Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To explore the effects of participatory interactive teaching in the clinical internship course of pediatric infectious diseases.Methods:217 undergraduate students of grade 2018 majoring in pediatrics were selected as the experimental group, and 208 undergraduate students of grade 2017 majoring in pediatrics were selected as the control group. The experimental group used the teaching method of BOPPPS combined with case-based learning and team-based learning, while the control group adopted the traditional teaching method. Evaluate the learning effectiveness by comparing the formative evaluation and theoretical exam scores of the two groups , and a questionnaire survey was conducted for the students in the experimental group to investigate teaching feedback. SPSS 19.0 was used to perform the t test for data analysis. Results:The experimental group had significantly better scores than the control group in final theoretical examination [(75.04±9.12) vs. (71.03±9.51), P<0.05] and formative evaluation [(81.03±6.13) vs. (70.02±10.32), P<0.05]. According to the results of the questionnaire survey on teaching satisfaction, the students were satisfied with the interactive participatory teaching method in the four aspects of improving learning interest, improving learning ability, classroom satisfaction level, and course acceptance level. Conclusions:The pragmatic teaching reform in the internship of pediatric infectious diseases is highly accepted by students and beneficial to improving students' clinical thinking ability and comprehensive quality, which is worth further application and promotion.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

30 patients with chronic periodontitis and Type 2 diabetes mellituse were included.By a split-mouth design,the teeth in the left side were served as the experiment group and given Nd∶YAG and Er∶YAG laser therapy adjunctive to conventional periodontal treatment;the teeth in the right side were served as the control group and given conventional periodontal treatment alone.Before and after treatment perio-dontal and CBCT image indexes were examinde and compare between the 2 groups.Before treatment all the indexes were not statistically dif-ferent between the 2 groups(P＞0.05).3 months after treatment,the bleeding index(BI)and probing depth(PD)of the experimental group were significantly lower than those of the control group(P＜0.05).6 months after treatment,BI,PD and attachment loss(AL)in the experi-mental group were significantly lower than those in the control group,and the surface area and volume of the root in the alveolar bone were significantly higher than those in the control group(P＜0.05).Nd∶YAG and Er∶YAG laser therapy adjunctive to conventional periodontal treatment is more effective than conventional periodontal treatment alone in the treatment of chronic periodontitis with type 2 diabetes melli-tus.

Objective To prepare paclitaxel-natural borneol complex,and to explore the prescription and preparation process of paclitaxel-natural borneol complex drug-loaded submicroemulsion,and its in vitro anti-tumor effect.Methods The Paclitaxel-natural borneol complex was prepared by grinding method and identified by Fourier Transform infrared spectroscopy(FT-IR)and differential scanning calorimetry(DSC).The compound drug-loaded submicroemulsion was prepared using a two-step high-pressure emulsification method.The single-factor investigation and the orthogonal experimental design were applied to optimize the formulation and preparation process.MTT assay,cell cloning assay,and cell scratch assay were used to evaluate the effect of this preparation on HCT-116 cells.Results The infrared spectral absorption peaks of taxol-natural borneol complex at 3 312.76 cm-1 and 3 513.92 cm-1 disappeared,and DSC analysis showed that a new absorption peak of taxol-natural borneol complex appeared at 154.56 ℃,indicating that taxol be coupled with natural borneol to form a new complex.The optimal prescription was 0.44％active pharmaceutical ingredient[paclitaxel-natural borneol(1∶3)],10％medium chain triglyceride,3％emulsifier[egg yolk lecithin-Poloxam 188(1∶2)],2％glycerol,0.3％oleate.The optimal process was emulsification at 80 ℃,60 MPa high pressure homogenization 10 times.The half inhibitory concentration(IC50)was 0.75 μg·mL-1 by MTT asssy in cell.In the cell cloning assay,the scratch healing area of blank control group,paclitaxel raw material and paclitaxel/natural borneol submicroemulsion were(36.44±3.35)％,(13.59±9.28)％,(8.30±4.09)％,respectively.The results were statistically significant(P＜0.05).In the plate cloning experiment,the cell cloning rates of blank control group,paclitaxel bulk drug group and submicroemulsion group were(37.92±0.729)％,(9.16±1.335)％and(3.36±1.065)％,respectively,the differents were statistically significant(P＜0.05).Conclusion This submicroemulsion has reasonable prescription,feasible process and good stability.Cell experiments showed that the submicronemulision effectively inhibits the proliferation and migration of HCT-116 cells,suggesting its potential as a promising antitumor agent.

Objective To construct models of viral transfection and hypoxia/reoxygenation induced cellular injury in adult mouse cardiomyocytes(AMCMs)isolated using a non-Langendorff method.Methods AMCMs were isolated,extracted,sedimented,and plated using a non-Langendorff method.The morphology and survival rate of the isolated cells were evaluated 2,24,48 and 72 h after plating,and their integrity was observed by immunofluorescence staining for α-actinin.The isolated AMCMs were infected with adenoviruses carrying an RFP-expressing vector and fluorescence images were obtained at 36 and 48 h post-infection and used to calculate transfection efficiency.The cells were cultured under hypoxic conditions for 45 min,reoxygenated for 24 h,and then stained with propidium iodide(PI)to verify establishment of the hypoxia/reoxygenation injury model.Results The survival rates of AMCMs at 2,24 and 48 h after plating were comparable,but survival was significantly reduced at 72 h.The integrity of the AMCMs was good and＞80%of the cells were transfected with adenovirus at 48 h.After hypoxia/reoxygenation treatment,42%of cells were stained by PI,suggesting successful establishment of the AMCM injury model.Conclusions In this study,we developed a non-Langendorff method for the fast and easy isolation of AMCMs with high cell viability.The isolated cells can be efficiently infected with adenovirus and respond to hypoxia/reoxygenation injury.These findings provide a systematic method for isolating AMCMs and for applying gene modification and hypoxia/reoxygenation injury in these cells.

Objective    To evaluate the learning curve of CT-guided medical glue localization for pulmonary nodule before video-assisted thoracic surgery (VATS). Methods    The clinical data of the patients with pulmonary nodules who underwent CT-guided medical glue localization before VATS in our hospital from July 2018 to March 2021 were retrospectively analyzed. The patients were divided into 3 groups: a group A (from July 2018 to August 2019), a group B (from September 2019 to June 2020) and a group C (from July 2020 to March 2021). The localization time, morbidity, complete resection rate and other indexes were compared among the three groups. Results    A total of 77 patients were enrolled, including 24 males and 53 females aged 57.4±10.1 years. There were 25 patients in the group A, 21 patients in the group B, and 31 patients in the group C. 77 pulmonary nodules were localized. There was no significant difference among the groups in the basic data (P>0.05). The localization time in the group C was 10.6±2.0 min, which was statistically shorter than that in the group A (15.4±4.4 min) and group B (12.9±4.3 min) (P<0.01). The incidence of complications in the group C was lower than that in the group A and group B (25.8% vs. 52.0% vs. 47.6%, P=0.04). The success rate of localization of the three groups was not statistically different (P=0.12). Conclusion    There is a learning curve in CT-guided medical glue localization for single pulmonary nodule before VATS. After the first 46 cases, the operation time can be shortened, and the incidence of complications can be decreased.

Objective:To explore the efficacy and safety of different anti-platelet regimens in the treatment of high-risk non-disabling ischemic cerebrovascular events (HR-NICE) guided by point-of-care testing of CYP2C19 gene. Methods:A single-centre, prospective, randomised, open-label, and blinded endpoint design was uesd in the study. From July 2020 to January 2022, HR-NICE patients were enrolled in the Stroke Green Channel and Department of Neurology of Xuzhou Central Hospital, and all patients were scraped the buccal mucosa for screening for CYP2C19 loss-of-function allele carriers by point-of-care testing . Patients with intermediate metabolism were defined as those who carried 1 loss-of-function allele and patients with poor metabolism were those who carried 2 loss-of-function alleles. This study reduced the test turnaround time to 1 hour by using a fully automated medical polymerase chain reaction analyzer for a point-of-care test of CYP2C19 genotype. CYP2C19 loss-of-function allele carriers were divided according to the random number table method into the conventional treatment group (clopidogrel 75 mg, once a day), the ticagrelor group (ticagrelor 90 mg, twice a day) and the intensive dose group (clopidogrel 150 mg, once a day) separately combined with aspirin (100 mg, once a day) dual antiplatelet for 21 days. Baseline information, Acute Stroke Org 10172 Treatment Trial staging, 90-day modified Rankin Scale score, occurrence of adverse events and severe adverse events were collected for all the 3 groups. The primary efficacy outcome was new stroke within 90 days, and the primary safety outcome was severe or moderate bleeding within 90 days. Results:A total of 716 patients were included: 240 in the conventional treatment group, 240 in the ticagrelor group and 236 in the intensive dose group. There was no statistically significant difference between the 3 groups at baseline (all P>0.05). There were 26 cases (10.8%) with new stroke events in the conventional treatment group, 11 cases (4.6%) in the ticagrelor group and 4 cases (1.7%) in the intensive dose group, with statistically significant differences among the 3 groups (χ 2=19.28, P<0.05), and the differences between the conventional treatment group and the ticagrelor group (χ 2=6.59, P=0.010) and between the conventional treatment group and the intensive dose group (χ 2=16.83, P<0.001) were statistically significant, whereas the difference between the ticagrelor group and the intensive dose group was not statistically significant ( P>0.05). In the 3 groups, there was 1 case (0.4%) of severe bleeding in the conventional treatment group, 6 cases (2.5%) in the ticagrelor group and none in the intensive dose group, which showed statistically significant differences (χ 2=7.23, P<0.05), and there was statistically significant difference between the ticagrelor group and the intensive dose group ( P=0.030). Among the patients with intermediate CYP2C19 metabolism, there were 13 cases (13/158, 8.2%) with 90-day recurrent stroke in the conventional treatment group, 4 cases (4/153, 2.6%) in the ticagrelor group, and 0 case (0/159) in the intensive dose group, with statistically significant difference (χ 2=16.04, P<0.001), and the differences between the intensive dose group and the conventional treatment group were statistically significant (χ 2=13.64, P<0.001), whereas there was no statistically significant difference between the intensive dose group and the ticagrelor group ( P>0.05). In the patients with 90-day recurrent stroke in the intensive dose group, there was 0 case (0/159) with intermediate metabolism and 4 cases (4/77,5.2%) with poor metabolism, with statistically significant differences ( P=0.011), whereas there were no statistically significant differences in the conventional treatment group and the ticagrelor group ( P>0.05). Conclusions:Screening carriers of CYP2C19 loss-of-function alleles by point-of-care testing can quickly and precisely guide the treatment of patients with non-cardiogenic HR-NICE. An intensive clopidogrel dose of 150 mg, once a day combined with aspirin was effective in reducing stroke recurrence with less occurrence of any bleeding and adverse events, and patients with intermediate CYP2C19 metabolism may be the best population to benefit.

Gastrointestinal viruses include acute gastroenteritis virus and enterovirus. These viruses are highly contagious and human populations are generally susceptible to them, and the viruses require only tens to hundreds of virus particles to cause infection. Digital polymerase chain reaction (dPCR) has the advantages of high sensitivity, strong anti-interference and direct quantification. It has shown its uniqueness in the detection of gastrointestinal viruses, especially for samples with low viral loads, which is a beneficial supplement to the real-time PCR technology. This article reviews and looks forward to the application of digital PCR technology in gastrointestinal virus detection.

Objective:To evaluate the differential diagnosis of papillary thyroid carcinoma (PTC) based on CT signs.Methods:Retrospective analysis was performed on 156 patients with PTC confirmed by surgery and pathology in the Imaging Department of Jinhua Hospital Affiliated to Zhejiang University College of Medicine from Jan. 2017 to Jan. 2022 as PTC group, and 132 patients with nodular goiter (NG) as NG group. There were 112 females and 45 males in the PTC group. The age was (49.32±3.25) years. There were 104 females and 52 males in NG group. The age was (50.12±3.27) years. Preoperative plain and contrast-enhanced CT scans were performed to analyze the features of the images, and univariate analysis was performed on the morphologic features, high tension, plain "bite cake sign" , enhanced "bite cake sign" , microcalcification, blurred/reduced scope after enhancement, nodule density, and asymmetric diffuse enlargement of thyroid gland. Statistically significant factors were included in the multivariate Logistic regression analysis, and the differential model of PTC was established according to the selected risk factors. The value of the model in the differential diagnosis of PTC was evaluated by ROC curve.Results:The percentages of irregular shape, no high tension, plain scan "bite cake sign" , enhanced "bite cake sign" , microcalcification, enhanced blur/reduced scope, uniform nodule density, completely slightly low tissue density, no cystic degeneration, and asymmetric thyroid diffuse enlargement in PTC group were higher than those in NG group ( χ2=161.014, 3.387, 95.885, 151.331, 60) . 200, 18.104, 105.260, 16.855, 89.064, 16.913, P<0.05) , suggesting that the above CT signs had important diagnostic value in differentiating PTC and NG. Among the single CT signs, plain scan "bite cake sign" had the highest sensitivity, specificity and accuracy. The sensitivity of PTC diagnosis combined with other signs gradually decreased, while the specificity gradually increased. At the same time, plain scan "bite cake sign" and microcalcification signs had high specificity in PTC identification, and the specificity of PTC identification reached 100.00% when any 4 or more signs were present. Multivariate Logistic regression analysis. The results showed that irregular morphology ( OR=15.831, 95% CI: 7.444-33.670) , high tension ( OR=0.162, 95% CI: 0.108-0.242) , plain scan "bite cake sign" ( OR=5.601, 95% CI: 2.691-11.659) , microcalcification ( OR=4.031, 95% CI: 2.062-7.880) , edge blur/range reduction after enhancement ( OR=4.761, 95% CI: 3.126-7.260) , uniform density of nodules ( OR=4.778, 95% CI: 3.299-6.290) and increased asymmetric diffusion ( OR=3.758, 95% CI: 1.911-7.391) were important signs for distinguishing NG from PTC ( P<0.05) . The above factors were incorporated into the Logistic regression equation to construct the model, and then the ROC curve was drawn. The results showed that the area under the curve of the model established based on CT signs was 0.94 (0.925-0.983) , and the sensitivity and specificity were 90.37% and 91.45%, respectively. Conclusions:In CT signs, irregular shape, high tension, "biting cake sign" on plain scan, microcalcification, blurred edge/scope reduction signs after enhancement, and uniform nodule density are important signs for differentiating papillary thyroid carcinoma from nodular goiter. The constructed model has good predictive value for identifying papillary thyroid carcinoma.