Objective:To explore the effect of ultrasound-guided femoral nerve block with dexmedetomidine combined with ropivacaine on the pain of patients after knee arthroscopy combined with high tibial osteotomy(HTO).Methods:A total of 97 patients who underwent the treatment of HTO combined with knee arthroscopy in the Ankang central hospital from 2021 to 2022 were selected,and they were divided into the observation group(46 cases)and the control group(51 cases)based on the random number table method.All patients received anesthesiology with ultrasound-guided femoral nerve block.For anesthesia,the observation group used ropivacaine combined with dexmedetomidine,and the control group only used ropivacaine.The visual analogue scale(VAS)scores of them were assessed respectively at rests before surgery,and 3h,6h and 12h after surgery,and the times that patients pressed the button of patient controlled analgesia(PCA)within 4 time intervals included the postoperative 0-6h(T1),6-12h(T2),12-18h(T3)and 18-24 h(T4)were recorded.In addition,the doses of oral opioid drug within postoperative 24 h,48 h and 72 h also were recorded,and the relevant adverse reactions of anesthesiology after surgery were recorded.Results:The pain levels at postoperative 3h,6h and 12h in the observation group were significantly lower than those in the control group,and the differences were statistically significant(t=2.181,3.113,3.073,P<0.05),respectively.The oral dosage of opioids within 24h,48h and 72h after surgery in observation group were significantly less than those in the control group,and the differences were statistically significant(t=6.356,9.778,11.284,P<0.05),respectively.The times of pressing PCA button within T1 and T2 intervals after surgery in observation group were also significantly lower than those in control group,and the differences were statistically significant(t=5.033,2.184,P<0.05),respectively.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,and the difference was statistically significant(x2=4.562,P<0.05).Conclusion:In the surgical anesthesia of knee arthroscopy combined with(HTO),the early analgesic effect of femoral nerve block with dexmedetomidine combined with ropivacaine is significant,and the oral dosage of opioids of patient decreases after surgery,and the risk of occurring adverse reaction that is relative to anesthesia after surgery is less.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To explore the differences of renal dynamic imaging parameters between operation group and non-operation group in infants with severe hydronephrosis, so as to accumulate theoretical basis for diuretic renal scintigraphy to help the treatment decision making.Methods:A total of 107 infants (age: 3(2, 6) months; 90 males and 17 females) with severe hydronephrosis, who underwent diuretic renal scintigraphy between March 2018 and October 2021 in Shanxi Children′s Hospital were retrospectively reviewed. All patients were diagnosed with ureteropelvic junction obstruction and divided into operation group ( n=87) and no-operation group ( n=20). The differences of differential renal function (DRF), peak time, half-time and drainage curve between the two groups were compared with the independent-sample t test or χ2 test, and the correlation between the renal function of the affected side and the anteroposterior pelvic diameter (APD) was analyzed with Pearson correlation analysis. Results:The operation group included 17 patients with DRF<40%, 60 patients with DRF between 40%-55%, and 10 patients with DRF>55%(supernormal renal function). The 40%-55% was considered as normal DBF, and the rest were abnormal. Infants with abnormal renal function in the operation group ( n=27) were more than those in the non-operation group ( n=3), but there was no statistical difference ( χ2=2.07, P=0.150). The proportion of obstruction curve in the operation group (85.1%, 74/87) was significantly higher than that in the non-operation group (55.0%, 11/20; χ2=7.24, P=0.007). Compared with the non-operation group, the peak time of affected kidney in the operation group was significantly longer ((22.77±7.52) vs (15.26±10.29) min; t=3.78, P<0.001), as well as the peak time of contralateral kidney ((11.25±8.47) vs (6.65±5.75) min; t=2.30, P=0.023). There was a negative correlation between the DRF of the affected side and the APD ( r=-0.48, P<0.001). Conclusions:The DBF is mostly in the normal range in infants with severe hydronephrosis, and supernormal renal function is common. The previous operation indication (DRF<40%) is not suitable for the infants, and it needs to be analyzed combined with the type of curve and the APD determined by color Doppler ultrasound. The prolongation of contralateral renal peak time may be an important parameter for the surgical evaluation of severe hydronephrosis in infants.

Humans ; Cohort Studies ; Body Mass Index ; Percutaneous Coronary Intervention ; Coronary Artery Disease ; Inflammation ; Treatment Outcome ; Risk Factors

Objective:To understanded the pathogen spectrum and epidemiological characteristics of common respiratory viruses in hospitalized patients with severe acute respiratory infection (SARI) in Lanzhou, in order to provide a reference for the prevention, control and treatment of SARI cases in Lanzhou.Methods:From January 2011 to December 2020, 2 571 samples including throat swabs, sputum and a small amount of alveolar lavage fluid from SARI cases in the First Hospital of Lanzhou University, and data and clinical information were collected at the same time, the monitored population was divided into 5 age groups (0 year-, 1 year-, 5 years-, 15 years-, 60 years-), and the nucleic acid detection of common respiratory viruses was performed by multiplex real-time PCR.Results:A total of 9 viruses were detected in 2 571 samples, with a total positive rate of 24.66%. Among them, the top 4 viruses were respiratory syncytial virus (8.71%), rhinovirus (4.60%), influenza virus (4.40%), and parainfluenza virus (3.85%). The 0 year-group had the highest proportion of infants (36.37%), the highest positive detection rate (26.95%), the highest detection rate of respiratory syncytial virus (13.05%) were found in this group, and in the 5 years-group rhinovirus detection rate was the highest (6.13%). The 15 years-group and 60 years- group had the highest detection rates of influenza virus, which were 9.75% and 6.35%. The difference in positive detection rate between different age groups was statistically significant( χ2=12.11, P=0.038). The peak incidence was in winter and spring every year. Conclusions:The virus with the highest infection rate of SARI cases in Lanzhou was respiratory syncytial virus. Different age groups have different dominant viruses. Winter and spring are the epidemic seasons.

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 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.

Objective:To understand the epidemiological characteristics of COVID-19 cases in different epidemic stages in Gansu province.Methods:Epidemiological investigation was conducted to collect the information of confirmed COVID-19 cases, including demographic, epidemiological and clinical information.Results:As of 25 February 2020, a total of 91 confirmed COVID-19 cases had been reported in Gansu. The epidemic of COVID-19 in Gansu can be divided as three different stages, i.e. imported case stage, imported-case plus indigenous case stage, and indigenous case stage. A total of 63 cases were clustered cases (69.23%), 3 cases were medical staff infected with non-occupational exposure.The initial symptoms included fever (54.95%, 50/91), cough (52.75%, 48/91), or fatigue (28.57%, 26/91), the proportion of each symptom showed a decreasing trend along with the three epidemic stages, but only the differences in proportions of fever (trend χ2=2.20, P<0.05) and fatigue (trend χ2=3.18, P<0.05) among the three epidemic stages were statistically significant. The cases with critical severe symptoms accounted for 42.85% (6/14), 23.73% (14/59) and 16.67% (3/18), respectively, in three epidemic stages, showed a decreasing trend ( H=6.45, P<0.05). Also, the incubation period prolonged along with the epidemic stage ( F=51.65, P<0.01), but the intervals between disease onset and hospital visit ( F=5.32, P<0.01), disease onset and diagnosis ( F=5.25, P<0.01) became shorter along with the epidemic stage. Additionally, the basic reproduction number ( R0) had decreased from 2.61 in imported case stage to 0.66 in indigenous case stage. Conclusions:The COVID-19 epidemic in Gansu was caused by the imported cases, and about 2/3 cases were clustered ones. No medical worker was observed to be infected by occupational exposure. With the progression of COVID-19 epidemic in Gansu, the change in initial symptom and incubation period suggests. the early screening cannot only depend on body temperature monitoring.

Objective:To study the epidemic and etiologic characteristics of influenza virus(Flu)and respiratory syncytial virus (RSV) infections in outpatient influenza-like illness(ILI)cases of children under 10 years of age in Gansu province in 2018 And to provide evidences for diagnosis, treatment, control and prevention of Flu and RSV infections in Gansu province.Methods:A total of 8 559 pharyngeal swab samples of ILI outpatients cases were tested with real-time fluorescent PCR to detect Flu, 3 436 of which were detected by RT-PCR for RSV.Results:Of the 8559 specimens, 934 (10.91%) samples were positive for Flu. Among them, 431 were positive for H1N1, 70 were positive for H3N2, 428 were positive for Flu B, 5 were mixed; 320 of the 3436 (9.31%, ) samples were positive for RSV. There were significant differences in the positive rates of Flu and RSV among 14 cities and prefectures ( χ2=56.99, χ2=263.34, Р< 0.01). Influenza reached its peak in January 2018 with a positive rate of 50.70%. Flu B/Yamagata strain (53.53%) and A H1N1 (39.93%) were prevalent simultaneously. The peak of RSV epidemic was from February to April, the positive rate was 13.98%. The RSV positive rate of children under 5 years of age was 10.11%, higher than that of children over 5 years of age was 6.94%. There was statistical significance ( χ2=7.67, Р<0.01). Conclusions:RSV and influenza viruses are the main pathogens in ILI cases of children under 10 years of age. There are epidemic peaks in winter and spring every year. It is suggested that the monitoring of RSV and the development and application of vaccine should be strengthened.