Objective To analyze the molecular characteristics of human pathogenic avian influenza A H7N9 virus.Methods The gene sequences of avian influenza A H7N9 virus (30 human-originated and 15 avian-originated) isolated in Zhejiang province from 2013 to 2015 were downloaded from Global Initiative on Sharing Avian Influenza Data ( GISAID), and then the evolution characteristics, the sites related to receptor binding, virulence and drug resistance of H7N9 virus were analyzed by MEGA 6.0 software. Results There were minor differences in HA and NA genes between human H7N9 virus strains and poultry reference strains in Zhejiang province with the homology of 98.0%-100.0% and 97.4%-100.0%, respectively.Viral amino acid variation showed that 30 representative strains had mutations at 226 (Q226L/I) and 186(G186V) sites in HA protein, and all strains isolated from 2015 had A134V mutation;one strain had R294K mutation in NA gene;19 strains had E627K mutation in PB2 and 2 strains had D701N mutation;mutation S31N was found in M2 gene in all isolates; and all HA cleavage sites were PEIPKGR↓GLF, indicating low pathogenic strain.Conclusions The homology of HA and NA genes is high between poultry reference strains and human H7N9 virus strains in Zhejiang province during 2013 and 2015.Strains have some significant mutations of amino acid in HA and NA protein.All isolates show ion channel inhibitors ( Amantadine) resistance, and some isolates show resistance mutations with neuraminidase inhibitors.

Human avian-origin influenza A (H7N9)virus is a novel subtype of avian influenza A virus,which firstly emerged at the end of March 2013 in Shanghai and Anhui province.It rapidly spread in China within a short time,causing high morbidity and mortality,arousing fear and panic in public,and attracting extensive attention worldwide.The analysis of human H7N9 avian influenza virus gene shows a high affinity for α-2,6-linked sialic acid receptors expressed on human respiratory epithelial cells.At present,the sporadic cases of human H7N9 avian influenza virusare occasionally reported with an epidemic peaksat winter and spring.This article reviews clinical features,epidemiology and genetic characteristics of H7N9 avian influenza virus,proving scientific evidences foreffective prevention and control of H7N9 virus infection.

Objective To evaluate the clinical value of 6 androgens in the serum of Sj?gren's syndrome (SS) measured by liquid chromatography tandem mass spectrometry (LC-MS).Methods 32 SS patients (SS group) and 25 healthy people (healthy group) were included in this study.6 androgens in the serum were analyzed by LC-MS after prepared.PCA,PLS-DA models and t-test were used to class differentiation of androgens between two groups.Results The results of PLS-DA showed that SS group and healthy group could be well classed by 6 androgens.The levels of testerone (T),dihydrotestosterone (DHT),dehydroepiandrosterone (DHEA),androsterone and DHEAS in SS group were significantly lower than those in healthy group (t=8.536,2.438,3.172,4.158,4.489,all P<0.05).The samples before or after menopause could be distinguished between the two groups by PLS-DA.Conclusion The significant difference of androgens was discovered between SS patients and healthy people via the measurement of 6 androgens in serum.It may arise a new idea for diagnosis and treatment of SS.

Objective:To investigate the efficacy of modified surgery in the treatment of breast abscess and its effects on inflammatory reaction and pain-related factors.Methods:A total of 100 patients with breast abscess who were treated in Zhoushan Women and Children's Hospital from December 2019 to October 2022 were included in this study. They were divided into an observation group and a control group ( n = 50 per group) using the random number table. The control group received vacuum assisted rotary resection, while the observation group underwent modified surgery. Operation conditions, postoperative complications, and postoperative conditions were recorded in each group. Before and 24 hours after surgery, inflammatory reaction and pain-related factors were compared between the two groups. Results:There was no significant difference in operative time between the two groups ( P > 0.05). The intraoperative bleeding volume in the observation group was (23.14 ± 4.53) mL, which was significantly lower than (36.52 ± 7.18) mL in the control group ( t = 11.14, P < 0.001). The incidence of complications in the observation group was 6.00% (3/50), which was significantly lower than 20% (10/50) in the control group ( χ2 = 4.33, P < 0.05). The observation group had significantly lower postoperative visual analogue scale score [(2.42 ± 0.78) points], fewer dressing changes [(5.26 ± 1.34) times], and lower scar degree [(6.82 ± 1.27) mm] compared with the control group [(3.56 ± 0.89) points, (7.43 ± 1.62) times, (9.12 ± 1.54) mm, t = 6.81, 7.30, 8.15, all P < 0.001]. At 24 hours after surgery, high-sensitivity C-reactive protein, interleukin-1 β, and tumor necrosis factor-α in the observation group were (14.52 ± 3.37) mg/L, (182.13 ± 23.32) ng/L, and (20.08 ± 2.89) ng/L, respectively, which were significantly lower than (29.94 ± 5.45) mg/L, (231.24 ± 16.56) ng/L, and (29.98 ± 4.36) ng/L in the control group ( t = 17.02, 12.14, 13.38, all P < 0.001). At 24 hours after surgery, prostaglandin E 2 and substance P in the observation group were (97.14 ± 18.78) ng/L and (175.18 ± 24.37) μg/L respectively, which were significantly lower than (148.65 ± 20.06) ng/L and (265.41 ± 27.86) μg/L in the control group ( t = 13.26, 17.24, both P < 0.001). Conclusion:The modified surgical treatment for breast abscess shows significant effects with fewer complications and minimal impact on inflammatory response, effectively inhibiting the release of pain-related factors.

Objective     To evaluate the early clinical outcomes of the Renatus® balloon-expandable valve in the treatment of severe aortic stenosis. Methods    From November 2021 to April 2022, a total of 38 patients who received Renatus® balloon-expandable valve for severe aortic stenosis in Guangdong Provincial People's Hospital were included. There were 22 males and 16 females, with an average age of 73.7±5.3 years. Mean aortic gradient and peak aortic jet velocity at baseline, post-procedure, and follow-up were compared. Clinical outcomes including all-cause mortality, perivalvular leakage, serious adverse cardiovascular events and the occurrence of permanent pacemaker implantation were assessed. Results    All patients completed the procedure successfully without conversion to thoracotomy or perioperative death. The post-implant mean aortic pressure gradient was decreased from 41.5 (27.8, 58.8) mm Hg to 6.0 (3.0, 8.0) mm Hg, and the peak aortic jet velocity was also decreased from 4.1±0.9 m/s to 1.7±0.4 m/s (P<0.001). Pacemakers were required in 2 (5.3%) patients. The median follow-up time was 27.5 (23.0, 87.5) d, with a follow-up rate of 100.0%. The mean aortic gradient was 8.0 (7.0, 10.8) mm Hg and peak aortic jet velocity was 2.0±0.3 m/s, showing significant improvement compared with those in the preoperative period (P<0.001). No severe aortic regurgitation or paravalvular leak was observed. There was no serious cardiovascular adverse event or reoperative event during the study period. Conclusion    Transcatheter aortic valve replacement with the domestic Renatus® balloon-expandable valve system is a safe and effective procedure for selected patients with severe aortic stenosis who are at high risk or not candidates for surgical aortic valve replacement.

Objective To summarize and analyze the preliminary clinical outcomes of the KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation (DMR). Methods This study was a single-arm, prospective, single-group target value clinical trial that enrolled patients who underwent the KokaclipTM transcatheter edge-to-edge repair (TEER) system for DMR in the Department of Heart Surgery of Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute from June 2022 to January 2023. Differences in the grade of mitral regurgitation (MR) during the perioperative and follow-up periods were compared, and the incidences of adverse events such as all-cause death, thoracotomy conversion, reoperation, and severe recurrence of MR during the study period were investigated. Results The enrolled patient population consisted of 14 (50.0%) females with a mean age of 70.9±5.4 years. Twenty-eight (100.0%) patients were preoperatively diagnosed with typeⅡ DMR, with a prolapse width of 12.5 (11.0, 16.1) mm, a degree of regurgitation 4+ leading to pulmonary venous reflux, and a New York Heart Association cardiac function class≥Ⅲ. All patients completed the TEER procedure successfully, with immediate postoperative improvement of MR to 0, 1+, and 2+ grade in 2 (7.1%), 21 (75.0%), and 5 (17.9%) patients, respectively. Mitral valve gradient was 2.5 (2.0, 3.0) mm Hg. Deaths, thoracotomy conversion, or device complications such as unileaflet clamping, clip dislodgement, or leaflet injury were negative. Twenty-eight (100.0%) patients completed at least 3-month postoperative follow-up with a median follow-up time of 5.9 (3.6, 6.8) months, during which patients had a mean MR grade of 1.0+ (1.0+, 2.0+) grade and a significant improvement from preoperative values (P<0.001). There was no recurrence of ≥3+ regurgitation, pulmonary venous reflux, reoperation, new-onset mitral stenosis, or major adverse cardiovascular events. Twenty-two (78.6%) patients’ cardiac function improved to classⅠorⅡ. Conclusion The domestic KokaclipTM TEER system has shown excellent preliminary clinical results in selected DMR patients with a high safety profile and significant improvement in MR. Additional large sample volume, prospective, multicenter studies, and long-term follow-up are expected to validate the effectiveness of this system in the future.