Objective: To analyze epidemiological and genetic characteristics of the fifth avian influenza A (H7N9) wave in Suzhou, and to provide scientific basis for prevention and control of H7N9 virus infection. Methods: Respectively, influenza A/B, H1N1 (pdm09), H3, H5N1, and H7N9 real-time PCR kits were used to detected pharyngeal swab samples which were collected from severe acute respiratory syndrome infection (SARI) cases in Suzhou. The H7N9-positive samples were further examined for virus isolation and gene sequencing. Results: The H7N9 virus was mainly prevalent in winter in Suzhou City. In the fifth H7N9 virus epidemic, the overall fatality rate of human infection with H7N9 virus in Suzhou city was 40% (22/55). Additionally, most were older people (median age was 58 years) and more than 80% of H7N9 patients had live poultry exposure history. The nucleic acid homology of HA gene was 98.7-100%. There were no mutations in the key sites of the HA gene sequence. Conclusions The H7N9 virus can not be effectively spread in the crowd currently, with no significant changes in receptor binding sites (RBS). In addition, exposure to live poultry or contaminated environment is still the main source of human infection with H7N9. At present, the viruses circulating in Suzhou city are low pathogenic to poultry.

Objective: To investigate the epidemical features, etiological and clinical characteristics of HFMD in Suzhou city, from 2011 to 2015, providing the scientific supports for HFMD prevention and control. Methods: In each district of Suzhou city, at least five specimens of mild cases were collected per month, while all of the severe cases were sampled. The RNA from each sample was examined using a commercially available real-time PCR kit. Statistical analysis was performed using SPSS version 11.5 software. Results: We retrospectively analyzed HFMD epidemiological data in Suzhou from 2011 to 2015, a total of 4 552 outpatients in Suzhou city were diagnosed with HFMD, including 2 818 positive specimen, the total positive rate was 61.90%, and there was a significant difference in the positive rates between the adjacent years (χ²=186.09, P<0.0001). From 2011 to 2015 in Suzhou, HFMD mainly affected children aged 1 to 5 years old, 66.17% of them were 1to 3 years old. Enterovirus 71(EV71) and coxsackievirus A16(CVA16) were the predominant viral genotypes in Suzhou from 2011 to 2012, and 2014. In 2013, other EVs were dominant, the severe cases mainly correlated with EV71 subtypes, and the proportion of patients with severe disease was significantly decreased in 2013. Conclusions EV71 and CVA16 are still the important pathogens of HFMD, other EVs also occupy a certain proportion, it is the time to select one or two advantage pathogens from the other EVs into the HFMD monitoring.

Objective:To disclose the epidemiological characteristics of the first human case of H9N2 subtype avian influenza and genetic characteristics of hemagglutinin (HA) gene of H9N2 avian influenza virus in Jiangsu province.Methods:Reverse transcription polymerase chain reaction (RT-PCR) assay was used to detect the nucleic acid of influenza virus A/B and various subtypes from throat swab specimens of patients with acute and severe respiratory infections of unknown cause. Sanger method was used to sequence the vial HA gene of H9N2 positive specimens. N-J phylogenetic tree of HA gene was constructed by using MEGA X software.Results:The first laboratory confirmed case of human infection with H9N2 avian influenza virus in Jiangsu province in March 2019 was reported by Suzhou Center for Disease Control and Prevention. Sequence analysis of the HA gene showed that the A/Suzhou/S683/2019 (H9N2) strain belonged to Y280-like sub-lineage of the Eurasian lineage, which had 99.23% nucleic acid identity with A/chicken/Shanghai/S1171/2018 (H9N2) strain. The amino acid sequence of the HA protein cleavage site is PSRSSR↓GLF, and the key amino acid in receptor binding site shared Q226L mutation. The location of potential glycosylation sites of HA protein of A/Suzhou/S683/2019 (H9N2) have changed.Conclusions:The H9N2 avian influenza virus obtained from the first case in Jiangsu province has low pathogenicity, but it may have acquired part of the ability to adapt to human hosts.

Objective:To analyze the activity of lithium chloride (LiCl) against influenza virus A (H3N2) in human non-small cell lung cancer cells (A549).Methods:Different concentrations of LiCl were incubated with A549 cells, and the cytopathic effect (CPE) was observed after 24 hours, and the effect of LiCl on cell activity was determined by CCK-8 method. After H3N2 (MOI=1) infected A549 cells, different concentrations of LiCl were added and incubated for 24 hours, and the viral load was measured by real time/reverse transcription quantitative polymerase chain reaction (RT-qPCR), and the CPE was observed, and the viral titer was determined. Different concentrations of LiCl were incubated with A549 at 37 ℃ and 5% CO 2 for 2 hours, virus was added and incubated for 24 hours, and the viral load was determined by RT-qPCR. LiCl, H3N2 and A549 were incubated at 4 ℃ for 1 hour, 35 ℃, 5% CO 2 for 24 hours, and viral load was determined by RT-qPCR. H3N2 and A549 were incubated at 4 ℃for 1 hour, then different concentrations of LiCl were added, incubated at 35 ℃ with 5% CO 2 for 24 hours, and the viral load was determined by RT-qPCR. After H3N2 infected A549 cells, different concentrations of LiCl were added and incubated for 24 hours, and the viral RNA load and viral titer of the supernatant and cells were measured, respectively, and then the corresponding ratios of the supernatant and the cells were calculated. After H3N2 (MOI=10) and BV (MOI=1) infected A549 cells, different concentrations of LiCl were added for 24 h, and the viral load was determined by RT-qPCR. Results:When the concentration of LiCl was<50 mmol/L, the cell viability of A549>90%. Different concentrations of LiCl could significantly reduce the viral load of H3N2 ( P<0.000 1), and the CPE of the LiCl treatment group was more dose-dependent than that of the control group. LiCl did not inhibit viral replication by affecting the cell itself; Different concentrations of LiCl significantly inhibited the entry of H3N2 into A549 ( P<0.000 1), and also had a certain inhibitory effect on the adsorption of A549 cells ( P<0.1). LiCl did not affect the assembly and release of H3N2 ( P>0.05), and it was also found that LiCl had a broad spectrum of antiviral effects against multiple influenza virus strains ( P<0.000 1). Conclusions:LiCl may exert antiviral effect by inhibiting the adsorption and entry of H3N2 into A549 cells and the replication of H3N2 in A549 cells, which provides a data reference for the prevention and treatment of viral infection by LiCl.

Objective:To investigate the viral molecular mutations of 2019 novel coronavirus (2019-nCoV) and host adaptability in Suzhou City.Methods:The throat swab specimens from nine local cases and six imported cases with 2019-nCoV viral nucleic acid test positive in Suzhou City were sequenced for the whole genome of the virus, and the Wuhan-Hu-1 strain was used as the reference sequence for alignment and analysis. The phylogenetic tree of the viral whole genome sequence was constructed by MEGA 7.0 software.Results:According to the Chinese typing method, Nextstrain typing method, Pangolin classification method and Global Initiative on Sharing All Influenza Data (GISAID) typing method, the 15 2019-nCoV genome sequences could be divided into seven types, six types, eight types and five subtypes, respectively. Compared with Wuhan-Hu-1 strain, the median number of amino acid sequence mutation sites based on nucleotide translation was three (ranging from 0 to 12). D614G mutation of spike protein was identified from all six imported viral strains, which could enhance the transmissibility. No Alpha, Beta, or Gamma mutants, which also could enhance the transmissibility, was found in the genomic sequences of the imported cases. The median number of nucleotide mutation sites in 15 sequences was eight (ranging from three to 23).Conclusions:2019-nCoV is constantly mutating, and a variety of evolutionary lineages/genotypes have been derived. All imported viruses in Suzhou City carry mutations that can increase infectivity.

PURPOSE: Duodenal stump leakage (DSL) is a potentially fatal complication that can occur after gastrectomy, but its underlying risk factors are unclear. This study aimed to investigate the risk factors and management of DSL after laparoscopic radical gastrectomy for gastric cancer (GC). MATERIALS AND METHODS: Relevant data were collected from several prospective databases to retrospectively analyze the data of GC patients who underwent Billroth II (B-II) or Roux-en-Y (R-Y) reconstruction after laparoscopic gastrectomy from 2 institutions (Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and HwaMei Hospital, University of Chinese Academy of Sciences). The DSL risk factors were analyzed using univariate and multivariate analysis regression. RESULTS: A total of 810 patients were eligible for our analysis (426 with R-Y, 384 with B-II with Braun). Eleven patients had DSL (1.36%). Body mass index (BMI), elevated preoperative C-reactive protein (CRP) level, and unreinforced duodenal stump were the independent risk factors for DSL. DSL was diagnosed in 2–12 days, with a median of 8 days. Seven patients received conservative treatment, 3 patients received puncture treatment, and only 1 patient required reoperation. All patients recovered successfully after treatment. CONCLUSIONS The risk factors of DSL were BMI ≥24 kg/m², elevated preoperative CRP level, and unreinforced duodenal stump. Nonsurgical treatments for DSL are preferred.

Objective:To understand the genome and genetic evolution characteristics of influenza B virus (FluB) in Suzhou city from July 2021 to January 2022.Methods:Real-time fluorescence reverse transcription polymerase chain reaction (Real-Time RT-PCR) was used for the typing of influenza virus (Flu). The detected FluB strains were sequenced by Miseq high-throughput sequencing platform through whole genome capture and library construction. The FluB hemagglutinin (HA), neuraminidase (NA) and matrix protein (MP) gene phylogenetic trees were constructed by Neighbor-Joining method (NJ) with MEGA X software. The Potential N-glycosylation sites of HA and NA proteins were predicted by NetNGlyc 1.0 server software.Results:FluB was detected in 280 of the 1 500 throat swab samples, and the FluB genome sequence was completed in 53 strains. The nucleic acid identity of 8 gene fragments (PB1, PB2, PA, HA, NP, NA, MP, NS) in the FluB strains was 99.3%-100%, 98.1%-100%, 98.8%-100%, 98.0%-100%, 99.2%-100%, 98.4%-100%, 98.2%-100% and 99.0%-100%, respectively. Except for the 4 samples in July 2021, which belonged to the V1A.3 clade of FluB, the rest of the samples belonged to the V1A.3a.2 clade. Every amino acid sequence of HA protein of Flu B collected after October 2021 showed 9-11 substitutions compared with the reference strain (B/Washington/02/2019), which sharing 9 mutation sites (H122Q, A127T, R133G, P144L, N150K, G184E, N197D, K203R and R279K). No drug-resistant mutations associated with NA inhibitors such as oseltamivir were found. Respectively, 11 and 4 potential glycosylation sites were identified in HA and NA proteins of the FluB strains.Conclusions:From July 2021 to January 2022, V1A.3a2 was the dominant FluB strains in Suzhou city, and the amino acid sequences of HA and NA proteins showed multiple site mutations.

Objective:To explore the current status of rumination in inpatients with metastatic prostate cancer (mPCa) under the disease coping mechanism, and analyzing its influencing factors.Methods:From March 2021 to December 2022, 267 mPCa inpatients at the Tenth People's Hospital of Tongji University were selected as the study subject using convenience sampling. The survey was conducted using the General Information Questionnaire, Chinese Version of Event Relate Rumination Inventory (C-ERI), Medical Coping Modes Questionnaire (MCMQ), International Prostate Symptom Score (IPSS), and Social Support Revalued Scale (SSRS), and the factors influencing the rumination in patients were analyzed.Results:This study collected 260 valid questionnaires, with an effective response rate of 97.4% (260/267). The total score of rumination in 260 mPCa patients was (31.08±6.46), with invasive rumination and purposeful rumination scores of (14.13±4.44) and (16.95±4.55), respectively. The initial prostate-specific antigen index, confrontation medical coping modes were the influencing factors of invasive rumination in mPCa patients ( P<0.05). The initial prostate-specific antigen index, course of disease, social support, and confrontation medical coping style were the influencing factors of purposeful rumination in mPCa patients ( P<0.05) . Conclusions:The rumination of mPCa patients is above the medium level, and is influenced by multiple factors under the disease coping mechanism. Clinical medical and nursing staff should combine the clinical situation and characteristics of mPCa patients, provide personalized interventions as early as possible, and assist patients in improving their positive cognitive processing abilities.

ObjectiveTo observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules （明视方颗粒） for low myopia in children with heart yang insufficiency. MethodsA multicentre， prospective， double-blind randomised controlled study was conducted， in which 290 children with low myopia from 8 centres were randomly divided into 145 cases in the treatment group and 145 cases in the control group， and the treatment group was given education， dispensing glasses， and Chinese herbal medicine Mingshi Granules， while the control group was given education， dispensing glasses， and granules placebo. Both Mingshi Granules and placebo granules were taken orally， 1 bag each time， twice daily， 4 weeks of oral intake and 2 weeks of rest as 1 course of treatment， a total of 4 courses of treatment （24 weeks）. Equivalent spherical lenses， best naked-eye distance visual acuity， ocular axis， corneal curvature K1， adjustment amplitude， traditional Chinese medicine （TCM） symptom scores， calculate the amount of progression of equivalent spherical lenses， were observed at the 12th and the 24th week of treatment， at the 36th week and 48th week of follow-up， resectively， the control rate of myopia progression was evaluated at the 24th week， and safety indexes were observed before treatment. ResultsThe amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher （57.60%， 72/125） than that in the control group （44.63%， 54/121） （P＜0.05）. The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group （P＜0.05）. Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment （P＜0.05）， and were higher in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment （P＜0.05）. The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up （P＜0.05）. Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment （P＜0.05）. The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treatment （P＜0.05）. The scores of white/dark complexion， white coating thin pulse， fatigue and total TCM symptom scores of children in both groups at the 12th， 24th， 36th and 48th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； the scores of blurred vision at the 24th and 36th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment （P＜0.05）. In the treatment group， the score of fatigue was higher than that of the control group at the 36-week follow-up， and the score of blurred vision was lower than that of the control group at the 48-week follow-up （P＜0.05）. No adverse reactions or obvious abnormalities of the safety indexes were observed of the two groups during the treatment. ConclusionChinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia， improving the best naked eye distance visual acuity， slowing down the growth of the eye axis， improving some of the TCM symptoms， with good safety.

Platelet-enriched plasma (PRP) contains high concentration of platelets and abundant growth factors, which is made by centrifuging of blood and separating of blood elements. PRP promotes tendon repair by releasing various cytokines to enhance cell proliferation, tenogenic differentiation, formation and secretion of matrix; meantime, it can reduce pain by inhibiting the expression of pain-associated molecules. A number of clinical studies demonstrated that PRP was effective in treatment of tendinopathy, including patellar tendinopathy, lateral epicondylitis and plantar fasciopathy. However, some studies did not support this conclusion, because of disparity of PRP types, therapeutic courses and injections protocols in clinical application. Based on its safety, PRP can be a choice of treatment for tendinopathy, in case other non-surgical therapies are of no effect.
Blood Platelets ; cytology ; Cytokines ; metabolism ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Platelet-Rich Plasma ; Tendinopathy ; therapy