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To observe the changes of glucocorticoid receptors(GR) in the nucleus raphes magnus (NRM)neurons of PTSD-like rats.
25 male Wistar rats were randomly divided into PTSD model 1d, 4d, 7d, 14d groups and a normal group with 5 rats in each group. Rats in model groups were treated with SPS procedure to reproduce PTSD model.The changes of expression of GR in NRM of rats were detected by immunohistochemistry and PCR in each group, and image analysis and statistical analysis were performed in each group.
GR was distributed in the nucleus of neurons. The expression of GR was sharply decreased on 1d, but gradually increased on 4d and 7d, then decreased on 14d. All of 4d, 7d, 14d are higher than the normal (P < 0.05).
The lasting dysfunction of GR in the nucleus raphes magnus (NRM) may play an important role in post-traumatic stress disorder rats.
To explore changes of Ca2+-CaM-CaMKIIα in basolateral amygdala of PTSD rats may reveal part of the pathogensis.
The SPS-method was used to set up the rat PTSD models. A total of 90 male Wistar rats were randomly divided into1d, 4d, 7d, 14d groups of SPS and normal control groups. The intracellular free calcium level in basolateral amygdala was examined by fluorescence spectrophotometer. CaM and CaMKIIα expression in basolateral amygdala were examined by immunohistochemistry, western blotting and reverse transcription-polymerase chain reaction (RT-PCR).
The intracellular free calcium level reached the peak 1 day after SPS stimulation, then gradually decreased to normal level. The expression of CaM 1day after SPS is also the most and then decreased to normal level. In contrast, CaMKIIα expression showed a significant down-regulation 1day after SPS throughout and then gradually increased to normal level. This findings suggest dysfunction of Ca2+-CaM-CaMKIIα in basolateral amygdala of PTSD rats.
Thus, the trauma-induced enhanced anxiety appear to be associated with, and possibly caused by, changes of Ca2+-CaM-CaMKIIα in basolateral amygdala.
Posttraumtic stress disorder (PTSD) is an anxiety disorder caused by traumatic experience, exhibiting three major clinical symptoms: re-experience, avoidance and numbing, and hyperarousal (APA,DSM-IV, 1994). It is thought to involve a dysregulation of medial prefrontal cortex (mPFC) activity in response to fear. The mPFC plays an important role in regulating the stress response (RJ. Ursano et al, Textbook of Disaster Psychiatry). Studies have reported that the calcium signal in the brain cell of PTSD rats is disordered (BING XIAO et al, 2009). Calreticulin, helping to deal with misfolded proteins during the endoplasmic reticulum stress (ERS) response as molecular chaperone, is a calcium binding protein.In this study,detection of the expression level of calreticulin in mPFC of rats with PTSD provides experimental evidence reveled part pathogenesis of PTSD and Single prolonged stress (SPS) method as an established animal model for PTSD was used. A total of 75 male Wistar rats were divided randomly into five groups: SPS1d,SPS4d,SPS7d,SPS14d, and the control group. The calreticulin expression in mPFC was examined using immunohistochemistry, western boltting and reverse transcription polymerase chain reaction (RT-PCR). Immunohistochemistry showed calreticulin widely distributed throughout the mPFC, mainly in the cytoplasm, appeared as buffy particle. Protein level of calreticulin of SPS group gradually increased and peaked at SPS 7d. The mRNA expression of calreticulin was upward trend and peaked at SPS4d. ERS induced by SPS stimulation made misfolded protein accumulation increase, which made calreticulin separate from calcium and increase to deal with misfolded protein. Then intracellular free calcium r increased, which exacerbated ERS and induced cell apoptosis. Expression change of calreticulin caused cell apoptosis, which may be closely related to changes of emotion,cognition of PTSD rats.
Post-traumatic stress disorder (PTSD) is a significant problem,The medial prefrontal cortex (mPFC) is known to be significantly involved in emotional adjustment.
To discuss the issue of post-traumatic stress disorder (PTSD) rat apoptosis-related genes Bcl-2, Bax and medial prefrontal cortex (mPFC) neuronal apoptosis, and to provide experimental evidence to reveal PTSD pathogenesis.
The single-prolonged stress(SPS) method was used to set up the rat PTSD models There were five groups after SPS 1 day 4 days 7 days 14 days groups and control group Serum corticosterone level was determined with chemiluminescence, mPFC neuronal apoptosis changes and detection of apoptotic index were detected with transmission electron microscopy, hoechst 33342 staining and in situ nick end labeling method (TUNEL) staining. Immunohistochemistry, immunofluorescence, RT-PCR and western blotting were used to detect the expressions of Bcl-2 and Bax in the medial prefrontal cortex neuronal.
PTSD rat mPFC neuron cell apoptosis, the number of apoptotic cells gradually increased with time and reached a peak at 7 days after SPS stimulates. Bcl-2 expression reached a peak at 4d and Bax expression reached a peak at 7d after SPS stimulates, Bcl-2/Bax ratio transient increased and then gradually decreased, reached a lowest point in seventh days after SPS stimulates.
The expression of apoptosis related genes Bcl-2 and Bax increase and their ratio imbalances are likely to be one of the reasons that lead to PTSD in rat mPFC neurons apoptosis, which may provide the pathophysiology basis for PTSD.
To detect molecular chaperone calreticulin(CRT) expression on the hippocampus in the rat model of post-traumatic stress disorder(PTSD), and discuss the regulation of CRT on Ca2+ in hippocampus of PTSD rats, further provide the experiment basis for pathogenesis of memory anomaly in PTSD rats.
The single-prolonged stress(SPS) is one of the animal models was used to set up the rat PTSD models. Male Wistar rats were randomly divided into 1, 4, 7 days groups after exposure to SPS and a normal control group. The expression of CRT was detected by using immunohistochemistry, Western blotting and RT-PCR. The intracellular free calcium was examined by fluorescence spectrophotometer.
The expression of CRT in the hippocampus obviously increased after SPS stimulation, and reached the peak at SPS 4d. The intracellular free calcium level in the hippocampus obviously increased, and reached the peak at SPS 1d, then gradually decreased.
PTSD caused endoplasmic reticulum stress(ERS), calcium overload, up-regulated expression of CRT, activation of unfolded protein response(UPR), which maybe result in cell apoptosis and maybe the pathogenesis basis on memory anomaly in PTSD rats.
The mechanism of PTSD is not fully understood until now. Previous studies showed PTSD induced endoplasmic reticulum stress (ERS). Grp 78 plays important role in ERS.
To explore changes of Grp78 and Ca2+-CaM-CaMKIIα in hippocampus of PTSD rats may reveal part of the pathogensis.
The models of PTSD were created by SPS, which is an established animal model for PTSD. Wistar rats were selected for this study and randomly divided into a normal control group and SPS groups of 1d, 4d and 7d. The expression of GRP78 was examined by immunofluorescence, western blotting and RT-PCR. The intracellular free calcium level was examined by fluorescence spectrophotometer. CaM and CaMKIIα were examined by RT-PCR. Apoptosis was examined by TUNEL and TEM.
The results showed the intracellular free calcium level reached the peak 1 day after SPS stimulation, then gradually decreased to normal level. The expression of CaM 1 day after SPS is the most and then decreased. CaMKIIα expression showed a significant down-regulation 1 day after SPS throughout and then gradually increased to normal level. Grp 78 reached the peak 4 day after SPS stimulation. TUNEL-positive cells significantly more than the normal control group and peaked at 7d after SPS stimuli, then gradually decreased to normal level. Furthermore, some cells had a characteristics change, including chromatin condensation, appearance of chromatin crescents, and nucleus fragmentation.
The results suggest that Grp 78 and changes of Ca2+-CaM-CaMKIIα in hippocampal might play an important role in the pathology of PTSD.
Schizophrenia is one of the most severe and chronic forms of mental illness. Quantum resonance spectrometer (QRS) test may be useful as a biological marker for the clinical diagnosis of psychiatric disorders of Schizophrenia.
To evaluate reliability and psychiatric clinical value of QRS via thought disorder detection.
We studied 1014 schizophrenic patients, 155 patients with bipolar disorders patient, and 100 normal controls. Thought disorder symptoms of same subjects obtained from QRS test and psychiatrists' diagnoses were compared. Also Thought disorder symptoms of renumbered 65 schizophrenia patient and 100 normal controls were discriminated using QRS test.
Kappa values of thought disorders detection and diagnosed were more than 65% in 6/9 symptoms of schizophrenia, and more than 74% in all 3 symptoms of bipolar disorder. Same consistency could also be seen in Pearson R value, and ROC AUC. In the discriminated analysis, sensitivity, specificity, positive predictive value and negative predictive of delusion, looseness of thought and paralogism thinking detected utilizing QRS are more than 70% same compared with psychiatrists diagnoses.
QRS in thought disorder detection seem to have a predictable value for outcome in schizophrenia and bipolar disorder, would become an objective identification and diagnosis instrument, and might promote psychiatric clinical diagnosis.
Schizophrenia and mood disorders are chronic forms of mental illness. Quantum resonance spectrometer (QRS) test may be useful as a biological marker for the clinical diagnosis of psychiatric disorders of mental illness.
To evaluate reliability and psychiatric clinical value of quantum resonance spectrometer (QRS) in affective disorders detection.
We studied 1014 schizophrenic patients and 248 patients with mood disorders (including 93 major depression patients). Affective disorder symptoms of same subjects obtained from QRS test and psychiatrists’ diagnoses were compared. Also 3 affective disorder symptoms of renumbered 93 major depressive patients were discriminated using QRS.
Kappa values of affective disorder detection and diagnosed were more than 0.69 in all 3 symptoms of schizophrenia, and more than 0.65 in 6/7 symptoms of mood disorder. Same consistency could also be seen in Pearson R value, and ROC AUC. In the discriminated analysis, sensitivity, specificity, positive predictive value and negative predictive of hypothymia, anxiety, and irritability detected utilizing QRS are more than 0.66 compared with psychiatrists’ diagnoses.
The study is limited by no collected psychiatric rating scale data.
QRS in affective disorder detection seem to have a predictable value for outcome in schizophrenia and mood disorder, would become an objective identification and diagnosis instrument, and might promote psychiatric clinical diagnosis.
Post-traumatic stress disorder (PTSD) is a stress-related mental disorder caused by traumatic experience. Some studies showed low hippocampal volumes in PTSD patients. Our previous research indicated apoptosis induced such atrophy in the hippocampus. Endoplasmic reticulum stress -induced apoptosis has been implicated in the development of disorder diseases.
Our study was to reveal whether apoptosis induced by single-prolonged stress (SPS) in the hippocampus involved in Endoplasmic reticulum-related pathway through observation expression of three important apoptosis-related indicators on ER pathway: Glucose-regulated protein (GRP) 78; calcium/calmodulin/CaM kinaseIIα and caspase-12.
Wistar rats were killed at 1, 4 and 7 days after exposure to SPS. The apoptotic cells in the hippocampus were assessed by TUNEL method and the free intra¬cellular Ca2+ concentration was measured. Immunohistochemistry, western blotting and RT-PCR were used to detection expression of GRP78, Ca2+/Calmodulin/ CaM kinase IIα and caspase-12.
Our results showed that apoptosis exactly occurred in hippocampus of SPS rats. Both GRP78 and Caspase-12 were significantly up-regulated during early PTSD. They reached peak in the 4 days and then returned to normal levels in 7 days after SPS. The free intra¬cellular Ca2+ concentration was significantly higher in 1 day after SPS and decreased in 7 days; However, CaM expression significantly increased, while CaMKIIα expression significantly decreased in the hippocampus 1 day after SPS.
SPS induced the change of GRP78, Ca2+ and caspase-12 in the hippocampus of PTSD rat, indicating that the endoplasmic reticulum pathway was involved in the process of SPS-induced apoptosis.
We describe an analytical method of SH-SY5Y cell membrane chromatography (SH-SY5Y/CMC) for recognition, separation and identification of active components from traditional Chinese medicines (TCMs). SH-SY5Y cells by means of culture with SH-SY5Y cell lines were used for preparation of the stationary phase in the CMC model. Retention components by the SH- SY5Y/CMC model were collected and active components then analyzed by SH-SY5Y/CMC under the optimized conditions. After investigating the suitability and reliability of the SH-SY5Y /CMC method using risperidone, sertraline and clozapine as standard compounds, this method was applied in screening active components from the extracts of TCMs such as Radix Gentianae, Radix Bupleuri, stir-baked semen ziziphi spinosae, rehmannia dride rhizome, uncaria rhynchophylla. Retention components from the extracts in the SH-SY5Y/CMC model were gentiopicrin and rosmarinci acid identified by the GC/MS method. In vitro pharmacological trials indicated that gentiopicrin and rosmarinci acid could concentration dependently protect the SH-SY5Y pre-treated by H2O2 (P < 0.05). The SH-SY5Y/CMC method is an effective screening system that can rapidly detect target components from a complex sample for antipsychotic candidate drug.
Post-traumatic stress disorder is an important manifestation of mental and behavioral disorders after the disaste Single-prolonged stress (SPS) is an received established animal model for post-traumatic stress disorder.
To investigate endoplasmic reticulum apoptosis pathway and unfolded protein reaction plays an important role in medial Prefrontal Cortex of PTSD rats by Single-prolonged stress (SPS).
Determined by the change of free intracellular Ca2+ the glucose-regulated Protein (GRP)94 and apoptosis-related cacaspase-12 expression.
A total of 60 healthy, male Wistar rats were selected for this study,randomly divided into a normal control group and SPS groups of 1d,4d,7d,14day and 28day. Behavioral of learning and memory capabilities of rats was observed by using Morris water maze. The expression of, GRP94 and cacaspase-12 was detected using immunohistochemical,Western Blotting and reverse transcription-polymerase chain reaction.
In this study compared with control groups the intracellular free calcium level in mPFC was increased 1 day after SPS exposure (P< 0.05) decreased 7 days after SPS. The expression cacaspase-12 peaked at SPS 7d and then gradually decreased. GRP94 express in normal control group and increased 1 day after SPS exposure peaked at SPS 7d and then gradually decreased, at SPS 28d still higher than normal control group.
In SPS-PTSD rats the learning and memory capabilities of the rats decline;mPFC free intracellular Ca2+ may relate to endoplasmic reticulum stress;Endoplasmic reticulum stress launch unfolded protein reaction Endoplasmic reticulum apoptotic process which may relate to the pathogenesis of medial prefrontal cortex abnormal function in PTSD.
Cytomegalovirus (CMV) enters latency after primary infection and can reactivate periodically with virus excreted in body fluids which can be called shedding. CMV shedding during the early stage of pregnancy is associated with adverse pregnancy outcome. The shedding pattern in healthy seropositive women who plan to have babies has not been well characterised. Vaginal swabs, urine and blood were collected from 1262 CMV IgG-positive women who intended to have babies and tested for CMV DNA by fluorogenic quantitative PCR method. Serum IgM was also detected. The association between sociodemographic characteristics and CMV shedding prevalence was analysed. Among 1262 seropositive women, 12.8% (161/1262) were detected CMV DNA positive in at least one body fluid. CMV DNA was more frequently detected in vaginal secretion (10.5%) than in urine (3.2%) and blood (0.6%) also with higher viral loads (P < 0.00). CMV shedding was more likely detected in IgM-positive women than IgM-negative women (29.5% (13/44) vs. 12.2% (148/1218); OR 3.03, 95% CI 1.55–5.93; P = 0.001). CMV shedding in vaginal secretion was highly correlated with shedding in urine, the immune state of IgM, the adverse pregnant history and younger age. CMV shedding was more commonly detected in vaginal secretion than in urine or blood with higher viral loads among healthy seropositive women of reproductive age. Further studies are needed to figure out whether the shedding is occasional or continuous and whether it is associated with adverse pregnancy outcomes.
To study the clinical effect of lens cleaning paper patching on traumatic eardrum perforations.
A total of 122 patients were divided into 2 groups, of which 56 patients were treated with lens cleaning paper patching and 66 acted as controls. The closure rate and healing time were compared between the two groups.
The healing rate of small perforations was 96.4 per cent (27 out of 28) in the patching group and 90 per cent (27 out of 30) in the control group. The difference was not statistically significant (p > 0.05). The healing rate of large perforations was 89.3 per cent (25 out of 28) and 80.6 per cent (29 out of 36) in the two groups, respectively. The difference was statistically significant (p < 0.05). The healing time of large perforations was shorter in the patching group than in the control group (p < 0.01).
Patching with lens cleaning paper under an endoscope can accelerate the closure of large traumatic eardrum perforations.
Accurate prediction of the flow around multi-element airfoil is a prerequisite for improving aerodynamic performance, but its complex flow features impose high demands on turbulence modeling. In this work, delayed detached-eddy-simulation (DDES) and zonal detached-eddy-simulation (ZDES) was applied to simulate the flow past a three-element airfoil. To investigate the effects of numerical dissipation of spatial schemes, the third-order MUSCL and the fifth-order interpolation based on modified Roe scheme were implemented. From the comparisons between the calculations and the available experimental result, third-order MUSCL-Roe can provide satisfactory mean velocity profiles, but the excessive dissipation suppresses the velocity fluctuations level and eliminates the small-scale structures; DDES cannot reproduce the separation near the trailing edge of the flap which lead to the discrepancy in mean pressure coefficients, while ZDES result has better tally with the experiment.
To investigate patterns of survival and estimate conditional survival rates among brain cancer patients in Canada. METHODS: Canadian Cancer Registry data were obtained for all patients with primary brain cancer diagnosed between 1992 and 2008 (n=38,095). Follow-up ended with patient death or December 31, 2008, whichever occurred first. Crude Kaplan-Meier estimates were calculated at one, two, and five years post-diagnosis and also used to estimate conditional survival (restricted to 2000-2008). Age group, sex, residence and microscopic confirmation were considered in estimating rates for major histology types using multivariate models. RESULTS: The overall five-year survival rate was 27%. Oligodendrogliomas had the highest 5-year survival rate (65%, 95% CI: 62.5-67.4%) and glioblastomas the lowest (4.0%, 95% CI: 3.7-4.3%). Compared to Ontario, the age- and sex-adjusted 5-year glioblastoma survival estimates were lower in British Columbia, Alberta and Manitoba-Saskatchewan, lower in all other regions for diffuse astrocytoma, and lower in Manitoba-Saskatchewan for anaplastic astrocytomas. Estimates were significantly higher for oligodendrogliomas in Alberta, and for anaplastic oligodendrogliomas in Alberta and Quebec (P<0.05). Longer term conditional survival rates (surviving an additional 2 years 1-4 years after diagnosis) varied by histologic group. CONCLUSION: There is a need to further explore the underlying reasons for the observed variation in survival rates by region in an effort to improve the prognosis of brain cancer in the Canadian patient population. Conditional survival information has value for clinicians as they plan the course of treatment and follow-up for individual patients.
Toxocariasis is a very prevalent zoonotic disease worldwide. Recently, investigators have focused more on Toxocara spp. seroprevalence in humans. Information regarding Toxocara seroprevalence in people from different ethnic backgrounds in China is limited. For this study, blood samples were collected from a total of 802 Han, 520 Korean, 303 Manchu, and 217 Mongol subjects from Jilin and Shandong provinces. The overall Toxocara seroprevalence was 16·07% (14·21% Han, 20·58% Korean, 11·22% Manchu, 18·89% Mongol). Living in suburban or rural areas, having dogs at home, exposure to soil, and consumption of raw/undercooked meat were risk factors for Toxocara infection. Exposure to soil was identified as the major risk factor for Toxocara seropositivity in all of the tested ethnicities. To the best of our knowledge, this is the first report concerning Toxocara infection in Manchus and Mongols in China. The present study provided baseline data for effective prevention strategies of toxocariasis in northeast China and recommends improvements in personal hygiene standards to achieve this goal.
At the end of 2013, China reported a countrywide outbreak of measles. From January to May 2014, we investigated the clinical and immunological features of the cases of the outbreak admitted to our hospital. In this study, all 112 inpatients with clinically diagnosed measles were recruited from the 302 Military Hospital of China. The virus was isolated from throat swabs from these patients, and cytokine profiles were examined. By detecting the measles virus of 30 of the 112 patients, we found that this measles outbreak was of the H1 genotype, which is the major strain in China. The rates of complications, specifically pneumonia and liver injury, differed significantly in patients aged <8 months, 8 months to 18 years, and >18 years: pneumonia was more common in children, while liver injury was more common in adults. Pneumonia was a significant independent risk factor affecting measles duration. Compared to healthy subjects, measles patients had fewer CD4+IL-17+, CD4+IFN-γ+, and CD8+IFN-γ+ cells in both the acute and recovery phases. In contrast, measles patients in the acute phase had more CD8+IL-22+ cells than those in recovery or healthy subjects. We recommend that future studies focus on the age-related distribution of pneumonia and liver injury as measles-related complications as well as the association between immunological markers and measles prognosis.
A cross-sectional study was conducted from June 2013 to August 2015 to determine the seroprevalence and possible risk factors for human Toxoplasma gondii infection in Korean, Manchu, Mongol and Han ethnic groups in eastern and northeastern China. A total of 1842 serum samples, including Han (n = 802), Korean (n = 520), Manchu (n = 303) and Mongol (n = 217) groups, were analysed using enzyme-linked immunoassays to detect IgG and IgM T. gondii antibodies. The overall T. gondii IgG and IgM seroprevalences were 13·79% and 1·25%, respectively. Of these groups, Mongol ethnicity had the highest T. gondii seroprevalence (20·74%, 45/217), followed by Korean ethnicity (16·54%, 86/520), Manchu ethnicity (13·86%, 42/303) and Han ethnicity (11·35%, 98/802). Multiple analysis showed that the consumption of raw vegetables and fruits, the consumption of raw/undercooked meat and the source of drinking water were significantly associated with T. gondii infection in the Han group. Likewise, having a cat at home was identified as being associated with T. gondii infection in the Korean, Manchu and Mongol groups. Moreover, the consumption of raw/undercooked meat was identified as another predictor of T. gondii seropositivity in the Mongol group. The results of this survey indicate that T. gondii infection is prevalent in Korean, Manchu, Mongol and Han ethnic groups in the study region. Therefore, it is essential to implement integrated strategies with efficient management measures to prevent and control T. gondii infection in this region of China. Moreover, this is the first report of T. gondii infection in Korean, Manchu, and Mongol ethnic groups in eastern and northeastern China.
While oral antidepressants reach efficacy after weeks, single-dose intravenous (i.v.) ketamine has rapid, yet time-limited antidepressant effects. We aimed to determine the efficacy and safety of single-dose i.v. ketamine augmentation of escitalopram in major depressive disorder (MDD).
Thirty outpatients with severe MDD (17-item Hamilton Rating Scale for Depression total score ⩾24) were randomized to 4 weeks double-blind treatment with escitalopram 10 mg/day+single-dose i.v. ketamine (0.5 mg/kg over 40 min) or escitalopram 10 mg/day + placebo (0.9% i.v. saline). Depressive symptoms were measured using the Montgomery–Asberg Depression Rating Scale (MADRS) and the Quick Inventory of Depressive Symptomatology – Self-Report (QIDS-SR). Suicidal ideation was evaluated with the QIDS-SR item 12. Adverse psychopathological effects were measured with the Brief Psychiatric Rating Scale (BPRS)-positive symptoms, Young Mania Rating Scale (YMRS) and Clinician Administered Dissociative States Scale (CADSS). Patients were assessed at baseline, 1, 2, 4, 24 and 72 h and 7, 14, 21 and 28 days. Time to response (⩾50% MADRS score reduction) was the primary outcome.
By 4 weeks, more escitalopram + ketamine-treated than escitalopram + placebo-treated patients responded (92.3% v. 57.1%, p = 0.04) and remitted (76.9% v. 14.3%, p = 0.001), with significantly shorter time to response [hazard ratio (HR) 0.04, 95% confidence interval (CI) 0.01–0.22, p < 0.001] and remission (HR 0.11, 95% CI 0.02–0.63, p = 0.01). Compared to escitalopram + placebo, escitalopram + ketamine was associated with significantly lower MADRS scores from 2 h to 2 weeks [(peak = 3 days–2 weeks; effect size (ES) = 1.08–1.18)], QIDS-SR scores from 2 h to 2 weeks (maximum ES = 1.27), and QIDS-SR suicidality from 2 to 72 h (maximum ES = 2.24). Only YMRS scores increased significantly with ketamine augmentation (1 and 2 h), without significant BPRS or CADSS elevation.
Single-dose i.v. ketamine augmentation of escitalopram was safe and effective in severe MDD, holding promise for speeding up early oral antidepressant efficacy.
Hand, foot and mouth disease (HFMD) is an acute contagious condition caused by a spectrum of human enteroviruses. HFMD reinfection is common in the absence of cross-protection from other virus subtypes. This study focused on reinfection in children in Anhui province, China between 2008 and 2013 using surveillance system data. We classified 8960 cases as reinfected, corresponding to a rate of 2·02%. The reinfection rate was higher in boys than in girls [odds ratio (OR) 1·27, 95% confidence interval (CI) 1·21–1·32, P < 0·001], children aged < 3 years (OR 3·82, 95% CI 3·58–4·07, P < 0·001), and children living in rural areas (OR 1·09, 95% CI 1·04–1·14, P = 0·001). The reinfection rate in children who were originally infected with non-enterovirus A71 (non-EVA71) enteroviruses was higher than those infected with EVA71 (OR 1·36, 95% CI 1·02–1·80, P = 0·034). Influential factors of reinfection rate included annual incidence (β coefficient = 0·715, P = 0·002) and the proportion of EVA71 in patients with mild HFMD (β coefficient = −0·509, P = 0·018). These results demonstrate that boys aged <3 years, especially those in rural areas or regions with a lower EVA71 proportion are more prone to reinfection, and specific health education programmes should be developed to protect these susceptible populations.