ObjectiveTo analyze the epidemiological and etiological characteristics of a cluster of human metapneumovirus (HMPV) infection in a kindergarten in Gongshu District of Hangzhou City in May 2024, and to provide reference for the prevention and control of similar outbreaks. MethodsAn on-site investigation was conducted using an epidemiological case investigation form. Throat swab specimens collected from cases were screened for 13 respiratory pathogens using real-time fluorescent polymerase chain reaction (PCR). For HMPV nucleic acid positive specimens, the F gene of HMPV was used as the target gene for amplification and sequencing. The sequencing results were then compared with sequences in GenBank database to determine the virus subtypes and perform phylogenetic analyses. ResultsThe outbreak occurred in a kindergarter junior class with a total of 28 preschoolers and 3 teachers and childcare workers. A total of 11 cases (10 preschoolers and 1 teacher) were identified, including 8 male cases and 3 female cases. Clinical manifestations included fever in all 11 cases (100.00%), cough in 8 cases (72.72%), catarrhal symptoms in 4 cases (36.36%), and headache in 3 cases (27.27%). All symptoms were mild, and no severe cases were observed. A total of 11 throat swab samples were collected. Real-time fluorescent PCR test results showed that 3 samples were positive for HMPV nucleic acid, 2 samples were positive for both HMPV and Streptococcus pneumoniae, and 1 sample was positive for both HMPV and rhinovirus. The sequences of the 6 HMPV nucleic acid positive specimens were amplified and analyzed using specific primers, and all were determined to be HMPV subtype A2b. The F gene fragment sequence showed the highest similarity to PV081665.1/Brazil/2024 (99.65%), and also exhibited high similarity to PP683455.1/Indonesia/2021 (99.48%), PV016275.1/Beijing/2024 (99.31%), and PV052230.1/USA/2024 (99.13%). ConclusionThis cluster of acute respiratory tract infection was caused by HMPV subtype A2b, with co-infection of rhinovirus and Streptococcus pneumoniae. The F gene fragment sequences of the HMPV in this outbreak were highly homologous to those of the A2b strains isolated from Brazil, Beijing, Indonesia, and the the United States.

Objective:To validate the application value and safety of blunt-tip needle technique for computer tomography (CT)-guided percutaneous biopsy of pancreatic lesions.Methods:Clinical data of 103 patients with pancreatic lesions undergoing CT-guided percutaneous biopsy with blunt-tip needle approach in the First Affiliated Hospital of Zhengzhou University from October 2021 to October 2023 were retrospectively analyzed, including 64 males and 39 females, aged (61.5±12.3) years. According to the access routes, procedures were divided into regular group ( n=70) and hard-to-reach group ( n=33). Technical data such as the duration of procedure, number of needle correction scans, and the incidence of complications were recorded. The technical success rate, diagnostic yield, accuracy, sensitivity, specificity, and false-negative rates were compared between groups. Results:The overall technical success rate was 100%(103/103). According to postoperative pathology and clinical follow-ups, the final diagnosis of 103 patients was 98 cases with neoplastic lesions and 5 with non-neoplastic lesions. The overall diagnostic rate of percutaneous biopsy was 91.3%(94/103), with a false negative rate of 5.8%(6/103), sensitivity of 92.9%(90/98), and specificity of 100%(90/90). Duration of procedure [(22.8±6.3) min vs. (22.4±7.9) min], number of needle correction scans [5.0 (3.0, 6.0) times vs. 5.0 (4.0, 7.5) times], length of target access [(69.9±15.4) mm vs. (73.7±17.4) mm], diagnostic yield [90.0%(63/70) vs. 93.9%(31/33)], and accuracy rate [90.0%(63/70) vs. 93.9%(31/33)] were comparable between regular group and hard-to-reach group (all P>0.05). Complications occurred in 8 patients, including 5 patients with hemorrhage and 3 with pancreatitis, which were successfully managed with conventional therapy. The incidence of complications were similar between the hard-to-reach and regular group [9.1%(3/33) vs. 7.1%(5/70), χ2=0.12, P=0.730]. Conclusion:CT-guided percutaneous biopsy in the diagnosis of pancreatic lesions with blunt-tip needle approach has a satisfactory technical success rate, diagnostic yield, accuracy, and safety, which can be used in patients with hard-to-reach lesions.

Objective:To validate the application value and safety of blunt-tip needle technique for computer tomography (CT)-guided percutaneous biopsy of pancreatic lesions.Methods:Clinical data of 103 patients with pancreatic lesions undergoing CT-guided percutaneous biopsy with blunt-tip needle approach in the First Affiliated Hospital of Zhengzhou University from October 2021 to October 2023 were retrospectively analyzed, including 64 males and 39 females, aged (61.5±12.3) years. According to the access routes, procedures were divided into regular group ( n=70) and hard-to-reach group ( n=33). Technical data such as the duration of procedure, number of needle correction scans, and the incidence of complications were recorded. The technical success rate, diagnostic yield, accuracy, sensitivity, specificity, and false-negative rates were compared between groups. Results:The overall technical success rate was 100%(103/103). According to postoperative pathology and clinical follow-ups, the final diagnosis of 103 patients was 98 cases with neoplastic lesions and 5 with non-neoplastic lesions. The overall diagnostic rate of percutaneous biopsy was 91.3%(94/103), with a false negative rate of 5.8%(6/103), sensitivity of 92.9%(90/98), and specificity of 100%(90/90). Duration of procedure [(22.8±6.3) min vs. (22.4±7.9) min], number of needle correction scans [5.0 (3.0, 6.0) times vs. 5.0 (4.0, 7.5) times], length of target access [(69.9±15.4) mm vs. (73.7±17.4) mm], diagnostic yield [90.0%(63/70) vs. 93.9%(31/33)], and accuracy rate [90.0%(63/70) vs. 93.9%(31/33)] were comparable between regular group and hard-to-reach group (all P>0.05). Complications occurred in 8 patients, including 5 patients with hemorrhage and 3 with pancreatitis, which were successfully managed with conventional therapy. The incidence of complications were similar between the hard-to-reach and regular group [9.1%(3/33) vs. 7.1%(5/70), χ2=0.12, P=0.730]. Conclusion:CT-guided percutaneous biopsy in the diagnosis of pancreatic lesions with blunt-tip needle approach has a satisfactory technical success rate, diagnostic yield, accuracy, and safety, which can be used in patients with hard-to-reach lesions.

Aim To identify the underlying target of bullatine A(BA)against rheumatoid arthritis(RA)u-sing limited proteolysis-small molecule mapping(LiP-SMap)drug target proteomics and to provide a scientif-ic basis for clinical application of Aconiti brachypodi Radix in the treatment of RA.Methods LiP-SMap drug target proteomics was employed to perform bioin-formatics analysis for comparing and validating the dif-ferential protein expression after BA intervention.A collagen-induced arthritis(CIA)model was estab-lished in DBA/1 mice using bovine type Ⅱ collagen.The mice were then divided into the CIA model group,methotrexate-positive control group(MTX group),and BA groups(10 mg·kg-1 and 20 mg·kg-1)based on their clinical scores.After drug intervention,the thera-peutic efficacy against RA was assessed by joint index scores and foot thickness measurements.Histopatholog-ical changes in the arthritic joints of CIA mice were e-valuated using hematoxylin and eosin(HE)staining.Enzyme-linked immunosorbent assay(ELISA)was employed to detect inflammatory cytokines interleukin-17(IL-17)and total IgG and IgG3 anti-collagen-spe-cific antibodies levels from the serum of CIA mice.Flow cytometry was used to detect the expression levels of intracellular Th17 cells(IL-17+CD4+T cells)and Th1 cells(IFN-γ+CD4+T cells).Fluorescent quanti-tative PCR was performed to detect the expression of genes related to differential proteins.Results The proteomic analysis identified Serpinb1a as a protein with strong binding affinity to BA,and KEGG enrich-ment analysis indicated IL-17 signaling pathway was a crucial pathway of BA in against RA.BA treatment significantly reduced clinical scores and foot thickness,improved local arthritis symptoms in CIA mice,and al-leviated inflammatory cell infiltration into arthritic joints(P＜0.05).Differential protein validation re-sults showed that BA had strong affinity with Serpinb1a(-5.92 kJ·mol-1)and downregulated the expres-sion of Serpinb1a mRNA.Furthermore,the administra-tion of BA markedly reduced serum IL-17 A levels from CIA mice,inhibited the expression of intracellular IL-17 A and IFN-γ cytokines in splenic CD4+T cells(P＜0.05),and significantly downregulated the transcrip-tional expression of IL-17F(P＜0.05).Conclusion BA exhibits therapeutic effects on collagen-induced arthritis,and its mechanism of action may involve the regulation of Serpinb1a and the IL-17 signaling path-way.

Objective To investigate the learning curve of CT-guided percutaneous lung biopsy.Methods Using cumulative sum(CUSUM)analysis method,the clinical data from 110 patients,who underwent CT-guided percutaneous lung biopsy performed by the same physician at the First Affiliated Hospital of Zhengzhou University of China between May 2024 and October 2024,were retrospectively analyzed.The CUSUM learning curve was fitted,and R2 was used to assess the goodness of fit.The baseline and perioperative data were compared between different stages of the learning curve so as to determine the number of accomplished surgical cases that was required for a physician to reach the proficiency stage from the learning stage in performing CT-guided percutaneous lung biopsy.Results Successful CT-guided percutaneous lung biopsy was accomplished in all patients,with a mean operation time of(20.2+3.4)minutes(range of 15-29 minutes).With the accumulation of surgical cases,the operation time showed a gradual downward trend.The learning curve was best fitted with a cubic equation,the equation was as follows:CUSUM(110)=0.000 3x3-0.081 3x2+5.597 9x+0.774 3(where x representing the number of cases),with a goodness-of-fit coefficient R2=0.991.The fitted curve reached its peak at the performance of the 46th case,which was used as the cutoff point to divide the learning curve into two phases.Compared with the learning phase,in the proficiency phase the incidence of complications was significantly lower(pneumothorax:18.8％vs 37.0％,P=0.033)and the mean operation time was obviously shorter[(18.33+2.31)min vs(22.80±3.02)min,P＜0.001].Conclusion Through precise CUSUM analysis of the learning curves obtained from 110 patients receiving CT-guided percutaneous lung biopsy,the results of this study indicates that it requires to accomplish 46 operations before a physician can skillfully master the technique of CT-guided percutaneous lung biopsy.

Nipah virus is a highly pathogenic zoonotic virus.The viral characteristics,epidemiological features,viral life cycle and pathogenic mechanisms of Nipah virus were summarized in the article,and the alternative drugs tar-geting various stages of the viral life cycle,including antibody drugs,peptide drugs,and small molecule com-pounds,were systematically reviewed.The current challenges confronting the process of research and development of alternative drugs for Nipah virus were analyzed,and an outlook was also made on future research direction of candidate drugs for Nipah virus,aiming to provide comprehensive and in-depth theoretical reference for prevention and control of Nipah virus as well as the development of drugs and to facilitate the further development of related fields.

Objective To design a digital intelligence-driven critical treatment platform to implement integrated treatment procedure inside and outside the hospital and intelligent whole-course managment from pre-hospital emergency care to discharge for critically ill patients.Methods The platform was designed with 5G,IoT,big data and aritificial intelligence techniques and developed with Java language,which adopted Oracle database-based data management and front-end and back-end separation mode,with the front end realized by Vue.js framework and the back end by microservice architecture.There were five functional modules for pre-hospital emergency care,multidisciplinary joint diagnosis and treatment,critical care,quality control management and post-discharge follow-up involved in the platform.Results The platform developed simplified the treatment procedure,enhanced the timeliness of emergency care,decreased the workload of nursing staffs and improved medical service efficiency and working efficiency effectively.Conclusion The platform increases first aid quality and treatment efficiency and provides critically ill patients with high-quality medical experience.[Chinese Medical Equipment Journal,2025,46(1):38-43]

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Nipah virus is a highly pathogenic zoonotic virus.The viral characteristics,epidemiological features,viral life cycle and pathogenic mechanisms of Nipah virus were summarized in the article,and the alternative drugs tar-geting various stages of the viral life cycle,including antibody drugs,peptide drugs,and small molecule com-pounds,were systematically reviewed.The current challenges confronting the process of research and development of alternative drugs for Nipah virus were analyzed,and an outlook was also made on future research direction of candidate drugs for Nipah virus,aiming to provide comprehensive and in-depth theoretical reference for prevention and control of Nipah virus as well as the development of drugs and to facilitate the further development of related fields.

Objective:To investigate the effect of osimertinib combined with pemetrexed and carboplatinon in patients with advanced lung adenocarcinoma epidermal growth factor receptor (EGFR) mutation, and its impact on serum interleukin-6 (IL-6) and cancer antigen 72-4 (CA72-4) levels.Methods:A total of 73 patients with advanced lung adenocarcinoma with EGFR mutation admitted to Peking University Medical Luzhong Hospital from December 2023 to December 2024 were prospectively selected and divided into a single group 36 cases and a treatment group 37 cases by random digits table method. The single group was treated with pemetrexed and carboplatin, and the treatment group was treated with osimertinib on the basis of the single group. The efficacy and pre- and post-therapy cellular immune function (CD 3+, CD 4+ and CD 4+/CD 8+), tumor markers [cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), CA72-4, tumor specific growth factor (TSGF), carcinoembryonic antigen (CEA)], vascular endothelial growth factor (VEGF), IL-6 and untoward reactions were compared. Results:Objective remission rate (ORR) and disease control rate (DCR) in the treatment group were greater than those in the single group: 27.03% (10/37) vs. 8.33% (3/36), 75.68% (28/37) vs. 52.78% (19/36), P<0.05. After therapy, CD 3+, CD 4+ and CD 4+/CD 8+ in the treatment group were higher than those in the single group: 0.675 ± 0.078 vs. 0.618 ± 0.067, 0.335 ± 0.033 vs. 0.275 ± 0.035, 1.25 ± 0.22 vs. 1.06 ± 0.15; the levels of TSGF, CEA, CYFRA21-1, CA72-4, IL-6 and VEGF in the treatment group were lower than those in the single group: (61.39 ± 7.43) kU/L vs. (78.23 ± 9.24) kU/L, (12.64 ± 1.42) μg/L vs. (16.87 ± 2.66) μg/L, (3.58 ± 0.48) μg/L vs. (4.14 ± 0.63) μg/L, (5.43 ± 0.81) kU/L vs. (7.06 ± 1.21) kU/L, (6.17 ± 0.82) ng/L vs. (8.57 ± 1.19) ng/L, (152.19 ± 18.14) pg/L vs. (216.47 ± 23.35) pg/L, P<0.05. The untoward reactions showed no statistical difference between two groups ( P>0.05). Conclusions:The joint of osimertinib combined with pemetrexed in the treatment of advanced lung adenocarcinoma patients with EGFR mutation is beneficial for improving efficacy, enhancing immune function, reducing tumor markers, and has certain safety.