Objective:To characterize the etiological and genetic features of pediatric influenza outbreaks in Changzhou between 2021 and 2024，with the goal of informing evidence-based prevention strategies and guiding effective management of influenza outbreaks in school settings.Methods:During the period of 2021 to 2024，throat swabs of influenza-like cases from school outbreaks in Changzhou were collected. These samples underwent real-time reverse transcription-polymerase chain reaction（RT-PCR）testing and virus isolation. Epidemiological data were integrated to conduct pathogenetic analysis. The HA genes of isolated strains were amplified and sequenced to perform genetic characterization.Results:Between 2021 and 2024，a total of 256 influenza outbreaks were reported in schools in Changzhou. A total of 3 201 specimens were collected，of which 2 245 were tested positive for influenza viruses，resulting in a positivity rate of 70.13%. The outbreak season was primarily concentrated from December to February each year，with settings predominantly distributed in primary schools（accounting for 73.83%）. The predominant epidemic strains were influenza A viruses，including 118 outbreaks caused by H1N1 and 104 by H3N2. A total of 74 influenza virus strains were successfully isolated from positive specimens，and sequencing of the hemagglutinin（HA）gene was completed. Phylogenetic analysis revealed that certain B/Victoria lineage strains（e.g.，B/Changzhou/01/2021）clustered closely with the vaccine strain B/Austria/3594/17（bootstrap support：99%）. Among influenza H1N1 strains，multiple isolates from 2023—2024 clustered within the same major branch as A/Victoria/4897/2022（bootstrap support：100%）. In contrast，the H3N2 strains exhibited a complex evolutionary pattern，showing variable genetic distances to vaccine strains from different years（e.g.，A/Massachusetts/18/2022，A/Darwin/6/2021）；some isolates were closely related to vaccine strains，while others were more distantly related and scattered across the phylogenetic tree.Conclusions:The influenza outbreak situation in schools was severe and has significant public health implications. Continuous surveillance is essential，and preventive strategies should be promptly adjusted based on the epidemiological and genetic characteristics of circulating strains.

Objective:To characterize the etiological and genetic features of pediatric influenza outbreaks in Changzhou between 2021 and 2024，with the goal of informing evidence-based prevention strategies and guiding effective management of influenza outbreaks in school settings.Methods:During the period of 2021 to 2024，throat swabs of influenza-like cases from school outbreaks in Changzhou were collected. These samples underwent real-time reverse transcription-polymerase chain reaction（RT-PCR）testing and virus isolation. Epidemiological data were integrated to conduct pathogenetic analysis. The HA genes of isolated strains were amplified and sequenced to perform genetic characterization.Results:Between 2021 and 2024，a total of 256 influenza outbreaks were reported in schools in Changzhou. A total of 3 201 specimens were collected，of which 2 245 were tested positive for influenza viruses，resulting in a positivity rate of 70.13%. The outbreak season was primarily concentrated from December to February each year，with settings predominantly distributed in primary schools（accounting for 73.83%）. The predominant epidemic strains were influenza A viruses，including 118 outbreaks caused by H1N1 and 104 by H3N2. A total of 74 influenza virus strains were successfully isolated from positive specimens，and sequencing of the hemagglutinin（HA）gene was completed. Phylogenetic analysis revealed that certain B/Victoria lineage strains（e.g.，B/Changzhou/01/2021）clustered closely with the vaccine strain B/Austria/3594/17（bootstrap support：99%）. Among influenza H1N1 strains，multiple isolates from 2023—2024 clustered within the same major branch as A/Victoria/4897/2022（bootstrap support：100%）. In contrast，the H3N2 strains exhibited a complex evolutionary pattern，showing variable genetic distances to vaccine strains from different years（e.g.，A/Massachusetts/18/2022，A/Darwin/6/2021）；some isolates were closely related to vaccine strains，while others were more distantly related and scattered across the phylogenetic tree.Conclusions:The influenza outbreak situation in schools was severe and has significant public health implications. Continuous surveillance is essential，and preventive strategies should be promptly adjusted based on the epidemiological and genetic characteristics of circulating strains.

Objective To explore the therapeutic effect of plum blossom needle tapping combined with 3M physical therapy on temporomandibular joint disorders(TMD).Methods sixty TMD patients admitted to our hospital from January 2022 to December 2022 were selected and divided into an observation group and a control group,with 30 cases in each group.The control group received 3M physical therapy treatment,while the observation group received plum blossom needle tapping combined with 3M physical therapy treatment.Compared the changes in the Jaw functional limitation scale(JFLS),visual analogue scale(VAS),maximum active mouth opening(MMO),root mean square(RMS)surface electromyography(EMG)of the masseter muscle in mandibular position and under tight cotton swab testing between two groups of patients.Results After 4 weeks of treatment,the JFLS and VAS scores in the observation group were significantly reduced compared to those in the control group,while the MMO significantly exceeded that of the control group,indicating a statistically significant difference(P<0.05).After 4 weeks of treatment,the RMS value of the masseter muscle in the mandibular position decreased in the observation group,but increased in the tight bite cotton swab test.The muscle recruitment ability was significantly improved,and the degree of improvement was notably superior to that of the control group,with the difference being statistically significant(P<0.05).Conclusion The combination of plum blossom needle acupuncture and 3M physical therapy can notably alleviate pain,enhance maximum mouth opening,and improve mandibular function in TMD patients,accurate effect.

Objective: To analyze the epidemiological characteristics and genetic characteristics of sapovirus (SaV) in a cluster of schools in Changzhou, so as to provide a reference for the treatment of clustered vomiting and diarrhea events in schools. Methods: The epidemiological data and laboratory test data of sapovirus clusters in Changzhou from 2019 to 2022 were collected and analyzed. Partial VP1 genes of SaV positive samples were amplified and sequenced for phylogenetic analysis. Results: A total of 8 cases of clusters of SaV epidemics were reported in Changzhou City from 2019 to 2022, with 118 reported cases. The total attack rate was 1.47%, and the median of the attack number was 15. There were 6 outbreaks in kindergartens and 2 outbreaks in primary schools, which were reported in the epidemic period from September to December. The main clinical manifestations were vomiting (113 cases, 95.76 %), abdominal pain (39 cases, 33.05%), and diarrhea (16 cases, 13.56%). Among the 8 outbreaks, 17 sample strains were successfully sequenced. 5 outbreaks were GII.3 , and the other 3 outbreaks were GI.1, GI .3 and GII.2. GI and GII were the main genotypes in this area, and GII .3 was the predominant strain. Conclusion SaV is an important pathogen in the clusters of vomiting and diarrhea in schools after the transmission of norovirus. Continuous surveillance of SaV should be carried out to further understand its epidemiological characteristics and genotype distribution, so as to provide scientific basis for the prevention and control of the epidemic in schools.

Objective To understand the epidemiological characteristics and variation of H3N2 influenza virus hemagglutinin (HA) gene in Changzhou from 2017 to 2018. Methods Throat swab specimens of the influenza-like cases were collected from Changzhou Influenza Monitoring Sentinel Hospital from April 2017 to March 2018. RNA was extracted from the specimens for influenza diagnosing and genotyping using real-time RT-PCR．H3N2 positive samples were isolated, and extracted RNA was used for amplification, sequencing and phylogenetic analysis of HA gene. Results From April 2017 to March 2018, 28 strains of influenza A (H3N2) virus were isolated. After gene sequencing, a phylogenetic tree was constructed. It was found that all of the strains belonged to Group3C.2a, which was similar to the vaccine strain A/Hong Kong/4801/2014. The HA amino acid sequence difference was analyzed and compared between the H3N2 influenza virus strains isolated in Changzhou and the vaccine strain A/Hong Kong/4801/2014. It was found that the epidemic strain isolated in Changzhou was in the HA epitope (A-E) region. Ten amino acid site mutations in the HA epitope (A-E) region and two amino acid site mutations in the stem region of HA antigen were found. Conclusion From April 2017 to March 2018, the influenza virus H3N2 prevalent in Changzhou was distributed on the same evolutionary branch with the vaccine strain A/Hong Kong/4801/2014 (group 3C.2a), rendering the popular trend of one subgroup. However, some amino acid sites of the HA epitope had variations, suggesting that mutations may occur, which may affect the immune effect of the vaccine. Monitoring needs to be strengthened in the future work.

OBJECTIVETo investigate the effect of treatment on end-stage liver disease and type-I diabetes mellitus with simultaneous liver-pancreas-duodenum transplantation.

METHODIn September 2003, one patient with chronic hepatitis B, liver cirrhosis, hepatic cellular cancer, and insulin-dependent diabetes received simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation. Liver and pancreas graft function was monitored after transplantation.

RESULTSThe function of pancreas allograft was recovered immediately and the patient became insulin-independence postoperatively. The liver allograft was experienced an acute rejection episode and reversed by intravenous bolus methylprednisolone. The recipient was currently liver disease-free and insulin-free more than 21 months.

CONCLUSIONSThe simultaneous liver-pancreas-duodenum transplantation is an effective method in the treatment of end-stage liver disease and type-I diabetes mellitus.

Diabetes Mellitus, Type 1 ; complications ; surgery ; Duodenum ; transplantation ; Female ; Follow-Up Studies ; Graft Rejection ; prevention & control ; Humans ; Immunosuppressive Agents ; therapeutic use ; Liver Cirrhosis ; complications ; surgery ; Liver Neoplasms ; complications ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Pancreas Transplantation ; Transplantation, Homologous