1.The Clinical and Genetics Characteristics of Oculopharyngodistal Myopathy
Jiaxi YU ; Zhihao QUAN ; Yilei ZHENG ; Jing AN ; Jing LIU ; Qingqing WANG ; Lingchao MENG ; Meng YU ; Zhiying XIE ; Jianwen DENG ; He LYU ; Wei ZHANG ; Yun YUAN ; Zhaoxia WANG
JOURNAL OF RARE DISEASES 2026;5(2):164-174
To analyze the clinical and genetic features of oculopharyngodistal myopathy (OPDM) patients and compare the phenotypic differences among various causative genes. A total of 65 genetically confirmed OPDM patients from 43 unrelated families, who were admitted to the Department of Neurology, Peking University First Hospital between January 2008 and December 2025, were retrospectively included.The general demographic data, clinical manifestations, laboratory/auxiliary examinations, muscle pathology, and genetic test results were systematically collected and analyzed. The clinical and pathological characteristics among different OPDM subtypes were compared. Among the 65 patients(39 male and 26 female), the mean age of onset was (31.20±10.43) years (range: 14 to 63 years). The initial symptom was predominantly distal limb weakness (67.44%), which gradually progressed to involve the extraocular muscles, pharyngeal muscles, facial muscles and proximal limb muscles. Serum creatine kinase levels were mildly to moderately elevated. Muscle pathological examinations revealed rimmed vacuoles and intranuclear inclusions (within muscle fibers). The mean duration from onset to diagnosis was (12.33±7.88) years (range: 1 to 32 years). All probands had negative results on conventional next-generation whole-exome sequencing; pathogenic variants were identified through third-generation long-read sequencing or OPDM-targeted repeat-primed polymerase chain reaction(RP-PCR). Among the 43 families, OPDM2 subtype was the most common genetic subtype ( OPDM2 was the predominant subtype in this study. All subtypes share similar age of onset and muscular pathological changes, yet exhibit distinct disease progression patterns. Future multicenter prospective cohort studies are warranted to further elucidate the clinical characteristics, pathogenetic mechanisms, and prognostic differences among OPDM subtypes.
2.Preoperative nebulized indocyanine green-assisted thoracoscopic anatomical lesion resection for congenital pulmonary airway malformations in children: A retrospective cohort study
Hongguang SHI ; Junpeng DU ; Jiaxi WANG ; Peiliang SUN ; Zhenqiu CHEN ; Weibo ZHANG ; Zhe FU ; Mingjun ZHENG ; Yongqian MA
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(09):1412-1418
Objective To investigate the efficacy of preoperative nebulized indocyanine green (ICG)-assisted thoracoscopic anatomical lesion resection (TALR) in treating pediatric congenital pulmonary airway malformation (CPAM). Methods A retrospective analysis was conducted on clinical data of 45 children with CPAM who underwent thoracoscopic surgery at the Third Affiliated Hospital of Zhengzhou University between June 2023 and March 2025. The patients were divided into an ICG group (preoperative nebulized ICG 0.5 mg/kg+TALR) and a non-ICG group (TALR under white light), with perioperative and postoperative recovery parameters compared between groups. Results A total of 45 children [22 males, 23 females; median age 7.4 (1.1-75.0) months] were enrolled. The ICG group (n=22) and non-ICG group (n=23) both achieved uneventful recoveries. Compared to the non-ICG group, the ICG group demonstrated significantly shorter surgical duration [91.3 (38.0-144.0) min vs. 100.0 (50.0-175.0) min, P=0.032], reduced intraoperative blood loss [3.0 (2.0-10.0) mL vs. 5.0 (1.0-10.0) mL, P=0.049], shorter postoperative drainage duration [2.7 (1.9-3.9) d vs. 3.4 (1.8-19.9) d, P=0.003], and shortened hospital stay [4.6 (2.9-9.8) d vs. 5.0 (3.9-21.5) d, P=0.013]. Residual lesions occurred in 2 patients from the non-ICG group but none in the ICG group. Intragroup comparisons revealed significant improvements in ratio of time to peak tidal expiratory flow to expiratory time, ratio of volume to peak tidal expiratory flow to expiratory volume, and tidal volume per kilogram after surgery in both groups (P<0.05), though intergroup differences showed no statistical significance (P>0.05). Conclusion Preoperative nebulized ICG administration facilitates lesion identification in CPAM, reduces technical difficulty of TALR, enhances therapeutic outcomes, and provides valuable assistance for performing TALR procedures.
3.Dystrophinopathy in the paravertebral muscle of adolescent idiopathic scoliosis: a prospective case-control study in China
Junyu LI ; Danfeng ZHENG ; Zekun LI ; Jiaxi LI ; Zexi YANG ; Xiang ZHANG ; Yingshuang ZHANG ; Miao YU
Asian Spine Journal 2025;19(1):64-73
Methods:
This study enrolled 40 patients with AIS, 20 patients with congenital scoliosis (CS), and 20 patients with spinal degenerative disease (SDD). All patients underwent open posterior surgery in our hospital, and a paravertebral muscle (multifidus muscle) biopsy was performed intraoperatively. This study included many indexes that describe muscle, especially dystrophin staining. The above pathological results were compared among the AIS, CS, and SDD groups. The correlation between the Cobb angle and Nash–Moe classification and the above pathological results was analyzed in patients with AIS.
Results:
Significant reductions in the dystrophin staining of dystrophin-1 (p<0.001), dystrophin-2 (p<0.001), and dystrophin-3 (p<0.001) were observed in the AIS group than in the CS and SDD groups. The higher the Nash–Moe classification in the AIS group, the more significant the loss of dystrophin-2 (p=0.042) in the convex paraspinal muscles. Additionally, a significantly positive correlation was observed between the reductions of dystrophin-2 on the concave side of the AIS group and Cobb angle (p=0.011).
Conclusions
Dystrophin protein deficiency in the paraspinal muscles plays a crucial role in AIS formation and progression. The severity of scoliosis in patients with AIS is correlated with the extent of dystrophin loss in the paravertebral muscles. Therefore, dystrophin dysfunction may be relevant to AIS occurrence and development.
4.Dystrophinopathy in the paravertebral muscle of adolescent idiopathic scoliosis: a prospective case-control study in China
Junyu LI ; Danfeng ZHENG ; Zekun LI ; Jiaxi LI ; Zexi YANG ; Xiang ZHANG ; Yingshuang ZHANG ; Miao YU
Asian Spine Journal 2025;19(1):64-73
Methods:
This study enrolled 40 patients with AIS, 20 patients with congenital scoliosis (CS), and 20 patients with spinal degenerative disease (SDD). All patients underwent open posterior surgery in our hospital, and a paravertebral muscle (multifidus muscle) biopsy was performed intraoperatively. This study included many indexes that describe muscle, especially dystrophin staining. The above pathological results were compared among the AIS, CS, and SDD groups. The correlation between the Cobb angle and Nash–Moe classification and the above pathological results was analyzed in patients with AIS.
Results:
Significant reductions in the dystrophin staining of dystrophin-1 (p<0.001), dystrophin-2 (p<0.001), and dystrophin-3 (p<0.001) were observed in the AIS group than in the CS and SDD groups. The higher the Nash–Moe classification in the AIS group, the more significant the loss of dystrophin-2 (p=0.042) in the convex paraspinal muscles. Additionally, a significantly positive correlation was observed between the reductions of dystrophin-2 on the concave side of the AIS group and Cobb angle (p=0.011).
Conclusions
Dystrophin protein deficiency in the paraspinal muscles plays a crucial role in AIS formation and progression. The severity of scoliosis in patients with AIS is correlated with the extent of dystrophin loss in the paravertebral muscles. Therefore, dystrophin dysfunction may be relevant to AIS occurrence and development.
5.Efficacy comparison of robotic-assisted versus manual percutaneous vertebroplasty for vertebral compression fractures
Shuangpeng JIANG ; Yuyang HAN ; Jiaxi WANG ; Gang ZHANG ; Chao DONG ; Hongxing SONG ; Qi YAO
Journal of Capital Medical University 2025;46(5):770-776
Objective To evaluate the clinical outcomes of robot-assisted percutaneous vertebroplasty(PVP)versus manual PVP in treating osteoporotic vertebral compression fractures(OVCF),and explore the advantages of robotic assistance for clinical decision-making.Methods Patients who underwent single-level PVP for OVCF at the Department of Joint Surgery and Bone Tumor,Beijing Shijitan Hospital,Capital Medical University,between April 2021 and April 2025 were enrolled.The robot group(n=29)and manual PVP group(control,n=88)were followed-up for 1 month.Parameters compared included:total hospital stay,operative time,cement volume,cement leakage rate,nerve injury rate,intraoperative fluoroscopy number,first-attempt success rate of puncture,postoperative versus preoperative anterior vertebral height difference,Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores preoperatively,at 1-day and 1-month postoperatively.Results No statistically significant differences existed in baseline characteristics(gender,age,fracture-to-surgery interval,and fracture distribution)between groups(P>0.05).The number of intraoperative fluoroscopy times and the ODI index on the first day after surgery in the robot group were significantly lower than those in the control group(P<0.05),and the first-attempt success rate of puncture was significantly higher than that in the control group(P<0.05).There were no statistically significant differences in the other parameters between the two groups(P>0.05).Conclusion Both robot-assisted PVP and manual PVP have good clinical efficacy in the treatment of OVCF.Robot-assisted PVP can reduce the number of intraoperative fluoroscopy times and may have more advantages in improving the first-attempt success rate of puncture and early postoperative lumbar function.However,its reliability needs to be further verified through large-sample randomized controlled studies with multivariate analysis.
6.Effects of aerobic exercise training combined with cognitive behavioral therapy on blood pressure, exercise tolerance, and sleep quality in patients with sleep disorders
Jiaxi PAN ; Yunrui ZHANG ; Fanqi KONG
Chinese Journal of Primary Medicine and Pharmacy 2025;32(2):214-221
Objective:To investigate the effects of aerobic exercise training combined with cognitive behavioral therapy on blood pressure, exercise tolerance, and sleep quality in patients with sleep disorders complicated by high-normal blood pressure.Methods:A total of 60 individuals with sleep disorders complicated by high-normal blood pressure, who underwent community health screening and received treatment at the Third Affiliated Hospital of Wenzhou Medical University (Ruian People's Hospital) from February 2022 to February 2024, were prospectively included in this study. The patients were randomly assigned to two groups using a random number table: a cognitive therapy group and a combined intervention group, with 30 patients in each group. The cognitive therapy group received cognitive behavioral therapy, while the combined intervention group received both aerobic exercise training and cognitive behavioral therapy. Changes in blood pressure, the proportion of patients with elevated blood pressure, exercise tolerance, and Pittsburgh Sleep Quality Index (PSQI) score were compared between the two groups. Additionally, the overall effective rate of treatment for sleep disorders was evaluated for both groups.Results:Before intervention, there was no statistically significant difference in blood pressure between cognitive therapy and combined intervention groups ( P > 0.05). After intervention, the 24-hour mean systolic blood pressure was (121.63 ± 3.47) mmHg (1 mmHg = 0.133 kPa) for the cognitive therapy group and (114.56 ± 3.07) mmHg for the combined intervention group. The 24-hour mean diastolic blood pressure was (81.03 ± 2.78) mmHg for the cognitive therapy group and (77.59 ± 2.09) mmHg for the combined intervention group. Both the 24-hour mean systolic and diastolic blood pressures in each group significantly decreased when compared with the values recorded before intervention ( t = 10.54, 17.52, 5.52, 10.68, all P < 0.05). After intervention, both the 24-hour mean systolic and diastolic blood pressures in the combined intervention group were significantly lower than those in the cognitive therapy group ( t = 8.36, 5.41, both P < 0.001). Before intervention, there was no statistically significant difference in the proportion of patients with elevated blood pressure between the two groups ( P > 0.05). After intervention, the proportion of patients with elevated blood pressure was 40.00% (12/30) in the cognitive therapy group and 66.67% (20/30) in the combined group. Both groups showed a significant increase in the proportion of patients with elevated blood pressure compared with pre-intervention values ( χ2 = 4.02, 11.38, both P < 0.05). After intervention, the proportion of patients with elevated blood pressure in the combined intervention group was significantly higher than that in the cognitive therapy group ( χ2 = 4.28, P < 0.05). Before intervention, there was no significant difference in exercise tolerance between the two groups ( P > 0.05). After intervention, the combined intervention group showed significant increases in anaerobic threshold [(1 475.25 ± 415.65) mL/min] and oxygen pulse [(14.78 ± 2.86) mL/beat] compared with pre-intervention values ( t = 3.58, 7.49, both P < 0.05). However, there was no significant difference in the carbon dioxide ventilation equivalent (VE/VCO 2@VCP) at the ventilatory compensation point compared with pre-intervention levels ( P > 0.05). After intervention, the anaerobic threshold and oxygen pulse in the combined intervention group were significantly higher than those in the cognitive therapy group [(1 137.41 ± 349.86) mL/min, (9.94 ± 2.05) mL/beat] ( t = -3.40, -7.53, both P < 0.05). There was no significant difference in exercise tolerance in the cognitive therapy group between pre- and post-intervention ( P > 0.05). Before intervention, there was no significant difference in PSQI score between cognitive therapy and combined intervention groups ( P > 0.05). After intervention, score for sleep quality [(1.65 ± 0.26) points , (1.24 ± 0.23) points], sleep onset time [(1.51 ± 0.19) points, (1.33 ± 0.18) points], sleep time [(1.47 ± 0.23) points, (1.31 ± 0.20) points], sleep efficiency [(1.31 ± 0.20) points, (1.05 ± 0.19) points], sleep disturbance [(0.93 ± 0.15) points, (0.77 ± 0.20) points], hypnotic medication use [(0.96 ± 0.22) points, (0.67 ± 0.17) points], and daytime function [(1.19 ± 0.25) points, (1.02 ± 0.22) points] decreased in both groups compared with pre-intervention scores ( t = 8.21, 15.58, 9.86, 14.76, 10.02, 15.36, 8.78, 17.59, 7.84, 12.36, 5.74, 11.98, 12.03, 17.14, all P < 0.05). After intervention, PSQI score in the combined intervention group was significantly lower than that in the cognitive therapy group ( t = 6.46, 3.76, 2.87, 5.16, 3.50, 5.71, 2.79, all P < 0.05). The total effective rate for treating sleep disorders in the combined intervention group was 86.67% (26/30), which was significantly higher than that in the cognitive therapy group [63.33% (19/30), χ2 = 4.35, P < 0.05). Conclusions:Aerobic exercise training combined with cognitive behavioral therapy can improve exercise tolerance, reduce blood pressure, and enhance sleep quality in patients with sleep disorders and high-normal blood pressure.
7.Efficacy comparison of robotic-assisted versus manual percutaneous vertebroplasty for vertebral compression fractures
Shuangpeng JIANG ; Yuyang HAN ; Jiaxi WANG ; Gang ZHANG ; Chao DONG ; Hongxing SONG ; Qi YAO
Journal of Capital Medical University 2025;46(5):770-776
Objective To evaluate the clinical outcomes of robot-assisted percutaneous vertebroplasty(PVP)versus manual PVP in treating osteoporotic vertebral compression fractures(OVCF),and explore the advantages of robotic assistance for clinical decision-making.Methods Patients who underwent single-level PVP for OVCF at the Department of Joint Surgery and Bone Tumor,Beijing Shijitan Hospital,Capital Medical University,between April 2021 and April 2025 were enrolled.The robot group(n=29)and manual PVP group(control,n=88)were followed-up for 1 month.Parameters compared included:total hospital stay,operative time,cement volume,cement leakage rate,nerve injury rate,intraoperative fluoroscopy number,first-attempt success rate of puncture,postoperative versus preoperative anterior vertebral height difference,Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores preoperatively,at 1-day and 1-month postoperatively.Results No statistically significant differences existed in baseline characteristics(gender,age,fracture-to-surgery interval,and fracture distribution)between groups(P>0.05).The number of intraoperative fluoroscopy times and the ODI index on the first day after surgery in the robot group were significantly lower than those in the control group(P<0.05),and the first-attempt success rate of puncture was significantly higher than that in the control group(P<0.05).There were no statistically significant differences in the other parameters between the two groups(P>0.05).Conclusion Both robot-assisted PVP and manual PVP have good clinical efficacy in the treatment of OVCF.Robot-assisted PVP can reduce the number of intraoperative fluoroscopy times and may have more advantages in improving the first-attempt success rate of puncture and early postoperative lumbar function.However,its reliability needs to be further verified through large-sample randomized controlled studies with multivariate analysis.
8.Effects of baicalin on ferroptosis of mouse fibroblasts under high glucose treatment and its mechanism
Zheng GONG ; Xiaowei ZHANG ; Xiaomei LI ; Zhimin YIN ; Limin BAI ; Jiaxi WANG ; Yujia HAN ; Shuangyi XU ; Lu YU ; Gang XU
Chinese Journal of Burns 2025;41(3):277-285
Objective:To investigate the effects of baicalin on ferroptosis of mouse fibroblasts (Fbs) under high glucose treatment and its mechanism, and to provide a basis for the treatment of diabetic wounds.Methods:The study was an experimental study. Mouse Fbs were collected and divided into control group with conventional culture, high glucose group treated with glucose at final molarity of 30.0 mmol/L, and low baicalin group and high baicalin group pretreated with baicalin at final molarties of 5 and 10 μmol/L respectively and then treated as that in high glucose group. After 48 h of culture, the cell survival rate was detected by the cell counting kit-8, the reactive oxygen species level in cells was detected by the fluorescent probe method, the levels of malondialdehyde, glutathione, and ferrous ion in cells were detected by colorimetry, and the protein expression levels of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) in cells and nuclear factor-erythroid 2-related factor 2 (Nrf2) in cytoplasm and nucleus were detected by Western blotting. Another batch of mouse Fbs were collected and divided into control group, high glucose group, high baicalin group, and high baicalin+ML385 group. The cells in the first three groups were treated as before, the cells in the last group were pretreated with baicalin and ML385 of Nrf2 inhibitor at final molarties of 10 μmol/L and then treated as that in high glucose group. After 48 h of culture, the protein expression levels of SLC7A11 and GPX4 in cells and the protein expression level of Nrf2 in cytoplasm and nucleus were detected as before. Except that the sample number in detecting SLC7A11 and GPX4 was 4, the sample number in detecting other indexes was 3.Results:After 48 h of culture, the cell survival rates in control group, high glucose group, low baicalin group, and high baicalin group were (100.0±10.7)%, (70.0±5.0)%, (80.9±3.2)%, and (91.4±1.9)%, respectively. Compared with those in control group, the cell survival rate, the glutathione level, and SLC7A11 and GPX4 protein expression levels in cells, and nuclear Nrf2 protein expression level were significantly decreased in high glucose group ( P<0.05), and the levels of reactive oxygen species, malondialdehyde, and ferrous ion in cells, and cytoplasmic Nrf2 protein expression level were significantly increased in high glucose group ( P<0.05). Compared with those in high glucose group, the cell survival rate, glutathione level, SLC7A11 and GPX4 protein expression levels in cells, and nuclear Nrf2 protein expression level in low baicalin group and high baicalin group were significantly increased ( P<0.05), the reactive oxygen species and ferrous ion levels in cells, and cytoplasmic Nrf2 protein expression level in low baicalin group and high baicalin group were significantly decreased ( P<0.05), and the malondialdehyde level in cells in high baicalin group was significantly decreased ( P<0.05). Compared with those in low baicalin group, the cell survival rate, glutathione level, SLC7A11 and GPX4 protein expression levels in cells, and nuclear Nrf2 protein expression level in high baicalin group were significantly increased ( P<0.05), and the reactive oxygen species, malondialdehyde, and ferrous ion levels in cells, and cytoplasmic Nrf2 protein expression level in high baicalin group were significantly decreased ( P<0.05). After 48 h of culture, compared with those in control group, the nuclear Nrf2 protein expression level and SLC7A11 and GPX4 protein expression levels in cells were significantly decreased ( P<0.05), and the cytoplasmic Nrf2 protein expression level was significantly increased in high glucose group ( P<0.05); compared with those in high glucose group, the cytoplasmic Nrf2 protein expression level was significantly decreased ( P<0.05), and the nuclear Nrf2 protein expression level and SLC7A11 and GPX4 protein expression levels in cells were significantly increased in high baicalin group ( P<0.05); compared with those in high baicalin group, the cytoplasmic Nrf2 protein expression level was significantly increased ( P<0.05), and the nuclear Nrf2 protein expression level and SLC7A11 and GPX4 protein expression levels in cells were significantly decreased in high baicalin+ML385 group ( P<0.05). Conclusions:Baicalin can inhibit the occurrence of ferroptosis in cells by activating the Nrf2 signaling pathway and up-regulating the expressions of proteins related to SLC7A11/GPX4 axis in Fbs in high glucose treatment, thus increasing the cell survival rate.
9.Identifying risk factors for acute graft-versus-host disease in patients with acute myeloid leukemia undergoing haploidentical hematopoietic stem cell transplantation
Dan FENG ; Wei LIANG ; Jiaxin CAO ; Yigeng CAO ; Xin CHEN ; Cuicui LIU ; Rongli ZHANG ; Weihua ZHAI ; Jialin WEI ; Qiaoling MA ; Donglin YANG ; Yi HE ; Sizhou FENG ; Mingzhe HAN ; Aiming PANG ; Hongtao WANG ; Jiaxi ZHOU ; Erlie JIANG
Chinese Journal of Hematology 2025;46(10):914-920
Objective:To identify the risk factors for acute graft-versus-host disease (aGVHD) in patients with acute myeloid leukemia (AML) undergoing haploidentical hematopoietic stem cell transplantation (HID-HSCT) .Methods:A total of 141 AML patients who underwent HID-HSCT at the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, from January 2020 to July 2021 were included. The cumulative incidence of aGVHD was analyzed using the Fine-Gray competing risk model, with relapse and death as competing events, to compare differences between groups. Potential risk factors were evaluated by univariable and multivariable Cox proportional hazards regression analyses to determine their independent effects on aGVHD.Results:Among the 141 patients, 86 (61.0%) were male and 55 (39.0%) were female, with a median age at transplantation of 34 years. Within 100 days post-transplant, 59 patients developed grade Ⅱ-Ⅳ aGVHD, whereas 86 patients experienced no or grade Ⅰ aGVHD (the grade 0-Ⅰ aGVHD group) . Survival analysis showed that the 3-year overall survival was 68.7% (95% CI: 57.7%-81.9%) in the grade Ⅱ-Ⅳ aGVHD group, compared with 78.8% (95% CI: 70.4%-88.3%) in the grade 0 - Ⅰ aGVHD group, with the difference not being statistically significant ( P=0.190) . Univariable analysis identified donor age ( P=0.020, HR=1.020, 95% CI: 1.000-1.040) and the female donor-male recipient sex combination ( P=0.033, HR=1.980, 95% CI: 1.160-3.380) as risk factors for grade Ⅱ-Ⅳ aGVHD. Multivariable analysis confirmed that donor age ( P=0.005, HR=1.026, 95% CI: 1.008-1.047) and the female donor-male recipient sex combination ( P=0.002, HR=2.339, 95% CI: 1.354-4.037) were independent risk factors for aGVHD. Patients receiving grafts from donors aged >45 years had a significantly higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD compared with those receiving grafts from donors ≤45 years [54.7% (95% CI: 42.3%-67.0%) vs 31.6% (95% CI: 21.0%-42.1%) , P=0.006]. Similarly, patients with the female donor-male recipient sex combination had a higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD than those with other sex combinations [56.8% (95% CI: 40.4%-73.1%) vs 36.9% (95% CI: 27.5%-46.3%) , P=0.015]. Conclusion:Older donor age and the female donor-male recipient sex combination remain independent risk factors for aGVHD in patients with AML undergoing HID-HSCT.
10.Investigation on an outbreak of acute hemorrhagic conjunctivitis at a boarding middle school in Guangdong Province
Chinese Journal of School Health 2025;46(6):878-882
Objective:
To investigate the characteristics and risk factors of an outbreak of acute hemorrhagic conjunctivitis (AHC) in a boarding middle school in Guangdong Province, in order to provide a scientific evidence for effective prevention and control of campus AHC outbreaks.
Methods:
From September 1st to 28th 2023, case identification was conducted among 559 students and 60 faculty members using standardized definition. Descriptive analysis was conducted on the three distrubution patterns of the outbreak. Questionnaires were designed, and a case-control study was adopted to analyze the possible risk factors of the disease transmission. The propensity score matching (PSM) method was used to control the difference of baseline data.
Results:
A total of 269 cases of AHC were identified, with an attack rate of 43.46%. The pathogen was confirmed as Coxsackie virus A24 variant (CA24v). Among these, 264 cases were students (attack rate of 47.23%) and 5 were staff (attack rate of 8.33%). A total of 153 pairs of PSM were successfully matched. After PSM matching, there were no statistically significant differences in gender, grade and class between the case group and the control group ( χ 2=0.12, 5.41, 11.24, P >0.05). The results of multivariate Logistic regression analysis showed that middle school students whose towels contacted with others ( OR =1.81), and direct contact with other AHC cases recently ( OR =4.89) were more likely to have AHC; while wearing glasses ( OR =0.43) and frequent use of hand sanitizer ( OR = 0.37 ) were less likely to have AHC ( P <0.05).
Conclusion
The outbreak of AHC is caused by CA24v, demonstrating rapid spread and extensive impact within the school setting.


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