Objective:To investigate the detection status and genotypes distribution characteristics of norovirus(NoV)in environmental sewage from three monitoring points in Fujian province, and to explore the significance of its application to NoV monitoring.Methods:Sewage samples were collected monthly at 5 sampling sites in representative monitoring cities, enriched and concentrated. Partial gene fragments of norovirus VP1 were amplified by reverse transcription-semi nested polymerase chain reaction (RT-snPCR), TA cloned and sequenced. Genotypes were identified based on the sequencing.Results:A total of 56 sewage samples were collected from July 2022 to June 2023. The detection rates of GⅠ and GⅡ were 89.29% (50/56) and 94.64% (53/56), respectively. A total of 7 NoV GⅠ genotypes and 13 GⅡgenotypes were identified. GⅠ.1, GⅠ.4, GⅡ.4 and GⅡ.17 were the dominant genotypes. NoV genotypes detected in different sampling sites were not exactly the same. The detection rate of NoV was low from August to November 2022, and the prevalence of the dominant genotypes was different in different seasons. GⅠ.1 and GⅡ.4 were highly prevalent from August to November 2022, but were replaced by GⅠ.4 and GⅡ.17 from December 2022 to June 2023, respectively. More NoV genotypes were detected in January-June 2023, comparing to the July-December 2022. The dominant genotype GII.17, has multiple clades and new variants have been discovered that are different from the 2014/2015 circulating strains.Conclusions:The detection rates of NoV in environmental sewage were very high, and genotypes were diverse. Environmental sewage surveillance could be an important complementary method for NoV cases surveillance.

Objective To detect the expression levels of tumor necrosis factor alpha induced protein 3(TN-FAIP3)and LINC00887 in clear cell renal cell carcinoma(ccRCC)tissue,and to study their relationship with clinical pathological parameters and prognosis.Methods A total of 101 ccRCC patients admitted to the hospi-tal from January 2013 to October 2018 were selected.The expression levels of TNFAIP3 and LINC00887 were detected in ccRCC cancer tissue and paired adjacent tissues,respectively.The relationship between TNFAIP3 and LINC00887 expression and clinical pathological parameters and prognosis of ccRCC patients was analyzed,and the influencing factors of poor prognosis in ccRCC patients were also analyzed.Spearman correlation coef-ficient was used to analyze the correlation between TNFAIP3 and LINC00887 expression.Results The posi-tive rate of TNFAIP3 expression in ccRCC(37.62％)was significantly lower than that in adjacent tissues(52.48％),and the difference was statistically significant(X2=4.500,P=0.034).The expression level of LINC00887 in ccRCC(1.38±0.61)was significantly higher than that in adjacent tissues(1.03±0.43),and the difference was statistically significant(t=5.396,P＜0.001).The positive rates of TNFAIP3 protein in pa-tients with maximum tumor diameter ≥4.5 cm and TNM stage Ⅲ-Ⅳ were lower than those in patients with maximum tumor diameter＜4.5 cm and TNM stage Ⅰ-Ⅱ,and the differences were statistically significant(P＜0.05).The positive rates of LINC00887 in patients with maximum tumor diameter ≥ 4.5 cm,pathologi-cal grading Ⅲ-Ⅳ,and TNM stage Ⅲ-Ⅳ were higher than those in patients with maximum tumor diameter＜4.5 cm,pathological grading Ⅰ-Ⅱ,and TNM stage Ⅰ-Ⅱ,and the differences were statistically signifi-cant(P＜0.05).Compared with the TNFAIP3 high expression group,the TNFAIP3 low expression group had a poorer prognosis,and the difference was statistically significant(x2=5.118,P=0.024).Compared with the LINC00887 low expression group of,the LINC00887 high expression group had a poorer prognosis,and the difference was statistically significant(x2=4.638,P=0.031).Low expression of TNFAIP3,high expres-sion of LINC00887,pathological grade Ⅲ-Ⅳ,and TNM stage Ⅲ-Ⅳ were risk factors for poor prognosis in ccRCC patients(P＜0.05).Spearman rank correlation analysis showed that there was a negative correlation between TNFAIP3 and LINC00887 expression in ccRCC tissue(r=-0.638,P=0.012).Conclusion TN-FAIP3 expression is down-regulated and L1NC00887 expression is up-regulated in ccRCC tissue,and there is a negative correlation.They may jointly regulate the occurrence and development of ccRCC,and have the poten-tial to become tumor markers for evaluating the prognosis of ccRCC patients.

Conventional 1.5T and 3.0T cardiac MRI(CMRI)had been widely used.The ultrahigh field MR behaved better in image resolution and signal-to-noise ratio.The domestic 5.0T whole-body ultrahigh field MRI had better balance between the field strength and quality in CMRI,which was expected to improve imaging quality and efficiency.The status challenges and future of 5.0T CMRI were reviewed in this paper.

Humans ; Retrospective Studies ; Cardiopulmonary Bypass/adverse effects* ; Coronary Artery Bypass/adverse effects* ; Coronary Artery Disease/surgery* ; Acute Kidney Injury/etiology* ; Postoperative Complications ; Risk Factors ; Treatment Outcome

Objective To establish a method to quantify serum fat-soluble vitamins by liquid chromatography-tandem mass spectrome-try and evaluate their performance in preliminary clinical application.Methods The contents of fat-soluble vitamin in serum were quantified by liquid chromatography-tandem mass spectrometry.The samples were collected from 1 113 pregnant women from November 2022 to November 2023 at the Obstetrics Clinic of the First Affiliated Hospital of Soochow University.The method of liquid chromatog-raphy-tandem mass spectrometry for determination of fat-soluble vitamins in serum was validated referring to"Consensus of method de-velopment and validation of liquid chromatography-tandem mass spectrometry in clinical laboratories".Results The linear ranges of vitamin A,E,D2,D3 and K1 in serum were from 40 to 4 000 ng/mL,0.5 to 50 μg/mL,2 to 200 ng/mL,5 to 250 ng/mL and 0.1 to 10 ng/mL,respectively.The detectable limit was 2.50 ng/mL,0.10 ng/mL,0.40 ng/mL,1.00 ng/mL and 0.02 ng/mL,respec-tively.The limit of quantitation was 10.00 ng/mL,0.50 ng/mL,1.00 ng/mL,5.00 ng/mL and 0.10 ng/mL,respectively.The intra-batch coefficient of variation(CV)and inter-batch CV were all less than 15％.The rate of recovery was 91.25％to 107.18％,90.00％to 105.51％,92.88％to 107.87％,93.36％to 107.40％and 90.20％to 104.40％,respectively.The various fat-soluble vitamins in ser-um remained stable within 7 days under-20 ℃.The levels of fat-soluble vitamins in serum of pregnant women were detected by liquid chromatography-tandem mass spectrometry.There were significant differences of the levels and distributions for various fat-soluble vita-mins in the pregnant women in different age groups(P＜0.05),and the levels of fat-soluble vitamins gradually increased with the age.Conclusion The basic performance of the liquid chromatography-tandem mass spectrometry verified in this experiment was in line with the evaluation criteria,thus it should be highly sensitive and accurate for analyzing the contents of various fat-soluble vitamins in serum.

Objective:To analyze the prevalence of different genotypes of wild measles virus in Fujian province from 2014 to 2019.Methods:The information of suspected measles cases and the throat swab specimens of the cases in Fujian province from 2014 to 2019 were collected. Reverse transcription-polymerase chain reaction was applied to amplify the 450 nucleotides of the 3-terminal of the nucleoprotein gene. Phylogenetic tree was constructed to identify and analyze the target sequence.Results:A total of 1 102 suspected measles cases were reported in Fujian province from 2014 to 2019, with an annual incidence rate of 0.47/100 000. Totally 884 throat swabs were tested in the laboratory, and 179 nucleotide sequences were obtained except vaccine strain. Sequence analysis showed that 110 measles genotypes were H1, 43 were B3 and 26 were D8. Nucleotide homology analysis showed that the H1a genotype measles virus in Fujian province distributed in two branches, divided into nine different sequence variants. Some of the variants were highly homologous (99.8%-100.0%) with the measles strains in other regions and countries. There were six different sequence variants of B3 genotype measles virus in Fujian province. The nucleotide homology between the B3 genotype measles virus in Fujian province and the domestic and foreign prevalent B3 strains was 98.4%-100.0%. The D8 genotype measles strain in Fujian province had five different sequence variants, some of which were highly homologous with the strains from Vietnam, Japan and Thailand.Conclusions:Three different genotypes of measles viruses (H1, B3 and D8) prevailed in Fujian province from 2014 to 2019, among which H1 genotype was still the local endemic genotype, while B3 and D8 genotypes were imported genotypes in Fujian province. The result indicated that although the local cases of measles were less in Fujian province in recent years, the risk of imported cases from abroad was increasing, and the surveillance of imported cases from abroad should be strengthened.

Objective:To explore the clinical features of acute pancreatitis (AP) complicated with portal vein system thrombosis (PVST) and the clinical prediction of symptomatic PVST.Methods:From January 2014 to December 2019, at First Affiliated Hospital and Second Affiliated Hospital of Kunming Medical University, 152 hospitalized patients who met the diagnostic criteria of AP complicated with PVST and had complete clinical data were retrospectively analyzed, and the clinical characteristics of them were analyzed. According to whether there were clinical manifestations caused by PVST (esophago-gastric variceal bleeding, persistent ascites, intestinal ischemia), AP patients complicated with PVST were divided into symptomatic group ( n=48) and asymptomatic group ( n=104). The differences in general information, laboratory test indicators, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Balthazar computed tomography (CT) score, local and systemic complications were compared between symptomatic group and asymptomatic group. Two independent sample t test, two sample rank sum test, and chi-square test were used for statistical analysis. The binary logistic regression was used for multivariate analysis. Results:The severe acute pancreatitis (SAP) complicated with PVST was common, accounted for 73.0% (111/152), and the hospital mortality rate was 14.5% (22/152). The splenic vein (46.1%, 70/152) was the most common single vessel involved. The hospital stay of the symptomatic group was longer than that of the asymptomatic group, the hospitalization costs and hospital mortality of the symptomatic group were both higher than those of the asymptomatic group ((26.31±19.38) d vs. (15.11±9.31) d, (103 463.68±15 312.74) yuan vs. (37 199.38±4 647.17) yuan, 25.0%, 12/48 vs. 9.6%, 10/104, respectively), and the differences were statistically significant ( t=-3.809 and -4.141, χ2=6.280; all P<0.05). The lactic acid dehydrogenase, C-reactive protein, and prothrombin time of the symptomatic group were all higher than those of the asymptomatic group (4.78 μmol·s -1·L -1, 2.96 μmol·s -1·L -1 to 7.82 μmol·s -1·L -1 vs. 4.42 μmol·s -1·L -1, 3.29 μmol·s -1·L -1 to 9.30 μmol·s -1·L -1; 69.53 mg/L, 29.49 mg/L to 147.14 mg/L vs. 40.90 mg/L, 8.88 mg/L to 104.89 mg/L; (16.88±8.23) s vs. (14.12±1.59) s), however the hematocrit and blood calcium in the symptomatic group were both lower than those of the asymptomatic group ((34.97±8.96)% vs. (39.18±7.17)%, (2.01±0.32) mmol/L vs. (2.17±0.19) mmol/L), and the differences were all statistically significant ( Z=-2.067 and -1.977, t=-2.281, 3.072 and 3.083; all P<0.05). The scores of APACHE Ⅱand Balthazar CT, the rate of local complications of pancreatic necrosis, and systemic complications including abdominal hemorrhage, septic shock, acute respiratory distress syndrome, lung infection and pleural effusion of the symptomatic group were higher than those of the asymptomatic group (7.21±3.84 vs. 5.27±2.31, 7.10±1.57 vs. 4.83±1.87, 87.5%, 42/48 vs. 28.8%, 30/104; 10.4%, 5/48 vs. 1.9%, 2/104; 18.8%, 9/48 vs. 1.9%, 2/104; 25.0%, 12/48 vs. 3.8%, 4/104; 91.7%, 44/48 vs. 60.6%, 63/104; 85.4%, 41/48 vs. 49.0%, 51/104; respectively), and the differences were statistically significant ( t=-3.241 and -7.331, χ2=45.320, 5.393, 13.852, 15.604, 15.323 and 18.191; all P<0.05). The results of binary logistic regression showed that Balthazar CT score was an independent risk factor for symptomatic PVST ( P<0.01), and odds ratio (95% confidence interval) was 1.79 (1.41 to 2.29). Conclusions:Balthazar CT score is an influencing factor of symptomatic PVST in AP patients, and patients with high scores should be treated early to improve the prognosis.

Objective:To establish and internally validate a visualized model for predicting the severity of acute pancreatitis (AP).Methods:From September 1st 2017 to August 31st 2020, 600 patients with AP diagnosed in the First Affiliated Hospital of Kunming Medical University were enrolled. According to the Atlanta classification of AP, the 600 patients were divided into severe acute pancreatitis (SAP) group (128 cases) and non-severe acute pancreatitis (NSAP) group (472 cases). The general clinical data (age, gender, body mass index, etc), laboratory indicators (fasting blood glucose, urea nitrogen, creatinine, etc.), complicated with ascites or pleural effusion, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores and bedside index of severity in acute pancreatitis (BISAP) score between the two groups were compared. The potential predictors of SAP were screened with least absolute shrinkage and selection operator (LASSO). The screened predictors were included in the multivariate logistic regression analysis to establish the logistic regression model. The operation characteristic curves of the model, APACHE Ⅱ scores and BISAP were drawn, the discriminative capability of the model was evaluated by comparing the area under the curve (AUC). Calibration, Hosmer-Lemesshow test and decision curve analysis (DCA) were used to evaluate the accuracy and clinical practicability of the prediction model. Bootstrap was used for internally validation of the model. Independent sample t test, Wilcoxon test and chi-square test were used for statistical analysis. Results:The difference of gender composition ratio between SAP and NSAP group was statistically significant ( χ2=4.092, P<0.05). The fatality rate of SAP group was higher than that of NSAP group(21.1%, 27/128 vs. 0, 0/472); the length of hospital stay of SAP group was longer than that of NSAP group((20.33±16.21) d vs. (8.42±4.26) d); the hospitalization cost, fasting blood glucose level, urea nitrogen level, creatinine level, C-reactive protein(CRP) level, D-dimer level, fibrinogen level, white blood cell count, percentage of neutrophils, neutrophil-lymphocyte ratio, APACHEⅡ and BISAP scores, the incidence of complicated with pleural effusion or ascites and the constituent ratio of alcoholic etiology of SAP group were all higher than those of NASP group (44 837.58 yuan (23 017.73 yuan, 102 579.77 yuan) vs. 12 301.46 yuan (8 649.26 yuan, 18 823.88 yuan); (10.48±4.84) mmol/L vs. (8.45±4.80) mmol/L; (8.80±6.50) mmol/L vs. (4.90±2.33) mmol/L; (139.56±127.75) mmol/L vs. (80.05±38.54) mmol/L; (187.33±87.25) mg/L vs. (90.81±82.53) mg/L; 5.19 mg/L (2.96 mg/L, 8.52 mg/L) vs.1.29 mg/L (0.53 mg/L, 2.87 mg/L); 6.13 mg/L (4.64 mg/L, 7.31 mg/L) vs. 4.58 mg/L (3.50 mg/L, 5.98 mg/L); (14.87±5.82)×10 9/L vs. (11.79±4.86)×10 9/L; 0.84±0.12 vs.0.78±0.12; 13.16±7.57 vs. 8.77±7.28; 9.80±6.09 vs. 3.79±2.59; 2.12±0.89 vs. 1.04±0.78; 65.6%, 84/128 vs. 12.9%, 61/472; 70.3%, 90/128 vs. 20.3%, 96/472; 18.8%, 24/128 vs. 11.4%, 54/472); serum albumin level, blood calcium level, and hematocrit level of SAP group were all lower than those of NSAP group ((30.86±4.95) g/L vs. (37.14±5.44) g/L; (1.98±0.31) mmol/L vs. (2.16±0.20) mmol/L; (42.40±8.67)% vs.(44.30±6.45)%), and the differences were all statistically significant ( χ2=99.403, t=8.235, Z=-13.330, t=4.239, 10.759, 5.207 and 11.227, Z=-11.406 and -6.234, t=6.097, 4.829, 6.011, 10.899 and 12.395, χ2=152.604, 117.563 and 4.757, t=-11.788, -6.180 and -2.310, all P<0.05). LASSO regression analysis screened out four predictors of CRP, urea nitrogen, D-dimer and ascites. The results of multivariate logistic regression analysis showed that CRP (odds ratio ( OR)=1.009, 95% (confidence interval) CI 1.006 to 1.012), urea nitrogen( OR=1.185, 95% CI 1.097 to 1.280), D-dimer( OR=1.166 95% CI 1.082 to 1.256), ascites ( OR= 4.848, 95% CI 2.829 to 8.307) were the independent predictors of SAP (all P<0.01). The AUC of the model (0.895 , 95% CI 0.865 to 0.926) was higher than those of the APACHE Ⅱ(AUC=0.835, 95% CI 0.791 to 0.878)and BISAP score (AUC=0.803, 95% CI 0.760 to 0.846), and the differences were statistically significant ( Z=2.578 and 4.466, both P<0.05). The results predicted by the model in the calibration chart and the Hosmer-Lemesshow test were highly consistent with the results of actual clinical observation. When the probability of SAP in the model was 10% to 95%, the DCA curve of the model was higher than the two extreme lines, which had certain clinical practical value. After bootstrap internal validation, the model had a high discrimination ability (AUC=0.892), and its predicted AP severity curve was still in good agreement with the actual clinical AP severity curve. Conclusion:The prediction model established based on CRP, urea nitrogen, D-dimer and ascites can predict the severity of AP, and help doctors to make more scientific clinical decision.

The etiology and pathogenesis of autoimmune hepatitis (AIH) remain unclear and are currently considered to be associated with genetic susceptibility and environmental factors. Regulatory T (Treg) cells play an immunosuppressive role by secreting IL-10 and TGFβ, while T helper 17 (Th17) cells mainly promote inflammatory response, suggesting that Treg cells, Th17 cells, and the dynamic balance between them may be involved in the development and progression of AIH; however, further studies are needed to explore related participation mechanisms. This article reviews the association between Treg/Th17 cells and AIH in recent years and elaborates on their mechanism of action and therapeutic targets.

Objective:To investigate the level of mumps virus (MuV) IgG antibody of healthy population and the genotyping of MuV in Fujian province in 2018.Methods:MuV IgG antibody of healthy population was detected by enzyme-linked immunosorbent assay (ELISA). Small hydrophobin (SH) gene of MuV was genotyped in pharyngeal swab and cell cultures of mumps patients using reverse transcription polymerase chain reaction (RT-PCR). The phylogenetic tree by SH sequences was constructed to identify MuV genotype.Results:A total of 4 925 people completed antibody testing, the positive rate of MuV IgG antibody was 78.58%(3780/4925), and the geometric mean concentration (GMC) was 245.83 IU/ml. There was no statistically significant difference in the positive rate of antibodies between people of different genders, while GMC had statistically significant differences ( χ2=4.295, P=0.117; Z=-2.220, P=0.026). There were significant differences in the positive rate of antibodies and GMC between people in different regions and age groups. Especially in infants and 12-15 years old group of people, the MuV IgG antibody positive rate and GMC were at low levels. The antibody positive rate and GMC of people with a history of mumps-containing vaccine (MuCV) immunization were higher than those without a history of MuCV immunization and those with unknown MuCV immunization history ( χ2=259.315, P<0.001; Z=-16.319, P<0.001). Eight strains of MuV were isolated from the mumps outbreak, which were all F genotypes. Conclusion:The immune level of mumps in infants and young children in Fujian province was low, and the 12-15 age group is the focus of attention. The epidemic strains of MuV in Fujian province in 2018 were mainly F genotype strains.