Objective To analyze the genetic characteristics and variations of influenza A (H3N2) viruses in Ma'anshan from 2022 to 2024, and to provide a scientific basis for local influenza prevention and control. Methods From April 2022 to March 2024, influenza-like illness (ILI) specimens were collected from three national influenza surveillance sentinel hospitals in Ma’anshan. Samples positive for influenza by real-time PCR were subjected to virus culture and identification. A total of 40 representative A/H3N2 strains with hemagglutination titers ≥8 were selected for whole-genome sequencing. Genetic evolution, homology, amino acid variations, and glycosylation sites were analyzed. Results All H3N2 representative strains from the 2022–2023 influenza season belonged to clade 3C.2a1b.2a.1a.1, while those from the 2023–2024 season fell into clade 3C.2a1b.2a.2a.3a.1. The nucleotide and amino acid sequence similarities of HA and NA between the 40 representative strains and the vaccine strain A/Darwin/6/2021 were all above 97.35%. Compared with the vaccine strain, amino acid mutations were identified in antigenic sites A, B, C, and E, as well as in receptor-binding sites of the HA protein. An I222V substitution was detected in the NA protein. The HA protein contained four additional glycosylation sites compared to the vaccine strain, while the glycosylation pattern of the NA protein remained consistent. Conclusion No antigenic drift was observed in the influenza A/H3N2 viruses in Ma'anshan City from 2022 to 2024, but genetic changes such as branching variations, key amino acid substitutions, and an increase in HA glycosylation sites were observed. These findings underscore the importance of sustained molecular surveillance of local influenza viruses.

Pulmonary anthrax is an acute zoonotic infectious disease caused by Bacillus anthracis infecting the human body. Humans can be infected by coming into contact with diseased animals and their products or by consuming diseased animals. According to the different infection routes, it can be classified into cutaneous anthrax, pulmonary anthrax and intestinal anthrax, etc. Among them, cutaneous anthrax is the most common, while case reports of pulmonary anthrax are rare. This article analyzes the clinical data of a case of occupational pulmonary anthrax diagnosed by metagenomic next-generation sequencing (mNGS) and successfully treated, so as to provide a reference for the clinical treatment of pulmonary anthrax.

BACKGROUND:Some research has suggested that regulation of gut microbiota may influence the course of intervertebral disc degeneration.However,the causal relationship of gut microbiota on intervertebral disc degeneration is unknown.OBJECTIVE:To assess the potential causal relationship between gut microbiota and intervertebral disc degeneration using a Mendelian randomization method.METHODS:Genome-wide association analysis summary statistics for 473 gut microbiota and genome-wide association analysis summary data for intervertebral disc degeneration from the R11 of the FinnGen database(46 205 cases of intervertebral disc degeneration and 322 314 controls)from the most recent publicly available publication were applied.Inverse variance weighting,MR-Egger regression,weighted median,weighted modeling,and simple modeling were used to investigate the causal relationship between gut microbiota and intervertebral disc degeneration.Sensitivity analyses were used to test whether the results of Mendelian randomization analyses were reliable.Reverse Mendelian randomization was performed with all gut microbiota as the outcomes for effect analysis and sensitivity analysis.RESULTS AND CONCLUSION:(1)The results of the inverse variance weighting method of the forward Mendelian randomization method showed that the order Trichosporonaceae,the family UBA-6960,the family Anaerobes thermophilus,the family Salmonellaceae,the genus Pseudomonas tufts,the species Gordonella and the species Euclidia showed a positive correlation with intervertebral disc degeneration.The order Spirochaetes,the order Pseudomonas,the family Spirochaetaceae,the genus CAG-776,the genus Helicobacter,the species CAG-448 sp003150135,the species CAG-776 sp000438195,the species Brautella-A sp000285855 and the species Hanson's Brautella showed a negative correlation with intervertebral disc degeneration.(2)The results of reverse Mendelian randomization showed that intervertebral disc degeneration was positively correlated with the genus Bartonella rosea,the genus Geobacillus C,the species Escherichia fumigatus,the species Propionibacterium fumigatus,the species UBA-1777 sp900319835,the species Pseudomonas aeruginosa and the species Bacillus subtilis,while negatively correlated with the species Streptomyces mingoldii,the species Prevotella sp000434975,the species Brault's A sp000285855,the species CAG-194 sp002441865 and the species CAG-590 sp000431135.(3)No heterogeneity or horizontal pleiotropy was found in the two-way sensitivity analysis.(4)The results described above indicate that the causal relationship between gut microbiota and intervertebral disc degeneration based on the Finnish database contributes to the exploration on new biomarkers for the early prediction and treatment of intervertebral disc degeneration in clinical practice.In addition,the establishment of a large database and the integration of medical data from multiple centers can be drawn upon in biomedical research in China to provide a solid foundation for studying the relationship between gut microbiota and intervertebral disc degeneration.We will strengthen communication and cooperation with research teams in other countries to jointly promote the research on the relationship between gut microbiota and diseases and contribute to the development of global medicine.

BACKGROUND:Some research has suggested that regulation of gut microbiota may influence the course of intervertebral disc degeneration.However,the causal relationship of gut microbiota on intervertebral disc degeneration is unknown.OBJECTIVE:To assess the potential causal relationship between gut microbiota and intervertebral disc degeneration using a Mendelian randomization method.METHODS:Genome-wide association analysis summary statistics for 473 gut microbiota and genome-wide association analysis summary data for intervertebral disc degeneration from the R11 of the FinnGen database(46 205 cases of intervertebral disc degeneration and 322 314 controls)from the most recent publicly available publication were applied.Inverse variance weighting,MR-Egger regression,weighted median,weighted modeling,and simple modeling were used to investigate the causal relationship between gut microbiota and intervertebral disc degeneration.Sensitivity analyses were used to test whether the results of Mendelian randomization analyses were reliable.Reverse Mendelian randomization was performed with all gut microbiota as the outcomes for effect analysis and sensitivity analysis.RESULTS AND CONCLUSION:(1)The results of the inverse variance weighting method of the forward Mendelian randomization method showed that the order Trichosporonaceae,the family UBA-6960,the family Anaerobes thermophilus,the family Salmonellaceae,the genus Pseudomonas tufts,the species Gordonella and the species Euclidia showed a positive correlation with intervertebral disc degeneration.The order Spirochaetes,the order Pseudomonas,the family Spirochaetaceae,the genus CAG-776,the genus Helicobacter,the species CAG-448 sp003150135,the species CAG-776 sp000438195,the species Brautella-A sp000285855 and the species Hanson's Brautella showed a negative correlation with intervertebral disc degeneration.(2)The results of reverse Mendelian randomization showed that intervertebral disc degeneration was positively correlated with the genus Bartonella rosea,the genus Geobacillus C,the species Escherichia fumigatus,the species Propionibacterium fumigatus,the species UBA-1777 sp900319835,the species Pseudomonas aeruginosa and the species Bacillus subtilis,while negatively correlated with the species Streptomyces mingoldii,the species Prevotella sp000434975,the species Brault's A sp000285855,the species CAG-194 sp002441865 and the species CAG-590 sp000431135.(3)No heterogeneity or horizontal pleiotropy was found in the two-way sensitivity analysis.(4)The results described above indicate that the causal relationship between gut microbiota and intervertebral disc degeneration based on the Finnish database contributes to the exploration on new biomarkers for the early prediction and treatment of intervertebral disc degeneration in clinical practice.In addition,the establishment of a large database and the integration of medical data from multiple centers can be drawn upon in biomedical research in China to provide a solid foundation for studying the relationship between gut microbiota and intervertebral disc degeneration.We will strengthen communication and cooperation with research teams in other countries to jointly promote the research on the relationship between gut microbiota and diseases and contribute to the development of global medicine.

Objective:To analyze the genetic characteristics of influenza B virus Victoria lineage in Ma′anshan from 2019 to 2022.Methods:Throat swabs were collect from cases with influenza-like illness in three sentinel hospitals and from influenza outbreak events in Ma′anshan city from 2019 to 2022. Real-time fluorescence-based PCR was performed to detect the nucleic acids of influenza viruses in the swab samples. Statistical analysis was conducted using the influenza year as the detection cycle. MDCK cells and chicken embryos were used for virus isolation, and 31 strains of B/Victoria lineage were selected for whole-genome sequencing and genetic analysis.Results:A total of 11 258 throat swabs were collected from ILI cases, and 8.90% (1 002/11 258) of them tested positive for B/Victoria. Except for the period from the winter of 2020 to the spring of 2021, during which no epidemic outbreak of influenza was observed, there were peaks in the prevalence of B/Victoria influenza in winter and spring of the other years, with the positive rates ranging from 12.65% (54/427) to 46.68% (176/377) during peak seasons. Compared with the recommended vaccine strains, the homology of the HA gene nucleotides of the viral strains isolated from 2019 to 2022 ranged from 98.40% to 99.26%, and the homology of amino acids ranged from 96.21% to 98.80%. All isolated strains carried mutations in the 190-helix of the hemagglutinin protein; the strains isolated from 2019 to 2020 had two amino acid insertions at position 160-loop; and the strains isolated from 2021 and 2022 had mutations at positions 120-loop and 150-loop. No drug-resistant mutations were detected in the neuraminidase gene.Conclusions:The B/Victoria strains isolated in Ma′anshan city from 2019 to 2022 have key site variations as compared with the recommended vaccine strains, suggesting a decrease in vaccine immune efficacy. Therefore, it is necessary to strengthen the surveillance of viral mutations to provide reference for updating vaccine strains and formulating epidemic prevention and control measures.

Pulmonary anthrax is an acute zoonotic infectious disease caused by Bacillus anthracis infecting the human body. Humans can be infected by coming into contact with diseased animals and their products or by consuming diseased animals. According to the different infection routes, it can be classified into cutaneous anthrax, pulmonary anthrax and intestinal anthrax, etc. Among them, cutaneous anthrax is the most common, while case reports of pulmonary anthrax are rare. This article analyzes the clinical data of a case of occupational pulmonary anthrax diagnosed by metagenomic next-generation sequencing (mNGS) and successfully treated, so as to provide a reference for the clinical treatment of pulmonary anthrax.

Objective:To analyze the genetic characteristics of influenza B virus Victoria lineage in Ma′anshan from 2019 to 2022.Methods:Throat swabs were collect from cases with influenza-like illness in three sentinel hospitals and from influenza outbreak events in Ma′anshan city from 2019 to 2022. Real-time fluorescence-based PCR was performed to detect the nucleic acids of influenza viruses in the swab samples. Statistical analysis was conducted using the influenza year as the detection cycle. MDCK cells and chicken embryos were used for virus isolation, and 31 strains of B/Victoria lineage were selected for whole-genome sequencing and genetic analysis.Results:A total of 11 258 throat swabs were collected from ILI cases, and 8.90% (1 002/11 258) of them tested positive for B/Victoria. Except for the period from the winter of 2020 to the spring of 2021, during which no epidemic outbreak of influenza was observed, there were peaks in the prevalence of B/Victoria influenza in winter and spring of the other years, with the positive rates ranging from 12.65% (54/427) to 46.68% (176/377) during peak seasons. Compared with the recommended vaccine strains, the homology of the HA gene nucleotides of the viral strains isolated from 2019 to 2022 ranged from 98.40% to 99.26%, and the homology of amino acids ranged from 96.21% to 98.80%. All isolated strains carried mutations in the 190-helix of the hemagglutinin protein; the strains isolated from 2019 to 2020 had two amino acid insertions at position 160-loop; and the strains isolated from 2021 and 2022 had mutations at positions 120-loop and 150-loop. No drug-resistant mutations were detected in the neuraminidase gene.Conclusions:The B/Victoria strains isolated in Ma′anshan city from 2019 to 2022 have key site variations as compared with the recommended vaccine strains, suggesting a decrease in vaccine immune efficacy. Therefore, it is necessary to strengthen the surveillance of viral mutations to provide reference for updating vaccine strains and formulating epidemic prevention and control measures.

Objective:To discuss the clinical efficacy of recombinant human growth hormone(rhGH)in the treatment of the pediatric patients with growth hormone deficiency(GHD)and idiopathic short stature(ISS),and to clarify its clinical application value in the pediatric patients with short stature of different etiologies.Methods:The clinical data of 132 children with short stature who treated with rhGH from January 2018 to January 2023 were collected.They were divided into GHD group(n=70)and ISS group(n=62)based on different etiologies.The bone age,target height(TH),body mass index(BMI),height standard deviation score(HtSDS),changes in height standard deviation scores(ΔHtSDS)before treatment and 6 months after treatment,and growth velocity(GV)of the pediatric patients were calculated.Propensity score matching(PSM)and inverse probability of treatment weighting(IPTW)were used to balance the confounding factors between the pediatric patients in two groups and the efficacy and safety of the pediatric patients in two groups were evaluated.Results:There were significant differences in whether children were full-term,bone age,bone age maturity,and TH of the pediatric patients between two groups(P<0.05).Compared with before treatment,the height and HtSDS of the pediatric patients in both GHD and ISS groups were significantly increased after treated for 6 months(P<0.05).Before matched by PSM,there were significant differences in full-term,bone age,bone age maturity,and TH of the pediatric patients between two groups(P<0.05).After matched by PSM,there were no significant differences in gender,region,term birth status,mode of delivery,feeding method,age,bone age,height,BMI,TH,and pretreatment HtSDS of the pediatric patients between two groups(P>0.05);the standardized mean difference(SMD)differences of covariates except for region were<0.2.After weighted by IPTW,there were no significant differences in gender,region,term birth status,mode of delivery,feeding method,age,bone age,height,BMI,TH,and pretreatment HtSDS of the pediatric patients between two groups(P>0.05);all SMD of covariates except for term birth status were<0.2.Before balancing covariates,after meatched by PSM matching,and after weighted by IPTW weighting compared with GHD group,the GV and ΔHtSDS of the pediatric patients in ISS group were slightly increased,but the difference was not significant(P>0.05).In terms of adverse reactions,2 cases(2.68%)of fasting hyperglycemia and 7 cases(10.00%)of hypothyroidism occurred in GHD group;3 cases(4.84%)of fasting hyperglycemia and 2 cases(3.23%)of hypothyroidism occurred in ISS group.Conclusion:rhGH can promote the height increase in the patients with GHD and ISS,and there is no significant difference in the height-increasing efficacy between GHD and ISS children.The incidence of adverse reactions is relatively low during treatment,indicating good overall safety.

Objective:To investigate the difference in clinical characteristics of drug-induced liver injury (DILI) between patients of different gender.Methods:Through the hospital electronic medical record system, clinical data of patients hospitalized because of DILI at Liver Research Center, Beijing Friendship Hospital, Capital Medical University from January 2005 to January 2021 were collected and retrospectively analyzed. The collected information included gender, age, body mass index, underlying diseases, medication, results of the first laboratory tests after admission, clinical manifestation and types of DILI, etc. The patients were divided into 2 groups according to gender and the clinical characteristics of DILI were compared. The factors affecting death/liver transplantation in DILI patients were analyzed by Cox regression method.Results:A total of 616 patients with DILI were entered, including 139 males (22.6%) and 477 females (77.4%). The median age was 56 (47, 64) years, ranging from 18 to 80 years. Drugs that caused DILI were traditional Chinese medicine and/or health care products (TCMHCP) in 345 patients (56.0%), western drugs in 148 patients (24.0%), and TCMHCP and western drugs in 123 patients (20.0%). Death/liver transplantation occurred in 42 patients (6.8%), including 3 liver transplantation, 19 death directly caused by the liver disease, and 20 death with causes other than liver disease. The incidences of dark urine and abdominal distension, severe liver injury, and death/liver transplantation in male patients were all higher than those in female patients, respectively [71.9% (100/139) vs. 60.0% (286/477), P=0.010; 28.8% (40/139) vs. 18.7% (89/477), P=0.010; 46.8% (65/139) vs. 40.5% (193/477), P<0.001; 15.1% (21/477) vs. 4.4% (21/139), P<0.001]. Laboratory test results such as the white blood cell count, hemoglobin, total bilirubin, direct bilirubin, total bile acid, triglyceride, and low density lipoprotein cholesterol in male patients were all higher than those in female patients, while the levels of pre-albumin, immunoglobulin G, immunoglobulin M, and serum creatinine were lower (all P<0.05). Cox regression analysis showed that male, older age, low albumin, high total bile acid, high serum creatinine, and prolonged international normalized ratio (INR) were the independent influencing factors of death/liver transplantation in patients with DILI. Conclusions:Clinical manifestation are different in DILI patients of different gender hospitalized in the Liver Research Center, Beijing Friendshop Hospital, Capital Medical University. In male patients, cholestasis is more obvious, the disease condition is more serious, and death/liver transplantation is more common. Male patients and patients with older age, lower albumin, higher total bile acid, higher serum creatinine, and higher INR are more prone to death/liver transplantation, which should be paid attention to in clinic.

Objective:To explore the clinical characteristics and prognosis of drug-induced liver injury (DILI) in elderly patients.Methods:The clinical data (including demographic characteristics, clinical features and relevant laboratory tests, suspected pathogenic drugs, and prognosis of DILI, etc.) of patients hospitalized due to DILI from January 2009 to December 2020 were collected through the DILI Data-base in Liver Research Center of Beijing Friendship Hospital, Capital Medical University. The patients were divided into young group (<40 years old), middle-aged group (40-59 years old), and elderly group (≥ 60 years old) according to their ages. The demographic characteristics, clinical features, and prognosis of DILI were compared among the 3 groups. The risk factors for all-cause death/liver transplantation in DILI patients were analyzed using univariate and multivariate COX regression models.Results:A total of 620 patients were entered in the study, including 477 females (76.9%) and 143 males (23.1%), with a median age of 56 (46, 64) years. There were 101 patients (16.3%) in the young group, 273 (44.0%) in the middle-aged group, and 246 (39.7%) in the elderly group, respectively. Compared with the young and middle-aged group respectively, patients in the elderly group had less fever [5.7% (14/246) vs. 18.8% (19/101) and 11.4% (31/273)], more abdominal distension [26.8% (66/246) vs. 11.9% (12/101) and 18.7% (51/273)], higher levels of alkaline phosphatase [171 (127, 265) U/L vs. 146 (104, 218) U/L and 158 (114, 221) U/L], gamma-glutamyltransferase [211 (132, 361) U/L vs. 122 (67, 200) U/L and 167 (94, 291) U/L], and serum creatinine [70 (59, 81) μmol/L vs. 58 (49, 72) μmol/L and 63 (57, 71) μmol/L], lower levels of serum albumin [36.2 (32.0, 38.8) g/L vs. 38.4 (35.2, 41.3) g/L and 37.3 (34.1, 40.7) g/L], immunoglobulin M [840 (610, 1190) mg/L vs. 1 030 (820, 1 460) mg/L and 1 060 (700, 1 480) mg/L], and platelet counts [186 (143, 236)×10 9/L vs. 214 (174, 270)×10 9/L and 210 (160, 257)×10 9/L], higher proportion of cholestasis type [13.0% (32/246) vs. 3.0% (3/101) and 5.5% (15/273)], lower rate of normalized liver function [80.5% (198/246) vs. 88.1% (89/101) and 89.0% (243/273)], and higher proportion of all-cause death/liver transplantation [5.7% (14/246) vs. 3.0% (3/101) and 1.5% (4/273)]. The differences above mentioned were statistically significant (all P<0.05). Multivariate COX regression analysis showed that age [hazard ratio ( HR)=1.029, 95% confidence interval ( CI): 1.002-1.056, P=0.034), serum albumin ( HR=0.933, 95% CI: 0.883-0.985, P=0.012), cholesterol ( HR=1.006, 95% CI: 1.004-1.008, P<0.001), serum creatinine ( HR=1.007, 95% CI: 1.000-1.015, P=0.049), and severity of DILI ( HR=2.328, 95% CI: 1.692-3.202, P<0.001) were independent influencing factors of all-cause death/liver transplantation in DILI patients. Conclusions:Age, serum albumin, total cholesterol, serum creatinine, and severity of DILI are independent influencing factors for all-cause death/liver transplantation in DILI. Cholestatic liver injury is more common in elderly patients with DILI and the prognosis is poor, which needs more clinical attention.