Objective To investigate the incidence of recurrence and occurrence rate of recurrence of hand-foot-and-mouth disease (HFMD)in Jiangbei District of Ningbo City between 2012 and 2014,analyze the influencing fac-tors,and provide a scientific basis for the prevention and control of HFMD.Methods Data of HFMD in Jiangbei in 2012-2014 were collected from China Disease Surveillance Information System,immunization data were from Im-munization Programme Information System of Ningbo City,the recurrent infectious cases were selected and analyzed by descriptive epidemiological methods.Results The occurrence rate of recurrent HFMD in Jiangbei in 2012-2014 was 5.40% ,the median month of patients with single occurrence and recurrence of HFMD were 33.77(20.03, 47.83)and 38.26(22.05,54.75)months respectively,median month of patients with the initial occurrence were 23.93(15.87,36.87)months,median of time interval of recurrent HFMD was 10.27(5.23,16.06)months. The oc-currence rate of recurrence was the highest in 3- years old group(χ2= 37.51,P<0.001). Most were scattered chil-dren and children in child-care center. Female was a protective factor of recurrence of HFMD (OR,0.73[95% CI, 0.57-0.92]),while children in child-care center was a risk factor (OR,1 .46[95% CI,1 .16-1 .84]). The median attack rate of recurrence in HFMD group and control group in blocks within 7 days were 10.36(9.29,11.44)/100000 and 8.95(8.16,9.74)/100000 respectively,there was significant difference(Z= -2.68,P<0.001). In-oculation frequency between recurrent HFMD group and control group was not significantly different (Z= -1.38,P= 0.17).Conclusion The epidemic of recurrence of HFMD was serious in Jiangbei District of Ningbo City between 2012 and 2014,boys and children in child-care center should be paid attention,contacts with patients should be re-duced,and targeted prevention and control measures should be carried out.

Objective To investigate the mutation of mitochondrial genome in lymphoma. Methods The peripheral blood or borrow fluid 2 ml from 14 lymphoma patients in the First Hospital of Qinhuangdao between May 2016 and July 2017 were collected. Polymerase chain reaction (PCR) was used to amplify and sequence mitochondrial DNA, and the results were compared with the revised Cambridge reference sequence (rCRS) and human mitochondrial genome database (mtDB), and then the mutation was also analyzed. Results There were 118 mutation genes, including 57.63％ (68/118) in D-loop region, 18.64％ (22/118) in NADH dehydrogenase 5 (ND5) region, 13.56％(16/118) in cytochrome b oxidase (CbO) region, 5.08％(6/118) in ND1 region, 3.39％ (4/118) in cytochrome oxidase (COⅡ) region, 1.69％ (2/118) in ND4 region. Conclusion Mitochondrial DNA mutation in lymphoma has a high mutation rate.

Objective To study the mitochondrial DNA mutation in patients with primary multiple myeloma. Methods The mitochondrial DNA of 5 patients with primary multiple myeloma in the First Hospital of Qinhuangdao from February to June 2017 were amplified by polymerase chain reaction (PCR) and sequenced directly, and the results were compared with revised Cambridge Reference Sequence (rCRS) and Human Mitochondrial Gene Database (mtDB) database. Results There were 42 mutation genes, with 52.38％(22/42) mutation genes in D-loop region, 9.52％(4/42) mutation genes in ND4L region, 2.38％(1/42) mutation genes in ND5 region, 26.19％ (11/42) mutation genes in Cytb region, 7.14％ (3/42) mutation genes in ND1 region, and 4.76％ (2/42) mutation genes in COⅡ region. Conclusion There is a high mitochondrial DNA mutation rate in patients with primary multiple myeloma.

Objective? To? explore? the? clinical? significance? of? early? oral? intervention? measures? in? the?prognosis?of?premature?infants.? Methods? 151?preterm?infants?admitted?to?neonatal?intensive?care?unit?(NICU)?of?Liaocheng?People's?Hospital?from?January?2015?to?January?2017?were?enrolled.?Premature?infants?were?divided?into?intervention?group?and?control?group?according?to?random?number?table?method?and?with?the?consent?of?legal?guardian.?Both?groups?received?routine?treatment?of?preterm?infants?after?stable?vital?signs.?The?intervention?group?received?the?oral?massage?method?adopted?by?none-nutritive?sucking,?stimulating?swallowing?function?and?SandraFucile?on?the?basis?of?routine?treatment,?once?a?day?for?14?consecutive?days.?Both?groups?were?followed?up?for?6?months.?The?oral?feeding?ability?of?premature?infants?was?evaluated?by?the?proficiency?(PRO),?rate?of?transfer?(RT),?feeding?process?and??non-nutritive?suction?(NNS).?At?40?weeks?of?postmenstrual?age?(PMA),?neonatal?behavioral?neurological?(NBNA)?was?used?to?assess?neonatal?brain?development;?Infanib?was?used?for?early?motor?development?evaluation?at?3?months?and??6?months?after?birth.? Results? Finally,?151?premature?infants?were?enrolled,?including?78?in?the?intervention?group?and?73?in?the?control?group.?The?time?to?complete?oral?feeding?of?the?intervention?group?was?significantly?shorter?than?that?of?the?control?group?(days:?18.1±3.7?vs.?23.4±5.8,?P??0.05).?Infanib?evaluation?at?3?months?of?age?showed?that?the?proportion?of?normal?children?in?the?intervention?group?was?significantly?higher?than?that?in?the?control?group?[67.95%?(53/78)?vs.?49.31%?(36/73),?P?

Objective To study the mitochondrial DNA mutation in leukemia.Methods Mitochondrial DNA of 16 leukemia patients in First Hospital of Qinhuangdao from February to June 2017 were amplified and sequenced by using polymerase chain reaction (PCR).The result was compared with revised Cambridge reference sequence (rCRS) and human mitochondrial genome database (mtDB),and the mutation was also analyzed.Results There were 106 mutation genes in total,including 47.17 ％ (50/106) in D-loop region,2.83 ％ (3/106) in ND4 region,17.92 ％ (19/106) in ND5 region,22.64 ％ (24/106) in Cytb region,7.55 ％ (8/106) in ND1 region,1.89 ％ (2/106) in Co Ⅱ region.Conclusion There is a high mitochondrial DNA mutation rate in leukemia patients.

Objective:To investigate the diagnostic value of nucleic acid matrix-assisted laser desorption ionization-time of flight mass spectrometry（MALDI-TOF MS）in sputum smear-negative patients with nontuberculous Mycobacterial（NTM）pulmonary disease.Methods:Clinical data of 123 patients suspected of NTM pulmonary disease admitted in Public Health Clinical Center Affiliated to Shandong University between July 2022 and November 2023 were retrospectively analyzed. Bronchoalveolar lavage fluid（BALF）specimens were collected for MALDI-TOF MS assay and MGIT 960 culture. The diagnostic efficacy of MALDI-TOF MS for NTM pulmonary disease in patients with negative sputum smears for acid-fast bacilli was evaluated with receiver operating characteristic（ROC）curve. Statistical analysis was performed using SPSS 26.0 software and MedCalc statistical software.Results:Diagnosis of NTM pulmonary disease was finally confirmed in 66 out of the 123 suspected patients. It took 8 to 24 h for MALDI-TOF MS to identify NTM species and resistance. By MALDI-TOF MS，72 NTM strains were identified，with the Mycobacterium avium complex being the most prevalent（34 strains，47.22%），followed by the Mycobacterium abscessus complex（13 strains，18.06%）；resistance to macrolides was detected in 6 cases，while no resistance to aminoglycosides was found. It took 9 to 45 days for BALF MGIT 960 culture to identify NTM，and took 7 to 15 days for NTM typing and drug sensitivity testing. By BALF MGIT 960 culture，28 NTM strains were identified；and 1 case was found to be resistant to macrolides. Using confirmed diagnosis as the gold standard，MALDI-TOF MS demonstrated higher sensitivity，negative predictive value，and agreement rate compared to MGIT 960 culture（84.85% vs. 42.42%，81.13% vs. 56.32%，80.49% vs. 62.60%， χ2=25.667，8.998，9.664， P<0.05 or <0.01）. The area under ROC curve（AUC）for MALDI-TOF MS was significantly higher than that of MGIT 960 culture（0.801 vs. 0.642， Z=3.300， P=0.001）. Conclusion:Compared to MGIT 960 culture，MALDI-TOF MS exhibits superior diagnostic efficiency in detecting NTM pulmonary disease in patients with acid-fast bacilli smear-negative sputum，with advantage of rapidly identifying NTM species and resistance.

Objective To investigate the role of irisin in exercise-induced improvement of renal function in type 2 diabetic rats. Methods Forty male SD rats aged 4-6 weeks were randomized into normal control group, type 2 diabetes mellitus model group, diabetic exercise (DE) group and diabetic irisin (DI) group (n=8). The rats in DE group were trained with treadmill running for 8 weeks, and those in DI group were given scheduled irisin injections for 8 weeks. After the treatments, blood biochemical parameters of the rats were examined, and renal histopathology was observed with HE, Masson and PAS staining. Western blotting was used to detect the protein expression levels in the rats' kidneys. Results The diabetic rats showed significantly increased levels of fasting insulin, total cholesterol, triglyceride, serum creatinine and blood urea nitrogen with lowered serum irisin level (all P<0.05). Compared with those in DM group, total cholesterol, triglyceride, serum creatinine and blood urea nitrogen levels were decreased and serum irisin levels were increased in both DE and DI groups (all P<0.05). The rats in DM group showed obvious structural disorders and collagen fiber deposition in the kidneys, which were significantly improved in DE group and DI group. Both regular exercises and irisin injections significantly ameliorated the reduction of FNDC5, LC3-Ⅱ/Ⅰ, Atg7, Beclin-1, p-AMPK, AMPK and SIRT1 protein expressions and lowered of p62 protein expression in the kidneys of the diabetic rats (all P<0.05). Conclusion Both exercise and exogenous irisin treatment improve nephropathy in type 2 diabetic rats possibly due to irisin-mediated activation of the AMPK/SIRT1 pathway in the kidneys to promote renal autophagy.

Objective To investigate the role of irisin in exercise-induced improvement of renal function in type 2 diabetic rats. Methods Forty male SD rats aged 4-6 weeks were randomized into normal control group, type 2 diabetes mellitus model group, diabetic exercise (DE) group and diabetic irisin (DI) group (n=8). The rats in DE group were trained with treadmill running for 8 weeks, and those in DI group were given scheduled irisin injections for 8 weeks. After the treatments, blood biochemical parameters of the rats were examined, and renal histopathology was observed with HE, Masson and PAS staining. Western blotting was used to detect the protein expression levels in the rats' kidneys. Results The diabetic rats showed significantly increased levels of fasting insulin, total cholesterol, triglyceride, serum creatinine and blood urea nitrogen with lowered serum irisin level (all P<0.05). Compared with those in DM group, total cholesterol, triglyceride, serum creatinine and blood urea nitrogen levels were decreased and serum irisin levels were increased in both DE and DI groups (all P<0.05). The rats in DM group showed obvious structural disorders and collagen fiber deposition in the kidneys, which were significantly improved in DE group and DI group. Both regular exercises and irisin injections significantly ameliorated the reduction of FNDC5, LC3-Ⅱ/Ⅰ, Atg7, Beclin-1, p-AMPK, AMPK and SIRT1 protein expressions and lowered of p62 protein expression in the kidneys of the diabetic rats (all P<0.05). Conclusion Both exercise and exogenous irisin treatment improve nephropathy in type 2 diabetic rats possibly due to irisin-mediated activation of the AMPK/SIRT1 pathway in the kidneys to promote renal autophagy.

Objective:To investigate the clinical and diagnostic value of liver stiffness measurement (LSM) for the evaluation and comparison of aspartate aminotransferas/platelet ratio index (APRI), fibrosis 4 indexes (FIB-4) and NAFLD fibrosis score (NFS) with liver fibrosis staging in relation to nonalcoholic fatty liver disease (NAFLD).Methods:103 cases with NAFLD who met the inclusion criteria confirmed by liver biopsy were selected for retrospective analysis. The results of serological tests and LSM were recorded. The APRI, FIB-4 and NFS were calculated. The accuracy and applicability of four liver fibrosis models in the diagnosis of liver fibrosis in NAFLD patients were compared with the receiver operating characteristic curve (ROC), and the diagnostic cut-off value of LSM was established.Results:Varying degrees of LSM, APRI, FIB-4 and NFS had shown positive correlations with the increasing degree of liver fibrosis. Among them, LSM was positively correlated with the degree of liver fibrosis, and the correlation coefficient was r = 0.727, P < 0.0001. Consistent with this, the area under the receiver operating characteristic curve, sensitivity, and specificity of LSM diagnosis of liver fibrosis in different stages was significantly higher than APRI, FIB-4 and NFS. Area under receiver operating characteristic curve of LSM was 0.862 and 0.928 for significant liver fibrosis ( f ≥ 2), and advanced liver fibrosis ( f ≥ 3). Conclusion:LSM has a good diagnostic exclusion value for NAFLD-induced fibrosis, and its sensitivity and specificity are better than APRI, FIB-4 and NFS.

Objective:To analyze the changes of helper T cell 22 (Th22) and related cytokines and chemokines in patients with IgA nephropathy (IgAN) and tonsillitis, and explore its relationship with clinical pathological changes.Methods:IgAN patients who were diagnosed at the Xiangya Hospital of Central South University from June 2015 to June 2016 were included. They were divided into IgAN and tonsillitis (IgAN+tonsillitis) group, IgAN group, mesangial proliferative glomerulonephritis (MsPGN) group and control group (HC) group according to renal pathology and whether associated with tonsillitis. Flow cytometry was used to detect the percentage of peripheral blood Th17, Th22 cells, CC-type chemokine receptor (CCR) 4, CCR6 and CCR10 cells. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of interleukin (IL)-22, IL-1β, IL-6, TNF-α, CCL22, CCL20 and CCL27. Immunohistochemical method (IHC) was used to detect the expression of CCL22, CCL20 and CCL27 in kidney tissue. The differences of clinicopathological indicators, the proportion of Th22 cells and related chemokine in each group were compared and analyzed.Results:A total of 44 IgAN patients were included, including 14 patients complicated with tonsillitis. Ten MsPGN patients and 16 healthy people were also included. There was no statistically significant difference in gender, age, blood pressure, kidney function, blood lipid and other biochemical indicators among the groups (all P>0.05). The peripheral blood Th22 cells and CCR10 positive cells in the IgAN group, MsPGN group, and IgAN+tonsillitis group were significantly higher than those of the control group, and serum IL-22, IL-1β, IL-6, TNF-α, CCL20, CCL22 and CCL27 levels were also significantly higher (all P<0.05). All above indexes reached the highest levels in IgAN patients combined with tonsillitis. The changes of CCL20, CCL22 and CCL27 in renal tissues were consistent with those in peripheral blood. The percentage of Th22 cells increased in hematuria-positive and higher MEST scores patients. Conclusions:Th22 cells cooperated with CCL27/CCR10 axis are involved in the pathogenesis of IgAN. Tonsillitis exacerbates clinical severity and kidney injury of IgAN.