Objective:To investigate the molecular epidemiological characteristics of norovirus (NoV) in hospitalized children with sporadic acute gastroenteritis in Tianjin in 2019.Methods:Fecal specimens and clinical data were collected from 3 116 hospitalized children with sporadic acute gastroenteritis possibly caused by viral infection in Tianjin Children′ Hospital between January and December, 2019. Real-time quantitative PCR was used to detect NoV. Partial sequences of RNA-dependent RNA polymerase (RdRp) and capsid genes of NoV were amplified by RT-PCR. Sequence alignment and phylogenetic analysis were performed for further analysis.Results:Among the 3 116 specimens, 809 (26.0%) were positive for NoV. There were significant differences in NoV detection rate between different age groups ( P=0.000), and the highest NoV detection rate (31.6%) was observed in the age group of 7-12 months. Moreover, the detection rate of NoV varied with seasons ( P=0.000), and the NoV detection rate was highest in winter (39.0%). Based on the sequence analysis of RdRp and capsid genes, 286 identified NoV strains belonged to six genotypes, which were GⅡ.P12-GⅡ.3, GⅡ.P16-GⅡ.2, GⅡ.P17-GⅡ.17, GⅡ.Pe-GⅡ.2, GⅡ.Pe-GⅡ.3 and GⅡ.Pe-GⅡ.4. The predominant genotype was GⅡ.Pe-GⅡ.4 Sydney 2012 (61.2%), followed by GⅡ.P12-GⅡ.3 (33.6%, 96/286), GⅡ.Pe-GⅡ.3 (2.4%, 7/286), GⅡ.P16-GⅡ.2 (2.1%, 6/286), GⅡ.Pe-GⅡ.2 (0.3%, 1/286) and GⅡ.P17-GⅡ.17 (0.3%, 1/286). Patients carrying the NoV of GⅡ.Pe-GⅡ.4 Sydney 2012 genotype were likely to suffer from vomiting than those positive for NoV of GⅡ.P12-GⅡ.3 genotype. Conclusions:NoV was an important pathogen causing acute gastroenteritis in children. GⅡ.Pe-GⅡ.4 Sydney 2012 and GⅡ.P12-GⅡ.3 were the major genotypes of NoV in hospitalized children with sporadic acute gastroenteritis in Tianjin in 2019.

Objective:To evaluate the prevalence of human rhinovirus (HRV) infection in hospitalized children in Tianjin and investigate the clinical impact of HRV infections.Methods:From July 2017 to December 2019, 2 945 nasopharyngeal secretion specimens were screened for HRV using polymerase chain reaction (PCR). VP4/VP2 sequences of HRV were further characterized. The clinical characteristics of the HRV infection were analyzed. The detection results of HRV for different groups and different months were compared using SPSS 19.0.Results:HRV-positive specimens accounted for 8.15% (240/2 945), of which 74.78% (86/115) were diagnosed with pneumonia, 40.83%(98/240) had co-infections with other common pathogens. HRV infections could be detected throughout the year with peaks in spring (11.00%, 66/660) and autumn (9.29%, 81/872). The positive rate of HRV was 4.14%(29/700) in winter. By VP4/VP2 sequence analysis, HRV-A was the most frequently detected strain(50.00%, 78/156), followed by HRV-C (41.67%, 65/156).46.15% (30/65) of HRV-C infections occurred in October and November. There were several different HRV-A types and HRV-C types. The most commonly detected HRV-A types were A12(11.54%, 9/78), A49(6.41%, 5/78), A22, A101, and A66(5.13%, 4/78), etc. The most common HRV-C types were C2(20.00%, 13/65), C22(9.23%, 6/65), C26, C43, C54 and C53(4.62%,3/65). Patients with HRV-A infections are more likely to show fever symptoms than HRV-C (χ2=5.411, P<0.05). No significant difference in other symptoms were found between the two types. Conclusions:HRV was a commonly detected virus among infants and had a clear seasonal distribution. It′s also possible for the HRV patients to have co-infections with other pathogens.HRV showed high genetic diversity.

Objective To evaluate left ventricular(LV) twist and untwist using velocity vector imaging(VVI) in patients with apical hypertrophic cardiomyopathy (ApHCM). Methods Twenty-three patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, parasternal basal and apical short-axis planes were scanned to quantify LV rotations,twist and LV untwist using VVI. Results Compared with the normal controls, the rotation and rotaional velocity of apical subendocardial myocardium were markedly decreased in ApHCM patients during the period of systole ( P＜0.05) ,but the decreases in basal planes were not significant. As a consequence,LV twist was significantly lower in ApHCM patients (P＜ 0.05). Compared to normal controls,the velocity of LV untwisting was also significantly decreased in ApHCM patients ( P＜0.05).Conclusions The twist and untwist of LV subendocardial myocardium were decreased in ApHCM patients.VVI is a useful method to assess the characteristics of LV twist and untwist in ApHCM patients.

Objective To evaluate the clinical effect of the facial soft tissue defect treated with platelet-rich plasma (PRP) mixed with purified fat.Methods 35 patients with facial soft-tissue defects were treated by PRP mixed with centrifuged fat tissue.Using Fuzzy judgment method the clinical effectiveness of therapeutic outcomes were evaluated on fullness,injection of frequency and satisfaction during 3 to 6 months of follow-up.Results The therapeutic outcomes showed that the reconstructed face became a relative symmetrical and natural appearance with not evidently fat resorption and stable after operation.Both patients and surgeons were satisfied with the results.The score of effectiveness was highest in Fuzzy judgment.Conclusions The efficacy of PRP is significant in enhancing fat graft,reducing fat necrosis and resorption.The fat tissue mixed with PRP is a reliable reconstruction option for the facial soft tissue defect.

Objective:To investigate the prevalence and clinical characteristics of Mycoplasma pneumoniae( Mp) genotypes and subtypes in children in Tianjin. Methods:Children with pneumonia admitted to Tianjin Children′s Hospital from December 2017 to December 2019 were selected as the research objects. Bronchoalveolar lavage fluid was collected by fiberoptic bronchoscopy. The positive samples were detected by real-time fluorescent quantitative PCR and Mp culture. PCR-restriction fragment length polymorphism(RFLP) and multiple variable number tandem repeats were used for genotyping. Detailed clinical and laboratory data were collected for all cases. Results:The results of RFLP showed that there were 138 cases (78.9%) of typeⅠand 37 cases (21.1%) of type Ⅱ; 37 cases of type M3-5-6-2, including six subtypes B, G, M, S, V and Y; 138 cases of M4-5-7-2 were detected, including seven subtypes of E, J, P, U, X, Z and a. In M3-5-6-2 type, there were 1 case of P1-Ⅰtype (2.7%), 36 cases of P1-Ⅱtype (97.3%), 137 cases of P1-Ⅰ type (99.2%) and 1 case of P1-Ⅱ type (0.7%) in M4-5-7-2 type. There was no significant difference in genotype distribution among different age groups. There were statistical differences in the distribution of four seasons among the 13 genotypes of B, G, M, S, V, Y and E, J, P, U, X, Z, a. All Mp infected children had symptoms of fever and cough. The hospitalization time, fever duration, high fever (>39℃), cough duration, skin changes, digestive system symptoms and liver function injury rate of P1-Ⅰ/M4-5-7-2 pneumonia children were higher than those of P1-Ⅱ/M3-5-6-2 pneumonia children, but the difference was not statistically significant. The WBC count of P1-Ⅱ/M3-5-6-2 types was higher than that of typeⅠand M4-5-7-2; the LDH of P1-Ⅰ/M4-5-7-2 was higher than that of Ⅱ and M3-5-6-2, with statistical difference. There was no significant difference in the incidence of inflammatory consolidation, atelectasis, pleural thickening and pleural effusion among different genotypes. Conclusions:Mp infection in children with pneumonia in Tianjin is mainly P1-Ⅰ/ M4-5-7-2, and P1-Ⅱ is on the rise. P1-Ⅰ and M4-5-7-2 were associated with fever and severe symptoms.

Objective:To understand the pathogen infection and epidemiological characteristics of children with diarrhea in Tianjin.Methods:Stool samples from 1 466 children with diarrhea in Tianjin Children's Hospital from August 2017 to July 2018 were collected, and all samples were tested for five intestinal-related pathogens (norovirus, rotavirus, Clostridium difficile toxin, adenovirus, and astrovirus). Results:Among the 1 466 samples, 627 samples were positive for nucleic acid detection of intestinal pathogens, with a positive rate of 42.8%. The detection rate of norovirus was the highest (26.3%), followed by rotavirus (15.3%), Clostridium difficile toxin (4.6%), adenovirus (4.1%), and astrovirus (1.84%). The infection has obvious seasonality. The positive detection rates of the five pathogens were similar among children of different sexes, and only the positive detection rates of norovirus and rotavirus were statistically significant among different ages ( P<0.05). There were 110 cases of mixed infection, and the mixed infection of norovirus and rotavirus was the most common, with a total of 37 cases. Conclusions:The pathogen spectrum of infant infectious diarrhea in Tianjin is complex and diverse, and the main pathogens are norovirus and rotavirus.

Objective:To explore the effect of self-made dynamic cardiovascular three-dimensional model combined with CBL (case-based learning) teaching method in the clerkship of valvular heart disease for medical students.Methods:Sixty five-year clinical medical undergraduates from Nanjing Medical University (Batch 2016) were randomly divided into experimental group and control group. The experimental group received dynamic cardiovascular 3D model combined with CBL teaching method, while the control group received traditional model combined with CBL teaching method. After the course, the teaching effect was evaluated by examination and questionnaire. SPSS 19.0 was used for independent sample t test and chi-square test. Results:Compared with the control group, the students in experimental group had higher scores of basic theoretical knowledge [(43.10±3.51) vs. (40.87±3.19)] and clinical thinking ability [(42.20±3.15) vs. (40.20±3.81)], with significant differences ( P<0.05). Furthermore, they showed higher evaluation and satisfaction to learning initiative and enthusiasm, mastery of theoretical knowledge, clinical thinking ability, classroom learning interest, classroom activity and clarity of knowledge teaching, with significant differences ( P<0.05). Conclusion:In the teaching of valvular heart disease clerkship, the application of self-made dynamic cardiovascular three-dimensional model combined with CBL teaching method, can cultivate students' clinical diagnostic thinking ability and improve teaching quality.

Objective:To analyze the molecular epidemiological characteristics of GⅡNorovirus (NoV) infection in children in Tianjin Children′s Hospital in 2018.Methods:Single center study. From January to December 2018, a total of 2 185 stool specimens were collected from the children with acute gastroenteritis suspected caused by virus infection in Tianjin Children′s Hospital. Norovirus was detected by real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR).The capsid protein VP1(VP1) region of positive samples was amplified and sequenced. The phylogenetic tree was constructed by MEGA5.05 for analyzing the results. The detection of NoV in different age groups and different months were compared by SPSS 20.0.Results:Among the 2 185 stool specimens,610 were NoV positive, the positive rate was 27.9% (610/2 185).All of the positive samples were GⅡgenogroup. Seven genotypes were found, with GⅡ.3 subtype accounting for 46.2%(151/327),GⅡ.4 subtype accounting for 40.1%(131/327),GⅡ.2 subtype accounting for 4.6%(15/327), other subtypes accounting for 9.1%(30/327).There was a significant difference in NoV detection rate among different age groups (χ 2=17.050, P=0.002). Among the positive specimens, the detection rate of less than or equal to 3 years old was the highest which is accounting for 89.2%.Also there was a significant difference in NoV detection rate among different months(χ 2=225.153, P<0.001).November and December are the most frequent months. There was significant difference between GⅡ.3 and GⅡ.4 NoV infection in children with granulocytopenia (χ 2=11.270, P=0.001) , and also in children with respiratory symptoms (χ 2=7.257, P=0.007) . Conclusions:GⅡ.3 and GⅡ.4 were the main genotypes of NoV infection in children in Tianjin in 2018. The Multiple genotypes suggests that the monitoring and prevention of NoV infection in children should continue to be strengthened in the future.

Objective:To investigate the clinical application and efficacy of microsurgical peripheral nerve decompression in the treatment of painful diabetic peripheral neuropathy (PDPN) .Methods:From Sep. 2017 to Jun. 2018, 33 PDPN patients of our department were treated with DELLON microsurgical peripheral nerve decompression. All surgeries were assisted with neuroelectrophysiological monitoring during the operation and were followed up for 0.5 to 1 years. Electromyography and VAS pain scores were performed 0.5 years before and after surgery, and the preoperative and postoperative results were compared.Results:Postoperative electromyography showed that sensory nerve conduction velocity (SNCV) was significantly improved compared with preoperative ( P<0.05) , while the postoperative VAS score (4.6±1.8) was significantly lower than that (8.3±2.6) of before ( P<0.05) . Conclusions:Microsurgical peripheral nerve decompression is an effective therapeutic method for PDPN. Intraoperative electrophysiological monitoring can effectively avoid iatrogenic nerve injury. Neurophysiological examination can be used as an objective evidence for definitive diagnosis and evaluation of surgical outcomes.

Objective:Analysis of subtype distribution characteristics of human papillomavirus (HPV) infection, pathological findings of HPV-positive patients operated colposcopy and cervical histopathological examination in Changsha from 2020 to 2022.Methods:Retrospective analysis of HPV infection status of 60 354 patients was treated in the First Affiliated Hospital of Hunan University of Chinese Medicine from Jan. 2020 to Oct. 2022. They were divided into<25 years old group (3 250 cases), 25-34 years old group (19 406 cases), 35-44 years old group (17 297 cases), 45-54 years old group (13 104 cases), 55-64 years old group (4 793 cases) and≥65 years old group (2 504 cases). Cervical exfoliated cells were collected from women and specimen of lesion site were collected from men. HPV genotyping detection used polymerase chain reaction (PCR) and flow fluorescence hybridization, which could detect 27 HPV genotypes. Analyze the distribution of HPV subtypes in patients of different age groups and different treatment departments. Analyze the relationship between the infection of HPV subtypes and the outcome of 224 patients with HPV positive who also underwent colposcopy and cervical histopathology. Pearson correlation test was used for correlation analysis, and two-tailed P<0.05 was statistically significant; Pearson chi-square test or continuous correction chi-square test was used to compare the rates between groups, and two-tailed P<0.05 was statistically significant; Chi-square split test was used to compare multiple sample rates. The standard test was corrected according to the number of groups and then compared. The difference was statistically significant when the two-tailed P value was less than the corrected standard test. Results:The overall positive rate of HPV was 16.4% (9 909/60 354). Among all HPV positive patients, affection of single type HPV accounted for 75.5% (7 479/9 909) and affection of multi-type HPV accounted for 24.5% (2 430/9 909). The top six HPV types with infection rates from high to low were: HPV52 22.8% (2 256/9 909), HPV58 11.1% (1 097/9 909), HPV53 10.5% (1 045/9 909), HPV16 9.0% (890/9 909), HPV61 7.8% (774/9 909) and HPV6 7.6% (750/9 909). The difference of overall infection rate between different age groups was statistically significant (χ 2=536.90, P<0.001). The HPV infection rate was the highest in the<25 years old group, 30.1% (978/3 250), and it is higher than the age groups of 25-34 years old, 15.6% (3 035/19 406), group of 35-44 years old, 14.2% (2 464/17 297), group of 45-54 years old, 16.1% (2 115/13 104), group of 55-64 years old, 19.1% (915/4 793) and group of≥65 years old, 16.1% (402/2 504), with statistical significance( P<0.001 respectively). The most common types of HPV infection were type 6, 16.7% (378/2 266) and type 11, 10.5% (239/2 266) in dermatology clinics. The positive rate of HPV16 accounted for 12/17 in cervical intraepithelial neoplasia (CIN) 3 and cervical cancer cases, it was significantly higher than that in the inflammatory cases, 25.0% (35/140) and CIN1 cases, 23.0% (11/48), the statistical values were χ 2=15.02, P<0.001 and χ 2=12.48, P<0.001, respectively, all of which were statistically significant. Conclusions:HPV infection rate is highest in young people under 25 years old. Low-risk HPV6 and 11 are the main types of skin and venereal diseases. Among the total cases, high-risk HPV52, 58 and 53 are the most common types of infection with women in Changsha. However, high-grade cervical intraepithelial neoplasia and cervical cancer are more closely related to HPV16 infection.