Objective　To detect norovirus in treated hospital sewage in Liuzhou City, and understand the local prevalence and molecular pathogenic characteristics of norovirus, thereby providing a scientific basis for the prevention and control of the diarrhea epidemic. Methods Treated hospital sewage samples from Liuzhou City, collected between 2016 and 2022, underwent viral enrichment followed by nucleic acid extraction and purification. Norovirus (NoV) nucleic acids were detected using real-time RT-PCR. Positive samples were subjected to high-throughput sequencing of the VP1 region gene sequence, with comparative analysis performed using online databases such as NCBI. MEGA11.0 was used to construct an evolutionary tree, DNAStar5.0 was used to analyze nucleotide sequence homology and amino acid sequence variation sites, and SPSS 21.0 was used for statistical analysis. Results Of 742 samples, 251 tested positive for norovirus, with a detection rate of 33.83%. Among them, genogroup Ⅰ(GⅠ) accounted for 138 cases with a detection rate of 18.60%, showing statistically significant differences in detection rates across the years (χ2=41.403, P<0.05); genogroup Ⅱ (GⅡ) accounted for 176 cases with a detection rate of 23.72%, also showing statistically significant annual variation (χ2=34.524, P<0.05). High-throughput sequencing results indicated that from 2016 to 2022, the genotypes of noroviruses in Liuzhou City were predominantly seven subtypes: GⅠ.4, GⅠ.5, GⅡ.2, GⅡ.3, GⅡ.4, GⅡ.12, GⅡ.17, with other subtypes appearing sporadically. The homology of GⅠ was 71.8% to 100.0%, and for GII it was 68.8% to 100.0%. Analysis of the amino acid sequence variation in the VP1 region of noroviruses revealed 14 amino acid variation sites in the GⅡ.3 subtype, 8 in the non-variant GⅡ.4 subtype, with variation sites for other subtypes not exceeding five. No variations were observed in the amino acid sequences of the VP1 region for GⅠ.4 and GⅡ.17 subtypes. Conclusions The prevalence of norovirus in Liuzhou City presents a diversified trend, and sewage monitoring plays a significant public health role in the early detection and warning of infectious disease outbreaks.

Natural medicines (NMs) demonstrate distinct advantages in the clinical management of chronic diseases. Recent years have seen growing recognition of the gut microbiota's role in the efficacy and synergy of NMs, providing new impetus for elucidating the material basis and mechanisms of NMs and their path toward modernization. A fundamental question that has emerged is how NM-microbiota interactions integrate into the multi-target holistic mechanisms of NMs, the answer to which may also illuminate new avenues for drug discovery. Metabolic regulation via small-molecule metabolites has been increasingly implicated in host-microbe interaction. This review presents an integral metabolic perspective on NMs-microbiota interaction in host health and disease. It highlights the emerging understanding of gut microbiota-related metabolic signals implicated in NM components' local and systemic actions. Additionally, it discusses key issues and prospects related to drug development and the translational study of NMs.
Gastrointestinal Microbiome/drug effects* ; Humans ; Biological Products/metabolism* ; Animals

Infectious diseases refer to various diseases caused by pathogens invading human body.Lymphocyte activation gene 3(LAG-3)is a negative immune checkpoint molecule similar to CD4.Most studies have found that LAG-3 plays a regulatory role in occurrence and development of infectious diseases(acquired immunodeficiency disease,active pulmonary tuberculosis,chronic hepa-titis B,falciparum malaria)via inhibiting activation and function of CD4+T and CD8+T cells,and can serve as an effective potential immunotherapy target.This article will summarize researches of LAG-3 and its roles in infectious disease.

Infectious diseases refer to various diseases caused by pathogens invading human body.Lymphocyte activation gene 3(LAG-3)is a negative immune checkpoint molecule similar to CD4.Most studies have found that LAG-3 plays a regulatory role in occurrence and development of infectious diseases(acquired immunodeficiency disease,active pulmonary tuberculosis,chronic hepa-titis B,falciparum malaria)via inhibiting activation and function of CD4+T and CD8+T cells,and can serve as an effective potential immunotherapy target.This article will summarize researches of LAG-3 and its roles in infectious disease.

Intracerebral hemorrhage (ICH) is a hemorrhagic cerebrovascular disease with high incidence and mortality. Oxidative stress response plays an important role in the pathological and physiological processes of ICH, and is also a potential effective target for clinical treatment. In this paper, the pathogenesis of oxidative stress after ICH, mechanism of nerve and vascular injury in oxidative stress, and detection and treatment of oxidative stress are reviewed in order to provide references for basic research and clinical practice in ICH.

Objective:To explore the risk factors for in-hospital mortality in patients with severe trauma and their predictive predictive value.Methods:A retrospective case-control study was used to analyze the data of 509 patients with severe trauma in the trauma database of the Trauma Center of the Second Affiliated Hospital of Soochow University from January 2017 to December 2021, including 377 males and 132 females, aged 18-94 years [53(42, 65)years]. Injury severity score (ISS) was 16-75 points [22(18, 29)points]. Injured parts included the head and neck in 409 patients (80.35%), the chest in 328(64.44%), the abdomen in 193(37.91%), the pelvis in 142(27.90%), the spine in 79(15.52%), and the limb in 247(48.53%). According to the clinical outcome during the hospital stay, the patients were divided into survival group ( n=390) and non-survival group ( n=119). Baseline and clinical data of the two groups were compared, including gender, age, cause of injury (traffic injury, fall from height, sharp instrument injury, etc.), injury site (head and neck, chest, abdomen, pelvis, spine, limb), vital signs on admission (temperature, systolic blood pressure, heart rate, respiratory rate), blood tests on admission [hemoglobin, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen (FIB)], Glasgow coma scale (GCS) upon admission to the emergency room, revised trauma score (RTS) upon admission to the emergency room, ISS after whole-body CT examination, quick sequential organ failure assessment (qSOFA) score upon admission to the emergency room, and INR combined with qSOFA score. The baseline and clinical data of the survival group and the non-survival group were first compared with univariate analysis. Then, the independent risk factors of in-hospital mortality in patients with severe trauma were determined by multivariate Logistic stepwise regression (forward and backward). Based on the above data, receiver operating characteristic (ROC) curves were generated with Medcalc statistical software to analyze the efficacy of each risk factor in assessing in-hospital mortality in patients with severe trauma. Results:Univariate analysis showed that there were significant differences in age, injury site, temperature, systolic blood pressure, hemoglobin, platelet, PT, APTT, INR, FIB, GCS, RTS, ISS, qSOFA score, and INR combined with qSOFA score between the two groups ( P<0.05 or 0.01), while there were no significant differences in gender, cause of injury, heart rate, and respiratory rate between the two groups ( P>0.05). Multivariate Logistic stepwise regression analysis showed that age, systolic blood pressure, APTT, ISS, and INR combined with qSOFA score were significantly correlated with in-hospital mortality in patients with severe trauma ( P<0.01). ROC curve analysis results showed that the area under the curve (AUC) of in-hospital mortality in patients with severe trauma predicted by age, systolic blood pressure, APTT, ISS, and INR combined with qSOFA score were 0.63(95% CI 0.59, 0.68) and 0.60(95% CI 0.55, 0.64), 0.66(95% CI 0.62, 0.70), 0.73(95% CI 0.69, 0.77), and 0.75(95% CI 0.72, 0.80), respectively. Conclusions:Age, systolic blood pressure, APTT, ISS, and INR combined with qSOFA score are the independent risk factors for in-hospital mortality in patients with severe trauma. ISS and INR combined qSOFA score can better predict in-hospital mortality of patients with severe trauma than age, systolic blood pressure and APTT.

Objective: To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district. Methods: A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9, 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR. Results: Among the 8 274 subjects, 2 745 (33.2%) were 2019-nCoV infected; 5 277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (40 vs 56, t=27.569, P<0.001; 52 vs 56, t=6.774, P<0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ²=24.105, P=0.003). Four types of respiratory tract samples and five types of non-respiratory tract samples were found to be positive for 2019-nCoV nucleic acid test. Conclusion The 2019-nCoV nucleic acid positive rate in male is higher than in female. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.

The outbreak of pneumonia caused by novel coronavirus (COVID-19) at the end of 2019 was a major public health emergency in human history. In a short period of time, Chinese medical workers have experienced the gradual understanding, evidence accumulation and clinical practice of the unknown virus. So far, National Health Commission of the People's Republic of China has issued seven trial versions of the "Guidelines for the Diagnosis and Treatment of COVID-19". However, it is difficult for clinicians and laymen to quickly and accurately distinguish the similarities and differences among the different versions and locate the key points of the new version. This paper reports a computer-aided intelligent analysis method based on machine learning, which can automatically analyze the similarities and differences of different treatment plans, present the focus of the new version to doctors, reduce the difficulty in interpreting the "diagnosis and treatment plan" for the professional, and help the general public better understand the professional knowledge of medicine. Experimental results show that this method can achieve the topic prediction and matching of the new version of the program text through unsupervised learning of the previous versions of the program topic with an accuracy of 100%. It enables the computer interpretation of "diagnosis and treatment plan" automatically and intelligently.
Betacoronavirus ; China ; Coronavirus Infections ; diagnosis ; therapy ; Humans ; Machine Learning ; Pandemics ; Pneumonia, Viral ; diagnosis ; therapy ; Practice Guidelines as Topic

Objective To investigate the value of leucine-rich repeat-containing G protein coupled receptor 5 (LGR5) and aldehyde dehydrogenase 1A1 (ALDH1A1) in progression and prognosis of non small-cell lung cancer (NSCLC),in order to find new targets for NSCLC-targeted imaging and radiation therapy.Methods Fresh tissues (n =24) and paraffin embedding tissues (n =109) of patients with NSCLC were collected from the First Affiliated Hospital of Soochow University between November 2009 and March 2012.Quantitative real time-PCR was used for the investigation of expression of LGR5 and ALDH1A1 mRNA in 24 NSCLC patients.Immunohistochemistry (IHC) was used for detecting LGR5 and ALDH1A1 expressions in NSCLC tissues and adjacent normal tissues.Data were analyzed by Mann-Whitney u test,x2 test,Pearson correlation analysis,Kaplan-Meier method,Cox proportional hazards regression model.Results Compared with adjacent normal tissues,LGR5 and ALDH1A1 mRNA were frequently increased in NSCLC tissues (u values:150,74,both P＜0.01),and the expression of LGR5 and ALDH1A1 mRNA was significantly correlated (r=0.416,P＜0.05).Positive LGR5 and ALDH1A1 expression was defined in 28.44％ (31/109) and 41.28％ (45/109) of the NSCLC tumors,respectively.Further analysis indicated that 24 of the LGR5 positive samples (77.42％,24/31) expressed ALDH1A1 (r=0.388,P＜0.01).LGR5 and ALDH1A1 ex pressions in NSCLC with higher TNM stage were significantly higher than those in NSCLC with lower TNM stage (x2 values:4.64,5.24,both P＜0.05).Coexpression of LGR5 and ALDH1A1 in NSCLC with lymph node metastasis was higher than that in NSCLC without lymph node metastasis (x2=4.12,P＜0.05).High expression of LGR5 or ALDH1A1 was related to poor prognosis (x2 values:6.24,4.18,both P＜0.05),and NSCLC patients with coexpression of LGR5 and ALDH1A1 had a poorer prognosis than the others (x2 =10.63,P＜0.01).Both of them were independent risk factors of a poorer prognosis (corrected hazard ratio (95％ CI):2.361(1.106-5.037),2.306(1.101-4.830);both P＜0.05).Conclusions The expressions of LGR5 and ALDH1A1 are closely associated with the tumorigenesis,metastasis and poor prognosis of NSCLC.LGR5 and ALDH1A1 might be new targets for NSCLC-targeted tumor imaging and radiation therapy.

Objective To study the diagnostic value of endoscopic ultrasonography (EUS)for benign and malignant bile duct stricture.Methods Data of 51 patients who underwent EUS from January 2007 to March 2015 due to distal biliary stricture were retrospectively studied.And their diagnosis with EUS,IDUS,bile duct cytological brushing and final diagnosis were compared.Results Malignant bile duct stenosis were finally confirmed in 19 cases and benign stenosis were confirmed in 32 cases.The sensitivity (73.7％ VS 57.1％) and positive predictive value (73.7％ VS 57.1％) of EUS for the benign and malignant diagnosis of biliary tract stenosis were significantly higher than that of IDUS (P＜0.05),while their specificity(84.4％ VS 84.2％)and accuracy(80.4％ VS 76.9％)were similar.The sensitivity of EUS was significantly higher than that of bile duct cytological brushing (73.7％ VS 50.0％),while their specificity (84.4％ VS 100.0％)and accuracy(80.4％ VS 81.6％)were similar.EUS findings of hypoechoic mass features had higher diagnostic accuracy for detecting malignant distal bile duct stricture than irregular thickening of the lumen in the distal bile duct (100.0％ VS 64.3％,P＜0.05).Conclusion For patients with lesions of the distal bile duct that CT/MRI could not diagnose,EUS has an important value for the further diagnosis of benign and malignant bile duct stricture.