Objective:To characterize the molecular evolution of coxsackievirus A10 (CVA10) strains in Anhui Province.Methods:The nucleic acids of CVA10 isolates in Anhui Province were extracted for whole-genome PCR amplification. One-generation sequencing was performed and the complete whole-genome sequences of 10 isolates were obtained. Nucleotide and amino acid sequence similarity analysis of CVA10 isolates and reference strains was performed using MegAlign in DNAStar software. MEGA 11.0 was used to classify the genotypes of CVA10 isolates and representative strains based on phylogenetic analysis of the VP1 region, and the average evolutionary differences between genotypes were calculated. BioEdit 7.2 was used to calculate the entropy of amino acid substitution in the P1-P3 region of the isolates and analyze the amino acid non-synonymous substitution sites. Recombination signals associated with the Anhui isolates were detected using RDP4 and further verified using Simplot 3.5. DnaSp6 software was selected to analyze the selection pressure of CVA10 isolates and prototype strains.Results:Based on the VP1 region, CVA10 isolates and CVA10 representative strains were categorized into A-F genotypes, and most of the CVA10 prevalent in mainland China belonged to the F genotype, with some isolates in Anhui Province being more closely related to the Yunnan isolates. The average rate of evolutionary difference in nucleotides among genotypes ranged from 18.70% to 33.70%. The isolates shared 17 non-synonymous amino acid mutation sites in the VP1 region, and amino acid substitutions in the VP1, 3A and 3C regions might affect the pathogenicity of the strains. The isolates frequently recombined with a variety of other EVA strains in the 5′UTR, 2C, 3C, 3D, and 3′UTR regions. Selection pressure analysis of the isolates showed that the isolate genes were affected by negative selection pressure.Conclusions:Genetic evolutionary analysis of CVA10 suggests that mutations and recombination with other types of EVA strains are prevalent, affecting the molecular epidemiological trend of CVA10, and that molecular surveillance of CVA10 strains in Anhui Province should continue to be strengthened.

Objective:To characterize the molecular evolution of coxsackievirus A10 (CVA10) strains in Anhui Province.Methods:The nucleic acids of CVA10 isolates in Anhui Province were extracted for whole-genome PCR amplification. One-generation sequencing was performed and the complete whole-genome sequences of 10 isolates were obtained. Nucleotide and amino acid sequence similarity analysis of CVA10 isolates and reference strains was performed using MegAlign in DNAStar software. MEGA 11.0 was used to classify the genotypes of CVA10 isolates and representative strains based on phylogenetic analysis of the VP1 region, and the average evolutionary differences between genotypes were calculated. BioEdit 7.2 was used to calculate the entropy of amino acid substitution in the P1-P3 region of the isolates and analyze the amino acid non-synonymous substitution sites. Recombination signals associated with the Anhui isolates were detected using RDP4 and further verified using Simplot 3.5. DnaSp6 software was selected to analyze the selection pressure of CVA10 isolates and prototype strains.Results:Based on the VP1 region, CVA10 isolates and CVA10 representative strains were categorized into A-F genotypes, and most of the CVA10 prevalent in mainland China belonged to the F genotype, with some isolates in Anhui Province being more closely related to the Yunnan isolates. The average rate of evolutionary difference in nucleotides among genotypes ranged from 18.70% to 33.70%. The isolates shared 17 non-synonymous amino acid mutation sites in the VP1 region, and amino acid substitutions in the VP1, 3A and 3C regions might affect the pathogenicity of the strains. The isolates frequently recombined with a variety of other EVA strains in the 5′UTR, 2C, 3C, 3D, and 3′UTR regions. Selection pressure analysis of the isolates showed that the isolate genes were affected by negative selection pressure.Conclusions:Genetic evolutionary analysis of CVA10 suggests that mutations and recombination with other types of EVA strains are prevalent, affecting the molecular epidemiological trend of CVA10, and that molecular surveillance of CVA10 strains in Anhui Province should continue to be strengthened.

Objective : To analyze the epidemiological characteristics and pathogen spectrum of hand，foot mouth disease (HFMD) in Anhui province from 2015 to 2022，and to provide scientific evidence for prevention and control measures of HFMD． Methods : The surveillance data of hand，foot and mouth disease in Anhui province from 2015 to 2022 were analyzed by descriptive epidemiology. Real-time PCR was used to detect and classify HFMD samples. Results : A total of 650 590 HFMD cases were reported in Anhui province from 2015 to 2022，including 1 406 se- vere cases and 17 deaths．The annual reported incidence was 131. 45 /100 000．The epidemic features of“low incidence in odd years and high incidence in even years”were presented from 2015 to 2019．The incidence showed a continuous decline from 2020 to 2022．The monthly distribution showed the characteristics of bimodal epidemic，and the main peak was not obvious in 2020．Hefei，Fuyang，Bozhou，Chuzhou and Suzhou ranked the top five cities in terms of cumulative incidence．The age of onset was mainly distributed in children aged 5 years and below，accounting for 89. 26% of the total cases．The male to female ratio was 1. 48 ∶ 1．A total of 28 657 laboratory-confirmed cases had been reported from 2015 to 2022．EV71 cases accounted for 10. 57% ，Cox A16 cases accounted for 24. 90% ，and other enterovirus cases accounted for 64. 53%．The dominant pathogens showed dynamic changes in different years．Since 2018，the proportion of EV71 decreased significantly，and the proportion of other enteroviruses gradually increased to become the dominant pathogens．Among other enteroviruses，Cox A6 strain was dominant (80. 48% ) ． Conclusion This study suggests that the prevention and control of HFMD in Anhui province should be paid more attention from April to July and from October to December．The focus areas are the cities in northern Anhui and Hefei where the floating population is large．The focus of prevention and control is on children aged 5 years and below．Other enteroviruses have become the dominant pathogens of hand-foot-mouth disease in Anhui province，Cox A6 strain is dominant.

Objective    To analyze the near-term clinical efficacy of two different surgical procedures (Sun's procedure and Debranching combined endovascular stent-graft procedure) to cure Stanford type A aortic dissection, and summarize the clinical experience to help better master the indications of the two surgical procedures. Methods     We retrospectively analyzed the clinical data of 46 patients with Stanford A aortic dissection in our hospital between September 2014 and September 2017. There were 39 males and 7 females at age of 20–74 (48.67±11.80) years. According to different surgical methods, the patients were divided into a Sun's procedure group (26 patients) and a debranching combined endovascular stent-graft procedure group (20 patients). The clinical effect of the two groups was compared. Results     The debranching combined endovascular stent-graft procedure group was significantly superior to the Sun's group in cardiopulmonary bypass (CPB) time, aortic cross clamp(ACC) time, intraoperative urine output, postoperative mechanical ventilation time, postoperative 24 h volumes of drain, CICU time, renal function recovery of postoperative 72 h and total hospital stay(P<0.05). The incidence of transient neurological damage after operation in the debranching combined endovascular stent-graft procedure group was significantly lower than that of the Sun's procedure group(P<0.05). The follow-up time ranged from 3 to 36 months. And the follow-up rate was 90.5%. One patient in the Sun's procedure group died of serious pulmonary infection postoperative 30 days. One patient in the debranching combined endovascular stent-graft group was found to have internal leakage in the early postoperative examination and   disappeared after 6 months. Sun's procedure group did not find endoleak. All patients during the follow-up time did not appear brain, coagulation disorders, stroke, paraplegia, upper limb ischemia and other complications. Conclusion     For Stanford type A aortic dissection, debranching combined surgery may have the risk of postoperative endoleak, but the overall effect is superior to Sun's operation. Therefore, debranching combined surgery should be preferred for the treatment of this type of dissection.

Purpose To investigate the gene expression and significance ofβ-catenin, Cyclin D1 and Notch1 in primary breast cancer stem cells ( BCSC) and matched lymph node metastasis stem cells. Methods 30 cases of breast invasive ductal carcinoma and matched metastasis lymph nodes were made into single cell suspensions, then BCSC were separated from them by immunomagnetic sor-ting. β-catenin, Cyclin D1 and Notch1 gene expressions of Wnt, Notch signaling pathway were detected by real time PCR. ResultsThe expression of β-catenin in primary BCSC and matched lymph nodes metastasis stem cells had statistically no differences ( P >0.05), while the expression of Cyclin D1 and Notch1 in matched lymph nodes metastasis stem cells were significantly higher than the expression in primary BCSC (P<0.01, respectively). Conclusion Compared with the primary cancer stem cells, Cyclin D1 and Notch1 activation in metastasis cancer stem cells are in higher level, which leades to a higher capability of invasion and metastasis, which may be a new therapeutic target.