Whole esophagus deep burn is an extremely rare upper gastrointestinal tract disease. We report a case of severe burns of involving extensive body skin, eyes, throat, and esophagus. Endoscopic examination revealed acute necrotizing esophagitis and detected a metal foreign body in the stomach. The patient underwent burn wound debridement with analgesia, anti-shock rehydration, anti-infection, and symptomatic treatments, which failed to improve the conditions. The patient died of respiratory and circulatory failure secondary to serious sepsis.
Burns ; complications ; Esophagus ; injuries ; Foreign Bodies ; complications ; Humans ; Male ; Middle Aged ; Stomach

Whole esophagus deep burn is an extremely rare upper gastrointestinal tract disease. We report a case of severe burns of involving extensive body skin, eyes, throat, and esophagus. Endoscopic examination revealed acute necrotizing esophagitis and detected a metal foreign body in the stomach. The patient underwent burn wound debridement with analgesia, anti-shock rehydration, anti-infection, and symptomatic treatments, which failed to improve the conditions. The patient died of respiratory and circulatory failure secondary to serious sepsis.

Whole esophagus deep burn is an extremely rare upper gastrointestinal tract disease. We report a case of severe burns of involving extensive body skin, eyes, throat, and esophagus. Endoscopic examination revealed acute necrotizing esophagitis and detected a metal foreign body in the stomach. The patient underwent burn wound debridement with analgesia, anti-shock rehydration, anti-infection, and symptomatic treatments, which failed to improve the conditions. The patient died of respiratory and circulatory failure secondary to serious sepsis.

Objective: To analyze the influencing factors of acute gastroenteritis outbreaks caused by norovirus in Beijing from 2014 to 2018. Methods: Data of acute gastroenteritis events caused by norovirus in Beijing from April 2014 to March 2018 were collected. Unconditional logistic regression model was conducted to identify the risk factors of the outbreaks. Results: A total of 765 acute gastroenteritis epidemics caused by norovirus were reported in Beijing, in which 85.88% (657/765) were cluster events and 14.12% (108/765) were outbreaks. Among the outbreaks, 70.37% (76/108) were reported in 2017; 84.26% (91/108) were reported in winter and spring; 88.89% (96/108) were reported in kindergartens, primary or secondary schools; 81.48% (88/108) were through person-to-person transmission; 93.52% (101/108) were caused by norovirus GⅡ infection. The risk of outbreaks in suburban and out suburb area were 1.84 times (95%CI: 1.13-3.02) and 3.78 times (95%CI: 1.62-8.82) as high as that in urban area, respectively. The risks of outbreaks in primary, secondary schools and other institutions were 6.26 times (95%CI: 3.53-11.10), 14.98 times (95%CI: 6.23-36.01) and 8.71 times (95%CI: 3.07-24.71) as high as that in kindergartens, respectively. The risk of outbreak in which patients having lower hospital visiting rate than the median rate of all events was 2.29 times than that in the context of having higher hospital visiting rate (95%CI:1.42-3.68). The risk of foodborne outbreak was 14.55 times as high as that transmitted through person-to-person (95%CI: 3.15-67.07). Conclusion Measures such as strengthening the prevention and control of norovirus outbreaks in suburbs, primary schools, secondary schools and other institutions, promoting patients to visit the hospital actively, improving the management of foodborne events and kitchen workers should be taken to reduce the incidence of acute gastroenteritis outbreaks caused by norovirus.

Objective:To provide evidence for clinical diagnosis, prevention and control of group A rotavirus (RVA) diarrhea, the clinical characteristics of RVA diarrhea in children in Beijing from 2011 to 2018 were analyzed.Methods:From January 2011 to December 2018, 4 819 stool samples from children under 5 years old with diarrhea were collected monthly from 3 hospitals in Beijing. General information, clinical characteristics and other information of children were collected. RVA was detected by enzyme-linked immunosorbent assay (ELISA), genotype was identified by multiple semi-nested RT-PCR. The Vesikari clinical severity score was used to define the severity of diarrhea in children. Dichotomous unconditional logistic regression was used to analyze clinical symptoms and other differences between RVA positive and negative cases. Chi-square and Fisher direct probability tests were used to compare the composition among different groups.Results:A total of 4 819 fecal samples were collected, 953 were positive for RVA, the positive detection rate was 19.78%. The positive rate of RVA was high in the younger age group, and the incidence was high in winter and spring. RVA-positive children had more risk on diarrhea ≥5 times a day, vomiting symptoms, fever, mild dehydration, and Vesikari score ≥11. The positive rate of RVA in watery stool samples (26.13%, 214/819) and infectious diarrhea cases (42.20%, 265/628) was the highest respectively. There were no significant differences in clinical symptoms, clinical diagnoses and fecal traits among children with different RVA genotypes.Conclusions:The clinical symptoms of RVA diarrhea were severe in children. RVA genotype did not affect the clinical symptoms. Stool traits (watery stools) and Vesikari score can assist physicians in diagnosing RVA diarrhea.

Objective: To analyze the infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses. Methods: Between April 2014 and March 2016, the clinical data and samples were collected from the patients in acute gastroenteritis outbreaks caused by noroviruses in Beijing. Noroviruses were detected and genotyped using real time RT-PCR, and the infection characteristics of norovirus gastroenteritis were analyzed using the descriptive epidemiological method. Results: A total of 1743 clinical diagnosed cases of norovirus gastroenteritis were collected, and children under 12 years old accounted for 77.68% (1354/1743). The detection rate of noroviruses was 73.98% (509/688). The detection rates of noroviruses in fecal, swab and vomitus samples were gradually decreased (χ²=67.798, P<0.001). Among these clinical diagnosed cases, vomiting was the most common symptom (93.98%), followed by abdominal pain (40.34%), diarrhea (30.35%) and fever (27.94%). The most common symptom of patients under 6 years old was vomiting(98.14%), whereas diarrhea was most common among over 18 years old patients (68.12%). With the increase of age of the patients, the incidence of vomiting was gradually decreased (χ²=100.913, P<0.001), whereas the incidence of diarrhea was gradually increased (χ²=261.164, P<0.001). There was no statistical difference in vomiting, diarrhea and abdominal pain symptoms between patients infected with genogroup Ⅰ and Ⅱ noroviruses, and patients infected with genogroup Ⅱ (34.49%, 149/432) had the higher incidence rate of fever than that of genogroup Ⅰ (18.18%, 14/77) (χ²=7.985, P<0.01). Conclusions Noroviruses mainly infected children under 12 years old in acute gastroentertis outbreaks. The most common symptom of patients with acute gastroenteritis caused by noroviruses was vomiting, and the incidences of vomiting and diarrhea were significantly correlated with age of the patients. Patients infected with genogroup Ⅱ had the higher incidence rate of fever than genogroup Ⅰ infection.

Objective To understand the distribution of virulence gene and the epidemiological characteristics of diarrheagenic Escherichia(E.) coli (DEC) from diarrheal patients in Beijing. Methods Stool specimens from diarrheal patients were cultured which were collected from the hospitals under sentinel surveillance program,during 2012-2013. DNA was examined by real-time PCR. Results 253 out of 6 370 specimens were positive for DEC detection with the rate as 4.0%. A total number of 262 DEC strains were isolated. Two different pathotypes of DEC strains with mixed infection,were isolated from 9 specimens. Different pathotypes would show the following profiles:42.8% for enteropathogenic E. coli (EPEC) including 42.0% atypical and 0.8% typical;38.9% for enterotoxigenic E. coli(ETEC)including 24.8%st positive,9.9%lt positive and 4.2%st and lt both positive;15.3% for enteroaggregative E. coli(EAEC);2.7% for enteroinvasive E. coli(EIEC);one strain STEC with serotype O26 ∶ K60. ETEC had obvious characteristics on age. All kinds of DEC were isolated throughout the year with seasonal fluctuation. Conclusion DEC isolates from diarrheal patients in Beijing were dominated by EPEC and ETEC,with atypical ones accounted for the majority of EPEC. One specimen was found under mixed infection. Pathotypes DEC were found to have different age and seasonal distributions.

Objective:To study the prevalence of Norovirus infection among kitchen workers in Beijing, and the contamination status of Norovirus in catering companies and train station.Methods:A cross-sectional survey was conducted to collect anal swab specimens and environmental specimens from catering companies in 16 districts of Beijing and in 3 big train stations. Norovirus nucleic acid was detected by fluorescence quantitative PCR. The contamination status of Norovirus in the environment and the asymptomatic infection status of kitchen workers was analyzed in this study.Results:A total of 650 catering companies were investigated. 1 302 anal swabs or stool specimens and 2 600 environmental swabs were collected and tested. Among the 644 catering companies out of train stations, 1 290 anal swabs or stool specimens and 2 576 environmental swabs were collected and tested. The asymptomatic infection rate of Norovirus was 0.85% (11/1 290) among kitchen workers of the catering companies out of the train stations, while the positive rate of norovirus contamination in the environment was 0.04% (1/2 576). Norovirus was not detected in the specimens collected from the kitchen workers and the environment of the catering companies in train stations.Conclusion:During the non-epidemic season of Norovirus in 2019, the infection rate of Norovirus among kitchen workers in Beijing is low, and the environment is contaminated by Norovirus.

Objective:To study the prevalence of Norovirus infection among kitchen workers in Beijing, and the contamination status of Norovirus in catering companies and train station.Methods:A cross-sectional survey was conducted to collect anal swab specimens and environmental specimens from catering companies in 16 districts of Beijing and in 3 big train stations. Norovirus nucleic acid was detected by fluorescence quantitative PCR. The contamination status of Norovirus in the environment and the asymptomatic infection status of kitchen workers was analyzed in this study.Results:A total of 650 catering companies were investigated. 1 302 anal swabs or stool specimens and 2 600 environmental swabs were collected and tested. Among the 644 catering companies out of train stations, 1 290 anal swabs or stool specimens and 2 576 environmental swabs were collected and tested. The asymptomatic infection rate of Norovirus was 0.85% (11/1 290) among kitchen workers of the catering companies out of the train stations, while the positive rate of norovirus contamination in the environment was 0.04% (1/2 576). Norovirus was not detected in the specimens collected from the kitchen workers and the environment of the catering companies in train stations.Conclusion:During the non-epidemic season of Norovirus in 2019, the infection rate of Norovirus among kitchen workers in Beijing is low, and the environment is contaminated by Norovirus.

Norovirus are now recognized as one of the main pathogens causing acute gastroenteritis in both developed and developing countries. However, norovirus are easily mutated and recombined, and have many genotypes. In early studies, norovirus were amplified and identified by amino acid sequence of VP1 region. It was found that norovirus were easily mutated and recombined in or near the overlapping regions of polymerase and capsid. A two regions genotyping method was positively proposed internationally. Depending on the 2 times standard deviation standard method for two regions identification, norovirus polymerase regions can be divided into 10 gene groups and 76 genotypes including 2 tentative gene groups and 16 tentative genotypes. The VP1 region can be divided into 12 gene groups and 53 genotypes including 2 tentative gene groups and 5 tentative genotypes. However, the tentative gene groups and genotypes need to be further identified and reclassified. In this article, characteristics of norovirus sequences, principles of different genotyping methods, methods of sequence amplification, on-line genotyping tools and the latest studies in norovirus genotypes are reviewed and introduced.