acid to total amino acids, were compared among the three groups. Selected ratios of amino acids were analyzed by receiver operating characteristic (ROC) curve analysis.Compared with the BA and INH groups, the NICCD group had significantly lower levels of alanine (Ala; 175.7 and 205.7 vs. 136.3 mumol/L, P = 0.0001), aspartic acid (Asp; 47.5 and 43.1 vs. 31.55 mumol/L, P = 0.0041), glutamic acid (Glu; 276.16 and 263.24 vs. 175.71 mumol/L, P = 0.0075) and tryptophan (Trp; 41.90 and 47.97 vs. 28.51 mumol/L, P = 0.0003), but significantly higher levels of methionine (Met; 28.24 and 29.35 vs. 71.40 mumol/L, P = 0.0390), tyrosine (Tyr; 55.8 and 57.02 vs. 116.81 mumol/L, P = 0.0072) and citrulline (Cit; 15.09 and 15.65 vs. 97.42 mumol/L, P = 0.0001). The ratio of each amino acid to total amino acids showed the same trends for the NICCD group. The calculated areas under the ROC curves of the ratios of Cit, Tyr, and Met to the total amino acids were 0.874 (95% CI: 0.752 - 0.996), 0.814 (95% CI: 0.706 - 0.923), and 0.705 (95% CI: 0.535 - 0.875) respectively. The calculated area under the ROC curve of the ratio of Cit to Ala was 0.893 (95% CI: 0.781 - 1.005), and when the cut-off value of the ratio of Cit to Ala was 0.14 for diagnosis of NICCD, the sensitivity and specificity were 75% and 95% respectively.The plasma amino acid spectrum may represent a diagnostic indicator for NICCD, particularly the ratio of Cit to Ala.

To understand the clinical and epidemiological aspects of avian influenza A (H7N9) virus infection in children.The clinical data of the first confirmed pediatric case of avian influenza A(H7N9) virus infection were collected, and the epidemiological information, presenting symptoms, laboratory investigation, management and outcome were analyzed. The data of the pediatric cases were also compared with those of the adults cases.The case reported in this paper was a previously healthy 3.6-year-old boy residing in rural area of Shanghai. He had onset of fever and mild rhinorrhea on 31 March 2013 and he was afebrile and well since April 3. Influenza A (H7N9) virus was detected in his nasopharyngeal sample collected on 1 April through national Influenza-like Illness surveillance using real-time reverse transcriptase PCR and virus culture.His family raised domestic poultry with no apparent disease and there was no virological evidence of H7N9 infection. Monitoring and testing of 16 contacts had not found any secondary infection.The clinical course of H7N9 avian influenza virus infection in children was relatively mild as compared to adult cases. The source of infection and detail of exposure for children have not been known yet. Continued surveillance studies of mild and severe respiratory disease and subclinical infection are essential to further characterize the epidemiology and clinical spectrum of this emerging H7N9 virus infection in children.

To study clinical features and gene mutations in Shwachman-Diamond syndrome (SDS), a rare autosomal recessive disease, in children.Clinical manifestations, laboratory examinations, image studies, and genetic testing of two cases with SDS were presented, analyzed, and discussed; 311 SDS cases from the related literature since 2004 were reviewed.(1) The two cases both presented with characteristic exocrine pancreatic insufficiency evidenced by abnormal pancreas on imaging and growth retardation, persistent or intermittent neutropenia (1500×10(6)/L) and/or anemia, and skeletal abnormalities. Analysis of the SBDS gene revealed the same compound heterozygous genotype (c.183_184TACT, c.258+2TC) for both subjects. This genotype is the result of the inheritance of abnormal alleles from both healthy parents. (2) Among 311 cases, 75 cases having complete clinical data were characterized by exocrine pancreatic dysfunction (61/75; 81.3%), hematologic abnormalities with single- or multi-lineage cytopenia (64/75; 85.3%), and bone abnormalities (47/75; 62.7%). c.183_184TACT, c.258+2TC, and c. [ 183_184TACT; 258+2TC] are the major types of SBDS gene mutation(85/138;61.6%).SDS is characterized by exocrine pancreatic dysfunction with malabsorption, malnutrition, and growth failure; hematologic abnormalities with single- or multi-lineage cytopenia, and bone abnormalities. The diagnosis of SDS relies on a combination of clinical features and gene-based tests. The SDS patients need long term follow-up and management.

To investigate the epidemiological features, genetic drift in the epitopes of hemagglutinin (HA) of the novel influenza A (H1N1) virus and oseltamivir-resistant variants characterized by H275Y and N295S mutations in children in Shanghai since the outbreak.Between June 2009 and May 2012, a prospective surveillance study was carried out in Shanghainese children who attended the outpatient clinic of Children's Hospital of Fudan University for influenza-like illness. One-step real-time fluorescence quantitative RT-PCR was performed to detect seasonal influenza A and influenza B virus and the novel influenza A (H1N1) virus in the respiratory samples. Genetic drift from the vaccine strain in HA epitopes of the novel influenza H1N1 virus and the molecular markers associated with oseltamivir resistance in neuraminidase (NA) were analyzed.Out of 3475 enrolled cases, the novel influenza A (H1N1) virus was confirmed virologically in 222 (6.4%) otherwise healthy children with 133 (59.9%) being boys and 89 (40.1%) girls. The median ages of children with the novel influenza A (H1N1) virus infection during the first wave from August 2009 to February 2010 and the second wave from December 2010 to February 2011 were 53.5 months and 32.0 months, respectively (Z = -4.601, P = 0.000); 119 (46.9%) had the close contact with persons suffering from fever or respiratory infection, of whom, 68 (57.1%) contacts were family members and 47 (39.5%) contacts were classmates. During the outbreak in 2009-2010 season, 66 (40.9%) were exposed to primary index cases, school students were the major exposure subjects, accounting for 50.0%. The nucleotide sequences of HA1 gene were highly homologous between the vaccine strain A/California/07/2009 and Shanghai circulating novel influenza A (H1N1) strains and only S83P mutation in epitope E of HA was detected inclusively in the circulating strains. The H275Y and N295S amino acid mutations associated with oseltamivir resistance were not found in the circulating novel influenza (H1N1) strains.Two major waves of the novel influenza A (H1N1) outbreaks occurred in Shanghainese children during 2009-2011. Institutional children were the major affected individuals during the 2009 pandemic wave. Households and schools were the main sites of transmission among children during influenza pandemic. Influenza vaccination should be enhanced in children and their close family contacts. The novel influenza A (H1N1) virus in Shanghai has not undergone significant genetic changes. Oseltamivir is effective for the treatment of the novel influenza A (H1N1) virus.

The significance of ABCB11 variants have been studied in some cholestatic diseases, but this is not clear in transient neonatal cholestasis (TNC). The aim of the present study was to explore the association between ABCB11 variants and TNC.This was a case-control study. A total of 192 children with TNC referred to a tertiary referral hospital in eastern China were enrolled as subjects, and 196 healthy children were selected as controls. Part of the promoter and exons of the ABCB11 gene were sequenced directly. The single nucleotide polymorphism (SNP) site of V444A was tested using fluorescent quantitative polymerase chain reaction. Potential consequences of variants were predicted using bioinformatics software. The biochemistry indices were compared between the patients with or without possibly pathogenic variants/mutations.Twenty-eight variants, including 14 novel ones, were detected. Four novel, possibly pathogenic mutations (I416I, K436N, R928Q and IVS7+5GA) were detected in six subjects. The γ-glutamyltransferase level of these six was lower than in the others (P = 0.054). The genotype distribution of the four common SNP sites, V444A, A535A, A865V and A1082A, was not significantly different between TNC patients and controls.Approximately 3% of TNC cases can be attributed to ABCB11 mutations.

SUMMARYWe retrospectively analysed the epidemiological data of all hand, foot, and mouth disease (HFMD) cases from the largest paediatric infectious diseases centre in Shanghai between 2007 and 2010. A total of 28 058 outpatients were diagnosed with HFMD, of which 3948 (14·07%) were hospitalized, 730 (2·60%) had complications with neurological disorders and pulmonary oedema/haemorrhage, and 11 (0·04%) died. The peak season was the summer months. Boys were more affected than girls. Since 2008, the major population group affected has shifted from native Shanghainese children attending preschool to migrant children and younger children cared for at home. Children aged 1–4 years constituted 82·27% of cases. EV-A71 was tested in clinical samples taken from severe cases in 2009 and 2010, and from most inpatients in 2010. EV-A71 was positive in 99·17% and 86·31% of severe cases, respectively in 2009 and 2010. All 12 cases with pulmonary oedema or haemorrhage were infected with EV-A71. Ten (90·90%) of 11 fatal cases were attributable to EV-A71 infection. In 2010, EV-A71-positive cases accounted for 54·12% of inpatients. The dominant circulation of EV-A71 led to the outbreak of HFMD and occurrence of severe and fatal cases.

A prospective investigation was carried out among pediatric outpatients and inpatients with acute non-dysenteric diarrhea between August, 2008 and July, 2009 in Shanghai, Hangzhou, Chongqing, and Tianjin, China. One step real-time RT-PCR was used for detection of norovirus (NoV) genogroups I and II (GI, GII). The NoV genotypes were classified based on partial capsid sequences. Rotavirus (RV) was detected in parallel. Among 4,123 fecal samples from outpatients, 1,067 (25.9%) were NoV-positive, of which 1,051 (98.5%) belonged to GII and 1,309 (31.7%) were RV-positive. In the inpatient group (n = 317), 25.6% were NoV-positive and 41.6% were RV-positive. Four hundred and fifty-one out of 1,067 NoV-positive strains were sequenced and genotyped and 6 typed strains were GI (3 GI.3, 2 GI.5, 1 GI.4) and 445 typed strains were GII. GII strains clustered into nine genotypes including GII.4 2006b (69.2%), the only GII.4 variant identified in this study, followed by GII.3 (23.8%), GII.6 (3.6%), GII.12 (1.3%), GII.2 (0.9%), GII.13 (0.4%), GII.14 (0.2%), GII.7 (0.2%), and GII.16 (0.2%). A peak of NoV infections was observed during the cold season in Tianjin, while NoV activity was higher between late summer and autumn and lower during winter in Shanghai, Hangzhou, and Chongqing. NoV is a common causative agent of childhood diarrhea in China and the seasons of NoV-associated diarrhea varies between regions. The results show that NoV GII.4 2006b was the predominant strain circulating in China between 2008 and 2009. J. Med. Virol. 84:145–151, 2011. © 2011 Wiley Periodicals, Inc.

Background: This multicenter study was undertaken to investigate the serologic evidence of antibodies to Bordetella pertussis toxin (IgG-PT) in children and adolescents. Methods: IgG-PT value in a single serum collected from 1616 children and adolescents was measured by enzyme-linked immunosorbent assay in the Food and Drug Administration (FDA)-units per milliliter from November 2008 to October 2009. The relationship between time since infection and IgG anti-PT levels were analyzed and the estimated age-specific incidences of infection were calculated. Results: The sera IgG-PT geometric mean concentrations of the samples were 1.7 FDA-U/mL. The sera protective rates of all the subjects were 6.6% (95% confidential interval [CI]: 5.4%, 7.8%). The rates in the group aged 2 years was 9.2% (95% CI: 3.5%, 14.9%), which was significantly higher than in those aged ≥3 years (χ 2 = 1615, P = 0.000). In the group aged ≥3 years, 4.0% (95% CI: 3.0%, 5.0%) of the individuals tested showed an IgG-PT level ≥40 FDA-U/mL, which was equivalent to an estimated incidence of B. pertussis infection of 7000 (95% CI: 5300, 8800) per 100,000 population per year in the year before serum sampling. There were 2 peaks of estimated incidence. One peak incidence of 9100 (95% CI: 4300, 14000) per 100,000 population per year was found in the population aged >6 to 8 years. Another peak was in the population of 12- to 20-year olds with the estimated incidence of 14,600 (95% CI: 9100, 20100) per 100,000 per year. Conclusions: The levels of protective antibodies against pertussis were very low in the immunized children aged 2 to 20 years. A booster dose of immunization for older children or adolescents should be an urgent priority. Moreover, using enzyme-linked immunosorbent assay to determine the efficiency of vaccines and even to obtain the serodiagnosis would be beneficial in controlling pertussis.

Pertussis is an acute respiratory tract infection caused by Bordetella pertussis. This disease, though preventable by vaccination, the resurgence or persistence was reported frequently in developed countries. The current clinical epidemiology of pertussis in China is scarcely known. In this multicenter clinical study, we investigated the prevalence of pertussis in children and adolescents with persistent cough in Shanghai, Chongqing, Kunming and Yinchuan.The nasopharyngeal swabs and serum (single) were collected from subjects aged ≥ 6 years with cough for more than 2 weeks during November 2008 to October 2009. The culture and multiplex PCR assays were used to identify the B. pertussis, and ELISA assay (Viron/serio, Germany) was used to test the antibody to pertussis toxin (PTIgG). The laboratory confirmed B. pertussis were culture positive and or PCR positive, and or PTIgG80 FDA-U/ml (single serum).Totally 1001 subjects were enrolled; 93.5% of subjects were immunized with diphtheria-pertussis-tetanus vaccine (DPT). The subjects were divided into group 1 aged from 6 to 8 years, group 2 (age -10 years), group 3 (age -12 years) and group 4 (age -18 years). The numbers of subjects of the four groups were 307, 249, 212, and 233; 113 subjects were B. pertussis positive (11.3%), 888 subjects were B. pertussis negative. The infection rates of the four groups were 7.2% (22, 307), 11.2% (28, 249), 10.4% (22, 212) and 17.6% (41, 233) respectively (χ(2) = 2915.2, P0.01). The total infection rate in Shanghai was 16.7% (65, 402), which was higher than that in the other regions (χ(2) = 3003.0, P0.01).Although the immunization rates of DPT is high, B. pertussis infection is still an important etiological factor associated with persistent cough in children and adolescent. Doctors and the laboratory staff should pay attention to diagnosis of pertussis.

To survey the clinical epidemiological features of norovirus and rotavirus diarrhea among children living in 5 cities.A prospective epidemiological investigation was conducted among outpatient children with acute diarrhea between August 2008 and July 2009 in Shanghai, Hangzhou, Guangzhou, Chongqing and Tianjin. The stool samples were randomly collected from children with non-dysentery diarrhea. Group A rotavirus antigen was tested by the kit that applies colloidal gold method in all specimens. GI and GII genogroups of norovirus were detected by one-step real-time reverse-transcription polymerase chain reaction (RT-PCR). The detection rates, seasonality and susceptible age of both viruses-associated diarrhea were analyzed.During the one-year period, 5091 fecal samples were obtained, of which 1563 (30.7%) were rotavirus-positive. The detection rates of rotavirus were 29.5% (268/916) in Shanghai, 36.1% (334/926) in Hangzhou, 26.3% (254/968) in Guangzhou, 34.1% (359/1054) in Chongqing and 28.2% (348/1233) in Tianjin, respectively. Among the remaining 3528 rotavirus-negative samples, 1049 (29.7%) were identified to be norovirus-positive. The detection rates of norovirus were 21.2%(136/642) in Shanghai, 31.3% (185/592) in Hangzhou, 24.2% (173/714) in Guangzhou, 31.8% (221/695) in Chongqing and 37.7% (334/885) in Tianjin, respectively. It is estimated that the infection rate of norovirus among outpatients with acute diarrhea is at least more than 20.6% (1049/5092). Of 1049 norovirus strains, 1036 (98.7%) were GII genogroup and 16 (1.5%) were GI genogroup, 3 were mixed with GI and GII genogroups. The 1049 children with norovirus diarrhea aged between 1 month and 14 years with the median age of 10 months (mean: 13.9 ± 16.9 months) and 91.8% were 2 years old or younger. The 1563 children with rotavirus diarrhea aged between 1 month and 11.3 years with the median age of 10 months (mean: 12.9 ± 13.7 months) and 92.5% were 2 years old or younger. The median ages between norovirus-infected children and rotavirus-infected children were significantly different (P0.05). The peak seasons of rotavirus diarrhea spanned autumn and winter (from October to February). The peak seasons of norovirus diarrhea presented in the winter and spring (from November to April) in Tianjin. Norovirus became active in April and usually predominantly prevalent in the summer and autumn (from July to October) in Shanghai, Hangzhou and Chongqing. However, norovirus was sporadically prevalent in the spring and detected more commonly in the other seasons in Guangzhou.Both rotavirus and norovirus are the major causative agents for childhood diarrhea. The seasonality of rotavirus diarrhea was similar among the 5 cities. Nevertheless, the seasonality of norovirus diarrhea was diverse in the different areas. In Tianjin located in the north of China, norovirus was quite prevalent in the cold season. In the east (Shanghai and Hangzhou) and south-west (Chongqing), norovirus prevailed dominantly in the summer and autumn. In the south (Guangzhou), the activity of norovirus was more obvious in the summer, autumn and winter.

To explore the causative role of human bocavirus (HBOV) played in acute respiratory infection and diarrhea in children, a case-control study was prospectively conducted to investigate HBOV detection in symptomatic children with acute respiratory tract infection, diarrhea and asymptomatic children.Between Oct. and Dec. of 2008, 436 nasopharyngeal aspirates (NPA) from hospitalized children with acute respiratory infection and 150 NPA from asymptomatic children undergoing cardiac operations were consecutively collected. During the same time, 220 stool samples were taken from outpatients with acute watery diarrhea and 200 control specimens were obtained from children without diarrhea. HBOV was screened in all samples by real-time PCR method. HBOV-positive respiratory samples were tested for other 9 common respiratory viruses and Mycoplasma pneumoniae. HBOV-positive fecal samples were also tested for common enteric viruses causing diarrhea.HBOV was detected in NPA samples from 45 (10.3%) of 436 symptomatic patients and from 1(0.7%) of 150 asymptomatic control children. There was a statistically significant difference in the detection rates of HBOV between the symptomatic group and the asymptomatic group (P0.001). HBOV co-existence with other respiratory pathogens occurred in 44.7% (20/45) of NPA from symptomatic patients. HBOV was detected in 10.3% (43/417) children with community-acquired respiratory infection and 10.5% (2/19) children with nosocomial respiratory infection. Children with HBOV infection were 1.3 to 72 months of age (mean: 18.3 ± 13.6 months). HBOV was found positive in 6 (2.7%) of 220 stool samples from diarrheal outpatients and in 4 (2%) of 200 control samples. All children with HBOV positive detection in the stool samples were less than 4 years old. No statistical significance was found (P0.05) in HBOV between diarrhea patients and asymptomatic ones. In addition, 5 of 6 HBOV-positive fecal specimens from children with diarrhea were found co-infected with rotavirus.This study supports that HBOV is related to acute respiratory infection in children and HBOV infection usually occurs in infants and young children. However, further study is needed to clarify if HBOV plays a pathogenic role in diarrhea in children.

Start-stop torque is one of the key parameters of valve's capacity. In China, a torque spanner is used to measure the small-bore torque, but the accuracy is not very high. In the large-bore situation, the previous method can not be used to measure the torque, so the torque is determined by the design calculation result. Sometimes this result is far from the practical one, and the difference will impact the apolegamy of the actuating device of a valve. Some other methods, such as inductance type transducer valve torque sensor, strain gauge valve torque sensor, appeared. They both have the advantage of high accuracy, but their automatic level is low and their measuring equipments are complex. In this paper, a new style torque measuring device which is based on theory of mechanics of materials and measuring principle of strain gauge is designed. The maximal torque is 2000Nm. The measuring device is easy for installation, accurate on results, and is able to meet the actually online measuring demands.

To evaluate the epidemiological effect of Haemophilus influenzae type b conjugate vaccine (Hib).Prospective Cohort Study was conducted to detect carrier rate of Hi in unvaccinated and vaccinated children by bacteria culture and Nest-PCR. Carrier rate of Hi and the incidence of lower respiratory tract infection in two groups children were analysed.The carrier rate of Hib in two groups children was very lower. The positive rate of NTHi in unvaccinated children was higher than vaccinated children significantly, which was mainly happened in the Children of 2-3 years old. The incidence of lower respiratory tract infection in unvaccinated children was higher than vaccinated children obviously. The protective effect of Hib vaccine against bronchitis was over 90%. The incidence of bronchitis of Hi culture positive was higher than that of Hi culture negative significantly.Children's bronchitis is related to the Hi carrier rate. To inoculate Hib vaccine can reduce the carrier rate of Hi and the incidence of bronchitis.

In this paper, digital image correlation method (DICM) is employed to measure the shear behavior of the spot welding specimens and the ones using adhesive under quasi-static lap shear testing. The images of the specimens' surfaces are captured in real-time by CCD and corresponding computer system. DICM is subsequently used to obtained strain by correlating the images captured before and after deformation. Then, both force-displacement curves and stress-strain curves of the specimens including the cracking load are obtained. The results and analysis show that the mechanical properties of specimens using adhesive compared with the spot welding specimens have an obvious advantage. This paper provides some experimental basis for improving this new type of structural adhesive. In this experiment, the method of non-contact measurement was used to obtain the strain. It has greater significance.

Since late March 2009, a novel influenza H1N1 strain emerged in humans in Mexico and the United States. It has rapidly spread to many countries on different continents, prompting unprecedented activation of pandemic preparedness plans. The present study aimed to investigate the characteristics of children with the novel influenza A (H1N1) virus infection.Twelve cases with influenza A (H1N1) infection were diagnosed according to the criteria of the Center for Disease Control and Prevention (CDC) of China during 1 May to 15 July 2009 in the Pediatric Hospital of Fudan University were analyzed. Influenza A (H1N1) RNA was detected by RT-PCR in CDC Shanghai China.All the 12 children with the novel influenza A (H1N1) virus infection were imported cases, aged from 11 months to 14 years 7 months, 7 of whom were boys, 5 were girls. Five cases contacted closely with influenza A (H1N1) patients; 12 cases had fever and no vomiting or diarrhea; 7 had cough or runny nose or anorexia. One had shortness of breath. Of the 11 cases who could tell about symptoms correctly, 6 had sore throat, 3 had stomachache, and none had muscle pain. Two of the 12 cases had pneumonia, and the disease in 1 of them was fatal and needed intensive care. One case was isolated and treated at home. The 11 cases hospitalized were treated according to the guidance of influenza A (H1N1) diagnosis and treatment issued by the Ministry of Health of China. Ten hospitalized cases were treated with oseltamivir. All the cases recovered completely. The median length of hospital stay was 8.1 days (range, 6 to 16), and the time of negative test results of influenza A (H1N1) RNA from illness onset to collection of samples for viral testing was from 5 to 15 days.Symptoms among children with the novel influenza A (H1N1) virus infection were classic and the majority of the cases we treated had a mild clinical course if they were isolated and treated promptly. Antivirals appears to have not had any major adverse effects. More data from different regions and large samples are needed to illuminate the characteristics of children with novel influenza A (H1N1) virus infection.

To observe the expression of insulin receptor substrate-2 (IRS-2) mRNA and protein, and its tyrosine phosphorylation in hepatic tissue of chronic hepatitis B (CHB) patients, and to explore the role of IRS-2 on insulin resistance in CHB patients.Eighteen patients with CHB were included, and 6 individuals with normal liver function were enrolled as control. Based on the insulin resistance index determined by homeostasis model assessment (HOMA), CHB patients were further divided into CHB without insulin resistance group (2.69, n=10) and CHB with insulin resistance group (2.69, n=8). Hepatic tissues were harvested from all patients during operation or with liver biopsy. The mRNA expression of IRS-2 in liver tissue was assessed by reverse transcription-polymerase chain reaction (RT-PCR), and the protein expression of IRS-2 was detected by Western blotting. Immunoprecipitation and enhanced chemiluminescent technique were used to measure the tyrosine phosphorylation of IRS-2.In CHB without insulin resistance group, the mRNA expression (0.38+/-0.06), the protein expression (0.94+/-0.18) and the tyrosine phosphorylation (0.78+/-0.09) of IRS-2 in hepatic tissue were decreased, but without statistically significant difference (all P0.05), as compared to those in control group (0.45+/-0.11, 0.99+/-0.20, 1.00+/-0.23, respectively). In CHB with insulin resistance group, the mRNA expression (0.26+/-0.08), the protein expression (0.67+/-0.11) and the tyrosine phosphorylation (0.63+/-0.14) of IRS-2 in hepatic tissue were significantly decreased compared with those of the control group with statistically significant difference (P0.05 or P0.01).The decreased expression of mRNA and protein and the reduced tyrosine phosphorylation of IRS-2 in CHB patients with insulin resistance inducing impairment of the insulin signal pathway may be one of the mechanisms underlying insulin resistance.

The aim of the study was to elucidate the role and characteristics of ATP8B1 gene mutations in mainland Chinese children with progressive intrahepatic cholestasis and low gamma-glutamyltransferase (GGT).Twenty-four children who presented with progressive intrahepatic cholestasis and low GGT were admitted to a tertiary pediatric hospital in eastern China from January 2004 to July 2007. Five children with homozygous or compound heterozygous ABCB11 gene mutations were excluded from the study. All encoding exons and their flanking areas of ATP8B1 gene were sequenced in the remaining 19 patients, in whom only 1 or no mutation of ABCB11 was found. Clinical features and liver histology obtained by reviewing the medical records were compared among patients with different genotypes.Nine mutations of ATP8B1 gene were found in 9 patients. All of them were novel except for mutations I694N and R952X. A linked P209T and IVS6+5GT mutation was found in 4 of 9 patients, including 2 homozygotes and 2 heterozygotes. Giant cell transformation of hepatocytes was demonstrated in 1 of 6 patients with ATP8B1 mutations and 4 of 5 patients with ABCB11 mutations.ATP8B1 gene mutations play an important role in Chinese patients with progressive intrahepatic cholestasis and low GGT. The linked mutation P209T and IVS6+5GT is a hot mutation in the Chinese population. Histological examination may be helpful in differentiating familial intrahepatic cholestasis type 1 from bile salt export pump-related disease.

Progressive familial intrahepatic cholestasis type 2 (PFIC2) is a severe autosomal recessive liver disorder of childhood that can cause cholestasis and progress to end-stage liver disease. ABCB11 gene mutations causing PFIC2 have been reported in some population groups, but not in mainland Chinese.To elucidate the existence of and characterize ABCB11 gene mutations in mainland Chinese with progressive intrahepatic cholestasis and low gamma glutamyltransferase (GGT).Twenty-four children presenting with progressive intrahepatic cholestasis and low GGT were admitted to a tertiary paediatric hospital in eastern China from January 2004 to July 2007. All encoding exons and flanking areas of the ABCB11 gene were sequenced. Hepatic histopathology results were obtained by review of the medical record.Twelve novel mutations of ABCB11 gene were found in seven patients: three nonsense mutations, six missense mutations, two splicing mutations and one intronic mutation. Giant cell transformation of hepatocytes was demonstrated in all the four patients with ABCB11 mutations and four of 12 patients without mutations in coding sequences of ABCB11 gene who received liver needle biopsy.ABCB11 gene mutations play an important role in Chinese patients with progressive intrahepatic cholestasis and low GGT. The characteristics of ABCB11 gene mutations in Chinese are different from other population groups. Histological examination may be helpful in diagnosis of PFIC2.

To evaluate the efficacy and safety of hydrochloride valacyclovir in treatment of varicella in pediatric patients between April 2006 and March 2007.A randomized controlled multi-center clinical trial was conducted in 5 pediatric centers, i.e., Children's Hospital of Fudan University, Children's Hospital of Zhejiang University, Children's Hospital of Nanjing Medical University, Pediatric Department of Tongji Hospital of Tongji Medical College, Huazhong University of ScienceTechnology and Children's Hospital, Chongqing University of Medical Sciences. Patients who were clinically diagnosed as varicella without any complications and were beyond 3 years of age were enrolled into the study from the out-patient clinics. The subjects were divided into two groups randomly, one was treated with hydrochloride valacyclovir, the other with ribavirin. There were 128 cases in the group treated with hydrochloride valacyclovir and 132 cases in control group treated with ribavirin. The treatment duration of two groups was five days. The clinical efficacy and safety were evaluated after the first day and the fourth day of the treatment and within three days after the end of the treatment. The clinical efficacy was assessed by efficacy index.(1) The efficacy index on the fourth day of the therapy (0.80 +/- 0.24) in the valacyclovir group was significantly higher than that of ribavirin control group (0.59 +/- 0.37) (t = 5.42, P0.01). The efficacy index at the end of the treatment (0.86 +/- 0.14) in the hydrochloride valacyclovir group was also significantly higher than that (0.70 +/- 0.30) of the ribavirin control group (t = 5.43, P0.01). (2) In the valacyclovir and ribavirin groups, the effective rates on the fourth day of the therapy were 94.53% and 72.7% respectively (chi2) = 22.38, P0.01). The effective rates at the end of the therapy were 99.2% and 88.6%, respectively (chi(2) = 12.60, P0.01). The rates of cure of the two groups were 33.6% and 25.0% (chi2) = 2.32, P0.05). (3) No severe adverse drug reactions were observed in any of the two groups.The hydrochloride valacyclovir was safe, reliable and convenient in treatment of uncomplicated varicella in children.

Martensitic phase transformation is an important style of nondispersive solid state change. Shape memory effect of shape memory alloy (SMA) was just discovered in this transformation. Generating, growing and spreading of martensitic phase transformation belt are the major areas of SMA research. Interface of martensitic phase transformation of NiTi polycrystal SMA under the tensile stress is studied by using Moire interference technique in the paper. Also ANSYS software is used to simulate the process of martensitic phase transformation under the same condition. These two methods get the uniform result, thus providing some reference to the further application study of SMA.

To explore whether SLC25A13 gene mutation exists and what is its mutation spectrum in mainland Chinese infants with intrahepatic cholestasis and abnormal blood amino acids.Blood amino acids were analyzed by mass chromatographic analysis in infants referred to Fudan University Children's Hospital from June 2003 to June 2007 for investigations of intrahepatic cholestasis of unknown origin. SLC25A13 gene mutations were studied in 14 children whose serum levels of citrulline and/or methionine were at least two times above the upper normal range. In patients in whom only one mutation was detected, all other exons and their neighboring sequences were then analyzed.Eight patients with SLC25A13 gene mutations, including 2 with compound heterozygous mutation 851del4/1638ins23, one with homozygous mutation 851del4/851del4, one with compound heterozygous mutation 851del4/R184X, one with homozygous mutation IVS6+1G more than A/IVS6+1G more than A, and 3 with heterozygous mutation 851del4 were found.SLC25A13 gene mutations exist in Chinese infants with intrahepatic cholestasis and abnormal blood amino acids. Their mutation spectrum is different from that in Japan. 851del4 is the most common mutation in our study. IVS6+1G more than A is a mutation that has not been reported before.

To investigate class I integron of Shigella flexneri, its prevalence in children, and its relation to bacterial resistance to antimicrobial agents.Totally 51 strains of Shigella flexneri were isolated from fecal samples of children suffering from bacterial diarrhea seen between June 2004 and November 2004 at Children's Hospital of Fudan University. Polymerase chain reaction (PCR) was employed to amplify various integron markers, including intI1, gene cassette region and 3' conserved region of class I intrgron; susceptibility of Shigella flexneri strains to 7 antimicrobial agents was determined by K-B (Kriby-Bauer) method.Forty-six strains of Shigella flexneri had intI gene with a positive rate of 90.2% (46/51); 24 strains of Shigella flexneri were positive for qacEDelta1-sul1, the positive rate was 47.1% (24/51); proportion of the isolates positive for all the three regions of class I integron was 43.1% (22/51); 46 strains of intI positive Shigella flexneri were all positive for ant (3'')-I. Among 46 strains of intI positive isolates, proportions of the isolates positive and negative for qacEDelta1-sul1 were 47.8% (22/46) and 52.2% (24/46), respectively. In the class I integron positive Shigella flexneri, the resistance rates of ampicillin (chi(2) = 10.13, P0.01) and chloramphenicol (chi(2) = 19.97, P0.01) were significantly higher than those in the class I integron-negative group.Class I integron was detected in 90.2% of Shigella flexneri in children; carriage of class I integron is related to antimicrobial resistance of Shigella flexneri.

To study the relationship between hepatitis B immunoglobulin (HBIG) injection before delivery and hepatitis B virus (HBV) S gene mutation.18 neonates infected with HBV in uterus and their mothers were divided to a) HBIG group (8) in which their mothers received HBIG injection before delivery and b) control group (10) in which their mothers never received any treatment HBV DNA fragments were amplified by nest-PCR from sera of these neonates and their mothers. S gene region of these HBV DNA fragments were directly sequenced and data on mutations was analyzed.There was no significant difference on nucleotide and amino acid changes in the S gene between the HBIG group and the control group. The majority HBV strains of newborn (17/18) were identical to their mother's dominant strains before delivery, including four mutation HBV strains. Among 18 newborns with HBV intrauterine infection, 12 were infected by B type (adw2), and 6 by C type (adrq+).Mothers who were asymptomatic HBsAg carrier and received injections ofHBIG before delivery would not be influenced by HBV S gene mutation. HBV intrauterine transmission with or without gene mutation might occur in the third-trimester of pregnancy. Gene mutation of HBV was not the main factor in intrauterine transmission of HBV.

It was noticed that coxsackievirus A16 (CA16) and enterovirus 71 (EV71) were two major etiological agents of hand, foot and mouth disease (HFMD) in children. Recently there were several large outbreaks of HFMD in the Asia-Pacific region, and there was a propensity to cause severe complications or death in children under 5 years of age. The severe forms were associated with EV71 infection. Although epidemics of HFMD have been reported in the mainland of China, few reports about EV71 as the pathogen of HFMD epidemics are available. The present study was conducted to investigate the causal agent of an HFMD epidemic in children in Shanghai from April to June of 2002.Totally 102 specimens (including vesicle fluid, stool and throat swabs) were collected from 72 patients with HFMD. The specimens were inoculated into Vero and/or RD cells. At first all the isolates were respectively neutralized by the RIVM pools of enterovirus antiserum, the type-specific antisera to EV71 or to CA16. Secondly all untyped isolates were tested by RT-PCR assay with two specific primer pairs for VP1 genes of EV71 and CA16 respectively. The EV71 and CA16 were identified depending on the size of PCR products. Sequence analyses of VP1 genes of 9 virus strains were performed by the laboratory of China CDC.Viruses were isolated from 91 specimens from 67 patients. Serotyping by neutralization failed for all the isolates. But the RT-PCR results indicated that the viruses isolated from 78 specimens from 58 patients were identified as positive for CA16 and the isolates from 13 specimens from 9 patients were identified as positive for EV71, the ratio between CA16 and EV71 was 6.4:1. The results of sequence analyses were consistent with those of PCR assay. Two EV71 strains isolated in this study belonged to a new lineage (C4) within genogroup C. One patient with EV71-associated HFMD had a complication of encephalitis with convulsion, shock, coma and dyspnea.CA16 and EV71 were the primary causes of HFMD during the epidemic. It was the first report of EV71-associated severe encephalitis occurred in patients with HFMD in Shanghai.

To explore the possible relationship between cytokines (TNF-alpha, IFN-gamma, IL-4 and IL-10), which were expressed abnormal quantity in the peripheral blood to intrauterine HBV infectious children, gene single nucleotide polymorphism (SNP) and susceptibility to HBV intrauterine infection.A cross sectional study on molecular epidemiology was carried out. The subjects were selected from outpatients of the hepatitis B vaccine special clinics of our hospital. According to intrant criteria, children under high risk of HBV intrauterine infection were divided into immuno-failure group (group I) and immuno-effective group (group II) while children without high risk were included in the control group. Four gene SNP sites of TNF-alpha-238, IFN-gamma + 874, IL-4-590 and IL-10-1082 region were determined by real-time quantitative fluorescent PCR.Significant differences of TNF-alpha-238 A allele frequency were found between group I and group II (chi(2) = 6.797, P0.05) as well as between group I and control group (chi(2) = 9.513, P0.05). No evident difference of TNF-alpha-238 A was found between group II and control group (chi(2) = 0.047, P0.05). Significant differences of IFN-gamma + 874 A allele frequency were found between group I and group II (chi(2) = 7.238, P0.05), and between group I and the controls (chi(2) = 5.199, P0.05) but no significant difference was found between group II and control group (chi(2) = 0.602, P0.05). Significant differences of IL-4-590 C/T allele frequency were not found between group I and group II (chi(2) = 0.632, P0.05), group I and control group (chi(2) = 0.584, P0.05), or between group II and control group (chi(2) = 0.004, P0.05) respectively. Significant differences of IL-10-1082 G allele frequency were found between group II and group I (chi(2) = 10.359, P0.001), and between group II and the controls (chi(2) = 35.418, P0.001), but not found between group I and control group (chi(2) = 1.759, P0.05).This study suggested the possibility that TNF-alpha-238 A allele and IFN-gamma + 874 A allele were associated with HBV intrauterine infection. There was no evident relationship between IL-4-590 C/T allele SNP and susceptibility to HBV intrauterine infection, but the IL-10-1082 G allele seemed to be associated with preventive efficacy to HBV intrauterine infection.