1.LncRNA SNHG15 promotes proliferation, migration and invasion of lung adenocarcinoma cells by regulating COX6B1 through sponge adsorption of miR-30b-3p.
Xiuying GONG ; Shunfu HOU ; Miaomiao ZHAO ; Xiaona WANG ; Zhihan ZHANG ; Qinghua LIU ; Chonggao YIN ; Hongli LI
Journal of Southern Medical University 2025;45(7):1498-1505
OBJECTIVES:
To explore the molecular mechanism by which lncRNA SNHG15 regulates proliferation, invasion and migration of lung adenocarcinoma cells.
METHODS:
The lncRNA microarray chip dataset GSE196584 and LncBase were used to predict the lncRNAs that interact with miR-30b-3p, and their association with patient prognosis were investigated using online databases, after which lncRNA nucleolar RNA host gene 15 (SNHG15) was selected for further analysis. The subcellular localization of lncRNA SNHG15 and its expression levels in normal human lung epithelial cells and lung adenocarcinoma cell lines were detected using fluorescence in situ hybridization and qRT-PCR. In cultured A549 cells, the changes in cell proliferation, migration, and invasion following transfection with a SNHG15 knockdown plasmid (sh-SNHG15), a miR-30b-3p inhibitor, or their co-transfection were assessed with EdU, wound healing, and Transwell assays. Bioinformatics analyses were used to predict the regulatory relationship between lncRNA SNHG15 and COX6B1, and the results were verified using Western blotting and rescue experiments in A549 cells transfected with sh-SNHG15, a COX6B1-overexpressing plasmid, or both.
RESULTS:
LncRNA SNHG15 was shown to target miR-30b-3p, and the former was highly expressed in lung adenocarcinoma, and associated with a poor patient prognosis. LncRNA SNHG15 was localized in the cytoplasm and expressed at higher levels in A549 and NCI-H1299 cells than in BEAS-2B cells. In A549 cells, lncRNA SNHG15 knockdown significantly inhibited cell migration, invasion and proliferation, and these changes were reversed by miR-30b-3p inhibitor. A regulatory relationship was found between lncRNA SNHG15 and COX6B1, and their expression levels were positively correlated (r=0.128, P=0.003). MiR-30b-3p knockdown obviously decreased COX6B1 expression in A549 cells, and COX6B1 overexpression rescued the cells from the inhibitory effects of lncRNA-SNHG15 knockdown.
CONCLUSIONS
LncRNA SNHG15 may compete with COX6B1 to bind miR-30b-3p through a ceRNA mechanism to affect proliferation, migration, and invasion of lung adenocarcinoma cells.
Humans
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MicroRNAs/metabolism*
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RNA, Long Noncoding/genetics*
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Cell Proliferation
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Cell Movement
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Lung Neoplasms/genetics*
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Adenocarcinoma of Lung
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Neoplasm Invasiveness
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A549 Cells
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Adenocarcinoma/genetics*
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Gene Expression Regulation, Neoplastic
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Cell Line, Tumor
2.β-sitosterol, an important component in the fruits of Alpinia oxyphylla Miq., prolongs lifespan of Caenorhabditis elegans by suppressing the ferroptosis pathway.
Junyi LI ; Siyuan CHEN ; Liyao XIE ; Jin WANG ; Ao CHENG ; Shaowei ZHANG ; Jiyu LIN ; Zhihan FANG ; Yirui PAN ; Chonghe CUI ; Gengxin CHEN ; Chao ZHANG ; Li LI
Journal of Southern Medical University 2025;45(8):1751-1757
OBJECTIVES:
To elucidate the anti-aging effect of β-sitosterol (BS), an important component in the fruits of Alpinia oxyphylla Miq., in C. elegans and its regulatory effect on ETS-5 gene to modulate ferroptosis.
METHODS:
C. elegans treated with 10 µg/mL BS were monitored for survival time and changes in body length, motility, and reproductive function. The effect of ETS-5 gene knockdown on survival time of C. elegans was observed, and the changes in fat accumulation and lipid redox homeostasis in the transfected C. elegans were assessed using Oil Red O staining and by detecting MDA levels and the GSH/GSSG ratio. The mRNA expression levels of ferroptosis-related genes (FTN-1, GPX-1 and AAT-9) were detected using qPCR. The effects of BS treatment and ETS-5 knockdown on AAT-9 enzyme activity in C. elegans were examined. The effect of BS on nuclear localization of FEV (the human homolog of ETS-5) was validated in cultured human umbilical venous endothelial cells (HUVECs).
RESULTS:
Both BS treatment and ETS-5 knockdown significantly prolonged the lifespan, promoted lipid accumulation and reduced lipid peroxidation in C. elegans. ETS-5 knockdown resulted in upregulated expressions of the ferroptosis repressors GPX-1, AAT-9 and FTN-1 and increased the GSH/GSSG ratio in C. elegans.
CONCLUSIONS
BS inhibits ferroptosis in C. elegans by suppressing the expression of ETS-5 transcription factor and hence the activity of AAT-9 enzyme, a key gene for ferroptosis, which in turn prolongs the lifespan of C. elegans.
Animals
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Caenorhabditis elegans/physiology*
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Ferroptosis/drug effects*
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Alpinia/chemistry*
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Sitosterols/pharmacology*
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Longevity/drug effects*
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Fruit/chemistry*
;
Humans
3.Clinical features of and influencing factors of obsessive-compulsive personality disorder in patients with obsessive-compulsive disorder
Wenjing JIANG ; Xuhui WANG ; Zhihan XU ; Xuedi ZHANG ; Zhongqi WANG ; Ping ZHOU ; Na LIU
Sichuan Mental Health 2024;37(4):317-322
Background Obsessive-compulsive personality disorder and obsessive-compulsive disorder(OCD)are common psychological disorders with similar clinical symptoms,but the differences between the two need further clarification.Objective To explore the clinical features of and influencing factors of obsessive-compulsive personality disorder in patients with OCD,so as to provide references for further relevant clinical diagnosis and treatment.Methods A total of 195 patients with OCD were selected as the research subjects,who received treatment at the outpatient and inpatient departments of the Affiliated Brain Hospital of Nanjing Medical University from July 2022 to December 2023 and met the diagnostic criteria for OCD in the International Classification of Diseases,tenth edition(ICD-10).Evaluation was conducted by using the Yale-Brown Obsessive Compulsive Scale(Y-BOCS),Personality Diagnostic Questionnaire-4+(PDQ-4+),Obsessive-Compulsive Inventory-Revised(OCI-R),Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI)and Sheehan Disability Scale(SDS).In accordance with the score of Obsessive-Compulsive Personality Disorder Scale in PDQ-4+,patients were divided into the OCD group with obsessive-compulsive personality disorder(n=58)and the OCD group without obsessive-compulsive personality disorder(n=137).Pearson correlation analysis and Spearman correlation analysis were adopted to examine the correlation between clinical features and the score of the Obsessive-Compulsive Personality Disorder Scale.Multiple linear regression analysis was used to explore the influencing factors of OCD patients with obsessive-compulsive personality disorder.Results Statistically significant differences were observed between OCD patients with and without obsessive-compulsive personality disorder in the age,family history of mental illness,time without treatment,hoarding and ranking dimension scores in OCI-R,OCI-R total score,score of Obsessive-Compulsive Personality Disorder Scale in PDQ-4,and BDI score(P≤0.05).OCD patients with obsessive-compulsive personality disorder in the time without treatment,OCI-R total score,hoarding and ranking dimension scores in OCI-R and BDI score are all positively correlated with the score of the Obsessive-Compulsive Personality Disorder Scale(r=0.120,0.526,0.364,0.492,0.414,P<0.05).The results of multiple linear regression analysis showed that time without treatment(β=0.132,P<0.05),hoarding dimension score(β=0.283,P<0.05)and ranking dimension score in OCI-R(β=0.418,P<0.05)were the influencing factors of OCD patients with obsessive-compulsive personality disorder.Conclusion OCD patients with obsessive-compulsive personality disorder may have longer untreated periods,more pronounced functional impairments in hoarding and sorting and more severe depressive symptoms.Untreated time,hoarding symptoms and sorting symptoms may be influencing factors for OCD patients with obsessive-compulsive personality disorder.
4.Recognition of unilateral auditory neuropathy in children
Ying LI ; Zhihan LIN ; Xueyao WANG ; Yang YANG ; Xiao ZHANG ; Yi ZHOU ; Xin JIN ; Zhipeng ZHENG ; Jifeng SHI ; Xuetong WANG ; Jie BAI ; Lining GUO ; Haihong LIU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(5):447-454
Objective:This study aimed to compare the audiological characteristics between children with unilateral auditory neuropathy (UAN) and single-sided deafness (SSD) to establish a valid basis for the differential diagnosis of children with UAN.Methods:A retrospective analysis was conducted on audiological and imaging evaluations of children with UAN and SSD who were treated at Beijing Children′s Hospital of Capital Medical University between May 2015 and June 2023. There were 17 children with UAN, comprising 10 males and 7 females, with an average age of 4.7 years. Additionally, there were 43 children with SSD, consisting of 27 males and 16 females, with an average age of 6.5 years. Audiological assessments included Auditory brainstem response (ABR), Steady-state auditory evoked potential (ASSR), Behavioural audiometry, Cochlear microphonic potential (CM), Distortino-product otoacoustic emission (DPOAE), and acoustic immittance test. The results of the audiological assessment and imaging phenotypic between the two groups of children were compared and analyzed by applying SPSS 27.0 statistical software.Results:(1) The UAN group (77.8%) had a significantly higher rate of ABR wave III L than the SSD group (20.9%) ( P<0.01). The PA thresholds at 500 Hz and 1 000 Hz of children with SSD were higher than those of children with UAN, while the ASSR thresholds at 500 Hz, 1000 Hz, 2 000 Hz, and 4 000 Hz of children with SSD were significantly higher than those of children with UAN ( P<0.05). (2) The degree of hearing loss in both UAN and SSD children was predominantly complete hearing loss. The percentage of complete hearing loss was significantly higher (χ2=4.353, P=0.037) in the SSD group (93.0%, 40/43) than in the UAN group (63.6%, 7/11). However, the percentage of profound hearing loss was significantly higher in the UAN group (27.3%, 3/11) than in the SSD group (2.3%, 1/43) ( Fisher′s exact test, P=0.023). In terms of hearing curve configuration, the percentage of flat type was significantly higher in the SSD group (76.7%, 33/43) than in the UAN group (36.4%, 4/11). The proportion of the UAN group (27.3%, 3/11) was significantly higher than that in the SSD group (2.3%, 1/43) in ascending type ( P<0.05). There were no statistically significant differences in the hearing curves of the declining type and other types between the two groups ( P>0.05). (3) The proportion of imaging assessment without abnormality was significantly more common in the UAN group (81.8%) than in the SSD group (37.1%) (χ2=6.695, P=0.015). Conclusions:Compared to children with SSD, the occurrence of wave III L on the ABR test was significantly more common in children with UAN. The percentage of ascending hearing curves was significantly higher in children with UAN than in children with SSD. ASSR thresholds were significantly lower in children with UAN. The normal imaging phenotype was significantly more common in children with UAN than in children with SSD.
5.Mechanism of iron death induced by high homocysteine via TRPC6/NF-κb in glomerular podiatocytes
Xiaoqin LI ; Lexin WANG ; Xiaojun MA ; Na LI ; Guanjun LU ; Zhihan ZHANG ; Pengcheng ZHANG
The Journal of Practical Medicine 2024;40(2):174-181
Objective To investigate the mechanism of iron death induced by TRPC6/NF-κB in glomerular podiocytes mediated by high homocysteine(Hcy).Methods Mouse glomerulopocytes were cultured in vitro and divided into Control group(0 μmol/L Hcy)and Hcy group(80 μmol/L Hcy).After 48h of intervention,Western blot was used to detect the expression levels of iron death related proteins GPX4 and SLC7A11 and TRPC6 and NF-κ B.Real-time quantitative fluorescence PCR(qRT-PCR)and immunofluorescence were used to detect the expression of TRPC6.The level of podocyte apoptosis was detected by flow cytometry.Malondialdehyde(MDA)assay kit was used to determine intracellular MDA levels.After transfection of TRPC6 interference fragment and TRPC6 negative control(NC),qRT-PCR was divided into Control,si-NC and si-TRPC6(Si-TRPC6-1,Si-TRPC6-2,Si-TRPC6-3).Western Blot was divided into Control,Hcy,si-NC+Hcy,si-TRPC6+Hcy.The expression of TRPC6 mRNA was detected by qRT-PCR.The expression levels of GPX4,SLC7A11,NF-κB and TRPC6 were detected by Western Blot.The level of podocyte apoptosis after interference was detected by flow cytometry.Results(1)Compared with Control group,the expression levels of iron death related proteins GPX4 and SLC7A11 in Hcy group were decreased,and the apoptosis rate was increased(P<0.05).(2)Compared with Control group,TRPC6 protein,mRNA levels and immunofluorescence expression were increased in Hcy group.The level of MDA and the expression of NF-κB signaling pathway protein increased in Hcy group,and the comparison between the two groups had statistical significance(P<0.05).(3)Compared with the si-NC group,the mRNA expression level of TRPC6 in si-TRPC6(Si-TRPC6-1,Si-TRPC6-2,Si-TRPC6-3)group was decreased,and the interference effect of Si-TRPC6-3 was the best(P<0.05).After transfecting TRPC6 NC and TRPC6 interference fragment and administering Hcy,there was no difference in GPX4,SLC7A11,NF-κB and TRPC6 expression in si-NC+Hcy group compared with Hcy group.Compared with the si-NC+Hcy group,the si-TRPC6+Hcy group had higher expression of iron death related proteins,GPX4 and SLC7A11,lower expression of NF-κB and TRPC6,and decreased apoptosis rate(P<0.05).Conclusion This study confirmed that TRPC6/NF-κB can regulate iron death of renal podocytes under the induc-tion of Hcy,which is one of the mechanisms leading to kidney injury.
6.Modified Wenshen Yixin Formula (温肾益心方加减) for Coronary Heart Disease Complicated with Hypothyroidism of Spleen-kidney Yang Deficiency:A Prospective Real-world Study of 51 Cases
Aolin LI ; Zhipeng YAN ; Lu LIAN ; Qianqian ZHANG ; Chi ZHANG ; Boyu ZHU ; Lei WEI ; Zhihan YANG ; Junping ZHANG
Journal of Traditional Chinese Medicine 2024;65(20):2116-2125
ObjectiveTo observe the clinical efficacy and relative mechanism of the Modified Wenshen Yixin Formula (温肾益心方加减, MWYF) as an auxiliary treatment of coronary heart disease (CHD) complicated with hypothyroidism of spleen-kidney yang deficiency. MethodsA total of 135 CHD patients complicated with hypothyroidism and spleen-kidney yang deficiency were included and divided into control group (67 cases) and experimental group (68 cases) according to the patients' wishes of herbal medicine administration. The control group was given conventional western medicine, while the treatment group was additionally given MWYF, 1 dose per day; both groups were treated for 8 weeks. The traditional Chinese medicine (TCM) syndrome scores, angina scores, SF-36 scores, thyroid function indicators including thyroid stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3), as well as serum cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), monocyte chemoattractant ligand 2 (CCL2), and tumor necrosis factor-related activator protein (CD40L) levels before and after treatment were compared between the two groups. The dosage and reduction and discontinuation rate of thyroid hormone preparations after treatment were compared between the two groups. The effectiveness regarding TCM syndrome and angina pectoris was evaluated, and the safety was assessed. ResultsBias was adjusted by matching on propensity score, and 102 cases were finally included in the statistical analysis, with 51 cases in each group. The total effective rate regarding TCM syndrome [94.12% (48/51) versus 64.71% (33/51)], the total effective rate regarding angina pectoris [80.39% (41/51) versus 62.75% (32/51)], and the reduction and discontinuation rate of thyroid hormone preparation [39.21% (20/51) versus 5.88% (3/51)] were significantly higher in the experimental group than those in the control group (P<0.05 or P<0.01). After treatment, the total TCM syndrome score, individual scores of major symptoms , the major symptoms score, the secondary symptoms score, angina pectoris score, and TSH level were significantly reduced (P<0.01), while all dimensions of SF-36 scores, T4, T3, and cAMP levels significantly increased in both groups (P<0.05 or P<0.01). The dosage of thyroid hormone preparations and the levels of cGMP, CCL2, and CD40L in the experimental group significantly decreased after treatment (P<0.01). When compared between the two groups after treatment, the total TCM syndrome score, the major symptoms score, the scores of individual major symptom (chest tightness, chest pain, fear of cold, cold limbs, waist and kness soreness and weakness), the secondary symptoms score, angina pectoris score, TSH, cGMP, CCL2, and CD40L levels of the experimental group were significantly lower than those of the control group (P<0.05 or P<0.01), while all dimension scores of SF-36, T4, T3, and cAMP levels were significantly higher (P<0.01). A total of three adverse events occurred during treatment, none of which were judged to be related to the interventions of this study. ConclusionMWYF can significantly ameliorate the TCM syndrome, angina pectoris, quality of life and thyroid function in CHD patients complicated with hypothyroidism and spleen-kidney yang deficiency, and can promote the reduction and disconti-nuation of thyroid hormone preparations. The mechanism may be related to the regulation of cAMP/cGMP balance, the regulation of hypothalamic-pituitary-thyroid metabolic axis and the reduction of immune inflammation.
7.Role of PI3K in systolic dysfunction of hiPSC-CMs induced by sunitinib
Congxin LI ; Guoqiang LIU ; Yang LIU ; Zhihan ZHANG ; Wei YAN ; Chunhui LIANG
China Pharmacy 2023;34(2):139-143
OBJECTIVE To study the role of phosphatidylinositol-3-kinase (PI3K) on sunitinib-induced myocardial systolic dysfunction. METHODS Using human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMS) as objects, the contractile force of cardiomyocytes was measured by CardioExcyte 96 system, and IC50 of sunitinib was calculated after hiPSC- CMS were treated with sunitinib at different concentrations [0 (control), 0.5, 1, 3, 5, 10 μmol/L] for 24 hours. The effects of sunitinib (3.14 μmol/L) on the contractile frequency of cardiomyocytes, calcium transient amplitude and calcium transient recovery time course, mRNA expression of myocardial injury markers atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and β-myosin heavy chain (β-MHC) were detected. PI3K activator 3,4,5-triphosphate phos-phatidylinositol (PIP3, 1 μmol/L) and sunitinib were used to intervene in hiPSC-CMs jointly, so as to investigate the role of PI3K in the myocardial systolic dysfunction induced by sunitinib. RESULTS Sunitinib inhibited the contractile force of hiPSC-CMs in a concentration-dependent manner. IC50 of sunitinib was 3.14 μmol/L. After intervention with 3.14 μmol/L sunitinib, the contractile frequency of hiPSC-CMs and calcium transient amplitude were decreased significantly (P<0.05 or P<0.01); the duration of calcium transient recovery was prolonged significantly (P<0.05), and mRNA expressions of ANP, BNP and β-MHC were significantly increased (P<0.01). After PI3K was activated with PIP3, the contractile force of hiPSC-CMs was increased significantly (P<0.01). CONCLUSIONS Activating PI3K activity is a potential molecular mechanism to improve myocardial toxicity induced by sunitinib.
8.Anticancer effect of bleomycin combined with cisplatin on human gastric cancer cells in vitro
Zi YANG ; Yonghui CUI ; Zhihan LI ; Zhiheng ZHENG ; Xiliang ZHANG ; Huijie GAO
Chinese Journal of Endocrine Surgery 2023;17(4):474-479
Objective:To explore the in vitro anticancer effect of bleomycin (Ble) combined with cisplatin (DDP) on human gastric cancer cells.Methods:CCK-8 experiment was conducted to detect the effect of Ble and DDP alone or in combination on the proliferation of gastric cancer cells; Flow cytometry was used to detect changes in cell apoptosis and changes in reactive oxygen species. Cell scratch test was employed to detect cell migration; Western blot experiment was conducted to detect protein expression.Results:The results of CCK-8 showed that 20 μM DDP could inhibit the proliferation of six types of gastric cancer cells by 40%, while the effect of 20 μM Ble was only about 20%. When used in combination, the inhibitory rate on six types of gastric cancer could reach over 60%, with the strongest inhibitory effect on AGS cells. When 10 μM Ble and 10 μM DDP were combined, the proportion of AGS apoptotic cells reached 75.68%, higher than that of the two drugs treated with 20%, respectively 20 μM processing effect. When 10 μM Ble and 10 μM DDP were used in combination, the number of migrating and invading cells was significantly reduced, and the inhibition rate reached 50%. Compared with single use, the difference was statistically significant ( P<0.05). Flow cytometry results showed that the combination of Ble and DDP promoted cancer cell apoptosis by up-regulating the level of reactive oxygen species in cells; Western blot results showed that the expression of p-JAK2 and p-STAT3 decreased after Ble and DDP were combined, indicating that the JAK2/STAT3 signal pathway was inhibited. Conclusions:The combination of Ble and DDP can inhibit the proliferation and migration of gastric cancer cells, promote the apoptosis of gastric cancer cells, and play a synergistic anti-cancer effect. Its mechanism may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the JAK2/STAT3 pathway.
9.Exosomes derived from neural stem cells regulates neural stem cells and applicates in nervous system diseases
Jiajun HUANG ; Hengsen CAI ; Zhihan ZHU ; Guilong ZHANG ; Yifan ZHANG ; Rong LI ; Jiale LIU ; Chenyang GU ; Jia FENG ; Lukui CHEN
Chinese Journal of Neuromedicine 2023;22(8):826-832
In recent years, studies have shown that transplanted neural stem cells (NSCs) help neural tissues regenerate and return to normal through paracrine action rather than just replacing cells. Exosomes are essential paracrine mediators that can participate in cell communication through substance transmission. This review focuses on NSCs regulated by exosomes and their application in treatment of nervous system diseases, in order to provide important references for further research and clinical application of NSCs exosomes..
10.Influenza-like illnesses and their etiological characteristics in Minhang District of Shanghai during 2010 to 2021
Shijiao HOU ; Hongjing YAN ; Shanshan ZHEN ; Zhihan WANG ; Yinghua ZHANG ; Chen SUO
Chinese Journal of Microbiology and Immunology 2022;42(12):965-972
Objective:To investigate the epidemiological characteristics of influenza-like illnesses (ILI) and the etiological characteristics of influenza viruses in Minhang District of Shanghai from 2010 to 2021.Methods:The surveillance data collected by influenza surveillance sentinel hospitals and the influenza laboratory network from the first week of 2010 to the 52 nd week of 2021 were used for a statistical analysis. Results:A total of 122 903 cases with ILI were reported by the national influenza surveillance sentinel hospitals in Minhang during 2010 to 2021, and the average percentage of ILI cases was 0.94%, showing an increasing trend ( P<0.001). Among them, those aged 0-4, 5-14, 15-24, 25-59 and ≥60 years accounted for 4.35%, 13.30%, 14.30%, 54.32% and 13.73%, respectively. The percentage of ILI showed obvious periodicity. The seasonal incidence of ILI peaked from December to February and from July to September. But the winter peak at the beginning of 2013 was postponed. There was no significant peak in 2021. A total of 11 625 samples were tested from 2010 to 2021, in which the detection rate of influenza viruses was 20.92% (2 432/11 625). The positive rate was 12.83% (1 492/11 625) for influenza A viruses and 8.09% (940/11 625) for influenza B viruses, indicating that the epidemic intensity caused by influenza A viruses was greater than that caused by influenza B viruses. The overall positive rates for influenza A/H3N2 virus, influenza A/H1N1 virus, influenza B/Victoria lineage and influenza B/Yamagata lineage were 9.04% (1 051/11 625), 3.79% (441/11 625), 2.69% (313/11 625) and 2.19% (255/11 625) during 2010 to 2021. The predominant circulating strains altered between influenza A and influenza B viruses in Minhang District of Shanghai during 2010 to 2019. It generally took six months for an epidemic strain to be replaced by a new one. No obvious regularity was observed in 2020 or 2021. The tendency of the incidence of ILI reported from 2010 to 2019 was basically the same as that of the positive rate of influenza viruses, while there were significant differences in 2020 and 2021. Conclusions:Influenza viruses circulated seasonally in Minhang District of Shanghai with alternating prevalent viral subtypes and the infections mostly occurred in the winter and summer seasons. During the epidemic of COVID-19, the intensity of influenza was decreased, but with the normalization of prevention and control measures, the influenza epidemic showed an obvious upward trend. Therefore, it was important to strengthen the prevention and monitoring of influenza and analyze the virus variations in time.

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