Objective:To investigate the effects of mobile intelligent cognitive training(MICT)on cognitive function,ac-tivities of daily living,and quality of life of patients with mild to moderate cognitive impairment after stroke in the community. Method:Ninty-two patients with mild to moderate cognitive impairment after stroke in the community were randomly divided into experimental group(n=46)and control group(n=46).Both groups received comprehen-sive management,and the experimental group received additional MICT for 12 weeks.The Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Prospective and Retrospective Memory Ques-tionnaire(PRMQ),Modified Barthel Index(MBI),Functional Activities Questionnaire(FAQ),and Quality of Life Index(QLI)were assessed before,4 weeks and 8 weeks after treatment,and 1-month follow-up after the end of treatment. Result:Before treatment,there was no significant difference in all scores between the two groups(P＞0.05).After 6 weeks of treatment,the MMSE,PRMQ,MBI,FAQ,and QLI scores of the two groups were im-proved(P＜0.05),and the MoCA,MBI,and QLI scores of the experimental group were higher than those of the control group(P＜0.05);After 12 weeks of treatment and 1 month of follow-up,the scores of MMSE,MoCA,PRMQ,MBI,FAQ,and QLI were significantly improved in two groups(P＜0.05),and all scores of the experimental group were better than those of the control group(P＜0.05). Conclusion:MICT can improve cognitive function,activities of daily living,and quality of life in patients with mild to moderate cognitive impairment after stroke in the community,with efficacy lasting at least 1 month.

Objective:To analyze the antigenicity and genetic characteristics of two strains of Eurasian avian H1N1 swine influenza virus (EAS-H1N1) isolated from 2 human cases found in Gansu province to provide scientific reference for disease prevention and control.Methods:Two cases of human infection with EAS-H1N1 discovered in Gansu province since February 2021 were analyzed for antigenicity and genome comparison, and their genome characteristics were analyzed using software such as Mega7.0.Results:Two human infections with EAS-H1N1 had related environmental exposure history. Two strains were obtained: A/Gansu-Xifeng/1143/2021 and A/Gansu-Xifeng/1194/2021. The two strains of HA, NA genes were all from the Eurasian avian H1N1 swine influenza virus, and are closely related to the human infection EAS-H1N1 virus in Hebei and Tianjin and the EAS-H1N1 virus isolated from the mink in Shandong; the HA receptor binding sites of 2 strains E190D and D225E mutations occurred in all spots, and there were no H274Y and N294S mutations in NA protein.Conclusions:Some important molecular mutations occurred in the genome of people infected with EAS-H1N1 virus in Gansu province, which may lead to increased virulence and potential human-to-human transmission. Strengthening the research and analysis of EAS-H1N1 gene characteristics will help to monitor the mutation and mutation of the virus at the molecular level and scientifically prevent and control the epidemic.

Objective:To disclose the genome characteristics and mutations of 2019 novel coronavirus (2019-nCoV) strains from the imported cases of Coronavirus Disease 2019 (COVID-19) in Gansu province, thereby to provide scientific reference for the prevention and control of COVID-19 in Gansu province. Methods:The respiratory tract specimens of imported COVID-19 cases from seven countries in Gansu province in 2020 were collected. The virus genome was sequenced by the second-generation sequencing technology, the whole genome sequences were compared and analyzed, and the MEGA software was used to construct a phylogenetic tree based on the neighbor-joining method.Results:A total of 46 2019-nCoV genome sequences with a length of 29 605~29 903 bp were obtained. Compared with the Wuhan reference strain (GenBank ID: NC_045512.2), it was found that the median (minimum to maximum) number of the nucleotide mutations of the 2019-nCoV genome sequence of the imported cases was 10 (7-24). A total of 134 nucleotide mutation sites were found in all 2019-nCoV genome sequences from 7 entry countries in Gansu province, distributed in 11 open reading frames (ORFs). The top three nucleotide mutations in different proteins: ORF1ab (78), S(20), N(12). Among the 134 nucleotide mutations, 82 caused amino acid mutations, and all of them were missense mutations. No insertions or deletions were seen. Types of deletion mutations, the top three amino acid mutations in different proteins: ORF1ab (46), S(11), N(10); the key sites of the receptor binding domain (RBD) of the S protein have not been mutated.Conclusions:No imported cases in Gansu province have been found to carry the reported mutations that can clearly lead to changes in the spread and pathogenicity of 2019-nCoV.

Objective: To describe the epidemiological characteristics of a cluster of COVID-19 cases reported in Baodi district of Tianjin as of 18 February, 2020, which might be associated with the exposure in a local department store, and provide suggestions for prevention and control strategy development. Methods: The basic characteristics, time and area distributions, clinical manifestations, epidemiological history and transmission mode of the COVID-19 cases associated with the department store exposure were analyzed. Results: A total of 40 COVID-19 cases were associated with the department store exposure, accounting for 75.47% of the total confirmed cases (53 cases) reported in Baodi district. The cases were mainly at the age of 60 years or older (35.00%) and farmers (40.00%). The main clinical manifestations included fever (95.00%), cough (35.00%), and diarrhea (15.00%). The proportion of confirmed severe cases was 32.50%. The incidence curve showed that the incidence peak occurred on 31 January, 2020. Among the 40 cases, 6(15.00%) were department store employees, 19(47.50%) were customers and 15(37.50%) were close contacts (secondary cases). The first case occurred on 21 January, 2020, this case was a department store employee who had a purchasing history at whole sale markets in other provinces and cities before the onset, and 3 employees were still on duty after symptom onsets. The median of the incubation period of customer cases was 6 days, and the median of the interval between onset and medical treatment of customer cases was 7 days. Conclusion This was a cluster epidemic of COVID-19, which might be associated with the exposure in the department store. By now, the current prevention and control measures have achieved satisfied effects.

Objective:To analyze the influenza surveillance results and epidemiological characteristics of the disease in Gansu province in 2010-2018, and provide scientific basis for the formulation and adjustment of influenza prevention and control strategies.Methods:Real-time PCR was used to detect the specimens of ILI illness (ILI) cases reported by 19 national influenza surveillance sentinel hospitals in Gansu province. Influenza virus isolation and culture were carried out using canine kidney cells (MDCK).Results:Total of 93 334 specimens from ILI cases were collected from Jan. 2010 to Dec. 2018, and 13 439 samples were positive for influenza virus nucleic acid. The positive rate of viral nucleic acid detection was 14.40%, and the proportion of influenza B virus in positive samples was the highest (37.02%), and seasonal H3N2 influenza virus (35.25%), H1N1 influenza virus (26.78%). The advantages are different in various periods. The peak period of influenza is from Dec. to Mar., and the highest incidence rate is in the age group of 5-15 years (20.34%). The incidence rates of the other age groups are similar. The difference of influenza positive rate in different age groups is statistically significant ( χ2=775.153, P<0.001), but in male and female was not significant. Total of 16 101 ILI specimens positive for influenza virus nucleic acid were subjected to virus isolation and cultured, and 3 892 strains of influenza virus were isolated, of which influenza B virus accounted for the highest proportion (37.82%), followed by seasonal H3N2 influenza virus (33.04%), H1N1 influenza virus (28.96%). Conclusions:The epidemic of influenza in Gansu province had an obvious regularity, and it was undulating and prevalent. It is necessary to strengthen prevention and control measures among school-age children and adolescents.

Objective:To analyze the genomic characteristics of human infection with H9N2 avian influenza virus in Gansu province.Methods:The etiological analysis was conducted for human infection with H9N2 avian influenza virus detected in influenza like illness cases in northwestern China in 2016. Molecular bioinformatics Mega 7.0 software was used to analyze the full genomic sequences of the viral isolate.Results:The gene fragments of HA, NA, MP, NP, NS, PA, PB1 and PB2 of the isolate were highly similar (>90%) to those of H9N2 avian influenza virus strain isolated in external environment in Gansu from 2014 to 2019. The HA gene belonged to BJ/94-like branch, PB2 and MP belonged to G1/97-like branch, and the PB1, PA, NS, and NP genes belonged to F/98-like branch. MP and PB2 were closely related to H7N9, H10N8 and H5N6 viruses. Amino acid sequence alignment showed that the HA cleavage site was arranged in PSRSSR ↓ GLF, H183N and Q226L mutated which included 7 HA glycosylated sites; 62-64 sites of NA absented 3 amino acids (ITE); and M2-31N, NS1-42S, PA-356R, and PA-409N mutated.Conclusions:Apparently, this case of human infection with human infection with H9N2 avian influenza virus was an incidental. However, the isolates of H9N2 influenza virus in external environment of Gansu had a series of mammalian adaptive molecular markers, suggesting that the risk of human infection is higher. It is necessary to strengthen the surveillance by multi departments to deal with influenza pandemic.

Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase in the downstream of the phosphatidylinositol 3-kinases (PI3K) family. This kinase plays an important role in the development and progression of hepatocellular carcinoma (HCC). Preclinical data demonstrate that 40%-50% of HCC patients have dysregulated expression of the effectors of the mTOR signaling pathway, and the activation of the mTOR pathway is associated with poorly differentiated tumors, early tumor recurrence, and poor survival/prognosis. This article reviews the research advances in the potential role of the mTOR signaling pathway and its inhibitors in the treatment of HCC.

Objective To study the epidemiologic characteristics of influenza in Gansu province of China and to optimize the related vaccination program.Methods Weekly influenza surveillance data from the first week of 2010 to the fortieth week of 2016 were collected,in Gansu province.x2 test was used to compare the differences of nucleic acid positive rate and the virus types in the four seasons.Time series seasonal decomposition (TSSD) was used to explore seasonal patterns and characteristics of influenza epidemics in Gansu.Results 59 791 specimens were tested,with 8 501 positive for influenza virus and positive rates as 14.22％.Types A(H1N1)pdm09,A(H3N2) and type B were accounted for 98.76％ of all the positive specimens.Proportions of the positive rate of influenza virus appeared in spring,summer,autumn and winter were 15.12％,0.98％,4.02％ and 24.26％ respectively.The predominant type of virus in autumn and winter was A(H3N2),with B mainly in spring.Influenza in Gansu province showed typical single-peak type distribution,with epidemic peak appeared from December to next January.The type A(H3N2) related peak appeared the earliest,followed by A(H1N1)pdm09,with type B the latest.Conclusions Peaks and the duration of influenza seasonal epidemics were related to the types of dominant strains.Annual influenza vaccination campaigns should start in October,to provide effective protection during the epidemic period.

Objective: To understand the contamination status of avian influenza virus H5, H7, and H9 in environmental samples in Gansu province during 2015, and provide scientific guidance for the prevention and control of human infection with AIV in the province. Methods: We detected the AIV nucleic acid of 2015 environmental samples with real-time PCR; the samples were collected from all of the monitoring points in the whole province, then we analyzed the result of environmental monitoring of pathogens in the province. Results: The detection rates of FluA, H5, H7 and H9 were 19.90%, 0.05%, 0 and 19.65% respectively. The sample specific detection rate of FluA was the highest in wipe specimen of the board surface of slaughtering or placing poultry (31.09%) and the lowest in stool specimens (13.85%). FluA detection rate was the highest in December and the lowest in June and July(8.59% and 8.66%). The detection rate of Dingxi city and Longnan city of nucleic acid of avian influenza virus FluA and H9 were significantly higher than those in other cities in the province(χ²=4.523~88.059, P<0.05). Conclusions The main AIV pollution of the external environment in Gansu province in 2015 were the H9 subtype, and there was no H7N9 positive, we should strengthen the monitoring and early warning for avian influenza.

Objective To offer a scientific basis for the influenza prevention and control,we analysed the influenza (flu) characteristics of Gansu province during the year of 2013 to 2015.Methods We detected the samples of flu virus,which collected from the throat swabs of outpatients with influenza-like illness (ILI) in the 19 national influenza surveillance sentinel hospitals of the Gansu province,by fluorescence quantitative PCR technique,the positive specimens were used to isolate and identify the virus with the canine kidney cells (MDCK).Results After the influenza virus nucleic acid detections of 37 332 ILI throat swabs,we got 5 928 positive samples,and the positive rate was 15.88％.From the 14 th week of 2013 to the 13th week of 2016,the positive rates of the influenza virus nucleic acid were in turn as following:14.52％,12.36％ and 20.15％ respectively.According to age groups,the results showed that the lowest positive rate of 12.78％ was from the babies below 5 years old,which was significantly lower than that of the other age groups.The highest positive rate of 24.75％ was came from the group of 15-24 years old.1 630 influenza virus was isolated from 6 285 specimens,the positive rate was 25.93％,which including395 A (H1N1),524 seasonal H3N2,342 B Victorian virus and 367 B Yamagata virus.Conclusions The epidemic types of influenza virus in Gansu province perform in the rule of alternative spreading.So it is necessary to take active measures to prevent and control human infection with the influenza virus.