Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.

Objective To investigate the technical outline and clinical value of percutaneons transhepatic portal vein port-catheter system implantation in preventing small hepatocellular carcinoma recurrence after curative treatments. Methods Fifteen patients with small hepatocellular carcinoma after curative treatment were included in this study. Guided by ultrasound and fluoroscopy, left branch of the portal vein were punctured and port-catheter system were implanted. Then drugs infusion into portal vein system was done for preventing recurrence of hepatic carcinoma. Results Interventional operations were succeed in all 15 cases. Drugs could drop into portal vein smoothly. No operating complications occurred. Conclusion Percutaneous transhepatic portal vein port-catheter system implantation was an easy operating and micro traumatic method. This technique could play an important role in preventing recurrence.

Objective To investigate the value of emergency observation time of chest pain patients for ruling-out myocardial infarction by using high-sensitive troponin T. Method Total 1 687 patients with chest pain from December 2015 to August 2016 visiting Sichuan University Huaxi Hospital emergency department were en-rolled.We included 1082 patients who diagnose with AMI finally.We define the time from the start of the chest pain to visiting the emergency as the onset time.We analyzed the level of high-sensitive troponin T of AMI patients at dif-ferent onset time and calculated the rate of patients with hs-cTnT level lower than the conventional hs-cTnT thresh-old of 14 ng/L. Result Among 1082 cases of AMI patients,32 patients with hs-cTnT level below threshold(14 ng/L).The for whose The onset time over 5h was observed in AMI patients with hs-cTnT level over 14 ng/L.Con-clusion AMI can not be excluded in chest pain patients whose hs-cTnT levels below the conventional threshold value of 14 ng/L,and these people should be dynamically monitored for 5h in emergency department.The patients can exclude AMI if the hs-cTnT levels are below 14 ng/L after 5 hours.

Objective To develop an arm support used for bilateral puncture during trans-radial coronary intervention (TRI) and to explore its effects. Methods The arm support used for bilateral radial artery puncture was designed and developed. Totally 100 patients who received TRI in the Cardiac Catheterization Room of Peking Union Medical College Hospital between May and June 2017 were selected and equally divided into an observation group and a control group according to the random number table. Patients in the observation group were served with the new arm support to reveal the points for radial artery puncture, while patients in the control group used the conventional wooden arm support. The effect of puncture was compared between the patients in the two groups. Results The time used for preparation before radial artery puncture was (1.58±0.56) min and the time need for puncturing and placing sheathing canal in the radial artery was (3.51±0.44) min in the patients in the observation group, both shorter than those of the patients in the control group (t=9.511, 8.740; P<0.05). Totally 96% of the patients felt comfortable with the new arm support, and the operation experience satisfaction in 80% of the doctors was excellent, both higher than those of the patients in the control group. Conclusions The performance of this new arm support for bilateral radial artery puncture is stable and reliable. Compared with conventional methods, the time used for preparation before radial artery puncture is shortened for nurses, and the time needed for puncturing and placing sheathing canal in the radial artery is shortened for doctors. The patients feel more comfortable when using this new arm support, and the doctors have a higher experience satisfaction. The new arm support is convenient and flexible for use, and may be used and promoted in cardiac catheterization rooms.