Objective:To analyze the non-enterovirus A71 (non-EVA71) and non-coxsackievirus A16 (non-CVA16) enteroviruses causing hand, foot and mouth disease (HFMD) in Kunming and Qujing of Yunnan Province in 2021 by sequencing the VP4/VP2 and VP1 genes and to analyze the phylogenetic characteristics of the VP1 gene of CVA2, aiming to provide reference for the prevention and control of CVA2.Methods:The samples were made and extracted strictly according to the Laboratory Manual for Hand, Foot and Mouth Disease (China Center for Disease Control and Prevention, 2018 Edition). VP4/VP2 junction regions were firstly amplified and sequenced by MD91/OL68-1 primers. These sequences were firstly edited and then "blasted" on the GenBank to determine the virus serotype. To analyze the phylogenetic characteristics of CVA2, the entire VP1 gene sequences were amplified in two segments using enterovirus species A primers. Virus serotype was again confirmed online by "Enterovirus Genotyping Tool Version 0.1". The sequences of the reference virus genotypes/sub-genotypes were downloaded according to the reference. The phylogenetic trees were constructed by Mega5.2 software and the genetic characteristics were analyzed.Results:A total of 749 non-EVA71 and non-CVA16 enteroviruses were detected in the two areas in 2021. Group A enteroviruses were the main pathogens, with CVA16 as the predominant virus, and a small number of group B enteroviruses were reported. Only five strains of CVA2 were detected with a detection rate of 0.67% (5/749), indicating that CVA2 was a rare pathogen for HFMD in the two areas. The sequencing and serotyping results were consistent using the two genomic regions of VP4/VP2 junction region and VP1 region. Phylogenetic analysis showed that three Kunming strains belonged to genotype A, while two Qujing strains belonged to genotype D.Conclusions:The detection rate of CVA2 in Kunming and Qujing was 0.67% in 2021. CVA2 was a rare pathogen for HFMD in the two regions. Phylogenetic analysis showed genotypes A and D spread in Kunming and Qujing, respectively, but had not caused epidemics. To our knowledge, this was the first report of genotype A of CVA2 in China. Strengthening the laboratory surveillance especially molecular epidemiological surveillance is valuable for the monitor and analysis of transmission source for CVA2.

Magnetic ferrite nanoparticles (MFNPs) have great application potential in biomedical fields such as magnetic resonance imaging, targeted drugs, magnetothermal therapy and gene delivery. MFNPs can migrate under the action of a magnetic field and target specific cells or tissues. However, to apply MFNPs to organisms, further modifications on the surface of MFNPs are required. In this paper, the common modification methods of MFNPs are reviewed, their applications in medical fields such as bioimaging, medical detection, and biotherapy are summarized, and the future application directions of MFNPs are further prospected.
Ferric Compounds ; Magnetic Resonance Imaging/methods* ; Magnetics ; Magnetite Nanoparticles/therapeutic use* ; Nanoparticles

Eyelid tumor is a serious eye disease that leads to vision loss or even blindness.The similarity between benign and malignant characteristics makes it difficult for ophthalmologists lacking clinical experience to distinguish between them.To address the problem,a method(ResNet101_CBAM)based on two-stage target localization using fully convolutional one-stage object detection(FCOS)and residual network incorporating a dual attention mechanism is proposed to realize the automatic diagnosis of benign and malignant eyelid tumors.FCOS is used to automatically localize the overall contour of the orbit,removing the background and surrounding noise,and then finely localize the tumor lesion inside the orbit.The obtained lesion region is input into ResNet101_CBAM for the automatic diagnosis of benign and malignant eyelid tumors.The experimental results show that the average precision of the target localization algorithm for tumor lesion is 0.821,and that compared with ResNet101,ResNet101_CBAM improves the sensitivity and accuracy in eyelid tumor classification by 4.7%and 3.0%,respectively,indicating that the proposed model has superior performances in the automatic diagnosis of benign and malignant eyelid tumors.

Objective:To explore the correlation between the expression of signaling lymphocyte activation molecule family 6 (SLAMF6) on peripheral blood CD8 +T cells and perforin and granzyme B and the clinical significance in patients with newly diagnosed severe aplastic anemia(SAA). Methods:The indicators of blood routine and bone marrow and peripheral blood samples of 32 newly diagnosed SAA patients admitted to Henan Provincial People′s Hospital from January 2016 to June 2019 were collected for retrospective analysis. Flow cytometry was used to detect the expression of SLAMF6, perforin and granzyme B on samples CD8 +T cell before therapy and 6 months after therapy (11 cases received transplantation, 21 cases received immunosuppressive therapy [IST]). Spearman correlation analysis was performed to determine the association between clinical indicators and laboratory test results. The expression of SLAMF6, perforin and granzyme B was also detected in 10 healthy people (normal group) and 13 myelodysplastic syndromes/paroxysmal nocturnal hemoglobinuria (MDS/PNH) patients (MDS/PNH group). Results:(1) At diagnosis: the expression of SLAMF6 was significantly lower in the SAA group than that in the normal group and the MDS/PNH group ([56.40±6.37]% vs [84.34±5.81]% and [82.24±4.98]% (both P<0.001]). The expression of perforin was significantly higher in the SAA group (32.73±8.46) than that in the normal control group (23.75%±5.10%), and the MDS/PNH group (26.12%±5.53%) (both P<0.05). The expression of granzyme B was also significantly higher in the SAA group (36.23%±7.94%) than that in the normal control group (21.67%±5.05%) and the MDS/PNH group (21.79%±5.10%) (both P<0.001). The expression of SLAMF6 was positively correlated with the hemoglobin ( r=0.804), and reticulocyte absolute values ( r=0.656) in peripheral blood, percentage of granulocytes ( r=0.643) and erythrocytes ( r=0.622) in bone marrow of SAA patients (all P<0.05). Expression of SLAMF6 was negatively correlated with perforin ( r=-0.792) and granzyme B ( r=-0.908) on CD8 +T cells in patients with SAA (both P<0.001). (2) After treatment: the expression of SLAMF6 in peripheral blood CD8 +T cells of 30 surviving patients was higher than pre-treatment ([79.19±12.69]% vs [56.40±6.37]%, P<0.001). The expressions of perforin and granzyme B were lower than pre-treatment level (both P<0.05). The expression of SLAMF6 on CD8 +T cells in 11 transplanted patients was higher than before transplantation ([86.54±3.75]% vs [56.40±7.35]%, P<0.001). The expressions of perforin and granzyme B were lower than before transplantation (both P<0.05). The expression of SLAMF6 on CD8 +T cells in 12 IST-respond patients was higher than that before treatment, while the perforin and granzyme B levels were lower than pre-treatment (all P<0.05). The post-treatment expressions of SLAMF6, perforin and granzyme B were similar as before treatment levels in 7 IST-unrespond patients (all P>0.05). Conclusion:SLAMF6 is significantly down-regulated on CD8 +T cells in newly diagnosed SAA, negatively correlated with the effective factors of CD8 +T cells, which might participate in the immune regulatory of CD8 +T cells as a negative regulatory factor in patients with SAA. The SLAMF6 is significantly up-regulated after hematopoietic recovery, while there is no significant change in treatment-unrespond patients, which could thus serve as an useful diagnostic and therapeutic index of patients with SAA.

Objective:To analyze the expression and clinical significance of serum retinol binding protein 4 (RBP4), superoxide dismutase (SOD) and hypersensitive C-reactive protein (hs-CRP) in patients with acute ST-segment elevated myocardial infarction (STEMI).Methods:Seventy-eight patients with STEMI who underwent percutaneous coronary intervention (PCI) admitted to Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2017 to March 2019 were enrolled. On the basis of the routine treatment, atorvastatin calcium or rosuvastatin calcium treatment was given. According to the results of coronary angiography, the patients were divided into three groups: single-vessel, double-vessel and three-vessel lesions, and the severity of coronary artery disease score (SYNTAX score) was performed. The serum RBP4, SOD and hs-CRP were measured and compared among different groups before and after treatment. The correlation between the three serum parameters of STEMI patients and the SYNTAX score, risk prediction (STEMI high-risk score) and prognosis were recorded and compared among different groups.Results:There was no significant difference in serum RBP4, SOD and hs-CRP among different groups before treatment. In multivessel (double-vessel and three-vessel) vascular disease group, SYNTAX score was significantly correlated with RBP4 and hs-CRP (double-vessel lesions: r values were 0.616 and 0.489 respectively, three-vessel lesions: r values were 0.423 and 0.357 respectively, all P < 0.05), but had no correlation with SOD ( r values were 0.108 and 0.055 respectively, both P > 0.05), and high-risk score was closely correlated with RBP4 and hs-CRP levels ( r values were 0.581 and 0.623 respectively, both P < 0.01). There was no significant difference in the prognosis of patients treated with different statins. There were 8 and 7 high-risk patients in the atorvastatin calcium group and rosuvastatin calcium group, respectively, and 2 and 3 dead patients respectively (both P > 0.05). Conclusion:Combined detection of serum RBP4, SOD and hs-CRP levels can be used as better indicators to predict the risk of STEMI, which is worthy of clinical application.

Objective To evaluate the safety and efficacy of induced hypotension and hypotension in carotid endarterectomy (CEA).Methods Data of 1 486 patients who underwent CEA in multicenters from Aug 2012 to Aug 2018 were retrospectively analyzed.After screening,a total of 1 448 patients met the inclusion criteria.Induced hypertension and hypotension was used in all thees patients.Results 87.8％ of the patients were with severe carotid stenosis.The average operative time was (51.8 ± 6.1) min,and the internal carotid artery clamping time was (11.4 ± 3.1) min.After induced hypertension,the stump pressure were higher than that before,of which 1 438 (99.3％) were greater than 50 mmHg.Monitoring of EEG oxygen saturation showed that the value of ipsilateral rSO2 was significantly lower than that of the contralateral [(56％ ± 3％) vs.(64％ ± 4％),P ＜ 0.05] before induced hypertension.After induced hypertension and clamp removal,the value of ipsilateral rSO2 was lower than that of the contralateral,but there was not significant difference (all P ＞ 0.05).Perioperative cerebral infarction occurred in 2 cases,ipsilateral cerebral hemorrhage in 1 case,contralateral cerebral hemorrhage in 1 case and myocardial infarction in 2 cases.Connclusion The technique of induced hypotension and hypotension play a temporary role in brain protection for patients undergoing CEA.This study demonstrated the safety and effectiveness of induced hypertension and hypotension technique.

BACKGROUND:Previous study has observed that the calf acellular dermal membrane exhibits slow repair efficiency, fast degradability speed and other shortcomings in the repair of cartilage defects. OBJECTIVE:To investigate the repair effect of the col agen type Ⅱ-modified acel ular dermal membrane on cartilage defects in rabbits. METHODS:The fetal rabbit chondrocytes were seeded onto the col agen type Ⅱ-modified acel ular dermal membrane, and the composite was then observed under scanning electron microscope at 3, 7 and 14 days. Cartilage defect models were established on the bilateral femoral condyles of 24 New Zealand white rabbits, and these model rabbits were randomly allocated to three groups. The cartilage-acellular dermal membrane and cartilage-collagen type Ⅱ-modified acellular dermal membrane were implanted into the defect regions of control and experimental groups, respectively. Those received no intervention were as blank control group. Collagen type Ⅱ immunohistochemical staining and Wakitani scoring system were performed at 6 and 12 weeks postoperatively. RESULTS AND CONCLUSION:Chondrocytes grew and adhered well in the scaffold. The Wakitani scores in the experimental group were significantly lower than those in the control and blank control groups at postoperative 6 and 12 weeks (P<0.05). At 6 and 12 weeks postoperatively, collagen type Ⅱ immunohistochemical staining was the strongest in the experimental group, with yellow and brown particles in the cytoplasm;the control group was positive for collagen type Ⅱ immunohistochemical staining, while the blank control group was negative for the staining. Our findings suggest that the collagen type Ⅱ-modified acellular dermal membrane is beneficial for the repair of cartilage defects.

Objective To investigate the correlation between the plasma homocysteine (Hcy) level and intra/extracranial artery stenosis in patients with ischemic stroke.Methods The medical history,baseline clinical data,imaging and Hcy and other laboratory test results in patients with ischemic stroke were collected.The patients were divided into either a stenosis group or a non-stenosis group according to magnetic resonance angiography.The artery stenosis group was further redivided into an isolated intracranial stenosis group,an isolated extracranial stenosis group,and combined extracranial and intracranial stenosis group.The relationship between plasma Hcy level and intra/extracranial stenosis was analyzed.Results A total 147 patients with ischemic stroke were enrolled,including 115 patients in the stenosis group and 32 in the non-stenosis group.There were significant differences in age (t =4.577,P ＜ 0.001),the plasma levels of Hcy (t =3.65,P ＜ 0.001),C-reactive protein (t =2.06,P =0.041),low-density lipoprotein cholesterol (LDL-C) (t =1.896,P =0.046),high-density lipoprotein cholesterol (HDL-C) (t =-4.261,P ＜ 0.001),as well as the proportions of diabetes mellitus (x2 =5.772,P =0.016),hypertension (x2 =10.507,P =0.001) and smoking (x2 =12.282,P ＜ 0.001) between the stenosis group and the non-stenosis group.Multivariate logistic regression analysis showed that age ≥60 years (odds ratio [OR] 3.374,95％ confidence interval [CI] 1.351-8.426; P=0.009),Hcy ＞15 mmol/L (OR 2.274,95％ CI 1.147-8.173; P=0.025),hypertension (OR 5.782,95％ CI 2.045-16.345; P =0.001),and smoking (OR 3.514,95％ CI 1.200-10.293; P=0.002) were the independent risk factors,while HDL-C ＞ 1.0 mmol/L was an independent protective factor for intra/extracranial stenosis (OR 0.166,95％ CI 0.054-0.511; P =0.002).The stenosis group was redivided into an isolated extracranial stenosis group (n =24),an isolated intracranial stenosis group (n =61) and a combined extracranial and intracranial stenosis (n =30) according to the sites of stenosis.The comparison of the clinical data and risk factors among the three groups showed that there were significant differences in the proportions of patients with hypertension (x2 =7.024,P=0.003),as well as the plasma levels of LDL-C (F =3.276,P =0.042) and C-reactive protein (F =3.645,P =0.029).Multivariate logistic regression analysis showed that hypertension was the common independent risk factor for isolated intracranial stenosis (OR 3.795,95％ CI 1.261-11.424; P =0.018),isolated extracranial artery stenosis (OR 18.490,95％ CI 3.117-10.966; P=0.001) and combined extracranial and intracranial stenosis (OR 9.178,95％ CI2.211-38.094; P=0.002),and the increased HDL-C level was the common protective factor for isolated intracranial artery stenosis (OR 0.150,95％ CI 0.043-0.523; P =0.003),isolated extracranial artery stenosis (OR 0.078,95％ CI 0.012-0.488; P=0.006) and combined extracranial and intracranial stenosis (OR 0.089,95％ CI 0.021-0.385; P=0.001).Age was an independent risk factor for isolated intracranial stenosis (OR 6.351,95％ CI 2.277-17.717; P ＜ 0.001).The increased LDL-C level was an independent risk factor for isolated extracranial stenosis (OR 6.021,95％ CI 1.212-29.917; P =0.028).The increased Hcy level was an independent risk factor for isolated extracranial stenosis (OR 4.376,95％ CI 1.026-18.671; P-0.046) and combined extracranial and intracranial stenosis (OR 4.951,95％ CI 1.378-17.783; P =0.014).Conclusions The increased plasma Hcy level correlated with extracranial stenosis.

Objective:To investigate the clinical value of neck vascular ultrasound and homocysteine (Hcy) level in patients with cerebral infarction and carotid stenosis.
Methods: Our research included 2 groups. Cerebral infarction group, n=115 patient who were treated in our hospital from 2012-01 to 2013-12, and Control group, n=110 healthy subjects from physical check-up. Neck vascular ultrasound was conducted to classify the degree of carotid stenosis as ①no stenosis, ②mild degree, the stenosis rate≤29%, ③moderate degree, the stenosis rate at 30%~69%,③severe degree, the stenosis rate at 70%~99%,④complete occlusion. Carotid plaque formation and vascular intima-media thickness (IMT) were examined by neck ultrasound. Blood levels of Hcy and triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were
measured in clinical laboratory.
Results: Compared with Control group, Cerebral infarction group had the higher rate of carotid stenosis 89.56%vs 10.91%, more plaque formation 73.91%vs 6.08%and increased IMT (1.85 ± 0.42) mm vs (0.75 ± 0.21) mm;higher blood levels of Hcy (42.32 ± 12.02) μmol/L vs (6.32 ± 2.45) μmol/L and higher rate of high blood Hcy syndrome 71.30%vs 3.63%;higher levels of TC (4.25 ± 1.12) mmol/L vs (1.63 ± 0.74) mmol/L and LDL-C (5.96 ± 1.36) mmol/L vs (2.32 ± 0.82) mmol/L, P<0.05. In Cerebral infarction group, the patients with complete carotid occlusion and severe stenosis had the higher rate of plaque formation and increased IMT;higher levels of Hcy and more high blood Hcy syndrome;higher levels of TG and LDL-C than the patients with mild and moderate carotid stenosis, P<0.05. Logistic analysis indicated that the levels of IMT, Hcy and LDL-C were the independent risk factors for cerebral infarction and carotid stenosis.
Conclusion: The patients with cerebral infarction and carotid stenosis have obviously increased blood level of Hcy. Hcy may predict various degree of carotid stenosis in relevant patients.